TEACHING HANDWASHING SOAP SKILL THROUGH DEMONSTRATION FOR KINDERGARTEN CHILDREN

The research aims to find out whether Effect of Health Education Demonstration Media on Knowledge of Handwashing with Soap (CTPS) in the Work Area of the Sei Pancur Health Center Batam City. Research methods used a quasi-experimental one-group pre-test-post-test . Research result shows that In the pre-test as many as 88.9% of respondents lack knowledge on washing Hands with Soap (CTPS) and on the Post-test as many as 92.6% of respondents Good knowledge of washing Hands with Soap (CTPS) in this case, there is a significant effect between the knowledge of 6 steps of handwashing before and after the intervention of health education about Hand Washing with Soap 6 Steps with demonstration media in Early Childhood in the Work Area of the Sei Pancur Health Center Batam City. Conclusion: There is an effect Demonstration Method on increasing the knowledge of early childhood in proper hand washing in the Work Area of the Sei Pancur Health Center Batam City. Suggestion: The school should further improve the provision of health information, especially about proper handwashing through various health education methods so that early childhood children are happy and not bored in following it. Soap 6 Steps with demonstration media in Early Childhood in the Work Area of the Sei Pancur Health Center Batam City. The results obtained p.value 0.00 (<0.05). on the of the that have the influence in and for


INTRODUCTION
The Covid-19 pandemic is currently engulfing various countries in the world, including Indonesia. Since early March 2020, Indonesia has been infected with the virus, which first appeared in early 2019 in the city of Wuhan, China. (Ministry of Health, 2020). In Indonesia, there were 333,000 positive cases of COVID-19 with 11,844 deaths, and in the Riau Islands, there were 2,525 cases with 60 deaths, while in Batam City alone there were 1,896 cases with 53 deaths (WHO, 2020; Batam Health Office, 2020). The World Health Organization (WHO) and the United States Centers for Disease Control and Prevention (CDC) also issued an advisory regarding what to do to prevent this new type of corona. Efforts that can be done are to take various preventive measures, Washing hands with soap is one of the sanitation measures by cleaning hands and fingers using water and soap by humans to be clean and break the chain of germs. Washing hands with soap (CTPS) is also known as an effort to prevent disease. Washing hands with water alone is more common, but it has proven to be ineffective in maintaining health compared to CTPS. According to (Kemenkes, 2020) through the Director-General of Public Health of the Ministry of Health, given that CTPS can prevent Covid-19. "The Covid-19 pandemic has been a strong reminder for all of us that one of the simplest but most effective ways to stop the spread of the virus is washing hands with soap and running water.
Based on data from (Ministry of Health, 2020), only half the population in Indonesia over the age of 10 have practiced proper handwashing behavior. Even during the Covid-19 pandemic, only 73 percent had access to handwashing facilities. During the current Covid-19 pandemic, hand hygiene is very important, to keep children at an early age, doctors, health workers, workers, and the general public safe from the spread of Covid-19 and other infectious diseases.
Early childhood is an effective health promotion target. After all, it has been able to disseminate information to a population that is very sensitive to change because it is at a stage of growth and development. Health education regarding washing hands with soap in children hopes to increase children's knowledge, so that early childhood can apply handwashing behavior with soap, according to new behavior it is acceptable and lasts a long time if the process of accepting the new behavior is based on knowledge. Knowledge can be obtained by a person or educational target from the learning process with various kinds of educational aids or media (Notoatmojo, 2011).
The media that is applied to elementary school children is easy to understand, and there are various health education media about handwashing that can be used, namely the demonstration method. The selection of the demonstration method according to research from (Ni Md. Ari Wulandari, 2019) turned out to be effective in increasing students' psychomotor abilities in carrying out wound care actions with 85.10% results in the good category.
The problems that exist in Permata Asri Kindergarten, Sei Beduk Sub-district, Batam City students do not understand how to wash hands with soap (CTPS), or how to wash hands with the 6-step technique. Based on the results of interviews with teachers at Permata Asri Kindergarten, Sei Beduk District, Batam City, that teachers do not teach students to wash their hands with soap using the 6-step technique, the teacher only teaches students to maintain general hygiene. And some students only wash their hands when their hands look dirty, while eating at school they rarely wash their hands. The impact on students at Permata Asri Kindergarten, Sei Beduk sub-district, Batam City for the last 5 months mentioned several diseases, including stomach pain and diarrhea, because students did not understand how to wash their hands properly. Therefore, the researchers used the demonstration method in this research. The reason the researcher uses this demonstration media is that the method teaches by demonstrating how to wash hands correctly and following health education and students can be demonstrated directly by him.
Washing Hands with CTPS Soap) Hand washing is one way to avoid food-borne diseases. The habit of washing hands regularly needs to be trained in children. If you are used to washing your hands after playing or when you are going to eat, it is hoped that this habit will carry over to old age (Mubarak, 2019).
Based on data from (Ministry of Health, 2020) The proper way to wash hands with soap (CTPS) is as follows: a. Wet both palms at mid-arm height using running water and scoop out the soap. b. Rub and rub both palms gently. c. Wipe and rub also the back of the hands alternately. d. Do not forget the fingers, rub between the fingers until clean. e. Clean the fingertips alternately by interlocking the palms. f. Rub and rotate both thumbs alternately g. Place your fingertips in your palms and rub gently to clean nails. h. Finally by rinsing all parts of the hand with clean running water and then dry using a towel or tissue. The use of special hand washing soap in the form of bars or liquids is highly recommended for maximum hand hygiene. The importance of washing hands properly and properly using soap is to maintain overall cleanliness and prevent germs and bacteria from moving from the hands into the body.
2. Knowledge Knowledge of cognition is a very important domain in shaping one's actions (over behavior). According to(Notoatmojo, Public Health Sciences And Arts, 2011) Knowledge has six levels, namely: a. Know (Know) Know is defined as remembering a material that has been studied previously after observing something.Therefore, knowing this is the lowest level of knowledge. b. Understanding (Comprehension) Understanding an object is not just knowing about the object, not just being able to mention it, but the person must be able to interpret correctly about the object he knows. c. Application (Application) This means that people who have understood the object in question can use the principles they know in other situations. d. Analysis (Analysis) Is the ability to describe a material or an object into components, but within one organization, and still have a relationship with each other. e. Synthesis (synthesis) Synthesis shows a person's ability to summarize in a logical relationship between its components. f. Evaluation (Evaluation)

Univariate Analysis
In this study, a univariate analysis was carried out to describe the knowledge of 6 steps of handwashing in early childhood before and after the administration of demonstration media.  Table 2

. Frequency Distribution of Respondents Based on Post-test Knowledge Levels In the implementation of demonstration media for early childhood in the Work Area of the Sei Pancur Health Center Batam City in 2021
Based on Table 2, the results show that the majority of knowledge is good after the implementation of the demonstration media (post-test) as many as 25 students or 92.6%.

Bivariate Analysis
The results of the marginal homogeneity test in this study were to determine the difference in the average level of knowledge of handwashing with soap (CTPS) in early childhood before and after the demonstration method was carried out on respondents by measuring through pre-test and post-test questionnaires. The results of the analysis are shown as follows: By using the help of a computer application, namely SPSS, the Marginal Homogeneity Test was carried out, the average value of the pre-test was 549,900 and the post-test decreased with an average value of 1508,200 with a pvalue of 0.000 (P < 0.05). Thus HO is rejected, so it can be concluded that there is an effective knowledge implementation of demonstration media in early childhood in the Work Area of the Sei Pancur Health Center Batam City.
Handwashing behavior is an activity carried out in cleaning the palms, backs of hands, and fingers so that they are clean from dirt and kill germs that cause diseases that are detrimental to human health and make hands smell good. (Notoatmojo, Public Health Sciences And Arts, 2011) Based on the existing phenomena, it can be seen that early childhood children have a habit of not paying attention to the need for handwashing in everyday life, especially in the school environment. They usually just eat the food they buy around the school without washing their hands first, whereas before they were playing. This behavior is certainly influential and can contribute to the occurrence of diarrheal disease. Hand washing is the most important basic technique in preventing and controlling infection transmission (Fermi Avissa, 2018).
The same thing was also researched by (Setyaningrum, 2016)shows the results that the level of knowledge of respondents about CTPS is mostly in the good category, namely as much as 86.67% at SDN Batuah I and 76.67% at SDN Batuah III, respondents' attitudes about CTPS are mostly in the good category as many as 83.33% in SDN Batuah I and SDN Batuah III. Furthermore, it was also investigated by(Sustainable, 2020) which shows the results that giving demonstrations is effective in increasing the level of knowledge of school children about proper handwashing.
According to the researcher's assumptions, before the intervention of providing health promotion, it was known that overall respondents, namely early childhood, lacked knowledge of doing 6 steps of handwashing correctly, where most of the respondents were unable to take actions ranging from distributing soap with their hands to foaming, unable to take action. washing hands at the step of washing between the fingers, the tips of the fingers, the act of washing the thumbs properly. Where respondents wash their hands only with irregular rubbing movements so that they are not able to reach every crevice between and fingertips which causes the actions taken by respondents to not be able to clean their hands as a whole.
While the level of knowledge is good as many as 25 respondents or (92.6%). Health implementation is any combination of health education and interventions related to economics, politics, and organizations designed to facilitate changes in behavior and a good environment for health (Notoatmodjo, 2012). One method of implementing health is to use the Demonstration method. The same thing was also researched by (Diamond, 2019) the results that after giving the demonstration students can know how to wash their hands properly and correctly. This is following research conducted by (Ashari, 2020) shows that there is a significant difference in knowledge, attitude, and practice between the pre-test and posttest in the control group, in the intervention group there is no significant difference in knowledge, attitude, and practice between before and after.
According to the researcher's assumption, after the implementation, namely the implementation of health education with Demonstration Media, it can be seen that respondents who have good knowledge of doing hand washing actions 6 steps correctly. This looks better when compared to before the intervention where overall respondents lacked knowledge of doing the 6-step challenge wash action correctly.

CONCLUSION
In a study conducted on 27 respondents in Early Childhood in the Working Area of the SEI Pancur Health Center, Batam City, namely: In the pre-test, 88.9% of respondents lacked knowledge on Handwashing with Soap (CTPS). Meanwhile, in the post-test, 92.6% of respondents had good knowledge of handwashing with soap (CTPS). Furthermore, there is a significant influence between the respondents' knowledge of 6 steps of handwashing before and after the health education intervention about Hand Washing with Soap 6 Steps with demonstration media in Early Childhood in the Work Area of the Sei Pancur Health Center Batam City. The results obtained p.value 0.00 (<0.05). Based on the results of the research that researchers have done, the influence of early childhood knowledge on handwashing in 6 steps is expected to be used as input and reference for comparison for further researchers and also to increase the knowledge of researchers, as well as evaluation material for students' understanding of Early STIKes Bros Batam on preparation to become a professional nurse.
There are several limitations in this study, namely: With this pandemic situation researchers cannot collect children at once because they are divided into 2 groups, Respondents at an early age have obstacles where children cannot read on their own so they must be accompanied by parents, Schools do not have tools that can help in the research process so researchers prepare the tools alone, in the room the lighting is not clear so that children can't see clearly.