The demographic data analysis was to determine the characteristics of respondents (gender, education, occupation, religion, marital status, knowledge, family support, and anxiety) among CKD patients undergoing hemodialysis during COVID-19. Table 1 shows the complete univariate analysis results

According to Table 1, as many as 28 respondents are female, 26 respondents are married, 51 respondents are Muslim, and 21 respondents have a diploma.

Table 2 shows that out of 54 respondents, the majority of respondents had good knowledge, namely 44 people. Table 3 describes the family support and Table 4 about the anxiety level of the patients.

Bivariate analysis was carried out to determine whether or not there was an effect of knowledge and family support on the anxiety of CKD patients undergoing hemodialysis during the Covid-19. The Chi-Square Test was used as the statistical test. The Bivariate analysis is presented in Table 5.

Table 5 shows that out of 54 respondents, those who had poor knowledge with mild and moderate anxiety were 1 person each respondent who had a poor knowledge with severe anxiety was 2 people. While respondents who had sufficient knowledge of mild, moderate, and severe anxiety were 2 people each (P=0.026).

Table 6 shows that out of 54 respondents, 48 respondents received good family support with the majority of them (26 people) experiencing mild anxiety. Meanwhile, respondents who received poor family support were 6 people with the majority of respondents experiencing severe anxiety 4 people p-value= 0.0001.

The majority of respondents experienced mild anxiety, namely 27 people. While respondents who experienced anxiety. There are differences from the results of previous research (Al Aziz & Sudiro, 2017), out of 54 respondents, the majority of respondents who were not anxious were 38 people, with mild anxiety 10 people, while respondents who experienced moderate anxiety were 5 people, and severe anxiety was 1 person. According to the prior study, anxiety is a signal that recognizes or warns of a serious hazard, allowing a person to take action to combat the threat (Nurlinawati et al., 2019). Mental health and combined mental health and social support account for 14% and 21% of the difference in death anxiety among CKD patients, respectively (Khodarahimi et al., 2021). In this study, most of these respondents experienced mild anxiety because many of them were highly educated so they had a deeper understanding of covid-19. In addition, because Islam is the majority religion, there must be many respondents who study Islam so that respondents only experience mild anxiety. This can also be observed by other observations found by researchers, namely the hemodialysis schedule for ordinary hemodialysis patients and hemodialysis patients with Covid-19 is separated in time, resulting in respondents being less anxious when undergoing hemodialysis in the dialysis unit.

In this study, out of 54 respondents, 44 respondents had good knowledge. respondents who had good knowledge and were not anxious were 5 people, who experienced mild anxiety were 24 people. This result is a positive thing that can be influenced by the education of respondents where the majority (Diploma and Senior High School) make it easier to receive information and knowledge about hemodialysis during the Covid-19 pandemic or about Covid-19 itself, so that it has an impact on the lighter anxiety experienced by respondents, while respondents with good knowledge who experienced moderate anxiety were 13 people and 2 people others experienced severe anxiety.

This can be influenced by other observations found by researchers, namely that some respondents lack exposure to knowledge about hemodialysis during the Covid pandemic or about Covid-19 itself and the presence of hemodialysis patients with Covid-19 who died which can affect the patient's psychological condition so that even though respondents are well informed, they still experience moderate and severe anxiety. In line with research (Al Naamani et al., 2021) which explains Fatigue, anxiety, depression, and sleep quality are significant problems for patients undergoing hemodialysis during the Covid-19 pandemic. Another thing is also in line with research (Feroze et al., 2012) which explains that anxiety and depression still often occur in patients who have routinely carried out hemodialysis with established conditions.

Respondents who had sufficient knowledge were 6 respondents, each of whom 2 people experienced mild, moderate, and severe anxiety. Respondents who had less knowledge were 4 respondents, 1 person experienced mild and moderate anxiety and 2 people experienced severe anxiety. This is consistent with research performed by (Dillard et al., 2017) which found that increased anxiety is connected to lower knowledge. Ignorance of something is regarded as a pressure that can lead to critical thinking and can cause anxiety. Individuals with limited knowledge may experience anxiety as a result of a lack of information. The chi-square person test revealed a significant relationship between knowledge and anxiety in CKD patients receiving hemodialysis at Dr. M. Yunus Bengkulu Hospital during the Covid-19 pandemic (p-value = 0.026). This study is in line with the explanation in the study by (Karadag & Samancioglu Baglama, 2019) that patients in the hemodialysis stage are prone to exhaustion and anxiety, and fatigue and anxiety levels decrease dramatically following aromatherapy.

According to the study, there is an influence of knowledge on anxiety in CKD patients undergoing hemodialysis during the Covid-19 at Dr. M. Yunus Hospital because the majority of respondents were educated (Diploma and Senior High School), making it easier to receive information and understand something, as well as having a deeper understanding of covid-19, which has an impact on respondents' lighter anxiety levels.

In this research, 48 of 54 respondents had good familial support. the majority of respondents who had good familial support experienced mild anxiety as many as 26 people and 5 people did not experience anxiety. This is a positive thing towards reducing patient anxiety. There were 15 people who experienced moderate anxiety and two people experienced severe anxiety. Other data obtained were respondents who received poor support as many as 6 people, of these 6 people 1 person each experienced mild and moderate anxiety, while four people experienced severe anxiety. A lack of family support can have an impact on this. This is consistent with previous studies which revealed that people who received good family support have less anxiety than those who received inadequate family support (Cordeiro, 2019). Mental health diseases are among Europe's most serious public health issues. It is a silent problem with a heavy burden of related impairment, encompassing illnesses including depression, anxiety, and schizophrenia, which account for a considerable share of early retirement due to disability in Europe, with high economic and social costs. This is not in line with previous research stated the mean level of perceived social support from the family was 15.23 ± 5.37 (Tezel et al., 2011). There was no statistically significant difference between all variables for the level of perceived social support from the family. Perceived social support from the family is negatively correlated with depression.

The study's findings indicate that almost all respondents had positive familial support. The results showed that family adaptation was positively connected with support within the family as recognized by patients, as well as with emotional support (Sarsak, 2022). Social support from family and friends, spirituality and religion, tele-nursing programs, and participation in network support groups can all help to reduce anxiety (Gerogianni et al., 2019), implying that there is a link between family support and patient anxiety. The presence of Family-based has been discovered to increase the implementation of health chores in the family (Meilianingsih & Sari, 2023). The main factors that arise from within oneself will give rise to motivation in the future life process, such as activities and eating patterns (Utami & D, 2023).