Dental Clinic Interior Model as an
Alternative to Child Anxiety
Semarang
Health Polytecnic, Semarang, Indonesia
Semarang
Health Polytecnic, Semarang, Indonesia
Semarang
Health Polytecnic, Semarang, Indonesia
Semarang
Health Polytecnic, Semarang, Indonesia
Email: [email protected]
article info abstraCT
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Date Received: 12 November 2020 Revision Date : 20 December 2020 Date Received : 03 January 2021 Keywords: Clinic Interior Model; Child Anxiety |
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Children
experience higher anxiety than adults this is due to emotional differences
and mental development according to age, one of the efforts to overcome
anxiety is to provide dental health education using methods, media and models
of dental clinic rooms tailored to the needs of the child. In general, dental
clinic rooms have white and creepy shades. The interior model of the dental
clinic is made specifically to address the anxiety of the child at the time
of childcare. Research Objective: produce an interior model of dental clinics
as an alternative to child anxiety management. Research and Development
(R&D) method, and model test using quasi-experimental non
randomized control group pre-test and post-test design. Sampling techniques
with purposive sampling, the study subjects were children who performed
treatment at the dental clinic, divided into 2 groups of 20 children each,
group 1. intervention of dental clinic interior models with wall wallpapers
and acoustic videostimulions and 2. Media posters
and dental health counseling as a control group. Data tested with Wilcoxon
and Mann-whitney tests. The result shows
"Dental Clinic Interior Model"effective
as an alternative to child anxiety management is shown with a p-value value of
0.036. There is a difference in the effectiveness of the "dental clinic
interior model" with counseling and poster for child anxiety management
is shown with a p-value of 0.102. The test results are not paired with a
p-value of 0.036. Thus, "Dental Clinic
Interior Model" effectively lowers children's anxiety levels |
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Coresponden Author: Email: [email protected] Article with open access under license |
INTRODUCTION
Anxiety in
dental care is a major obstacle for the child when receiving dental care.
Children have limited communication skills and are less able to express their
fears and anxieties. Their behavior is a reflection of their inability to cope
with anxiety.(Sutela, Rahaswanti, & Weta, 2019), (Gupta, Marya, Bhatia, & Dahiya, 2014) The feeling
of anxiety experienced by the child is an instinct that arises according to the
development process, the difference in age is different as well as the
emotional development shown by the child. These feelings arise through
observations in the surrounding environment as well as strange and unpleasant
objects and the child tries to avoid them in an effort to protect themselves
from harm, this reason that can be made by the child not to do dental care.(Agustiyaningsih & Kustiningsih, 2017).
The
prevalence of anxiety in dental care worldwide reaches 6-15%, with variations
in different countries and in different sample populations. (Simon R, 2014)
Based on the survey by Al Sarheed, 16% of schoolchildren have feelings of
anxiety and even fear to go to the dental clinic.(SP, 2014),(Bunga’Allo, Lampus, & Gunawan, 2016) The results of the study in Indonesia 22% expressed fear and anxiety when
doing dental treatment bhkan before going to the clinic was already anxious.5
These feelings can be found in children in various dental care units such as in
dental clinics, health centers and in hospitals.(Bunga’Allo et al., 2016).
Research
conducted by Kartono and Sartono suggests that there are three factors that
influence anxiety: the sound of bur 81.46%, sitting in the dental chair 50.72%,
the needle 39.13%, the dental instrument 39.13% and the negative experience
story about dental care from others 33.33%.(Arlette Suzy Setiawan, Zidnia, & Sasmita, 2010) However, anxiety will decrease with age. (Shim, Kim, Jeon, & An, 2015).
The health of the
child's teeth and mouth, can be attempted by parents by inviting the child to
check to the dental clinic but in practice, the children are less cooperative in the treatment process
so dental health workers have difficulty to handle the child..These difficulties are not only related to the treatment process, but there
are also emotional differences between the child and the health workers. Fear
and anxiety are emotions often shown by the child during dental treatment.(Mittal & Sharma, 2012)
The
success of dental and oral health services in children is influenced by good
service facilities, so as to reduce children's anxiety while in dental care and
can increase children's trust in the services provided by dental health
workers.(Tanudjaya, 2014)
General
Purpose: Produce the interior model of the dental clinic as an Alternative to
Child Anxiety.
Based
on the background above, researchers intend to design a child-friendly dental
clinic interior model tailored to the child's age characteristics, using
perception stages for control with therapeutic communication, attention focus
using wall wallpaper media and mind therapy with acoustic stimulation videos. as
an attempt to decrease anxiety levels at the time of childcare treatment at the
dental clinic.
METHOD
The research
method used is Research and Development (R&D). This research aims to
produce innovative dental clinic models. The R&D method is a research
method used to produce new products or improve existing products and can be
answered the results(Sugiyono, 2017), (Sukmadinata, 2012)
Research and
Development (R&D) research is a mix-method research. The research
mix-method is a method of combining qualitative and quantitative approaches.
Research and development procedures include 5 main steps including: 1) information
collection, 2) product or model design, 3) expert validity and revision, 4)
trial of product or model and 5) product or model results.(Fatahilah, Rahayu, & Soekardi, 2017) Sampling technique
using purposive sampling with 2 intervention groups and control group of 20
children each.
A
child's anxiety can be measured by questionnaires, scales or degrees of varying
levels of validity and reliability. Questionnaires to be used are Modifed
dental axienty scale and Abeer Dental Children Axienty Scale.(Al-Namankany, Ashley, & Petrie, 2012), (Humphris, Morrison, & Lindsay, 1995) This questionnaire is a measurement of anxiety based on the appearance of
reactions in individuals who check into dental clinics.
A
child's anxiety can be measured by questionnaires, scales or degrees of varying
levels of validity and reliability. Questionnaires to be used are Modifed
dental axienty scale and Abeer Dental Children Axienty Scale.(Al-Namankany et al., 2012), (Humphris et al., 1995). This questionnaire is a measurement of anxiety based on the appearance of
reactions in individuals who check into dental clinics. Each item in
observation is given 5 levels of score as follows:
RESULT AND DISCUSSION
A. Information Collection
Dental
and Oral Health Services are conducted by providing Communication, Information
and Education (KIE) to parents and/or other family members in the form of:
counseling/counseling about the growth phase of the firstborn teeth and the
circumstances that accompany the process of teething and abnormalities/diseases
that often occur in children and teaching how to maintain the health of the child's
oral cavity before teething until the teeth of the series grow complete. The
involvement of parents and/or other family members must be actively carried out
in order to establish healthy behaviors and independence of toddlers and
preschool-aged children optimally in the maintenance and improvement of their
dental and oral health. The method is a persuasive and communicative direct
approach method, therapeutic communication, indirect communication with 2D and
3D media With the method of play, puppet play, in the gift
of giving care, can be by watching videos from visual media. Media used are: Praga tool that can be held, poster media, or 3D media that
can be seen by the child, audio visuals containing images that are of interest
to the child, Media posters, images, animated videos, puppet plays, so that the
child can distract him.
B.
Design model
The results of information collection are used
in the design of the interior model of the dental clinic as an alternative to
child anxiety management.
C.
Expert Validation
Table 1 Expert Validation Statistics Test
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Expert Validity |
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N |
f(%) |
P-Value |
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Relevant |
10 |
100 |
0.01 |
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Irrelavant |
0 |
0 |
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*intraclass
correlation coefficient
The
result of expert validation shows that the p-value = 0.001, which means that
D.
Trial Product
|
Group |
Paired t-test |
Unpaired t-test |
||||||
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n |
Mean |
SD |
p-value |
Δ Mean |
Sum of Rank |
p-value |
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Intervensi |
Pre |
20 |
2.20 |
0.410 |
0.020 |
17.80 |
356.00 |
0,036 |
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Post |
20 |
1.85 |
0,366 |
|||||
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control |
Pre |
20 |
2.35 |
0.489 |
0.102 |
23.20 |
464.00 |
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Post |
20 |
2.15 |
0.489 |
|||||
*Wilcoxon Test *Mann-Whitney Test
Statistical test results
of data pairing child anxiety intervention group p-value value is 0.020
(p<0.05) meaning the Dental Clinic Interior model effectively lowers child
anxiety.
The results showed that
there were differences between the intervention group and the control group
after being treated. The results of the data test did not show that the p-value
between intervention and control groups was 0.036 (p<0.05) meaning that
there were differences in the Interior model of ran dental clinics more
effective at lowering anxiety compared to dental clinics that were counseled
and given posters.
MODEL RESULTS

Before

After

Dental Clinic Interior Model manual
DISCUSSION
Efforts to lower children's anxiety
levels when dental care is needed is a special dental clinic interior model for
the child and one of the models in tackling anxiety in the child's dental and
oral care through innovation and development of the interior model of a
child-friendly dental clinic.
The process of validation of experts
is important in the development of useful models in health promotion activities.(Heri Setiawan, Adi, & Ulfah,
2017) The equipment required in
development research is the experts (ecpertist) who will be used as determining
the theory and validity of the model.
Based on the results of the study
there were some children who did not control back to the clinic in the intervention
group of the number of children who did not control as many as 3 children with
moderate anxiety criteria while in the control group as many as 2 children,
with moderate and severe anxiety criteria. This is influenced by lack of
knowledge, negative parental attitudes, time constraints, moving places of
residence, quality of health care, no family support.(Sihotang & Rahma, 2017)
The age of 5-12 years is a sensitive period
or sensitive period in the child, i.e. a period where a certain function needs
to be stimulated, directed so as not to be inhibited by development. This
period to perform the first basis in developing physical, cognitive, language,
social, emotional, self-concept, discipline, self-reliance and others.(Indraswari, 2012)
The decrease in anxiety caused by the
proper therapeutic communication process between health workers and child
patients means a lot to the success in childcare measures so that the
information conveyed is appropriate and does not cause anxiety.(Slamet & Sarwinanti, 2014)
The decrease in anxiety caused
because before the child is taken treatment is given the introduction of the
room first, visualize the waiting room with in the video of acoustic
stimulation and in ruangna action is carried out the introduction of an
attractive room for the child with a media wallpaper wall that has colors and
images that can educate the child to recognize and understand the mis health of
the teeth and how to maintain dental health with help by dental health workers.
So that the child's attitude can be formed by obtaining information, providing
feedback and actions after being given the information.(Siwiendrayanti, Pawenang, &
Indarjo, 2017) Therapy to overcome children's
anxiety can be done with non pharmacological therapy, with special vision,
sound and comfort in the room environment in the dental clinic can affect the
anxiety of the child at the time of dental treatment.(Savitri, 2018)
The success of the dental clinic
interior model is also seen from the decrease in child anxiety, because the
child is introduced to an attractive and child-friendly interior room model,
this is supported by previous research stating that Modelling wall wallpaper
and acoustic stimulation videos is a technique performed by utilizing the
child's vision to introduce a friendly room in the same way of experience, thus
reducing the anxiety of the child high.22, 23.
CONCLUSION
Dental Clinic Interior Model is
feasible as an alternative model to lower the level of child ness, This is
evidenced by the results of effectiveness test showing that the value of
p-value=0.036
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