135 JNK JURNAL NERS DAN KEBIDANAN (JOURNAL OF NERS AND MIDWIFERY) http://jnk.phb.ac.id/index.php/jnk A Cultural Approach (Socio Demography) in Preventing Covid-19 Disease in the Family Khairir Rizani1, Bisepta Prayogi2, Angga Irawan3, Taufik Hidayat4 1,2Nursing Department, Poltekkes Kemenkes Banjarmasin, Indonesia 3Nursing Department, Universitas Sari Mulia Banjarmasin, Indonesia 4Nursing Department, STIKes Intan Martapura, Indonesia Article Information Abstract Handling the Covid-19 pandemic can be assisted by a cultural approach as disease and culture are two related things, disease is often caused by culture or in other words, disease can occur due to certain cultures that exist in social life. In addition, the disease can have a socio-cultural effect. Thus, socio-cultural factors generally affect efforts to control and prevent Covid-19 disease. In addition, the involvement of the family in the control and prevention of Covid-19 is very important, in addition to controlling the transmission, it also stabilizes the control of the spread of the virus. The aim of this study was to identify the influence of culture on the prevention of Covid-19 in the family. This study used an associative analytical design through a transversal approach. The population consisted of all families affected by the Covid-19 case in South Kalimantan. Bivariate data were analyzed with chi-squared and multivariate with multiple logistic regression. There was a relationship between sex, education, marriage, occupation, income and distance from health services with the prevention of covid 19 in the family (ρ <0.05), and there is a shared influence between gender, education, marriage and work on the prevention of covid 19 in the family (ρ <0.05). It is up to the community to redouble its efforts to prevent covid 19 disease in the family, so it is necessary to take a cultural approach to prevent covid 19 in the family. History Article: Received, 15/03/2022 Accepted, 04/07/2022 Published, 15/08/2022 Keywords: cultural approach, covid-19, family © 2022 Journal of Ners and Midwifery Correspondence Address: Poltekkes Kemenkes Banjarmasin – South Kalimantan, Indonesia P-ISSN : 2355-052X Email : bisepta87@gmail.com E-ISSN : 2548-3811 DOI: 10.26699/jnk.v9i2.ART.p135-141 This is an Open Access article under the CC BY-SA license (http://creativecommons.org/licenses/by-sa/4.0/) http://jnk.phb.ac.id/index.php/jnk mailto:bisepta87@gmail.com https://doi.org/10.26699/jnk.v9i2.ART.p135-141 136 Journal of Ners and Midwifery, Volume 9, Issue 2, August 2022, page 135-141 INTRODUCTION Covid-19 is still a problem in the world today caused by SARS-CoV-2 (Lin, L. et al., 2020). According to WHO, the prevalence of COVID-19 is estimated on April 20, 2020, to spread to 213 countries. Overall, on April 20, 2020, there were 2,285,210 confirmed cases of COVID-19 and 155,124 deaths (6.79%) (WHO, 2020), while in Indonesia on March 29, 2020, there were 1,285 cases of COVID-19, deaths of 114 people. and recovered 64 people. According to WHO, effective strategies to control COVID-19 that can be implemented are washing hands, applying effective coughing, avoiding direct contact with anyone showing symptoms of respiratory disease such as sneezing and coughing. Meanwhile, the strategy implemented in Indonesia is implementing social distancing, physical distancing and large-scale social restrictions, but this is considered less successful because there are still additional Covid-19 cases in Indonesia up to 100 people per day (Nurhalimah, 2020). Efforts to handle the Covid-19 pandemic can be assisted through a cultural approach because disease and culture are two related things, disease is often caused by culture or in other words disease can arise due to certain cultures that exist in social life. In addition, the disease can have a socio-cultural effect. Thus, socio-cultural factors generally affect efforts to control and prevent COVID-19 disease. A culture is a form of human relationship that sometimes becomes a habit and is difficult to change. Culture can affect human behavior in its social relationships. Culture and knowledge about illness have a close relationship as a habit and belief that is used as knowledge about health. One form of cultural application in health is traditional medicine which is done when suffering from illness based on values, local wisdom, knowledge and experience. Prevention and control of COVID-19 should use a cultural approach in society, both modern medical and traditional medicine as well as self- management of health (self-treatment). Meanwhile, health prevention and control efforts include: health promotion, preventive measures, treatment and recovery after illness. Family involvement in the control and prevention of COVID-19 is very important, in addition to controlling transmission, it is also stabilizing control in the spread of the virus. Information about culture in the community about COVID-19 is still minimal, so it is very important to be able to use it in preventing and controlling COVID-19 in the family and community. Socio-cultural issues related to the transmission of COVID-19 include; family and community habits during prevention which are influenced by knowledge, attitudes, perceptions and beliefs about the transmission of covid-19 (Ningsi, & Nurjana, 2010). The purpose of the study was to identify the influence of culture (socio-demographic) on the prevention of COVID-19 in the family. METHOD The design of this study used associative analytics with a cross sectional approach. This study examined the effect of a cultural approach (sociodemographic) on the prevention of COVID-19 in the family. The population was all of the families affected by the Covid-19 case in South Kalimantan, a total of 11,400 families. The sample was some families affected by the COVID-19 case in South Kalimantan totaling 570 families This study used a cultural approach (socio- demographic) including age, gender, education, marriage, occupation, income, distance to health services and knowledge. and prevention of COVID- 19 in the family. The data collection method used an online questionnaire. The researcher also conveyed the objectives of the study to the respondents written in the online questionnaire. After the prospective respondent understood and agreed, then they filled in the existing questions. The analysis of the data used univariate analysis, bivariate analysis with chi square and multivariate with multiple logistic regressions. The values were set on p<0,05. RESULT Distribution of cultural variables Table 1: Distribution of cultural variables on the prevention of covid19 in the family Research Variable Frequency (f) Percentage (%) Prevention of covid 19 in the family Enough 245 43 Rizani, Prayogi, Irawan, Hidayat, Student Perceptions of Skills Training Program as a … 137 Good 325 57 Total 570 100 Age Early Adult < 45 years 447 78,4 Mature Adult ≥ 45 years 123 21,6 Total 570 100 Gender Male 208 36,5 Female 362 63,5 Total 570 100 Education Basic 0 0 Middle 324 56,9 Higher 246 43,1 Total 570 100 Marital Status Not married yet 289 50,7 Married 281 49,3 Total 570 100 Work Does not work 259 45,4 Work 311 54,6 Total 570 100 Income Under UMP 158 27,8 Above UMP 412 72,2 Total 570 100 Distance to Health Services < 5 km (near) 395 69,2 > 5 km (far) 175 30,8 Total 570 100 Knowledge Enough 51 8,9 Good 519 91,1 Total 570 100 Bivariate analysis Table 2: Bivariate analysis of factors that influence the prevention of covid 19 in the family Variabel Bebas Pencegahan Covid 19 OR ρ Value (0,05) Cukup Baik Total n % n % n % Age Early Adult < 45 years Mature Adult ≥ 45 years 166 69 37,03 56,52 281 54 62,97 43,48 447 123 100 100 0,452 0,063 Total 235 41,23 335 58,77 570 100 Gender Male Female 117 18 56,48 43,11 91 244 43,52 69,89 208 362 100 100 3,010 0,000 Total 235 41,23 335 58,77 570 100 Education 1,659 0,026 138 Journal of Ners and Midwifery, Volume 9, Issue 2, August 2022, page 135-141 Middle Higher 140 95 43,29 31,51 184 151 56,71 68,49 324 246 100 100 Total 235 41,23 335 58,77 570 100 Marital Status Not married yet Married 65 170 22,73 54,39 224 111 77,27 45,61 289 281 100 100 0,247 0,000 Total 235 41,23 335 58,77 570 100 Work Does not work Work 58 177 22,65 51,59 201 134 77,35 46,41 259 311 100 100 0,275 0,000 Total 235 41,23 335 58,77 570 100 Income Under UMP Above UMP 47 188 29,47 41,67 111 224 70,53 58,73 158 412 100 100 0,585 0,037 Total 235 41,23 335 58,77 570 100 Distance to Health Services Near Far 176 59 44,58 24,29 219 116 55,42 75,71 395 175 100 100 2,506 0,000 Total 235 41,23 335 58,77 570 100 Knowledge Enough Good 18 217 35,48 38,61 33 302 64,52 61,39 51 519 100 100 0,875 0,733 Total 235 41,23 335 58,77 570 100 Multivariate analysis This logistic regression test was carried out in several stages so that independent variables were actually found which together affected the dependent variable. Stage 1 Table 3: The influence of shared culture on the prevention of covid 19 Variable OR 95 % CI ρ Gender 0,427 0,250 - 0,730 0,002 Education 0,302 0,172 - 0,527 0,000 Marital Status 2,835 1,427- 5,633 0,003 Income 1,524 0,848 - 2,740 0,159 Work 2,044 0,980 - 4,266 0,049 Distance 0,660 0,376 - 1,157 0,147 Based on table 3 above, there is a relationship between gender, education, marriage, occupation, income and distance to health services with the prevention of covid 19 in the family. Stage 2 Table 4: The influence of shared culture on the prevention of covid 19 Variabel OR 95 % CI Ρ Gender 0,430 0,254 - 0,730 0,002 Education 0,307 0,177 - 0,532 0,000 Marital Status 3,154 1,587 - 6,270 0,001 Work 2,172 1,038 - 4,547 0,040 Rizani, Prayogi, Irawan, Hidayat, Student Perceptions of Skills Training Program as a … 139 Based on the table 4 above, there is a joint influence between gender, education, marital status and work on the prevention of covid 19 in the family. DISCUSSION The relationship between age and prevention of covid 19 in the family Based on table 2 above, it shows that the prevention of COVID-19 disease is better in early adulthood than in late adulthood. The value of = 0.063 means that there is no relationship between age and prevention of covid 19 in the family. The OR value = 0.452, which means that elderly adults have a 0.452 time opportunity to behave fairly in preventing COVID-19 disease compared to early adulthood. In theory, this result contradicts the theory that older people have better responsibility and accuracy than younger people (Nursalam, 2014). So maybe there are other factors that are more closely related to awareness in preventing covid 19. The relationship between gender and prevention of covid 19 in the family Based on table 2, there are 69.89% of female respondents and 43.52 % of male respondents doing the prevention of covid 19 in the family well. The value of = 0.000 means that there is a sex relationship with the prevention of covid 19 in the family. The OR value = 3.010, which means that female respondents have 3.01 times the opportunity to prevent COVID-19 in their families compared to male respondents. So that there are differences in the prevention of covid 19 in the family carried out between male and female respondents. This is in accordance with the results of study which says that there is a relationship between gender and a healthy lifestyle (eko dan sinaga, 2018), and Lawrence Green's theory which states that one of the predisposing factors for behavior is gender (Notoatmodjo, 2010). So, gender that related to a healthy lifestyle can determine good actions to prevent covid 19. The relationship between education level and prevention of covid 19 in the family Based on table 2, there are 68.49% of respondents with higher education and 56.71% with secondary education doing the prevention of covid 19 in the family well. The value of = 0.026 means that there is a relationship between education and prevention of covid 19 in the family. The OR value = 1.659, which means that respondents with higher education have 1.659 times the opportunity to prevent COVID-19 in their families compared to respondents with secondary education. This is in accordance with the results of research which states that there is a relationship between the level of education and prevention of DHF (Putri dan Naftassa, 2017), This study is in line because DHF and Covid 19 both need good prevention to overcome their disease, and study which says that the level of education affects the community when carrying out prevention (Gannika dan Sembiring, 2020), and Lawrence Green's theory which states that one of the predisposing factors for behavior is the level of education (Notoatmodjo, 2010) The relationship between marital status and prevention of covid 19 in the family Based on table 2, there are 77.27% of respondents with unmarried status and 45.61% with married status doing prevention of covid 19 in the family well. The value of = 0.000 means that there is a relationship between marriage and the prevention of covid 19 in the family. The OR value = 0.247, which means that respondents with unmarried status have 0.247 times the opportunity to prevent COVID- 19 in their families compared to respondents who are married. This is in accordance with the results of research which says there is a relationship between marital status and behavior for healthy living (Adliyani, 2015). Thus, marital status is one of the factors in preventing COVID-19 behavior The relationship between work status and prevention of covid 19 in the family Based on table 2, there are 77.35% of respondents who do not work and 46.41% who work can prevent covid 19 in the family well. Value = 0.000 means that there is a relationship between work and prevention of covid 19 in the family. The OR value = 0.275 means that respondents who do not work are 0.275 times to prevent covid 19 in their families compared to those who work. This is in accordance with Lawrence Green's theory which states that one of the predisposing factors for behavior is work (Notoatmodjo, 2010). Work status is related to income and behavior which will have an impact on meeting the needs for the prevention of covid 19 The relationship between income and prevention of covid 19 in the family 140 Journal of Ners and Midwifery, Volume 9, Issue 2, August 2022, page 135-141 Based on table 2, there are 70.53% of respondents who earn below the UMP and 58.73% of respondents who earn above the UMP do the prevention of covid 19 in their families well. The value of = 0.037 means that there is a relationship between income and prevention of covid 19 in the family. The value of OR = 0.585 means that respondents with income below the minimum wage have 0.585 times the opportunity to prevent covid 19 in their family compared to respondents who earn above the minimum wage. This is in accordance with research which states that there is a relationship between income and clean and healthy living behavior (Roni, Ruhmawati, Sukandar, 2013). and Blum's theory (1974) which states that social, cultural, economic, and political factors influence health behavior, where education and income are social factors of the community (Notoatmodjo, 2010). So good income will be able to meet the needs for health and prevention of covid 19. The relationship between distance to health services and prevention of covid 19 in the family Based on table 2, there are 75.71% of respondents who are far away from health services and 55.42% of respondents who are close to health services are doing prevention of covid 19 in their families well. The value of = 0.000 means that there is a relationship between distance to health services and prevention of covid 19 in the family. The OR value = 2.506 means that respondents who are far away from health services have 2.506 times the opportunity to prevent COVID-19 in their families compared to respondents who are close to health services. This is in accordance with Lawrence Green's theory which states that distance to health facilities is an enabling factor for a person to behave (Notoatmodjo, 2010). So, the ease of accessing health services can make it easier to get information about the prevention of covid 19. The relationship between knowledge and prevention of covid 19 in the family. Based on table 2, it was found that 64.52% of respondents had sufficient knowledge and 61.39% had good knowledge and were able to prevent covid 19 well. The value of = 0.733 means that there is no relationship between knowledge and prevention of covid 19 in the family. The OR value = 0.875 means that respondents with sufficient knowledge have 0.875 times the opportunity to prevent COVID-19 in their families compared to those with good knowledge. This result contradicts the theory which explains that one of the predisposing factors for a person to behave is knowledge (Notoatmodjo, 2010). Maybe there are other factors that make the discrepancy between facts and theory such as obstacles in meeting the needs of preventing covid 19. The influence of shared culture on the prevention of covid 19 Based on the table 4, there is a joint influence between gender, education, marital status and work on the prevention of covid 19 in the family. This is in accordance with Blum's theory (1974) which states that social, cultural, economic, and political factors influence health behavior, where education and income are social factors of the community (Notoatmodjo, 2010). So that, in preventing covid 19, you must pay attention to gender, education, marriage and work status in family. CONCLUSION The majority of COVID-19 prevention in the family is good, the age of the respondents is dominated by less than 45 years, the majority of respondents are women, the majority of respondents have secondary education, more respondents are unmarried, more respondents are working, the average respondent's income is above the minimum wage, the distance to the majority of health services is close (less than 5 km), and the majority of respondents' knowledge about covid 19 is good. There is a relationship between gender, education, marriage, employment, income and distance to health services with the prevention of covid 19 in the family. There is a shared influence between gender, education, marriage and work on the prevention of covid 19 in the family. SUGGESTION This study recommends for the community in order to further increase efforts to prevent COVID- 19 in the family. While for researchers, it is by conducting research with other variables such as the role of health workers in preventing COVID-19 in the family. ACKNOWLEDGEMENT The author would like to thank to Director of Poltekkes Kemenkes Banjarmasin, the head of the nursing department Poltekkes Kemenkes Banjarmasin, the head of the research and community service center Poltekkes Kemenkes Banjarmasin and all the partisipants in this study. Rizani, Prayogi, Irawan, Hidayat, Student Perceptions of Skills Training Program as a … 141 FUNDING This research was funded by the DIPA Poltekkes Kemenkes Banjarmasin. Poltekkes Kemenkes Banjarmasin helps all the costs incurred in this research. 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