Tidal flood disasters in coastal areas cause chronic psychological stress due to economic, social, and residential disruption. Psychological stress is closely linked to systemic inflammatory responses-marked by elevated Monocyte-to-Lymphocyte Ratio (MLR), Neutrophil-to-Lymphocyte Ratio (NLR), and Platelet-to-Lymphocyte Ratio (PLR)-which are associated with depression and anxiety symptoms. Mindfulness interventions, particularly body scan techniques, have been shown to reduce psychological distress and modulate immune responses, but empirical evidence on coastal flood survivors in Indonesia remains limited.
This study aims to evaluate the effectiveness of a community-based mindfulness body scan intervention on inflammatory biomarkers (MLR, NLR, PLR) and psychological parameters (stress, depression, anxiety, trauma, sleep quality, and resilience) among tidal flood survivors in Sayung, Demak. Participants will undergo baseline blood work and psychometric assessments, receive an 8-day mindfulness body scan intervention, and complete post-intervention evaluations.
Adults aged 18 to 60 years.
Survivors of tidal flooding (bencana rob) residing in the Sayung coastal area for at least 6 months.
Minimum educational attainment of Primary School (Sekolah Dasar / SD).
Literate in Indonesian (able to read and write).
Active psychotic disorders or severe mental illness.
Cognitive impairment that limits ability to complete assessments.
History of diagnosed autoimmune disorders, active allergies, or chronic inflammatory diseases.
Presence of acute infectious disease symptoms within the past 1 month.
Single group
Mindfulness Body Scan
BehavioralA structured 8-day behavioral intervention consisting of guided mindfulness body scan practices. Participants are instructed to direct non-judgmental attention sequentially across different regions of the body to enhance somatic awareness, promote relaxation, and reduce psychological stress reactivity.
Change in Monocyte-to-Lymphocyte Ratio (MLR)
Changes in MLR derived from routine complete blood count to evaluate systemic inflammation.
Change in Neutrophil-to-Lymphocyte Ratio (NLR)
Changes in NLR derived from routine complete blood count to evaluate systemic inflammation
Change in Platelet-to-Lymphocyte Ratio (PLR)
Changes in PLR derived from routine complete blood count to evaluate systemic inflammation.
Change in DASS-21 Score
Evaluation of changes in psychological distress using the Depression, Anxiety, and Stress Scale-21 (DASS-21). Total score ranges from 0 to 63, where higher scores indicate higher levels of psychological distress.
Change in Pittsburgh Sleep Quality Index (PSQI) Score
Evaluation of sleep quality using the PSQI questionnaire. Total score ranges from 0 to 21, where higher scores indicate poorer sleep quality.
Change in Connor-Davidson Resilience Scale (CD-RISC) Score
Evaluation of psychological resilience levels using the CD-RISC questionnaire. Total score ranges from 0 to 100, where higher scores indicate greater resilience.
Change in Impact of Event Scale-Revised (IES-R) Score
Evaluation of post-traumatic stress distress related to the tidal flood disaster using the IES-R. Total score ranges from 0 to 88, where higher scores indicate greater post-traumatic distress.
Change in WHOQOL-BREF Score
Evaluation of quality of life across physical, psychological, social, and environmental domains using the WHOQOL-BREF scale. Domain scores are transformed to a scale of 0 to 100, where higher scores indicate higher quality of life.
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Natalia Dewi Wardani, MD
Lead sponsor
Universitas Diponegoro
Sponsor institution
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