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JOURNAL OF CRITICAL REVIEWS THE INFLUENCE OF PHYSICAL DISTANCE TO

STUDENT ANXIETY ON COVID-19, INDONESIA

Article · July 2020

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 JOURNAL OF CRITICAL REVIEWS

ISSN- 2394-5125 VOL 7, ISSUE 17, 2020

THE INFLUENCE OF PHYSICAL DISTANCE TO

STUDENT ANXIETY ON COVID-19, INDONESIA
M. Ardan1, Ferry Fadzlul Rahman2, Godefridus Bali Geroda3
1
Departement of Hospital Management, Sekolah Tinggi Ilmu Kesehatan Mutiara Mahakam Samarinda,
East Kalimantan, Indonesia
2
Program Study of Public Health, Universitas Muhammadiyah Kalimantan Timur, East Kalimantan, Indonesia
3
Program Study of English Education, Universitas Widya Gama Mahakam Samarinda, East Kalimantan,
Indonesia
1
ardan0410@gmail.com, 2ffr607@umkt.ac.id, 3godefridus88@gmail.com

Received: 01 May 2020 Revised: 23 June 2020 Accepted: 04 July 2020

ABSTRACT: Background: Covid-19 causes a variety of reactions along with its appearance, many new things
actually have never been thought of and cause anxiety itself. This study aims to determine the effect of physical
distancing on the level of student anxiety on the spread of Covid-19 cases in Indonesia.

Methods: In this Cross-Sectional study, data were obtained from 248 students aged > 18 years in East
Kalimantan in March - April 2020, and the level of student anxiety was measured based on the Hamilton Rating
Scale for Anxiety (HRS-A) measurement.

Result: Data obtained by respondents who did not experience anxiety / mild anxiety 148 (59.7%), moderate
anxiety 68 (27.4%) and severe anxiety 32 (12.9%) with the majority characteristics < 20 years 55.6%, female sex
65.7%, Islam 81.0%, unmarried 94.8% and normal body mass index 83.9%. Statistical results indicate the
influence of quarantine/isolation appeal (0.016), contact history (0.003), activities outside the home (0.021),
length of stay at home (0,000), mask use and handwashing (0.005), physical activity (0.012), family contact
(0.028), co-19 knowledge (0,000) and travel history (0.044) on student anxiety levels.

Conclusions: Pandemic COVID-19 impacts students in undergoing physical distancing. Students feel worried
that they will be exposed to co-19 and less able to carry out daily activities. So managing psychosocial
well-being during a pandemic is as important as managing physical health is undergoing physical distancing.

KEYWORDS: Covid-19, Physical Distance, Student Anxiety

I. INTRODUCTION
Corona virus or Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a virus that attacks the
human respiratory system (Bao et al., 2020). This viral infection is called Corona Virus Disease 2019 / Covid-19
(Shereen, Khan, Kazmi, Bashir, & Siddique, 2020). Corona virus can cause mild disruption in the respiratory
system, severe lung infections to death (Jin et al., 2020). Corona virus infection was first discovered in Wuhan
City, China in late December 2019 (Roosa et al., 2020). This virus is transmitted very quickly and has spread to
almost all countries including Indonesia in just a few months through human-to-human transmission and objects
exposed to the virus (Gavgani, 2020).
WHO data (April 29, 2020) states that the number of positive confirmed has reached 301.89 / 1,000,000 world
population with a mortality rate of 6.8% (WHO, 2020) While data in Indonesia shows that the number of
confirmed cases was 97.71 / 10,000 population with a rate 8.02% mortality (Kemenkes RI, 2020). East
Kalimantan, which is one of the 34 Provinces that has confirmed positive, shows a distribution of cases of 11.9 /
1,000 population with a proportion of cases in Samarinda City of 15.96% (Health Office East Kalimantan,
2020).
Physical distancing is recommended and promoted by national and international institutions in terms of
maintaining a physical distance between people (Dalton, Corbett, & Katelaris, 2020). But what is avoided is not
only the mass crowd such as markets, places of worship, places of entertainment, places of education and others
(Chen et al.,2020; Miller, Loaiza, Takyar, & Gilman, 2020; Yang et al., 2020), but all efforts which can transmit
so as to prevent transmission of the virus to others (Pfattheicher, Nockur, Böhm, Sassenrath, & Petersen, 2020).
Physical distancing in the middle of the Covid-19 pandemic becomes a necessity for society to be implemented

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(Duan & Zhu, 2020; Jarvis et al., 2020; Xiao, 2020). However, besides that humans are accustomed to gathering
together, working together will cause anxiety if they have to limit the distance even though the world of
technology is now adequate (Mossong et al., 2008; Whyle & Olivier, 2020). In essence, humans as social beings
will require interaction with other humans (Kim et al., 2020). This social interaction is usually carried out in
public spaces where anyone can access it. However, with the limitation of physical distance activity for humans
during the epidemic COVID-19 this will face a variety of mental and psychological problems that have become a
human habit itself (Fraser et al.,2020). Anxiety which is neurotic helplessness, insecurity, fear, immature and
lack of ability to face the demands of reality (environment), the difficulties and pressures of daily life (Ardan,
Zulkifli, & Jafar, 2019; Viana & de Lira, 2020).
II. MATERIALS AND METHODS
2.1. Participants
This research has been taken from March to April 2020, respondents were drawn from active students at all
University in Samarinda, East Kalimantan Province where the survey was conducted. This study used a
cross-sectional design with inclusion criteria including (1) age > 18 years, (2) being an Active student in the area
of Samarinda, (3) not diagnosed with dementia, (4) not currently using antidepressants. Participants from this
study were taken as many as 248 respondents who were included in the analysis. Before participating, all
participants received information about this study and submitted the signed agreement. Data is taken and
collected through e-mail and Google form software applications.
2.2. Measurement of Physical Distance
Measurement of characteristics in this study is that each respondent records data in the form of age, gender,
religion, marital status, and body mass index. Whereas physical distance measurement is in the form of (1) the
respondent is asked to quarantine/isolate, (2) the respondent lives or contacts with someone who has symptoms
of cough, fever, and shortness of breath, (3) the respondent is active outside the home, (4) the length of the
respondent is inside a home, (5) respondents use masks when outside the house and always wash their hands, (6)
respondents engage in physical / sports activities, (7) respondents contact with family (face to face), (8)
respondents' knowledge about COVID-19, and (9) respondents have traveled to co-19 infected areas (Cao et al.,
2020; Jarvis et al., 2020).
2.3. Assessment of Anxiety
Student anxiety levels were measured using a Hamilton Rating Scale for Anxiety (HRS-A) questionnaire of 14
question items. information about HRS-A was also used in other studies (Konradt et al., 2018; Sugarman, Loree,
Baltes, Grekin, & Kirsch, 2014). The anxiety level has the lowest score of 14 and the highest of 56 (Porter et al.,
2017).
2.4. Statistical Analysis
Analysis of the respondent's characteristic variables is expressed in terms of numbers and percentages. The
statistical results of the independent variable are divided into 2 (two) categorical variables while the dependent
variable is divided into 2 categorical groups: (1) Score < 20 No anxiety / Lightness, (2) Score> 20anxiety
moderate / severe. Univariate data results will be analyzed by descriptive while bivariate data will be tested by
logistic regression analysis. The alpha level for testing significance was set at a p-value <0.05 (5%). Statistical
analysis was performed using SPSS statistical software version 24.
III. RESULT
The observational cross-sectional study was conducted with 248 respondents to assess the effect of physical
distancing on student anxiety on the distribution of co-19. The results show as follows:
Table 1: Characteristics of Respondents Against Anxiety Level
Level of Anxiety
Number of
Characteristic Respondents Tidak Cemas / Cemas
(%) Cemas Ringan Cemas Berat (%)
Sedang (%)
(%)
Age
< 20 Tahun 138 (55,6%) 75 (50,7%) 42 (61,8%) 21 (65,6%)
> 20 Tahun 110 (44,4%) 73 (49,3%) 26 (38,2%) 11 (34,4%)
Gender

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Female 163 (65,7%) 100 (67,6%) 44 (64,7%) 19 (59,4%)

Male 85 (34,4%) 48 (32,4%) 24 (35,3%) 13 (40,6%)
Religion
Muslim 201 (81,0%) 127 (85,8%) 53 (77,9%) 21 (65,6%)
Christian 47 (19,0%) 21 (14,2%) 15 (22,1%) 11 (34,4%)
Marital Status
Unmarried 235 (94,8%) 142 (95,9%) 63 (92,6%) 30 (93,8%)
Married 13 (5,2%) 6 (4,1%) 5 (7,4%) 2 (6,3%)
Body Mass Index (kg/m2)
Normal (18,0 – 25,0) 208 (83,9%) 129 (87,2%) 54 (79,4%) 25 (78,1%)
Abnormal (< 18,0 or > 25,0) 40 (16,1%) 19 (12,8%) 14 (20,6%) 7 (21,9%)
Total 248 (100%) 148 (59,7%) 68 (27,4%) 32 (12,9%)

3.1. Univariat Analysis

Table 1 shows that the characteristics of respondents in this study were the majority aged <20 years 138 (55.6%),
female gender 163 (65.7%), Islamic religion 201 (81.0%), unmarried 235 (94.8%) and normal body mass index
208 (83.9%). While the level of student anxiety faced the spread of co-19 which felt no anxiety / mild anxiety
148 (59.7%), moderate anxiety 68 (27.4%), and severe anxiety 32 (12.9%).
3.2. Bivariat Analysis
Table 2 shows that the results of the physical analysis are measured against the level Student anxiety has a
significant influence. Respondents who were asked to quarantine / isolate (p = 0.016; OR = 0.473; IK95% =
0.265-0.845), live or contact with someone who has symptoms of cough, fever and shortness of breath (p =
0.003; OR = 0.458; IK95% = 0,270-0,777), activities outside the house (p = 0.021; OR = 1,889; IK95% =
1,129-3,159), length of time inside the house (p = 0,000; OR = 4,224; IK95% = 2,441-7,331), using masks when
outside home and diligently washing hands (p = 0.005; OR = 0.373; IK95% = 0.192-0.724), physical / sports
activities (p = 0.012; OR = 2,000; IK95% = 1,192-3,356), contact with family face to face ( p = 0.028; OR =
1.840; IK95% = 1.099-3.082) Knowledge about covid-19 (p = 0,000; OR = 8,401; IK95% = 4,704-15,003) and
having traveled from covid-19 infected areas (p = 0.044; OR = 0.535; IK95% = 0.303-0.946) on the level of
pollution college student.
Table 2: Bivariate Analysis Based on Physical Distancing of Anxiety
Level of Anxiety IK 95%
Physical Distance* n : 248 No Anxiety / Medium /
Anxiety (%) Heavy P value OR Min Maks
Anxiety (%)
Requested Implement quarantine /
isolation
Yes, quarantine /isolation No quarantine / 29 (19,6%) 34 (34,0%) 0,016** 0,473 0,265 0,845
isolation 119 (80,4%) 66 (66,0%)
Living or Contact with
Someone Who Has Symptoms of
Cough, Fever, and Shortness of Breath
Yes / Never No 44 (29,7%) 48 (48,0%) 0,003** 0,458 0,270 0,777
104 (70,3%) 52 (52,0%)
Out of Home activities
Yes / Often No 84 (56,8%) 41 (41,0%) 0,021** 1,889 1,129 3,159
64 (43,2%) 59 (59,0%)
Being Home
< 14 days 92 (62,2%) 28 (28,0%) 0,000** 4,224 2,441 7,311

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> 14 days 56 (37,8%) 72 (72,0%)

Using masks when outside the
home and diligently Washing Hands
Yes 103 (69,6%) 86 (86,0%) 0,005** 0,373 0,192 0,724
No / Sometimes 45 (30,4%) 14 (14,0%)
Physical / Sports Activity
<30 Minutes / day 96 (64,9%) 48 (48,0%) 0,012** 2,000 1,192 3,356
> 30 Minutes / day 52 (35,1%) 52 (52,0%)
Family Contact (Face to
Face)
< 14 days 80 (54,1%) 39 (39,0%) 0,028** 1,840 1,099 3,082
> 14 days 68 (45,9%) 61 (61,0%)
Knowledge About Covid-19
Good Enough 117 (79,1%) 31 (31,0%) 0,000** 8,401 4,704 15,003
31 (20,9%) 69 (69,0%)
Have traveled from place that
Infected by covid-19
Yes / Never No 32 (21,6%) 34 (34,0%) 0,044** 0,535 0,303 0,946
116 (78,4%) 66 (66,0%)
Total 148 (59,7%) 100 (40,3%) - - - -
* During Pandemic Covid-19 ** Multivariate Candidates (p<0,25)
Table 3: Multivariate analysis distancing Based On the Level Physical
% C.I. for EXP(B)
Variabel in the Equation* B S.E. Wald df Sig. Exp(B)
Lower Upper
Requested Implement ,931 ,539 2,985 1 ,084 2,536 ,882 7,288
quarantine /isolation (1)
Living or Contact with 1,743 ,432 16,265 1 ,000 5,717 2,450 13,341
Someone Who Has Symptoms
of Cough, Fever, and
Shortness of Breath (1)
Being Home (1) -2,417 ,480 25,393 1 ,000 ,089 ,035 ,228
Using masks when outside the 4,564 ,823 30,744 1 ,000 9,597 1,912 48,176
home and diligently Washing
Hands
Knowledge About Covid-19 -4,186 ,762 30,166 1 ,000 ,015 ,003 ,068
Constants -1,029 ,392 6,899 1 ,009 ,357
* step model 5
3.3. Multivariate Analysis
Table 3 shows the statistical analysis that physical distancing variables that affect the level of student anxiety are
respondents who are asked to carry out quarantine/isolation, stay or contact with someone who has symptoms of
cough, fever, and shortness of breath, long time in the house, wearing a mask when outside home and diligently
washing hands, as well knowledge of COVID-19. The greatest influence strength (OR = 9.597) and the smallest
influence (OR = 0.015). The equation (Dahlan, 2014) obtained y = -0.394 with the probability value of
respondents experiencing anxiety levels in the co-19 transmission is 40.27%.
IV. DISCUSSION
In this study, the effect of physical distancing on the level of student anxiety on the spread of co-19 was
measured objectively which was analyzed through quantitative methods. The proportion of moderate/severe
anxiety levels (HRS-A score> 20) is 40.3%, consistent with the research (Abdessater et al., 2020) reporting more

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than 90% of respondents feel depressed by a co-19 pandemic. Whereas (Cao et al.,2020) mentioned 0.9% of
respondents experienced severe anxiety, 2.7% moderate anxiety and 21.3% experienced mild anxiety. In this
study, the physical distancing evaluation is also in accordance with previous research (Cornine, 2020) which
shows that public health emergencies can have many psychological effects on students which can be expressed
as anxiety, fear, and worry, where during the pandemic 24.9% of college students suffered anxiety that occurs
due to increasing distance between people who are quarantined (Wang, Horby, Hayden, & Gao, 2020) and lack
of communication and information (Kmietowicz, 2020).
This anxiety is also influenced by a large number of students and the community who carry out activities to
return to their area of origin because colleges or schools even offices take steps to be temporarily closed and
online learning, and there are still many people still doing activities outside the home due to socio-economic
factors for living needs as well as seeking government or private assistance, this is also in accordance with
studies of Previous various countries conducting travel warnings and restrictions and extending days off (online
learning) to control outbreaks that certainly disrupt life as usual (Kwok, Wong, Wei, Wong, & Tang, 2020; Tang
et al., 2020). Besides, also with the restrictions on mass gatherings and school closures cause students to be more
stay at home and do not indulge as usual so that the impact on the psychological, a person will feel tired and
bored to the situation, which is in line with studies past that restriction meeting mass and school closures have an
impact on public health during the pandemic (Juni et al., 2020).
Indications are that with the increasing number of patients and suspected cases, all provinces in Indonesia and
almost all countries affected (Bao et al., 2020; WHO, 2020), has caused public concern about COVID-19
outbreak infections, causing anxiety. Mass media coverage is related to the lack of personal protective equipment,
masks, disinfectants, and the many mass movements which add to people's anxiety and fears (Ayittey, Ayittey,
Chiwero, Kamasah, & Dzuvor, 2020). The results of this study indicate that the application of physical
distancing in an effort to use masks when outside the home has the highest risk of student anxiety, this also
illustrates that students have concerns about exposure to COVID-19 when mask distribution is increasingly
scarce and the selling value is relatively high so that some people do not affordable.
Other risk factors of living with or having been with someone who has symptoms of cough, fever, and shortness
of breath make it possible to make someone psychology a concern for themselves, due to the possibility of the
risk of exposure to COVID-19 will be even higher. This study has previously shown that relatives or
acquaintances infected with Covid-19 are independent risk factors for student anxiety about epidemics (Song et
al., 2019). Similar to the implementation of quarantine/isolation both carried out by health agencies and carried
out independently also have a significant correlation related to the level of anxiety, because it is related to
community stigma and or related to socio-economic problems. Those who carry out lectures while working will
not be able to carry out activities as usual so that economic conditions will be increasingly vulnerable and no
longer able to deal with it. This research is supported by research (Lei et al., 2020) that implementing quarantine
will make them anxious because they cannot be able to estimate how long this impact will last. This is what
allows physical distancing factors will trigger more anxiety levels especially students in the co-19 pandemic
period.
V. CONCLUSION
COVID-19 pandemic has an impact on students in undergoing physical distancing. Students feel worried that
they will be exposed to co-19 and are less able to carry out daily activities so that almost half of the respondents
experience moderate to severe anxiety. Students' mental health is greatly affected when faced with a public
health emergency, and they need attention, assistance, and support from the community, family, and tertiary
institutions in carrying out physical distancing. It is recommended that the government and University should
collaborate in solving this problem to provide timely, high-quality crisis-oriented psychological services to
students so that by managing psychosocial well-being during a pandemic it is equally important to manage
physical health is undergoing physical distancing.
VI. ACKNOWLEDGMENTS
Funding: none.
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