UNIVERSITI TEKNOLOGI MARA

THE EFFECT OF COVID-19 ON EMOTIONAL

MENTAL HEALTH AMONG BANDAR BUKIT
MAHKOTA COMMUNITY

MUHAMAD NURHAQEEM BIN MUHAMAD

KHAIRUDDIN
2020961227

Bachelor of Sport Science (Hons)

Faculty of Sport Science and Recreation

FEBRUARY 2022
 AUTHOR’S DECLARATION

I declare that the work in this thesis was carried out n accordance with the regulations of
Universiti Teknologi MARA. It is original and is the results of my own work, unless otherwise
indicated or acknowledged as referenced work. This thesis has not been submitted to any other
academic institution or non-academic institution for any degree or qualification.

I, hereby, acknowledge that I have been supplied with the Academic Rules and Regulations for
Postgraduate, Universiti Teknologi MARA, regulating the conduct of my study and research.

Name of Student : Muhamad NurHaqeem Bin Muhamad Khairuddin

Student I.D : 2020961227
Programme : Bachelor of Sport Science (Hons) – SR243
Faculty : Sport Science and Recreation
Thesis Title : The Effect of Covid-19 on Emotional Mental Health Among
Bandar Bukit Mahkota Community
Signature of Student :
Date : February 2022

i
 ACKNOWLEDGEMENT

First and foremost, I'd like to express my gratitude to Allah SWT for providing me with
the strength, blessings, and motivation to complete my research work on time. This difficult
challenge would not have been possible without my supervisor's, lecturers', friends', and
family's encouragement, support, and advice.
I would first like to thank my supervisor, Miss Nur Atikah Binti Mohamed Kassim who
has been amazing mentor, resource, and guidance throughout my research. I would not made
it this far without her support. Her wealth of knowledge, encouragement and advise have been
an immeasurable source of support for me during the process. Wan Muhammad Izzuddin and
Muhammad Aiman Fahmi have become a great partner in doing the research together. Always
have each other’s back when any of us need help and support.
In addition, I'd want to thank everyone at UiTM Pahang's Faculty of Sport Science and
Recreation for making my undergraduate experiences and memories in Jengka so memorable.
Thank you to every one of my family and friends for their unwavering support throughout the
process. I'd like to show my gratitude and appreciation to those who have stood with me for
the past two years, encouraging and supporting my work.
I would like acknowledge my parents, Juliana Binti Jufri and Muhamad Khairuddin Bin
Abu Bakar, and my partner Madarina Aman who have been my biggest supporter and thank
you for the unconditional love, patience, and also my shoulder to cry on when I need it. I
express my gratitude to them.

ii
 ABSTRACT
Mental health is a major public health concern that includes the risk of developing depression,
anxiety and stress. The rapid increase in urban population worldwide is one of the important
global health issues of the 21st century. The impact of urbanization is associated with an
increase in mental disorder through the influence of increase stressors and given the high
concentration population and economic activities in urban area, they are often becoming
hotspots of Covid-19 infections. The pandemic also determined a high risk for developing
negative emotions among the general population resulting from different factors, such as fear
of the contagion, economic burden, and social isolation. Therefore, the main purposed of this
study is to determine the mental health status among Bandar Bukit Mahkota community during
Covid-19 pandemic outbreak. This study also aimed to investigate the differences in mental
health status between gender and age-ranged among Bandar Bukit Mahkota community. A total
of 300 participants were selected through purposive sampling technique in this study. DASS-
21 questionnaire was used to measure the community’s mental health level respectively.
Independent sample t-test showed that there is a difference in mental health status between
gender among Bandar Bukit Mahkota community. Furthermore, one-way analysis of variance
(ANOVA) also showed that there was a statistically significant difference in mental health
status between age-group among Bandar Bukit Mahkota community. This concluded that when
self-isolation is applied on individual, several variables may cause them to engage in a different
sort of activity. The importance of the research findings might raise awareness about
community mental health, which had become one of the Malaysia's most critical concerns
during Covid-19 pandemic.

Keywords: DASS-21, mental health, Bandar Bukit Mahkota, Covid-19

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 TABLE OF CONTENTS
Page
LETTER TRANSMITTAL Ⅰ
AUTHOR’S DECLARATION Ⅱ
ACKNOWLEDGEMENT Ⅲ
ABSTRACT Ⅳ
TABLE OF CONTENTS Ⅴ
LIST OF TABLES Ⅵ
LIST OF FIGURES Ⅶ

CHAPTER ONE: INTRODUCTION

1.1 Background of Study 1
1.2 Problem Statement 2
1.3 Research Objectives 3
1.4 Research Questions 3
1.5 Significance of Study 3
1.6 Delimitation of Study 3
1.7 Limitation of Study 4
1.8 Definition of Terms 4

CHAPTER TWO: LITERATURE REVIEW

2.1 Introduction 6
2.2 Coronavirus Disease 2019 6
2.3 Movement Control Order 7
2.4 Depression 8
2.5 Anxiety 9
2.6 Stress 10

CHAPTER THREE: METHODOLOGY

3.1 Introduction 11
3.2 Research Design 11
3.3 Population and Sampling 11
3.4 Instrumentation 13
3.5 Data Procedure 13
3.6 Data Analysis 14

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CHAPTER FOUR: RESULTS AND DISCUSSIONS
4.1 Introduction 15
4.2 Normality Assumption 15
4.3 Normality Testing 16
4.4 Demographic Data 17
4.5 Descriptive Analysis 19
4.6 Independent Samples T-Test 19
4.7 One-Way ANOVA 21

CHAPTER FIVE: CONCLUSION AND RECOMMENDATION

5.1 Introduction 22
5.2 Discussion 22
5.3 Implication of Study 24
5.4 Future Recommendation 24
5.5 Conclusion 25

REFERENCES 26
APPENDICES 29

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 LIST OF TABLES
Tables Title Page
Table 4.1 Normality Assumption 15
Table 4.2 Demographic Data of Respondents 17
Table 4.3 Descriptive Data 19
Table 4.4 Group Statistics on Male and Female 19
Table 4.5 Independent Samples T-Test 20
Table 4.6 One-Way ANOVA 21
Table 4.7 Multiple Comparisons 21

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 LIST OF FIGURES
Figures Titles Page
Figure 4.1 Normal Q-Q for DASS-21 16

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 CHAPTER ONE
INTRODUCTION

1.1 Background of Study

Coronavirus disease or formally known as COVID-19 brought a big influence on our

daily life since its’ first outbreaks. As of 2nd June 2021, there were more than 178 billion
COVID-19 cases were reported worldwide and almost 2 billion deaths were confirmed
according to the World Health Organization (2020). The outbreak was declared as public health
emergency of international concern in January 2020, and in March 2020, it was declared as a
pandemic (WHO, 2020).
Numerous governments imposed severe restrictions on public life in an attempt to
contain the spread of disease. Initial data support the assumption that related measures (e.g.,
business closures, prohibitions on social gatherings or lockdowns), as well as the
recommendation of social isolation, can effectively limit the virus's spread (Wilke et al., 2020).
Governments’ immediate protective restrictions modified the habit of the individuals which
included complete lockdowns of cities, travel restrictions, social gathering restrictions, and
school suspensions (Di Corrado et al., 2020).
With lots of public health measures and standard of operation it would be expected that
the people will face with new norms and changes on the things that they usually do on a daily
basis. For example, the limitation of the public recreation facilities, public parks and
playgrounds would make the people do things innovatory in their new physical activity
practices. Despite these potential challenges to physical activity engagement through restricted
recreation centre access and closure of city parks and playgrounds, as working from home
becomes mainstream, opportunities to engage in flexible lifestyles may permit opportunities to
incorporate physical activity more naturally into daily living (Nations, 2020).
These procedures changed radically the routine of the individuals, imposing a large
burden on families, whereby parents and children stayed at home for the entire day (Di Corrado
et al., 2020). A noted increase in negative psychological side-effects such as post-traumatic
stress syndrome, confusion and anger have been reported as an outcome of the pandemic and
associated quarantine (Lesser & Nienhuis, 2020). However, it could also be argued that

1
lifestyle disruption may result in the formation of increased physical activity habits
(Hargreaves et al., 2021).

1.2 Problem Statement

This pandemic might take a long time to subside and its lasting impact on the
individuals’ lifestyle-related behaviour including diet, physical activity and sleep patterns is
bound to be significant (Kumari et al., 2020). In order to curb the transmission and better
managed the clusters, Malaysia imposed the Movement Control Order (MCO) which is now in
its fourth phase. The MCO, in conjunction with targeted screening, has significantly slowed
the spread of the COVID-19 epidemic (Aziz et al., 2020). These exceptional war-like restrictive
measures induced a huge effect on psychosocial health and strongly influenced lifestyle habits.
Along these lines, it is mandatory to pay attention to negative psychological effects (i.e.
anxiety, fear, panic) and changes in lifestyle and nutritional habits (Cirillo et al., 2021).
Restrictions have been applied in different ways all over the world, including remote-
flexible working hours, lockdown for the elderly and individuals with chronic diseases who
constitute the risk group, and advising other individuals not to go out unless necessary, in order
to reduce social mobility to prevent the spread of the epidemic (Ozdemir et al., 2020).
Individual psychological factors include such factors as confidence and perceived competence,
while the social environment is inclusive of emotional and logistical support from the home,
and lastly the physical environment is inclusive of access to low-cost recreational opportunities
and outdoor physical activity opportunities (Lesser & Nienhuis, 2020).
A fitness centre is an indoor activity by offering sports activities using equipment, or
without using expensive and sophisticated equipment, which among others aims at health or
achievement. According to Butarbutar (2002), the reason individuals do fitness sports activities
in a fitness place is to satisfy their needs, in other words individuals have different motivations
in doing sports fitness activities in a fitness place. Physically active individuals generally
experience less stress, depression, and anxiety, and physical activity has received attention in
recent years as a potential treatment for depression and anxiety in addition to, or in place of,
pharmaceuticals. An especially promising benefit of physical activity arises from research done
in an outdoor environment with increased nature exposure (Di Renzo et al., 2020).
However, during this pandemic situation, all Malaysian are required to stay and
exercise at home, only allowed to do physical activity within 10km radius and were not allowed
to do their routine activity at any fitness centre. Physical activity (PA) increases the quality of

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life and overall health. There is a growing body of literature that recognizes the positive effects
of exercise on mood states such as anxiety, stress and depression (Mikkelsen et. al., 2017).
Since the COVID-19 pandemic is still going, thus it will affect the mental health of many
persons because they are not allowed to engage in their physical activity normally. Hence, the
purpose of this study is to identify the mental health status of the Seksyen 6, Bandar Bukit
Mahkota community during COVID-19 pandemic outbreak.

1.3 Research Objectives

There are two main objectives in this study. The objective of this study is:
1.3.1 RO1: To investigate the mental health status among Seksyen 6, Bandar Bukit
Mahkota community.
1.3.2 RO2: To investigate the difference in mental health status between gender
among Seksyen 6, Bandar Bukit Mahkota community.
1.3.3 RO3: To investigate the difference in mental health state between age-group
among Seksyen 6, Bandar Bukit Mahkota community.

1.4 Research Questions

1.4.1 RO1: Is there any difference in mental health status between gender among
Seksyen 6, Bandar Bukit Mahkota community?
1.4.2 RO2: Is there any difference in mental health status between age-group among
Seksyen 6, Bandar Bukit Mahkota community?

1.5 Significance of Study

Individuals might have different factors may engage in a different type of activity when
self-isolation have been implemented to them. The significance of the study’s findings might
create awareness regarding community’s mental health as it had become one of the serious
issues in Malaysia during COVID-19 pandemic.

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1.6 Delimitation of Study

There are some of the delimitations of study:

1.6.1 The respondents of this study are the community who lives in Seksyen 6,
Bandar Bukit Mahkota only.
1.6.2 This study using Depression Anxiety Stress Scale (DASS-21) by Lovibond
and Lovibond (1995).

1.7 Limitation of Study

1.7.1 It is unknown whether all respondents fully comprehend the explanation and
instruction provided, however, a written and brief explanation was included in
the questionnaire.
1.7.2 It is difficult to know whether the respondents honestly answer the
questionnaire as required therefore, the importance of the data usage and the
significance contribution made from this study will be enlighten.

1.8 Definition of Terms

1.8.1 Coronavirus Disease 2019 (COVID-19)

COVID-19 is an illness caused by a new coronavirus strain. Corona is
represented by the letter CO, virus by the letter VI, and illness by the letter D. This
disease was previously known as the ‘2019 novel coronavirus,' or ‘2019-nCoV.' The
COVID-19 virus is a novel virus that belongs to the same virus family as Severe Acute
Respiratory Syndrome (SARS) and several ordinary colds.

1.8.2 Quarantine and Isolation

By restricting public exposure to those who have or may have a contagious
disease, quarantine and isolation help to safeguard the public. Quarantine is the process
of separating and restricting the movement of people who have been exposed to a
contagious disease in order to see if they become ill. Isolation is a method of separating
sick persons with infectious diseases from healthy ones.

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1.8.3 Depression
Depression (major depressive disorder) is a widespread and significant medical
condition that has a negative impact on how you feel, think, and behave. It is also,
luckily, curable. Depression produces unhappiness or otherwise have a loss of interest
in previously appreciated activities. It can cause several of the mental and physical
issues, as well as a reduction in your capacity to perform at work and at home.

1.8.4 Anxiety
Anxiety is an emotion of uneasiness that can range from minor to severe, such
as worry or fear. Anxiety affects everyone at some time in their lives. You could be
scared and nervous about taking an exam, a medical test, or a job interview, for
example.

1.8.5 Stress
Stress is a natural human emotion that affects everyone at some point in their
lives. In reality, the human body is built to recognise and respond to stress. Your body
creates physical and mental reactions in response to changes or difficulties. That is what
stress feels like.

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 CHAPTER TWO
LITERATURE REVIEW

2.1 Introduction

This chapter will examine the literature related to mental health which consists of
depression, anxiety, and stress. To enable easy comprehension of the literature, this chapter
discussed the related literature review under several sub-headings.

2.2 Coronavirus Disease 2019

Coronavirus is an enveloped, positive single-strand RNA virus. It belongs to the

Orthocoronavirinae subfamily, as the name, with the characteristic “crown-like” spikes on their
surfaces.5 Together with SARS-CoV, bat SARS-like CoV and others also fall into the genus
beta-coronavirus. (Wu et al., 2020) In the history, SRAS-CoV (2003) infected 8098 individuals
with mortality rate of 9%, across26 countries in the world, on the other hand, novel corona
virus (2019) infected 120,000 individuals with mortality rate of 2.9%, across 109 countries, till
date of this writing. It shows that the transmission rate of SARS-CoV-2 is higher than SRAS-
CoV and the reason could be genetic recombination event at S protein in third region of SARS-
CoV-2 may have enhanced its transmission ability (Shereen et al., 2020) .
SARS-CoV-2 spreads rapidly from person to person, but it was initially hypothesized
that, SARS-CoV-2 was propagated by animal to human via direct contact with an
intermediary host. Consumption of infected, raw or semi-cooked meat may also lead to the
transmission of the virus. COVID-19 is a zoonotic disease where an animal virus undergoes
mutations that permit it to infect and replicate inside the human body where it spreads
rapidly through the human population. (Elengoe, 2020) Therefore, it is crucial to trace the
travel and exposure history when approaching a suspected patient back from an epidemic
area. (Wu et al., 2020) COVID-19 symptoms are manifest usually as fevers, a dry cough and
tiredness. Some infected individuals may have mild symptoms like headaches, muscle pains,
runny nose, sore throat or diarrhea. Some COVID-19 patients may suffer from severe
pneumonia, organ failure, acute respiratory tract infection and septic shock, which can lead
to death. (Elengoe, 2020)

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2.3 Movement Control Order

In Malaysia, the Movement Control Order (MCO) was implemented on the 18th March
and was in place until the 28th April to control the spread of COVID-19 nationwide. (Elengoe,
2020) The urgent need to understand what type of political, social, and economic interventions
must be implemented to confront COVID-19 has prompted various countries to quickly take
practical actions to limit the spread. However, more studies are required to analyse the
effectiveness of these intervention actions. One major action that is enforced in most countries
is locking down the whole area or city in controlling the spread of the pandemic (Amiruzzaman
et al., 2020).
The early management of COVID-19 in Malaysia, prior to the MCO, was challenging.
Initially, the reporting of COVID-19 was classified as an influenza infection due to the
concurrent winter season in the northern hemisphere countries together with the movement of
people during the end of year holiday season. Based on this presumption, although initial
precautions had been implemented by the Ministry of Health, earlier actions identified people
who were at risk and those with influenza like illness to be screened and further managed. Due
to the novel characteristics of the virus, many countries including Malaysia had assumed that
the COVID-19 infection could be a local outbreak whereby chances of the spread to other
countries were slim (Aziz et al., 2020).
The MCO incorporated three key measures, namely, implementation of border control,
control of public movement, and prohibition of public gathering and promotion of social
distancing. Malaysia closed its international border entry points except for foreigners leaving
the country and for Malaysians returning from overseas (Hashim et al., 2021). Predicting the
nature of growth of the COVID-19 infections is important so that resources can be allocated,
and national scale decisions can be made to slow down the spread of the infection through
MCO and/or other actions that can be implemented to reduce the spread between individuals.
In the past, researchers followed statistical and mathematical approaches in forecasting the
spread of a virus (Amiruzzaman et al., 2020).

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2.4 Depression

The COVID-19 pandemic embodies many overwhelming stresses. A few of the obvious
ones are loss of employment; deaths of family members, friends, or colleagues, financial
insecurity; and isolation from others, particularly in those who live alone. When called upon,
clinicians must try to sort out demoralization from depression. Demoralized persons benefit
from encouragement and support and from engagement in any efforts that lead to a sense of
mastery (Shader, 2020). For the individual who is depressed - often frightened, lonely and
bewildered - and for that person's relatives, this book does not have the immediate helpful
impact of an earlier paperback (McCarron et al., 2021). According to Ju et al. (2021), previous
studies have documented the huge psychological impact of a new and dangerous pathogen on
infected patients during the acute phase and aftermath. For those who survived, studies have
shown long-term psychological consequences such as anxiety, depression, and post-traumatic
stress disorder (PTSD).
We begin by providing an historical overview of cognitive theories of depression. We
then review major advances in our understanding of cognition and depression, focusing
specifically on cognitive deficits in executive functioning, working memory, and pro-cessing
speed; cognitive biases in self-referential processing, attention, interpretation, and memory;
deficits in cognitive control over stimuli or information that is congruent with one's emotional
state (i.e., mood-congruent material); and the cognitive emotion regulation strategies of
rumination, distraction, and reappraisal. (LeMoult & Gotlib, 2019) Hence, it is interesting to
examine the effect of different isolation forms on the mental status of cured patients through
an empirical investigation. In this study, we assessed the level of depression, anxiety, and self-
rated health in cured patients with COVID- 19 before and after post-discharge isolation, aiming
to investigate the impact of isolation form on the psychological well-being of patients with a
pandemic infectious disease (Ju et al., 2021).
Given the high prevalence and substantial burden of depression, it is not surprising that
investigators have conducted a great deal of research with the goal of increasing our
understanding of the onset, maintenance, and treatment of depressive episodes (LeMoult &
Gotlib, 2019).

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2.5 Anxiety

Anxiety disorders form the most common type of mental illness (Penninx et al., 2021).
According to author, anxiety disorders comprise separation anxiety and selective mutism
(occurring primarily in childhood; between the ages of 4 years and 18 years), specific phobias,
social anxiety disorder, and generalised anxiety disorder (occurring in childhood as well as in
adulthood), as well as panic disorder and agoraphobia (occurring primarily in adulthood; from
the age of 18 years and older). We are already seeing ways that COVID-19 can heighten anxiety
in those with a history of traumatic isolation, or OCD, or chronic schizophrenia with a need for
predictable routines. Such forms of anxiety typically benefit from targeted support, behavioural
interventions such as mindfulness and CBT, and/or medication (Peteet & Org, 123 C.E.).
Psychosocial responses to infectious disease outbreaks are variable and can include
feelings of anxiety or weakness, an overestimation of the likelihood of infection, the excessive
and inappropriate adoption of precautionary measures and an increased demand for health care
services in a time of shortage (Choi et al., 2020) Anxiety about COVID-19 and associated
social isolation are not limited to China. In Iran, Ahorsu et al. (in press) investigated anxiety
specifically from COVID-19, finding moderate COVID-19 anxiety and moderate associations
with general anxiety and depression severity (Elhai et al., 2020).
The current pandemic, like the onslaught of cancer, also evokes in many of us a deeply
rooted, existential anxiety experienced as a threat to our accustomed identity, and to our sense
of place in the world. The virus’s rapid worldwide spread engenders a confrontation with our
selves, with who we are as a society, and with our assumptions about where we can ultimately
place our trust (Peteet & Org, 123 C.E.). Fear and anxiety about the COVID-19 pandemic can
be overwhelming and cause strong emotions. Besides, poor mental health during infectious
disease outbreaks can be related to an individual’s misinterpretation of health-related stimuli
such as bodily sensations and changes. People might misinterpret harmless bodily sensations
or changes as signs of infection, causing them to become unduly distressed (Choi et al., 2020).

9
2.6 Stress

The concept of ‘stress’ is pervasive in biology, and the responses to stress can be
appreciated at various timescales. The term also has both positive and negative connotations.
If talking about physical strain, i.e. mechanical stress, then stress can be intertwined with
normal developmental processes. Martin (2014) Selye used the word “stress” to denote the
specific physiological response that organisms mount to nonspecific demands, including both
negative challenges (e.g., starvation, infection) and positive challenges (e.g., foraging or
mating opportunities; Selye 1976) (Del Giudice et al., 2018).
The literature on recent outbreaks, such as Ebola, the Severe Acute Respiratory
Syndrome (SARS), and Middle Eastern Respiratory Syndrome (MERS), showed unique
consequences of mental health burden during pandemics. Several factors were identified in the
process of under-standing how the public would respond during disease out-breaks, including
disease course, media and misinformation, quarantine, neuropsychological sequelae of the
infected in-dividual, and the mental health burden among health care-workers. During a
quarantine, people face many consequences of physical and emotional social distancing,
including isolation and future uncertainty. Degrees of isolation vary between individuals,
ranging from physical (i.e., contact) or symbolic (i.e., separation from loved ones), and affect
the human psyche (AlAteeq et al., 2020).
A recent review examined the psychological impact of quarantine, reporting stress
symptoms, confusion, anger, infection fears, frustration, and boredom. Other researchers
concluded that quarantine and isolation could lead to anxiety and depression. Moreover, the
prolonged home stay in many cases may include a reduction of the level of physical activity
(hence lower energy expenditure) to maintain an adequate health status (Di Corrado et al.,
2020). To this end, in this study we sought to identify the major causes of stress for Korean
employees and to examine the correlation of each cause with depression, anxiety and,
ultimately, suicidal ideation. We also investigated what kind of stress is associated with suicidal
ideation when the impacts of depression and anxiety, which influence suicidal ideation, were
controlled (Shin et al., 2017).

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 CHAPTER THREE
RESEARCH METHODOLOGY

3.1 Introduction

This chapter discussed about the research design, population and sampling, data
collection procedures and data analysis to achieve the desired objective of this study. Secondly,
this chapter also described the method of administering the questionnaire. Finally, it discussed
the way of getting the data ready for analysis and the statistical tools used to analyse the data.
The purpose of this study is to investigate the mental health status among Seksyen 6, Bandar
Bukit Mahkota community. Specifically, this study attempted to:

3.1.1 To investigate the difference in mental health state between gender among
Seksyen 6, Bandar Bukit Mahkota community.
3.1.2 To investigate the difference in mental health state between age-group among
Seksyen 6, Bandar Bukit Mahkota community.

3.2 Research Design

This study employed a descriptive research design and was conducted via survey
method. This method was chosen due to the cost and time savings associated with it, as well as
the fact that it had a higher return rate and was more representative than a postal or telephone
survey (Sekaran, 2003).

3.3 Population and Sampling

The population is a group to whom a researcher’s research result would be generalized

(Gay, Mills, & Airasian, 2009). The first step in sampling technique is to identify the target
population and the accessible population. The targeted population in this study will be the
community from Seksyen 6, Bandar Bukit Mahkota. Next, the sampling method used in this
study was purposive sampling technique to select the population since the researcher knows
the specific characteristics that exist in the targeted population. The sampling criteria needed
was the respondents must reside in the MCO zone area.

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3.3.1 Sample Size

The total population for this study is 1671. According to Krejcie and Morgan
(1970), the recommended sample size for the above total population will be about 310
participants. However, a total of 372 participants will be involved in this study
considering 20% of dropout rate if there is any missing or incomplete data.

Calculation:
The sample size will be determined using the Krejcie and Morgan table (1970).
N = population, S = sample size.
N = 1671
S = 310
20% dropout = 62
TOTAL = 372 participants
N S N S N S
10 10 220 140 1200 291
15 14 230 144 1300 297
20 19 240 148 1400 302
25 24 250 152 1500 306
30 28 260 155 1600 310
35 32 270 159 1700 313
40 36 280 162 1800 317
45 40 290 165 1900 320
50 44 300 169 2000 322
55 48 320 175 2200 327
60 52 340 181 2400 331
65 56 360 186 2600 335
70 59 380 191 2800 338
75 63 400 196 3000 341
80 66 420 201 3500 346
85 70 440 205 4000 351
90 73 460 210 4500 354
95 76 480 214 5000 357
100 80 500 217 6000 361
110 86 550 226 7000 364
120 92 600 234 8000 367
130 97 650 242 9000 368
140 103 700 248 10000 370
150 108 750 254 15000 375
160 113 800 260 20000 377
170 118 850 265 30000 376
180 123 900 269 40000 380
190 127 950 274 50000 381
200 132 1000 278 75000 382
210 136 1100 285 1000000 384
Note — N is population size. S is sample size. Source: Krejcie & Morgan, 1970

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3.4 Instrumentation

The research instrument in this study will be in questionnaire form. The questionnaire
will be consisted of two parts. Section A deals with demographic profiles of the respondents
that describe respondent’s characteristics such as age, gender, and marital status. In this section
also close ended question will be use. Meanwhile, section B comprised with depression,
anxiety, and stress scale (DASS-21) in dual language (Malay/English) version. The DASS 21
measures symptoms of depression, anxiety, and stress. It comprises three subscales that each
has seven items: depression (Q3,5,10,13,16,17,21), anxiety (Q2,4,7,9,15,19,20), and stress
(1,6,8,11,12,14,18). Each item is scored on a 4-point Likert scale ranging from 0 (“did not
apply to me at all”) to 3 (“applied to me very much”). The DASS-21 Scale was conducted
locally and the Cronbach’s alpha values at baseline were between 0.81 and 0.83 whereas for
test retest, the values were from 0.82 to 0.84 (Musa et. al,. 2011). According to Pallant (2012),
the generally agreed upon power limit for Cronbach’s Alpha was 0.7, hence, this questionnaire
is valid and reliable to be used in this study.

3.5 Data Procedure

The permission to conduct the study was carried out by first submitting the ethics form
to get the approval from the faculty and UiTM Research Committee. Once approved, a data
collection procedure was done. All the participants were approach via personal email or any
online resources such as What’s App or Telegram App. Once they agreed to do the study, they
were informed about the purposed of the study and be assured of their confidentiality in this
study. All the information taken will be used as the purpose for research study only. The
questionnaires were distributed to the participants through online platform and the participants
were asked to fill out an inform consent letter and demographic data form. Written instruction
and ample time was given for them to answer the questionnaire. It was estimated that the time
taken to finish answering the questionnaire will be less than 10 minutes.

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3.6 Data Analysis

Statistical Package for Social Science (SPSS) software for Windows application
version 26.0 will be used to analyse the data. Descriptive statistics (mean, standard deviation
and percentage) will be used to describe the demographic data (e.g. gender, age, age-group) of
the respondents and determine level of mental health.
For inferential statistics, independent samples t-test was used to compare the difference
of quality of life between gender among the Seksyen 6, Bandar Bukit Mahkota community and
meanwhile to compare the difference on quality of life between different age-group among
Seksyen 6, Bandar Bukit Mahkota community, one-way Analysis of Variance (Anova) was
used.

14
 CHAPTER FOUR
RESULTS AND FINDINGS

4.1 Normality Assumption

The table 4.1 below showed the normality testing for all variables. The results of the
normality tests revealed that the skewness and kurtosis value of the variables with normal
distribution. Skewness and kurtosis value each variable were examined to assess the assumption
of normality. The variable’s skewness values for the measures ranged from .60 to .88 while
kurtosis values ranged from -.32 to .01. The skewness and kurtosis values of these variables are
different from zero, which indicates that although all values are in the range of +/- 1 SD, none
of the distributions are completely normal, so reasonable assumptions about normality can be
made. Skewness and kurtosis between -2 to +2 will be considered acceptable based on (Taber,
2018).

Table 4.1
Normality Assumption on Depression Anxiety Stress Scale-21 (DASS-21)
Variables Mean SD Min Max Skewness Kurtosis
Depression .89 .78 0 3 .88 .01
Anxiety .88 .71 0 3 .80 .14
Stress 1.00 .73 0 3 .60 -.32

15
4.2 Normality Testing

Normality testing refers to the shape of the data distribution that correspond to the data
distribution (Pallant, 2013). Among of them wore the Q-Q plot, skewness, and kurtosis. Graph
below shows normality plot for the distribution.

Figure 4.1: Normal Q-Q Plot for DASS-21

The graph in figure 4.1 above showed the normality data obtained from the result of
DASS-21 among the Bandar Bukit Mahkota Community. The data points will be close to
diagonal when the data is normally distributed. The data will not normally distributed if the
data points deviate from the straight line in a significantly non-linear manner. As can be seen
from the graph above that the data is normally distributed.

16
4.3 Demographic Data

The first section of the questionnaires described about the demographic profile of the
respondents. The demographic profile included gender, age range, marital status, occupation and
ethnicity.

Table 4.2
Demographic Data of Respondents
Frequency Percent
Gender Male 117 39.0
Female 183 61.0
Total 300 100.0
Age Range Early Adulthood 203 67.7
(18-34)
Early Middle Age 34 11.3
(35-44)
Late Middle Age
63 21.0
(45 and above)
Total 300 100.0

Marital Status Single 194 64.7

Married 105 35.0
Divorced 1 .3
Total 300 100.0
Occupation Government Sector 28 9.3
Private Sector 67 22.3
Self Employed 25 8.3
Unemployed 35 11.7
Student 145 48.3
Total 300 100.0
Ethnicity Malay 291 97.0
Chinese 2 .7
Indian 4 1.3
Other’s 3 1.0
Total 300 100.0

17
 Table 4.2 showed that 300 respondents’ demographic data. Respondents’ gender that
answered the questionnaire mostly are female with frequency 183 (61%) and male with a
frequency 117 (39%).
The age range of respondents’ who is mostly from the early adulthood category in 18
to 34 years old with 203 (67.7%) followed with late middle age which is 45 and above with
frequency 63 (21.0%) and the least is from the early middle age which 35 to 44 years old with
the frequency of 34 (11.3%).
In marital status section, the singles were the highest among the respondents that answer
the questionnaires with frequency of 194 (64.7%). The second highest is married with 105
(35.0%) and the least which is divorced is only 1 (0.3%) respondent only.
For the occupation sections, students are more likely to answer the questionnaires with
145 (48.3%) majority of the respondents. Follow with private sector with 67 (22.3%)
respondents, follow with unemployed with 35 (11.7%), the second least is come from the
government sector with 28 (9.3%) respondents and the least frequency is from the self-
employed which is 25 (8.3%).
Most of the respondents based on their ethnicity is come from the Malay with a
frequency of 291 (97.0%), followed with the Indian which is 4 (1.3%) respondents, and the
least is Chinese and others with frequency of 3 and 2 respondents.

4.4 Descriptive Analysis

Table 4.3
Descriptive Data
N Mean Std. Deviation
Depression 300 .89 .78
Anxiety 300 .88 .71
Stress 300 1.00 .73

Table 4.3 showed the descriptive data on three subscales and the total of the subscales
of 300 respondents among Bandar Bukit Mahkota Community which is (Q3, Q5, Q10, Q13,
Q16, Q17 and Q21) is for the depression scale, (Q2, Q4, Q7, Q9, Q15, Q19 and Q20) is for the
anxiety scale and the scale for stress is (Q1, Q6, Q8, Q11, Q12, Q14, and Q18). In this table,
mean for the stress is 1.00 which is the highest among the other two depression = .89 and anxiety
= .88. It means that Bandar Bukit Mahkota Community tend to feel stress throughout the
pandemic and self-isolation.

18
4.5 Independent Samples T-Test

Table 4.4
Group Statistics on Male and Female
Gender N Mean Std, Deviation Std. Error Mean
Total Male 114 .69 .55 .05
Female 178 1.07 .73 .06

The independent sample t-test was conducted to investigate whether DASS-21 score
differ between male and female participants. The results in Table 4.4 showed the total DASS-
21 score between male and female. It revealed that the female participants (M = 1.07, SD =
.73) had higher mean score in total of DASS-21 compared to male participants (M = .69, SD =
.55).

Table 4.5
Independent Samples T-Test
Levene’s Test
for Equality
of Variances
T-test for Equality of Means
95%
Confidence
Std Interval of the
Sig (2- Mean Error Difference
F Sig. t df tailed) Diff Diff Lower Upper
Total Equal 10.601 .001 -4.793 290 .000 -.384 .080 -.541 -.226
variances
assumed
Equal -5.100 283. .000 -.384 .075 -.532 -.236
variances 003
not
assumed

In order to compare the mean score of total DASS-21 score, Independent Sample t-test
was used. The Levene’s test for equality of variances indicated that there was a violation of
assumption in total DASS-21 (F = 10.60, p <.05), therefore the equal variance not assumed t-
statistics was used for evaluating the hypothesis of equality means. The result from t-test
conducted demonstrated that there was a significant difference in the total DASS-21 mean
score between male and female participants (t (283) = -5.10, p <.05).

19
4.6 One-Way ANOVA
To establish whether the mental health status would differ among age-group, one-way
Analysis of Variance (ANOVA) was used. The age-group was divided into three categories
with reference by Medley (1980). The age-group which is early adulthood, early middle age,
and late middle age it is to determine is there any differences of mental health status among the
age range. Group one consists of below 34 years old (early adulthood), group two consists of
35 to 44 years old (early middle age) and group three consists of 45 and above (late middle
age).

Table 4.6
ANOVA
Sum of df Mean F Sig.
Squares Square
Between 29.46 2 14.73 38.73 .000
groups
Within 109.91 289 .38
groups
Total 139.37 291

Based on the Table 4.7 below, one-way Analysis of Variance (ANOVA) has showed
that p < .05 which mean there is a significant difference between early adulthood and early
middle age, late middle age. But there is no significant difference between early middle age
and late middle age since the p > .05.

Table 4.7
Multiple Comparisons
95% Confidence
Interval
Mean Lower Upper
Difference Std. Bound Bound
(I) Age Range (J) Age Range (I-J) Error Sig.
Early Adulthood Early Middle Age .494* .115 .000 .22 .76
(18-34) (35-44)
Late Middle Age .750* .090 .000 .54 .96
(45 and above)
Early Middle Early Adulthood -.494* .115 .000 -.76 -.22
Age (35-44) (18-34)
Late Middle Age .257 .132 .127 -.05 .57
(45 and above)
Late Middle Early Adulthood -.750* .090 .000 -.96 -.54
Age (45 and (18-34)
above)
Early Middle Age -.257 .132 .127 -.57 .05
(35-44)

20
 CHAPTER FIVE
DISCUSSION

5.1 Introduction
The overall data that has been analysed is summarised in this chapter. The purpose of
this study is to investigate the mental health status among Bandar Bukit Mahkota Community.
Furthermore, this study aims to determine the differences mental health status among gender
and to know the differences mental health status among different age-group. The data was
collected to measure the community’s mental health state level using Depression Anxiety
Stress Scale-21 (DASS-21) developed by Lovibond and Lovibond (1995). The data was
analysed using Statistical Package for Social Science Version 26 Program (SPSS). Conclusions
and recommendations are discussed at the end of this study based on the data that have been
analyse.

5.2 Discussion

Discussion would be based on research objective from earlier chapter on this study. The
objective of this study was to investigate the level of mental health state among gender and
different age-group among Bandar Bukit Mahkota Community. Result showed that female is
the highest respondent with 183 respondents (61%) more than male 117 respondents (39%).
Based on Mental Health Foundation (2021) women generally find it easier to talk about their
feelings and have stronger social networks, both of which can help protect their mental health.
Male responded with adverse life events, using more frequently denial, self-distraction and
venting, which contradictory with previous studies finding which indicate that women using
more emotional coping strategies as compared to man (Tamres et al., 2002).
Next, result for the normality assumption it shows that mostly Bandar Bukit Mahkota
Community more likely to feel stress than depression and anxiety. The mean score for the stress
normality score is M = 1.0. With the restriction order and new norm of doing things online may
put a positive and negative impact to the community itself. However, too much stress can
cause negative effects. It can leave us in a permanent stage of fight or flight, leaving us
overwhelmed or unable to cope. Long term, this can affect our physical and mental health
(Mental Health Foundation, 2016).

21
 For the Independent Samples t-test for total DASS-21 shows that on Levene’s Test for
Equality of Variances shows that the p value is .001, this means that the variances for the male
and females are not the same. Therefore, the data violate the assumption of equal variance and
it will indicate Equal variances not assumed. On the Sig. (2-tailed) the p value is .000 hence
there is a significant difference in the total DASS-21 score among male and female. Hence,
these results seem to point out that although the objective risk, due to morbidity and mortality
of the COVID-19 pandemic, is significantly greater for men, the emotional response is higher
in women, which evidences the existence of other factors, beyond verified data on severity,
influencing the emotional response (García-Fernández et al., 2021).
On the ANOVA results, the p value on the Sig. is .000 which means there is a significant
difference in somewhere among the mean score for the DASS-21 score among early adulthood,
early middle age, and late middle age. If there is a significant difference in the overall ANOVA.
The post-hoc multiple comparisons shows the differences among the age range, the
significance value in the column Sig. showed that .000 which means early adulthood and early
middle age, early adulthood and late middle age there are statistically significantly different
from one another. It shows that the groups differ significantly in terms of their optimism scores.
However, there is no significant differences between the early middle age and late middle age
which the Sig. shows that p < .05 between the two-age group.
Explore Health Careers (2020) said among the older generations, mental health is still
something that isn’t talked about enough. This isn’t because older generations don’t believe in
mental healthcare. It’s because a high percentage of older adults don’t have access to healthcare
that covers mental health services. Adults who were relatively older may have regulated their
emotions by focusing on the good or choosing activities and interactions that lowered their
stress while the COVID-19 outbreak was beyond their control. However, only time will tell
whether older adults were overly optimistic. While false optimism can help people manage
their emotions in the short term, it can also make them unprepared for poor results in the future.

22
5.3 Implication of study
The findings showed that in this hard time we always need to take care of our mental
regardless of gender and age range to ensure we live in a healthy physiological and
psychological life. The implication of this study is divided by two which are the implication
different type of mental health settings among people and the implication of different
generation of struggles. First, the researcher hopes that this study can contribute significantly
to the community through better mental health awareness among gender and age range. Hence,
by providing the data to the universities, the researcher hope that it will give them awareness
and eye opening to those who suffer from mental illnesses are deserving of compassion,
understanding, and chances to hope, healing, recovery, and fulfilment.
Social media platforms are progressively developing as a rich source of mass
communication. Increasing mental health awareness with the help of social media can be a
good initiative to reach out to many people in a short time frame (Latha et al., 2020).

5.4 Future recommendation

Finally, this research is mainly focus on Bandar Bukit Mahkota Community. The result
of this study comes out with a lot of information to know the differences emotional mental
health state among gender and age range. It will benefit for next researcher and create
awareness on mental health. Furthermore, it will be interesting if future study can conduct other
research with the participation of the differences background of socioeconomic to see the
different emotional mental health state. Future research can know how different socioeconomic
could affect their emotional mental health state. Other suggestion is using the same method of
this study but more focus specifically on the level depression, anxiety and stress scale among
gender and age range but different socioeconomic.
Finally, future researcher can conduct future research on different area which is rural,
sub-urban, and urban area that would influencing the different of emotional mental health state
among different socioeconomic. This study argues that a sharper focus on socioeconomic
factors is required in research and policy to address inequalities in mental health. Current
attempts to move this direction include evaluation of the impact of economic policies on mental
health, community-based partnerships, increased professional awareness and advocacy on
socioeconomic factors (Macintyre et al., 2018).

23
5.5 Conclusion

In conclusion, this research focuses on how covid-19 effecting the emotional mental
health among Bandar Bukit Mahkota Community between gender and age range. Hence, there
is a significant difference between gender on emotional mental health among this community
and the differences of age range effecting the emotional mental health among Bandar Bukit
Mahkota Community. In addition, mental health is something that we need to take seriously
because it is in our community and everyone could have the same mental health problem. Based
on the result, lack of mental health awareness could lead to another problem in the future and
people would be more afraid to speak out on what their feeling. Raising mental health
awareness can help you understand the symptoms, find treatment, and possibly break the
stigma associated with mental illness that keeps so many people suffering in silence.

24
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Appendices
Demographic Data
SOAL SELIDIK LATAR BELAKANG PENDUDUK BANDAR BUKIT MAHKOTA.
BACKGROUND QUESTIONNAIRE FOR BANDAR BUKIT MAHKOTA COMMUNITY.

Sila tandakan (/) atau isikan tempat kosong untuk jawapan berkenaan dengan diri anda.
Please tick (/) or fill in the blank for the answer that referring to you.

1. Jantina/Gender
( ) Lelaki/Male ( ) Perempuan/Female

2. Umur/Age
___ years old.

3. Status Perkahwinan/Marital Status:

( ) Bujang/Single ( ) Berkahwin/Married

4. Pekerjaan/Occupation
( ) Sektor Kerajaan/Government Sector ( )Sektor Swasta/Private Sector
( ) Bekerja Sendiri/Self Employed ( )Tidak Bekerja/Unemployed
( ) Pelajar/Student

5. Etinik/Ethnicity:
( ) Melayu/Malay ( ) Cina/Chinese ( ) India/Indian ( ) Lain-lain/Other: ______

28
Questionnaire DASS-21
Please read each statement and circle a number 0, 1, 2 or 3 which indicates how much the
statement applied to you over the past week. There are no right or wrong answers. Do not spend
too much time on any statement.
Pilih jawapan yang menggambarkan keadaan anda sepanjang minggu yang lalu. Tiada
jawapan yang betul atau salah. Jangan mengambil masa yang terlalu lama untuk menjawab
mana-mana kenyataan.
The rating scale is as follows:
0- Did not apply to me at all
0- Sama sekali tidak berlaku pada saya
1- Applied to me to some degree, or some of the time
1- Sedikit/jarang-jarang berlaku pada saya
2 -Applied to me to a considerable degree or a good part of time
2 -Banyak/ selalu berlaku pada saya
3 -Applied to me very much or most of the time
3 – sangat banyak/ sangat selalu berlaku pada saya

1 I found it hard to wind down 0 1 2 3

Saya dapati diri saya sukar ditenteramkan
2 I was aware of dryness of my mouth Saya 0 1 2 3
sedar mulut saya terasa kering
3 I couldn’t seem to experience any positive feeling at all Saya 0 1 2 3
tidak dapat megalami perasaan positif sama sekali
4 I experienced breathing difficulty (e.g. excessively rapid breathing, 0 1 2 3
breathlessness in the absence of physical exertion)
Saya mengalami kesukaran bernafas (contohnya pernafasan yang laju,
tercungap-cungap walaupun tidak melakukan senaman fizikal
5 I found it difficult to work up the initiative to do things 0 1 2 3
Saya sukar untuk mendapatkan semangat bagi melakukan sesuatu
perkara.
6 I tended to over-react to situations 0 1 2 3
Saya cenderung untuk bertindak keterlaluan dalam sesuatu keadaan.
7 I experienced trembling (e.g. in the hands) 0 1 2 3
Saya rasa menggeletar (contohnya pada tangan)
8 I felt that I was using a lot of nervous energy 0 1 2 3
Saya rasa saya menggunakan banyak tenaga dalam keadaan cemas
9 I was worried about situations in which I might panic and make a fool 0 1 2 3
of myself
Saya bimbang keadaan di mana saya mungkin menjadi panik dan
melakukan perkara yang membodohkan diri sendiri
10 I felt that I had nothing to look forward to 0 1 2 3
Saya rasa saya tidak mempunyai apa-apa untuk diharapkan
11 I found myself getting agitated 0 1 2 3

29
 Saya dapati diri saya semakin gelisah
12 I found it difficult to relax 0 1 2 3
Saya rasa sukar untuk relaks
13 I felt down-hearted and blue 0 1 2 3
Saya rasa sedih dan murung
14 I was intolerant of anything that kept me from getting on with what I 0 1 2 3
was doing
Saya tidak dapat menahan sabar dengan perkara yang menghalang
saya meneruskan apa yang saya lakukan
15 I felt I was close to panic 0 1 2 3
Saya rasa hampir-hampir menjadi panik/cemas
16 I was unable to become enthusiastic about anything 0 1 2 3
Saya tidak bersemangat dengan apa jua yang saya lakukan
17 I felt I wasn’t worth much as a person 0 1 2 3
Saya tidak begitu berharga sebagai seorang individu
18 I felt that I was rather touchy 0 1 2 3
Saya rasa yang saya mudah tersentuh
19 I was aware of the action of my heart in the absence of physical 0 1 2 3
exertion (e.g. sense of heart rate increase, heart missing a beat) Saya
sedar tindakbalas jantung saya walaupun tidak melakukan aktiviti
fizikal (contohnya kadar denyutan jantung bertambah, atau
denyutan jantung berkurangan
20 I felt scared without any good reason 0 1 2 3
Saya berasa takut tanpa sebab yang munasabah
21 I felt that life was meaningless 0 1 2 3
Saya rasa hidup ini tidak bermakna

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