Average Anxiety Research Articles

Association of Benign Paroxysmal Positional Vertigo with Depression and Anxiety-A Systematic Review and Meta-Analysis.

To evaluate the extent to which Benign Paroxysmal Positional Vertigo (BPPV) is associated with a higher prevalence of depression and anxiety in patients. Three databases including PubMed, Embase, and The Cochrane Library were searched by two independent authors from inception to June 12, 2022 for observational studies and randomized controlled trials investigating the association between BPPV and depression and anxiety. We included studies published as full-length articles in peer-reviewed journals with an adult population aged at least 18 years who have BPPV, detected through validated clinical methods like clinical diagnosis, interview and Dix-Hallpike test. A total of 23 articles met the final inclusion criteria and 19 articles were included in the meta-analysis. BPPV was associated with a 3.19 increased risk of anxiety compared to controls, and 27% (17%-39%) of BPPV patients suffered from anxiety. Furthermore, the weighted average Beck's Anxiety Inventory score was 18.38 (12.57; 24.18), while the weighted average State-Trait Anxiety Index score was 43.08 (37.57; 48.60). There appears to be some association between BPPV and anxiety, but further studies are required to confirm these associations. Laryngoscope, 134:526-534, 2024.

Pengaruh Kombinasi Aromaterapi Mawar dan Hipnoterapi terhadap Kecemasan Ibu Hamil saat Pemeriksaan Triple Eliminasi di UPTD Puskesmas Kuta II

Introduction: Pregnancy is a physiological process that almost every woman goes through. Pregnant women must have their pregnancies checked on a regular basis and receive integrated antenatal care. A laboratory examination, one of them is a triple elimination examination, as one of the minimum integrated antenatal service standards. Blood is drawn during the examination, which often causes anxiety in patients. Rose aromatherapy and hypnotherapy are non-pharmacological methods that can help patients relax and reduce anxiety. This study aimed at determining the effect of combining between rose aromatherapy and hypnotherapy on anxiety of pregnant women during triple elimination examination. Methods: This study was carried out at the UPTD. Kuta II Public Health Centre in November - December 2022, employing a pre-experimental research design with a one-group pretest-posttest design. Non-probability sampling was used, along with accidental sampling. The STAI (State Trait Anxiety Inventory) sheet was used to assess anxiety, and the Wilcoxon Sign Rank Test was used to analyze the data. Result: According to the study’s findings of 28 pregnant women, the average anxiety level before the intervention was 54.04, while the average anxiety level after the intervention was 26.50. Anxiety level analysis with Wilcoxon yielded a p-value (p-value = 0.000, α = 0.05), so H0 was rejected and Ha was accepted, indicating that there was an effect of combining between rose aromatherapy and hypnotherapy on anxiety of pregnant women during triple elimination examination at UPTD. Kuta II Public Health Centre. Suggestion: According to the findings of this study, the administration of a combination between rose aromatherapy and hypnotherapy can be used as a consideration in providing midwifery care to pregnant women, particularly those who will undergo blood tests.
 
 Keywords: aromatherapy, hypnotherapy, pregnant women, anxiety

FACTORS ASSOCIATED WITH ANXIETY LEVEL OF TRIMESTER III PRIMIGRAVIDA PREGNANT WOMEN IN MENUR HEALTH CENTER SURABAYA

Pregnancy and childbirth are normal things experienced by women, but this still has a high risk and burden women. The purpose of this study is to determine the associated factors of anxiety level among pregnant women in the early third trimester in the Surabaya City Health Service Center Menu. This research is an observational study, which means that it is carried out by conducting field observations with a cross-sectional design and taking samples with a convenient sampling technique of 44 people. Our findings show that the anxiety level in pregnant women with mild levels of primigravida in the first 3 months was reported among 19 people (43.2%) and an average high anxiety level of up to 25 people (56.8%). The analysis was carried out in two dimensions using the Chi-Square test which showed a p value of 0.002. Thus the relationship between the husband's support and anxiety in the third trimester of pregnancy at the Surabaya City Health Service Center is closely related. Therefore, it is suggested that a husband to provide full support to his wife in the third-trimester primigravida because this can reduce anxiety.

Evaluating a psychology clinic in a community weight management service

Background/Aims Living with obesity and being physically inactive increases the risk of several cardiovascular conditions, including hypertension. This study aimed to evaluate a psychology clinic, which was established in a tier 2 community adult weight management service in a real-world setting. Methods The psychology clinic was delivered by an assistant psychologist, working jointly with community dieticians, and included approaches informed by acceptance and commitment therapy, cognitive behavioural therapy and mindfulness. Quantitative data were collected regarding patients' weight, body mass index, and anxiety and depression scores in their first and last session, as well as attendance and drop-out rates. Data were analysed using descriptive statistics and a one-sample t-test, with P<0.05 indicating significance. Qualitative feedback was collected by the assistant psychologist. Results A total of 31 patients were accepted for an initial assessment, of whom 27 were offered follow up and 17 completed the intervention. Patients' average weights and anxiety scores decreased significantly, but their average body masses indices and depression scores saw no significant difference. Qualitative feedback indicated that the clinic helped patients to increase their physical activity levels, improve their wellbeing, reduce emotional eating behaviours and develop strategies to cope with difficult emotions more effectively. Conclusions Psychological input can add value to weight management services, emphasising the importance of a multidisciplinary team when addressing modifiable cardiovascular risk factors, with a holistic approach to heart health and weight management interventions.

THE REFLECTION OF STUDENTS’ EFL CLASSROOMS ANXIETY IN UNDERGRADUATE PROGRAM

Anxiety is one of the constraints affecting EFL learners in acquiring the target language of the communicative classroom contexts, especially for university students. Therefore, the research aims to shed light on the students' English foreign language classroom anxiety in undergraduate programs. The research employed a qualitative approach with a case study design. This research involved sixty-two students in an undergraduate program. Purposive sampling was applied in this research to select the participants. The instruments used in this study were questionnaires and semi-structured interviews. The Questionnaire adopted from Horwitz, Horwitz, and Cope (1986) consisted of 33 items. The result revealed that the average student's anxiety level was 114, categorized as anxious in the EFL classrooms. Another result showed that the students experienced some symptoms and phenomena based on the three subdimensions, indicating anxiety in EFL classrooms.

Higher Students' Anxiety Level and Factor in Writing Essays through Google Docs


 
 
 This study aimed to investigate the level and factors of anxiety experienced by higher students while writing essays through Google Docs. It used a quantitative data collection method collected through questionnaires adapted from the Second Language Writing Anxiety Inventory (SLWAI) by Cheng and ESL Writing Anxiety by Zhang using Five-Point Likert Scale. There were 10 participants in this study selected by using convenience sampling. The results showed an average anxiety score of 63, indicating moderate anxiety levels. The study identified that a lack of sufficient writing practice was students' primary cause of anxiety. Overall, this study provides valuable insights into the factors contributing to students' anxiety levels while writing essays through Google Docs. It can inform educators' strategies to support students in their writing assignments.
 
 

PENGARUH PROGRESIVE MUSCLE RELAXATION TECHNIQUE TERHADAP KECEMASAN PASIEN PRE OPERASI BEDAH MAYOR DI RUMAH SAKIT MUHAMMADIYAH PALEMBANG

Introduction: Major surgery is a stressor that is quite severe for patients and can evoke stress reactions psychologically in the form of anxiety. Preoperative anxiety must be handled immediately by nurses to minimize complications that can occur after surgery, because they can cause physiological changes. Objective: To determine the effect of progressive muscle relaxation technique on the anxiety of patients with pre-major surgery at Muhammadiyah Palembang Hospital. Methods: This study used a pre-experimental approach with a pretest-posttest one group design without control approach. The population includes all patients pre-major surgery in January-February 2022 with a sample of 19 respondents and was taken by consecutive sampling. Hypothesis testing was carried out using the Paired Samples T-test in the form of a dependent t-test with a significance level of α 0.05. Results: The average anxiety before the progressive muscle relaxation technique intervention was 21.95, and after the intervention was 20.53. Then based on data analysis it is known that there are differences in anxiety levels before and after being given progressive muscle relaxation therapy with a p-value of 0.015. Conclusion: There are differences in the level of anxiety before and after the progressive muscle relaxation technique therapy at the Muhammadiyah Palembang Hospital

Comparison of Recurrence and Quality of Life Between Myoma Embolization and Myomectomy.

Uterine myomas represent the most frequently diagnosed tumors amongwomen of childbearing age. Symptoms often include profuse menstrual bleeding, diminished quality of life, and in some cases, infertility. The size and position of the fibroids typically influencethe condition's manifestations. Moreover, symptomatology often varies depending on the fibroids' location. This investigation aimed to discern if there exists a significant correlation between life quality, reoccurrence rate, quality of life, and recurrence levels among patients who have undergone myomectomy and uterine fibroid embolization, respectively. A retrospective cross-sectional study was conducted to compare the rates of recurrence and impacts on life quality between uterine fibroid embolization and myomectomy in women diagnosed with uterine myomas. Data were collected from 152 women who sought treatment at the Obstetrics and Gynecology clinic and also theInterventional Radiology clinicbetween January 2009 and January 2021. Thirteen participants were excluded due to the inability to maintain contact. The trial encompassed 76 patients who underwent myomectomy and 63 who had uterine fibroid embolization. In both groups, the life quality of 50 patients, five years postsurgery, was assessed using the UFS-QOL measure. Eligible participants were females between 20 and 40 years, with symptomatic Type 3-5 fibroids as per the FIGO classification, and with no comorbidities. Individuals under 20 or over 40 years, or those with fibroids classified as FIGO types 1,2,6,7,8, were not included. Other exclusion criteria included pregnancy status, abnormal endometrial biopsy results, abnormal smear tests, polyps, cancer, adenomyosis and coagulation disorders. The recurrence of fibroids was identified through symptomatology and diagnostic radiological methods. The recurrence rate was found to be 31.6% (n=24) for myomectomy patients and 14.3% (n=9) for those who underwent uterine fibroid embolization, with no statistically significant difference between the two groups (p > 0.05). The group subjected to myomectomy exhibited fewer symptoms, lower anxiety, and better physical mood scores. The myomectomy group displayed higher average anxiety scores (p<0.01). There were no significant disparities in control, consciousness, sexual function, or overall scores between the two groups. Symptoms and anxiety saw a marked reduction in the first postoperative year compared to the preoperative period (p<0.01). Compared to presurgery, energy, mood, awareness, and sexual function exhibited significant improvements in the first and fifth postoperative years (p<0.01). Our findings suggest a nonsignificant recurrence rate in the myomectomy group compared to the uterine artery embolization group. Notably, the decrease in symptom occurrence and anxiety following myomectomy was significantly favorable in terms of quality of life. While embolization was offered as a therapeutic option, myomectomy yielded more favorable results concerning quality of life.

Analysis of Mathematics Anxiety Experienced by Students of Vocational School in Padang City and The Factors That Affect Them

Mathematics is a subject that many students fear. This fear has a negative impact, one of which is math anxiety. This study aims to describe the level of math anxiety of SMKN students in Padang and the factors that influence it. This research is a descriptive study with a total sample of 72 students at one of the State Vocational Schools in Padang City. Sampling used a purposive sampling technique, which is based on the results of recommendations, observations, and interviews from counseling teachers and Mathematics teachers at SMKN Padang. This study measures math anxiety which includes math test anxiety, numerical anxiety, and abstraction anxiety. The data collection tool used in this study was a questionnaire with a Likert scale model totaling 38 statement items with 5 alternative answers. Overall, Students' math anxiety is in the high category of 45.83%, which means that many students experience math anxiety, the average student anxiety towards mathematics is the high category which is influenced by personality, environmental and intellectual factors. Keywords:anxiety, math anxiety, vocational school students in the city of padang

Intravenous Midazolam for Anxiolysis in MRI

ObjectiveThe purpose of this project was to understand the effect of administration of intravenous (IV) midazolam on duration of procedure times and anxiety levels experienced by adult outpatients having magnetic resonance imaging (MRI). Secondarily, this project sought to compare duration of procedure times and anxiety scores of adult outpatients receiving intravenous lorazepam or intravenous diazepam for MRI-associated anxiety. MethodsAll adult outpatients scheduled for MRI over the course of 12 months were assessed for self-reported anxiety and offered anxiolytic administration. In this group, 116 adult outpatients received a benzodiazepine, 50 patients received midazolam, 35 received lorazepam, and 31 received diazepam. Patients rated their anxiety as zero (none), 1 (mild), 2 (moderate), or 3 (severe). Nurses rated the level of patient sedation using the Richmond Agitation Sedation Scale (RASS), a 10-point scale rating patients from combative (+4) to unarousable (−5). These scores were recorded upon arrival to MRI, following medication administration at the start of the MRI, and at the completion of the MRI. Duration of procedure times were measured as the time from anxiolytic administration to the time of MRI completion. ResultsUpon arrival to MRI, the average patient-reported anxiety levels for midazolam, lorazepam, and diazepam were 2.3 ± 0.6, 2.3 ± 0.7, and 2.3 ± 0.6; RASS scores were 0.8 ± 0.5, 0.7 ± 0.7, and 1 ± 0.7. Following benzodiazepine administration at the beginning of the MRI, the average patient-reported anxiety levels for midazolam, lorazepam, and diazepam were 1.4 ± 0.9, 1.5 ± 0.8, and 0.9 ± 0.6; RASS scores were −0.04 ± 0.7, 0.02 ± 0.8, and 0.1 ± 0.6. Patient-reported anxiety levels for midazolam, lorazepam, and diazepam following the MRI were 0.2 ± 0.6, 0.6 ± 0.7, and 0.03 ± 0.1; RASS scores were −0.1 ± 0.4, −0.2 ± 0.6, and −0.2 ± 0.4.Duration of procedure times for midazolam, lorazepam, and diazepam were 42.5 ± 28.9, 55.6 ± 19.8, and 49 ± 19 minutes. Vital signs decreased slightly after administration of all 3 drugs; however, not one adverse or over sedation event occurred. ConclusionIntravenous midazolam appears to be a safe and effective anxiolytic for adult outpatients in MRI. Patient anxiety scores and nursing assessed level of sedation scores were comparable to those taking IV lorazepam or IV diazepam. Duration of procedure times were also comparable to those receiving IV lorazepam or IV diazepam.

Examining the components and stability of negative affect in disordered eating frequency.

There is a limited understanding of the unique components of negative affect that are most important to disordered eating. Our study tested the contributions and stabilities of unique components of negative affect in the frequency of both binge eating and restricted eating. We examined if: (1) symptoms of depression, anxiety and stress share unique, concurrent associations with binge eating and restricted eating, respectively, and if (2) instability of depression, anxiety, and stress predict binge eating and restricted eating, respectively. 627 first year undergraduate students completed 7 assessments of these constructs across their first academic year. Generalised multilevel modelling was employed. Higher than average anxiety, but not depression or stress, was concurrently associated with restricted eating. No concurrent associations between negative affect and binge eating were found. Instability of depression, but not anxiety or stress, predicted both binge and restricted eating. Anxiety may be a more salient predictor of restricted eating than depression or stress. However, larger monthly changes in depression may confer risk for more frequent binge eating and restricted eating.

The level of corona anxiety in mothers with children suffering from cancer and other diseases referring to Shahid Sadoughi Hospital in Yazd during the covid 19 pandemic

Introduction: This study was conducted to compare Covid-19 anxiety in mothers with cancer children and mothers with children who have other diseases during the Covid-19 pandemic.&#x0D; Methods: This was a descriptive-analytical and cross-sectional study conducted on 250 mothers with cancer children and mothers with children who have other diseases. They visited the clinic and oncology department of Shahid Sadoughi Hospital in Yazd in 1400.&#x0D; Convenience sampling method was used. Data collection tools were demographic information and Covid-19 anxiety questionnaires. Data were analyzed with a confidence level of 95%.&#x0D; Results: The mean anxiety score of mothers of children with cancer was 36.36±11.16. The mean anxiety score of mothers of children with other diseases was lower ( 34.65±10.82), based on the t-test statistical test, but no significant difference was statistically observed between them.&#x0D; Conclusion: Findings showed that, in general, the average anxiety of mothers in both groups was high (more than 30 out of 54), but there was no significant difference between them regarding the anxiety score.&#x0D; More studies should be done in different situations and times to more precisely determine the factors affecting the intensity of anxiety of mothers with cancer children .

Factors influencing the preoperative anxiety in lung cancer patients undergoing video-assisted thoracoscopic surgery: The role of information needs, illness perception and patient trust

ObjectivesThis study aimed to investigate preoperative anxiety in patients with lung cancer scheduled for video-assisted thoracoscopic surgery (VATS) and explore the influence of demographic factors, information needs, illness perception, and patient trust in preoperative anxiety. MethodsThis cross-sectional study was conducted at a tertiary referral center in China from August 14 to December 1, 2022. Patients with lung cancer (N = 308) scheduled for VATS were evaluated using the Amsterdam Anxiety and Information Scale (APAIS), Brief Illness Perception Questionnaire (BIPQ), and Wake Forest Physician Trust Scale (WFPTS). Multivariate linear regression was employed to determine the independent predictors of preoperative anxiety. ResultsThe average total APAIS anxiety score was (10.6 ± 4.2). Of the sample, 48.4% reported high preoperative anxiety (APAIS-A: ≥10). Multivariate linear regression analysis showed that preoperative anxiety was higher in women (B = 0.860); and that preoperative length of stay ≥24 h (B = 0.016), more information needs (B = 0.988), more severe illness perceptions (B = 0.101) and more patient trust (B = −0.078) may lead to higher preoperative anxiety levels. ConclusionsPreoperative anxiety is common in patients with lung cancer scheduled for VATS. Therefore, more attention should be paid to women and patients with a preoperative length of stay of ≥24 h. Meeting information needs, transforming positive disease perceptions, and strengthening the doctor-patient trusting relationship are key protective factors for preoperative anxiety.

“Wake-and-bake” cannabis use: Predictors and cannabis-related outcomes of use shortly after waking

BackgroundGiven recent historical increases in young adults frequent cannabis use and changes in cannabis policies throughout the United States, there is a need to examine high-risk patterns of use. This paper examined predictors and cannabis-related outcomes of “wake-and-bake” cannabis use, operationalized as use within 30min of waking. MethodsParticipants were 409 young adults (Mage=21.61 years, 50.8% female) enrolled in a longitudinal study on simultaneous alcohol and cannabis use (i.e., using alcohol and cannabis at the same time such that their effects overlap). Eligibility criteria included reporting alcohol use 3+ times and simultaneous alcohol and cannabis use 1+ times in the past month. Participants completed twice-daily surveys for six 14-day bursts across two calendar years. Aims were tested using multilevel models. ResultsAnalyses were limited to cannabis use days (9406 days; 33.3% of all sampled days), and thereby to participants who reported using cannabis (384 participants; 93.9% of the sample). Wake-and-bake use was reported on 11.2% of cannabis use days and at least once by 35.4% of participants who used cannabis. On wake-and-bake use days, participants were high for more hours and had greater odds of driving under the influence of cannabis, but did not experience more negative consequences, relative to non-wake-and-bake cannabis use days. Participants who reported more cannabis use disorder symptoms and those reporting higher average social anxiety motives for cannabis use reported more frequent wake-and-bake use. ConclusionsWake-and-bake cannabis use may be a useful marker of high-risk cannabis use, including driving under the influence of cannabis.

Antidepressants for pain management in adults with chronic pain: a network meta-analysis.

Antidepressants for pain management in adults with chronic pain: a network meta-analysis.

A study on the relationship between motivation and psychological state during preparation for the examination

To explore the relationship between motivation of further education and students' psychological state during exam preparation, and to provide guidance for preventing students' anxiety due to excessive stress and for early psychological intervention. The students' motivation for graduate school was quantified by preparing a Postgraduate Motivation Scale（PMS）. Reliability testing of the PMS using the results of a survey of 800 school students. The students' psychological state was analyzed in combination with anxiety and stress values,Mental health monitoring for students once a month during exam preparation(June~ December). Cronbach's α was 0.926, the fold-half reliability was 0.887, the retest reliability was 0.931, and the Cronbach's α coefficients of the four subscales were 0.74, 0.83, 0.79, and 0.92. The results of the anxiety and stress tests showed that the average anxiety value of the "active" group was 5.81 less than that of the "passive" group, and 61.64% of the total number of students had anxiety during the preparation period, while 31.2% felt too much stress. Students' negative emotions are positively related to the value of motivation to study for the exam, and the phenomenon of anxiety and the emergence of stressful emotions have a certain time difference. Feelings of anxiety during exam preparation are temporary and disappear with the end of the exam.

Dhikr Relaxation Training in Pregnant Women Classes In Purbosari Posyandu Purbayan Village

Pregnancy is a vulnerable period with psychological disturbances in the mother. Anxiety can arise due to worries about the pregnancy and the fetus it contains. Especially when the Covid-19 pandemic emerged, causing anxiety for pregnant women, especially the fear of being infected with Covid-19. The aim of PKM (community service) activities is to improve skills in performing dhikr relaxation techniques in pregnant women. Method of Implementation: The partner for this PKM activity is the class of pregnant women at Posyandu Purbosari in Purbayan Village, Sukoharjo district. It is carried out by holding training using lecture and discussion methods, simulations and demonstrations. Then the pregnant women are accompanied to practice dhikr relaxation technique skills. The training conducted has been able to increase the ability of pregnant women to relax dhikr by 100%. The average anxiety level of pregnant women measured by the HARS scale is a score of eight, meaning that pregnant women are in the mild anxiety category. Based on the interview results, the majority of pregnant women said they felt calmer and more relaxed after doing dhikr relaxation exercises. Pregnant women are committed to continuing the practice independently using the dhikr relaxation guide video at their respective homes. Conclusion: Pregnant women are able to practice the dhikr relaxation method taught, feel more relaxed and calm after doing the training. The results of the evaluation in the last week showed that mothers were able to do dhikr relaxation exercises independently at their respective homes using the video guide provided.

Analysis of Factors Causing Anxiety in Children with Cancer Experiencing Hospitalization

Hospitalization is a stressful experience, both for the child and his parents. Stress in children can cause sleep disturbances, decreased appetite, and developmental disorders so that this can delay the healing process of the disease. Stressors that children receive while being treated can be in the form of a foreign hospital environment, physical conditions such as pain and illness that children experience, treatment procedures and medical examinations at the hospital. The many stressors experienced by children while undergoing hospitalization have negative impacts that interfere with children's development. The purpose of this study was to determine the dominant of the six factors that cause anxiety in children with cancer who experience hospitalization. This study used an analytic descriptive design with a cross sectional study approach. Samples that met the inclusion criteria amounted to 165 people. The results of the six factors that cause anxiety in children with cancer who experience hospitalization, it was found that those with a p value &lt;0.05 were complaints of pain and physical weakness. In complaints of pain, 163 children with cancer were found with an average anxiety score of 21.34. The statistical test produces a p value of 0.001 which is smaller than α (0.05), meaning that there is a significant relationship between pain and anxiety in children with cancer.&#x0D; Keywords: Anxiety, childhood cancer, hospitalization

The Application of Contextual Teaching and Learning for Increasing Learning Outcomes and Reducing Anxiety in Elementary School Mathematics

The study aimed to determine the effectiveness of Contextual Teaching and Learning (CTL) in reducing and improving learning outcomes and math anxiety among students at a private elementary school in Indonesia. The research utilized a one-group control pre-posttest design with a sample of 51 4th-grade students. The study used a combination of pre-test and post-test and a closed-ended questionnaire as the data collection instruments. The independent variable in the study was CTL, while the dependent variables were learning outcomes and math anxiety. The paired t-test showed a significant increase in the students' average learning outcomes and a decrease in the average math anxiety levels. The findings suggest that implementing CTL is a practical approach to reducing math anxiety and improving student learning outcomes.

The Effectiveness of Pregnancy Online Classes (PROCLASS) on the Level of Knowledge and Anxiety Ahead of Labor During the COVID-19 Pandemic

Background: Restrictions on health services such as prenatal checks and the Pregnant Women Class program during the COVID-19 pandemic in several regions will have an impact on the quality of services for pregnant women. Purpose: Pregnancy online classes can potentially increase knowledge and reduce anxiety ahead of labor during the COVID-19 pandemic. Methods: Quasi-experimental and nonequivalent control group, pretest and posttest design approach Each group of 30 people (purposive sampling technique). Pre-test and PROCLASS provide material every week through videos uploaded to the WhatsApp group. The instrument uses a questionnaire (Google Form). Independent t-test and Mann-Whitney test to compare the PROCLASS and control groups. Dependent t-test and Wilcoxon test to compare the pre-and post-test in the PROCLASS group. Results: There were differences in the pre-post test on the variables of knowledge and anxiety in the PROCLASS group, respectively (p-value 0.000). There was a difference in knowledge between the PROCLASS and control groups (p-value 0.002), with an average knowledge of 88.83 in the PROCLASS group and 85.73 in the control group. There were also differences in anxiety levels between the PROCLASS and control groups (p-value 0.000), with an average anxiety level of 28.17 in the PROCLASS group and 45.70 in the control group. Conclusion: PROCLASS has proven effective in increasing knowledge and reducing the anxiety level of pregnant women before giving birth during the COVID-19 pandemic so that health workers can carry out the process (Puskesmas).