Jurnal Keperawatan Indonesia, 2024, 27 .
, 107Ae117 DOI: 10.
7454/jki.
Received November 2023.
Accepted July 2024
A JKI 2024
pISSN 1410-4490.
eISSN 2354-9203 Traditional Art Dance Therapy to Reduce Stress Levels of Elementary School Students Shinta Restu Wibawa1* .
Christantie Effendy1 .
Heny Suseani Pangastuti1 .
Ami Novianti Subagya2 .
Eriyono Budi Wijoyo3 .
Aisya Puteri Andari4 .
Dwi Apriliana4 .
Qurrota Aini Zahrotu Sholikhah4 Department of Medical Surgical Nursing.
Universitas Gadjah Mada.
Yogyakarta 55281.
Indonesia Department of Child and Maternity Nursing.
Universitas Gadjah Mada.
Yogyakarta 55281.
Indonesia Nursing Department.
Universitas Muhammadiyah Tangerang.
Tangerang 15118.
Indonesia Nursing Science Study Program.
Universitas Gadjah Mada.
Yogyakarta 55281.
Indonesia *E-mail: shinta.
w@mail.
Abstract COVID-19 pandemic has accelerated the development of new learning systems that are more student-centered.
Unfortunately, elementary school students experienced stress and difficulties in adapting from face-to-face to online learning system.
Online learning environment lacks in accommodating outdoor activities which are important for children.
Several techniques can be applied to reduce stress, including dancing.
This research aimed to examine the effectiveness of Traditional Art dance Therapy (TATA) for elementary school students in reducing stress.
In this quasi-experimental research, one-group pretest-posttest design without control group was applied, involving 84 students at one elementary school in Yogyakarta .
Indonesia.
StudentsAo levels of stress were measured using the school-based stressors scale and were analyzed using bivariate Wilcoxon test.
The results of the data analysis showed that older students had relatively lower stress levels than younger ones.
A significant decrease in stress .
< 0.
90 to 41.
99 was identified between the stress levels before and after the implementation of TATA.
It concludes that TATA effectively reduces the stress levels among elementary school students adapting to the new learning system in the new normal era after COVID-19 Keywords: elementary school, stress, traditional art dance therapy Abstrak Terapi Tari Seni Tradisional (TATA) untuk Mengurangi Tingkat Stress pada Siswa Sekolah Dasar.
Pandemi COVID19 telah mempercepat pengembangan sistem pembelajaran baru yang lebih berpusat pada siswa.
Sayangnya, siswa sekolah dasar mengalami stres dan kesulitan dalam beradaptasi dari sistem pembelajaran tatap muka ke sistem pembelajaran online.
Lingkungan belajar online kurang mengakomodasi kegiatan di luar ruangan yang penting bagi anak-anak.
Beberapa teknik dapat diterapkan untuk mengurangi stres, termasuk menari .
Penelitian ini bertujuan untuk mengetahui efektivitas Terapi Tari Seni Tradisional (TATA) untuk siswa sekolah dasar dalam mengurangi stres.
Penelitian ini merupakan penelitian quasi-experimental dengan desain pretest-posttest satu kelompok tanpa control grup.
Delapan puluh empat siswa di salah satu sekolah dasar di Yogyakarta.
Indonesia , berpartisipasi dalam penelitian ini.
Tingkat stres diukur dengan menggunakan school-based stressors scale.
Data dianalisis secara bivariate menggunakan uji Wilcoxon.
Siswa yang berusia lebih tua dilaporkan memiliki tingkat stres yang relatif lebih rendah dibandingkan siswa yang berusia lebih muda.
Terdapat penurunan stress yang signifikan .
< 0,.
antara tingkat stres pada siswa sebelum dan sesudah terapi tari seni tradisional, dengan tingkat stres dari 61,90 menjadi 41,99.
Terapi tari seni tradisional (TATA) efektif menurunkan tingkat stres pada siswa sekolah dasar yang mengalami perubahan sistem pembelajaran di era new normal.
Kata Kunci: sekolah dasar, stres, terapi tari seni tradisional Introduction mic has revolutionized the school learning system through the implementation of online learning.
In higher education, this situation has dis- The new normal era after the COVID-19 pande107 Wibawa, et al.
Traditional Art Dance Therapy to Reduce Stress Levels of Elementary School Students JKI.
Vol.
27 No.
July, 107Ae117 rupted the three principles of higher education known as Tri Darma Perguruan Tinggi with the shift from face-to-face activities to online activities (Indrawati, 2.
The shift appears as a challenge for all humans, especially educators, students, and even parents (Husein, 2.
Information technology limitations hinder both teachers and students from effectively using online media, especially when both groups face similar challenges in understanding technology Furthermore, self-assessment cannot be effectively conducted, and the exploration of studentsAo skills and talents becomes less effective (Sari et al.
, 2.
Such situation does not only pose academic problems, but also triggers psychological impacts as students need to deal with the difficulties in using online media and inadequate social relations with their peers (Palupi, 2.
peer interaction, limited learning method, and small study space at home (Palupi, 2.
These conditions can cause weariness, depersonalization, and low self-efficacy, resulting into emotions of laziness, discouragement, apathy, impatience, truancy, and neglect of learning activities (Lindasari et al.
, 2021.
Rifai & Triyono.
Stress in children needs proper therapy (Malhotra & Sahoo, 2.
Stress management allows children to have stronger focus, concentration, and ability to effectively comprehend various information.
Strong learning concentration will boost student achievement (Kintari & Yahya, 2.
which can be enhanced using group counselling services, brain gyms, quantum learning, and relaxation (Wirmayani & Supriyadi, 2.
It is necessary to find solution to the burden that students experience due to the shift in the learning system (Wirmayani & Supriyadi, 2.
Students may have physical and psychological health issues from the feeling of pressure and subjected to certain demands (Kintari & Yahya, 2.
, including anxiety, stress, and depression.
While in online learning, elementary school children often experience significant stress.
According to Kintari and Yahya .
, older students in grades 4Ae5 have an average stress level of 79, while younger students in grades 1Ae3 have an average stress level of 29.
Erik Erikson's Theory of Psychosocial Development describes the industry versus inferiority stage, which occurs during elementary school years.
In this stage, children begin to develop a sense of competence and mastery through new experiences and relationships.
this stage, children learn from their environment and will be capable of exploring new skills (Issawi & Dauphin, 2.
Given the importance of fostering a strong connection with the environment, support from teachers and parents, along with social interaction with friends, is essential in addressing feelings of inferiority (Mokalu & Boangmanalu, 2.
, which cannot be adequately addressed in an online setting.
Online learning has been known to trigger symptoms of stress in elementary school students that include: .
emotional symptoms such as irritability, difficulty concentrating, and mood .
cognitive symptoms such as lack of attention and fear of failure.
physical symptoms such as sleep disturbances and decreased appetite.
In 1987.
Jacobsson established and refined relaxation as a behavioral therapy to reduce tension and anxiety since all forms of tension, including mental strain, are created by muscle contractions (Mulyani, 2.
When experiencing stress or worry, relaxation lowers the physiological responses, resulting in a more relaxed body and a more tranquil state of mind (Georgios et al.
, 2.
Relaxation can be achieved by extracurricular or non-learning-related activities (Nugraha & Sari, 2.
Extracurricular activities are beneficial for building disciplined character, cultivating artistic and athletic talents and hobbies, and enhancing academic performance (Abdullah et al.
, 2014.
Monteiro et al.
, 2.
As an extracurricular activity.
The stress experienced by students in the new normal period may result from tight learning schedule with relatively short break between subjects or courses, excessive workload, lack of Wibawa, et al.
Traditional Art Dance Therapy to Reduce Stress Levels of Elementary School Students JKI.
Vol.
27 No.
July, 107Ae117 dancing allows children to interpret body motions, perform multiple movements, and balance the body and mind (Salo, 2.
The dancing extracurricular activity can be offered in the forms of traditional dance or traditional art and depression (Abdullah et al.
, 2014.
Nugraha & Sari, 2.
According to Rahmawati et al.
, dance therapy is useful to increase studentsAo cognition, affection, and self-efficacy, as well as overcoming emotional problems or pressures.
In this research.
Traditional Art dance Therapy (TATA) was created by the first author .
s a nurse and dance creato.
to address stress among elementary school children.
TATA has been registered to the Directorate General of Intellectual Property - Ministry of Law and Hu-man Rights of the Republic of Indonesia with number EC00 Dance therapy can be utilized as a non-pharmaceutical therapy to assist overcome emotional problems as it enhances the circulation of oxygen in the blood to the muscles and brain, hence stimulating the release of endorphins (Fares et , 2.
Students taught using traditional dance-based learning methods have a higher quality of life than those educated with learning methods that only focus on the educational curriculum.
It is because traditional dance-based learning methods can help students find new knowledge that has a significant impact on physical fitness, self-confidence, relationships, and social activities, as well as fostering a more positive environment (Georgios et al.
, 2.
Additionally, combining art dance with Javanese gamelan music featuring pelog, a heptatonic tuning employed for Javanese gamelans with unequal intervals that form various pentatonic scales, has been demonstrated to decrease stress Methods This research was conducted in November 2022 in a quasi-experimental method using pre-test and post-test, without a control group, involveing 84 .
%) students at one of elementary school in Yogyakarta.
Indonesia.
This research employed a total sampling method, excluding students who had trouble concentrating.
Two out of 86 participants were disqualified for not meeting the criteria.
The inclusion criteria requir- Figure 1.
Steps of Traditional Art Dance Therapy Movements Wibawa, et al.
Traditional Art Dance Therapy to Reduce Stress Levels of Elementary School Students JKI.
Vol.
27 No.
July, 107Ae117 ed students to be able to hear, move actively, and have no mobility problems.
The school-based stressors scale (Monteiro et al.
, 2.
was used as a questionnaire to measure the stress levels of the students.
Descriptive analysis was performed to explore the demographic characteristics of the respondents, including percentage, mean, and standard deviation (SD).
The effectiveness of the TATA in reducing stress was analyzed using the Wilcoxon test.
The validity value of the instrument is 0.
3, and its reliability nal dance teachers, and nurses.
Trials were carried out with 10 children once a day for a week with a duration of six minutes.
The trial results showed that 9 out of 10 children considered the dance easy, fun, interesting, and relaxing.
also increased their enthusiasm for learning and motivated other children to participate in the Results There were 84 .
%) elementary school students who met the criteria and agreed to participate in the research.
The participants' mean age was .
76A1.
years old.
Stress in children during the transition from offline to online learning might be triggered by multiple factors, such as age .
ounger children tend to have much higher stress score.
, sex .
emale children tend to have higher stres.
, birth order .
iddle children tend to experience less happiness, whereas youngest children have greater resilienc.
, sleep schedule .
hildren start sleeping at 9 PM have relatively higher levels of stres.
, and parentsAo profession .
hildren whose parents are self-employed tend to have higher stress levels than children of office worker.
(Table .
Participants completed 31 questionnaires on a scale where a score of 1 indicated the least disturbance or influence, and a score of 3 indicated the most disturbance or influence.
Therapy sessions were conducted in five large groups and divided into three stages.
In the first phase, students received 10 minutes of instructions.
the second phase, they spent another 10 minutes completing a pre-test to assess their stress levels.
In the third phase, they received a 30minute therapy, including opening activities, warm-ups, core treatment, and closing exercises.
Each therapy session lasted for 50 minutes.
This therapy was administered once a week over a span of three weeks.
In carrying out the therapy, the researcher was assisted by 3 research assistants as role models who also helped with the collection of the filled-out questionnaire.
The research was conducted with strong compliance to research ethics and respect to participantsAo rights, welfare, fairness and approval through informed consent.
This research and writing of manuscripts have been approved by the Ethics Commissions of Faculty Medicine.
Public Health, and Nursing under number KE/FK/1043/EC/2022.
The academic domain was found to contribute the least to stress in school-aged children, whereas peer interaction showed the greatest contribution.
In the academic context, elementary school students experience distress when they are unable to complete schoolwork due to peer Moreover, they feel stressed when they receive harsh words from peers, being teased, and when the teacher sends negative reports to their parents.
Impact of Intervention.
As shown in Table 2, younger children, female, being 1stAe3rd child in the family, parents who work at home, and sleep before 9 PM have considerably greater stress scores.
Meanwhile.
Table 3 presents the stress levels before and after TATA intervention according to their grades.
The post-test was carried out after the intervention had been completed.
The traditional art dance practiced combined a variety of Yogyakarta-style dance movements which originally created by the Shinta Art Dance Studio (Figure .
This traditional art dance was developed by the first author who has experience both as a nurse and a traditional dancer.
The dance then evaluated by expert traditional music composers, psychologists, traditio110 Wibawa, et al.
Traditional Art Dance Therapy to Reduce Stress Levels of Elementary School Students JKI.
Vol.
27 No.
July, 107Ae117 Table 1.
Description of Participant Demographics Demographic Characteristic Ages 7 years old 8 years old 9 years old 10 years old 11 years old 12 years old 13 years old Sex Male Female Position in the family 1st child 2nd child 3rd child 4th child 5th child Parent profession Self-employed Manual worker Homemaker Officer Farmer Civil servant Doctor Sleep schedule 19:00 WIB 20:00 WIB 21:00 WIB 22:00 WIB 23:00 WIB 00:00 WIB n (%) 6 .
Discussion liness from the lack of social interaction.
Stress in students during the pandemic can also be caused by issues that occur between students and teachers which can trigger tension, lack of family attention, poor eating patterns, lack of sleep, and poor stress management (Yasmin et , 2.
ParticipantAos Characteristics.
Before the intervention, participants experienced significant stress during the new normal era with an average stress score of 61.
As Palupi .
explained, during the COVID-19 pandemic, elementary school students were prone to experiencing stress.
Jatira and Neviyarni .
also added that the learning process during the COVID-19 pandemic caused students to experience higher stress and reluctance to learning.
Maunula et al.
asserted that stress in elementary school students during the pandemic was caused by sudden changes in the learning process which put pressure on children, boredom from limited daily activities and lone- Stress Levels Before and After TATA Intervention.
In general, this research found that all participants had relatively higher levels of stress based on the results of the pre-test.
After given traditional art dance therapy three times, the stress levels of students from all classes were decreased.
Based on the results of the pretest and post-test in Table 2, 1st grade students had a relatively higher stress level compared to Wibawa, et al.
Traditional Art Dance Therapy to Reduce Stress Levels of Elementary School Students JKI.
Vol.
27 No.
July, 107Ae117 Table 2.
The Demographic of Stress Levels Stress Score Before the Intervention MeanASD Min-Max Demographic Ages 7Ae10 years old 11Ae13 years old Sex Male Female Position in the family 1st Ae 3rd child 4th Ae 5th child Parent profession Self-employed Manual worker Homemaker Officer Farmer Civil servant Doctor Sleep schedule 19:00 Ae 21:00 WIB 22:00 Ae 00:00 WIB 60A5.
81A8.
55Ae75 46Ae69 27A9.
59A8.
41Ae80 39Ae75 47A9.
41A4.
42Ae76 57Ae65 76A10.
46A9.
50A4.
41A9.
17A6.
39Ae74 41Ae73 59Ae75 41Ae76 55Ae80 34A9.
23A11.
43Ae75 42Ae71 Table 3.
Participants' Stress Levels .
efore and after TATA Interventio.
Grade n (%) Total 8 .
Pre-test*(Before TATA) MeanASD MinAeMax 75A0.
71Ae80 88A0.
60Ae76 45A1.
41Ae71 14A1.
46Ae66 21A2.
39Ae71 77A1.
53Ae71 90A9.
39Ae80 Post-test*(After TATA) MeanASD Min-Max 13A1.
50Ae60 29A0.
47Ae55 50A1.
31Ae52 86A1.
31Ae41 71A0.
31Ae41 31A0.
33Ae41 99A8.
31Ae60 Effect Size < 0.
* Min.
total score = 31.
Max.
total score = 39.
1 = not disturbing.
2 = slightly disturbing.
3 = very disturbing students from other classes, while the 5th graders had a relatively lower stress level.
The gap could occur as older children have developed better the behavioral, cognitive, and emotional strategies as well as more effective stress coping strategy (Monteiro et al.
, 2.
Based on the results of the Wilcoxon test, the probability value of sig.
-taile.
< 0.
indicates the presence of a significant difference in the pre-test results compared to the post-test In addition, there is a very large difference between the pre-test and post-test results (Cohen's d = 2.
Scientific Concept Related to Art Dance.
The designed choreography for the dance comprises of seven primary movements that accommodate muscle stretching and relaxation.
This combination of stretching exercises has been shown to reduce stress levels, boost learning motivation, and decrease student tiredness (Hastuti & Kurnia, 2.
This can be done by performing extension, rotation, slight adduction flexion, followed by extension and slight hyperextension.
The initial movement is stretching the left hand.
Wibawa, et al.
Traditional Art Dance Therapy to Reduce Stress Levels of Elementary School Students JKI.
Vol.
27 No.
July, 107Ae117 followed by wrist and finger flick called ngithing for three times-eight counts.
This exercise focuses on the motor abilities of the hands, wrists, fingers, and the biceps and triceps of the hands through a combination of stretching and a variety of Yogyakarta dances, specifically The stimulation of motor skills in the arms and hands stimulates the blood flow to the brain that balances the right and left brain.
This movement also activates the memory for clearer mind and creativity.
The second movement is intended to emphasize hand motor skills and foot motor skills.
This movement consists of nylekenthing the toes or toes movement, stretching the hands, and ngithing or flicking the wrists and fingers for a total of 4x8 counts.
Each hand is kept in the certain position to allow the foot motor exercise reduce blood pressure and maintain a normal heart rate (Sonhaji, 2.
The third movement seeks to calm breathing by coordinating slow circular movements with alternate inhalations and exhalations.
Both the right and left hands are extended upwards, then the wrists and fingers are extended straight up to create the ngruji dance variety with a period of 4x8 counts, and then gently rotated.
Breath relaxation promotes alveolar ventilation, maintain oxygen exchange in the lungs, decreases muscle tension, and facilitates oxygen transfer to the brain to induce a state of calm and relaxation (Auliya & Yudiarso, 2.
Besides, breath relaxation can help lessen levels of anxiety (Wulandari & Wahyuningsih, 2.
relaxation technique, which involves tensing and then relaxing the muscles to minimize muscle tension, muscle soreness, improve fitness, and enhance oxygen flow (Wulandari & Wahyuningsih, 2.
Repetition and regularity of this progressive muscle relaxation technique can also reduce stress levels.
This relaxation will decrease the activity of the sympathetic nerves and stimulate the parasympathetic nerves to control the adrenocorticotropic hormones and the adrenal glands to lower the release of Lower adrenaline hormone eliminates the feelings of wrath, worry, fear, and tension, allowing the body to rest (Ilmi et al.
The seventh movement is body standing with legs crossed and toes up, while two hands are extended towards the lower body, the wrists and fingers make various ngithing dances.
This movement is followed by 4x8 counts of leaping forward and backwards, each four times.
In the movement, the legs are stretched to alleviate muscle tension caused by exhaustion after long activities or long duration of sitting.
Stretching the leg muscles will stimulate the back and neck muscles, which will induce a sense of peace and relaxation to lower the stress levels.
Traditional art dance has been useful in lowering stress in primary school-aged children, according to this research.
In this research, the average stress score has decreased from 61.
99 after the intervention of traditional art dance therapy which was delivered once a day for 3 days a week.
The results of this research align with Bryuninger .
who found that dance therapy effectively reduces both shortterm and long-term psychological stress and improves stress management.
Dance therapy, which uses a psychodynamic approach combining directive and non-directive leadership as well as interpersonal approaches, can enhance quality of life, improve coping mechanisms, and reduce stress levels.
Badave et al.
explained that art dance therapy also significantly reduces the tension and anxiety.
Kella et .
revealed that dance movement-based treatment can help lessen both physiological and psychological symptoms of depression.
The fourth movement is performed by bending the right and left hands in front of the chest, then followed by the wrists and fingers of the hands facing down to form a variety of worship dances with a duration of 3x8 counts.
Meanwhile the body movement is to sit with the right leg bent and the knee up, and left leg with knee flat on the floor.
This movement is similar to squat and called sitting jengkeng which aimed to train focus and relaxation.
The fifth and sixth movements are designed to relax the back and The sixth movement is a blend of the ngithing, ngayang, and ogek lambung dances.
This exercise is part of the progressive muscle Wibawa, et al.
Traditional Art Dance Therapy to Reduce Stress Levels of Elementary School Students JKI.
Vol.
27 No.
July, 107Ae117 Azizah and Tondok .
showed that art dance therapy may be implemented for children to adults and has shown successful in improving health and helping to deal with psychological problems such as schizophrenia, depression, stress, quality of life, eating disorders, and emotional disorders.
levels of stress.
Children of mothers who are overburdened with household tasks with no time for relaxation or self-care more likely to exhibit behavioural issues (Friedman, 2.
Art dance therapy is effective in reducing academic stress and helping to overcome personal problems as a coping strategy.
It increases selfefficacy, provides social support, addresses mood and emotional problems, enhances spirituality, assists the cognitive system, stimulates imagination, and facilitates easier adaptation to the environment (Rahmawati et al.
, 2018.
Valarmathi et al.
, 2.
In a different research, dance therapy had a favourable effect because dance motions are effective at reducing students' stress levels (Masruroh & Nugroho, 2.
Dance is a fundamental art form that expresses ideas through bodily movements.
Dance is transformed into an effective therapy for expressing one another's emotions and providing support.
It is considered that movement in dance allows the creation of creative ideas, releases the stress and cheers up the children (Rasman & Nurdian.
According to Filippou et al.
, traditional dance helps lower tension and anxiety.
Engaging in traditional dance enhances memory and mental endurance, improves self-confidence, self-expression, emotional exploration, goal setting and achievement, and helps overcome new challenges (Salo, 2.
Georgios et al.
also highlighted the significance of traditional dance in improving motor abilities and assisting in preserving physical fitness, self-confidence, and social relationships.
It fosters a more pleasant environment where youngsters can organize themselves and acquire repetitive movements (Filippou et al.
, 2.
Furthermore, traditional dance motions alleviate stress by lowering blood pressure, managing stress, improving cardiovascular parameters, maximizing the oxygen flow and reducing the stress level (Auliya & Yudiarso, 2022.
Sonhaji, 2.
During dance therapy sessions, distinct treatments and approaches are required for each group of participants in order to enhance therapy outcomes (Bryuninger, 2.
Strengths and Limitations.
In this research, researchers did not employ a control group which could have generated data with higher validity due to the limitations of the participants.
Instead, the researchers used the pre-test and post-test to examine the gap in the stress levels before and after the treatment.
A control group was not employed considering that this research only examined whether TATA could reduce stress in elementary school-aged children.
Limitations could also occur during the data collection, where studentsAo moods could have impacted the validity of the data.
Characteristics of Stress Before and After Administering the TATA Intervention.
According to Monteiro et al.
, a person's behavioural, cognitive, and emotional stress coping methods, as well as their problemsolving skills, improve with age.
In this research, female participants, the fourth child, and those who began sleeping at 9 PM had relatively higher stress levels.
Girls are known to release more cortisol in response to stress than boys (Raffington et al.
, 2.
Children who are born as middle children tend to experience less happiness, whereas the youngest children in families have greater resilience (Fukuya et al.
, 2.
In addition, participants whose parents are homemakers report higher Conclusion The new learning systems applied in the new normal era after the COVID-19 pandemic have triggered stress among elementary school students who had to adapt to learn within limited space for movement.
In this research.
TATA was developed to reduce the stress level of Wibawa, et al.
Traditional Art Dance Therapy to Reduce Stress Levels of Elementary School Students JKI.
Vol.
27 No.
July, 107Ae117 Fares.
Saadeddin.
Al Tabosh.
Aridi.
El Mouhayyar.
Koleilat.
Chaaya.
& El Asmar.
Extracurricular activities associated with stress and burnout in preclinical medical students.
Journal of Epidemiology and Global Health, 6 .
, 177Ae doi: 10.
1016/j.
elementary school students during their adaptation to the new learning systems.
Future studies are encouraged to conduct deeper research on the implementation of TATA for pathological patients.
Acknowledgements Filippou.
Rokka.
Pitsi.
Gargalianos.
Bebetsos.
, & Filippou.
D-A.
Interdisciplinary Greek traditional dance course: Impact on student satisfaction and International Journal of Instruction, 11 .
, 363Ae374.
doi: 10.
12973/iji.
This publication was supported by the Faculty of Medicine.
Public Health, and Nursing at Universitas Gadjah Mada.
Yogyakarta.
Indonesia.
To create dance art therapy, the researcher collaborated with the Shinta Art Dance School.
Yogyakarta.
Friedman.
How our careers affect our Harvard Business Review.
Retrieved from: https://hbr.
org/2018/11/how -our-careers-affect-our-children
References