Stress Management Training For Persons With Disabilities In Sedayu District

. People with disabilities have a high level of stress. People with physical disabilities are often not accepted by the society, criticized, stigmatized, and not encouraged to live independently and productively so that they become psychologically pressured. People with disabilities are often seen as a burden to families and society. Proper infrastructural support for persons with disabilities is also lacking. One of the efforts to fulfill the rights of persons with disabilities is by establishing an inclusive village or a disability-friendly village to be implemented by village government. Persons with disabilities are expected to have equal opportunities to participate in the development process. Through inclusive villages, it is hoped that the community will support the fulfillment of the right of persons with disabilities to be productive. Motivation and mental health are two of many factors that affect the productivity of persons with disabilities. LazisMu, as the research partner, provided a forum for people with disabilities to increase productivity and independence. Argosari village in Sedayu, Bantul, Yogyakarta has a commitment to become an inclusive village. The community partnership program implemented before was to form an organization of persons with disabilities in Argosari village of which one of the goals was economic empowerment. Motivation and mental health for persons with disabilities are aspects that must be developed so that economic empowerment for them can run well and can be more productive. This community service program was expected to be able to overcome the problem of the need to increase the motivation and mental health of persons with disabilities in Argosari inclusive village in Sedayu, Bantul by practicing effective stress management. The activities were carried out through training. The activity began with a preparation for a module of stress and motivation management for persons with disabilities which was compiled by the community service team. Furthermore, the module was implemented for the target participants. Participants were 23 persons with disabilities from the related village. The assessment of the participants’ stress level was carried out at the beginning of the activity using the Self Reporting Questionnaire (SRQ-20), and the results showed that 7 participants (30%) had a score of > 6 or experienced mental emotional disorders. After the training, participants said they really felt the benefits of this community service activity and would continue it on an ongoing basis in each village in Sedayu sub-district, Bantul.


Introduction
Persons with disabilities are those who experience physical, mental, intellectual, and/or sensory limitations so that they experience barriers to interact with their surroundings and find it difficult to participate in the society (Law No. 8 of 2016).WHO stated that more than one billion people had disabilities, and 200 million of them experienced disturbances in daily functioning [1].Disability can be a physical, cognitive, mental, sensory, emotional, or developmental disorder or a combination of these conditions.Physical disability is defined as any disorder that limits the physical function of one or more limbs or fine or gross motor skills [2].Disabilities can be present at birth or acquired after birth throughout a person's life.
Emotional disorders of people with disabilities can lead to depressive disorders [3].Various factors influence their condition.The United Nations mentioned that 80% of those people lived in developing countries, and 20% of them lived in poverty.People with physical disabilities are often not accepted by society.They are criticized, stigmatized, and not encouraged to live independently and productively.These issues add psychological pressure for them [3].In addition, they are often seen as an additional burden on families due to loss of productive labor, increased spending on special care, and the need to provide special facilities.Appropriate infrastructure support for caring for people with disabilities is still lacking [4].Robert and Hirschfeld reported that depression and anxiety are the most common comorbid mental disorders accompanying all types of disability [5].
One of the efforts to fulfill the rights of persons with disabilities is by establishing an inclusive village or a disability-friendly village to be implemented by the village government.People with disabilities are expected to have equal opportunities to participate in the development process.Through inclusive villages, it is hoped that the community will support the fulfillment their right to be productive.Motivation and mental health are two of the factors that affect their productivity.People with disabilities have a high level of stress.Argosari village in Sedayu, Bantul, Yogyakarta has a commitment to become an inclusive village.The community partnership program implemented before was to form an organization of persons with disabilities in Argosari village of which one of the goals was economic empowerment.Increasing motivation and mental health for persons with disabilities are factors that must be developed so that economic empowerment for them can run well, and they can be more productive.
The purpose of this community service was to increase motivation and implement an effective stress management for persons with disabilities and their families as caregivers.Participants who had received training could apply the stress management strategies and increase motivation in everyday life.

Methodology
This community service applied training methods provided by experts in the field of mental health.Program activities were carried out in stages as shown in the diagram below.Permits for community service activities were submitted to the head of LazisMu, in Sedayu sub-district, Bantul district, Yogyakarta Special Region.Permission was the granted, and a letter of cooperation was signed between the service team and the leader of LazisMu.

Permits Preparation Implementation Evaluation
Preparatory activities consisted of coordination, preparation of facilities and infrastructure, as well as preparation of participants.a. Preparation began with coordination namely: 1) Internal coordination of the community service team 2) Coordination between the service team and the LazisMu leader 3) Coordination between the service team and the disabled people association in Sedayu sub-district, Bantul b. Preparation of facilities and infrastructure for activities including: 1) Laptops 2) LCDs 3) LCD screen 4) Stationery c. Participants The participants in this service program were 23 people with the following characteristics: 1) Having disabilities 2) Living in the Sedayu sub-district, Bantul

Implementation
The method applied in this community service was to provide training on motivation and stress management.The training used the following three different methods.a. Lecture on Health Education The lecture method was chosen to convey theories and concepts so that participants could master the material.The material presented was in the form of knowledge of motivation and stress management.The activity began with a preparation of modules by the service team.The module consisted of 2 parts namely motivation and stress management.Modules were discussed by speakers offline.b. Discussion and Q&A Session The lecture method often caused boredom for the participants so that active interaction was required.This training was made interactive with the participants through case discussions, and question and answer session.c.Formation of Self-Help Groups A self-help group (SHG) was a group consisting of two or more people who have a desire to share problems and help each other solve the problems they face to improve cognitive, emotional, and psychomotor abilities in solving problems.In this group, they had the opportunity to share feelings and experiences, help each other solve the problems they face, and choose ways to solve the problems.
The training was held in 2 meetings for 2 hours each.The first meeting was held jointly, while the second implementation was carried out independently by selfhelp groups that had been formed in all villages in Sedayu sub-district, Bantul.Participants were assessed for their stress levels using the SRQ-20 prior to training.

Evaluation
Evaluation of activities was carried out by looking at the results of training on motivation and stress management, and the formation of self-help groups, which covered the following aspects.
a.The activeness of the participants.b.The continuity of the participant's motivation monitoring and stress management program after the community service program was over.

Results and Discussion
1. Participants' characteristics Self-help group activities for persons with disabilities in the Sedayu sub-district were held at SD Muhammadiyah Argosari, Sedayu, Bantul on Sunday, April 24, 2022 at 15.00-18.30WIB.This community service used training methods provided by expert speakers in the fields of mental health, economics, and public health who were also members of the UMY Center for Disability and Humanity Studies.The activities carried out were training that began with a preparation of modules by the service team.The module consisted of 2 parts about motivation and stress management.
The modules were discussed by resource persons in the form of power points and learning videos.The training was made interactive with the participants and ended with a question-and-answer session.The activity was attended by 23 participants with the characteristics listed in Table 1 as follows.

Characteristic Frequency (n) Percentage (%)
Less than 1,500,000 1,500,000 -3,500,000 More than 3,500,000 Most of the participants were male for 15 people (65%), while there were 8 female participants (35%).The ages of the participants varied from children, teenagers, adults, to elderly.Most of the participants were in the age group of 31-60 years for 13 people (57%).There was only 1 child participant (4%) who took part in self-help group activities.The marital status of the participants in this community service activity was mostly married for as many as 12 people (52%).The education level of the participants varied with high school level as the highest for 9 people (39%).The occupations of the participants were very diverse, with the highest number of participants working as freelancers and self-employed with 5 people (22%) each.
Most of the participants were persons with physical disabilities for as many as 17 people (74%), while the least were people with sensory disabilities (deaf, speech, and blind) for 1 person.More participants lived with their parents for as many as 11 people (48%), while the rest chose to live with their husband/wife, other families, or alone.Even though many lived with their parents, as many as 17 participants (74%) carried out activities independently and did not depend on other people.
Participants said that training on motivation and stress management, and forming selfhelp groups for them were very useful.Participants felt that they had the means to share, support, and motivate each other.This was expressed by the participants in several statements as follows.
"I am happy because I can reduce my stress, hang out with other friends.My child often gets emotional when he asks to be obeyed so it makes me stressed."(P1) "I am happy.I can share with other friends in activities like this.Everyone has problems, don't know where to tell." (P2) " I am often stressed, every day, and I want to try the stress management methods that are taught."(P3) "I really need motivation.I often feel lazy, sluggish, especially when I don't have friends... It's a pleasure to be together" (P4) Participants' Stress Levels Participants' stress levels were assessed using the Self Report Questionnaire (SRQ-20) from the World Health Organization (1994) consisting of 20 questions.Each question item had two answer options of "yes" and "no".The "yes" answer was scored 1, while the "no" answer was scored 0. Individuals who received a total score of > 6 were categorized as individuals indicated as experiencing psychological disorders (neurotic disorders) and were advised to consult with a psychiatrist or other mental health personnel.The SRQ results of the community service participants are shown in table 2 as follows.In the table 2 above, it can be explained that the number of participants with a score of <6 is 16 (70%).This indicates that participants had no problems with emotional and mental disorders, whereas the SRQ value of >= 6 indicates a mental and emotional problem, which was experienced by 7 participants (30%).
Stress is an unpleasant condition in which a person sees a demand in a situation, and the demand is beyond his ability [6].Stress is a person's physical and emotional reaction to changes in the environment that require him to adapt.Stress is a natural and important part of life, but if it is heavy and lasts a long time, it can interfere with mental health [7].Stress can help a person to be more resilient in dealing with problems and be more alert and anticipative when needed, but if it is not managed properly, then stress will turn into an interference.Improperly managed stress can have physical effects such as feeling tired, having trouble sleeping, headache, overeating, ache and pain in the neck and head, and stomachache.The effect can also be on feelings, such as feelings of sadness, anxiety, worry, becoming irritable, easily losing patience, and concentrating difficulty.If left unchecked, it will affect one's mental health and reduce one's motivation, productivity, and quality of life.
Effective stress management is needed by everyone in order to be able to positively manage stress (eustress) which makes a person more skilled in dealing with problems in life.People with disabilities with high levels of stress really need effective stress management skills.Stress management focuses on an individual's ability to handle pressure/stress situations and minimize the emotional reactions that arise [8].Stress management is divided into two namely emotional focus and problem focus.Emotional focus is stress management that focuses on managing emotions so as to reduce feelings of psychological discomfort.Meanwhile, problem focus is stress management that focuses on finding alternatives in solving problems to minimize or eliminate situations that cause stress.Participants are taught by means of stress management modules so that they are expected to increase their understanding of stress management and implement it in everyday life.
Health Education is a health program used to increase one's knowledge at a short time [9].In this community service program, participants were given health education about motivation and stress management.Providing the right information will help improving cognitive and affective management so that awareness and willingness exist to change behavior to become more positive [10].
Providing health education with lecturing method is the most often used.This method also has drawbacks, namely it is easy to cause participant to become bored, and participants tend to be more passive.Therefore, in order to increase the activeness of the participants during the lecture, the team provided questions and discussions.With active interaction, the concentration of participants will also increase so that information reception becomes better [11].Demonstration of how to do stress management makes participants understand more about how to do it properly.This method has the advantage of being easy for participants to understand.Participants are stimulated to observe and can practice on their own.This method stimulates all the senses so that it is easier to understand and is known to be able to improve participants' abilities [12].The resource persons in this community service provided examples of stress management to make it easier for participants to better understand and try to practice independently.

Conclusion
After the community service activities were carried out, it can be concluded that: a. Self-help groups for persons with disabilities have been formed in Argosari village, Argodadi village, Argorejo village, and Argomulyo village in Sedayu district, Bantul regency.b.Participants experience the benefits of self-help group activities.c.Self-help group activities will still be routinely carried out by each association after the community service activities are finished.d.Participants feel the benefits of the training on motivation and stress management.

Fig. 1 .
Fig.1.Schematic stages of activities.1.PermitsPermits for community service activities were submitted to the head of LazisMu, in Sedayu sub-district, Bantul district, Yogyakarta Special Region.Permission was the granted, and a letter of cooperation was signed between the service team and the leader of LazisMu.2.Preparation