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Meningitis is a serious infectious disease that can be prevented through vaccination; however, the vaccination process often causes anxiety in patients, especially during the pre-procedure phase. Uncontrolled anxiety can affect patient readiness and comfort. Therapeutic communication by nurses is one intervention that has the potential to reduce this level of anxiety. This study aims to determine the relationship between nurses’ therapeutic communication and the anxiety levels of patients prior to meningitis vaccination at Pambalah Batung Amuntai Regional General Hospital. This study used a quantitative analytic design with a cross-sectional approach. The sample consisted of 107 respondents selected using a convenience sampling technique. Data on therapeutic communication were collected using an observation sheet, while anxiety levels were measured using the DASS questionnaire (anxiety subscale). Data analysis was conducted using univariate and bivariate methods with the Chi-Square test at a significance level of 0.05. The results showed that most therapeutic communication was in the good category, and patient anxiety levels were predominantly in the normal category. Statistical test results indicated a significant relationship between nurses’ therapeutic communication and patient anxiety levels (p = 0.000 < 0.05). The better the therapeutic communication provided, the lower the patient’s anxiety level. In conclusion, nurses’ therapeutic communication plays an important role in reducing patient anxiety prior to meningitis vaccination and needs to be optimized in nursing practice.

This study aims to analyze the difference in anxiety levels before and after the administration of Qur’anic murottal therapy among third-trimester pregnant women. The third trimester is often associated with increased physical discomfort and psychological stress, which may lead to higher anxiety levels. This research employed a pre-experimental design using a one-group pretest-posttest approach involving 25 respondents selected through purposive sampling. Anxiety levels were measured using the Perinatal Anxiety Screening Scale (PASS), and the data were analyzed using the Wilcoxon Signed Ranks Test. The findings showed that before the intervention, 48% of respondents experienced moderate anxiety and 52% experienced severe anxiety. After the intervention, 40% experienced mild anxiety, 48% moderate, and only 12% severe anxiety. The statistical test result indicated a Z value of -4.376 with a p-value of 0.000 (p < 0.05), which means there was a significant difference in anxiety levels before and after the intervention. These results suggest that murottal therapy is effective in reducing anxiety among third-trimester pregnant women and can be considered as a safe non-pharmacological intervention.

Online games are one of the digital entertainment activities widely favored by adolescents; however, high-intensity use can lead to psychological impacts, one of which is anxiety. Anxiety in adolescents is characterized by feelings of restlessness, irritability, difficulty concentrating, and sleep disturbances, especially when they are unable to play online games or when they experience defeat in the game. This study aimed to determine the relationship between the intensity of online game use and the level of anxiety among adolescents. This study used a quantitative design with a cross-sectional approach, involving 113 respondents selected using a cluster sampling technique. The research instruments used were the DASS questionnaire and an online game usage intensity questionnaire, and the data were analyzed using univariate and bivariate analysis. The respondents in this study were adolescents from SMAN 1 Wanadadi, most of whom were 16 years old (49.6%) and predominantly female (61.9%). The intensity of online game use was mostly in the moderate category (55.8%), while the level of anxiety was mostly in the mild category (89.0%). The results showed that most respondents had a moderate level of online game usage intensity and a mild level of anxiety. Bivariate analysis indicated that there was no significant relationship between the intensity of online game use and the level of anxiety among adolescents, with a p-value of 0.425 and a contingency coefficient value of 0.076. Therefore, it can be concluded that there is no relationship between the intensity of online game use and the level of anxiety among adolescents.

Anxiety is a prevalent mental health issue that affects psychological well-being and daily functioning. In Muslim communities, Islamic spiritual practices are commonly used as coping strategies, yet empirical evidence regarding their effectiveness in reducing anxiety has not been systematically consolidated. This study aimed to synthesize scientific evidence on Islamic spiritual interventions for anxiety reduction. A systematic literature review was conducted in accordance with PRISMA guidelines by searching Google Scholar, PubMed, ScienceDirect, and Elsevier. Observational studies published between 2019 and 2026 that examined Islamic spiritual interventions and reported anxiety outcomes were included and analyzed narratively. Ten eligible articles were identified. The review demonstrates that Islamic spiritual interventions, such as dhikr, prayer, Qur’an recitation, and Islamic spiritual counseling, are consistently associated with reductions in anxiety across diverse populations and settings. Although the magnitude of effects varied, the overall findings indicate a beneficial role of Islamic spiritual practices in anxiety management. These results suggest that Islamic spiritual interventions may be integrated as complementary approaches within mental health and public health services for Muslim populations, while further methodologically rigorous studies are required to strengthen the evidence base.

The Objective Structured Clinical Examination (OSCE) is a form of evaluation that demands the physical and mental readiness of nursing students. Academic pressure, the demands of clinical performance, and the fear of failure can trigger anxiety, potentially disrupting sleep patterns. Poor sleep patterns can impact nursing students' concentration, memory, and academic performance.  This study used a quantitative design with a cross-sectional approach. The population of this study were students of the Faculty of Nursing, Muhammadiyah University of Semarang who were taking the OSCE exam. The sample size was 119 respondents, taken using a proportionate random sampling technique. Data collection was carried out using the Hamilton Anxiety Rating Scale (HARS) questionnaire to measure anxiety levels and the Pittsburgh Sleep Quality Index (PSQI) to assess sleep patterns. Data analysis was carried out univariately and bivariately using the Spearman Rank statistical test. The results showed that most respondents were 20 years old (83.2%) and female (82.4%). Most students experienced mild anxiety (43.7%) and had good sleep quality (58.8%). The Spearman Rank test results showed a correlation value (r) = 0.898 with a p-value = 0.000 (p <0.05), which means there is a very strong and significant relationship between students' anxiety levels and sleep patterns in facing the OSCE exam.  There is a very strong and significant relationship between students' anxiety levels and sleep patterns during the OSCE.

Anxiety is an emotional response that children often experience when facing medical procedures, including circumcision. Unresolved anxiety can have a negative impact, such as increasing pain, disrupting the process of action, and causing trauma. Non-pharmacological efforts such as audiovisual administration and puzzle game therapy can be used to reduce anxiety. This study aims to analyze the difference in anxiety levels in pre-circumcision children between audiovisual giving and puzzle games at Pondok Khitan, Bancang Village, Tahulu Village. Research design using quantitative with post test design only design. The research population is pre-circumcision children at Pondok Khitan, Bancang Hamlet, Tahulu Village with a sample of 40 respondents taken with the purposive sampling technique. Consists of 20 children of the Audiovisual group and 20 children of the Puzzle Game Group. The research instrument is in the form of a child anxiety questionnaire. The research results were analyzed using the Mann-Whitney test with a significance level of α = <0,05 with an Asymp value. Sig. (2-tailed) = 0.029 < 0.05. the mean rank value of the Audiovisual group of 24.23 and the Puzzle Game group of 16.77 shows that the Puzzle Game is more effective in minimizing anxiety in pre-circumcision children which means H1 is accepted. The discovery of meaningful differences between Audiovisual and Puzzle Games towards anxiety so that the technique can be used as an interactive educational medium.

The prevalence of hypertension in the elderly continues to increase and is a major cause of morbidity and mortality. Uncontrolled blood pressure can lead to serious complications such as heart disease, stroke, and kidney failure. Anxiety, which is often experienced by the elderly, also plays a role in worsening hypertension through activation of the sympathetic nervous system and increased stress hormones. This study aims to determine the relationship between anxiety levels and the incidence of hypertension in the elderly at the Kuta Alam Community Health Center in Banda Aceh City. The study used a quantitative method with a cross-sectional analytical design. The study population consisted of 145 elderly people with hypertension, with a sample of 59 people selected through a purposive sampling technique. The study was conducted from April 28 to May 8, 2025. Anxiety levels were measured using the Geriatric Anxiety Inventory (GAI) questionnaire, and blood pressure was measured using a digital sphygmomanometer. Data analysis was carried out univariately and bivariately using the Chi-square test. The results showed that the majority of respondents experienced panic anxiety (39.0%) and Grade III hypertension (44.1%). There was a significant relationship between anxiety levels and the incidence of hypertension in the elderly (ρ = 0.000; ρ < 0.05). In conclusion, anxiety influences the severity of hypertension, so psychological aspects need to be considered in elderly health services at the Kuta Alam Community Health Center.

Background: Sectio caesarea is performed to ensure the safety of the mother and baby. Before the operation, health workers, especially nurses, need to provide education to the mother about informed consent and the operation procedure to reduce the mother's anxiety and concerns about the safety of her baby. Objective: To determine the effect of providing informed consent education on surgical preparation with anxiety levels in patients with Pre-Operational Caesarean Section. Method: This study is an analytical survey study using the cross-sectional method. The study was conducted at RSIA Murni Teguh Rosiva Medan. The population was 30 people and all of them were used as samples, sampling was done using purposive sampling. The analysis was performed univariately in the frequency distribution table and bivariately using the Kendall's tau-b test. Results: This study showed that the majority of pre-operative caesarean section patients stated that the provision of informed consent education in preparation for surgery was in the good category (60.0%). The majority of pre-operative caesarean section patients felt mild anxiety (50.0%). The provision of informed consent education in preparation for surgery had a significant effect on the level of anxiety of pre-operative caesarean section patients at RSIA Murni Teguh Rosiva Medan, p-value = 0.005 <0.05. Conclusion: The anxiety of pre-operative caesarean section patients was influenced by the provision of informed consent education in preparation for surgery by nurses. Suggestion: It is recommended that nurses provide informed consent education regarding preparation for caesarean section surgery to improve the knowledge and readiness of mothers to overcome anxiety that can affect caesarean section procedures.

This study aims to describe the level of anxiety, stress, and depression in women undergoing In Vitro Fertilization (IVF) program and to see the distribution of psychological disorders based on sociodemographic characteristics and the stage of IVF program undertaken. The design of this study was descriptive quantitative with purposive sampling technique on 28 women who were undergoing IVF cycles in infertility clinics in Yogyakarta Special Region. Data were collected online through a questionnaire containing Hamilton Anxiety Rating Scale (HARS), Perceived Stress Scale (PSS), and Beck Depression Inventory-II (BDI-II) instruments. Descriptive analysis showed that most respondents experienced moderate anxiety (42%), mild stress (38%), and mild depression (36%). The analysis also showed that sociodemographic characteristics, such as age older than 35 years, non-working employment status, and low education, had a higher tendency towards psychological disorders. In addition, certain phases of IVF, such as the waiting phase after embryo transfer, appeared to be associated with increased levels of anxiety and stress. This study emphasizes the importance of more intensive psychological support, especially for women who are in the more stressful stages of IVF, as well as for those with sociodemographic risk factors that increase their vulnerability to psychological disorders.

The level of anxiety during competition needs to be considered because it can interfere with the athlete's focus, cause difficulty in controlling movements, reduce the quality of the game, and hinder the application of strategies, which overall has a negative impact on athlete performance. This study was motivated by the observation of researchers who found that there were still many athletes experiencing symptoms of anxiety, such as cold sweaty hands and nausea. The research method used was a survey with Nyak Amir's Sport Anxiety Scale (SAS) questionnaire consisting of 22 statement items. The subjects of this study were 20 athletes who had met the criteria and were analyzed using descriptive statistics with Microsoft Excel and SPSS. The results of the research on the anxiety of Dukati Taekwondo Club athletes before the match were in the “rather low” category with an average score of 41.25. However, if analyzed further based on aspects of anxiety, there are differences in anxiety levels in each aspect. The somatic aspect has the highest anxiety with a score of 15.5, showing physical symptoms such as heart palpitations and body trembling. Motor aspects with a score of 14.75, affective with a score of 5.45, and cognitive 5.55 were mostly in the moderate category, reflecting muscle tension, feelings of anxiety, and negative thoughts before competing.  

Hospitalization in preschool children often causes anxiety, which can disrupt the recovery process. If this anxiety is not addressed, it can worsen the child's condition, lengthen hospital stays, and cause negative psychological effects. Therefore, an effective intervention is needed to help children manage their anxiety. This study aims to examine the effect of puzzle play therapy on the anxiety levels of preschool children hospitalized at Meuraxa Hospital, Banda Aceh. The research used a one group pre-test post-test design with 15 selected samples based on specific criteria. The instrument used was an observation sheet filled out three times to assess the children's anxiety before and after the intervention. The data were analyzed using a Paired T-test to compare anxiety levels before and after the therapy. The results showed a significant reduction in anxiety after the children participated in puzzle play therapy, with a p-value = 0.000 (p < 0.05). In conclusion, puzzle play therapy can effectively reduce anxiety in preschool children during hospitalization and can be implemented as a routine nursing intervention with support from healthcare professionals and families.

Anxiety is an emotional response that is commonly experienced by patients before surgery, including in pre sectio caesarean patients. High levels of anxiety can affect the patient's physiological and psychological condition, so appropriate handling efforts are needed. Non-pharmacological interventions, such as prayer dhikr therapy, can be used as an alternative to help reduce anxiety because it provides relaxation, calmness, and increased spirituality. This study aims to analyze the effectiveness of dhikr sholawat therapy on anxiety levels in pre sectio caesarean patients. The research design used a quasi-experiment with a pre-test and post-test control group approach. The research sample consisted of pre-sectio caesarea patients who met the inclusion criteria, then divided into two groups, namely the intervention group that was given prayer dhikr therapy and the control group that only received standard treatment. The instrument used to measure anxiety levels is the Hamilton Anxiety Rating Scale (HARS). Data analysis was carried out by statistical tests according to the distribution of data to find out the difference in results between the two groups. The results showed a significant decrease in anxiety levels in the intervention group compared to the control group (p < 0.05). These findings prove that prayer dhikr therapy is effective in reducing anxiety in pre-sectio caesarean patients. Thus, this therapy can be recommended as one of the non-pharmacological nursing interventions that support the improvement of service quality and patient comfort.

Cancer is still one of the leading causes of death in Indonesia and poses a major challenge in the world of health. Cancer patients undergoing chemotherapy generally face various psychological problems, one of which is anxiety arising from side effects of therapy, uncertainty of treatment, and deterioration of physical condition. This study aimed to analyze the relationship between family support and anxiety levels in patients undergoing chemotherapy. The research design uses a quantitative approach with a cross-sectional method. The research sample amounted to 40 chemotherapy patients at RSI Sultan Agung Semarang who were selected using a total sampling technique. The research instruments were in the form of family support questionnaires and the Hamilton Anxiety Rating Scale (HARS). Data analysis was carried out using the Marginal Homogeneity test. The results showed that most patients received family support in the moderate to high category (75%) and experienced mild to moderate levels of anxiety (70%). Based on statistical tests, a value of p = 0.001 was obtained, which showed a significant relationship between family support and anxiety levels in chemotherapy patients. The conclusion of this study confirms that good family support plays an important role in helping patients reduce anxiety during treatment. These findings indicate the importance of active family involvement in accompanying patients, both emotionally, informationally, and instrumentally. Therefore, educational programs involving families are highly recommended to improve the quality of care and support the psychological condition of cancer patients.

Preoperative anxiety is one of the psychological problems that patients often experience and can affect physiological stability, response to anesthesia, and the postoperative recovery process. High levels of anxiety in patients leading up to surgery can have negative impacts, both physically and emotionally. One of the interventions that can be done to reduce anxiety is therapeutic communication by nurses. Therapeutic communication has an important role in creating a relationship of mutual trust, providing a sense of security, and helping patients understand the medical procedures to be undertaken. However, there are still conditions where therapeutic communication has not been implemented optimally. This study aims to determine the relationship between nurses' therapeutic communication and the level of anxiety of preoperative patients at RSI Pekajangan. The study used a quantitative approach with a correlational design and involved 72 respondents who were selected through purposive sampling techniques. The research instruments included a therapeutic communication questionnaire and the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Data analysis was carried out using the Spearman Rank test. The results showed that most respondents rated therapeutic communication in the categories of good (81.9%) and moderate anxiety (72.2%). Statistical tests showed a significant relationship between nurses' therapeutic communication and preoperative patients' anxiety levels (p = 0.027) and moderate correlation strength (r = -0.260). The conclusion of this study confirms that therapeutic communication plays a role in lowering patients' anxiety, so it is recommended that nurses improve therapeutic communication skills as part of pre-surgical interventions.

Patients undergoing hemodialysis require effective and adaptive coping mechanisms to manage both the physical and psychological stress experienced during treatment. Inadequate or maladaptive coping strategies may result in physiological disturbances and heightened emotional distress, ultimately reducing the quality of life of patients with chronic kidney disease (CKD). This study aims to analyze the relationship between coping mechanisms and anxiety levels among patients undergoing hemodialysis. The research employed a quantitative approach with a cross-sectional correlational design. A total of 35 respondents were recruited using purposive sampling based on specific inclusion criteria, including diagnosis of CKD and ongoing hemodialysis treatment. The study was conducted in the hemodialysis unit of RSUI Harapan Anda, Tegal, in 2025. Data collection was carried out through structured questionnaires, while statistical analysis utilized the Pearson Chi-Square test. Results indicated a p-value of 0.001 (p < 0.05), confirming a statistically significant association between coping mechanisms and anxiety levels. Patients who employed adaptive coping strategies demonstrated lower levels of anxiety, whereas those relying on maladaptive strategies experienced heightened anxiety. These findings highlight the importance of targeted nursing interventions that focus on strengthening adaptive coping skills to reduce psychological burden. Furthermore, the study emphasizes the need for comprehensive patient education and structured psychosocial support programs to promote resilience, improve coping capacity, and enhance overall psychological well-being in patients undergoing long-term hemodialysis.

Anxiety and sleep quality are two closely related aspects in patients undergoing surgical procedures. High levels of anxiety in the preoperative phase often result in decreased sleep quality, while poor sleep can exacerbate anxiety, thus affecting the postoperative recovery process. This study aims to compare anxiety levels and sleep quality in patients before and after surgery. The research design used was a quasi-experimental with a pre-post test approach. The study sample consisted of 119 respondents selected through a purposive sampling technique in the Kenanga Ward of Dr. H. Soewondo Kendal Regional Hospital. The instruments used included the Zung Self-Rating Anxiety Scale (SAS) questionnaire to measure anxiety levels and the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality. Data were analyzed using the Chi-Square test with the help of SPSS version 25 software. The results showed a significant relationship between anxiety levels and sleep quality in both the pre- and postoperative phases (p = 0.000; p < 0.05). A total of 54.4% of patients with poor sleep quality before surgery showed improvement after surgery. Furthermore, in the group with moderate anxiety, 54.8% experienced a reduction to mild anxiety. In conclusion, reducing anxiety levels has been shown to positively impact patients' sleep quality after surgery.

Coronary heart disease is one of the major health problems that not only affects the physical condition of patients but also impacts their psychological state, particularly anxiety. Anxiety levels in patients with coronary heart disease usually increase when they are about to undergo invasive medical procedures such as Percutaneous Coronary Intervention (PCI). Anxiety can be influenced by several factors, including age, gender, educational level, and occupation. High levels of anxiety may worsen the patient’s clinical condition, making appropriate non-pharmacological interventions highly necessary to help reduce anxiety. This study aims to determine the effect of spiritual support in the form of dzikir on the anxiety levels of patients with coronary heart disease. The research design used was a true experimental design with a pretest-posttest control group design. The sample consisted of 30 respondents who were evenly divided into two groups: 15 respondents in the intervention group and 15 respondents in the control group. The sampling technique used was total sampling. The instrument for measuring anxiety was the Hamilton Anxiety Rating Scale (HARS). The results showed that providing spiritual support in the form of dzikir was effective in reducing patient anxiety, with a p-value of 0.001. In addition, there was a significant difference in post-therapy anxiety levels between the control and intervention groups, with a p-value of 0.019 (p < 0.05). These findings demonstrate that dzikir, as a form of spiritual support, can be used as a non-pharmacological intervention to reduce anxiety in patients with coronary heart disease. Thus, spiritual support can be an important component of nursing care for patients in the ICU.

Patients admitted to the Intensive Care Unit (ICU) often experience physiological disturbances caused by both medical conditions and intensive treatment procedures. One of the most common problems encountered is sleep disturbance. Several factors contribute to poor sleep quality in ICU patients, including repeated medical procedures, environmental noise from medical equipment and staff activities, discomfort due to body positioning, frequent interactions with health workers, continuous exposure to lighting, pain, and the underlying disease process. Persistent sleep disturbances can delay the healing process, increase blood pressure, and even elevate the risk of stroke. This study aimed to analyze the relationship between anxiety levels and sleep quality in compos mentis patients in the ICU of Sultan Agung Islamic Hospital Semarang. The research design employed a correlational approach with a cross-sectional method. A total of 30 respondents were selected according to the inclusion criteria. Data were collected using the Pittsburgh Sleep Quality Index (PSQI) to measure sleep quality and the Hamilton Anxiety Rating Scale (HARS) to assess anxiety levels. The Chi-Square test was used for statistical analysis. The results showed an equal distribution of male and female respondents (15 each). Ten respondents had a post-laparotomy medical diagnosis, and the majority belonged to the late elderly age group (10 respondents). Most respondents experienced moderate anxiety (18 respondents), while poor sleep quality was reported by 17 respondents. The Chi-Square test revealed a p-value of 0.001, indicating a significant relationship between anxiety levels and sleep quality. In conclusion, higher anxiety levels were associated with poorer sleep quality among compos mentis patients in the ICU. These findings highlight the importance of nursing interventions that address both the physical and psychological aspects of patients to improve sleep quality and support recovery.

Breast cancer is the leading cause of death globally, following heart disease and stroke. One of the most commonly used treatments is chemotherapy, which offers various benefits but also causes physical and mental side effects. One of the psychological side effects often experienced is anxiety. Extreme fear and the threat of death from cancer can affect adherence to treatment. This study aims to assess the relationship between anxiety levels and medication adherence in breast cancer chemotherapy patients at RSUD Semarang. This research used a quantitative approach with a descriptive correlational method, involving 110 participant samples. The questionnaires used for data collection were DASS-42 to measure anxiety levels and MMAS-8 to assess medication adherence. The study was conducted from June 30 to July 31, 2025, in the Oncology Center room of RSUD Sultan Agung Semarang. Bivariate analysis using Pearson's correlation test showed a p-value of 0.001 < 0.05, indicating a significant relationship between anxiety levels and medication adherence in breast cancer chemotherapy patients. The measured correlation coefficient of -0.325** shows a moderately strong negative relationship, meaning that the higher the anxiety level, the lower the patient's adherence to medication. Based on these findings, it is recommended that nurses in the oncology unit provide additional education and support to patients regarding their anxiety. Effective psychological support can help patients reduce anxiety and increase adherence to treatment, which in turn can improve the outcomes of chemotherapy treatment.

Patients admitted to the Intensive Care Unit (ICU) frequently experience physiological disturbances that significantly affect their sleep quality. These disturbances are triggered by various factors, including repeated medical procedures, environmental noise, discomfort from medical devices, intensive interactions with healthcare workers, inappropriate lighting that disrupts circadian rhythms, pain, and the underlying disease process. Sleep disturbances in ICU patients may slow down the healing process, elevate blood pressure, trigger metabolic disorders, and increase the risk of serious complications such as stroke. This study aims to examine the relationship between anxiety levels and sleep quality among compos mentis patients in the ICU of Sultan Agung Islamic Hospital, Semarang. The research employed a correlational design with a cross-sectional method. A total of 30 respondents were included based on specific criteria. Anxiety levels were measured using the Hamilton Anxiety Rating Scale (HARS), while sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Data were analyzed using the Chi-Square test to determine the relationship between the two variables. The findings showed that the distribution of male and female respondents was balanced (15 respondents each). The most common medical diagnosis was post-laparotomy (10 respondents), with the dominant age category being late elderly (10 respondents). Anxiety levels were predominantly in the moderate category (18 respondents), while the majority of respondents demonstrated poor sleep quality (17 respondents). Statistical analysis revealed a p-value of 0.001, indicating a significant relationship between anxiety levels and sleep quality. In conclusion, the study highlights that higher levels of anxiety are associated with poorer sleep quality among compos mentis patients in the ICU. These findings emphasize the importance of nursing interventions aimed at reducing anxiety to improve patient sleep quality and support recovery.