Meditation Guidance, Spiritual Strengthening, and Mental Health for Patients with Covid-19: Neuroscience Approach

ABSTRACT


Introduction
Since the outbreak of the Covid-19 case in Indonesia, the government issued a policy to limit activities outside the home and social distancing in early March 2020 [1].This policy was carried out to break the chain of transmission of the Covid-19 virus [2].The high number of Covid-19 patients and limited health facilities have resulted in difficulties in handling Covid-19 patients in healthcare facilities.Patients with severe symptoms are mostly accommodated in hospitals, while patients with mild symptoms and patients without symptoms are only required to carry out independent isolation without special health facilities from the State [3].However, self-isolation for asymptomatic patients raises problems in the form of exclusion and discrimination by the surrounding community [4].This causes the patient's mental health to decline and results in a longer recovery time [5].Therefore, an alternative isolation model is needed that does not marginalize Covid-19 patients.They still live in isolation but still socialize with other people [6].
The main problem in this study is the unstoppable number of Covid-19 patients in hospitals throughout Indonesia.But unfortunately in this case the alternatives provided by the government are very limited.Based on preliminary data, researchers found the location of a hospital that is still developing and managing drugs and services for Covid- 19  Based on online information data issued by the government in Indonesia, it is interesting to follow up with researchers.As a contribution by researchers to the Indonesian government or hospital health doctors, this research is expected to be an alternative to health services and an alternative way of treating and treating health problems [9].Based on previous research literature and references as support to continue in this study.There are references and supporting literature from Google Scholar that add validation and strength to the development of this research [10].
The novelty of this study is that the researcher wants to analyze research that has a field model or case study at the Covid-19 Islamic Boarding School which focuses on research at the Yogyakarta Muhammadiyah Hospital.The study aimed to analyze Muhammadiyah Covid-19 patients who were given health services using a spiritual (Neuro-spiritual) approach, Covid-19 meditation guidance with the perspective of disaster law issued by the Central Leadership of Muhammadiyah where the research was located within the Muhammadiyah environment.

Materials and Method
The research approach used in this study is qualitative [11].In this study, the type of data analysis used the Miles and Huberman (1994) method, namely the activities in qualitative data analysis were carried out interactively and continued continuously until complete so that the data was saturated.Activities in data analysis are data reduction, data display, and drawing conclusions/verifying data [15].The flow can be seen in Figure 1.The research subjects were PKU Muhammadiyah Yogyakarta medical staff and Covid-19 patients to obtain valid data, namely meditation guidance and a spiritual approach in Covid-19 patients with symptoms and Covid-19 patients without symptoms.The determination of research subjects was carried out using a purposive sampling technique.Data collection was carried out through interviews, observation, and documentation.Interviews were conducted using in-depth interviews based on interview guidelines and unstructured interviews.Observations were made by researchers by observing the environment of the Muhammadiyah Covid-19 Islamic boarding school, which was used as a Pusat Kesehatan Masyarakat.The documentation method that will be studied is text and photos of activities at the Covid-19 Muhammadiyah Islamic boarding school [14].

Results and Discussion
Based on the data obtained, the number of COVID-19 patients increased significantly at the beginning of the appearance of COVID-19 handled by the Muhammadiyah Hospital.Based on the results of the information obtained from the interviews, it was also known that Covid-19 patients who were affected and infected with Covid-19 consisted of adolescents, adults, and the elderly, both men and women.People are experiencing shocks of fear and anxiety, due to the uncertainty of Covid-19.As the following statement: "At the beginning of the spread of Covid-19, many Covid-19 patients were infected with Covid-19.Both symptomatic and asymptomatic COVID-19 patients.Therefore, patients at the Yogyakarta City Muhammadiyah Hospital are followed up with other medical teams commanded or initiated by the leadership of the Covid-19 Islamic boarding school."(Informant 1) "The alternative provided by the medical team and doctors at PKU Muhammadiyah Yogyakarta is a meditation on the psychological and spiritual strengthening of Covid-19.This means that someone is tasked with providing strong motivation and support with the aim that Covid-19 patients recover quickly.It is known that Covid-19 patients on the one hand experience prolonged or excessive shock stress.Therefore, the alternative provided by the Medical Team is strengthening the Covid-19 Meditation." (Informant 1) Based on the results of the interviews, it can be understood that the approach developed by the Yogyakarta Muhammadiyah Hospital in dealing with COVID-19 uses a vertical and horizontally based spiritual approach.The following is a map of the Covid-19 Spiritual landscape developed by PKU Muhammadiyah Yogyakarta (Figure 2).As the following statement:  The approach and alternatives given by the Covid-19 management are more directed toward neuro-spiritual (spiritual brain approach).Based on the results of information provided by medical officers: "One of the supporters in supporting the improvement and health of Covid-19 patients is the development of faith and spiritual improvement programs.Asymptomatic Covid-19 patients were given direction and guidance to increase faith and immunity by the Muhammadiyah Covid-19 Islamic boarding school.One example is the existence of a program of religious worship beginning with obligatory prayers, which are held regularly and consistently five times in Islamic boarding schools.And also coupled with sunnah prayers such as tahajjud and dhuha carried out as a routine activity.The Qur'an tadarus program is carried out after prayers for Covid-19 Asymptomatic patients."(Informant 3)

Discussion
The COVID-19 outbreak is a national and even global disaster.According to Law Number 24 of 2007, a disaster is an event or series of events that threatens and disrupts people's lives and livelihoods caused, both by natural factors and/or non-natural factors as well as human factors, resulting in human casualties, environmental damage, losses possessions and psychological impact [32].Therefore, Muhammadiyah views COVID-19 as a non-natural disaster category [21].
In looking at disasters, Muhammadiyah always links normative texts in the Qur'an and hadith with modern science.As an organization that carries the tajdid jargon, Muhammadiyah's perspective in viewing social reality, including Covid-19, always uses the bayani, burhani and irfani approaches [26].Muhammadiyah rejects atomistic and partial views, especially the irrational view that disasters occur because of mystical things that have nothing to do with disasters [33].

Sprituality
The Covid-19 virus outbreak has created uncomfortable conditions in society, such as anxiety and fear of contracting the Covid-19 virus outbreak.This attitude is very influential in the pattern of our daily lives.Covid-19 in the Perspective of Islamic neuroscience education.When the Covid-19 outbreak occurred, irrational attitudes emerged in response to it, including; 1) Refusal to comply with health protocols including 3M (washing hands with soap in running water, wearing masks, and maintaining distance); 2) The emergence of residents' refusal to bury bodies affected by COVID-19 because it will become a source of transmission; 3) Rejection and intimidation of health workers who were evicted from their contracts because they could infect residents.This irrational attitude reflects a quality of thinking that is deadlocked on how to deal with this.then it is necessary to have the best solution needed to solve the problem [34].
Increasing the needs of the immune system in the body and preventing stress in handling Covid-19, it can be done with the help of meditation and relaxation.Meditation in general can be interpreted as ideas or contemplation, contemplation, and reflection [17].Meditation is a psychophysiological condition in which a person experiences a passive but active and silent but creative state [18].Therefore, for someone who does meditation, his soul will become calm and fresh.
Someone does meditation when the mind does something that can reflect on itself and learn to determine what the purpose and mission of life are.The way that needs to be done is to control the body, mind, and emotions to find our identity.Letting the mind hear and absorb all the positive energy and learning to be silent for satisfying results [19].
Meditation relaxation exercises can also reduce high blood pressure.Relaxation causes hypertension drugs to be effective if pharmacological treatment is done with shame.Meditation essentially maintains awareness of an object that is focused on always maintaining good manners, not being careless, and respecting yourself.
Meditation therapy is a way or method that can respond to the body so that it can respond positively and make the body calmer and fresher.It is also beneficial for improving health, both mentally and physically.When relaxed the mind will be focused so that the blood vessels become more elastic than before [20].
In the vertical aspect, the direction and management of the Covid-19 Islamic boarding school are more on the relationship between Covid-19 patients and Covid-19 peer members, both symptomatic and asymptomatic patients.Spiritual verticality means that it is more directed toward fellow human beings, especially Covid-19 patients who can still communicate with their families at home both online and offline face-to-face while still observing health protocols [21].The musings given by the administrators of the Muhammadiyah Islamic boarding school are for all patients to stay together with their families for those who visit and are visited by their families.Fellow Covid-19 patients, can still chat, communicate, and meet.Meditation is psychosocially strengthened based on good religious behavior [22].
Spiritually level, meaning that Covid-19 patients are still given moral support, religious assistance, online recitation, and Islamic studies.The Covid-19 Islamic Boarding School has scheduled lecturers and ustadz (religion teacher) to give spiritual sermons according to the theme of the existing recitation.All patients are given spiritual guidance related to Allah SWT.Such as praying in congregation, reading the Qur'an, and sunnah fasting.
The spiritual approach here researchers associate it with a neuro-spiritual approach, namely in a scientific context, namely under neurobiology is a science related to the science of the brain [23].The science of the brain, whose part is close to lifestyle or clear thinking, focuses on inner cultivation.Increasing worship and faith in the totality of religious behavior in life [24].
Certain brain abilities differ from those found in computers or other technologies.But unfortunately, sometimes people even think about this technology where the brain is used as a storage box only.The brain learns with a mixture of various emotions, memories, intentions, and so on that make up its mental life [25].For this reason, in the learning process, it is the brain that puts information into containers that previously contained relevant information that requires restructuring, restructuring, and reassessment [26].
The neuro-spiritual in question is Spiritual Quotient (SQ), according to Danah Zohar and Ian Marshall as the initial initiator, is an ability related to transcendence to deal with problems of life's meaning or values.SQ can also be understood as the ability to place behavior in a wider and richer context of meaning and judge that one's actions or way of life are more meaningful than others.
Another term that is the same as SQ is ma'rifah Quotient (MaQ) or makrifat intelligence [27].This intelligence was introduced by Abdul Munir Mulkhan and developed from the great tradition of Sufi intellectuals.In the great tradition of Sufi scholars, MaQ can be understood as guidance or giving what one can strive for (effort).In this context, education places humans as microcosmic figures connected by the spirit with the peak of synthetic unity between the senses, rational, philosophical, and metaphysical.The way MaQ works is called kasyf and the result is called ma'rifat.knowledge [28].
Spiritual intelligence is another form of intelligence as the third aspect of the two previous aspects of intelligence (IQ and EQ), self-knowledge and especially self-awareness is internal awareness.The brain is a process that takes place within the brain itself without the influence of the five senses and outside the world, which forms true human consciousness [29].
Anatomically, the 3 pieces of intelligence have high singlism, although some are more dominant than others.Someone who has a high IQ does not necessarily have a high EQ or SQ.On the other hand, someone who has a high EQ has the opportunity to develop his IQ optimally but his SQ is not needed.Meanwhile, someone who has a high SQ automatically has the same IQ and EQ.That is why spiritual awareness or intelligence is also referred to as "Highest Intelligence", the pinnacle of intelligence or highest intelligence [30].
Spiritual intelligence gives birth to the ability to find the meaning of life and develop morals.A person can give meaning to his life in whatever capacity he has.One does not need to wait to reach a high position or education to give meaning to life, in other words, every time people have the same opportunity to give meaning to their lives regardless of their capacity.Spiritual intelligence is the ability to give spiritual meaning to thoughts, behaviors, and activities and to be able to comprehensively energize IQ, EQ, and SQ [31].
Etymologically, neuroscience is neuroscience that studies the nervous system, specifically studying neurons or nerve cells with a multidisciplinary approach [35].In terminology, neuroscience is a field of science that specializes in the scientific study of neuroscience.On this basis, neuroscience is also referred to as the study of the brain and all other functions of the nerves.The development of the world of neuroscience as the science of the human nervous system or brain is currently experiencing significant progress.Experts continue to research its relationship with human life, including the world of education where the specificity of brain growth and development is closely related to the achievement of an educational process [34].

Conclusion
Based on the results and discussion, it can be concluded that Covid-19 meditation with a neurospiritual approach applied at Yogyakarta Muhammadiyah Hospital is a good alternative for improving the physical and spiritual health of Covid-19 patients.It is hoped that this research can contribute to the development of services for Covid-19 patients.Declaration patients, namely the Muhammadiyah Hospital in the City of Yogyakarta, which is collaborating with Yogyakarta 'Aisyiyah University under the leadership of Muhammadiyah Disaster Management Center (MDMC).The city of Yogyakarta accommodates Covid-19 patients by establishing a health institution called the Yogyakarta Muhammadiyah Covid-19 Islamic Boarding School.So far, many studies have discussed and studied Covid-19, Covid-19 patients, and the Muhammadiyah Hospital, both in Indonesia and in Yogyakarta [7].Followed by research that responds to meditation for the recovery of Covid-19 patients related to the stress of Covid-19 patients [8].Health and mental health of Covid-19 patients due to the stress of suffering from Covid-19.Interesting research is also about the existence of alternatives and solutions for Covid-19 patients related to drugs or handling spiritual strengthening and motivation to stay healthy for Covid-19 patients.

Figure 1 .
Figure 1.Case Study Research

"
The activities managed by the Covid-19 Islamic boarding school include vertical and horizontal spiritual-based.The management of PKU Muhammadiyah Yogyakarta makes a team as well as a medical team but also continues to serve as a Covid-19 spiritual coach.The Covid-19 spiritual companion or coach is tasked 6 with providing direction, religious support, and prayer for both Covid-19 patients and their families at home." (Informant 2)

Table 1 .
Based on Table 1, there were 1 (one) symptomatic and 5 (five) asymptomatic Covid-19 patients at Muhammadiyah Yogyakarta as a shelter for the Muhammadiyah Covid-19 Islamic Boarding School.Meditation for Covid-19 is usually directed by doctors for spiritual strengthening meditation directed at remembrance, strengthening faith beliefs, strengthening faith, and religious advice that touches the heart.The Characteristic of Respondents