NURSING INTERVENTION OF FAMILY

ABOUT THE BENEFITS OF FAMILY SOCIAL SUPPORT IN ANTICIPATION

BEHAVIORS OF PREGNANCY HAZARDS IN PRIMIGRAVIDA MOTHER
 
Arranged for meet task courses
NURSING FAMILY
fostered by Ns. Sri Wahyuni Adriani , M.Kep ., Sp.Kep.Kom
 
 

 
 
 
By :
Devi Islamiyah (1611011050)
Cahya Risky Abdillah (1611011051)
Anis D wi A isah (1611011057)
Fredy Dicky P. (1611011061)
 
 
NURSING STUDY PROGRAM
FACULTY OF HEALTH SCIENCE
MUHAMMADIYAH JEMBER UNIVERSITY
April, 2019
 
 BENEFITS OF FAMILY SOCIAL SUPPORT ON ANTICIPATION BEHAVIOR OF
MORTAL PREGNANCY IN PRIMIGRAVIDA MOTHER
 

A. Introduction

Every pregnancy has the possibility of complications or complications that can

endanger the mother or baby, both in the form of pain and death (Rochjati, 2005). At
least 40% of pregnant women have experienced one form of complication during
pregnancy and around 15% of these complications are potentially life-threatening and
require emergency obstructive treatment (National Family Planning Coordinating Board,
2005). According to SKRT (2001), the cause direct obstetric complications of 90%, most
are bleeding (28%), eclampsia (24%) and infection (11%). Indirect causes in the form of
conditions health suffered by mothers for example Less Chronic Energy (SEZ) 37%,
anemia (Hb <11 g%) 40% and cardiovascular disease.
According to District Health Office data Magetan has 2 Puskesmas with the
largest number of high-risk pregnancies, wrong one in Karangrejo Health
Center. total high risk pregnancy at the Puskesmas Karangrejo in 2006 reached 26
people (37.14%) and experienced an increase in in 2007 which amounted to 40 people
(57.97%) among others because of the location abnormalities of 8people
(11.59%), maternal age > 35 years as much 4 people (5.79%), hypertension as many as
10 people (15.94%), anemia as many as 12 people g (17.39%) and high parity as many as
6 people (7.25%).
Many factors affect the high mortality rate of pregnant and childbirth, including
factors of education and knowledge of mothers that are still relatively low, socio-
economic conditions and the family environment of women who do not support, socio-
cultural life of people who are still gender biased, access to pregnant women in health
facilities modern is very lacking, as well as inadequate pregnancy services and childbirth
assistance to pregnant women (Chairunnisya, 2002).
 Early detection of symptoms and danger signs during pregnancy is the best effort
to prevent serious disturbances in pregnancy and maternal safety (Wiludjeng,
2005). Conduct early recognition of risk factors in pregnancy and childbirth, as much as
possible by pregnant women themselves, husbands and / or families (Rochjati, 2005).
Families are expected to act as the closest support system for pregnant women
because in the family there is a strong emotional bond, so that pregnant women will feel
more confident, happier and ready to undergo pregnancy, childbirth and the puerperium
(Fauzi, 2003). According to Friedman (1998) families play a supportive role during the
healing and recovery of family members.
 
B. Understanding
Primigravida is the first pregnant woman. Pregnancy (gravidity) begins with
conception (conception) and ends with the beginning of labor. Pregnancy is a crisis of
maturity that can be stressful but valuable because these women need themselves to
provide care and assume greater responsibility. When preparing to replace the new role,
the woman changed the concept she used to become a parent. After he finishes he
changes from someone who is free and successful to himself and becomes a person who
can survive to care for others. Associated with managing certain developmental tasks:
accepting thinking, taking on the role of mother, agreeing on the relationship between
mother and child and between partners and partners, building relationships with unborn
children and preparing to seek experience in obtaining results (Bobak et al., 2005 )

Pregnancy involves all family members because conception is the beginning, not
only for the developing fetus but also for the family by the presence of a new family
member and the occurrence of changes in family relationships, so each family member
must adapt to pregnancy and interpret it according to their individual needs ( Grossm
1980 in Bobak 2005).

C. Intervention
The researcher gave an intervention in the form of information to the family about
the importance of anticipating the danger signs of pregnancy and motivating the family to
continue providing informative support to pregnant women, so that pregnant women get
 clear information about the types of pregnancy danger signs, the danger of high risk
pregnant women and how to maintain health during pregnancy. The more
information obtained, the better the knowledge of pregnant women about anticipating the
danger signs of pregnancy.
D. Journal Discussion
1. Method
This study uses quasy experimental design . The population used was
primigravida mothers who did ANC visits at Karangrejo Magetan Health
Center. Respondents who met the criteria were 20 people. The study was conducted
from June to July 2008. Data collection for family social support using a
questionnaire, while collecting data for anticipated gestures of pregnancy danger
using questionnaires, structured interviews and KMS observations of pregnant
women. Data analysis used Wilcoxon Signed Rank Test and Mann Whitney U Test.
2. Results
There is the influence of family social support for actions on pregnant women in
anticipation of pregnancy danger with the results of the Wilcoxon Signed Rank
Test statistical analysis . The results showed that the majority of respondents in the
treatment and control groups had positive attitudes as many as 6 people (60%) before
being given intervention.
3. Discussion
Based on the results of the study found the level of knowledge of pregnant women
in anticipating pregnancy danger signs before the intervention of both the treatment
group and the control group mostly with sufficient categories and in the treatment
group experienced an increase after being given the intervention showed a good
category. This is reinforced by the results of content analysis (Analyze Content) of a
structured interview. In accordance with the opinion of Caplan quoted by Friedman
(1998) which explains that families have a supportive function namely through
informational support, the family functions to provide guidance and disseminate
information to other family members. In groups treatment has increased, namely most
respondents have an attitudepositive as many as 7 people (70%), while in the control
group did not experience change after being given an intervention. According to
Notoatmodjo (2003), an attitude not yet materialized in aaction ( overt behavior ), a
factor is needed supporters or situations that make it possible, among others are
facilities and factors support ( support ) to realize attitude become a real
act.Environmental influence and trust from the family can affect the attitude of the
mother pregnant. Family is very influential for mothers get pregnant because it is a
source of support the biggest. For primigravida mothers who have not have enough
experience, family especially parents are places obtain information and ask for
advice related to pregnancy. Support the family who gets pregnant will cause a
feeling of calm, positive attitude against yourself and pregnancy, so It is expected that
the mother can take care of the pregnancy well until delivery. Concern and
encouragement from the family make pregnant women feel cared for and motivated
to care for and maintain pregnancy carefully.
 

  
 BIBLIOGRAPHY

National Family Planning Coordinating Board. 2005. Pregnancy and Risk

Understanding of Welfare Mother , (Online),
( http://www.gemapria.bkkbn.go.id ., Accessed on April 19, 2008, at 12.00 WIB).
Chairunnisya. 2002. Current Issues about Pregnancy Complications , (Online),
( http://www.library.usu.ac.id ., accessed on April 20, 2008, at 11:30 WIB).
Fauzi. 2003. 17 Emergency When Pregnant, (Online),
( http://www.kesrepro.info.com .,accessed on April 17, 2008, at 11.00 WIB).
Friedman. 1998. Family Nursing . Issue 3. Jakarta: EGC, p. 10-11.
Notoatmodjo. 2003. Health Education and Behavior. Jakarta: Rineka Cipta,
p. 96.
Perry, et al . 1999. Maternity Nursing Fifth Edition . St. Louis: Mosby Inc., pp.
7984.
Rochjati. 2005. Antenatal Screening for Pregnant Women . Surabaya: Airlangga
University Press, p. 39,
138-155.
SKRT. 2001. Mother's Function Is Difficult to Change , (Online),
( http://www.balipost.co.id/balipostcetak/2006/12/17/kel2.html ., Accessed April 18,
2008, at 07.00 WIB).
Smet. 1994. Health Psychology . Jakarta: Grasindo, p. 133, 136, 137, 140-143.
Wiludjeng, 2005. Overview of the Causes of Maternal Death in Hospitals , (On line),
( http://www.kalbe.co.id ., accessed on April 20, 2008, hours 08.00 WIB).
 
THE ANTICIPATORY BEHAVIOR OF PREGNANCI ES SIGN'S ALERT IN
PRIMIGRAVIDA, THE BENEFICIENCE OF FAMILY SOCIAL SUPPORT
TOWARD
 
Aditiawarman *, Ni Ketut Alit Armini **, Yunita Ike Kristanti **
 
*   Dr. Hospital Soetomo Surabaya. Jl. Prof. Moestopo. Tel / Fax: (031) 5913257. E-mail:
[email protected]
 
**    Faculty of Nursing, Airlangga University, Surabaya
 
 
ABSTRACT
 
Introduction: Complication in pregnancy can end up both mother and fetus.  Pregnancy woman and
her family must be able to recognize risk factors of the complication.  Family support is more
confident, happy and ready to face her pregnancy.  The aim of this study is to learn the influences of
social family support toward the anticipatory behavior of pregnancy sign's alert in
primigravida. Method: A quasy experimental purposive sampling design was used in this study.  There
were 20 respondents who met the inclusion criteria.  Groups, intervention and control groups, each
comprising 10 respondents. The independent variable in this study was social family support and the
dependent variable was the anticipatory behavior of pregnancy sign's alert in primigravida.  Data
were collected by using questionnaire, observation and structured interviews and then analyzed by
using Wilcoxon Signed Rank Test and Mann Whitney U Test with significance level  α0.05. Result: The
result was that the social family level with a significant level of p = 0.011, social family support also
had a significant level of p = 0.008 and the action  of pregnant woman p = 0.017. There were
differences in knowledge, attitude and action between intervention and control groups after treatment
with a significant level of p = 0.000 for knowledge, p = 0.015 for attitude and p = 0.002 for
action. Discussion: It can be concluded that social family supports influence of anticipatory behavior
(knowledge, attitude and action) of pregnancy sign's alert in primigravida.Further studies should be
concerned with the other factors that influence the anticipatory behavior of pregnancies sign alerts in
primigravida, both of internal and external factors.
 
Keywords: social family support, pregnant women, behavior, pregnancy's risk factor
 

PRELIMINARY
 
Every pregnancy has the possibility of complications or complications that can endanger the
mother or baby, both in the form of pain and death (Rochjati, 2005). At least 40% of pregnant women
have experienced one form of complication during pregnancy and around 15% of these complications
are potentially life-threatening and require emergency obstructive treatment (National Family Planning
Coordinating Board, 2005).According to SKRT (2001), the causes of direct obstetric complications
were 90%, most of which were bleeding (28%), eclampsia (24%) and infection (11%).
 
Indirect causes include health conditions suffered by the mother, for example Chronic Energy Deficiency
(KEK) 37%, anemia (Hb <11 g%) 40% and cardiovascular disease.
 
According to data from the Magetan District Health Office, there are 2 Puskesmas with the
highest number of high-risk pregnancies, one of which is at the Karangrejo Health Center. The number of
high-risk pregnancies in Karangrejo Community Health Center in 2006 reached 26 people (37.14%) and
experienced an increase in 2007, which amounted to 40 people (57.97%), among others due to location
abnormalities of 8 people (11.59%), age mothers> 35 years as many as 4 people (5.79%), hypertension as
many as 10 people (15.94%), anemia as many as 12 people
Journal of Ners Vol. 3 No. 1:
 
(17.39%) and high parity of 6 people (7.25%).
 
Many factors affect the high mortality rate of pregnant and childbirth, including factors of
education and knowledge of mothers that are still relatively low, socio-economic conditions and the
family environment of women who do not support, socio-cultural life of people who are still gender
biased, access to pregnant women in health facilities modern is very lacking, as well as inadequate
pregnancy services and childbirth assistance to pregnant women (Chairunnisya, 2002). Pregnant women
who are identified as having a risk of complications do not get the guaranteed care needed.  On the one
hand the government has not been able to provide adequate health services, on the other hand pregnant
women cannot and do not want to seek health help even though it is a high risk category. This is caused
by the inability to pay for maintenance costs, busy, not allowed by the husband and family or lazy to get
health checks (National Family Planning Coordinating Board, 2005).
Early detection of symptoms and danger signs during pregnancy is the best effort to prevent the
occurrence of serious disorders of pregnancy and maternal safety (Wiludjeng, 2005). Conduct early
recognition of risk factors in pregnancy and childbirth, as much as possible by pregnant women
themselves, husbands and / or families (Rochjati, 2005).  According to Gjerdingens et al. (1991) in
Perry et al. (1999), social support obtained by mothers during pregnancy and childbirth from the
surrounding environment is closely related to positive adaptation to the role of mother during the
transition period as a new parent.
Families are expected to act as the closest support system for pregnant women because in the
family there is a strong emotional bond, so that pregnant women will feel more confident, happier and
ready to undergo pregnancy, childbirth and the puerperium (Fauzi, 2003). According to Friedman (1998)
families play a supportive role during the healing and recovery of family members. This is what drives
the writer to examine the effect of family support on anticipating pregnancy danger signs in primigravida
mothers. The purpose of this study was to study the effect of family social support on anticipatory
behavior of pregnancy danger signs in primigravidian mothers.
 
MATERIALS AND METHODS
  This research uses quasyexperimental design . Population that is used were primigravida mothers
who did ANC visits at Karangrejo Magetan Health Center. Respondents who met the criteria were 20
people. The research was conducted from June to July 2008.
The independent variable in this study is family social support, while the dependent variable in
this study is anticipatory behavior of pregnancy danger in primigravida mothers. Data collection for
family social support using a questionnaire, while collecting data for anticipatory behavior of danger
signs
 
pregnancy using questionnaires, structured interviews and KMS observations of pregnant
women. Analysis of the data used by the Wilcoxon Signed Rank Test and the Mann Whitney U Test, with
the level of significance α <0.05.
 
RESULTS
 
Table 1 shows that there is an influence of family social support on the knowledge of pregnant
women regarding the anticipation of pregnancy danger signs with the results of the Wilcoxon Signed
Rank Test statistical analysis showing a significance value of p = 0.011 and Mann Whitney U Test p =
0,000. Average results knowledge of primigravida mothers in anticipation of pregnancy danger signs,
quantitatively increased from 15.9 ( pre test ) to 18.5 ( post test ) after intervention.
The effect of family social support on the attitudes of pregnant women in anticipating pregnancy
danger signs can be seen in table 2 with the results of the statistical analysis Wilcoxon Signed Rank
Test showingsignificance value p = 0.008 and with Mann Whitney U Test shows value

Benefits of Family Social Support (Aditiawarman)

 significance p = 0.015. The attitude of pregnant women in anticipating pregnancy danger signs is
quantitatively increased with an average yield of 69.9 ( pre test ) to 75.7 ( post test ).
 There is the influence of family social support for actions on pregnant women in anticipation of
pregnancy danger with the results of the Wilcoxon Signed Rank statistical analysis The test shows a
significance value of p = 0.017 and with the Mann Whitney U Test
 shows p = 0.002. The mean results showed an increase from 13.2 ( pre test ) to 14.5 ( post test ) (see table
3).
 
DISCUSSION
  Based on the results of the study found the level of knowledge of pregnant women in anticipating
pregnancy danger signs before the intervention of both the treatment group and the control group mostly
with sufficient categories and in the treatment group experienced an increase after being given the
intervention showed a good category. This is reinforced by the results of content
analysis (Analyze Content) of a structured interview. The following is an answer from one of the
respondents on the question: What are the danger signs of pregnancy that you know? "After I read the
brochure from Ma'am, it turns out that there are many signs of pregnancy.  Bleeding, no baby move,
abdominal pain and cloudy amniotic fluid " .
 
In accordance with the opinion of Caplan quoted by Friedman (1998) which explains that the
family has a supportive function that is through support informational, the family functions to provide
guidance and disseminate information to other family members. Families of women who are pregnant
 must have sufficient understanding and knowledge of the processes or changes experienced by pregnant
women so that they can avoid or overcome possible dangers in pregnancy. Knowledge of respondents in
the treatment group experienced a 100% increase after being given an intervention.  This is due to the
provision of information to families and pregnant women regarding the danger signs of pregnancy. The
researcher gave an intervention in the form of information to the family about the importance of
anticipating the danger signs of pregnancy and motivating the family to continue providing informative
support to pregnant women, so that pregnant women get clear information about the types of pregnancy
danger signs, the danger of high risk pregnant women and how to maintain health during pregnancy. The
more information obtained, the better the knowledge of pregnant women about anticipating the danger
signs of pregnancy.
Table 1. Results of statistical analysis of respondents' knowledge in anticipating the danger signs of
pregnancy in the working area of Karangrejo Magetan Health Center
   Treatment Group Control group Treatment Control
   Pre Post Pre Post Post Post
  Mean 15.9 18.5 15.3 15.6 18.5 15.6
Elementary
  school 2,424 1,178 1,418 1,173 1,178 1,173
  Results Wilcoxon Signed Rank Wilcoxon Signed Rank
Mann-Whitney U Test
     

  Analysis   Test   Test (p = 0,000)

 
  Statistics (p = 0.011) (p = 0.317)    

 
Table 2. Results of statistical analysis of respondents' attitudes in anticipating the danger signs of
pregnancy in the working area of Karangrejo Community Health Center Magetan
   Treatment Group Control group Treatment Control
   Pre Post Pre Post Post Post
  Mean 69.9 75.7 70.6 70.6 75.7 70.6
Elementary
  school 6,951 5,396 3,339 3,339 5,396 3,339
  Results Wilcoxon Signed Rank Wilcoxon Signed Rank
Mann-Whitney U Test
     

  Analysis   Test   Test (p = 0.015)

 
  Statistics (p = 0.008) (p = 0.083)    

Journal of Ners Vol. 3 No. 1:

 
 
Table 3. Results of statistical analysis of respondent's actions in anticipating the danger signs of
pregnancy in the working area of Karangrejo Magetan Health Center
   Treatment Group Control group Treatment Control
   Pre Post Pre Post Post Post
  Mean 13.2 14.5 12.6 13.0 14.5 13.0
Elementary
  school 1,229 0.527 1,264 1,333 0.527 1,333
  Results Wilcoxon Signed Rank Wilcoxon Signed Rank
Mann-Whitney U Test
     

  Analysis   Test   Test (p = 0.002)

 
  Statistics (p = 0.017) (p = 0.157)    

  Information:            
SD = Standard
 p = significance Deviation Mean = Average  

 
The results showed that the majority of respondents in the treatment and control groups had
positive attitudes as many as 6 people (60%) before being given intervention. Respondents who are
positive are respondents who are able to give positive statements in terms of receiving, responding,
 appreciating and being responsible for maintaining health during pregnancy. In the treatment group
experienced an increase, most of the respondents had positive attitudes as much as 7 people (70%),
while in the control group did not experience change after being given an intervention. According to
Notoatmodjo (2003), an attitude has not been automatically manifested in an action (  overt behavior ),
it requires supporting factors or possible situations, among others, facilities and factors of support
( support ) to realize attitudes become a real action. The influence of the environment and the beliefs
of the family can affect the attitude of pregnant women. The family is very influential for pregnant
women because it is the biggest source of support. For primigravida mothers who do not have enough
experience, families, especially parents, are places to obtain information and ask for advice related to
pregnancy. Family support obtained by pregnant women will lead to feelings of calm, positive
attitudes toward oneself and pregnancy, so that the mother is expected to be able to keep the pregnancy
well until delivery.
 
From the results of the study of the actions of pregnant women in anticipating pregnancy
danger signs before being given an intervention, the treatment group was mostly in the good category,
while in the control group with category  enough. Enhancement after intervention occurred in both the
treatment and control groups in the good category. It is strengthened by the results of content
analysis (Analyze Content), the following quote from one of the respondents' answers to the question:
Any attempt to anticipate the mother during the pregnancy danger signs?  "Check regularly go to the
midwife / doctor and exercise regularly and follow all advice from the midwife. "
 
The main support that can be given to improve the actions of pregnant women in anticipating
the danger signs of pregnancy, among others, by providing emotional support and appreciation and
instrumental support optimally. According to Smet (1994), emotional support is indicated by the
acceptance or understanding by the family, caring, attention, praise for the success of the respondent, and
acceptance of the complaints of the respondents. Instrumental support includes direct assistance, namely
financial assistance, assistance with facilities, personnel assistance and various other facilities provided
 directly when the respondent needs. This assistance is provided with the aim of making it easier for
pregnant women to care for and monitor pregnancy. Concern and encouragement from the family make
pregnant women feel cared for and motivated to care for and maintain pregnancy carefully.
 

CONCLUSIONS AND SUGGESTIONS

 Conclusion
 
Social support, especially family support plays an important role in the behavior of
primigravida mothers in caring for and maintaining pregnancy. Pregnant mother especially primigravida
mothers need physical and psychological support that must be met.  Pregnant women also need treatment,
rest and will feel happy to get practical help.  Support provided by the family (as the closest source owned
by the respondent) will give rise to a response including feeling accepted, feeling cared for, feeling
valued, getting a sense of security and getting ease of resolving difficulties, so that it can face pregnancy
smoothly.
 Suggestion
Researcher recommend so that motherpregnancy requires intensive pregnancy care and
monitoring to maintain the health and safety of the mother and fetus. Increasing family involvement by
providing support to pregnant women needs to be done in order to make pregnant women feel
comfortable. Puskesmas need to provide health education to families related to the importance of family
support and provide consulting services for pregnant women to anticipate pregnancy danger signs and
further research can be done to examine the effect of family support on the motivation of pregnant women
to make ANC visits.

LITERATUR

National Family Planning Coordinating Board. 2005. Pregnancy and Risk

Understanding of Welfare Mother , (Online),
( http://www.gemapria.bkkbn.go.id ., Accessed on April 19, 2008, at 12.00 WIB).
Chairunnisya. 2002. Current Issues about Pregnancy Complications , (Online),
( http://www.library.usu.ac.id ., accessed on April 20, 2008, at 11:30 WIB).
Fauzi. 2003. 17 Emergency When Pregnant, (Online),
( http://www.kesrepro.info.com .,accessed on April 17, 2008, at 11.00 WIB).
Friedman. 1998. Family Nursing . Issue 3. Jakarta: EGC, p. 10-11.
Notoatmodjo. 2003. Health Education and Behavior. Jakarta: Rineka Cipta,
p. 96.
Perry, et al . 1999. Maternity Nursing Fifth Edition . St. Louis: Mosby Inc., pp.
7984.
Rochjati. 2005. Antenatal Screening for Pregnant Women . Surabaya: Airlangga
University Press, p. 39,
138-155.
SKRT. 2001. Mother's Function Is Difficult to Change , (Online),
( http://www.balipost.co.id/balipostcetak/2006/12/17/kel2.html ., Accessed April 18,
2008, at 07.00 WIB).
Smet. 1994. Health Psychology . Jakarta: Grasindo, p. 133, 136, 137, 140-143.
Wiludjeng, 2005. Overview of the Causes of Maternal Death in Hospitals , (On line),
( http://www.kalbe.co.id ., accessed on April 20, 2008, hours 08.00 WIB).