THE PSYCHOLOGICAL CONDITIONS OF MOTHER AND CHILD SURVIVORS ON WEST LOMBOK POST-EARTHQUAKE

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Introduction
Natural disasters in Indonesia in the past five years have caused many casualties and extraordinary losses such as material and psychological. Disasters that often occur are earthquakes. As happened on the island of Lombok, West Nusa Tenggara in July 2018. The Meteorology Climatology and Geophysics Agency , the earthquake in Lombok occurred in 4 times, the first chronology of an earthquake measuring 6.4 on the Richter Scale on the week of July 29, 2018 at 06.47 WITA, then aftershocks measuring magnitude 7.0 on the week of August 5, 2018 at 17.46 WITA. The earthquake occurred again with a magnitude of 6.2 SR on Thursday 9 August 2018 at 00.25 WITA, and the last earthquake measuring 6.9 SR at 22.56 WITA on Sunday 19 August 2018 . Earthquakes that occur repeatedly will of course have a prolonged psychological impact on earthquake victims. Various assistance came to support the recovery of earthquake victims experienced by the people of Lombok, especially psychological assistance.
The psychological assistance provided is often incidental and has a mass tendency so that the assistance has not touched the underlying psychological problems caused by the earthquake. The earthquake that claimed many victims and destroyed their homes, public places and other infrastructure. Psychological trauma cannot be avoided, many residents experience post-traumatic stress disorder (PTSD) (APA, 2013), and require certain treatment to recover. Theoretically, the negative effects that survivors will feel when experiencing stress, anxiety or depression can be reflected in the form of loss of concentration, unwillingness to interact with the environment, insomnia or difficulty sleeping, feeling lonely and often having nightmares. These conditions will certainly inhibit individuals from living their lives in the future.
Earthquakes survivors with PTS conditions, require more intensive psychological therapy treatment in order to recover and be able to live a life after the earthquake. A problem that needs attention is if PTS is experienced by mothers who have early childhood, considering that mothers are the main foundation of the family in the process of sustaining the lives of children and families. So in this study would like to report the results of research conducted in May 2019 -July 2019, from the results of surveys and measurements with the DASS scale in the village of West Lombok Kekait in April 2019 on 163 mothers and children one of the screening found 53 mothers experienced anxiety with severe conditions. Form of anxiety that arises is the continual concern that a severe earthquake will come back, when sleeping often have nightmares, hear loud noises immediately think the earthquake is coming back, if you are in a room or a terraced house is not calm, afraid of an earthquake will come. The anxiety experienced by earthquake survivors is enough to disrupt their daily activities and hinder the process of recovering from the effects of the earthquake. Based on this background, this article would like to report the results of interventions that have been carried out, one of which is reducing anxiety, psychological interventions carried out by using two models of therapy, namely mindfulness for trauma healing and play therapy.

Methods
This study uses quantitative methods to describe the psychological condition of mothers and children of earthquake survivors in Kekait village, West Lombok, West Nusa Tenggara after the 2018 earthquake. Participants in this study were mother and child from Kekait Village, West Lombok, West Nusa Tenggara. There were 163 mothers and child who participated in the initial screening, with the criteria for participation are mothers had to have been experiencing to earthquakes condition and also had children under 9 years old.
This study were used instruments. The first instrument was an adapted version of the Depression, Anxiety, and Stress scale (DASS), originally developed by Lovibond and Lovibond (1995), which was modified by Damanik (2014). The second instrument was depression, anxiety, and stress scale (DASS). DASS consists of 42 items. This instrument aims to measure the conditions of depression, anxiety, and stress experienced by individuals. The distribution of DASS items can be seen in table 1. Participants were given the opportunity to respond to 42 items in the DASS instrument with four choices of answers that were not appropriate (rated 0), sometimes according to what I experienced (rated 1), often I experienced (rated 2 ), and very often I experience (rated 3).  ,5,10,13,16,17,21,24,26,31,34,37,38,42 14 Anxiety 2,4,7,9,15,19,20,23,25,28,30,36,40,41 14 Stress 1,6,8,11,12,14,18,22,27,29,32,33,25,39 14 The second instrument is the screening for child anxiety related disorders (SCARED) developed by Birmaher (1999). This instrument consists of 41 items that aim to measure the symptoms of anxiety that may be experienced by children who fall into four domains namely panic / somatization, separation anxiety, anxiety disorders, and school phobias. The items on the SCARED instrument have been translated into Indonesian so that they can be understood by the participants and have been contextualized with the conditions of earthquake survivors in Lombok, West Nusa Tenggara. SCARED item distribution can be seen in table 2.
Children are given the opportunity to respond to each item with three answer choices namely incorrect (rated 0), sometimes correct (rated 1), and very true / often correct (rated 2). The first step in this research is the preparation stage for the measurement instruments to be used. This preparation phase includes language transfer over the SCARED instrument used to measure anxiety experienced by children. The translation was done by three psychologists and followed up with a qualitative evaluation of measuring instruments by five psychologists. The purpose of evaluating measuring instruments is to ensure that the items that have been translated into Indonesian are good items, those are unambiguous and in accordance with the research context. In addition, the first stage also includes designing the DASS and SCARED instrument layout to be used.
The second stage in this study conducted a preliminary assessment of the psychological condition of earthquake survivors in Kekait village, West Lombok, West Nusa Tenggara. The initial assessment is to observe the participant's living conditions, interview, and fill in the DASS and SCARED instruments. Participants who can read or are still able to read are given the opportunity to complete the DASS and SCARED instruments independently. Meanwhile, participants who have not been able to read will be guided by data collectors in filling out the DASS and SCARED instruments. Data collection in this second stage are seven scientists with a minimum educational background of S2 in the field of psychology/ professional psychology.
Based on research conducted in the second stage, it can be obtained that 163 pairs of mothers and children experience various psychological conditions. The results of the assessment with the DASS and SCARED instruments are then interpreted with established norms. Norms of DASS instruments can be seen in table 3 and SCARED instrument norms can be seen in table 4.

Findings and Discussion
Initial screening results from 163 earthquake survivors in Lombok found some demographic data on earthquake survivors in Lombok, described in table 5 below. Most respondents have started to occupy their own houses that have been rebuilt. There are 43 pairs of mothers and children who are still living in temporary shelters because they are still afraid that the earthquake will come back. In general, the average mother's education is elementary and junior high and only as a housewife.
The results of screening of 163 earthquake survivors found 3 psychological conditions of earthquake survivors in general, levels of depression, anxiety and stress were in the normal range. But it was found there were 18 people at moderate level and 5 people at severe depression level. Then there are 53 people in severe and very severe anxiety levels. the mother of survivors of the earthquake in Lombok of 163 indicated severe and to very severe numbered 53 people. Can be seen in table 6 below. Anxiety is an individual's response to an unpleasant situation experienced by all living things in everyday life. As for the psychological symptoms that are included in anxiety namely uncontrolled worries, sleep disturbance, anxiety and difficulty concentrating. Anxiety occurs as a result of threats to yourself or self-identity that is very basic for the existence of individuals. The survey shows that, after a catastrophic event, around 15-20% of the population will experience mild or moderate mental disorders that refer to the condition of post-traumatic stress disorder (PTSD), while 3-4% will experience severe disorders such as psychosis, major depression and anxiety which is high (Richman, 2012).
The results of this study indicate the psychological condition of mothers and children survivors of earthquake who on average still experience anxiety, there are 53 mothers who experience severe and very severe anxiety as well as in children, anxiety that arises is the anxiety of being separated from mothers as many as 109 children and the remaining 54 children indicated experiencing anxiety in general. As a result of earthquakes, children are still often difficult for mothers to leave, so that wherever mothers go children always participate.
Psychological problems found in survivor after an earthquake include the fear of re-occurrence of earthquakes, difficulty forgetting earthquake events, anxiety, anxiety thinking about the earthquake, fear of entering the house, hearing rumbling or fear when night falls (Dwidiyanti et al, 2019). In another study found that women think more about disasters and have a deeper emotional attachment to the family than men (Naeem, 2011). Separation from family, husband, children due to earthquake can increase the risk of PTSD (Faroouqi, 2017) considering this phenomenon is part of the impact of the earthquake disaster. Loss of house and heavy economic burden also aggravated the psychological condition of earthquake survivor. As happened to earthquake survivor in Kekait village, West Lombok, NTB.
Several studies have shown that women are known to be twice as likely to experience PTSD compared to men (Zhang, Shi, et al., 2012). This is reinforced by research conducted by Naeem et al (2011) which shows that women experience PTSD more than men. The results of the study showed that women who experienced PTSD reached 55.2%, while men who experienced PTSD only 33.4%. This happens because women have more emotional ties than men (Farooqui et al., 2017). Respondents in this study are mothers with high anxiety who have children under the age of 9 years, most are not in school or have low education, namely elementary-junior high school, housewives and also do not work. In a study of economic conditions being risk factors for stress, mental health disorders due to lack of knowledge about post-disaster management, trauma healing, and weak economic conditions of survivor (Brewin, 2011).

Conclusion
The earthquake disaster still left a psychological impact on the earthquake survivors. Mother and child are individuals who are quite susceptible to experiencing psychological disorders after the earthquake. The results showed that anxiety is a psychological condition that is still widely experienced by mothers and children survivors of the earthquake. In children, found an indication of anxiety that often arises is the anxiety of being separated from the mother. Even though an earthquake has passed a year, memories of events that have an impact on the psychological earthquake survivors still exist in individuals and affect their daily lives. Post-earthquake psychological conditions require psychosocial treatment to be resolved, an indication of high anxiety will result in a more acute psychological condition.