Abstract
Thalassemia is one of the top eight catastrophic diseases. Data from Yayasan Thalasemia Indonesia dan Perhimpunan Orang tua Penderita Thalasemia Indonesia (YTI/POPTI) have shown that in Indonesia the number of cases of this disease increased from 2011 to 2015. Preschool-aged children who experience thalassemia every month are subjected to invasive measures such as blood transfusions. Repeated blood transfusions make children feel threatened and can trigger various responses, one of which is anxiety. Anxiety is an emotional response to something dangerous, closely related to feeling uncertain and helpless. Puppet play therapy can reduce anxiety in children with thalassemia who undergo blood transfusions. This study aims to determine the effect of puppet play therapy on anxiety of preschool children (3-6 years) with thalassemia at the Thalassemia Polyclinic at Al-Ihsan Hospital, Bandung. The design used in this study used a quasi-experimental study with a one group pre-post test design without control approach using the Wilcoxon test. The number of samples in this study were 30 respondents who were taken by total sampling technique. The instrument used refers to the content / research theme developed from the Spence Children Anxiety Scale. The results of the Wilcoxon statistical test obtained a significance figure, namely p = 0.009, thus p <α (0.009 <0.05), then H0 is rejected. It can be concluded that there are differences in the level of anxiety of children with thalassemia before and after being given puppet play therapy.
 
 Keywords: puppet play therapy; worry; preschool; Thalassemia
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