EDUKASI PENURUNAN KECEMASAN PADA BALITA SAAT IMUNISASI MELALUI PENDEKATAN TERAPI BERMAIN PUPPET PLAY DI POSYANDU

Abstract

Background: Toddler anxiety during immunization remains one of the challenges in primary health services, particularly in posyandu settings. Fear of needles, crying, and uncooperative behavior often disrupt the immunization process. Puppet play therapy has been shown to effectively reduce anxiety in children undergoing medical procedures, yet its application in immunization settings is still limited. Objective: To implement caregiver and cadre education combined with puppet play intervention to reduce toddler anxiety during immunization and to improve caregiver/cadre knowledge regarding emotional support for children. Methods: A pre–post quasi-experimental design was conducted involving 30 toddlers aged 2–5 years at Posyandu Mawar.The intervention included educational sessions for caregivers/cadres, followed by a 10–15-minute puppet play session before immunization. Anxiety was measured using the Faces Anxiety Scale before and after the intervention. Data were analyzed descriptively and using Wilcoxon and paired t-tests. Results: Toddler anxiety significantly decreased from 11.8 ± 2.7 to 7.1 ± 2.5 (p < 0.001). Caregiver/cadre knowledge increased from 5.3 ± 1.4 to 8.7 ± 1.1 (p < 0.001). Observations showed improved interest, engagement in play, and cooperation during immunization. Conclusion: Educational sessions combined with puppet play effectively reduced toddler anxiety during immunization at the posyandu. This child-friendly intervention is easy to implement, low-cost, and recommended for routine integration into posyandu immunization services..