Model of Trauma Healing Policy for Mitigation Communities in the

COVID-19 Pandemic Period in Padang Pariaman District - Indonesia

Aulia Asman

1,*

, Rina Alfina

and Auzia Asman

Departement of Diploma III Nursing, Universitas Negeri Padang, Indonesia

Departement of Food Crops, Politeknik Pertanian Negeri Payakumbuh, Indonesia

Keywords: COVID-19, Policy Model, Trauma Healing.

Abstract: Padang Pariaman Regency is one of the top 5 largest COVID-19 cases in West Sumatra. Coronavirus Disease

2019 or COVID-19 is a disease caused by the corona virus with the fastest spread in the time and way, so that

it becomes a pandemic in the world, including in Indonesia and West Sumatra. -existing psychological

problems and secondary traumatic stress (STS), so this study aims to develop a trauma healing policy model

for the community during the COVID-19 pandemic in Padang Pariaman Regency so that the community

adapts and mitigates this pandemic. This research is a quantitative descriptive study, using in-depth interview

data collection techniques to expert respondents whose results were analyzed using the Analytical Hierarchy

Process. In formulating the policy model, stigma or point of view, mental or mental health and behavior are

used as policy criteria. The results of the study indicate that the priority policies to be considered for the

Padang Pariaman Regency Government are: (1) Promoting and socializing the prevention of COVID-19

transmission directly or online to the community, then getting people used to implementing it in daily life by

applying various rules in the community. public environment (84.9%); (2) Conduct socialization and increase

public knowledge and awareness about COVID-19, its transmission and prevention, so that the negative

stigma of the community can change and become support for positive sufferers (75.4%); (3) Increasing

vertical and horizontal cooperation from the community to the government (73.5%); and (4) Improving the

adaptation and recovery of COVID-19 through re-centering, personal awakening, emotion stabilizing, and the

implementation of the buddy system (64.3%).

1 INTRODUCTION

The COVID-19 virus or Coronavirus Disease 2019

became a disease with human-to-human transmission

in the fastest time and way, so it was declared a world

pandemic by WHO (Bender, 2020). The COVID-19

virus originated from Whuhan City, China (WHO,

2020), which finally arrived in Indonesia due to

Indonesia's geographical location which is directly

adjacent to several countries affected by the spread of

the COVID-19 virus, the development of

globalization and the increasingly smooth traffic

between countries. Indonesia is one of many

countries that are facing a non-natural disaster,

namely the COVID-19 virus pandemic.

https://orcid.org/0000-0001-5837-9306

https://orcid.org/0000-0002-2220-7630

https://orcid.org/0000-0002-2820-0675

Indonesia, from the beginning of the case on

March 2, 2020 to May 20, 2020, has reached 19,189

people with 4,575 recoveries and 1,242 people who

died from the site https://covid19.go.id (Asman et al.,

2020). The speed of the spread of this virus is due to

the fact that transmission can occur only by touching

a contaminated surface or object, which then

knowingly or not touches the eyes, nose or mouth

(Steffens, 2020). The large number of cases of

COVID-19 from time to time, one of which is

because a vaccine for a cure has not yet been found,

so the government can only carry out treatment and

care with symptoms that are still early as well as

control and prevent the spread of virus transmission

(Yi et al., 2020) .

Asman, A., Alﬁna, R. and Asman, A.

Model of Trauma Healing Policy for Mitigation Communities in the COVID-19 Pandemic Period in Padang Pariaman District - Indonesia.

DOI: 10.5220/0011094600003368

In Proceedings of the International Conference of Mental Health (Icometh 2021), pages 33-38

ISBN: 978-989-758-586-9

This COVID-19 has spread to all provinces in

Indonesia, where of 34 provinces, West Sumatra

Province which is located in the west of Sumatra

Island which consists of 19 regencies/cities is the

province with the most positive cases of COVID-19,

namely 428 people or 2, 2% or in position 9. The

results from West Sumatra's corona response on May

20, 2020 from the website

https://corona.sumbarprov.go.id/details/peta_covid1

9 it is Including the top 5 highest cases, Padang

Pariaman Regency can be caused because Padang

Pariaman Regency, which is a regency with a large

area, close to the provincial capital, namely Padang

City, is a crossing point for migrants who will go to

other districts/cities in West Sumatra Province

(Asman et al., 2020). In addition, the transmission

and spread of COVID-19 in Padang Pariaman

Regency tends to be local transmission or

transmission that occurs locally, with the center of the

spread being at several points such as the markets of

each Nagari in Padang Pariaman Regency, the border

with the City of Padang, Bukittingi and Pasaman. ,

and hospitals. Pariaman Padang.

During the current COVID-19 outbreak, with the

enactment of PSBB in almost all of Indonesia

including the Padang Pariaman Regency, people are

required to stay at home and go out only to fulfill

mandatory or daily needs. The enactment of this

PSBB has caused many people to lose their jobs due

to staff reductions, loss of livelihoods, and health

workers who cannot meet their families as well as

large work demands such as working longer hours or

40 hours a week and with a continuous work schedule

compared to normal working hours (Hua & Shaw,

2020). The obligation to stay at home and do physical

distancing, over time makes people who do not have

activities or busy at home experience stress, which

will have an impact on their mental well-being and

health, such as depression, excessive fatigue and

anxiety (Kim & Knesebeck, 2015). This is

exacerbated by the amount of social stigma and

discriminatory behavior towards patients who are

positive for COVID-19 or their families or

communities who come into contact with positive

patients (Pfefferbaum & North, 2020), which then has

an impact on exclusion and cynical or negative views

(ILO, 2020).

These conditions cause people to panic and if they

last for a long time can cause people to experience

psychological problems such as stress and trauma.

Each individual who experiences stress and trauma

has a different response from each other in terms of

intensity and expression, depending on the windows

of tolerance. Windows of tolerance is the extent or

narrowness of an individual's tolerance level when

dealing with stressful or traumatic situations (Dewi,

2020). Dewi also explained that if this window of

tolerance does not work, stress and trauma will

reappear, causing pre-existing psychological

problems such as psychosomatic, depression and

anxiety disorders, post-traumatic stress disorder

(PTSD), obsessive-compulsive disorder (OCD),

interpersonal conflict (attachment issue), self-esteem

issue, chronic emotional problems, aggressiveness

relapse (dropping treatment & care), and family and

marriage problems (Dewi, 2020). There needs to be

the right strategy so that it doesn't increase again in

the number of positive COVID-19 (Asman et al.,

2021).

In addition to experiencing pre-existing

psychological problems, people, especially those

with the highest risk of exposure, can also experience

secondary traumatic stress (STS), such as excessive

worrying and fear of something bad happening, being

easily surprised or alert all the time, experiencing

physical stress (eg: palpitations, cold sweats),

nightmares or recurring thoughts about the traumatic

event, and a feeling that someone else's trauma is his

or her own. This stress and trauma, apart from

occurring in patients with COVID-19 and patients

with ODP and PDP status, also often occurs in health

workers. The impact of COVID-19 showed a high

level of distress (72%), with very high rates of

depression (50%), anxiety (45%) and insomnia

(34%), where symptoms were more severe. arise in

those with prolonged contact with the patient (Muhdi,

2020).

These pre-existing psychological problems and

Secondary Traumatic Stress (STS) can be minimized

by doing trauma healing for vulnerable groups and

groups who really need it. However, until now the

government has not issued a policy regarding trauma

healing which is very much needed for positive

COVID-19 patients, ODP, PDP and health workers in

particular and for the community in general.

Therefore, in this study, the formulation of a trauma

healing policy model for the community in Padang

Pariaman Regency was carried out.

2 RESEARCH METHODS

This research is a quantitative descriptive study, using

interview data collection techniques to expert

respondents to obtain the most prioritized policies in

trauma healing. According to Saaty (1991) and Saaty

(2008) furthermore, using a pairwise comparison

questionnaire between elements at each level to

Icometh 2021 - International Conference of Mental Health

obtain a hierarchical structure, which was processed

with Criterium Decision Plus 4.0 software, and

analyzed using the Analytical Hierarchy Process

(AHP) method. According to Marimin (2004) and

Latifah (2005) the working principle of AHP consists

of hierarchical arrangement (decomposition),

assessment of criteria and alternatives (comparative

judgment), prioritization (synthesis of priority), and

logical consistency (local consistency). The basic

concept of the AHP is the use of a pairwise

comparison matrix (matrix of pairwise comparisons)

to generate relative weight values between criteria

and alternatives. A criterion is compared to another in

terms of how important it is to the achievement of the

above objectives (Saaty, 1991)

3 RESEARCH AND

DISCUSSIONS

Padang Pariaman Regency is one of the regencies that

has the 5 highest number of COVID-19 cases on the

island of Sumatra. Of all community activities in

Padang Pariaman Regency, transmission of COVID-

19 will pose a higher risk to people who work on the

front lines, such as health care workers, and in

particular those who are actively involved in handling

the outbreak (first responder from the emergency

medical team, health care workers in emergency

departments and special care units, transportation and

first aid), psychiatrists for providing the services

needed by patients experiencing psychological stress,

fatigue, and negative stigma; sellers of basic

necessities such as in traditional and modern markets;

and workers in the transportation sector such as

online transportation and public transportation.

The extent and high risk of transmission of the

virus, makes the government must implement PSBB

rules to break the chain of transmission. However,

from March to May 2020, the number of patients

affected by COVID-19 continued to increase. This

means that there have been no significant changes due

to the enactment of the PSBB. This can be caused by

the mental weakness of the community in

implementing the PSBB and dealing with the

COVID-19 virus. Therefore, a policy model

regarding trauma healing or trauma recovery that can

be implemented by the Padang Pariaman Regency

government has been formulated to improve mental

health and windows of tolerance for every Covid-19

positive patient, health worker, and the general

public.

In the formulation of this trauma healing

policy model, three criteria were used, namely the

point of view or stigma, mental or mental health, and

behavior. This means that the policies formulated

focus on changing the stigma circulating in the

community regarding COVID-19 and its sufferers,

improving the mental or mental health of positive

patients and the general public in dealing with

COVID-19, and getting used to people's behavior to

be able to live clean and healthy in order to avoid

COVID -19. From these criteria, 9 alternative policies

are produced that can be implemented by the

government which in the implementation will pay

attention to policy priorities. The alternative policies

are as follows:

1. Application of relaxation and therapy methods as

a way to restore mental or mental health.

2. Prioritizing and implementing Occupational

Safety and Health (K3), especially for people who

have the potential to have a high risk of

transmitting COVID-19.

3. Increase positive activities and limit information

containing negative news, especially for patients

with COVID-19 and people who are at the

forefront.

4. Activate and socialize to the public regarding self-

checking services for psychological problems and

telemedicine regarding online drug consultation

services.

5. Improve communication and good cooperation

between family members, including the

application of appreciative parenting.

6. Increase cooperation vertically and horizontally

from the community to the government.

7. Conduct socialization and increase public

knowledge and awareness about COVID-19, its

transmission and prevention, so that the negative

stigma of society can change and become support

for positive sufferers.

8. Improving adaptation and recovery of COVID-19

through re-centering (building each individual's

internal system), personal awakening (rising up

and then adjusting life patterns), emotion

stabilizing (increasing sense of control), and

implementing the buddy system (colleague

system).

9. Promote and socialize the prevention of COVID-

19 transmission directly and online to the

community, then familiarize the community with

applying it in daily life by applying various rules

in the public environment

The criteria and policy alternatives, using

CDP (Criteria Decision Plus) software produce a

policy hierarchy as shown in Figure 1. The policy

Model of Trauma Healing Policy for Mitigation Communities in the COVID-19 Pandemic Period in Padang Pariaman District - Indonesia

hierarchy shows that in the formulation of the policy

model, the criteria will be interrelated with all policy

alternatives. Furthermore, the consistency ratio value

resulting from the analysis of the pairwise

comparison matrix (paired comparison matrix) is

0.055 or less than 0.1. This means that in compiling a

pairwise comparison matrix, expert respondents or

experts are consistent so that policy priorities can be

determined.

Figure 1: Hierarchy of the Trauma Healing Policy Model.

Figure 2: Consistency Ratio.

Figure 3 shows that there are 4 policy priorities in

formulating a trauma healing policy model in Padang

Pariaman Regency, which can be applied with the

following strategies:

1. Promote and socialize the prevention of COVID-

19 transmission directly and online to the

community, then familiarize the community with

applying it in daily life by applying various rules

in the public environment

a. Improve communication and openness of health

in the family.

b. Be transparent to the surrounding community.

c. Local governments with Nagari leaders, Korong

leaders, religious leaders or traditional leaders or

community leaders carry out promotions both

directly and online.

d. Involving radio broadcasts and print media in the

promotion of transmission prevention.

e. The teacher always informs the students to get

used to living a healthy and clean life.

f. The government has begun to implement health

protocols in all work and public environments.

2. Conduct socialization and increase public

knowledge and awareness about COVID-19, its

transmission and prevention, so that the negative

stigma of the community can change and become

support for positive sufferers.

a. The government conducts socialization in stages

to save financing.

b. Evaluating the results of socialization on a regular

and consistent basis.

c. Follow up on the evaluation results.

d. Communicate actively with Nagari leaders,

Korong leaders, religious leaders or traditional

leaders or community leaders to be able to convey

information and convince and increase public

awareness so that they no longer have negative

stigma.

e. Spreading facts both online and in person

regarding the transmission and prevention of

COVID-19.

f. Amplifying the voices of people recovering from

COVID-19.

g. Equalize perceptions about COVID-19 so that if

there are positive citizens, they can be given

support.

3. Increase cooperation vertically and horizontally

from the community to the government.

Icometh 2021 - International Conference of Mental Health

a. Avoiding miscommunication between the Padang

Pariaman Regency government and the

community.

b. Making Nagari leaders, Korong leaders, religious

leaders or traditional leaders or community

leaders a source of information about COVID-19.

c. Provide support and assistance for residents who

are positive for COVID -19 or self-isolating or

affected by COVID-19 using a local economy-

based approach/ assisting in providing basic

needs.

d. Active involvement of the local community/

Nagari-Korong in supporting the process of

implementing self-quarantine/ isolation by

providing a place for migrants.

e. Forming a task force unit with the aim of

monitoring residents who are either self-isolating

or affected.

4. Improving adaptation and recovery of COVID-19

through re-centering (building an individual's

internal system), personal awakening (rising up

and then adjusting life patterns), emotion

stabilizing (increasing sense of control), and

implementing the buddy system (a coworker

system).

a. Improving the quality of each individual's faith by

worshiping.

b. Build emotional stability by always thinking

positively.

c. the head of the Nagari, Korong, religious or

traditional leaders or community leaders always

urge and invite the community to behave in a

healthy life and exercise.

d. Keeping pet animals for mind distraction.

e. Increase awareness among individuals in the

family, in the neighborhood, workplace and

public places by reminding each other not to

forget the health protocol.

f. Especially for the front row, the government must

pay attention to mental/mental health conditions

by increasing immunity, monitoring mental/

mental health.

Regularly, providing a psychiatrist, setting up

facilities that make them more confident,

comfortable, and stay positive.

Figure 3: Priority Model of Trauma Healing Policy.

Thus, the trauma healing policy model for the

community in Padang Pariaman Regency during the

COVID-19 pandemic can be done by eliminating the

community's negative point of view or stigma first

against positive patients or people who make contact

so that isolation is necessary. This is in accordance

with (Asman et al., 2020) WHO stated that negative

stigma must be annulled with optimal health literacy

from various parties because COVID-19 sufferers are

not people who commit disgraceful acts, so there is

no need to be isolated or shunned. If this stigma is

allowed, it can: 1) encourage people to hide their

illness to avoid discrimination, 2) prevent people

from seeking immediate health care, and 3) prevent

them from adopting healthy behaviors.

Furthermore, trauma recovery will be easier to

overcome if the community has a healthy mental or

spirit. In improving this mental or mental health, it is

very necessary to support the family and the

surrounding environment. Communication is the key

to the success of this mental or mental health, so that

individuals can have good windows of tolerance in

dealing with stress or trauma. Then, trauma and stress

in the community in Padang Pariaman Regency can

also be overcome by changing people's behavior who

have started to get used to maintaining cleanliness

and healthy living, so that indirectly also apply

positive thinking, always be enthusiastic and get used

to being open and transparent about the conditions

experienced. The policy with the above

implementation strategy can be carried out by the

Padang Pariaman Regency government in

collaboration with the community.

4 CONCLUSIONS

Padang Pariaman Regency is one of the regencies on

the island of Sumatra that has the highest 5 major

Model of Trauma Healing Policy for Mitigation Communities in the COVID-19 Pandemic Period in Padang Pariaman District - Indonesia

COVID-19 cases. This condition makes the

government issue a policy for implementing PSBB

(Large-Scale Social Restrictions) by requiring people

to only carry out activities at home. As a result, many

people have lost their jobs due to staff reductions, lost

their livelihoods, health workers are unable to meet

their families and high work demands, people who are

at home also experience conditions of boredom,

boredom and stress. This condition, if left unchecked

for a long time can cause pre-existing psychological

problems and secondary traumatic stress (STS), so a

policy is needed to recover the trauma and stress.

Policy priorities to be able to recover community

stress and stress that can be taken into consideration

for the Padang Pariaman Regency government are (1)

Promoting and socializing the prevention of COVID-

19 transmission directly or online to the community,

then getting people used to applying it in daily life by

applying various rules. in the public environment

(84.9%); (2) Conduct socialization and increase

public knowledge and awareness about COVID-19,

its transmission and prevention, so that the negative

stigma of the community can change and become

support for positive sufferers (75.4%); (3) Increasing

vertical and horizontal cooperation from the

community to the government (73.5%); and (4)

Improving the adaptation and recovery of COVID-19

through re-centering, personal awakening, emotion

stabilizing, and the implementation of the buddy

system (64.3%).

REFERENCES

Asman, A., Asman, A., & Dewi, A. K. (2021). Community

Nursing Strategies for Tourism Health Families during

COVID-19 Pandemic. International Journal of Health

Sciences, 5(3), 224–231.

https://doi.org/10.53730/ijhs.v5n3.1449

Asman, A., Barlian, E., Fatimah, S., Dewata, I., & Asman,

A. (2020). Model of Trauma Healing Policy for

Communities in the COVID-19 Pandemic Period in

Padang City – Indonesia. Journal of Advanced

Research in Dynamical and Control Systems, 12(7),

646–651.

Bender, L. (2020). Pesan dan Kegiatan Utama Pencegahan

dan Pengendalian COVID-19 di Sekolah.

www.who.int. https://www.who.int/docs/default-

source/searo/indonesia/covid19/pesan-dan-kegiatan -

utama-pencegahan-dan-pengendalian-covid-19-di-

sekolah---indonesian--march-2020.pdf

Dewi, L. Z. (2020). Masa Darurat COVID 19 & Kesehatan

Jiwa. PPH ATMADJAYA.

Hua, J., & Shaw, R. (2020). Corona Virus (COVID-19)

“Infodemic” and Emerging Issues through a Data Lens:

The Case of China. International Journal of

Environmental Research and Public Health, 17(7), 1–

12.

ILO. (2020). Dalam Menghadapi Pandemi: Memastikan

Keselamatan dan Kesehatan di Tempat Kerja.

wwwl.ilo.org.

Kim, T. J., & Knesebeck, O. Von Dem. (2015). Is An

Insecure Job Better for Health Than Having No Job At

All? A Systematic Review of Studies Investigating The

Health-Related Risks of Both Job Insecurity and

Unemployment. BMC Public Health, 15(985), 1–9.

Latifah, S. (2005). Prinsip-Prinsip Dasar Analytical

Hierarchy Process. Repositori Institusi Universitas

Sumatera Utara.

Marimin. (2004). Teknik dan Aplikasi Pengambilan

Keputusan Kriteria Majemuk. Jakarta: Grasindo.

Muhdi, N. (2020). Layanan Konseling Tenaga Kesehatan

Era Pandemi COVID-19: Peluang dan Tantangan.

www.persi.or.id.

Pfefferbaum, B., & North, C. S. (2020). Mental Health and

The Covid-19 Pandemic. New England Journal of

Medicine, 383(6), 510–512.

Saaty, T. L. (1991). Pengambilan Keputusan Bagi Para

Pemimpin. Jakarta: Pustaka Binaman Pressindo.

Saaty, T. L. (2008). Decision Making with The Analytic

Hierarchy Process. Int. J. Services Sciences, 1(1), 83–

98.

Steffens, I. (2020). A Hundred Days Into the Coronavirus

Disease (COV ID-19) Pandemic. Euro Surveil, 25(14),

1–4.

WHO. (2020). Stigma Sosial terkait dengan COVID-19.

www.who.int. https://www.who.int/docs/default-so

urce/searo/indonesia/covid19/panduan-untuk-mence

gah-dan-mengatasi-stigmasosial.pdf?sfvrsn=4f8bc7

34_2

Yi, Y., Lagniton, P. N. P., Ye, S., Li, E., & Xu, R. H. (2020).

COVID-19: What Has Been Learned and To Be

Learned About The Novel Coronavirus Disease.

International Journal of Biological Sciences, 16(10),

1753–1766.

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