The Effect Of Storytelling Therapy On Anxiety Of Hospitalization

Children At Rsud Haji Makassar

Jumasing1, Syisnawati2, Patima3, Nahri Samsu4
1
Student of Nursing Major in Alauddin State Islamic University, Makassar
2
Lecturer of Nursing Major in Alauddin State Islamic University, Makassar
3
Lecturer of Nursing Major in Alauddin State Islamic University, Makassar
4
Lecturer of Kamanre Midwifery Academy, Palopo
70300116039@uin-alauddin.ac.id

Abstract
Anxiety is a response from an unpleasant child that occurs in every individual/child who is
experiencing pain, especially in children aged 4-6 years who are hospitalized, to reduce the
impact of anxiety on children, it requires an entertainment or media to reduce anxiety, one of
which telling stories and storytelling. This study aims to determine the effect of storytelling
therapy on the anxiety of hospitalized children.
This type of research uses a research method with a quasi-experimental design of two
groups pre-test and post-test by pre testing each respondent group, measuring modifications
Dewi Permata Intan Stikes Jombang 2018 and then post-test treatment was given therapy
the story of the prophet Ayyub using books. The populations in this study were preschool
children aged 4-6 years who were undergoing treatment in the Al-Fajar treatment Room Haji
Makassar hospital with 32 responden, 16 respondens for the intervention group and 16
responden for the control group, the study sample was taken using probability sampling so as
many as 32 respondens were ontained
The results of the study used the Wilcoxon alternative statistical test that gets result in
the group of the story of the prophet Ayyub is p=0,001 or (<0,05) which means that it has
significant results and the fairy tale group gets results p=0,00 or (<0,05) which means it has
meaning full results. It can be concluded that the Ayyub prophet’s story group and the hare’s
faily tale group have significant result showing thet there is an effect of the therapy of Ayyub’s
prophet and the hare’s fairy tale to a decrease in the hospitalizations anxiety. It is expected
that service personnel at the hospital can implement storytelling therapy in pediatric patients
undergoing hospitalization so that it can assist in the process of worshiping client children
who are undergoing haspitalizations.

Keywords : Storytelling, Therapy, Anxiety, Preschoolers (Age 4-6 Years),

Hospitalization
Introduction
Anxiety is a response from an unpleasant child taht occurs in every
individual/child who experiences illness, especially in children aged 4-6 years who
experience hospitalization. This is because children experience separationanxiety or
anxiety problem caused by a separation such as a farewell to a safe and comfortable
environment, changes in physical/health status that allow them to often deal with
other people who can cause anxieta and aggravate the child’s condition during
hospitalization (Sutrisno, 2017).
Children who are hospitalized often troubled by interacting with their
surrounding. Children are often faced with conditions where they have to stay in the
hospital for treatment, which presents childre with a crisis that triggers excessive
anxiety not to mention hospital condition such as room layout, hospital euipment,
distinctive smells, nurse clothes and how nurses interact with children (Ngastiyah,
2012).
According to data of Word Health Oganisations (WHO, 2015) the prevalence
of children experiencing hospitalization and anxiety in the hospital reaches 45% of all
children who experience hospitalization. Meanwhile, data according to UNICEF in
2013, the prevalence of children experiencing hospitalization with anxiety was 84%.
According to (Anxiety Disorder Association of America, 2010), it explains
that children's anxiety will have a negative impact on the child's personality in the
future performance of the child will tend to be shy and not stand out, even children
who experience child anxiety. In urban areas according to the age group of 4-6 years
it is 25.8%, 7-12 years old is 14.91%, aged 13-15 is around 9.1%, aged 16-21 years is
8.13%. In Indonesia, it is estimated that 35 per 1000 children undergo hospitalization.
The prevalence (morbidity) of anxiety disorders that occur in children while in
the hospital ranges from 60-80% of the general population (Riskesdas, 2018).
According to data of (Dinkes Prov Sul-Sel, 2016) children experiencing illness in
South Sulawesi province have increased every year with 66% of all children
experiencing anxiety. This figure is a fairly large number of cases of child illness in
sul-cells, so in this case a war for health workers or nurses is needed in an effort to
care for children. In overcoming anxiety several previous studies have been
conducted.
According to previous research conducted at Dr. Sobirin Lubuklinggau
Bengkulu Hospital, entitled the effect of storytelling play therapy on reducing anxiety
levels in pre-school age children due to hospitalization of Dr. Sobirin Lubuklinggau
Bengkulu, explained that the therapy of playing storytelling can reduce anxiety with
significant results (Pawiliyah, 2019). Whereas in the research (Sysnawati, 2016)
according to previous research conducted at Dr. Sobirin Lubuklinggau Bengkulu
Hospital, entitled the effect of storytelling play therapy on reducing anxiety levels in
pre-school age children due to hospitalization of Dr. Sobirin Lubuklinggau Bengkulu,
explained that the therapy of playing storytelling can reduce anxiety with significant
results (Padilla, 2019). Likewise, other research states that storytelling play therapy
has an impact on reducing anxiety in preschool children who experience
hospitalization (Pawiliyah, 2019).
In another study, play therapy reduced the anxiety levels of hospitalized
children. In addition, the therapy of reading fairy tales can also affect the anxiety of
children who are hospitalized (Chief et al., 2018). Storytelling and storytelling
therapy can reduce anxiety in children 4-6 years because storytelling can make
children calm with the stories presented can make children adjust. with the hospital
environment (Shafiee Mina Seyedeh, 2018). The data of RSUD Haji Makassar on
children hospitalized every year has increased with data (2016 1550 children), (2017
1600 children), and (2018 1750 children) most of the diseases in children aged 4-6
years are the average non-chronic disease or Acute diseases such as ARI, diarrhea,
dengue hemorrhagic fever with a percentage of 95% of all children treated at RSUD
Haji Makassar, 50% experience anxiety.
Based on preliminary observations made on December 4, 2019, there are 25
children who are currently undergoing treatment at the RSUD Haji and 16 of them
are children aged 4-6 years. Based on the description above, there have been many
efforts made to overcome the problem of anxiety problems in hospitalized children
including previous research, but from previous research it still has shortcomings
because the tales given or stories are only fictional and have no Islamic value, so the
authors feel interested in conducting research. regarding: “the effect of storytelling
therapy on children's anxiety in hospitalization at RSUD Haji Makassar.”
Method
Good research design is structured research starting from identifying the
structure of the research to be carried out, designing research data collection
techniques, and analyzing data to achieve research objectives and answer research
questions (Nursalam, 2017). According to Tiro, (2014). The design of this research is
astudy quasi-experimental with two groups of pre-test and post-test, namely the type
of research that looks at children's anxiety before and after being given the
intervention group of the story of the Prophet Ayyub and the group storytelling
therapy of the mouse deer on the anxiety of hospitalized children at the RSUD Haji
Makassar. This research was conducted at RSUD Haji Makassar on January 30-28
February 2020.
Result
Preschool children who were hospitalized were then treated to the story of the
Prophet Ayyub and the tale of the mouse deer 3 times for each respondent, after re-
treatment, measurements were taken (post-test) on anxiety in preschool children using
an anxiety questionnaire.
Table 1.1 Anxiety Frequency Distribution of Children Before and After Being
Given Storytelling Therapy to the Intervention Group at the RSUD Haji
Makassar (N: 16)

category Pre and post N Frequency Mean SE P-value

Normal Before 16 - - -
After 16 7 1.13 239
Linght Before 16 2 2.63 1.55
 After 16 5 1.13 .239
Moderate Before 16 4 2.63 1.55 0.001
After 16 2 1.13 .239
weight Before 16 5 2.63 1.55
After 16 2 1.13 .239
panic Before 16 5 2.63 1.55
After 16 - - -

Source: Primary Data, 2020

Based on table 1.11 shows the frequency in the intervention group before and
after being given treatment, most of the intervention group before being given
treatment were at the panic and severe level, namely as many as 5 (31.3%)
respondents. Meanwhile, after being given therapy for the story of the prophet Ayyub
in the intervention group, most children aged 4-6 years had an anxiety category at the
normal level of 7 (43.8) respondents.

Table 1.2 Anxiety Frequency Distribution of Children Before and After Giving
Storytelling Therapy to the Control Group at the RSUD Haji Makassar (N: 16)
category Pre and post N Frequency Mean SE P-value
Normal Before 16 - - -
After 16 7 .88 .221
Linght Before 16 1 1.19 .277
After 16 5 .88 .221
Moderate Before 16 5 1.19 .277 0.000
After 16 3 .88 .221
weight Before 16 6 1.19 .277
After 16 1 .88 .221
panic Before 16 4 1.19 .277
After 16 - - -

Source: Primary Data, 2020

Based on table 1.12 shows the frequency in the control group before and after
being given treatment, most of the control group before it was given treatment as
many as 6 (37.5%) respondents at the weight level. Whereas after being given the tale
of the Mouse deer therapy in the control group, most children aged 4-6 were at
normal levels 7 (43.8%) of respondents.

Table 1.13 The Effect of Storytelling Therapy on Children's Anxiety

Hospitalization at the RSUD Haji Makassar(n=16)
Category Normal Light Moderate Weight Panic P-value
Group
Intervention
Pre-test - 2 4 5 5 0.001
Post-test 7 5 2 2 -
Group
Control
Pre-test - 1 5 6 4 0.000
Post-test 7 5 3 1 -

Source: Primary Data, 2020

Table 1.13 shows the results of thetest, Wilcoxon the p-value = 0.001 or <0.05
on the therapeutic effect of the Prophet Ayyub's story on Hospitalization Child
Anxiety, which means there is a significant relationship. Meanwhile, on the effect of
the tale of the Mouse deer on Children's Anxiety Hospitalization, the p-value = 0.000
or <0.005, which means that there is a significant relationship between the
storytelling therapy of the mouse deer and the decrease in anxiety.test was Wilcoxon
used for categories. The correlation level criterion (r) in thetest Wilcoxon is p <0.05,
which means that storytelling therapy has an effect on reducing anxiety in children
who are hospitalized. This is in line with research (padilla, 2019) which states that
story telling therapy and cartoon animation can reduce anxiety.
In research of (Setyawan & Ismahmudi, 2018) also said that storytelling can
stimulate children's brains and release endorphins that can release happiness in
children. and trigger a decrease in anxiety in preschool children. Another study
conducted (a’diillah, 2016) said that in storytelling activities, children will be able to
stimulate the development of children's coping which will enable children to control
anxiety and stress. Fairy tales and storytelling is a story that is fictional or not real but
will make the reader carry on the situation in the fairy tale, a fairy tale can be a story
that will influence the reader which can stimulate the brain and lower the atmosphere
in the story (Anggraeni Lina, 2019).
According to Delaune and Ladner, 2011 fairy tales are a strategy to develop
children's focus on negative emotions, storytelling is also a reframing technique, this
technique also changes negative emotions to become positive. Whereas a story is
something that is real or reality, behavior that occurred in the past or has passed that
can be read, recognized and used as a role model for behavior. everyday like the story
of the prophets and apostles and other story books that have a positive impact.
According to (Lestari & Isnaini, 2018), anxiety is a feeling that is not
controlled or a reality that is not in accordance with predictions that can trigger
uncontrolled negative thoughts and can have an impact on psychology. Before being
given therapy to the intervention group and the control group, respondents who had
the same characteristics were selected, namely preschool children aged 4-6 years who
were cooperative and willing to cooperate with researchers. In the intervention group,
the respondents were given therapy for the story of the Prophet Ayyub as, while in
the control group, the therapy for the tale of the Mouse deer was given. The story
given was different, the intervention group was given the story of the prophet, while
the control group was given the tale of the Mouse deer but it was given the same
duration. The research process was carried out on children aged 4-6 years who were
treated in the al-Fajar child care room who were willing to become respondents.
In the implementation of the study, given therapy to children who experience
anxiety in the nursery room or in bed. This condition can make children relax and
distract the respondent. Before giving treatment to the intervention group and the
control group (pre-test), the child's anxiety scale was measured for all respondents
using the DASS questionnaire. The researcher reads the story of the Prophet Ayyub
(as) to the intervention group and provides therapy for the Mouse deer fairy tale using
books and hand puppets in the control group, the treatment is carried out with the
same session and duration for each group of respondents, namely 3 sessions and
every one session with a duration of 10 minutes After being given treatment in each
group of respondents, (post-test) is done by re-measuring the child's anxiety using the
DASS (Depression Anxiety Stress Scale) questionnaire to determine the child's
anxiety after being given the treatment.
This research in the intervention group uses the story book of the prophet
Ayyub by telling the life journey of the prophet Ayyub as from his wealth and
authority, insistent trials to the recovery of the prophet Ayyub from his illness. This
research is in line with research (Dhin Nya Cut, 2019), using Islamic stories in
improving children's personality and character is new and not much has been
researched. Whereas in the control group using the mouse deer on anxiety which has
been widely researched in preschool children including research (Palawiah, 2019)
entitled the effect of storytelling therapy on anxiety in hospitalization children, but in
the use of hand puppets not many have done it so that children are so interested in
listening to fairy tales. by using a doll. This research in the intervention group uses
the story book of the prophet Ayyub by telling the life journey of the prophet Ayyub
as from his wealth and authority, insistent trials to the recovery of the prophet Ayyub
from his illness. This research is in line with research (Dhin Nya Cut, 2019), using
Islamic stories in improving children's personality and character is new and not much
has been researched. Whereas in the control group using the mouse deer on anxiety
which has been widely researched in preschool children including research (Palawiah,
2019) entitled the effect of storytelling therapy on anxiety in hospitalization children,
but the use of hand puppets not many have done it so that the children are very
interested in listening to fairy tales using hand puppets to completion. Based on this,
the researchers are interested in seeing the therapeutic effect of the story of the
prophet Ayyub as and the tale of Si the Mouse deer on anxiety.
Based on research results, before treatment was given to the prophet story.
Ayyub as and the story of Si Kancil on the anxiety of the respondent's children are in
the category of heavy and panic as many as 5 (31.3%), medium 4 (25.0%), and light 2
(12.5%) respondents, there is a change After giving therapy to the story of the
prophet Ayyub, most of the respondents became normal levels as many as 7 (43.8%)
respondents, mild anxiety level 5 (31.3%) respondents, moderate anxiety level 2
(12.5%) respondents, and the level of anxiety. anxiety 2 (12.5%) of respondents. In
previous research using the story of the prophet Ayyub as has never been used to
reduce anxiety, but there was only cognitive enhancement and personality formation
carried out by (Dhin Nyah Cut, 2019) who argued that the story of the prophet
Ayyub as can shape personality and suggest that the prophet's story is very It is
interesting to introduce preschool children, especially the story of the prophet Ayyub
as teaches about patience in dealing with calamities and more effectively building
children's morals, As Allah swt. Saying in QS. Ar-Ra'd 13: 28-29 explained that:
 ُ‫وا َوت َۡط َمئِ ُّن قُلُوبُهُم بِ ِذ ۡك ِر ٱهَّلل ۗ ِ أَاَل بِ ِذ ۡك ِر ٱهَّلل ِ ت َۡط َمئِ ُّن ۡٱلقُلُوب‬
ْ ُ‫ٱلَّ ِذينَ َءا َمن‬
ٖ zَ‫ت طُوبَ ٰى لَهُمۡ َوح ُۡس ُن َٔ‍م‬
‫اب‬ َّ ٰ ‫وا ٱل‬
ِ ‫صلِ ٰ َح‬ ْ ُ‫وا َو َع ِمل‬ْ ُ‫ٱلَّ ِذينَ َءا َمن‬
Translation:
(That is) those who believe and their hearts are at ease by remembering Allah. Remember,
only by remembering Allah will the heart be at ease. And those who believe and do good
deeds, they get happiness and a good place to return. QS Ar-Ra'd / 13: 28-29

Complete Interpretation of the Ministry of Religion explains:

In this verse, Allah describes those who receive His guidance, that is, people
who believe and have their hearts at ease because they always remember Allah. By
remembering Allah, the heart is at ease and the soul is calm, not feeling restless,
afraid or worried. They do good things, and feel happy with the goodness they do. It
is explained that people who believe and do good deeds, will undoubtedly find
happiness and a good place back with Allah in the next day, in connection with the
research of this verse teaches about serenity heart and be patient (Kementerian
Agama RI, 2019)
According to (Legi Rosalita Juita & Sulaiman Suhendar, 2019) in his research
entitled The Effect of Story Telling on Changes in Anxiety in Preschool Children by
using the tale of the hare, it was found that story telling could be applied as an
intervention in nursing services for preschool children. Research (Trihastuti Annisa,
2018) entitled the effect of fairy tales in increasing positive emotions of preschool
children also says that fairy tales are the best solution children's negative emotions,
although there are many studies on story telling to reducethat use the tale of the
Mouse deer and are able to reduce anxiety, while research on the story of the prophet
Ayyub is available. Some research, however, on the improvement of children's
personality and character, no one has examined the story of the prophet Ayyub on
anxiety, but in this study it turns out that the story of the Prophet Ayyub is more
effective in reducing anxiety with the results of hypothesis testing the intervention
group before being given treatment is at a panic and severe level, namely 5 (31.3%)
of respondents. Meanwhile, after being given therapy for the story of the prophet
Ayyub in the intervention group, most children aged 4-6 years had an anxiety
category at the normal level of 7 (43.8) respondents. the results obtained by the
Prophet Ayyub have an effect on reducing anxiety with the results p = <0.005 or p =
0.001. While the tale of the mouse deer has the results of the control group before and
after being given treatment, most of the control group before being given treatment
were 6 (37.5%) respondents at the weight level. Meanwhile, after being given the tale
of the Mouse deer therapy in the control group, most children aged 4-6 were at the
normal level of 7 (43.8%) respondents with significant results with p = <0.005 or p =
0.000. Which means that it has the effect of reducing the anxiety of children being
hospitalized in the hospital. So, it can be concluded that the therapy of the story of the
Prophet Ayyub and the therapy of the tale of the Mouse deer both have an effect on
reducing anxiety, but the story of the Prophet Ayyub as has an additional value
because it has religious values and patience that we should exemplify and we imply
in our daily life.
Conclusion
It can be concluded that the therapy for the story of the Prophet Ayyub and the
therapy for the tale of the Mouse deer both have an effect on reducing anxiety, but the
story of the Prophet Ayyub has its own added value because it has religious values,
patience that we should exemplify and apply in everyday life.
Acknowledgments
This research certainly would not have gone well without the support and
assistance of various paties. For that, the authors thank the State Islamic University
Alauddin Makassar for giving permission to conduct research at the Makassar Haji
Hospital in child care who are willing to voluntarily listen ti stories and fill out
questionnaires
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