JURNAL SURYA
Jurnal Media Komunikasi Ilmu Kesehatan Faculty of Health Sciences Universitas Muhammadiyah Lamongan Volume 17 Issue 2 2025 e-ISSN: 2715-064X p-ISSN: 1979-9128 The Relationship Between Nurse Caring and Anxiety Levels in Preschool Children During Hospitalization in the Pediatric Ward Mei Widyawati* .
Tiara Putri Ryan Dini.
Lukman Hakim.
Hyan Oktodia Basuki.
Nurhadi and Niswatul Khalimah Nursing Program.
Institut Ilmu Kesehatan Nahdlatul Ulama.
Tuban.
East Java.
Indonesia
ARTICLE INFORMATION
ABSTRACT
Article process Submission: June 5, 2025 Revision : August 27, 2025 Accepted : September 18, 2025 Introduction: Pre-school children often find the experience of being cared for in a hospital to be frightening.
Which can increase their anxiety.
The purpose of this study was to determine the relationship between nursing care and anxiety levels in preschool children during hospitalization in the pediatric ward.
Co-Author Mei Widyawati widyawatimei92@gmail.
Nursing Program.
Institut Ilmu Kesehatan Nahdlatul Ulama.
Tuban.
East Java.
Indonesia Methods: This study uses a non-experimental analytical design with a cross-sectional approach.
The sample of this study consisted of all parents of preschool children who were hospitalized in the pediatric room in February-March 2025, totaling 56 respondents.
By using accidental sampling technique and data analysis was carried out using the sperm rank test.
The Cite this as:
instrument used to measure nurses' caring behavior is the Nurse Widyawati.
Dini.
Caring Questionnaire, while the Spence Children Anxiety Scale Hakim.
Basuki.
arent repor.
questionnaire is used to measure children's Nurhadi.
, & Khalimah.
anxiety levels.
The Relationship Between Nurse Caring and Results: The Spearman correlation test indicated a significant Anxiety Levels in Preschool relationship between nurse caring and the anxiety levels of Children During Hospitalization preschool-aged children during hospitalization with pvalue = in the Pediatric Ward.
SURYA: 0,002 .
<0,.
The negative, indicates that this relationship is Media Komunikasi Ilmu statistically significant.
The negative correlation coefficient (Kesehatan, 17 .
, 103-109.
indicates a negative relationship or an opposite between https://doi.
org/10.
38040/js.
v17i2 the child's level of anxiety and the caregiver's level of care.
other words, the more caring that nurses provide, the more anxiety that pre-school children experience.
Conclusion: The research findings indicate that nurses' caring is very important in reducing preschool children's anxiety during Therefore, nurses need to improve the quality of their caring holistically, both thru direct interaction and by participating in special training programs.
Keywords: Anxiety Level.
Caring nurse.
Hospitalization.
Pre School Children https://jurnal.
id/index.
php/Js INTRODUCTION Preschool children are children aged 3-6 years, which is a continuation phase of the growth and development of toddler-aged children.
Preschool-aged children often see the experience of hospitalization as something They still have difficulty distinguishing between imagination and reality, often thinking that hospital care is a form of punishment for their behavior.
Staying in a hospital or being hospitalized is an experience that often causes anxiety in preschool children.
This condition can cause children to feel a loss of control, experience trauma, and react negatively, such as crying, refusing care, or becoming easily irritable (Wulandari & Eriyanti, 2.
Additionally, limitations on physical activity during treatment can also increase a child's anxiety levels (Fitryasari et al.
, 2.
This anxiety is influenced by various factors, including the unfamiliar environment and interactions with healthcare professionals, especially nurses.
Therefore, this study focuses on the relationship between nurses' caring as one of the main factors that can influence children's experiences and the level of anxiety experienced by preschool children during treatment in the Pediatric Ward.
The impact will be direct on the child, and psychologically, the child will feel behavioral changes from the family, especially the parents who accompany them during the treatment (Nursalam, 2.
Based WHO (World Health Organizatio.
data from 2020, 4%-12% of pediatric patients hospitalized in the United States experience stress during hospitalization.
About 3%-6% of school-aged children hospitalized in Germany also experience similar issues, and 4%-10% of children hospitalized in Canada and New Zealand also show signs of stress during hospitalization (WHO, 2.
The morbidity rate among children in Indonesia reaches more than 58% of the total child population in Indonesia https://jurnal.
id/index.
php/Js (Ministry of Health of the Republic of Indonesia, 2.
Thus, there was an increase in hospitalizations among children according to data from the Central Statistics Agency (BPS) in 2020, with the number of inpatient admissions or hospitalizations for children in Indonesia rising by 19% compared to 2019 (Central Statistics Agency, 2.
Children can cause tension and fear that affect the healing of diseases.
In the initial survey conducted by the researchers through direct observation of pediatric patients in September, 10 pediatric patients were found.
There were 3 children who appeared fussy and restless, 3 children who were afraid of healthcare workers, especially nurses, and some who cried and said they wanted to go home.
And there are also those who refuse when medical procedures are Staying in a hospital or being hospitalized is an experience that often causes anxiety in preschool children.
This condition can cause children to feel a loss of control, experience trauma, and react negatively, such as crying, refusing care, or becoming easily irritable (Wulandari & Erawati, 2.
Additionally, limitations on physical activity during treatment can also increase a child's anxiety levels (Alfiyanti, 2.
This anxiety is influenced by various factors, including the unfamiliar environment and interactions with healthcare professionals, especially nurses.
Therefore, this study focuses on the relationship between nurses' caring as one of the main factors that can influence children's experiences and the level of anxiety experienced by preschool children during Pediatric Ward.
Hospitalization is often a traumatic experience for preschoolers, triggering anxiety in them.
This condition occurs due to separation from parents and familiar environments, as well as fear of medical procedures and pain (Faidah & Marchelina, 2.
Children at this age are very sensitive to changes in routine and unfamiliar environments, which can worsen their anxiety (Pratiwi, 2.
If this anxiety is not addressed, its impact can extend to disorders(Rahmania, 2.
Considering that nurses are the healthcare professionals who most frequently interact directly with patients, their behavior has a significant influence on a child's psychological condition during Therefore, it is important to identify how the interaction between nurses and children can affect anxiety levels (Qomariah.
As the front line in healthcare, nurses have a great responsibility not only to meet patients' physical needs but also their psychological One effective approach is to implement caring behavior, which is a professional attitude based on attention, empathy, and concern for patients (Potter & Perry, 2.
This caring behavior has been proven to reduce anxiety in preschool children (Blais.
By providing emotional support, creating a comfortable environment, and using therapeutic communication, nurses can help children feel safer and more comfortable during hospitalization (Dewi, 2.
Based on the urgency of this issue, this study aims to determine the relationship between nurses' caring and the level of anxiety in preschool children during hospitalization in the Pediatric Ward.
selected based on inclusion and exclusion Inclusion criteria included parents of patients whose children were admitted to the Pediatric Ward, had the ability to read and write, and were willing to participate as Meanwhile, exclusion criteria included parents of patients who refused to participate in the study and parents of patients whose children were undergoing treatment in the intensive care unit (ICU).
The respondents in this study were some of the parents of pediatric patients admitted to the Pediatric Ward, with a total of 56 people.
The research sample was selected based on inclusion and exclusion criteria.
Inclusion criteria included parents of patients whose children were admitted to the Pediatric Ward, had the ability to read and write, and were willing to participate as respondents.
Meanwhile, exclusion criteria included parents of patients who refused to participate in the study and parents of patients whose children were undergoing treatment in the intensive care unit (ICU).
The instrument used to measure nurses' caring behavior in this study was a questionnaire developed by Dr Kusnanto.
Kep.
Kes.
(Kusnanto, 2.
and the Spence Children Anxiety Scale (Parent Repor.
Questionnaire, with a total of 15
Analysis was conducted using the Spearmen rank correlation test
METHOD
RESULTS
The research design used in this study was non-experimental correlation analytic using a cross sectional approach.
The sample population of this study were parents of pediatric patients in the Paediatrics Room, namely 65 people during February to March Sampling technique in this study using non-probability sampling technique with AoAccidental samplingAo.
The respondents in this study were all parents of pediatric patients admitted to the Pediatric Ward during the period from February to March 2025, with a total of 65 people.
The research sample was Based on table 1 shows that 56 .
%) of respondents mostly 32 .
1%) were female and almost half were male 24 .
9%).
%) respondents almost half 18 .
1%) were 3 years old.
%) respondents almost half of them 19 .
9%) had a length of hospitalisation of 3 days.
%) respondents in can care for nurses well with a frequency of 28 .
0%).
%) respondents, almost half of whom experienced a severe level of anxiety, 20 .
7%).
https://jurnal.
id/index.
php/Js Based on table 6 shows that the level of moderate anxiety is mostly obtained by pediatric patients treated in the pediatrics room who get good caring behaviour with a value of 13 .
3%), while the level of severe child anxiety is mostly obtained by pediatric patients treated in the pediatrics who get enough nurse caring behaviour with a value of 8 .
3%).
DISCUSSION
Nurse Caring Based on research conducted by researchers, most respondents get good nurse caring As caring nurses are obtained through the approach to nursing care provided by nurses to clients through sympathy and Therefore, the better the nurse's caring behaviour, the more positive the impact on the patient.
Caring behavior is the core of nursing care, focusing on the therapeutic relationship between nurses and patients.
According to Jean Watson's theory, caring is an attitude of concern, respect, and appreciation for others, reflected in actions and attention given (Watson in Trisusanti.
, et al.
Similarly.
Kristen Swanson defines caring through five processes: maintaining belief .
aintaining the patient's belief.
, knowing .
eeply understanding the patient's situatio.
, being with .
hysically and emotionally presen.
, doing for .
aking actions needed by the patien.
, and enabling .
acilitating the patient's recovery proces.
(Swanson in Rahmawati.
, and I.
Puspitasari, 2.
Both theories emphasize that caring is not just a physical action, but also an interpersonal, emotional, and spiritual interaction aimed at creating a sense of security, peace, and comfort for the patient.
Field evidence shows that caring behavior has a significant impact on patients, not only increasing satisfaction but also reducing Previous research by Ridya Listiana https://jurnal.
id/index.
php/Js .
showed that the majority of respondents .
7%) rated nurses' caring behavior as quite good.
This finding aligns with other studies that suggest that nurses' caring, manifested through sympathy, empathy, and therapeutic communication, can accelerate the patient's healing process (Siswanti, 2.
and provide necessary support for patients and their families (Dwi et , 2.
This demonstrates that caring focuses not only on clinical tasks but also on the overall process of providing reassurance and sincerity, which are the primary motivations for nurses in providing optimal care (Fitryasari et al.
, 2.
Tabel 1.
Frequency demograpic data Demographic Data Gender Category Male Female Total Age 2 years 3 years 4 years 5 years 6 years Total Length of Hospitalization 1 Day 2 Day 3 Day 4 Day 5 Day Total Caring Nurse Good Sufficiet Less Total Mild Anxiety Levels in Moderate Children Severe Panic Total Table 2.
Cross-Table of the Relationship between Nurse Caring and Anxiety Levels in Preschool Children During Hospitalization in the Pediatric Ward in 2025 Anxiety Level in Children Caring Nurse Total Mild Moderate Severe Panic Less .
Sufficiet .
Good .
Spearman rank statistical test results sig .
-taile.
Based on the results of this study, it was found that the majority of respondents rated the nurses' caring behavior as good.
This is evidenced by the positive responses to 18 questionnaire items, indicating that nurses in the Pediatric Ward have made every effort to provide caring and empathetic care.
In my opinion, this finding is very important because it reinforces the idea that nurses play a vital role in creating a conducive environment for pediatric patients.
The better the caring behavior demonstrated by nurses, the greater the positive impact on the child's physical and well-being.
Therefore, improving the quality of caring should be a continuous priority in nursing services.
Anxiety levels in pre-school children during The results of this study indicate that out of a total of 56 respondents .
%), almost half, or 20 respondents .
7%), experienced a severe level of anxiety.
The results of this study indicate that the level of anxiety in preschool children during hospitalization tends to be in the mild to moderate category.
Out of 56 respondents, almost half .
7%) showed symptoms of anxiety, such as fear when in the treatment room and screaming when approached by This finding aligns with previous research by R.
Pitun & G.
Budiyati https://jurnal.
id/index.
php/Js Total , where the majority of respondents .
%) did not experience anxiety, but nearly half experienced mild .
5%) and moderate .
5%) anxiety.
The results of this study indicate that anxiety is a relevant issue, although its severity level is not always high.
Anxiety is a common emotional response experienced by preschool children during hospitalization, especially if the treatment is sudden or unplanned.
This anxiety is a subjective experience that is difficult to observe directly, but can be recognized thru changes in a child's behavior (Stuart, 2.
According to theory, anxiety in children arises from a feeling of not having a specific object, such as a fear of the unknown.
Suboptimal interaction with nurses, or a lack of caring, tends to be a trigger for anxiety in children during hospital stays.
Based on the results of this study, it can be concluded that nurses' caring behavior plays a crucial role in reducing anxiety.
The facts found thru the questionnaire show that questions related to children's responses to "less than good" nursing actions are often answered by respondents as a cause of anxiety.
In my opinion, these results confirm that the caring approach is not just a professional duty, but also a highly effective therapeutic Nurses who can demonstrate empathy, good communication, and full attention can help children feel safer and reduce their fears, thereby optimizing the recovery process.
nurses also has a big contribution in frequent anxiety in pre-school children.
The Relationship between Caring Nurses and Anxiety L evels in Pre-school Children During Hospitalisation The results of the research conducted by the researcher showed that the level of moderate anxiety is mostly experienced by pediatric patients treated in the pediatrics room who receive good caring behavior, with a value of 13 .
3%).
Severe child anxiety is mostly experienced by pediatric patients treated in the pediatrics room who receive sufficient nurse caring behavior, with a value of 8 .
3%).
The relationship between caring nurses and anxiety levels in pre-school children during hospitalisation in the pediatrics room based on the Spearman Rank test with a significance level of = <0.
05 using SPSS ver.
25 for windows obtained the results of the Asymp sig value .
-side.
= 0.
002 which means that the greater the value of A = 0.
02 <0.
H1 is The correlation coefficient value obtained the result r = 0.
401 which means that the strength of the relationship between the two variables is a fairly strong category.
This shows that there is a relationship between caring nurses and anxiety levels in pre-school children during hospitalisation in the pediatrics room at RSNU Tuban.
In accordance with the theory (Kaplan and Sadock, 1.
, that affect the level of anxiety include: age, gender, education level, socioeconomic level, length of care and caring In relation to anxiety in pre-school children, of these factors that most influence the level of anxiety in pre-school children is the caring behaviour of nurses.
Positive caring behaviour will also have a positive impact on patients and their families and vice versa.
From the results of the study in the pediatrics , it was concluded that the lack of caring behaviour of nurses mostly resulted in anxiety that was still felt by 20 .
So that the caring behaviour of CONCLUSION https://jurnal.
id/index.
php/Js Based on the summary of research findings titled "The Relationship between Nurses' Caring Behavior and Anxiety Levels in Preschool Children During Hospitalization in the Pediatric Ward," it can be concluded that this study aims to analyze the relationship between nurses' caring behavior and the anxiety levels experienced by preschool children during treatment in the pediatric inpatient ward.
The research results show that the nurses' caring behavior in that room was rated as good by half of the respondents.
However, an interesting fact is that almost half of the children studied actually experienced severe levels of anxiety.
This finding confirms a significant relationship between the two variables, meaning that nurses' caring has a crucial role in influencing children's emotional The results of this study have significant implications for nursing practice.
Although the majority of nurses are considered to have good caring behavior, the high rate of severe anxiety in children indicates that existing approaches are still not fully effective in addressing Therefore, improvements are needed in nursing care practices.
REFERENCES