“PLAYDOUGH TO REDUCE ANXIETY”: Alternative Therapy in Pre-School Children with Hospitality

Hospitalization is an experience that produces every child who has physical and psychological effects as a result of the environment, and officers they do not know. Therefore the effort that can be done by nurses is to provide distraction therapy with playdough. The study aimed to prove the effect of treatment on Playdough play on anxiety in preschoolers because of hospitalization in the Kertawijaya Room Dr. Wahidin Sudiro Husodo Mojokerto. The design of this study uses pre-experiment with one group pretest approach. The population in this study were all preschool children who were in hospital treatment in the first week of October 2018. Samples were 20 children, with consecutive sampling. Playdough therapy for 20 children. Data collection used a mYPAS (Modified Yale Preoperative Anxiety Scale) questionnaire. After that, the data processing with Wilcoxon signed test was 0.00 which was <0.05, As for the conclusions in this study there is a therapeutic effect of playing plasticine on children's anxiety with hospitalization. The value of preschool children's anxiety before being given play therapy is the majority of respondents 13 respondents (65%) experienced moderate anxiety and And a small proportion of respondents experienced severe anxiety as many as 5 respondents (25%). The value of anxiety after being given play therapy most of the respondents experienced a decrease in anxiety as many as 12 respondents (60%) experienced mild anxiety and almost half of the respondents were 8 respondents (40%). Stress will stimulate the body to send messages from the hypothalamus to the adrenal gland which will affect vasodilation and vasoconstriction of blood vessels that will determine the increase or decrease in blood pressure which is one of the physiological characteristics of the body when experiencing anxiety.


INTRODUCTION
Hospitalization is a critical condition experienced by children when sick and hospitalized. This situation occurs because children try to adapt to foreign environments and new environments, namely the hospital environment so that the condition becomes a stressor for both children and parents and families. This change in terms is a considerable problem that causes fear, anxiety for children which can cause physiological and psychological changes in children if the child is unable to adapt to these changes (Saputro & Fazrin, 2017). If a child is in hospital treatment, the child will be prone to crisis because of: (1) the child experiences stress and anxiety due to changes both to his health status and his environment in daily habits, and (2) the child has a number of limitations in coping mechanisms to overcome problems and stressful events (Nursalam, 2008).
Anxiety condition for children undergoing hospitalization is a serious problem and must receive special attention.
For children aged 3 to 6 years (preschool), hospitalization is a bad stressor that can affect children's growth and development.
So that the role of nurses in minimizing stress and anxiety due to hospitalization in children and infants is crucial because nurses need to understand the concept of stress hospitalization and the principles of nursing care through nursing care approaches such as giving play therapy to children (Nursalam, 2008).
Weak conditions in children allow children to need health care at the hospital.
In the United States, children who receive hospital care are more than 5 million for surgical procedures and more than 50% of this amount; children experience anxiety and stress (Kain et al., 2006in Tjahjono, 2014. In Indonesia, the number of preschool-aged children (3 -6 years) based on the National Economic Survey in 2010 amounted to 72% of the total population of Indonesia, and an estimated 35 per 100 children experienced the hospitalization, and 45% experienced anxiety.
Based on the results of the research (ALINI, 2017), explained that the average anxiety level of respondents before being given intervention in the form of playdough therapy was 14.07. Whereas after being given plasticine therapy the average anxiety level of Respondents was 9.60 so that the difference in respondents' anxiety levels before and after giving playdough therapy was 4,467.
To reduce the impact arising from external and internal stimulation reactions, using play therapy will significantly help alleviate stress caused by hospitalization.
Playing is very important for mental, emotional and social health. Playing activity is an activity that is fun for children, even though it does not produce certain commodities, such as financial benefits.
Children are free to express feelings of fear, anxiety, joy, or other beliefs, so that by giving freedom to play parents know the child's mood (Ambarwati & Nasution, 2012). Playdough games are one alternative toy for therapy when hospitalized (Arvin, 2000).
The purpose of this study was "Is there an effect of Playdough Playing Therapy Against Anxiety of Preschool Age Children Experiencing Hospitality."

MATERIALS AND METHODS
The research design used in this study was pre-experimental. There was no random element in this study. The control group. This design does not pay attention to internal factors that affect the validity of the survey (Brockopp, 1999 The results of the study above table   1 show that out of 20 respondents, almost half of the respondents were 3 years old as many as 8 respondents (40%). Most of the respondents were female respondents as many as 13 respondents (65%). Most respondents have never received hospital treatment as many as 14 respondents (70%). to deal with them. Therefore the response of each child will be different in expressing their anxiety.

Anxiety after therapy with playdough play in preschool children
The results of the study in According to the theory of (Ambarwati & Nasution, 2012), with the playroom provided for children, it will help to please and feel safe at the same time in children.
Based on the results of the study above Based on the results of the study above When in a hospital the child will experience a new environment and re-adapt.
The entry of children to the hospital to get treatment is a threatening experience. (Asmadi & Kep, 2008). In addition to the mechanism of action the distraction, technique provided with playdough play therapy can reduce anxiety levels. Decrease in children's anxiety level due to the stressor that can interfere with the child can be diverted by giving playdough therapy that can provide stimulation to the brain which will then be delivered to the adrenal and norepinephrine glands which can affect vasodilation of blood vessels which causes blood pressure to decrease more than when the anxious child. So that after being given play therapy, it will show differences in the level of anxiety of the child before being given treatment to play to them.