THE EFFECT OF COVID-19 PREVENTION EDUCATION ON PUBLIC MOTHERS IN REDUCING ANXIETY LEVEL IN THE TIME COVID-19 PANDEMIC

Abstract


Introduction
The postpartum period begins after childbirth and lasts for about six to eight weeks (Anggraeni & Saudia, 2021).Prior to entering the pandemic, based on data from WHO, mothers who experienced mild postpartum anxiety were between 10 per 1000 live births and those who experienced moderate or severe postpartum anxiety were between 30 and 200 per 1000 births.The incidence of postpartum maternal anxiety is still high in various countries such as Portugal (18.2%),Bangladesh (29%), Hong Kong (54%), and Pakistan (70%) (Istiqomah et al., 2021).Based on data from an American study, 16 pregnant women and 15 postpartum women reported six times higher levels of Jurnal Health Sains, Vol. 3, No. 9, September 2022 prenatal anxiety during the pandemic compared to a previous study conducted in the Colorado region, America (Farewell et al., 2020).
Postpartum psychosis is a serious mental illness that mothers often experience in the postpartum period, in this case this understanding has an impact on how the pandemic and various public health measures impact fear and mental health status dur Veftisia, V., Annisa, Rahmasanti, A., Puspanagar, A., Mayola, D., & Sawiti, P. (2020).Prenatal Yoga dalam Mengurangi Tingkat Kecemasan dan Stress Dimasa Pandemi Covid-19.ing pregnancy and the puerperium, and the experience of giving birth to women.Providing education during a pandemic, of course, must pay attention to the health protocols that have been determined.Health workers can use technology to convey information needed by postpartum and breastfeeding mothers regarding the Covid-19 disease, (Suminar, Herliani, and Mardiani 2021).From the results of the study, it was found that as many as 40 respondents (74.1%) had a low level of knowledge and as many as 13 people (25.9%) had good knowledge before being given education about preventing Covid-19.Under normal circumstances, maternal and neonatal mortality in Indonesia is still a big challenge, especially during a disaster situation.Currently, Indonesia is facing a non-natural Covid-19 national disaster so that maternal and neonatal health services are one of the services affected both in terms of access and quality.So that the situation experienced by Indonesia can lead to an increase in maternal and newborn morbidity and mortality.
Providing education about preventing Covid-19 using video media via Whatsapp resulted in an increase in the level of knowledge of respondents, namely the level of good knowledge of 51 respondents (96.3%) and very good knowledge level of 2 respondents (3.7%), .In addition to providing education through videos for postpartum mothers, they can also implement a healthy lifestyle with Prenatal Yoga, the results of a study conducted by with the title Prenatal Yoga in Reducing Anxiety and Stress Levels during the Covid-19 Pandemic showed that there was a significant relationship between There was a significant difference between pregnant women who participated in health promotion activities through videos and posters about the importance of prenatal yoga for pregnant women in the II and III trimesters in reducing anxiety and stress levels during the Covid-19 pandemic,1610010014335

Research methods
This study uses the Scoping Review technique.Scoping review is becoming an increasingly popular approach to synthesizing research evidence.Scoping reviews to determine the value, potential scope and costs of systematic reviews, summarize disseminating research results, and identify research gaps in the literature.To identify the relevant articles, the researcher conducted inclusion and exclusion criteria.
Inclusion criteria are articles used published since 2020, using English or Indonesian, primary research (primary research, review articles (systematic review or literature review), articles discussing the impact of anxiety on postpartum mothers during the Covid-19 pandemic, articles discussing regarding the effects of the Covid-19 pandemic on postpartum mothers on health workers.The exclusion criteria were articles based on opinions, articles discussing anxiety in postpartum mothers during the Covid-19 pandemic.
In analyzing and developing the focus of a topic and a literature search strategy to formulate scoping review questions, the researchers used the PEos Framework "Population Exposure Outcame" (PEos).To form questions and facilitate literature The Effect Of  The Time Covid-19 Pandemic searches.The following is a framework that is used as the basis for preparing research questions in a scoping review.

Table 1 Frame work PeOS
After determining the keywords that match the framework, then doing a search on the database to be used, by entering the keywords that have been determined.In searching for evidence, using relevant data bases through 3 data bases, namely pudmed, scientific direct and gray literature.The search strategy involves searching for research evidence through electronic data sources for the search for existing articles.The articles used as references are original research papers to develop keywords to get specific papers.
The research method used in problem solving includes analytical methods.Picture captions are placed as part of the picture title (figure caption) not part of the picture.The methods used in completing the research are listed in this section.

Results and Discussion
After determining the keywords that match the framework, then doing a search on the database that will be used, by entering the keywords that have been determined.In the search for evidence using relevant databases through 3 databases, namely pubmed, science direct and gray literature.The strategy in literature search involves searching for research evidence through various sources of electronic data to search for existing articles.The article used as a reference is a paper which is an original research to develop words.
From the twelve articles obtained, a critical appraisal process has been carried out by scoring each question according to the assessment method from JBI, the articles or journals that have been selected are of good quality.The assessment of articles is carried out based on good quality and categorizes based on the number and grade.This item characteristics of sources of evidence displays the results of abstraction/charting of data according to the characteristics of the article.on research design, characteristics based on country characteristics based on year of After entering the selected keywords, 200 publication and based on grade.journals were obtained.After duplication, the results were 170 journals.Further screening was carried out again with themes related to the anxiety of postpartum mothers during the Covid-19 pandemic and education for postpartum mothers in reducing anxiety levels during the Covid-19 pandemic, 154 journals were obtained, then a full text search found 24 articles which were irrelevant to 6 articles.is a literature study, with 14 articles according to the purpose of the review and with 10 articles not meeting the objectives.So a total of 12 articles that deserve to be assessed.conducting critical appraisal, 6 journals were selected using Quantitative design, 2 using Qualitative, 2 journals using the Mixed method, 2 Quasi Experimental then poured into the Charting Data table can be seen by the following tables and diagrams:

A. Characteristics Based on the research design Figure 1 based on research method
Of the 12 journals that were found there were 6 articles that used quantitative research designs, 2 qualitative articles, 2 Mixed Method articles, 2 Quaisi Experimental can be seen in the diagram below: Of the 12 articles that have been screened and 2. Characteristics by country

Figure 2 Characteristics by country
The following countries included in the study were Singapore, England, Germany, Japan, Canada, Australia, Turkey, Rwanda, and Chile.After grouping, it was carried out in developed countries, namely 1 in Singapore, 2 in England, 1 in Germany, 1 in Japan, 1 in Canada, and 1 in Australia.For developing countries, namely I in Turkey, I in Rwanda, and 1 in Chile and 2 in Indonesia.The results illustrate the significant findings of this study.

Figure 4 Characteristics by grade
Of the 12 on average, they produced garde A, each with good quality and with the Cross sectional method there were 5 articles, namely A2, A4, A5, A6, A9, grade A in the Randomixed Controlled Trial A7 methodology, grade A in the Qualitative methodology.there are 2 articles, namely A1 and A10 and Grade A on the Mixed method methodology, out of 10 articles there are 2 articles, namely A6 and A8 and there are 2 articles with grade B, namely A 3 and A5 with Cross sectional methodology and 2 articles with Quasi Experimental methodology.Based on the result of 12.Of the 12 on average, they produced garde A, each with good quality and with the Cross sectional method there were 5 articles, namely A2, A4, A5, A6, A9, grade A in the Randomixed Controlled Trial A7 methodology, grade A in the Qualitative methodology.there are 2 articles, namely A1 and A10 and Grade A on thzze Mixed method methodology, out of 10 articles there are 2 articles, namely A6 and A8 and there are 2 articles with grade B, namely A 3 and A5 with Cross sectional methodology and 2 articles with Quasi Experimental methodology.Based on the result of 12.

B. Anxiety of postpartum mothers
Anxiety or anxiety is tension, insecurity, and worry that arises because it is felt that something unpleasant will happen, but the source is mostly unknown (Maramis, 2009).Anxiety is a response experienced by postpartum mothers to situations that are felt to be threatening, followed by physiological, emotional or psychological and cognitive symptoms.Anxiety as an emotion without a specific object, the cause is unknown and Anxiety is different from fear.Fear has a clear source and its object can be defined.Fear is an assessment of threatening stimulation and anxiety is an emotional response to that assessment (Stuart, 2016).The impact of the Covid-19 pandemic on postpartum mothers Anxiety experienced by mothers during the puerperium has an impact on the lack of handling and care for newborns.One of the causes of the lack of handling and care for newborns is the lack of knowledge of mothers about newborn care, especially for primigravida mothers who do not have direct experience in caring for newborns, causing maternal anxiety in caring for newborns in the first week of life.(Amolo, Irimu, and Njai 2017).These conditions can cause psychological problems for pregnant women postpartum, which can cause anxiety.A study reported that symptoms of depression and anxiety in pregnant women and postpartum women after the declaration of the Covid-19 pandemic were higher than before the declaration of Covid-19 (Wu et al., 2020).
According to (Sari et al., 2021), providing education for health workers cannot meet directly with postpartum mothers and many other people because they have to do physical distancing/social distancing to avoid Covid-19 transmission, so health workers use module media to provide education.and knowledge to postpartum mothers to reduce their anxiety during the postpartum period, to stay safe and smooth, the result is that there is an influence of counseling during the Covid-19 pandemic on the anxiety level of 1449 postpartum mothers, this is an indicator of the effectiveness of providing modules on care during the postpartum period that have been carried out in community service activities.
In every postnatal visit during the pandemic, both face to face or online, psychological assessments of postpartum mothers can be carried out more optimally, so that if they are detected as suffering from psychological problems such as anxiety, further management can immediately be given.The application of health protocols was able to reduce maternal anxiety so that they still wanted to visit health services.Every time you visit, the mother can make an appointment in advance with the midwife, so that the preparation is carried out more optimally.4. Handling to reduce anxiety levels in postpartum mothers The husband's support in reducing anxiety levels and the higher the husband's support for the mother will affect the incidence of anxiety and stress levels during pregnancy and the postpartum period and the positive influence of husband's support can protect the mother's mental health.The mother's physical condition will be like an emotional state, such as paying special attention to the mother in the postpartum period and helping the mother in dealing with the anxiety of psychological and physical changes, during the Covid-19 pandemic, (Chrzan-Dętkoś et al., 2021) Aromatherapy, which is given during labor reduces anxiety in the mother.With regard to the specific biologic conditions of the postpartum period and the subsequent decrease in hormone levels, this study investigated the effects of lavender on the prevention of stress, anxiety, and postpartum depression in women (Kianpour et al., 2016).Yoga can reduce body and mental tension so that they are stronger in dealing with stress, increase self-confidence and the ability to think positively so it is suitable for someone who wants to increase selfconfidence and reduce stress.The purpose of this study was to determine the effectiveness of yoga during pregnancy on the level of anxiety in postpartum mothers (A Buchari, 2018).

Conclusion
During the Covid-19 pandemic, a pandemic is a matter that causes health status to be something that is now being given attention, especially pregnant women to postpartum mothers because they are a vulnerable group of contracting Covid-19, causing mothers to experience anxiety, with educational interventions regarding the prevention of Covid-19 19 and can not be separated from participating in husband's support for postpartum mothers can provide knowledge and reduce maternal anxiety levels during the postpartum period by health workers, especially midwives and are expected to be able to apply also to the scope of health facilities.

Figure 3
Figure 3 Characteristics by year of publication