Jurnal Internasional 3

Proceeding
International Webinar
Life Long Learning Series
on Good Health & Well Being
”Ensure Healthy Lives and Promote Well-being for All at All Ages”
STIKes Mitra Husada Medan, September 11th, 2020, Friday
Editor :
Eka Falentina Tarigan, SST, M.Keb
Ester Simanullang, STr.Keb, Bd, M.Kes
Lidya Sinuhaji, SKM, M.Kes
Reviewer :
Prof. Dr. Amiya Bhaumik
(President, Lincoln University College, Malaysia)
Dr. Faridah Md bt Said
(Associate Professor, Post Graduate PhD Committe Incharge
Faculty of Nursing, Lincoln University)
Dr. Siti Nurmawan Sinaga, SKM, M.Kes
(Institute of Health Science Mitra Husada Medan Indonesia)
Dr. Joel Rey Acob
(Dean, College of Nursing, Visavas State University, Philippines)
Ms. Arpita Dutta
(NRS Medical College & Hospital, Kolkata, India)
Proceeding
International Webinar Life Long Learning
Series on Good Health & Well Being
”Ensure Healthy Lives and Promote Well-being for All at All Ages”
STIKes Mitra Husada Medan, September 11th, 2020, Friday
Condescendent (Yayasan Mitra Husada Medan)

Responsibe Person (Chief of STIKes Mitra Husada Medan)
Chief (Ester Simanullang, STr.Keb, Bd, M.Kes)
Vice Of Chief ( Eka Falentina Tarigan, SST, M.Keb)
Secretary (Juliana Munthe, SST, M.Kes)
Treasuree (Rosmani Sinaga, SE)
Editor :
Eka Falentina Tarigan, SST, M.Keb
Ester Simanullang, STr.Keb, Bd, M.Kes
Lidya Sinuhaji, SKM, M.Kes
Reviewer :
Prof. Dr. Amiya Bhaumik
(President, Lincoln University College, Malaysia)
Dr. Faridah Md bt Said
(Associate Professor, Post Graduate PhD Committe Incharge
Faculty of Nursing, Lincoln University)
Dr. Siti Nurmawan Sinaga, SKM, M.Kes
(Institute of Health Science Mitra Husada Medan Indonesia)
Dr. Joel Rey Acob
(Dean, College of Nursing, Visavas State University, Philippines)
Ms. Arpita Dutta
(NRS Medical College & Hospital, Kolkata, India)
Steering Committee :
Herna Rina Yanti Manurung, STr.Keb, Bd, M.Kes
Publisher :
STIKes Mitra Husada Medan
Jl. Pintu Air IV Pasar 8 Kel. Kwala Bekala Kec. Medan Johor Medan
Tel (061) 8367405
Fax : (061) 8367405
Web : mitrahusada.ac.id
Email : [email protected]
ISBN : 978-623-96458-1-6
Second edition, March 2021

Copyriht protected by regulations.
Reproduction in any form and manner that is prohibited without the written permission of the publish
FOREWORD
Praise our gratitude for the presence of God Almighty, because it is for His blessings and grace
that the Proceedings of the International Ensure Healthy Lives and Promote Webinar Well
being for all at All Age can be carried out as expected. The International Webinar organized by
STIKes Mitra Husada Medan and in collaboration with Lincoln University College, Medical
College & Hospital Kolkata India and College of Nurshing Visayas State University Philippines
on September 11, 2020, at STIKes Mitra Husada Medan. As an educational institution, one of
the main tasks and functions of the academic community is to conduct research which is then
published so that it can be distributed to the wider community. Therefore STIKes Mitra Husada
Medan carries out activities in the form of an International Webinar in 2020. STIKes Mitra
Husada Medan organizes 4 health study programs consisting of Midwifery Professional
Education Study Program, Professional Program Midwifery Study Program, Midwifery Study
Program Diploma Three, Nursing Study Program Diploma Three who have a strategy during
this pandemic to increase the understanding of students and midwives and nurses regarding the
benefits of reproductive health care therapy in the Covid-19 Pandemic Era with these activities
so as to increase knowledge and understanding of Reproductive Health Service Care in the
Covid-19 Pandemic Era and raise awareness about the importance of publications for research,
both those who receive research grants from the Ministry of Research, Technology and Higher
Education and Husada Medan partner foundations, as well as provide assistance in scientific
publications for researchers, lecturers, and students, as well as the academic community and
society other. The participants of this International Webinar were attended by lecturers, students
and other researchers, totaling 6809 participants and invited guests and 30 speakers. Invited
speaker in this seminar invited Dr. Siti Nurmawan Sinaga, SKM, M.Kes (Chairman of STIKes
Mitra Husada Medan), Dr. Sandeep Poddar, MSc., PhD., Dip Diet (Lincoln University
Collage), Ms. Arpita Dutta (Medical College & Hospital Kolkata India), Dr. Joel rey Acob
(College of Nurshing Visayas State University Philippines). On behalf of the committee, we
would like to express our deepest gratitude for the willingness of resource persons, participants
and all related parties to participate in this International Webinar. To the speakers who have
sent their papers to be published in the 2020 International Webinar proceedings. Thank you to
the Mitra Husada Medan Foundation, the Chairperson of STIKes Mitra Husada Medan and all
the committees who contributed to the successful implementation of this activity
chairman of the committee
Ester Simanullang, S.Tr.Keb., Bd., M.Kes
iii
Schedule for Webinar International “International Webinar Life
Long Learning Series on Good Health & Well Being” ”Ensure Healthy Lives
and Promote Well-being for All at All Ages” Date September 11th, 2020
Date Time Activity Speaker Person in
change
moderator
September 01:00-01.30 1. Welcoming and greeting - Siti MC:
11th,2020 PM 2. Opening prayer Nurmawan, Zulkarnain
3. Sing the National anthem of SKM, M.Kes Batubara,
Indonesia Raya - Prof. Dr. S.Pd.I, M.Hum
4. Welcome speach Dr. Siti Amiya
Nurmawan Sinaga, SKM, Bhaumik
M.Kes (Institute of Health
Science Mitra Husada Medan
Indonesia)
5. Welcome speach Prof. Dr.
Amiya Bhaumik (President,
Lincoln University College,
Malaysia)
01.30-02.00 Topic from Lincoln University : Dr. Faridah Md Ester

PM Care Giver Burden of Alzheimers bt Said Simanullang,
patients community perspective (Associate SST, M.Kes
Professor, Post
Graduate PhD
Committe
Incharge Faculty
of Nursing,
Lincoln
University)
02.00-02.30 Topic from NRS Medical College Ms. Arpita Dutta RetnoWahyuni,
PM & Hospital, Kolkata, India : S.Tr.Keb.,
Implementation of Goverment M.Tr.Keb
Program abaout the healthty life
community action in preventing
COVID -19 and improving theof
public health
02.30-03.00 Topic from Indonesia STIKes Zuraida, S.Kep., RetnoWahyuni,
PM Mitra Husada Medan: Ners., M.Kep S.Tr.Keb.,
Delivering caring amidst the M.Tr.Keb
pandemic : reflecttion in the
conduct of community health
programs
iv
03:00-03:30 Topic from Dean, College of Dr. Joel Rey RetnoWahyuni,
PM Nursing, Visavas State Acob S.Tr.Keb.,
University, Philippines : M.Tr.Keb
Health -hand & Hygiene
03:30-06:30 Section 1 presenter Section 1-10 Oral

PM presenter Presentation
Section 1
Section 2 presenter Section 11-20 Oral
presenter Presentation
Section 2
Section 3 presenter Section 21-29 Oral
presenter Presentation
Section 3
06:30-07:00 1. Closing Ceremony Retno
PM 2. Best paper and performance Wahyuni,
Announcement S.Tr.Keb,
3. Closing Speech From and M.Kes
greeting The Chief of College
Indonesia
v
TABLE OF CONTENTS
FOREWORD ...............................................................................................................................iii
RUNDOWN EVENT ................................................................................................................... iv
TABLE OF CONTENTS ............................................................................................................. vi
PHYSICAL ACTIVITY AND EXERCISE DURING PREGNANCY COVID-19

Dessy Fitri Natalia Silaban ......................................................................................................... 1
THE EFFECTIVENESS OF GINGER IN DEALING WITH TRIMESTER 1

HYPEREMESIS GRAVIDARUM IN PREGNANT WOMEN
Destin Murni Yanti Ndraha, Anggita Aulia Pane, Vivi Kartika Dewi .................................. 5
HUSBAND SUPPORT RELATIONSHIP WITH THE COMPLIANCE OF antenatal

CARE EXAMINATION in THE PREGNANT WOMEN TM III AT PRIMARY
CLINIC VINA IN 2019
Donna Betaria Tampubolon, Lidya Natalia Br Sinuhaji, Febriana Sari ............................... 9
NURSING CARE IN ELDERLY WITH HYPERTENSION NURSING CARE WITH

HYPERTENSION IN THE ELDERLY
Yenni Sihombing ....................................................................................................................... 13
INCREASING CONTRACEPTIVE USE DURING THE COVID-19 PANDEMIC

Indah Anggraini ........................................................................................................................ 16
CONDOM USE MEASURES IN PREVENTION OF TRANSMISSION OF

SEXUALLY TRANSMITTED INFECTIONS (STIS) IN THE PANDEMIC COVID-
19
Makdalena ................................................................................................................................. 19
RELATIONSHIP BODY MASS INDEX AND PHYSICAL ACTIVITY WITH

DISMENORE ON ADOLESCENT IN SMA N 64 JAKARTA2019
Mei Kristina Gea ....................................................................................................................... 22
EFFECTS OF REPRODUCTIVE HEALTH INFORMATION SERVICES DURING

THE COVID-19 PANDEMIC
Mutiara Asia Putri .................................................................................................................... 31
REPRODUCTIVE HEALTH IN PREGNANT AND LACTATING WOMEN

DURING THE COVID-19 PANDEMIC
Oktaria Christin Br Tambunan............................................................................................... 35
THE ELDERLY CARING NURSING CENTER: PERCEPTION OF NURSING

PROFESSION STUDENTS
Oni Ulima Sinurat ..................................................................................................................... 38
THE RELATIONSHIP OF MATERNAL KNOWLEDGE OF THE COMPLETE

BASIC IMMUNIZATION IN INFANTS AT THE PUBLIC HEALTH CENTER OF
KUTAMBARU SOUTHEAST ACEH IN 2019
Putri Yani br Siahaan, Sabarita br. Selian ............................................................................. 43
vi
FACTORS THAT AFFECT ANEMIA OCCURRING IN PREGNANT WOMEN
WITH COMPLIANCE WITH THE TABLETS OF THE FE IN THE CLINIC
RIMENDA BR. TARIGAN MEDAN DENAI DISTRICT IN 2019
Selfi Indah Saputri, Sari Mentari ............................................................................................ 49
CASE STUDY OF GERONTIC NURSING CARE IN FAMILY Ny M WITH

HIPERTENS IN THE KWALA BEKALA VILLAGE MEDAN JOHOR SUB-
DISTRICT, MEDAN CITY
Siti Nur Fadila ........................................................................................................................... 54
APPLICATION OF SALT WATER WARM TO REDUCE HYPERTENSION IN

ELDERLY
Sri Lestari................................................................................................................................... 58
IMPROVING THE QUALITY OF LIVING AGE (LANSIA) IN DEPOK CITY

WITH BALANCE TRAINING
Wilsari Buulolo .......................................................................................................................... 62
THE RELATIONSHIP OF MATERNAL KNOWLEDGE OF THE COMPLETE

BASIC IMMUNIZATION IN INFANTS AT THE PUBLIC HEALTH CENTER OF
KUTAMBARU SOUTHEAST ACEH IN 2019
Putri Yani br Siahaan, Sabarita br. Selian ............................................................................. 69

HIPERTENS IN THE KWALA BEKALA VILLAGE MEDAN JOHOR SUB-
DISTRICT, MEDAN CITY
Siti Nur Fadila ........................................................................................................................... 74
THE IMPORTANCE OF RAISING INDIVIDUAL AWARENESS TO IMPROVE

REPRODUCTIVE HEALTH AS AN EMERGENCY MANAGEMENT OF
CORANA VIRUS (COVID 19)
Kartini Nainggolan .................................................................................................................... 79
THE RELATIONSHIP OF BREASTFEEDING TECHNIQUE WITH THE

OCCURRENCE OF BLISTERS ON NIPPLES MILK IN BREASTFEEDING
MOTHERS IN THE WORK AREA OF THE GLUGUR DARAT HEALTH CENTER
IN EAST MEDAN DISTRICT 2019
Desrima H Sihombing, Retno Wahyuni, Lasria Simamora .................................................. 85
NURSING CARE FOR CLIENTS WITH BONE METABOLISM DISORDERS

OSTEOPOROSIS
Lindang Tumanggor ................................................................................................................. 90
THE NUTRITIONAL STATUS OF THE ELDERLY BASED ON KNOWLEDGE

AND PHYSICAL ACTIVITY, IN THE WORKING AREA OF PUSKESMAS
SUKAWATI 1, GIANYAR, BALI
Vivin Febriani Lumbangaol ..................................................................................................... 94
vii
PENGARUH PENYULUHAN TERHADAP PENGETAHUAN DAN SIKAP IBU
HAMIL TENTANG HYPNOBIRTHING DI KLINIK PRATAMA VINA
KECAMATAN MEDAN BARU TAHUN 2018
Desy Kristina Damiani Malau .................................................................................... 100
MENSTRUAL CYCLE DISORDERS DURING THE COVID-19 PANDEMIC

Veny Adenina .......................................................................................................................... 106
ELDERLY COMPLIANCE WITH HYPERTENSION IN DIET FULFILLMENT

HYPERTENSION
Elvina Vandinata ..................................................................................................................... 109
THE EFFECT OF CLASSICAL MUSIC THERAPY ON THE LEVEL OF LABOR

PAIN IN ACTIVE 1-PHASE INPARTU MOTHER IN BPM VILLAGE SAWIT
SEBERANG KABUPATEN LANGKAT 2018
Evi Rosida Sihombing, Try Mely Cristiani Pinem ............................................................... 115
RELATIONSHIP OF MIDWIFERY SERVICE EXCELLENT SERVICE WITH

MATERNITY SATISFACTION AT TANJUNG PURA REGIONAL HOSPITAL
Ainun Syahfitri, Eka Falentina Tarigan, Sari Nduma Ambarita ....................................... 121
RELATIONSHIP TYPE OF LABOR TO POSTPARTUM DEPRESSION RISK IN

THE MIDWIFERY ROOM OF THE PUBLIC HOSPITAL MUHAMMAD ALI
KASIM DISTRICT GAYO LUES YEAR 2020
Fadhilah Husnah, Febriana Sari, Normal Anita .................................................................. 128
KNOWLEDGE'S RELATIONSHIP WITH THE ATTITUDE OF THE MOTHER

WEEKING BABIES UNDER 1 YEAR IN THE REGION THE WORK OF
PUSKESMAS MEDAN JOHOR
Marliani, Kamelia Sinaga ....................................................................................................... 135
THE EFFECT OF COUNSELING ON THE KNOWLEDGE AND ATTITUDES OF

PREGNANT WOMEN ABOUT HYPNOBIRTHING AT PRATAMA VINA
CLINIC, KECAMATAN MEDAN BARU 2019
Siska Suci Triana Ginting, Nopalina Suyanti Damanik, Isyos Sari Sembiring ................ 144
viii
International Webinar Life Long Learning Series on Good Health & Well Being
Physical Activity And Exercise During Pregnancy Covid-19
PHYSICAL ACTIVITY AND EXERCISE DURING PREGNANCY

COVID-19
Dessy Fitri Natalia Silaban

Student of Diploma three of Midwiery STIKes Mitra Husada Medan
[email protected]
ABSTRACT
Exercise may not be a cure for depression and anxiety during pregnancy, but it certainly seems
to help. A systemic review of physical exercise during pregnancy for healthy women found that
it is safe and beneficial for mother and child. Exercise may not be a cure
for depression and anxiety during pregnancy, but it certainly seems to help. A systemic review
of physical exercise during pregnancy for healthy women found that it is safe and beneficial for
mother and child. Exercising while physical distancing is important as it can help improve your
mood, reduce back pain, improve your posture, prepare you for childbirth, and more.
Key word : Exercise, physical exercise, pregnancy, physical distancing
Introduction nose, eyes and mouth, applying the proper

According to the BKKBN (National cough ethics, and keeping a distance.
Population and Family Planning Agency) Staying active during pregnancy by doing
pregnancy is a process that begins with the light exercise (exercise) has many benefits
release of a mature egg on fallopian tubes for pregnant women and fetuses, including
which then meet with sperm, then both during the Corona virus pandemic (COVID-
fused to form cells that will grow. 19) as it is today.
The increasing status of the corona The following health tips for pregnant
virus in Indonesia might make most people women during the Covid-19 pandemic,
feel scared and worried, especially pregnant 1. Eat foods that are nutritionally balanced
women. In normal conditions, approaching and healthy, and consume enough vitamins
childbirth sometimes makes some pregnant for pregnant women.
women worry, especially if they have to 2. Perform light physical activity such as
give birth in the middle of a corona yoga or pregnancy exercises, and take
outbreak, this can certainly be quite blood-boosting tablets according to the
stressful. Well, the key to calm down and recommended dosage.
multiply useful information to reduce your 3. Keep your personal & environmental
worry ya moms, because excessive worry clean and diligently wash your hands for at
can also make pregnant women stressed. least 20 seconds. Avoid touching your face,
However, in the Corona virus nose, mouth & eyes before washing hands.
pandemic (COVID-19) as it is now, it 4. Avoid leaving the house if not needed. If
requires people to remain at home by forced to leave the house, wear masks &
carrying out physical and social restrictions clothes tightly closed. Upon returning from
(physical distancing). the benefits of mild the outside, immediately clean the body and
exercise during pregnancy is to increase the take a shower, and do not approach the
energy of pregnant women, can also child before cleaning the body.
improve sleep quality, reduce stress, and 5. Regular sunbathing to increase vitamin D
restore the body to its prime condition more levels for pregnant women. There is
quickly after childbirth. research that shows that vitamin D
The most basic is to apply the deficiency can trigger the risk of premature
Covid-19 health protocol, which is washing pregnancy.
hands, using masks, avoiding touching the
1
As long as the mother does not ankles. It can be done for free, almost
experience severe headaches, normal blood anywhere, and at any time during
pressure, no nausea, vomiting, no severe pregnancy.
contractions, or rupture of membranes. The Safety tip: As pregnancy progresses, your
signs are an emergency and must undergo a center of gravity changes, and you can lose
doctor's examination. But if there are no your sense of balance and coordination.
complaints, then just check the condition of Choose smooth surfaces, avoid potholes,
the body independently at home, and for rocks, and other obstacles, and wear
husbands and families to maintain and supportive footwear.
accompany pregnant women in fulfilling 2. Swimming
nutrition and mental, emotional and Swimming and exercising in water give a
psychological readiness of pregnant women better range of motion without putting
during this pandemic. Because a husband pressure on the joints. The buoyancy
and family who are always on standby offered by the water may offer some relief
pregnant women can feel safe and from the extra weight.
comfortable protection during their Swimming, walking in water, and aqua
pregnancy during this pandemic. aerobics offer health benefits throughout
Regular exercise during pregnancy pregnancy.
can improve health, reduce the risk of Safety tip: Choose a stroke that feels
excess weight gain and back pain, and it comfortable, and that does not strain or hurt
may make delivery easier. Moderate your neck, shoulders, or back muscles, for
exercise during pregnancy may give a example, breaststroke. A kickboard can help
newborn a healthier start. strengthen the leg and buttock muscles.
Exercise at any time can improve Safety tips:
heart health and stamina, decrease fatigue  Use the railing for balance when
and constipation, boost mood and energy entering the water, to prevent
levels, enhance sleep, and improve muscle slipping.
strength.  Avoid diving or jumping, as this
A well-chosen exercise program can have could impact the abdomen.
the same benefits during pregnancy. It is  Avoid warm pools, steam rooms, hot
important to discuss any changes in exercise tubs, and saunas, to minimize the
habits with a health care provider, to make risk of overheating.
sure you do the right kind of exercise at the 3. Stationary cycling
right stage of pregnancy. Cycling on a stationary bike, also called
spinning, is normally safe even for first-
Discussion time exercisers. It helps raise the heart rate
Suitable activities during pregnancy without putting too much stress on the
are brisk walking, swimming, indoor joints.
stationary cycling, prenatal yoga, and low- The bike helps support body weight, and,
impact aerobics, guided by a certified because it is stationary, the risk of falling is
aerobics instructor. low.
These carry little risk of injury, they benefit Later in pregnancy, a higher handlebar may
the entire body, and they can continue until be more comfortable.
delivery. 4. Yoga
1. Brisk walking Prenatal yoga classes keep the joints limber
If pre-pregnancy exercise levels were low, a and help maintain flexibility.
quick stroll around the neighborhood is a Yoga strengthens muscles, stimulates blood
good way to start. circulation, and enhances relaxation. These
This will provide a cardiovascular workout may contribute to a healthy blood
without too much impact on the knees and pressure during pregnancy.
2
The techniques learnt in yoga class can also Exercise during pregnancy can help:
help you to stay calm and in control during  shorten the labor process
labor.  increase the chances of an
Safety tip: As pregnancy progresses, skip unmedicated birth
positions that could cause you to  decrease the need for pain relief
overbalance.  speed up recovery after delivery
From the second semester, it is better to  reduce the risk of
avoid poses that involve lying on the gestational diabetes and hypertensio
abdomen or flat on the back. n
Lying on the back can cause the weight of  decrease the likelihood of preterm
the fetus and the uterus to put pressure on labor and birth
major veins and arteries and decrease blood It may also give an infant a healthier start.
flow to the heart. Research shows that when pregnant
It can be tempting to overstretch, as the women exercise, fetal heart rate is lower.
hormone relaxin increases flexibility and Newborns may also have a healthier birth
joint mobility during pregnancy. weight, a lower fat mass, improved stress
Overstretching could lead to injury. tolerance, and advanced neurobehavioral
5. Low-impact aerobics maturation.
Aerobic exercise strengthens the heart and Women who were exercising
lungs and helps maintain muscle tone. Low- regularly before pregnancy, and who are
impact aerobics excludes jumping, high healthy during pregnancy, should be able to
kicks, leaps, or fast running. continue exercising as before, with slight
In low-impact exercise, one foot should stay changes depending on the trimester. Women
on the ground at all times. who have not been exercising before
Compared with high-impact aerobics, the pregnancy will benefit from taking up a
low-impact option: low-intensity program and gradually move
 limits stress on the joints to a higher activity level.
 helps maintain balance Health authorities in the United
 reduces the risk of weakening the States recomend that adults should do at
pelvic floor muscles least 150 minutes a week of moderate-
A weak pelvic floor increases the chances intensity physical exercise, including during
of urine leakage. pregnancy and in the first year after
Some aerobics classes are designed delivery.
especially for pregnant women. This can be Most exercises are safe to perform during
a good way to meet other pregnant women, pregnancy if done with caution.
as well as exercising with an instructor who Who should not exercise?
is trained to meet your specific needs. Exercise is rarely harmful, but anyone with
Women who already attend a regular a medical condition, such as asthma, heart
aerobics class should let the instructor know disease, hypertension, diabetes, or a
that they are pregnant so they can modify pregnancy-related condition should speak to
exercises and advise about suitable a health care provider first.
movements. Exercise may not be advised if there is:
During pregnancy, exercise should aim to:  vaginal bleeding or spotting
 increase heart rate steadily and  low placenta, or low-lying or
improve circulation placenta previa
 keep the body flexible and strong  a history or possibility of
 support and control healthy weight miscarriage or preterm delivery
gain  weak cervix
 prepare the muscles for labor and Stop exercising if you:
birth  feel fatigued
3
 develop persistent pain

 experience any vaginal bleeding
 have regular contractions more than
30 minutes after exercise, as this
may be a sign of pre-term labor
A health-care provider can suggest personal
exercise guidelines, based on the
individual’s medical history.
Conclusion
Stop exercising and consult a health care
provider if you:
 experience pain, including
abdominal, chest, or pelvic pain
 have muscle cramps
 feel faint, dizzy, or nauseous
 feel cold or clammy
 notice vaginal bleeding
 have a sudden gush of fluid from the
vagina or a trickle of fluid that leaks
steadily, possibly indicating a
rupture of the amniotic membrane
 have an irregular or rapid heartbeat
 notice sudden swelling in the ankles,
hands, face, or all of them
 experience increased shortness of
breath
 have persistent contractions that
continue after rest
 have difficulty walking
Regular physical activity can boost maternal
and fetal health, and it can make pregnancy,
labor, and post-delivery recovery easier.
However, it is important to stay safe during
exercise.
References
Andriani, D. (2020, Juni 22). Tetap Aman
dan Sehat Saat Hamil di Masa
Pandemi. JurnaL Kebidanan, p. 7.
Efendi, A. (2020, april 18). Olahraga Ibu
Hamil yang Berguna Saat Pandemi
COVID-19. Kesehatan Masyarakat,
p. 1.
Miller, A. (2017, May 26). Exercise tips for
pregnancy. medicalnewstoday.com,
p. 6.
4
The Effectiveness Of Ginger In Dealing With Trimester 1 Hyperemesis Gravidarum In Pregnant Women
THE EFFECTIVENESS OF GINGER IN DEALING WITH TRIMESTER 1

HYPEREMESIS GRAVIDARUM IN PREGNANT WOMEN
Destin Murni Yanti Ndraha1, Anggita Aulia Pane2, Vivi Kartika Dewi3
1,2,3
Mahasiswa Sarjana Kebidanan Mitra Husada Medan
ABSTRACT
Nausea and vomiting are common for pregnant women in the first trimester when around 50-
80% of pregnant women increase nausea and vomiting caused by imbalance of the hormones
progesterone and estrogen but if the mother experiences excessive nausea, vomiting can
interfere with maternal activity and cause the condition of the mother to be worse that is
hyperemesis gravidarum. The condition of pregnant women is also vulnerable to drugs, so
mothers need therapy to reduce nausea and vomiting in mothers. And the efforts made by
giving mothers to consume ginger which has anitiemetic and anxiolytic activity and has a high
iron and calcium content.
Introduction et al, 2014). Vomiting nausea that is not

Pregnancy is a gift that is so treated immediastely can be a case of
coveted for a woman. Every pregnancy is a complications in pregnancy that are more
natural process. Pregnancy affects the serious and fatal, namely hyperemesis
mother's body as a whole by causing gravidarum (Tiran, 2008). The prevalence
physiological changes that occur throughout of hyperemesis gravidarum in Indonesia in
the organ system, most of the changes in the 2008 was 150 people. The prevalence of
mother's body are mostly caused by hyperemesis gravidarum in East Java in the
hormonal work. These changes occur due to case of the 2008 Jamkesda program was 13
an imbalance of the hormones progesterone cases, whereas in the Cunda Muara Dua
and estrogen, the female hormones in the Lhok Seumawe Community Health Center
mother's body since the pregnancy process (NAD) reported that around 2.4% of
(Mandriwati, 2008). Some complaints that women who experience nausea and
make mothers feel uncomfortable include vomiting needed hospitalization for
nausea and vomiting (Smith, et al, 2009). hyperemesis gravidarum. Hyperemesis
About 50-90% of pregnant gravidarum can make the mother's body to
women experience complaints of nausea be very weak, pale face and urination
and vomiting. These complaints are usually frequency to decrease dramatically so that
accompanied by hypersalivation, body fluid decreases and blood becomes
headaches, flatulence, and weakness in the thick (hemoconcentration). This situation
body. These complaints are generally can slow down blood circulation so that the
known as "morning sickness." consumption of oxygen and food to the
Nausea vomiting (emesis tissues is also reduced, causing tissue
gravidarum) occurs early in pregnancy due damage that can endanger the health of the
to changes in the gastrointestinal tract and mother and the health of the fetus it
increased levels of Human Chorionic contains (Hidayati, 2009). The principles of
Gonadotropin (hCG) in the blood causing managing hyperemesis gravidarum include
several complaints that make the mother prevention, reducing nausea, vomiting,
feel uncomfortable during pregnancy, correction of dehydration and electrolyte
including nausea and vomiting. This emesis imbalance, provision of adequate vitamins
gravidarum causes a decrease in appetite so and calories to maintain nutrition (Setiawati
there is a change in electrolyte balance with and Ramadhian, 2016).
potassium, calcium and sodium which can In dealing with nausea and
change the body's metabolism (Parwitasari, vomiting in pregnant women needed
5
materials that relieve stomach cramps and drink to the intervention group, there was a
cramps. Complementary therapy using decrease in nausea and vomiting. Ginger
herbs that can be used to reduce nausea and that will be used by researchers is red
vomiting during pregnancy is ginger. The ginger because red ginger has a high
pharmacological function of ginger, one of essential oil content and spicy taste than
which is antiemetic (anti-emetic). Ginger is elephant ginger. This type of red ginger is
also a strong aromatic stimulant, besides suitable for pharmaceutical and herbal
being able to control vomiting by increasing ingredients or is extracted by oleoresin and
intestinal peristalsis. Ginger is one of the essential oils. The use of red ginger is also
choices of herbal ingredients that have used in previous studies in the form of stew
essential oils of Zingiberena (zingirona), (Parwitasari, 2014).
zingiberol, bisabilena, curcumen, gingerol,
flandrena, in ginger it has been proven to Method
have effective antiemetic (anti-emetic) The method used in writing this
activity (Fitria, 2013). Vitamin A and the paper is the study of literature. The main
bitter resin that can block serotininya is a types of references used in literature studies
neurotransmitter that is synthesized in are books, journals and webside or
serotonergic neurons in the central nervous scientific articles relating to the discussion.
system and enterochromafin cells in the The data analysis technique is in the form
digestive tract so that it is believed to be a of argumentative descriptive.
giver of comfort in the stomach so that it
can overcome vomiting nausea (Ahmad, Results and Discussion
2013). Hyperemesis gravidarum is a state
The main product of the ginger of excessive nausea and vomiting so that
plant is the ginger rhizome. Ginger rhizome daily work is interrupted and general
is a source of ginger oil called essential oils. conditions become worse (Mansjoer, 2009).
Ginger oil contains flying oil (which is The incidence of nausea and vomiting
volatile) such as gingerol (Rukmana, 2011). during pregnancy according to midwife
Gingerol compound as the main ingredient participants occurred around 40-50% of all
in the ginger rhizome is a strong oxidant pregnancies, but that reached the state of
that is effective in treating inflammation. hyperemesis gravidarum around 20-30%.
Ginger has antiemetic and anxiolytic Participants in this study both pregnant
activities. This can also help morning women and their husbands have a correct
sickness. Gingerol and shogaol from ginger understanding of hyperemesis gravidarum,
can stimulate the flow of saliva, bile and a state of vomiting caused by pregnancy.
gastric secretion. Ginger is also found to Participants of pregnant women are also
suppress gastric contractions and increase able to mention the real symptoms of
intestinal and peristalsis muscle tone. hyperemesis gravidarum namely tired,
Constituents in ginger can interact with nausea, vomiting due to lack of appetite and
5HT-3 receptors and may be partly sleeplessness. By knowing the symptoms of
responsible for being antiemetic (Zhion, hyperemesis gravidarum participants are
2011). expected to be able to prevent the more
Research conducted by Suwarni severe consequences of the situation. This is
(2007) in Parwitasari (2014) about the in accordance with the results of research
effectiveness of ginger drink in reducing (Wiwik, Niman and Susilowati, 2016)
emesis gravidarum in first trimester which states that there is a relationship
pregnant women, found that administration between knowledge and attitudes of
of ginger drink is very effective in dealing pregnant women in preventing the
with nausea and vomiting in first trimester occurrence of hyperemesis gravidarum in
pregnant women. After giving the ginger the work area of Padalarang Public Health
6
Center. This good knowledge will mint leaves, all respondents experienced
encourage them to be supportive towards moderate nausea and vomiting as many as
preventing the occurrence of hyperemesis 11 people (100%), while the frequency of
gravidarum from getting worse. nausea of vomiting in first trimester
As a result of continuous nausea, vomiting pregnant women after being given red
can occur dehydration, hyponatremia, ginger and leaves mint most of the
hypochloremia, decreased urine chloride respondents experienced 9 mild nausea
which can then occur hemoconcentration vomiting (81.8%), and 2 moderate nausea
which reduces blood perfusion to the tissue vomiting (18.2%).
and causes toxic accumulation (Mansjoer,
2009). Nutritional conditions and poor Table. 2 Differences in the degree of nausea
health status can be fatal for pregnant and vomiting in the ginger powder group
women and their fetuses. This is because and those without the ginger powder group
according to (Proverawati and Asfuah, Level of Treatment
Control Group
2009) mothers or prospective mothers are a vomiting Group
vulnerable group, because it requires nausea Before After Before After
adequate nutrition so that nutritional status Mild 1 5 3 2
and health must be maintained in order to vomiting
give birth to a healthy baby. Ginger is also a nausea
Medium 9 7 8 9
strong aromatic stimulant, besides being
sized
able to control vomiting by increasing nausea
intestinal peristalsis. Several studies Severe 2 0 1 1
mention that ginger has beneficial effects nausea
on cancer prevention, nausea and vomiting vomiting
during pregnancy, nausea and vomiting in Total 12 12 12 12
chemotherapy patients and vomiting after
surgery (Amelia and Isna, 2017). Based on Based on the above data it can be explained
researchers' assumptions that Ginger can that in the group that was given ginger
prevent nausea and vomiting because ginger powder there was an increase in mild
is able to be a barrier to serotinin, a nausea and vomiting, initially only 1
chemical that can cause stomach respondent (8.3%) to 5 respondents
contraction, causing nausea. (41.7%), severe nausea and vomiting that
were previously 2 people (16.7 %) to 0
Table 1. Frequency Distribution of Nausea people (0%) because it was reduced to
and Vomiting in First Trimester Pregnant moderate nausea and vomiting.
Women Before and After being given a Respondents in the group that were not
decoction of red ginger and mint leaves. given ginger powder experienced an
Level of Before After increase in the occurrence of moderate
vomiting F % F % nausea and vomiting, which initially had 8
nausea people to 9 people due to a change in mild
Mild 0 0 9 81,8 nausea to moderate vomiting by 1
vomiting respondent.
nausea Based on the table above to find
Medium 11 100 2 18,2 out whether there is a difference before and
sized nausea after being given ginger powder tested
Total 11 100 11 100 using the Wilcoxon Matched Pairs Test that
is obtained P value 0.33 <0.05 then H0 is
Based on the frequency of nausea, vomiting rejected and H1 is accepted. In conclusion,
in first trimester pregnant women before there is an effect of ginger powder on the
being given a decoction of red ginger and decrease in nausea and vomiting in
7
pregnant women aged 0-16 weeks in the previously had 2 people (16.7%) to 0
Wonorejo Public Health Center, people. (0%) due to reduced nausea and
Ngadiluwih District, Kediri Regency. moderate vomiting. The results of 30
respondents showed that the Effectiveness
Table. 3 Effectiveness of Ginger and Mint of Ginger Stew Water Giving Against the
Leaves Stew Water on the Intensity of Intensity of Vomiting in First Trimester
Vomiting Nausea Pregnant Women is very effective in
Level of reducing the frequency of nausea and
Total Mean P
vomiting nausea vomiting in first trimester pregnant women.
Ginger Before 15 9,47
0,000 Reference
Stew After 15 3,80
Dhita Aulia Octaviani, Rizky Amelia,
Complaints of nausea and vomiting Ursula Orcena Mau Soa, 2018,
in pregnant women is something that is very “Perbandingan Efektivitas Pemberian
common, therefore in addition to Rebusan Jahe Merah Dan Daun Mint
pharmacological treatment there are also Dengan Jeruk Dan Madu Terhadap
non-pharmacological treatments. In this Mual Muntah Pada Ibu Hamil
study, the administration of ginger water Trisemester I Di Puskesmas Waepana
and mint leaves decoction to first trimester Ngada, NTT” jurnal kebidanan vol.2
pregnant women who were nauseous no.8.
vomiting. Based on the results of research Finta Isti Kundarti, Dwi Estuning Rahayu,
from 30 respondents showed that the Reni Utami, 2015, “Efektifitas
Effectiveness of Ginger Stew Water Giving Pemberian Serbuk Jahe (Zingiber
Against Vomiting Intensity in First Officinale) Terhadap Tingkatan Mual
Trimester Pregnant Women in Dahlia Muntah Pada Ibu Hamil” Jurnal Ilmu
Health Center Makassar, the researchers Kesehatan Vol. 4 Nomor.1, Poltekes
can draw conclusions that there is a change Kemenkes Malang Prodi Kebidanan
in nausea and vomiting after being given Kediri
Ginger Stew Water before and after Sumarni, Rosita, Musdalifah, 2019,
treatment, the mean value of p 0,000 . Efektivitas Pemberian Air Rebusan
Jahe Dan Daun Mint Terhadap
Conclusion Intensitas Mual Muntah Pada Ibu
Characteristics of respondents Hamil Trimester I Di Puskesmas
obtained that most respondents with Dahlian Makassar.
frequency of nausea and vomiting in first Siti Rofi’ah, Sri Widatiningsih, Arfiana,
trimester pregnant women before being 2019, Studi Fenomenologi Kejadian
given a decoction of red ginger and mint Hiperemesis Gravidarum Pada Ibu
leaves, all respondents experienced Hamil Trisemester I, Jurnal Riset
moderate nausea and vomiting as many as Kesehatan, 8 (1), Jurusan Kebidanan ;
11 people (100%), while frequency of Poltekkes Kemenkes Semarang Jl.
nausea and vomiting in first trimester Tirto Agung ; Pedalangan ;
pregnant women after given red ginger and Banyumanik ; Semarang
mint leaves, most respondents experienced Kevin gunawan, Paul Samuel Kris
9 mild nausea and vomiting (81.8%), and Manengkei, Dwiana Octavianti, 2011,
moderate nausea and vomiting as many as 2 Diagnosis dan Tata Laksana
people (18.2%). And in the group that was Hiperemesis Gravidarum, J Indon
given ginger powder there was an increase Med Assoc, Volum: 61, Nomor: 11,
in mild nausea and vomiting, initially only Rumah Sakit Umum Pusat Cipto
1 respondent (8.3%) to 5 respondents Mangunkusumo, Jakarta
(41.7%), severe nausea and vomiting which
8
Husband Support Relationship With The Compliance Of antenatal Care Examination in The Pregnant Women Tm III
At Primary Clinic Vina In 2019
HUSBAND SUPPORT RELATIONSHIP WITH THE COMPLIANCE OF

antenatal CARE EXAMINATION in THE PREGNANT WOMEN TM III
AT PRIMARY CLINIC VINA IN 2019
Donna Betaria Tampubolon1, Lidya Natalia Br Sinuhaji2, Febriana Sari3
1,2,3
[email protected]
ABSTRACT
According to the Kemenkes RI (2017) Factors affecting the achievement of the visit K1 and K4
expectant mothers are internal Factors (parity and age) and external (knowledge, attitude,
economics, socio-cultural, geographic, and support). Based on the results of the Ministry of
Health showed the maternal mortality rate in childbirth since 2015-2017. Based on the data
quoted from the KEMENKES maternal mortality rate during childbirth fell from 4.999 cases in
2015 to 4.912 cases in 2016. While The year 2017 occurred 1.712 cases of death in mothers
during childbirth. (No. 2018). To learn about the influence of Husband's support on the
compliance of antenatal care visits to mother hail at the primary Clinic of Vina in 2019. The
Study used quantitative research research using analytical surveys with cross sectional research
racilation with a retrospective approach. Design Observational research with the approach,
observation or data collection at one time also (point time approach). Number of Respnen as
many as 35 people, total sampling sample technique. The results of the Bivariate Alalisis stated
there was a link between the Husband's support to the ANC support compliance in the pregnant
Mother TM III p value < of 0.05 (P = 0.001). P = 0.001 meaning Ho is rejected and Ha
ACCEPTQED. Thus, it can be concluded that HA is acceptable, from research indicating there
is a significant influence between husband's support towards the compliance of antenatal care
visits to expectant mothers at Vina Primary Clinic, year 2019.
Keywords: Husband support, antenatal care (ANC) Compliance visit
INTRODUCTION
Based on a report from the profile of In the previous research conducted
the district or maternal city reported by by Fasyah Nabilah in 2017 in BPM wife
North Sumatra year maternal mortality rate Utami Sleman Yogyakarta concluded that
reaches 194 people in 2017. The number the complete expectant mother in the ANC
has decreased from 2016 to 240 inhabitants. visit received support from a good category
Likewise, the infant mortality rate of 2017 husband as many as 41 respondents (100%),
was 1,064 people, down from 1,080 in bad category as much as 3 respondents
2016. Although maternal mortality and (75%). While the wife who is not complete
infant mortality rates show a decline, the in the ANC visit received the support of a
health sector has the SDG reducing good category of 0 respondents (0%), bad
maternal mortality to under 70 per 100.00 as much as 1 respondent (25%).
live births and lowering neonatal mortality Husband support can be emphasized
to 12 per 1,000 live births in 2030. (Pofil as a resource provided through interaction
health Sumut,2017). with others "support the resoince to use
Percentage coverage of K1 and K4 through our interaktion with other people"
from 2016 years decreased from 2015. another opinion that support about
Percentage T1 in 2015 amounted to 94.9% information from others is he is loved and
and in 2016 was 92.6% or decreased by cared for, has self-esteem and is
2.3%. Similarly, the coverage of K4 in 2015 appreciated, as well as being part of a
was 87.1%. Sedangan in 2016 amounted to network of communication and mutual
85% or decreased by 2.1%. obligations (Azwar,2012).
9
Antenatal care (ANC) is a population (Notoatmodjo, 2010). The

pregnancy screening to optimize the mental sampling technique in research is total
and physical health of the pregnant BU, so sampling. Total Samplingis a sampling
as to be able to face childbirth, when the technique where the number of samples is
NIFAS, preparations provide breast milk equal to the population (Hidayat, 2011).
and return the health of The reason for taking the total sampling
reprodusireasonably. The goal is to get to technique is because the population is less
know and deal with the earliest possible than 100 the entire sample is used as
complications that are present during research. The samples in this study were 35
pregnancy, during childbirth, when Nifas, pregnant mothers who had the TTP above
identify and deal with the illness the month of June.
accompanying pregnancy, childbirth, when Data retrieval techniques are
Nifas and decrease the number of pain and primary data through the filling of
maternal mortality and prenatal. questionnaires. Questionnaires for husband
Based on the initial survey support during pregnant mothers undergo
conducted in the primary clinic of Vina pregnancy while secondary data is obtained
there are 25 pregnant mothers who from the mother's book KIA to see the
conducted the ANC examination and 20 of number of visits/adherence of expectant
them were not delivered by the husband, so mothers in Vina Primary clinic.
the author is interested in taking a title
about the husband's support to the ANC RESULT
examination compliance. After the collection, management
General Purpose Know the and analysis and data obtained, the results
relationship of husband support with of the study gained on the "husband support
Antenatal Care (ANC) compliance to relationship with Antenatal Care
pregnant women at Vina Primary Clinic, examination in the pregnant women TM III
year 2019. in primary Vina" obtained the total data of
35 respondents with the following results.
METHODS
Type and design research This Univariat Analysis
research is a quantitative study using Table of respondents distribution based
analytical surveys with cross sectional on husband's support
research with a retrospective approach, No Husband support F Percentage
aimed at knowing the husband's support (%)
relationship with the compliance of 1 TDK Support 14 40.0
antenatal Care examination in pregnant 2 Support 21 60.0
women at Vina primary Clinic, year 2019. . Total 35 100.0%
Design observational research with
approach, observation or data collection at Table 1.1 based on the data in the table 1.1
one time also (point time Approach) can be known from 35 respondents (100%)
(Notoatmodjo, 2010). The population is the The majority of support husbands do not
whole subject to be researched (Hidayat, support 14 respondents (40.0%) and support
2011). This study was studied and minority husband supports 21 respondents
concluded that the population in this study (60.0%).
was all pregnant mothers who came to visit
the Ante Natal Care(ANC) to the primary No ANC F Percentage
clinic OF VINA TM III as much as 35 Compliance (%)
people. 1 Disobedient 13 37.1%
The sample is partly examined and 2 Obedient 22 62.9%
considered to represent the entire Total 35 100.0%
10
Husband Support Relationship With The Compliance Of antenatal Care Examination in The Pregnant Women Tm III At
Primary Clinic Vina In 2019
1.2 Table of respondents distribution based on ANC visitcompliance

Table 1.2 based on the data in the table 1.2 can be known from 35 respondents (100%) Majority
adherent to the visit of ANC 22 respondents (62.9%) and minority disobedient in the visit of the
ANC 13 respondents (37.1%).
Bivariate analysis
Table 1.3 Analysis of husband's support relationship with Antenatal Care screening in pregnant
women TM III at primary clinic Vina
No ANC Compliance Category Result P Count
Husband support Disobedient Obedient Total 0.001
F % F % F %
1. No support 100 28.6% 4 11.4% 14 40.0%
2. Support 3 8.6% 18 51.4% 21 60.0%
Total 13 37.1% 22 62.9% 35 100%
From the data table 1.3 can be seen Majority adherent to the visit of ANC 22
that based on the majority of support respondents (62.9%) and minorities.
husband who is not obedient to the visit of Disobedient in the visit of ANC 13
ANC 10 respondents (28.6%), and did respondents (37.1%).
comply with the visit of ANC 4 respondents Based on the results of the study can
(11.4%) be seen that based on the majority of
Based on the majority of support support husband who did not comply with
husbands who did not support the visit of the visit of ANC 10 respondents (28.6%),
ANC 3 respondents (8.6%) And husband and did comply with the visit of ANC 4
supports the visit of the 18-respondent ANC respondents (11.4%) Based on the majority
(51.4%). Results of bivariate Analysis of support husbands who did not support
stated there was a relationship between the visit of ANC 3 respondents (8.6%) And
support husband to support the ANC husband supports the visit of the 18-
compliance in the pregnant women TM III respondent ANC (51.4%). The results of
p value < of 0.05 (P = 0.001). p = 0.001 Bivariat analysis stated there was a link
means Ho is rejected and Ha is accepted. between the husband's support to the ANC
support compliance in the pregnant Mother
CONCLUSION TM III p value < of 0.05 (P = 0.001). P =
Based on the results of the study "husband 0.001 meaning Ho is rejected and Ha
support relationship with Antenatal Care accepted.
compliance in pregnant women TM III in
Primary clinic Vina year 2019" with the REFERENCE
number of 35 respondents and the data Arikunto S 2010. Prosedur penelitian
processing that has been done using SPSS pendekatan praktik.Jakarta : rineka
can be concluded that the test value of chi cipta.
square p = 0.001 means that Ho is rejected Dahlan M S. 2011. Statistika Untuk
and Ha accepted: Kedeokteran dan Kesehatan :
Based on the results of the study can Deskritif Bivariat,d dan Multivariat,
be known from 35 respondents (100%) The Dilngkapi Aplikasi dengan
majority of support husbands do not support Menggunakan SPSS. Jakarta :
14 respondents (40.0%) and support Selemba Medika.
minority husband supports 21 respondents Departemen Kesehatan Republik Indonesia
(60.0%). (2016). Laporan Hasil Riset
Based on the results of the study can Kesehatan Dasar Indonesia
be known from 35 respondents (100%)
11
(RISKESDA). Jakarta : Kemenkes

RI
Pusat Data dan Informasi Kementrian
Kesehatan (2017). Laporan Hasil
Riset Kesehatan Dasar Indonesia
(RISKESDA). Jakarta : Kemenkes
RI
Dinas Kesehatan Sumatera Utara,(2017).
Diakses pada tanggal 22 Mei 2019
diakss dari
http://dinkes.sumut.go.id/
Astuti, N.A. 2013. I Hubungan Dukungan
Suami Dengan Kelengkapan
Kunjungan ANC pada Ibu Hamil
TM III di Puskesmas Jetis II Bantul
Tahun 2013. Jurnal Kebidanan.
Volume 1, No Mei Hal 60-69.
Diakses pada tanggal 22 Mei 2019
Azwar,S. 2012. Metode Penelitian.
Yogyakarta: Pustaka Pelajar
Haryati, T., Ida N., Surwano. 2016.
Hubungan Dukungan Keluarga
Dengan Kepatuhan Pemeriksaan
Antenatal Care Pada Ibu Hamil Di
Puskesmas Kasih II Bantul. Skripsi.
Yogyakarta : Stikes Jenderal
Achmad Yani Yogyakarta
12
Nursing Care In Elderly With Hypertension Nursing Care with Hypertension In The Elderly
NURSING CARE IN ELDERLY WITH HYPERTENSION

NURSING CARE WITH HYPERTENSION IN THE ELDERLY
Yenni Sihombing1
1STIKes Mitra Husada Medan
[email protected]
ABSTRACT
Hypertension is a disease of the cardiovascular system that is often found in the community.
Hypertension can be defined as persistent blood pressure, where the systolic pressure is above
140 mmHg and the diastolic is above 90 mmHg. In the elderly population, hypertension is
defined as a systolic pressure of 160 mmHg and a diastolic pressure of 90 mmHg. At present,
the death rate due to hypertension in Indonesia is very high. The prevalence of hypertension in
Indonesia based on riskesdas (basic health research) in 2007 reached 30 percent of the
population. Hypertension can be divided into 2, namely essential hypertension and secondary
hypertension. The cause of hypertension in the elderly is due to changes in; the heart valve
thickens and stiffens, the heart's ability to pump blood decreases by 1% every year after the age
of 20, so the contraction and volume also decline. Clinical manifestations of hypertension
patients include: Complaining of headaches, dizziness, weakness, fatigue, anxiety, nausea and
vomiting, epistaxis, decreased consciousness. Supporting examinations in hypertension include:
laboratory tests, CT Scan, ECG, IU, and chest photo.
INTRODUCTION MATERIAL AND METHODS

The term hypertension is taken from According to Darmajo &
English hypertension which comes from the Hadimartono (1999), hypertension in the
Latin "hyper" and "tension. "Hyper" means elderly can be divided into; hypertension
super or extraordinary and "tension" means where systolic pressure is equal to or
pressure or tension. Hypertension has greater than 140 mmHg and diastolic
finally become a popular medical term for pressure is equal to or greater than 90
high blood pressure. Blood pressure is the mmHg, and isolated systolic hypertension
power used by blood pumped from the heart where systolic pressure is greater than 160
to fight blood vessel resistance, if a person's mmHg Primary or essential hypertension or
blood pressure rises sharply and then idiopathic hypertension is unknown
remains high. hypertension. . This type of hypertension is
EpidemiologyBased on Global B 90% of cases of hypertension that often
Examination Survey data (NHANES) occurs in the community. Hypertension is a
shows that from 1999-2000, the incidence complex process of several major organs
of hypertension in adults is around 29-31%, and systems, including the heart, blood
which means there are 58-65 million vessels, nerves, hormones and kidneys.
sufferers of hypertension in America, and Secondary hypertension is an
an increase of 15 million from the increase in blood pressure caused by a
Examination Survey data (NHANES) ) cause. This type of hypertension occurs in
shows that from 1999-2000, the incidence 5% of cases that occur in the community. In
of hypertension in adults was around 29- addition there are several types of
31%, which means there were 58-65 million hypertension with special characteristics.
people with hypertension in America, and Isolated Systolic Hypertension is
there was an increase of 15 million from the hypertension that occurs when systolic
data. pressure is more.
13
Pathophysiology caused by the release of ketokolamin levels.

In Medical Nursing Nursing Urinalysis: blood, protein, glucose,
Textbook Brunner & Suddarth (2000) suggesting kidney dysfunction and DM.
explains the pathophysiology of
hypertension found in, the mechanism that Medical Intervention
regulates or controls blood vessel relaxation The goal of antihypertensive therapy
and relaxation located at the center of the is to reduce the morbidity and mortality of
vasonator. In the brain medulla, from this cardiovascular and kidney disease. Because
vasomotor center begins the sympathetic most patients with hypertension, especially
nerve pathway, which continues down to those aged at least 50 years, get normal
the cordpinalis and out of the column, the diastolic blood pressure if normal systolic
spinal cordgangliasimpatis in the thorax and pressure can be realized, the main goal of
abdomen. Vasomotor central stimulation is hypertension therapy is to maintain systolic
delivered in the form of impulses that move pressure within normal limits. Maintaining
down through the sympathetic nervous systolic and diastolic blood pressure less
system to the gangliasimpatis. At this point, than 140/90 mmHg is associated with
pre ganglion neurons release acetylcholine, decreased cardiovascular complications. In
at the same time, the sympathetic nervous patients with hypertension accompanied by
system stimulates blood vessels in response. diabetes and kidney disease, the target
blood pressure is 130/80 mmHg.
Clinical Manifestations
In hypertension signs and symptoms Complications
can be divided into: Asymptomatic: that Hypertension patients usually die
means there are no specific symptoms that sooner if the disease is not controlled and
can be associated with an increase in blood has caused complications to several vital
pressure, other than the determination of organs. The most common cause of death is
arterial pressure by the doctor who checks, heart disease with or without stroke and
if arterial abnormalities are not measured, kidney failure. With a per organ system
then arterial hypertension will never be approach, it can be known.
diagnosed. Common symptoms: Symptoms
that commonly accompany hypertension are Nursing Care
headache, fatigue. But this is a common According to Hidayat (2009)
symptom in most patients who seek medical nursing care in the elderly with
help. According to Rokhlaeni (2001), hypertension includes:
clinical manifestations of hypertensive History or presence of risk factors,
patients include: complaining of headaches, including: positive family history of
dizziness, weakness, fatigue, anxiety, obesity, increased serum lipid levels, kidney
nausea and vomiting, epistaxis, decreased disease recovery, chronic hormone therapy,
consciousness. Other symptoms are often heart failure, pregnancy.
found: anger, buzzing ears, feeling heavy Activity / Rest, symptoms: weakness,
on the neck, difficulty sleeping, dizzy eyes. fatigue, shortness of breath, lifestyle
integrity Ego, symptoms: history of
Supporting Investigation personality changes, kidney disease in the
Laboratory examination; Hb / Ht: to past).
assess the relationship of cells to fluid
volume (viscosity) and can indicate risk RESULT
factors, such as: anemia. BUN / creatinine: Maintaining adequate tissue perfusion:
provides information about / kidney blood pressure within acceptable ranges
function. Glucose: Hyperglycemia (DM is with dietary treatment and lifestyle changes,
the originator of hypertension) can be showing no symptoms of angina,
14
palpitations or decreased vision, stable

BUN and creatinine levels, and palpable
pulse rate Adhering to early care programs:
taking medication as prescribed and report
any side effects, adhere to the
recommended dietary rules: reduction of
sodium, cholesterol.
CONCLUSION
Hypertension is a public health
problem which can be dealt with either in
some countries in the world or in Indonesia.
Factors that can cause hypertension are
from people's habits or lifestyles, namely
the hereditary factors obtained in the
family, age, sex .
REFERENCE
Anonymous. (September 2009). Pender
Prone to hypertension. Accessed on
September 18, 2010,
fromhttp://www.waspada.co.id/index
.php?option = com_content & view =
article & id = 542 6z hypertension
suffererscartilage & catid = 28 &
Itemid = 48.
Brunner & Suddarth. (2002).
Textbooks:Surgical Medical Nursing
Volume 2. Jakarta: EGC Medical
Book Publisher. Doengoes, Marilynn
15
Increasing Contraceptive Use During The Covid-19 Pandemic
INCREASING CONTRACEPTIVE USE DURING

THE COVID-19 PANDEMIC
Indah Anggraini1
1The Midwifery Study Program Dipoma Three Of STIKes Mitra Husada Medan
[email protected]
ABSTRACT
The Covid-19 pandemic, besides having an impact on the economy, education and society,
also impacts on health, one of which is impact on women's reproductive health services,
reproductive health services for women are a form of necessity or cannot be postponed. Many
women face several changes as a result of social and physical distancing, including for their
reproductive health checks. One of these services is the use of contraceptives. Contraceptive
use during The covid-19 pandemic is one of the efforts that must be done in couples of
childbearing age (PUS) which are expected to postpone pregnancy before the covid-19
pandemic. health workers continue to monitor the use of contraception for women's
reproductive health.
Keywords : Women's Reproductive Health, Fertile Age Couples, Contraception, Covid-

19 Pandemic
INTRODUCTION clear proof that this virus can spread from

World Health Organization (WHO) animals to humans. In fact, now
said that Corona virus or Severe Acute transmission can be from human to human.
Respiratory Syndrome Corona Virus 2 Here are some of the mild symptoms of the
(SARS-CoV-2) is a virus that can attack corona virus :Runny nose, Headache,
the respiratory system in humans. This Cough, Sore throat, Fever, Feel unwell.
disease caused by a viral infection is called What needs to be emphasized is
COVID-19. Severe acute respiratory that some corona viruses can cause severe
syndrome coronavirus 2 (SARS-CoV-2), symptoms. The infection can turn into
better known as the Corona virus, is a new bronchitis and pneumonia (caused by
type that is transmitted to humans. Corona COVID-19), which results in symptoms
virus can cause mild disturbances in the such as: Fever that may be quite high if the
respiratory system, severe lung infections, patient has pneumonia, Cough with mucus,
which can result in death. COVID-19 Hard to breathe, Chest pain or tightness
appeared for the first time in the city of when breathing and coughing, Infection
Wuhan, China. can get worse if it attacks certain groups of
COVID-19 incubation period is not individuals. For example, people with
known with certainty. However, the heart or lung disease, people with
average symptoms that occur after 2-14 weakened immune systems, babies, and
days after the first virus enters the body. In the elderly. Prevention from covid-19,
addition, the transmission method of namely: wearing a mask, diligently
COVID-19 is also not known with washing hands, physically distancing,
certainty. Initially, the COVID-19 corona social distancing, and not direct physical
virus was thought to originate from contact.
animals. The corona virus COVID-19 is a Contraception is an effort to
virus that circulates in several animals, prevent pregnancy. These efforts can be
including bats. Actually this virus rarely temporary and permanent, preventing
evolves and infects humans and spreads to fertilization of the egg by sperm cells
other individuals. However, the case in (conception) or preventing attaching the
Wuhan, China and even the world is now a
16
fertilized egg to the uterine wall kinds of must always be available and available in
contraception are : disaster situations. In order for
The simple contraceptive method reproductive health rights to be fulfilled
consists of 2 namely simple contraceptive during disasters, affected populations must
methods without tools and contraceptive have access to reproductive health
methods with tools. Methods of information and services.
contraception without tools include: The National Population and
Lactation Amenorhoe Method (MAL), Family Planning Agency (BKKBN) notes
Interuptus Couitus, Calendar Method, that the installation of family planning
Cervical Mucus Method, Body Basal contraception (KB) during the SARS-
Temperature Method, and Simptotermal, CoV2 corona virus pandemic (Covid-19)
which is a combination of basal decreased by almost 50 percent. This
temperature and cervical mucus. Whereas decrease in number has the potential to
the simple contraceptive method is a increase pregnancy in the country by up to
condom, diaphragm, cervical cup and 20 percent.
spermicide (Handayani, 2016). However, in the COVID-19
The hormonal contraceptive pandemic health crises can arise, including
method is basically divided into 2 namely the need for reproductive health which is
a combination (containing the hormone often overlooked. It is possible that a
progesterone and synthetic estrogen) and health facility is not maximally assisting
which contains only progesterone. delivery because the focus of handling
Combined hormonal contraception is covid-19 transmission. It can be seen from
present in pills and injections / injections. the handling of Covid-19 involving almost
While hormonal contraceptives that all health professionals including doctors,
contain progesterone are found in pills, dentists, midwives, nurses, pharmacists,
injections and implants (Handayani, 2016). etc. Although up to now there are no data
Long-term contraception is and reports on the number of pregnant
divided into two, namely hormonal long- women in disaster areas in Indonesia, but
term contraception namely under the skin from previous disaster experiences it is
contraception (implants) and non- known that in disaster situations, there are
hormonal long-term contraception that is always mothers who give birth or
an intrauterine device (IUD). experience pregnancy complications due to
Solid contraceptive methods the disruption of the health care system.
consist of 2 types, namely the Women's Therefore, to answer this
Operative Method (MOW) and the Male problem, CIE (Communication,
Operative Method (MOP). MOW is often Information and Education) about
known as tubectomy because the principle emergency contraception, abbreviated as
of this method is to cut or bind the Kondar, is needed. This is intended to
fallopian tubes / fallopian tubes so as to prevent unwanted pregnancy immediately
prevent the meeting between the ovum and after sexual intercourse because it does not
sperm. Whereas MOP is often known as use contraception. Stay at home reduces
vasectomy, namely vasectomy cutting or our interactions with others, but increases
binding the vas deferens. interaction in the family. This policy
invites the public to limit activities outside
DISCUSSION the home in order to prevent covid-19
Health is a human right that must transmission.The stigma of fear of
be fulfilled in any situation, including contracting covid-19, increasingly makes
disaster situations. Likewise with couples of childbearing age reluctant to get
reproductive health which is part of health. contraceptive services where health
Therefore, reproductive health services facilities are used as a sampling place. Of
17
course, who want to re-visit, will not CONCLUSION

access family planning services to the During the COVID-19 pandemic
health facilities while biological needs are such as this is very important to ensure
still running. midwives can continue to provide
If the couple does not use reproductive health services, including the
contraception, it is very likely that an safe installation of contraceptives, namely:
unwanted pregnancy will occur. Pregnancy 1. Ensure the supply of contraceptives
should be planned with consideration of is easily accessible and available
health, economic, social and religious on various channels.
aspects. If these considerations are 2. Improve communication to health
accepted, then the pregnancy will workers through various webinar
continue. If not, then there are efforts for activities aimed at health workers.
abortion that can threaten the safety of 3. Providing online contraception
both mother and child. consultation services
Emergency Contraception 4. Donations in the form of
Emphasis can be used in situations and contraception, reproductive health
periods that should not be postponed, that products and personal protective
is, after having sexual intercourse without equipment to health workers and
contraception. This method is better than the community.
not using contraception at all. If this
method is applied, many unwanted REFERENCE
Channel News Asia. Wuhan virus
pregnancies can be prevented, thereby
outbreak: 15 medical workers
reducing maternal and infant mortality.
infected, 1 in critical condition.
The type of Emergency
[Homepage on The Internet]. Cited
Contraception in question is the copper T.
Jan 28th 2020.
pill and IUD The pill works by blocking
Availableon:https://www.channeln
the egg cell from releasing the ovaries and ewsasia.com/news/asia/wuhanpneu
interfering with the work of the hormone monia-outbreak-health-workers-
progesterone which plays a role in coronavirus-12294212 (Jan 21st
preparing the uterus as a place to grow the 2020).
fetus. The effectiveness of the pill is taken Handayani, S. 2010. Textbook on Family
before 72 hours after sex. IUD work by Planning Services. Yogyakarta:
blocking sperm from entering the fallopian Rihama Library.
tubes. The effectiveness of the IUD is John Hopkins University. Wuhan
installed before 5 days post sexual Coronavirus (2019-nCoV) Global
intercourse. The longer the period of pill Cases(by John Hopkins CSSE).
consumption or installation of an IUD [Homepage on The Internet]. Cited
from sexual intercourse, the effectiveness Jan 28th 2020.
is also reduced. For that, immediately use Availableon:https://gisanddata.map
one of these contraceptives after s.arcgis.com/apps/opsdashboard/in
remembering it. dex.htm
However, in a covid-19 pandemic l#/bda7594740fd40299423467b48e
situation PUS can prevent pregnancy by 9ecf6. (Jan 2020)
using long-term contraceptive methods World Health Organization. Clinical
such as IUDs, implants, MOW management of severe acute
(tubectomy) and MOP (vasectomy) to be respiratory infection when novel
safe and comfortable in the long term. We coronavirus (2019-nCoV) infection
don't know when this outbreak ends, but is suspected. interim guidance.
prevent unwanted pregnancies using the [Serial on The Internet]. Cited Jan
Long-Term Contraception Method. 30th 2020.
18
Condom Use Measures In Prevention Of Transmission Of Sexually Transmitted Infections (STIS) In The Pandemic
Covid-19
CONDOM USE MEASURES IN PREVENTION OF TRANSMISSION OF

SEXUALLY TRANSMITTED INFECTIONS (STIS) IN THE PANDEMIC
COVID-19
Makdalena1
[email protected]
ABSTRACT
Aim/Objective this study aims to improve public reproductive health in the use of condoms
in efforts to prevent the transmission of sexually transmitted infections (STIs) in the days of
the pandemic covid 19 Material and method isThis type of research is a qualitative survey
by means of Unrestricted Samples, Screened Samples, Recruited Samples. This method uses
internet-based data search because data is stored on scattered servers. worldwide that can be
accessed and read quickly, easily and free of charge by Internet visitors (netter) about
reproductive health by using condoms in an effort to prevent the transmission of sexually
transmitted infections in this pandemic era. Result Research results show that respondents'
knowledge about condom use in efforts to prevent sexually transmitted infections (STI) in the
low category among people who do not take care of reproductive health during the pandemic
so that the pregnancy rate also increases because in addition to preventing sexually
transmitted diseases, this condom can also prevent the occurrence of pregnancy during
pandemic. Conclusion: Health education is a form of health promotion that is simple and can
cover broad targets. From the results of counseling about Reproductive Health Knowledge
with condom use measures to prevent sexually transmitted infections that have been done, it
can be concluded that there are differences in the actions before and after the use of condoms
for the prevention of sexually transmitted infections. husband and wife to maintain
reproductive health which is the main demand in the health priorities of this pandemic during
covid 19.
Keyword :Reproductive health, Sexually transmitted diseases, CONDOM, covid 19
INTRODUCTION To be able to prevent transmission of

In this world, humans can suffer course we must know what media can be
from various diseases that attack the body. an intermediary for the origin of the
The types of diseases that occur in humans disease. If you already know, then we
also come from different factors. Humans avoid it.
can develop diseases due to contracting, or And among the infectious diseases,
from bacteria to viruses. including diseases that are very
Infectious disease according to recognizable by people today, namely
experts is a disease that can move from COVID-19 or Corona Virus Disease 2019
one person to another. This is called caused by the coronavirus virus group.
transmission which can occur directly or Coronavirus is a collection of viruses that
indirectly and can also be transmitted can infect the respiratory system. In many
through intermediaries or contacts. cases, this virus only causes mild
Infectious diseases are usually respiratory infections, such as flu.
characterized by the cause of a living However, this virus can also cause severe
disease and can move to attack the host respiratory infections, such as lung
(patient). Infectious diseases can move infections (pneumonia).
from one person to another. This process COVID-19 virus infection was first
of transmission is what we must prevent. discovered in the city of Wuhan, China at
19
Covid-19
the end of December 2019. The virus is Efforts to prevent health problems
transmitted very quickly and has spread to in preventing the transmission of sexually
almost all countries, including Indonesia, transmitted infections condoms become a
in just a few months.This pandemic also protective tool used when having sexual
caused global socioeconomic disruption, intercourse. According to WHO, male
delays or cancellation of sporting and condoms effectively prevent pregnancy by
cultural events, and widespread concerns up to 98 percent if used correctly and
about shortages of goods that led to panic consistently. Male condoms are also
purchases, and not only that. effective in preventing HIV and other
Misinformation and conspiracy theories sexually transmitted diseases. Whereas
about viruses have also spread online, and female condoms can prevent pregnancy by
incidents of xenophobia and racism have up to 90 percent if used correctly
occurred against Chinese and East and
Southeast Asian people. MATERIAL AND METHODS
According to WHO, reproductive This study is a non-experimental
health is a state of complete physical, study with a cross-sectional study design
mental and social well-being not only free because the subjects were observed only
from disease or disability in all aspects for a moment or once With a qualitative
related to the reproductive system, its approach to reproductive health that has
functions and processes been happening coupled with the
Likewise with reproductive health occurrence of a pandemic, reduced
that occurred during the pandemic, we community activity so that many also
must understand what sexually transmitted experience frustration due to the negative
diseases are.STDs (sexually transmitted effects of this pandemic.
diseases) are one of the Data Frequency Reproductive
infections.reproductive tract (ISR) that is health problems for sexually transmitted
transmitted through sexual contact.Germs diseases are obtained from information
that cause infections can be fungi, viruses, data on the internet by means of a
and parasites.Women are more susceptible qualitative survey by means of
to ISR than men, because of the channel Unrestricted Samples, Screened Samples,
female reproduction is closer to the anus Recruited Samples. This Method use
and urinary tract. ISR onwomen are also internet-based data search because data
known because the symptoms are less stored on servers spread all over the world
clear compared with men. Among ISRs, can be accessed and read quickly, easily
sexually transmitted diseases (STDs) is an and free of charge by Internet visitors
infectious disease that is often found and (netter) about reproductive health by using
transmitted through sexual relations (Yani condom use in an effort to prevent
Widyastuti, 2009: 38).Infectious infections transmission of infection Sexually
Sexual (STI) is still apublic health transmitted during this pandemic.
problems throughoutthe world, both in Methods or prevention efforts
developed countries (industry) and Prevention of health problems in
indeveloping country. World Health preventing the transmission of sexually
Organization estimates there are more than transmitted infections condoms become a
340 million New cases of STIs that can be protective tool used when having sexual
treated like syphilis, gonorrhea, chlamydia relations male condoms effectively prevent
and trachomatis trichomonas vaginalis pregnancy by up to 98 percent if used
which occurs every year in the world, correctly and consistently. Male condoms
especially in aged men and women 15-49 are also effective in preventing HIV and
years. other sexually transmitted diseases.
Whereas female condoms can prevent
20
Covid-19
pregnancy by up to 90 percent if used case, the condom is a barrier to the entry of

correctly sperm to reach the egg. But apparently,
Before the use of condoms The condoms can also prevent a person from
problem or the level of the occurrence of sexually transmitted diseases. The trick is
sexually transmitted infections become the to use condoms consistently.
main highlight of reproductive health If condom use is done consistently,
problems in the world of health especially infectious diseases can be avoided. More
in the midwifery if reproductive health for someone who has an active sexy
affects health there will be many activity and often mutually partner. But it
complications of health problems caused must also be discussed, if the use of
during pregnancy or pre conception. After condoms is not appropriate and not in
the use of condoms infectious diseases accordance with the instructions for use,
sexual because there is prevention by the then the risk of communicable diseases
use of condoms will affect the tendency will increase.
for sexually transmitted infections. Even so, there are several theories
that agree that condoms are not fully
RESULT approved by users of HIV (human
The results of research and immunodeficiency virus). According to a
internet-based data search data on the study at the National Institutes of Health,
internet is available on reproductive health United States, found condom pores larger
for the prevention of sexually transmitted than the HIV virus. Related, the use of
infections with condom use is a maximum condoms that are considered not to be
effort. carried out effectively transmission of the
Sales or effectiveness of usage of virus.
condoms becomes significant in the However, there are those who
community because condoms become one agree to continue using condoms. The
of the efforts to prevent sexually reason, the use of condoms can still reduce
transmitted diseases to prevent the risk of sexually transmitted diseases
reproductive health problems during the while not 100 percent. In addition, avoid
pandemic. also having sex with more than one
Basically, the purpose of condoms partner.
is to prevent pregnancy, which is a
physical barrier that stops sperm from REFRENCE
entering the vagina and reaching the egg. https://ukh.ac.id/images/file/20.pdf
The use of condoms consistently and https://www.halodoc.com/health/pregn nt-
correctly can reduce the risk of sexual-pms
transmission of sexually transmitted http://makalahkesehatanraze.blogspot.com/
diseases such as genital herpes and 2014/07/makalah-pms.html
syphilis. The use of condoms also reduces file:///C:/Users/ACER/Downloads/13880-
the risk of transmission of the HIV / AIDS 28546-1-PB.pdf
virus, as well as the risk of HPV infection https://lifestyle.kompas.com/read/2017/07/
that causes genital warts to cervical cancer. 22/155959720/apakah-kondom-
Various studies have shown that condoms bisa-mencegah-penyakit-menular-
are an effective barrier to prevent sexually seksual-
transmitted diseases caused by germs and
even the smallest viruses
CONCLUSION
Condoms are contraceptives
commonly used to avoid pregnancy. In this
21
Relationship Body Mass Index And Physical Activity With Dismenore On Adolescent In SMA N 64 Jakarta 2019
RELATIONSHIP BODY MASS INDEX AND PHYSICAL ACTIVITY

WITH DISMENORE ON ADOLESCENT IN SMA N 64 JAKARTA
2019
Mei Kristina Gea
STIKES Mitra Husada Medan
ABSTRACT
Background: The incidence of menstrual pain or dysmenorrhea in the world is very large.
On average more than 50% of women from each country experience menstrual pain. The
incidence of dysmenorrhoea in Indonesia is 107,673 people (64.25%) women, consisting of
59,671 people (54.89%) experienced primary dysmenorrhoea and 9,496 people (9.36%)
experienced secondary dysmenorrhoea.
Objectives: To determine the relationship of body mass index and physical activity with
dysmenorrhea in SMA N 64 Jakarta in 2019
Methodology: This research is a quantitative study, with analytic survey method with cross
sectional approach. The sample in this study amounted to 80 people. Sampling technique
with total sampling. The research instrument consisted of a dysmenorrhea questionnaire,
body mass index and adolescent physical activity.
Research Results: Chi-square test results on body mass index and dysmenorrhea obtained p
value 0,000 (p value <0.005) that there is a relationship between body mass index with
dysmenorrhea, chi-square test on physical activity and dysmenorrhea obtained p value 0.524
(p value > 0.005) that there is no relationship between physical activity and dysmenorrhea.
Conclusions and Recommendations: There is a relationship between Body Mass Index and
dysmenorrhea. Abnormal body mass index caused by malnutrition, young women should pay
more attention to eating patterns and avoid eating fast food.
Keywords: Dysmenorrhea, Body Mass Index, Physical Activity.

Literature: 36 (2011-2018)
PRELIMINARY incidence of menstrual pain or

Adolescence is a period of human dysmenorrhea in the world is very large.
growth and process of maturity, during this On average more than 50% of women
time there are very unique and sustainable from each country experience menstrual
changes. Physical changes due to growth pain. The prevalence of dysmenorrhea in
that occur will affect the health status and America is around 60%, while in Sweden
nutrition (Hasdianah, 2014). Adolescents it is around 70% (Mulastin, 2013).
are those who are in the transition phase of Research by Kumbhar et al (2011)
childhood and adulthood, aged 10-19 years in Khadapa also found that the prevalence
(WHO, 2014) of dysmenorrhea is quite high, reaching
According to the World Health 65%. Even research conducted by Al
Organization (WHO), the incidence rate of Kindi and Al Bulushi (2011) in Omani and
dysmenorrhoea is 1,769,425 people (90%) El Hameed et al (2011) high schools in
of women. The incidence of Egypt found a very high prevalence of
dysmenorrhoea in Indonesia is 107,673 dysmenorrhea of 94% and 94.4% (Al
people (64.25%) women, consisting of Kindi et al., 2011). Research conducted by
59,671 people (54.89%) experienced Utami et al (2013) on young women in a
primary dysmenorrhoea and 9,496 people high school in Bone District, showed the
(9.36%) experienced secondary results of 87.1% of young women
dysmenorrhoea (Zshasa et al, 2016). The experiencing dysmenorrhea. Whereas
22
research conducted by (Sianipar et al, beginning of menstruation (Pieter &

2009) in Pulo Gadung Subdistrict, East Janiwarty, 2013).
Jakarta found 63.2% of young women
experiencing dysmenorrhea, (Kemenkes MATERIALS AND METHODS
RI 2016). Dysmenorrhea is pain during
According to Lestari (2013), the menstruation, the word dysmenorrhea
cause of menstrual disorders can be due to comes from the Greek, namely
biological and pathological abnormalities. dysmenorrhea, which according to the
Other factors that influence menstrual meaning of the word consists of "dys"
disorders are stress, nutritional status, age, means difficult, "meno" means the moon,
and physical activity. Pain in and "rrhea" means flow. According to
dysmenorrhoea is associated with a (Okoro G. & Madhubala C, 2013).
number of other signs and symptoms such Dysmenorrhea is a gynecological
as headaches, diarrhea, anorexia, nausea disorder that often occurs. There are some
and vomiting. Primary dysmenorrhoea women who feel pain or cramps in the
causes activity intolerance and in severe lower abdomen during menstruation that
pain can result in absenteeism at work or lasts, and to cause symptoms such as loss
school, thus causing reduced work results of consciousness due to pain that is so
and attention in class (Aziato et al, 2014). severe that it cannot withstand the pain.
The results of the Research Center This disorder can be called dysmenorrhea
for Adolescent Reproductive Health and (Pribakti B, 2011).
Counseling (PIK-KRR) in Indonesia in
2009 the incidence of dysmenorrhea 2.1.1 Types of Dysmenorrhea
ranged from 45 to 95% among the a. Based on the Type of Pain.
productive age, consisting of 72.84% 1) Spasmodic pain
primary dysmenorrhea and 27.11% Spasmodic pain begins when
secondary dismenor (Proverawati & menstruation or after menstruation begins
Maisaroh, 2009). Based on research data, to feel pain in the lower abdomen.
the incidence of dysmenorrhea in West Spasmodic dysmenorrhea can at least be
Java is quite high, as many as 54.9% of reduced if the birth of the first child or can
women experience dysmenorrhea, be treated, but not all women can
consisting of 24.5% experiencing mild experience such things (Calis, 2011).
dysmenorrhoea, 21.28% experiencing Congestive pain is pain that is felt
moderate dysmenorrhea and 9.36% before the menstrual period will begin, and
experiencing severe dysmenorrhoea (Arnis the patient has known since the previous
2012, in the journal Aisyiyah, 2015). day.
Pain during menstruation causes b. Based on abnormalities
discomfort in doing daily physical 1) Primary Dysmenorrhea
activities. This complaint is related to Primary dysmenorrhea is often
repeated absence from school or work, so referred to as primary dysmenorrhea, a
that it can interfere with productivity. symptom that is caused without
Approximately 70-90% of cases of pathological abnormalities in the pelvic
menstrual pain occur at the age of region and which is felt is menstrual cyclic
adolescents and adolescents who pain, and has a characteristic pain that can
experience menstrual pain affect academic, occur after the first few years of menarche
social and sports activities Puji (2010). (Sarwono, 2011 & JO Schorge , 2008).
Dysmenorrhea is usually caused by an 2) Secondary Dysmenorrhea
imbalance of the hormone prostaglandin Secondary dysmenorrhea is defined
which makes the uterine muscles contract as menstrual pain due to anatomic or
strongly and is more common at the macroscopic pelvic pathology, as seen in
23
women with endometriosis or chronic (Rhistianingrum et al, 2010). Besides

pelvic inflammatory disease. being used to monitor the nutritional status
of BMI it can also be used as a fitness
2.1.2 Signs of Dysmenorrhea Symptoms benchmark. Someone who is overweight
a) Signs and symptoms of primary can be said to have a lot of body fat and
dysmenorrhea low physical fitness (Watulingas, 2013).
Research conducted by Alatas
(2016) says that the primary form of 2.2.1 Factors Affecting Body Mass Index
dysmenorrhea experienced by many a. Age
adolescents is stiffness or spasms in the Research conducted by
lower abdomen. It feels so uncomfortable Tungtrochitr and Lotrakul shows that there
that it causes irritability, irritability, is a significant relationship between older
nausea, age and obesity category IMT.
vomiting, weight gain, abdominal b. Gender
bloating, back pain, headache, tension, BMI with overweight category is
lethargy, and depression. more common in men. However, the
B) Signs and symptoms of incidence of obesity is higher in women
secondary dysmenorrhea compared to men
Secondary dysmenorrhea has c. Dietary habit
symptoms that correspond to what causes Diet is a repetition of the
it, if the patient has endometriosis, composition of food that occurs when
symptoms will occur in the form of more eating. Pattern eating with respect to the
severe pain during menstruation and the type, proportion and combination of foods
pain persists and can be found not only in eaten by an individual, community or
the uterus. group of populations
d. Physical Activity
2.1.3 Pathophysiology 1) Definition of Physical Activity
a. Primary dysmenorrhoea Physical activity is the physical
The pathogenesis of primary movements carried out by the body's
dysmenorrhoea is due to excess or muscles and their supporting systems.
imbalance in the amount of prostaglandin Physical activity is any body movement
(PG) secretion from the endometrium produced by skeletal muscle that requires
during menstruation, prostaglandin F2α energy expenditure.
(PGF2α) is a strong myometrial stimulant 2) Type of Physical Activity
and vasoconstrictor in the endometrium Types of adolescent physical
(Calis K et al 2015). activity Physical activity can be classified
b. Secondary dysmenorrhoea into three levels, physical activity suitable
High prostaglandins may also play for adolescents is as follows:
a role in the pathogenesis of secondary a) Light activities: only require a little
dysmenorrhoea, but secondary energy and usually do not cause
dysmenorrhoea must have pelvic changes in breathing or endurance.
pathology (Calis K et al 2015). b) Medium activity: requires intense or
continuous energy, rhythmic muscle
2.1.5 Degrees of Dysmenorrhoea movements or flexibility (flexibility).
a. Body Mass Index c) Heavy activities: usually associated
BMI is a simple way to monitor the with sports and requires strength
nutritional status of adults. BB further (strength), making sweat.
increases the risk of degenerative diseases.
Maintaining a normal BB allows a person
to achieve a longer life expectancy
24
Table 2.2.2 Table of Categories of b. Body mass index

Physical Activity Levels Table 4.2 Distribution of Frequency of
MET CATEGORY Respondents Based on Body Mass Index
MET ≥ 3000 Height in SMA N 64 Jakarta 2019
Body Frequency
3000 > MET ≥ Mass (%)
Medium Index Percentage
600
Abnormal 60 75
600 < MET Low Normal 20 25
Total 80 100
2.3 Teenagers
2.3.1 Definition of youth Based on body mass index
According to Halock (1991) obtained by the number of respondents
adolescents come from the Latin word with an abnormal body mass index of 60
"adolescere" which means to grow or grow respondents with a percentage of 75%, and
into adulthood, the overall maturity in the number of normal body mass index of
emotional, mental, social and physical 20 respondents with a percentage of 25%
(Universitas Indonesia, 2009). c. Physical Activity
This research is a quantitative study, Table 4.3 Distribution of Frequency of
with an analytical survey method to Respondents by Physical Activity of
determine the relationship of body mass Young Women in SMA N 64 Jakarta in
index and physical activity with 2019
dysmenorrhoea in young women at SMA Physical Frequency Percentage
N 64 Jakarta in 2019 with a cross sectional Activity (%)
time approach and sampling technique
using Total Samplinng. Low 24 30,0
Medium 39 48,8
RESULTS AND DISCUSSION Height 17 21,2
4.1.1 Univariate Analysis
Total 80 100
a. Dysmenorrhea
Table 4.1 Distribution of Frequency of
Based on physical activity, the
Respondents by Dysmenorrhea Young
number of respondents with low physical
Women in SMA 64 Jakarta2019
activity was 24 respondents with a
Dismenore Percentage Frequency (%)
percentage of 30%, respondents with
No 24 30 moderate activity 39 respondents with a
Yes 56 70 percentage of 48.8% and respondents with
Total 80 100 high activity 17 respondents with a
percentage of 21.2%.
Based on dysmenorrhea obtained by Based on physical activity, the
the number of respondents who did not number of respondents with low physical
experience dysmenorrhea as many as 24 activity was 24 respondents with a
respondents with a percentage of 30%, and percentage of 30%, respondents with
respondents who experienced moderate activity 39 respondents with a
dysmenorrhea as many as 56 respondents percentage of 48.8% and respondents with
with a percentage of 70%. high activity 17 respondents with a
percentage of 21.2%.
25
4.1.2 Bivariate Analysis respondents (35.3%) experienced

a. Relationship between Body Mass Index dysmenorrhea, 11 respondents (64.7%)
and Dysmenorrhea experienced dysmenorrhea. Value of p:
Body Dysmenorrhea 0.524 (p> 0.05) where Ho fails to reject
Mass No Yes Total P. OR then there is no relationship between
Index Value 95% CI
physical activity with dysmenorrhea.
f % f % F %
AbNormal 18 30 42 70 60 100 1,000
Normal 6 30 14 70 20 100 1.000 (0.331-
4.2.1 Dysmenorrhea
Total 24 30 56 70 80 100 3.017) The results of research conducted
at SMA N 64 Jakarta the number of
The relationship of body mass respondents who did not experience
index with dysmenorrhea in this study dysmenorrhea as many as 24 respondents
showed that of the 80 for the body mass with a percentage of 30%, and respondents
index is not normal there are 18 who experienced dysmenorrhea as many
respondents (30%) who did not experience as 56 respondents with a percentage of
dysmenorrhea and 42 respondents (70%) 70%. Hour dysmenorrhea is a physical
who experienced dysmenorrhea and for disorder in the form of pain (abdominal
respondents who had a normal body mass cramps) before, during and after
index there were 6 respondents (30%) did menstruation, this disorder usually starts
not experience dysmenorrhea and 14 24 hours before the onset of menstrual
respondents (70%) experienced bleeding and can be felt 24-36 Dita pain
dysmenorrhea. Statistical Test Results (2010).
(Chi-Square Test) Value p: 1,000 (p> Young women who are
0.05) where Ho fails to reject then there is experiencing menstrual pain
no relationship between body mass index (dysmenorrhea) while participating in
with dysmenorrhea. learning activities, can cause learning
activities to be disrupted, not excited,the
b. The Relationship Between Physical concentration becomes decreased even it is
Activity and Dysmenorrhea difficult to concentrate so that the material
Physical Dysmenorrhea delivered during learning cannot be well
Activity Total P. received even to those who do not attend
Tidak Ya Value school (Ernawati, 2010)
F % f % F %
4.2.2 Body Mass Index
Low 6 25 18 75 24 100 The results of research conducted
Moderate 12 30,8 27 69,2 39 100 0,524
Height 6 35,3 11 64,7 17 100 at SMA N 64 Jakarta about relationships
Total 24 30 56 70 80 100 Based on body mass index obtained the
number of respondents with an abnormal
The relationship of physical body mass index of 60 respondents with a
activity with dysmenorrhea in this study percentage of 75%, and the number of
showed that of 80 respondents for low normal body mass index of 60 respondents
physical activity there were 6 respondents with a percentage of 25%. Most of the
(25%) who did not experience respondents had a BMI <18.5 in the
dysmenorrhea and 18 respondents (75%) abnormal category. BMI is obtained by
who experienced dysmenorrhea, measuring height and weight, so BMI
respondents with moderate activity there depends on a person's nutritional status.
were 12 respondents (30.8 %) who did not A good BMI shows the
experience dysmenorrhea and 27 fulfillment of optimal nutrition. Optimal
respondents (69.2%) who experienced nutrition can help accelerate the growth
dysmenorrhea, and for heavy activity 6 and development of sexual organs, while
26
the non-fulfillment of nutrients can result Stimulating Hormone) and LH

in late sexual maturation and growth (Luteinizing Hormone) Pebrina (2016).
inhibition. This nutritional intake is Whereas overweight (nutritional
influenced by diet, level of education and status) can also result in dysmenorrhoea
knowledge, socio-economic status, and because there is excessive fat tissue which
attitude of Soetjiningsih (2017). can result in hyperplation of blood vessels
The results of the study (Rika et by fat tissue in the female reproductive
al, 2018) in young women in SMP N organs. so that blood that should flow
Pekanbaru from 61 young women in SMP during the menstrual process is disrupted
PGRI Pekanbaru found that the majority of and causes pain during menstruation. So
normal nutritional status was 62.3% (38 that nutritional status is not normal has the
people) and the minority of fat nutrition possibility for Pebrina dysmenorrhea
status was 4.9% ( 3 people) . The results of (2016).
this study are consistent with research This research is supported by
(Utari, 2016) at the Muhammadiyah Dwi, P (2012) research on the relationship
University of Surakarta, where the results between individual characteristics,
of the study were obtained from 46 physical activity and consumption of milk
respondents having a normal nutritional products with primary dysmenorrhea
status of 78.3% (36 respondents). obtained p value of 0.16, Rika S Research
(2018) about the relationship of body mass
4.2.2 Physical Activity index with dysmenorrhoea in young
The results of research conducted women in SMP Pekan, only p = 0.47 This
at SMA N 64 Jakarta obtained the number research is contrary to the research of
of respondents with low physical activity Novita R (2018) on the Relationship of
as many as 24 respondents with a Nutrition Status with).
percentage of 30%, respondents with
moderate activity 39 respondents with a 4.2.5 Relationship between Physical
percentage of 48.8% and respondents with Activity and Dysmenorrhea in Young
high activity 17 respondents with a Women at SMA N 64 Jakarta
percentage of 21.2%. The results of this study illustrate
Sedentary lifestyle (relaxing, that each person reacts differently to
sitting) is what is seen when students are at menstrual pain. This is because menstrual
school during recess. On average, young pain is not only influenced by physical
women make use of free time when at activity but can be caused by each
home, just relaxing or doing activities that individual's perception of pain that is
only require a little effort and only a few subjective so that it can affect the pain
students who often do physical activities response varies. Menstrual pain
(exercise) in the past week . (dysmenorrhoea) can also be caused by
several factors such as nutritional status,
4.2.4. The relationship of body mass severe menstrual flow, history of
index with dysmenorrhea in girls in hereditary stress and Afrida hormone
SMA N 64 Jakarta imbalance (2018).
Low nutritional status The results of this study are in
(underweight) can be caused due to lack of line with the Khairunisa 2018 study. Data
food intake, including iron. Lack of were analyzed with the chi-square test with
nutritional intake will have an impact on a value (p = 0.238) showing no
decreased hypothalamic function that does relationship between physical activity and
not provide stimulation to the anterior menstrual pain and also in line with
pituitary to produce FSH (Follicle research Tristiana A (2017) Relationship
between Physical Activity and Primary
27
Dysmenorrhea in Santri at Islamic about dysmenorrhea in mass /

boarding school X in Bogor District 2017 electronic media, books on
showed no relationship between physical reproductive health, or health
activity and menstrual pain (p = 0.372). workers, so that the incidence of
The results of this study contradict Linda dysmenorrhea can decrease.
Research Research (2017) The relationship 2) For schools
of physical activity with the degree of PIKRR extracurricular needs to be
primary dysmenorrhea in adolescents is added so that students can know
obtained p-value = 0,000 indicating there reproductive health better. Schools
is a relationship between physical activity should be able to provide facilities
and the incidence of dysmenorrhea. and implement pain management
(pain management) in an effort to
CONCLUSIONS AND SUGGESTIONS eliminate menstrual pain
5.1 Conclusions (dysmenorrhea) both in terms of
Based on the results of research nonpharmacology such as massage
on the Relationship of Body Mass Index and warm water compresses and in
and Physical Activity with Dysmenorrhea terms of pharmacology such as
in Adolescent Girls at SMA N 64 Jakarta providing pain relievers and
in 2019, the following conclusions can be appropriate handling measures if
drawn: experiencing menstrual pain
1) In class X students at SMA N 64 (dysmenorrhea).
Jakarta the incidence of 3) For further researchers
dysmenorrhea was 56 respondents Further research needs to be done
(70%) while those without on other factors that are related to
dysmenorrhea were 24 respondents the level of dysmenorrhoea with a
(30%) larger sample.
2) Body Mass Index for grade X
students at SMA N 64 Jakarta is in BIBLIOGRAPHY
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and> 25, 60 respondents (75%). Medical, F., & Diponegoro, U. 2014.
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5.2 Suggestions the Difference in Dysmenorrhea
1) For Teens Intensity After Performing
Students should look for more Dysmenorrhea Gymnastics in Young
information that increases insight Women in SMP Negeri 21
about knowledge and information Pekanbaru. Journal: Midwifery
related to reproductive health, Ernawati. 2010. Relaxation therapy for
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Kumalasari, Saryono, et all. 2009. The Surakarta
relationship of body mass index with Rika, S. 2017. Relationship between Body
blood uric acid levels in the residents Mass Index and Dysmenorrhoea in
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30
Effects Of Reproductive Health Information Services During The Covid-19 Pandemic
EFFECTS OF REPRODUCTIVE HEALTH INFORMATION SERVICES

Mutiara Asia Putri
1819401035
The Midwifery Study Diploma Program Three
High School of Health Science (STIKes)
Mitra Husada Medan
[email protected]
Abstract
The Covid-19 pandemic that is occurring today is one of the non-natural disasters experienced
by various countries in the world, including Indonesia. The corona virus has reached more than
170 countries around the world, including Indonesia. Every day co-19 victims continue to grow,
making the emergency situation worse. In the co-19 pandemic health crises can arise, including
the need for reproductive health services that are often overlooked. services include childbirth,
antenatal care, childbirth and family planning (KB) programs.
The purpose of this study is to improve reproductive health during the panemic covid-19 by
providing IEC services to the community and maintaining the quality of health life for the
community.
The research method uses the method of data collection by observation where information
search involves various factors in the implementation of health service information where
researchers are directly involved in people's daily activities or situations that are observed as
sources of data during the co-19 pandemic.
The research material uses primary data, that is data collected directly.
Conclusion : Health is a human right that must be fulfilled in any situation, including the
current co-19 pandemic disaster situation. Likewise, reproductive health is part of health.
Therefore, reproductive health services must always be available and available in disaster
situations. In order for reproductive health rights to be fulfilled during disasters, affected
populations must have access to reproductive health information and services.
Keywords :information services, reproductive health
INTRODUCTION percent, the handling of this epidemic has

The Covid-19 pandemic that is not been controlled, so there is a possibility
occurring today is one of the non-natural that the victims will increase and the
disasters experienced by various countries additional emergency response period will
in the world, including Indonesia. The be longer.
corona virus has reached more than 170 Since the beginning of the COVID-
countries around the world, including 19 pandemic, one concern has been that the
Indonesia. Every day co-19 victims elderly are more at risk of being affected by
continue to grow, making the emergency COVID-19. However, health and non-
situation worse. health impacts on young people have also
Based on data from Johns Hopkins proven to be significant. A general
University, as of March 29, 2020 there were understanding of these impacts and the role
678,720 people who were positively of young people in creating solutions is
infected by the corona virus. While the very important in the response to a
number of victims who died as many as pandemic. The impact of COVID-19 will be
31,700 cases, and as many as 145,609 who more than just a health effect and will last
experienced healing. Even though the CFR even after the pandemic ends. This global
(Case Fatality Rate) is still below 10 crisis is exacerbating the vulnerabilities and
31
inequalities that already exist today. All of aspects. If these considerations are
these impacts are exacerbated in accepted, then the pregnancy will continue.
humanitarian emergencies where social If not, then there are efforts for abortion that
fragility, conflict and emergencies can threaten the safety of both mother and
undermine institutional capacity and child.
limitations to various services. The type of Kondar in question is
Although up to now there are no the copper T. pill and IUD The pill works
data and reports on the number of pregnant by blocking the egg cell from releasing the
women in disaster areas in Indonesia, but ovaries and interfering with the work of the
from previous disaster experiences it is hormone progesterone which plays a role in
known that in disaster situations, there are preparing the uterus as a place to grow the
always mothers who give birth or fetus. The effectiveness of the pill is taken
experience pregnancy complications due to before 72 hours after sex. IUDs work by
the disruption of the health care system. blocking sperm from entering the fallopian
Therefore, to answer this problem, IEC tubes. The effectiveness of the IUD is
(Communication, Information and installed before 5 days post sexual
Education) about emergency contraception, intercourse. The longer the period of pill
abbreviated as Kondar, is needed. This is consumption or installation of an IUD from
intended to prevent unwanted pregnancy sexual intercourse, the effectiveness is also
immediately after sexual intercourse reduced. For that, immediately use one of
because it does not use contraception. these contraceptives after remembering it.
During the COVID-19 pandemic, it However, in a covid-19 pandemic
is hoped that Family Planning (KB) situation PUS can prevent pregnancy by
services will continue to run by taking into using long-term contraceptive methods
account protocols to prevent the spread of (MKJP) such as IUDs, implants, MOW
the corona virus. On the other hand, no less (tubectomy) and MOP (vasectomy) to be
important is the service and promotion and safe and comfortable in the long term. We
counseling of reproductive health is also don't know when this outbreak ends, but
still needed in the current pandemic. At the prevent unwanted pregnancies using MKJP.
time of this pandemic, community access to
services and health counseling was limited, MATERIALS AND METHODS
and to minimize contact with health Material
workers, most promotional and counseling This research method uses the
activities including related to reproductive Observation method. The Observation
health made more use of social media and Method is a complex data collection
long distance communication media both method because it involves various factors
online and offline. in its implementation. Such as involving
The stigma of fear of contracting internet access networks in gathering
covid-19, increasingly makes couples of accurate data and looking for information in
childbearing age (EFA) reluctant to get a straightforward manner with events
contraceptive services where health experienced by the community at this time
facilities are used as a sampling place. Of during the co-19 pandemic took place
course, EFAs who want to re-visit, will not Observation data collection methods
access family planning services to the not only measure the attitudes of
health facilities while biological needs are respondents, but can also be used to record
still running. If the couple does not use various phenomena that occur. Observation
contraception, it is very likely that an data collection techniques are suitable for
unwanted pregnancy will occur. Pregnancy research aimed at studying human behavior,
should be planned with consideration of work processes, and natural phenomena.
health, economic, social and religious This method is also appropriate for
32
respondents whose quantity is not too large. because men's reproductive health can also
Observation data collection methods are affect women's reproductive health. Pre-
divided into two categories, namely : pregnancy health services are aimed at three
a. Participant observation target groups, namely adolescents, the bride
In participant observation, researchers are and groom (PUS) couples.
directly involved in the daily activities of Based on SIHA data from the
people or situations that are observed as Ministry of Health, 2020 mentioned 5
sources of data. provinces in Indonesia which had the
b. Non participant observation highest HIV cases (viruses that can reduce
Contrary to participant observation, non immunity), namely DKI Jakarta (65,578
participant observation is observation where cases), East Java (57,176 cases), West Java
the researcher does not participate directly (40,215 cases), Papua (36,382 cases) ),
in the activity or process being observed. Central Java (33,322 cases) and AIDS
In this article the observation data collection Cases (A collection of symptoms of a
method uses participant observation disease caused by a decrease in the immune
because this research is carried out directly system) Highest Papua (23,599 cases), East
by involving community activities or Java (20,787 cases), Central Java (11,724
activities in daily life. cases), DKI Jakarta (10,157 cases) , Bali
The material used in this study uses primary (8,230 cases), Hasto said at KTD has a
data, that is data collected and processed by broad impact such as increasing cases of
the researcher directly from the subject or abortion, increasing the risk of maternal and
object of research. child mortality, anemia in pregnant women,
malnutrition in pregnant women and
RESEARCH RESULT fetuses, premature birth babies, low birth
Based on the results of research weight babies (LBW) and lack of affection
using observation methods and primary data and care because children are unwanted.
to obtain results regarding reproductive For this reason, it is intended to ensure the
health information during the co-19 continued use of contraceptive devices and
pandemic. Until now, Indonesia still faces drugs during the Covid-19 disaster crisis
reproductive health problems which are period, such as: Family planning services,
characterized by the high number of visits to EFAs that require contraception.
marriages and pregnancy among Reducing the number of discontinuation of
adolescents. Riskesdas 2013 showed that contraceptive devices and drugs so as to
2.6% of women got married for the first prevent KTD by: optimizing the role of
time at the age of less than 15 years, and PKB / PLKB and mobilizing the KB
23.9% of women got married at the age of Information Unit Car to the community for
15-19 years. The high number of marriages CoE-19 Prevention IEC. In addition, Hasto
and pregnancies that are too young shows also invited all Indonesian families to carry
the low reproductive health status of out Action 8 (eight) Family Functions
women in this country. This is accompanied (religion, social culture, love and affection,
by health problems that commonly occur in protection, reproduction, education,
women including Chronic Energy economy and environment) to avoid
Deficiency (KEK), anemia, and HIV. exposure to diseases and viruses.
Pre-pregnancy health services are a Every family carries out 8 (eight)
series of activities aimed at women from family functions and according to President
adolescence to pre-pregnancy in order to Joko Widodo's suggestion to learn from
prepare women for pregnancy, childbirth, home, work from home and worship at
and delivering healthy babies. Aside from home, so it can be expected to minimize the
being aimed at women, pre-pregnancy spread of Covid-19 or Corona especially in
health services are also aimed at men, the smallest unit of society, the family.
33
CONCLUSION practicum. Yogyakarta: Nuha

Health is a human right that must be Medica.
fulfilled in any situation, including disaster 6. Herdman, T. H., &
situations. Likewise with reproductive Kamitsuru, S. 2015.
health which is part of health. Therefore, Diagnosis Keperawatan Definisi
reproductive health services must always be dan Klasifikasi Edisi 10. Jakarta.
available and available in disaster EGC.
situations. In order for reproductive health 7. Santoso, H., & Ismail, H.
rights to be fulfilled during disasters, Memahami Krisis Lanjut Usia.
affected populations must have access to BPK: Gunung Mulia. 2009,h.36-44.
reproductive health information and 8. Sudoyo, A.W., Setiohadi, B., Alwi,
services. However, in the co-19 pandemic I., Simadibrata, K.M., Setiati, S.
health crises can arise, including the need (2010). Buku Ajar Ilmu Penyakit
for reproductive health which is often Dalam. Jilid III
overlooked. It is possible that a health 9. Sonjaya, M.R., Rukanta, D. &
facility is not maximally assisting delivery Widayanto,
because the focus of handling covid-19 W.(2015).KarakteristikPasienOsteo
transmission. It can be seen from the arthritis Lutut Primer di
handling of Covid-19 involving almost all PoliklinikOrtopedi Rumah Sakit
health professionals including doctors,
dentists, midwives, nurses, pharmacists, etc.
SUGGESTION
1. Hopefully with the reading of this article
can understand reproductive health in
ourselves and be able to protect one's own
health
2. Hopefully this article gets criticism and
suggestions for building creativity in
writing an article.
REFERENCES
1. Dinkes PROVSU, (2012). Health
profile of North Sumatra
province.Medan Indonesia.
2. Dinkes North Sumatera.2015.
Health profile of North Sumatera
province.
3. Helmi,N.Z.(2014).BukuAjarGanggu
anMuskuloskeletal.SalembaMedika:
Jakarta
4. Journal of Youth Studies (Print
ISSN 2252-9020; Online ISSN
2527-3639) is published by the
Youth Studies Center in
collaboration with the Faculty of
Social and Political Science,
Gadjah Mada University.
5. Maryanti D, et al. (2009).
Reproductive health theory and
34
Reproductive Health In Pregnant And Lactating Women During The Covid-19 Pandemic
REPRODUCTIVE HEALTH IN PREGNANT AND LACTATING WOMEN

Oktaria Christin Br Tambunan
[email protected]
ABSTRACT
To explore of perspectives pregnant women related toThe reproductive health of a woman's
pregnancyandbreastfeeding. in the covid-19 pandemic.A qualitative research using
phenomenology approachemployed focus group discussion (FGD) and in-depth interview. FGD
was held separately for pregnant women and breastfeeding. The data were analyzed using
interactive analyzes model The research was carried out in Besitang Village,Besitang District,
LangkaRegencyFrom theresearch conducted there are still many pregnant and lactatingwomen
who still ignore health protocols on thegroundsbecause in their area is still a safe zone.The
indifference of pregnant women and the communitytowards their cleanliness during the current
pandemic is still very large, evenmany pregnant women who are still traveling without wearing
masks. so health providers must educate the public and change their behavior use anacceptable
approach.
Keywords: Reproduction Healt, Pregnant And Breastfeeding woment, Covid-19
INTRODUCTION Coronaviruses cause respiratory infections

Many factors have been stated as that are generally mild, such as colds,
challenges in health development, such as although some forms of the disease such as;
the environment and facilities that are still SARS, MERS, and COVID-19 more
less supportive, among others not yet deadly. Which is where this virus will
adequate supply of clean water, not yet attack the body's immune system or
achieving good environmental sanitation, immune system.
the high prevalence of infectious diseases Pregnant and lactating women fall
and other infectious diseases, are still high into a category that is susceptible to
birth and infant mortality rates. However COVID-19 corona virus infection. One
things to note as well the challenges of reason is that they have low immunity due
health development are response to people's to hormonal changes during pregnancy and
behavior in receiving change. breastfeeding.
Reproductive function is often Therefore it is important for
associated with the nature of women as pregnant and lactating women to maintain
creatures that can get pregnant in a special their health by consuming nutritiously
position or status that is not supportive balanced foods, doing light physical
giving the same treatment as men. The activities such as yoga or pregnancy
unfair treatment is one of the factors that exercises, and taking blood-boosting tablets
can cause it to increasematernal mortality according to the dosage. In addition, it is
rate. As some data have shown that the also important to maintain personal and
maternal mortality rate is still unresolved. environmental hygiene by washing hands
Coronavirus is a collection of with soap and regularly disinfecting
viruses from the deep subfamily surfaces of objects or objects that are often
Orthocronavirinae the Coronaviridae family touched. If you cough or have a cold, wear
and the order of Nidovirales. This group of a mask and apply the ethics of coughing by
viruses can cause diseases in birds and covering your mouth using the elbow folds.
mammals, including humans. In humans, Don't forget, to ask the nearest health
35
service facility if there are danger signs that RESULT

have been written in the KIA handbook. Besitang village has a population a
population of 850, with the number of
MATERIAL AND METHODS family heads is 182 households. Most
This research is explorative research (51.38%) of the population has high school
with a qualitative approach, which explores or high school education or equivalent. The
and review information about habits that livelihood of the population is more modern
society related to pregnancy care, labor and and agrarian style. Seen the majority of
childbirth in terms of effort dealing with villagers become employees private sector
problems and prevention efforts with factors (26.95%) and farmers (25.86)
that are influence it. This qualitative Perception about pregnancy by
approach done in order to obtain a society determines behavior society towards
description and rich conclusion about that pregnancy. Perception about this pregnancy
context researched and understood the based on beliefs and symbols owned by the
meaning of that underlie the behavior of the community. Experience pregnancy in
community. The location of the study was particular is the source of symbol of
conducted in the village of Besitang, fertility, infant growth in utero, and
District of Besitang, Langkat Regency. maternal health and child.' Based on the
Primary data collection is done through results of a Limited Group Discussion and
Limited Group Discussion (DKT) in-depth interviews, obtained that of
techniques conducted by assisted pregnancy, childbirth, and the puerperium is
researchers by trained personnel a special event in family so that family care
(enumerators) then triangulation of data is and society is quite high. Concern it is
done also DKT with other informants who manifested in its existence dietary
related to. The selection of informants is restrictions and behavioral ones show
based on the rules that apply in the research family concern for the safety of the mother
method qualitative namely appropriateness and her baby from things which they
and adequacy. With consideration of these consider dangerous to pregnancy and
rules then which determined as an childbirth. “if his mother does not obey
informant for pregnant women as many as taboo, children born are often affected
10 people included is primipara (first-time disease, pyrite / circle, bunyu black, the
mother pregnant) and multiparas (mothers child is born black, no body big man, big
with pregnancy second, third and so on). head and belly, there also robusta
Another informant is the Postpartum and children's disease so skinny "(in-depth
Breastfeeding Mother 6 people. To interview with sanro).
complete the DKT results indepth interview There are still many and even the
with midwife (1 person). Analysis of the average community in Besitang village still
data in this study using interactive analysis ignores their hygiene and environment,
models in Qualitative research, data especially pregnant women, they still often
analysis is done since the beginning of the ignore health protocols related to Covid-19
research and throughout the process with the reason "because in their area it is
research carried out. Data obtained, then still a safe zone from the distribution of
collected to be processed in a way covid-19".
systematic. Starting with the interview, For mothers who are also
observation, editing, classifying, reduce, breastfeeding is still very less attention to
then the presentation activity data as well as cleanliness and care for her breasts.
inferring data. Although studies have not found the Covid-
19 virus contained in mother's milk, what
we are worried about is bacterial
36
contamination from the outside which will taken in accordance with the
enter through the baby's mouth. condition of your body.
CONCLUSION REFERENCES
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COVID-19:
1. Consumption of nutritious and
healthy foods and vitamins for
pregnant women.
2. Avoid leaving the house if not
needed. If you have to leave the
house, wear tightly closed clothes
and masks. Upon returning from
home, clean the body immediately
by bathing, and do not approach the
child before cleaning the body.
3. Avoid being in the crowd. Try to
keep your distance from each other
when in a crowd.
4. If the nursing mother has symptoms
of flu, fever, when giving ASI, it
should not be given directly, but
pumped in advance and given
through other equipment (spoon,
bottle pacifier, etc.).
5. Immediately consult a doctor if you
feel unwell and have flu-like
symptoms.
6. Consult your obstetrician about
other precautions that need to be
37
The Elderly Caring Nursing Center: Perception Of Nursing Profession Students
THE ELDERLY CARING NURSING CENTER: PERCEPTION OF

NURSING PROFESSION STUDENTS
Oni Ulima Sinurat
[email protected]
ABSTRACT
The Elderly Caring Nursing Center was an integrated and comprehensive care for the
elderly.The Objective to know perception of nursing profession students in providing nursing
service at Elderly Caring Nursing Center. Qualitative research with phenomenology approach.
Participants were nursing student who have been through the community profession stage and
have joined the Elderly Caring Nursing Center's activities. In-depth interview with 5 nursing
profession students. Data analysis using Colaizzi method.
Five themes of student perception in providing nursing service at Elderly Caring Nursing
Center were: 1) Elderly Caring Nursing Center was a place to improve health, and to provide
education for the elderly; 2) Activities in Elderly Caring Nursing Center useful for the elderly;
3) New atmosphere, variety of activities, and different facilities available at Elderly Caring
Nursing Center, 4) Students can learn to become health educator,
foot gym facilitator and conduct medical examination on elderly, 5) Students applied
therapeutic communication directly to the elderly. The presence of Elderly Caring Nursing
Center was felt to be very useful for students and can provide new ideas related to the elderly
program so the students feel enthusiastic and happy to join.
Keywords: Perception, elderly caring nursing center, nursing profession students
INTRODUCTION starting from the deterioration of body cells,

The growth of the elderly population so that the function and endurance of the
of Indonesia experienced the largest growth body decreases and risk factors for disease
in Asia, namely 414%, Thailand 337%, also increase. Frequent health problems
India 242% and China 220% (WHO, 2015). experienced by the elderly is malnutrition,
The number of elderly Indonesians balance disorders, sudden confusion, etc. In
according to BPS in 2010 was 14,587,381 addition, several diseases that often occur in
(6.19% of the total population of the elderly include hypertension, hearing
237,641,326). WHO predicts that in 2020 and vision disorders, dementia,
the number of elderly people in Indonesia osteoporosis, etc. (Shrivastava, SRB,
will be around 80,000,000 (WHO, 2017). Shrivastava, PS, Ramasamy, J., 2013). On
Significant increase in the number of the other hand, an increase in the number of
elderly each year also occurs in North elderly shows an increase in life
Sumatra Province with a population of expectancy. The increasing population of
around 13,937,797 people. In 2015 the the elderly reflects an increase in health
number of elderly people in North Sumatra services. A number of policies have been
was 945,361 people, where the number of carried out by the government to address
elderly men was 427,725 and elderly the problems faced by the elderly. Nurses
women were 517,636 (BPS North Sumatra, have the opportunity to provide health
2015). services and health promotion for the
This figure is a significant amount if elderly as an integral holistic nursing. This
efforts are not made to improve the welfare holistic assessment will help nurses identify
and health of the elderly since now, because realistic nursing interventions to improve
the elderly have some health problems the quality of health services of the elderly.
38
One way that can be done is to establish the leg exercises for the elderly, students
Elderly Caring Nursing Center as an conduct health checks on elderly, such as
integrated service center for nursing checking blood pressure, weighing,
services (Miceli, DG, Wilson, LD, Stanley, checking blood sugar levels, uric acid,
J., Watman, J., Shire, A., Sofaer, S., et al., cholesterol. Students give new ideas for
2014). activities with the elderly. Elderly services
at the Elderly Caring Nursing Center are
MATERIALS AND METHODS different from elderly services in the elderly
Discussion Posyandu. Elderly Caring Nursing Center is
The discussion of this study will show the a way of overcoming elderly health
results regarding students' perceptions about problems by integrating management of
the perceptions of nursing profession education, health services, nursing research,
students in providing nursing services at the and health information services so as to
Elderly Caring Nursing Center. For students create integrated and comprehensive care
who have joined the Elder Caring Nursing for the elderly (Barger, S.E., 2004). Elderly
Center, they feel that the activities carried Caring Nursing Center, as an effort to
out are important for the elderly and provide improve the performance of Puskesmas
benefits to improve quality of health and nurses in providing nursing services to the
quality of life of the elderly. Of the various elderly so as to create integrated and
activities carried out, all participants stated comprehensive care for the elderly. The
that foot gymnastic activities and health method of approach used in realizing
education were felt to provide considerable nursing services for the elderly, with the
benefits for the elderly. Foot exercises are main program of establishing the Elderly
quite easy and only require a short amount Caring Nursing Center. Furthermore,
of time, making the elderly interested to do collaborating with Puskesmas to identify
it regularly again at their respective homes. elderly problems, action plans /
While counseling given can increase the interventions, program socialization for
knowledge and understanding of the elderly service recipients, families and
related to the disease they suffer, so that the communities, service delivery, monitoring
elderly can control their behavior in and evaluation (Oros, M., Johantgen, M.,
implementing a healthy lifestyle. According Antol, S., et al. (2001) So the services
to Korostynski (2000), in her study entitled provided at the Elderly Caring Nursing
Adult Learning Center: A Unique Center are indeed only focused on the
Adventure for a School Nurse, after 10 elderly, while the service at the Puskesmas
months of activities at the Adult Learning is a health service facility that organizes
Center in Nashua, New Hampshire, carried public health efforts and first-level
out by involving nursing students. They also individual health efforts, with more
said that this activity was felt to provide emphasis on promoting and preventive
many benefits for the elderly and students efforts, to achieve the highest degree of
themselves. Involvement of nursing public health in the working area, with the
students includes health assessments and aim of realizing a community that has
providing appropriate nursing care for the healthy behavior that includes awareness,
elderly. They provide health services to willingness and ability to live healthy, able
elderly people who are at risk due to lack of to reach quality health services, live in a
health education, have bad health-related healthy environment, and have optimal
habits, or lack access to health care for the health degrees, both individuals , family,
elderly. Involvement of students in the group and community (RI Ministry of
activities of the Elderly Caring Nursing Health (2014). . The range of activities
Center, namely students doing health carried out at the Elderly Caring Nursing
education, students become facilitators for Center is also quite extensive, including
39
foot gymnastics, counseling, medical check- 2012). . Research instruments in the form of
ups, consultation and medical treatment by interview guidelines, and voice recording
a medical team from the Puskesmas. The devices. Data collected by in-depth
facilities used are also more leverage to interviews. Data saturation occurred in
support the various activities above, participants 5. The data were analyzed by
including checking uric acid, blood sugar the Colaizzi method by determining
and cholesterol, using the LCD, screen and keywords, coding, and themes from the
TOA when counseling, as well as some transcript script.
snacks and drinks for the elderly who
attended, the distribution of souvenirs and RESULT
leaflets was also given to be taken home by Demographic Data
the elderly. Benefits of the Elderly Caring The total number of participants in the
Nursing Center for students namely, study were 5 in which all participants were
students can learn to communicate good and women, aged 22-24 years and had
right directly to the elderly, students can completed the community profession stage.
provide nursing care to the elderly, adding Demographic data from the participants are
to the experience of students in practicing shown in Table 1. All participants were
their knowledge to the elderly. Nursing women and had graduated from nursing.
Center (NC) is an effort to improve nurses' 1. Research Participant Demographic Data
performance in overcoming public health Data Analysis Results
problems by integrating management of In this study found five main themes that
education, health services, nursing research, describe the perceptions of nursing
and health information services (Cleary, B. profession students in providing nursing
L., 2001). So that in this activity nurses and services in the elderly
nursing students involved in providing Caring Nursing Center, namely: 1) Elderly
nursing care for the elderly. Nursing care Caring Nursing Center is a place to improve
starts from nursing assessment to nursing health, and a means to provide education
intervention (Barger, S.E., 2004). for the elderly, 2) Elderly Caring Nursing
According to Korostynski (2000), activities Center activities are beneficial for the
held by the Adult Learning Center in elderly, 3) A new atmosphere, a variety of
Nashua, New Hampshire, make nursing activities, and different facilities are
students interested in being involved available in Elderly Caring Nursing Center,
continuously until they develop and this 4) Students can learn to become health
activity provides a challenge for them to educators, foot fitness facilitators and
provide support and health education for the conduct health checks on the elderly, 5)
elderly, so as to increase their experience. Students apply therapeutic communication
Likewise the nursing profession students to the elderly directly.
who were directly involved in the elderly Theme 1. Elderly Caring Nursing Center Is
Caring Nursing Center activity. They feel a place to improve health, and a means to
the benefits in the form of being able to provide education for the elderly
communicate good and right directly to the Elderly Caring Nursing Center is a place,
elderly, being able to apply the knowledge specifically for the elderly to improve the
gained to the elderly directly and being able health of the elderly, add insight into the
to provide new ideas for the various health of the elderly, a means to provide
activities that will be carried out in the health education for the elderly who have or
future. are at risk of experiencing health problems.
"Elderly nursing center is a special place for
Methods the elderly to be able to improve health and
This research is a qualitative research with a increase insight into elderly health" (P3).
phenomenological approach (Pollit & Beck,
40
"Elderly nursing center is a community Theme 4. Students can learn to become

facility that was formed to be a forum to health educators, foot fitness facilitators and
improve the health status of the elderly and health checks on the elderly.
as a means to provide health education to Involvement of students in the activities of
the elderly who are already or are at risk of the Elderly Caring Nursing Center, namely
experiencing problems" (P1). students doing health education, students
Theme 2. Elderly Caring Nursing Center become facilitators for leg exercises for the
activities benefit the elderly. elderly, students conduct health checks on
According to students, the activities held by elderly, such as checking blood pressure,
the Elderly Caring Nursing Center every weighing, checking blood sugar levels, uric
week are considered important and provide acid, cholesterol. Students give new ideas
great benefits for the elderly. Where elderly for joint activities of the elderly.
people present are provided with nursing "Yes, we students are very active and very
care services so as to improve the quality of enthusiastic to join because we can
health and the quality of life of the elderly. contribute in terms of providing practical
"Where in this activity the elderly can have knowledge in ecclesiastical care, such as
their health checked, there is a KGD check, counseling and leg exercises for the elderly
uric acid and cholesterol, foot exercises, and health checks" (P5). "In FKEP many
consulted about current health problems things and input can done and can certainly
faced so that the elderly can prevent be different every week, and also here
diseases that often occur in old age "(P2). students can play a role in giving ideas that
"There is, in the activities of the elderly can be used for elderly nursing caring
Caring Nursing Center not only treatment centers "(P3).
but preventive against diseases or Theme 5. Students apply therapeutic
complications of the disease carried out communication to the elderly directly.
here, such as foot gymnastics activities for The benefits of the Elderly Caring Nursing
the elderly to expedite blood circulation in Center for students namely, students can
the legs so as to reduce numbness and learn to communicate good and right
prevent complications especially in people teraupetik directly to the elderly, students
with DM" (P5 ). can provide nursing care to the elderly, add
Theme 3. New atmosphere, variety of to the experience of students in practicing
activities, and different facilities available their knowledge to the elderly. "And also
at the Elderly Caring Nursing Center the activities held at FKEP then this activity
Service differences according to students' can be used for students to learn how to
perceptions namely, health services at the deal with the elderly directly, communicate
Elderly Caring Nursing Center is a new directly so that later in the profession they
atmosphere for the elderly, health services are no longer nervous ”(P4).
at the Elderly Caring Nursing Center has a "Yes, nursing students can be as providers
variety of activities for the elderly, health of nursing care, where students can carry
services at the Elderly Caring Nursing out assessments to the implementation of
Center have various facilities such as LCD, the elderly according to health problems
TOA, leaflets, cakes "What else if held at faced" (P2).
the Faculty of Nursing can create a new
atmosphere for the elderly" (P3). "In FKEP, CONCLUSION
it can also use supporting facilities such as The presence of the Elder Caring Nursing
screens, projectors, speakers and a wide Center is felt to be very beneficial for
space, because sometimes when the students in applying science and as a place
Puskesmas is only done at home houses of for channeling ideas related to the elderly
citizens with limited facilities "(P1). program so as to make students feel
enthusiastic and happy to join.
41
REFERENCE Journal of Preventive Medicine. 4

1. Barger, S. E. (2004). Academic (10), 1224-1225.
Nursing Centers: The Road From 10. WHO. (2015). Number of people
the Past, The Bridge to the Future. over 60 years set to double by 2050,
Journal of Nursing Education, 43 Major Societal Changes Required.
(2), 60-65. Diakses Tanggal 13 September,
2. BPS Provinsi Sumatera Utara. 2017, dari http://www.who.int/.
(2015). Jumlah Penduduk Menurut 11. WHO. (2017). Older People and
Kelompok Umur dan Jenis Kelamin Primary Health Care (PHC).
(Jiwa) 2015.Diakses Tanggal 7 Diakses Tanggal 13 Setember, 2017,
September, 2017, dari dari http://www.who.int/.
https://sumut.bps.go.id/.
3. Cleary, B. L. (2001). The North
Carolina Center for Nursing: A
Pioneering StateNurse Workforce
Policy Initiative. Policy, Politics, &
Nursing Practice, 2(3), 210-215.
4. Oros, M., Johantgen, M., Antol, S.,
et al. (2001). Community-Based
Nursing Centers: Challenges and
Opportunities in Implementation
and Sustainability. Policy, Politic &
Nursing Practice, 4(2), 277-287.
5. Kemenkes RI,. (2014). Peraturan
Menteri Kesehatan Republik
Indonesia Nomor 75 Tahun 2014
Tentang Pusat Kesehatan
Masyarakat. Jakarta: Kemenkes RI
6. Korostynski, M. A. (2000). Adult
Learning Center: A Unique
Adventure for a School Nurse.
Journal of School Nursing, 16 (2),
50-51.
7. Miceli, D. G., Wilson, L. D.,
Stanley, J., Watman , J., Shire, A.,
Sofaer, S., et al. (2014). Improving
the Quality of Geriatric Nursing
Care: Enduring Outcomes From the
Geriatric Nursing Education
Consortium. Journal of Professional
Nursing, 30 (6), 447-455.
8. Polit, D. F., & Beck, C. T., (2012).
Nursing Research: Generating and
Assessing Evidence for Nursing
Practice. Philadelphia: Lippincot
Williams & Wilkins.
9. Shrivastava, S. R. B., Shrivastava,
P. S., Ramasamy, J. (2013). Health-
care of Elderly: Determinants,
Needs and Services. International
42
The Relationship Of Maternal Knowledge Of The Complete Basic Immunization In Infants At The Public Health Center
Of Kutambaru Southeast Aceh In 2019
THE RELATIONSHIP OF MATERNAL KNOWLEDGE OF THE

COMPLETE BASIC IMMUNIZATION IN INFANTS AT THE PUBLIC
HEALTH CENTER OF KUTAMBARU SOUTHEAST ACEH IN 2019
Putri Yani br Siahaan1, Sabarita br. Selian2

[email protected]
ABSTRACT
Basic Immunization is an immunization that must be given to infants and children
from birth so that the body is protected from harmful diseases. Immunization Program in
Indonesia requires a complete basic Immunization for each infant (age 0 – 11 months)
consisting of 1 dose of Hepatitis B, 1 dose of BCG, 3-dose DPT-Hib, 4 doses of polio, and 1
dose of measles.This Research aims to know the relationship of maternal knowledge about the
with the complete basic immunization in infants at the care center of Kutambaru Southeast
ACEH in 2019.Cross Sectional Analytic Survey Research method is a study to learn the
dynamics of correlation between factors and effects, through the observation/data collection at
one time, that each subject is only observed one time and the measurement of the subject
variable is done at the time of the study.The results of the statistical analysis using the Chi
Square Test stated that there is a mother of knowledge about immunization with basic the
treatment in the baby at the health center of Kutambaru southeast ACEH year 2019 with p-
value 0.015 (P-value < 0.05The conclusion of this study is that there is a relationship of
maternal knowledge about basic immunization in infants at the care center of Kutambaru
Southeast Aceh in 2019 years, so it is advised to health workers who are concerned to do health
counseling to mothers to improve the access to basic immunization.
Keywords: Knowledge, basic immunization
INTRODUCTION Renstra's target, in the tahun2017 complete

Immunisation comes from the word basic immunization in Indonesia amounted
immune, immune or resistant. Children are to 91.12, this figure is slightly below the
immunized, which means being given target of Renstratahun 2017 by 92%.
immunity to a particular disease. The child According to the province, there are 15
is immune or resistant to a disease but not provinces that reached targetRenstra in
necessarily immune to other diseases. 2017 (Health profile of Indonesia RI, 2017).
Immunization is an attempt to raise/increase Immunization Program 2012 –
the person's immunity actively against a 2016, the achievement of antigen
disease, so that when a time is exposed with administration was decreased, but in 2014,
the disease will not be sick or only suffer BCG immunization coverage, Polio 4
mild illness (Hadianti, 2015).The global danCampak had increased but not for
child immunization prevalence in 2012 IS DPT3/HB3. In the year 2015, the measles
DPT 83%, Polio of 84%, measles of 84%, cakupanimunization suffered considerable
Hepatitis B of 79%, AND BCG amounting decline of 95.69% (2014) menjadi89, 4%
to > 80%. The global immunization (2015); Similarly, the DPT3/HB3 coverage
percentage continues to increase from declined from 89.5% (2015) menjadi88,
previous years (WHO, 2014). 5%(2015). In 2016 the number of
The complete basic immunization immunization coverage increased to BCG,
coverage in Indonesia in the last five years DPT1/HB1, DPT3/HB3, and measles
has always been above 85%, but has not yet except for Polio 4 there was a decline of
reached the specified ministry of Health 97.77% (2015) to 90.30% (2016). Because
43
of the reduction of Polio 4 immunization MATERIALS AND METHODS

coverage, it causes the average drop out rate Design Research
to increase and reach sekitar7%. This This study uses desain's descriptive
condition is very far above the number of research of collationwith a cross sectional
tolerance which is 3.55% (Dinkes approach which is a research relationship
sumut,2016). between the DUA variable in a situation or
Immunization administration is a a group of subjects conducted to see the
preventive measure so that the body is not relationship between the variable satu with
infected with certain infectious diseases the other variables, which aims to know the
such as tetanus, whooping cough (pertussis), Mother's knowledge relation to 2019 the
measles, polio and tuberculosis or if complete basic Population and samples
exposed does not give a fatal effect to the The population is an area of
body, while infants who do not get generalization that has a specific quantity
immunization will be susceptible to diseases and characteristic set by the researcher to be
such as lung tuberculosis, diphtheria, studied and then pulled in its conclusion.
pertussis, tetanus and also measles. That is the definition of the population in
From the health office data in a research (Siyoto, 2015). The population in
baby in the province of South Sumatera, this study is a mother who has children or
Lampung, Jambi and West Nusa Tenggara infants aged 0-1 years in the month,
have obtained complete basic immunization. amounting to 40 respondents.
While the lowest achievement province is Samples are part of the number and
North Kalimantan (66.2%), Papua (68.6%), characteristics owned by the population, or
and Aceh (70.0%). Data and information small portions of population members taken
related to basic immunizations in infants according to certain procedures so that they
detailed according to the provinces in 2017 can represent their population. The
(Dinkes RI, 2017) sampling techniques used in this study were
From the introductory survey total sampling. The total sampling
conducted by researchers obtained results technique is sampling techniques when all
from 10 mothers who have babies, 8 babies population members are used as
do not get complete basic immunization, samples,samples from the study used a
still a lack of knowledge of the importance saturated sample of all populations as
of basic immunization complete in the samples amounting to 40 samples.
baby. Based on the problem above Data Collection Techniques
researchers are interested to raise the title of The data collection techniques are
"Mother's knowledge about basic conducted by the researchers directly using
immunisation in the infant in the care center the primary data, the interview techniques
of Kutambaru southeast ACEH year 2019" with respondents and the use of the
General purpose of this research to questionnaire with the questions that have
know the relationship of maternal been compiled by researchers. The
knowledge about immunization with the Association of Questionnaire is open based
provision of basic immunization in infants on the concept of Mother knowledge theory
at the care center Kutambaru southeast on basic immunisation in infants. Before the
ACEH year 2019. Rsponden record first to seek approval from
the leadership of the Puskesmas by
submitting a letter from the institution.
44
RESULT
Table 4.1
Frequency distribution of respondents characteristics by age in health care center
Kutambaru ACEH Tenggara Year 2019
Age Amount %
< 20 years 8 20
20-35 year 19 47.5%
> 35 years 13 32.5%
Amount 40 100%
Based on the table 4.1 above, it is revealed that from a total of 40 respondents studied,
the result of the majority of the respondents was 25-35 years, which 19 respondents (47.5%)
and minority respondents < 20 years of age: 8 respondents (20%).
Table 4.2
Frequency distribution of respondents characteristics based on the health center of
Kutambaru ACEH Tenggara year 2019
Job Amount %
Work 16 40,%
Not working 24 60%
Amount 40 100%
the majority of respondents did not work for 24 respondents (60%).
Table 4.3
Frequency distribution of respondents characteristics based on the Educative Health
center of Kutambaru ACEH Tenggara year 2019
Education Amount %
Sd 13 32.5%
Junior 23 57.5%
Sma 3 7.5%
Pt 1 2.5%
Amount 40 100%
the result of the majority of respondents with junior secondary education is 23 respondents
(57.5%), and the minority of respondents PT is 1 respondent (2.5%).
4.2.2 Univariat Analysis

Table 4.4
Frequency distribution based on the completeness of Immunization Medical Health
Center Kutambaru ACEH Tenggara Year 2019
Immunization completeness Amount %
Complete 17 42.5%
Incomplete 23 57.5%
Amount 40 100%
45
the majority of respondents did not get a complete basic immunization of 23 respondents
(57.5%).
Table 4.5
Frequency distribution of respondents based on knowledge of the health care center of
Kutambaru Aceh Tenggara year 2019
Knowledge Amount %
Good 14 35%
Enough 2 5
Less 22 60%
Amount 40 100%
Based on the table 4.5 above, it is known that from a total of 40 respondents were
studied, the result of the majority of the knowledgeable respondents was 22 respondents (60%),
and the minority received results of enough knowledgeable respondents 2 respondents (5%).
4.2.3 Bivariate Analysis

Table 4.7
Knowledge relationship with the completeness of immunization of the Health Care Center
Kutambaru ACEH Tenggara Year 2019
Immunization completeness Total
P-Value
Knowledge Complete Not
N % N % N %
Good 10 25 4 10 14 35
Enough 2 2.5 2 2.5 4 5 0.015
Less 5 12.5 17 42.5 22 60
Total 32 40 13 60 40 100
The results of the statistical Knowledge is an understanding of

analysis using the Chi Square test stated some information and an objective
that there is a mother of knowledge about introduction to objects or things.
immunization with basic immunisation Knowledge can also be gained through the
treatment in the baby at the health center of experience of a person and through the
Kutambaru ACEH Tenggara year 2019 with results of learning a person formally or
p-value 0.015 (P-value < 0.05). informally knowledge can be influenced by
fear so as to know more about it. The
4.3.2 Bivariate Analysis deeper the knowledge gained, the more
A. Contact mother about immunization wise the mother will be in perception of
with the introduction of basic things and making decisions. The behavior
immunization in infants that is founded by knowledge will be
The results of the statistical analysis using prolonged or persistent compared to the
the Chi Square test stated that there is a behavior that is based on compulsion
mother of knowledge about immunization (Toruntju, 2013).
with basic immunisation treatment in the According to the theory of
baby at the health center of Kutambaru Achmadi 2016Explains that knowledge
ACEH Tenggara year 2019 with p-value about immunization is very important for
0.015 (P-value < 0.05). mothers, especially for mothers who have
46
just given birth to their babies. immunization of 23 respondents

Immunization-giving vaccines in infants so (57.5%).
that infant immunization can be increased 3. Distribution of the knowledge of
and immune to disease. Because when they mothers about the complete and
are born, immunization in the body of comprehensive majority of the less
babies is still very weak and very easy to knowledgeable of 22 respondents (60%).
attack various diseases that are not even a 4. There is a relationship of maternal
little that leads to infant death. Maternal knowledge about immunization with the
education is one of the factors affecting introduction of basic immunization in
basic immunization completeness. The infants at the care center of Kutambaru
higher the education of a mother, then the Southeast Aceh in 2019.
knowledge of mothers about immunization
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Based on statistical tests concluded that: of Muhammadiyah Jakarta.
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12. Ranuh, I. G. (2011). Immunization
guidelines in Indonesia:
Immunization task Force,
Indonesian pediatrician bonding.
Siyoto, et al. 2015. Research
methodology. Media Publishing
Literacy. Karanganyar-clothe
004/027 Sendangtirto Berbah
Sleman Yk.
13. Setiyani A, Sukesi, Esyuananik.
2016. Childcare neonatal infants,
toddlers, and Pre school
children.Jakarta: HR Center health.
14. Toruntju Sa. 2013. Socio-economic
factors related to mothers in the
Gaky endemic region. Thesis.
Yogyakarta: UGM
15. Warrohmah, Berliana, S. M.,
Nursalam, N., Efendi, F., Haryanto,
J., has, E. M. M., Wahyuni, S. D.
(2018). Analysis of the survival of
children under five in Indonesia and
associated factors. Paper presented
at the IOP Conference series: Earth
and Environmental science. Wawan,
et al. 2018. Human knowledge,
attitudes and behaviors.
Yogyakarta: Nuha Medika
48
Factors That Affect Anemia Occurring In Pregnant Women With Compliance With The Tablets Of The Fe In The Clinic
Rimenda Br. Tarigan Medan Denai District In 2019
FACTORS THAT AFFECT ANEMIA OCCURRING IN PREGNANT

WOMEN WITH COMPLIANCE WITH THE TABLETS OF THE FE IN
THE CLINIC RIMENDA BR. TARIGAN MEDAN DENAI DISTRICT
IN 2019
Selfi Indah Saputri1, Sari Mentari2
[email protected]
STIKesMitraHusada Medan
ABSTRACT
Anemia is a problem that still occurs in women, especially in expectant mothers. The
prevalence of anemia in pregnant women around the world is 41.8%. Incidence of anemia
around the world, 50% iron reserves less. While the effect of anemia on pregnancy is
miscarriage, partus premature which causes shock bleeding,
Afibrinonogemiadanhypofibrinogenemia, intrapartum infections, and in the case of Gravis
anemia (Hb less 4 gr%) A terrible heart happens not only complicate pregnancy and childbirth,
can even be fatal (Marmi,2011).
The research design is an analytical survey with a cross sectional approach which is a research
between two variables in a situation or a group of subjects to see the relationship between the
variables and samples of 34 pregnant women. In the clinic Rimenda Br. Taringan District
Medan Denai conducted in February 2019.
The results of this study are known to respondents have sufficient levels of knowledge but are
disobedient in the implementation; To consume Fe tablets in the clinicRimenda Br. Taringan as
much as 4 (36,4%) While a small portion of mothers with less knowledge but not obedient to
consume Fe tablets a number of 15 people (88.2%). Statistic test result obtained Pvalue = 0,000
or value p > A or 0.05 thus, Ho rejected and Ha received. This suggests that there is a
knowledge relationship with compliance implementation in consuming Fe tablets.
Keywords: Anemia, Tablet Fe, Haemoglobin
INTRODUCTION prevalence of pregnant women anemia in

Anemia is the health problem Indonesia amounted to 70% or 8-10
of the world community that can increase pregnant woman suffering from anemia.
morbidity and mortality rates. The Iron defesiensi anemia found 40% pregnant
prevalence rate of anemia is still high, women. Anemia found 40% pregnant
evidenced by the World Health women. It was noted that from 11,441
Organization (WHO) 2012 data, the global pregnant women there were 1,074 who had
prevalence of anemia in pregnant women anemia during pregnancy. One component
around the world is 41.8%. Population of of pregnant women's health services is the
anemia in pregnant mothers is estimated at delivery of iron as many as. k 90 tablet (Fe).
48.2%, Africa 57.1%, US 24.1%, and Iron is a mineral that the body needs to form
Europe 25.1%. In developing countries blood cells (haemoglobin). Iron has a vital
there are about 40% of maternal deaths role in fetal growth. During pregnancy, the
related to anemia in pregnancy. Most intake of iron should be coupled with the
Anemia in pregnancy is caused by iron increase in the gestation, to be able to keep
defesiensi and acute bleeding, even the the maternal blindness increased, so that, to
distance of both interacted (World Health be able to fulfill the needs of mothers and
Organization, 2012). supplying food and oxygen to the fetus
Based on data from the provincial through the placenta, it is needed more iron
health office of North Sumatera (2010), the intake (Kemenkes RI,2015).
49
The coverage of pregnant women knowledge questionnaire sheet that affects

who got 90 iron tablets in North Sumatra the anemia occurring in pregnant women
showed a decrease of 84.3% in 2014, to with the compliance of consuming Fe
74.42% in 2015 this figure is still far from tablets. Data obtained is the primary data,
the specified target of 80% (Kemenkes, then data in the univariate analysis and
2015). sufficient with the program Statistical
The coverage of pregnant women Product and Service Solution (SPSS) 20 for
who got 90 iron tablets in North Sumatra Windows and analyzed by the statistical
showed a decrease of 84.3% in 2014, to calculation technique of Chi Square.
74.42% in 2015 this figure is still far from The following are the results of
the specified target of 80% research on the display in the form of
(Kemenkes,2015). tables with several characteristics:
MATERIAL AND METHODS 4.1 Univariat Analysis

The research method is an analytical Univariate analysis is a method to
survey with a cross sectional approach see the results of the research of each
which is the translation of a relationship variable used that sees the frequency
between two variables in a situation or a Distributi as well as a single percentage
group of subjects conducted to see the related to the research.
relationship between the other variables. Variables in this study are the
The goal is to know the factors that affect frequency of knowledge, education
the anaemia in the clinic Rimenda Br compliance, age and work against that
Taringan District Medan Denai Kota affects Terajadi anemia in pregnant women
Medan. with compliance of the Fe tablets in the
The population in this study is all clinic Rimenda Br. Taringan Medan Denai
expectant mothers about anemia at district year 2019.
Rimenda Br. Tringan District of Medan
Denai year 2019 from February – June 34 4.1.1 Univariat Analysis
people. This research using the total Table 4.1 frequency distribution
sampling technique is the sampling is done Respnden based on knowledge
by taking all the respondents of pregnant No Knowledge F%
mothers who have anemia. Sample in the Affects anemia
study of the total sampling amounting to 34 In pregnant women
people. 1. Good 6 20.6
2. Simply 11 29.4
RESULTS 3. Less 17 50.0
Based on research conducted in the Total 34 100.0
clinic working area Rimenda Br. Taringan Source: Primary Data in August 2019
obtained data that affects anemia occurs in
pregnant women with compliance of According to table 4.1 you can
consuming Fe tablets as much as 34 know the most respondents have a level of
pregnant women. In this research the author knowledge affecting mother anemia in
used the sampling technique using a total pregnant women who are 17 (50.0%) And
sampling i.e. the overall number of the at least have a good level of knowledge 6
population as much as 34 pregnant women. people (20.6%)
The data retrieval technique in this study is
that respondents were given questionnaire
sheets and filled in the data form first. Then
the respondent fills a knowledge
questionnaire question sheet and a
50
Table 4.2 frequency distribution based on According to Table 4.1, the most
age and education, work and respondents can know the level of
mother disobedience to consume a tablet as much
No Age F% as 19 people (55.9) and at least a degree of
obedience consumed 15 Fe tablets (44,1%).
1. < 20 years 18 52.9
2.20-35 years 10 29.4 4.1.2 Bivariate Analysis
3. > 35 years 6 17.6 4.4 Table of knowledge frequency
Total 34 100.0 distribution of mothers with
No Education F% compliance of consuming tablets
Fe
1. 7 20.6 No Compliance Amount Q
knowled Obedient Disobedient Value
ELEMENTARY ge N % N % N %
SCHOOL 1. Good 6 100.0 0 00.0 6 100
2. JUNIOR 11 32.4 2. simply 7 63.6 4 36.4 11 100 0.000
HIGH SCHOOL 3. less 2 11.8 15 88.2 17 100
3. SMA 6 17.6
4. PT 10 29.4
34 100.0 Total 15 44.1 19 44.1 34 100
Total
No Jobs F% Source: Primary Data processed August 2019
1. work 22 64.7 According to table 4.3 shows that

2. does not work 12 35.3 from 34 mothers mostly have sufficient
Total 34 100.0 levels of knowledge but are disobedient in
Source: Primary Data processed August the implementation; To consume Fe tablets
2019 in the clinic Rimenda Br. Taringan as much
as 4 (36,4%) While a small portion of
According to table 4.2 It can be mothers with less knowledge but not
explained that from 34 mothers of the most obedient to consume Fe tablets a number of
aged are known to many respondents with 15 people (88.2%). The test result statistic
age < 20 years 18 people (52.9%) and at obtained with p Pvalue= 0.000 or the value
least > 35 years 6 people (17.6%). Based on p <a or 0.05 thus, then Ho rejected and Ha
junior high school education at most 11 received. This indicates that there is a
people (32.4%) and high school education knowledge relationship with the adherence
at least 6 people (17.6%). It is based on the to the consumption of Fe tablets.
success, known that many respondents
worked there 22 people (64.7%) and did not Table 4.5 frequency distribution of
work less than 12 people (35.3%) mothers age with compliance
consuming Tablet Fe
Table 4.3 frequency distribution No Age Compliance Amount Q
Obedient Disobedient Value
compliance consuming Tablet N % N % N %
Fe 1. < 20 6 33.3 12 66.7 18 100
No compliance consumes F% years 0.004
2. 20- 9 81.8 2 18.2 11 100
Fe tablet 35
1. Obey 15 44.1 3. > 35 0 0.0 5 100.0 5 100
years
2. disobedient 19 55.9
Total 24 100.0 15 44.1 19 55.9 34 100
Total
Source: Primary Data in August 2019 Source: Primary Data processed August 2019
51
From the table 4.5 Most Source: Primary Data processed August 2019
respondents were caught with the age of <
20 years but did not obey to consume Fe From the table 4.7 Most respondents
tablets of 12 people (66.7%) And the age were known by not working but did not
of 20-35 years disobedient consume a Fe obey the Fe tablets consume 16 people
tablet that is 2 people (18.2). Statistical test (72.7%) and work less obediently consume
results obtained p = 0,004 or value p >a or a Fe tablet that is 3 people (25.0). The test
0.05. Thus, the Ha is accepted and H0 is results statistic at the Get value p = 0,020
rejected. This suggests there is that the or the value p >a or 0.05. Thus, the Ha was
relationship age with compliance accepted and Ho was rejected. This
consuming the Fe tablets. suggests that Hubunga work with
compliance consumes Fe tablets.
4.6 Table of education frequency
distribution of mothers with CONCLUSION
compliance consuming Tablet Fe Based on the results of the study of the
No Compliance Amount Q factors that affect the pregnant women with
Educati Obedient Disobedient Value
on
compliance with the consumption of Fe
N % N % N %
1. SD 0 0.0 7 100.0 7 100 tablets in the clinic Rimenda Br Taringan
2. SMP 3 27.3 8 72.7 11 100 District Medan Denai Early 2019 then can
3. SMA 4 66.7 4 33.3 10 100 0.004
be concluded as follows:
1. of 34 respondents who have a level of
knowledge that affects mother
4. PT 8 80.0 2 20.0 34 100
Total 19 55.9 15 44.1 34 100
anemia in pregnant women who are
.0 17 people (50.0%) And at least have
Source: Primary Data processed August 2019 a good level of knowledge 6 people
(20.6%)
From table 4.5 Most respondents 2. of the 34 respondents most of the
were known by junior high school degree of disobedience consuming
education but did not obey to consume Fe the tablet Fe 19 people (55.9) and at
tablets of 8 people (72.7%) and elementary least a degree of obedience
school education is not obedient consume consumed as many as 15 Fe tablets
Fe tablets that is 4 people (33.3%). Ststistic (44,1%).
test results obtained the value p = 0,004 or 3. from 34 respondents Most of the age
a value of p >a or 0.05. Thus, the Ha was are known to many respondents with
accepted and Ho was rejected. This an age of < 20 years 18 people
indicates there is a founding relationship (52.9%) And at least the age of > 35
with the compliance of consuming Fe years 6 people (17.6%).
tablets. 4. from 34 respondents SMP education
Level 11 people (32.4%) and high
Table 4.7 Frequency distribution of school education at least 6 people
mothers working with (17.6%).
compliance to consume tablets 5. from 34 respondents , it is revealed
Fe that many respondents worked there
No Knowledge of pregnant Amount Q 22 people (64.7%) and did not work
Jobs women Value
Obedient Disobedient
less than 12 people (35.3%)
N % N % N %
1. work 9 75.0 3 25,0 12 100 REFERENCES
2. does 6 27,3 16 72,7 22 100 0.020
not
1. Anon, I, (2011).Pregnant with mild
work Anemia.(Online).
15 44,1 19 55,9 34 100 Available:http://maphiablack.blogsp
Total
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ot.com/2011/01/askeb-ibu-hamil-
dengananemiaringan. html.
Retrieved 23 February 2018.
2. Ambarwati, (2011).Obstetrics
practices. Expert in Devi Yulianti.
Jakarta: EG
3. Anwar, M, Baziad, A, &Prabowo,
RP, (2011),Gynecology. Jakarta
:BinaPustakaSarwonoPrawirohardjo.
4. Arikunto, 2012.Health Research
methods. Yogyakarta: Fitramaya
5. Astuti, (2012).Obstetrics during
pregnancy. Jakarta: SalembaMedika.
6. Desi, DKK (2016). Factors related
to iron deficiency in
pregnantwomen. (Accessed August
15, 2019) Retrieved
https://jurnal.jikm.unsri.ac.ad
7. Dinkes PROVSU, (2012). Health
profile of North Sumatra
province.Medan Indonesia.
8. Dinkes North Sumatera.2015.
Health profile of North Sumatera
province.
9. Fadlun. 2012. Upbringing of
pathological obstetrics. Jakarta:
SalembaMedika.
10. Hani.Dkk. (2011).Obstetrician
Orphanage in physiological
pregnancy Jakarta: Salemba Medika.
53
Case Study Of Gerontic Nursing Care In Family Ny M With Hipertens In The Kwala Bekala Village Medan Johor Sub-District,
Medan City

HIPERTENS IN THE KWALA BEKALA VILLAGE MEDAN JOHOR
SUB-DISTRICT, MEDAN CITY
Siti Nur Fadila

[email protected]
ABSTRACT
Aim/Objective: health development is an effort to fulfill one of the basic rights of the
community, namely the right to obtain health services in accordance with the 1945 Constitution
Article 29 H paragraph 1 and Law Number 23 of 1992 concerning health. This study aims to
determine the general picture of a Case Study of Mrs. M. with hypertension in the kwala Bekala
village,Medan Johor sub-district Medan city The research method used is the case study method
is a study that explores a nursing problem in detail, has in-depth data collection and includes
various sources of information. The results of the study after an assessment of Mrs. M. found
that the lack of knowledge of hypertension and lack of information about one of the diseases
that always occur in the elderly. After the Family Gerontik Nursing Care Actions were taken,
Ms. M. could understand the importance of how to overcome hypertension problems by using
herbal medicines or visiting community service centers that were available, Healt Education
became an important factor in the application of Gerontik Nursing Care for Ms. M.'s family.
Key words: Family Nursing, Gerontik, Hypertension
INTRODUCTION patients with hypertension and secondary

Health development is an effort to hypertension (Yolanda 2017).
fulfill one of the basic rights of the Sugiharto (2007) in Masriadi (2016),
community, namely the right to obtain argues that secondary hypertension is
health services in accordance with the 1945 hypertension whose causes can be
Constitution Article 29 H paragraph 1 and identified, often associated with several
Law Number 23 of 1992 concerning health. diseases such as kidney, coronary heart
Health development must be viewed as an disease and diabetes, central nervous system
investment to improve the quality of human disorders.
resources which, among others, are a major Meanwhile, according to Brunner &
component for education and the economy Suddart, (2015), the causes of primary
and health which also has a role in poverty hypertension are emotional disturbances,
reduction (Santosa, 2011 in Nurhikmah obesity, excessive alcohol consumption,
2016). coffee, drugs, heredity. Generally new
Hypertension is a condition where symptoms are seen after complications
systemic pressure is above 140 mmHg and occur. Complications that occur when high
diastolic pressure is above 90 mmHg blood pressure is not treated and treated,
(Brunner & Suddarth (2005) in Wijaya & then in the long run will cause damage to
Putri (2013). the arteries in the body until the organs that
Hypertension is also one degenerative get blood supply from these arteries.
diseases that occur a lot and have a fairly Complications of hypertension can occur in
high mortality rate and affect one's quality heart, brain, kidney and eye organs, which
of life and productivity. Hypertension can can lead to heart failure, risk of stroke,
be classified as primary hypertension or kidney damage and blindness (Yolanda,
essential hypertension which is 95% of all 2017).
54
Medan City
High blood pressure or hypertension MATERIALS AND METHODS

kills 9.4 million people worldwide every Hypertension can be defined as
year. World Health Organization (WHO) persistent blood pressure where the systolic
Figures estimate, the number of people with pressure is above 140 mmHg and diastolic
hypertension will continue to increase along pressure above 90 mmHg. Hypertension is a
with an increasing population. In the next major cause of heart failure, JDJDO
2025, it is projected that around 29% of the JLQMDO 'LVHEXW VHEDJDL
world population will be affected by ³SHPEXQXK GLDP-GLDP³ because
hypertension. The highest percentage of people with hypertension often do not show
hypertension sufferers is currently found in symptoms (Brunner & Suddart, 2015).
developing countries. Global Status Report Meanwhile according to Sheps (2005)
on Noncommunicable Disesases 2010 data in Masriadi (2016), hypertension is a
from WHO said that 40% of developing disease with signs of systolic and diastolic
economies have hypertension, while blood pressure disorders that rise above
developed countries only 35%. Africa holds pressure.n normal blood. Systolic blood
the top position of hypertension sufferers as pressure is the peak pressure that is reached
much as 46%. While the American region when the heart contracts and pumps blood
occupies a distended position with 35%. For out through the arteries. Diastolic blood
the Asian region, this disease has killed 1.5 pressure is taken when the heart drops to the
million people each year. lowest pressure when the heart relaxes and
fills the blood again (Yolanda, 2017).
Theory Study on gerontik nursing care Hypertension is a condition where a person
The assessment process is characterized by experiences an increase in blood above
continuous information gathering and normal as indicated by the systolic number
professional decisions that contain meaning (upper part) and diastolic number (lower
to the information collected. Family data part) in blood pressure examination using a
collection comes from a variety of sources: blood pressure measuring device in the form
interviews, observations of family homes of mercury cuff (Sphygomanometer) or
and facilities, experiences reported by other digital devices (Irwan, 2016).
family members.
Research methods
Understanding gerontik or elderly Case study research is a study that explores
Gerontik is the study of aging processes that a nursing problem with detailed, has deep
occur in humans at the age of 60 years data retrieval and includes various sources
(Sofia, 2014). Diana is someone who has of information. Case study research is
reached the age of 60 years and over. Aging limited by time and place, and cases studied
is not a disease, but it is a process that are events, activities or individuals.
gradually results in cumulative changes, it is The method in preparing this case study is
a process of decreasing endurance in descriptive which is a form of case study in
dealing with stimulation from within and implementing nursing care in a case using
outside the body. Many among the elderly the nursing process approach and describes
are still productive and able to play an nursing care actions given to families with
active role in social, national and state life. elderly hypertension starting from
Efforts to improve social welfare of the assessment, nursing diagnosis, intervention,
elderly are essentially the preservation of implementation and evaluation (Nursalam,
national religious and cultural values (Siti 2015).
Nur Khalifah, 2016).
RESULT
Ny.M said that she often consumed
excessive salt, consumed salted fish and
55
Medan City
never followed hypertension gymnastics these arteries. Complications of

and exercising, and stated that the causes of hypertension can occur in heart, brain,
hypertension were in accordance with kidney and eye organs, which can lead to
(Brunner & Suddart, 2015) namely heart failure, risk of stroke, kidney damage
emotional disturbances, obesity, excessive and blindness. (Brunner & Suddart, 2015).
alcohol consumption, coffee , medication,
heredity, renal artery narrowing, renal Nursing Interventions
parenchymal disease, various drugs, organ Family nursing interventions are made
dysfunction, tumors and pregnancy. based on assessment, nursing diagnosis,
Another case according to (Black & Hawks, family statements, and family planning, by
2014) risk factors for hypertension that formulating goals, identifying alternative
cannot be changed are family history, age, intervention strategies and sources, and
gender and ethnicity. While the risk factors determining priorities, interventions are not
that cannot be changed are diabetes routine, random, or standard, but it is
mellitus, stress, obesity, nutrition designed for certain families with whom the
(consuming excessive salt) and drug abuse. family nurse is working (Friedman, 2010).
Next treat family members by
Diagnosis demonstrating relaxation techniques (deep
The first diagnosis is that there is a gap breathing). Furthermore, counseling and
between the theories which the theory states motivating families to be able to modify a
Nonpharmacological countermeasures of comfortable environment and Utilize health
hypertension according to (Brunner & services to overcome the problem of
Suddart, 2015) namely by reducing weight, hypertension. Third diagnostic intervention
limiting alcohol, sodium and tobacco, High risk of complications occurring b / d
exercise and relaxation are mandatory family inability to care for sick families In
interventions that must be performed on accordance with the task of the first family
every anti-hypertension. (Ridnamirudin, care namely recognize the problem by
(2007) in Wijaya & Putri, (2013) also said reviewing family knowledge about the
that nonpharmacological countermeasures aftermath of hypertension, and discussing
consist of various ways of lifestyle the aftermath of hypertension. Next take a
modification to reduce hypertension. decision by discussing the actions that must
The second diagnosis is Acute Pain b / d be taken if there are problems in the family.
family's inability to care for a sick family Furthermore, caring for family members by
this data is supported by Ny.M says the demonstrating traditional medicine (grated
head feels pain, dizziness, pain in the neck cucumber juice). Furthermore, counseling
and feels heavy, pain scale 5-6, Ny.M says and motivating to be able to modify a
pain disappear arises . While the objective comfortable environment and Utilize health
data that supports are: TD: 160/90 mmHg, services to overcome the problem of
pulse 88 x / minute, Mrs. M. looks hypertension
grimaced.
The third diagnosis is in accordance Nursing implementation
with the theory that obesity, emotional The implementation of the first diagnosis is
disorders. Excessive alcohol consumption, in accordance with the theory according to
coffee drugs and heredity, reducing sodium Ridwanamiridin (2007) in Wijaya & Putri
intake, new symptoms appear after (2013) where in the management of non-
complications occur. Complications that pharmacology consists of various ways of
occur if high blood pressure is not treated lifestyle modification which is very
and overcome, then in the long run will important in preventing the increase in high
cause damage to the arteries in the body blood pressure, which is a diet containing
until the organs that get blood supply from climates and calcium, reducing sodium
56
Medan City
intake, reducing stress, avoiding smoking. CONCLUSION

Supported by Situmorang research (2015). After the authors do Nursing Care directly
Implementation of the second diagnosis of to Mrs. M with Hypertension In Kelurahan,
Acute Pain b / d family's inability to care for Barombong, Tamalate District, Makassar
families who are aware of Ny.M City, several conclusions can be drawn as
recognizing the problem is done by follows; after an assessment of Mrs. M. was
assessing family knowledge about pain and obtained that the lack of knowledge of
discussing the causes of pain felt, then hypertension and the lack of information
deciding the actions to be done, subsequent about one of the diseases that always occur
implementation further demonstrating in the elderly, after taking action to care for
relaxation techniques ( deep breaths). the family Gerontik Nursing Mrs. M. can
Followed by modifying a comfortable understand the importance of how to
environment and utilizing health services. overcome the problem of hypertension by
Implementation of the third diagnosis High using herbal medicines or visiting an
risk of complications arising from the available community service center, Healt
inability of the family in caring for a sick Education is an important factor in the
family. In Mrs. recognizing the problem is application of Gerontik Nursing Care for the
done by reviewing family knowledge about Family of Mrs.
the continued consequences of hypertension
and discussing the further consequences of REFRENCE
hypertension, then deciding the actions to 1. Ahmadi, 2008. Basic Concepts of
be taken, subsequent implementation Nursing. Jakarta: EGC
demonstration of traditional medicine for 2. Irwan, 2016. Epidemiology of non-
grated cucumber juice. Followed by communicable diseases. Yogyakarta:
modifying a comfortable environment and Budi Utama
utilizing health services. Implementation of 3. Nurhikmah, 2016. The Old
the third diagnosis is in accordance with the Relationship between Smoking and the
theory where the purpose of each treatment Degree of Hypertension in Rannaloe
program for each patient is prevent Village, Bungaya District, Gowa
occurrence morbidity and Accompaniment Regency
mortality by achieving and maintaining 4. Nursalam, 2015. Concept and
blood pressure below 140/90 mmHg. The Application of Nursing Science
effectiveness of each program is determined Research Methodology. Jakarta:
by the degree of hypertension, Salemba Medika
complications, cost of care and quality of 5. Ministry of Health Profile. South
life in relation to therapy (Brunner & Sulawesi Province health
Suddart, 2015). profileCitation on May 24, 2018. At
22.00
Nursing Evaluation 6. Sofia Rhosma, 2014. Textbooks on
Family nursing evaluation is a process Nursing Gerontik. Yogyakarta: Budi
to assess the success of the family in Utama
carrying out their health duties so as to have 7. Sunaryo, 2015. Gerontik Nursing Care.
high productivity in developing each family Yogyakarta: Andi
member. As the fifth component in the 8. Suprajitno, 2014. Family Nursing Care.
nursing process, evaluation is the stage that Jakarta: EGC
determines whether the goals set will 9. Vitahealth, 2014. Hypertension.
determine the ease or difficulty of carrying Jakarta: Gramedia Main Library
out the evaluation (Sugiharto, 2012). 10. Yolanda, 2017. Family Nursing Care
with Hypertension in the Early Stage
Elderly in the Andalang Public Health
Center in Padang
57
Application Of Salt Water Warm To Reduce Hypertension In Elderly
APPLICATION OF SALT WATER WARM TO REDUCE

HYPERTENSION IN ELDERLY
Sri Lestari
[email protected]
ABSTRACT
One of the non-pharmacological therapies for hypertensive patients is hydrotherapy.
Hydrotherapy can reduce blood pressure if done routinely. The types include warm baths,
compresses, and soaking feet with warm water. The general objective of this case study is to
find out the picture of salt warm water soak therapy in elderly with hypertension. The material
used in this case study is a spygmomanometer and the tools and materials used are warm water,
salt, and basin. This writing method is an experimental case study with quantitative results by
collecting data by means of observation to the elderly by conducting assessments and
measuring blood pressure before and after therapy. The results obtained were during the 3 days
of the implementation of the salt warm water foot soak therapy the author found a decrease in
blood pressure. At least a decrease of approximately 10-20 mmHg for systole and
approximately 5-10 mmHg for diastole. This is caused by the effect of warm water which can
make relaxation and vasodilation (dilation of blood vessels) which can make blood flow
smoothly, and the workload of the heart becomes lighter. The conclusion that salt warm water
foot bath therapy in the elderly with hypertension can be done either in the elderly who are in
the family or the elderly who are in the tresna werdha nursing home. This is caused by the
effect of warm water which can make relaxation and vasodilation (dilation of blood vessels)
which can make blood flow smoothly, and the workload of the heart becomes lighter. The
conclusion that salt warm water foot bath therapy in the elderly with hypertension can be done
either in the elderly who are in the family or the elderly who are in the tresna werdha nursing
home. This is caused by the effect of warm water which can make relaxation and vasodilation
(dilation of blood vessels) which can make blood flow smoothly, and the workload of the heart
becomes lighter. The conclusion that salt warm water foot bath therapy in the elderly with
hypertension can be done either in the elderly who are in the family or the elderly who are in
the tresna werdha nursing home.
Keywords: elderly, hypertension, salt warm water soak therapy
INTRODUCTION (WHO, 2013). Riskesdas (2018) shows that,

Hypertension is a cardiovascular disease hypertension cases in Indonesia have
which cannot be underestimated. Persistent increased, in 2013 hypertension cases in
increase in blood pressure (persistent) can Indonesia reached 25, 8% while in 2018
cause damage to the kidneys (kidney cases of hypertension increased to 34.1%.
failure), heart (coronary heart disease), and Cases of hypertension at the age of 18 in
brain (causing strokes) if not detected early Indonesia diagnosed by doctors reached
and receive adequate treatment. 8.4%, with the highest case of hypertension
Hypertension is suffered by one billion occurring in North Sulawesi (13.2%)
people in the world and it is estimated that followed by Yogyakarta and East
in 2025 it will surge to 1.5 billion people. Kalimantan. Hypertension cases in
Every year nearly 9.4 million people die of Yogyakarta in terms of ranking have
heart disease and stroke and these events are increased, in 2013 Yogyakarta ranks 15th
combined, these two diseases are the while in 2018 ranks 2nd (Riskesdas, 2013).
number one cause of death in the world Hypertension is more experienced by
58
women with a prevalence rate of 36.9% water. Salt solution with warm temperatures
compared to men at 31.3%, and can increase local blood flow, causing
hypertension cases are most common in vasodilation of blood vessels. Therefore, the
lanisa (Riskesdas, 2018) 2%) followed by authors are interested in doing a case study
Yogyakarta and East Kalimantan. to see how the description of Nursing Care
Hypertension cases in Yogyakarta in terms in the Elderly with Hypertension using Soak
of ranking have increased, in 2013 Foot Therapy Warm Salt Water where the
Yogyakarta ranks 15th while in 2018 ranks warm water makes the blood circulation
2nd (Riskesdas, 2013). Hypertension is smooth and strengthens the ligament
more experienced by women with a muscles that affect the joints of the body
prevalence rate of 36.9% compared to men (Lalage, 2015). Meanwhile salt solutions at
at 31.3%, and hypertension cases are most high concentrations can kill bacterial
common in lanisa (Riskesdas, 2018) 2%) growth by drawing water from the bacterial
followed by Yogyakarta and East cells and causing lysis. This is related to the
Kalimantan. Hypertension cases in high osmotic pressure of salt water. Salt
Yogyakarta in terms of ranking have solution with warm temperatures can
increased, in 2013 Yogyakarta ranks 15th increase local blood flow, causing
while in 2018 ranks 2nd (Riskesdas, 2013). vasodilation of blood vessels. Therefore, the
Hypertension is more experienced by authors are interested in doing a case study
women with a prevalence rate of 36.9% to see how the description of Nursing Care
compared to men at 31.3%, and in the Elderly with Hypertension using Soak
hypertension cases are most common in Foot Therapy Warm Salt Water where the
lanisa (Riskesdas, 2018).Broadly speaking warm water makes the blood circulation
the treatment of existing diseases is divided smooth and strengthens the ligament
into two namely medical / pharmacological muscles that affect the joints of the body
treatment (using drugs with chemicals) and (Lalage, 2015).
complementary or traditional / non- Meanwhile salt solutions at high
pharmacological treatment (using natural concentrations can kill bacterial growth by
ingredients). One of the non- drawing water from the bacterial cells and
pharmacological therapies for hypertensive causing lysis. This is related to the high
patients is hydrotherapy. Hydrotherapy can osmotic pressure of salt water. Salt solution
reduce blood pressure if done routinely. The with warm temperatures can increase local
types include warm baths, compresses, and blood flow, causing vasodilation of blood
soaking feet with warm water. The benefits vessels. Therefore, the authors are interested
of this warm soak therapy is the effect of in doing a case study to see how the
hot spots / warmth which can cause liquids, description of Nursing Care in the Elderly
solids and gases to expand in all directions with Hypertension using Soak Foot Therapy
and can increase chemical reactions. Warm Salt Water Meanwhile salt solutions
Hydrotherapy can reduce blood pressure if at high concentrations can kill bacterial
this therapy is done routinely. Scientifically, growth by drawing water from the bacterial
warm water has an impact and physiological cells and causing lysis. This is related to the
factors for the body especially on blood high osmotic pressure of salt water. Salt
vessels, where warm water makes the blood solution with warm temperatures can
circulation smooth and strengthens the increase local blood flow, causing
ligament muscles that affect the joints of the vasodilation of blood vessels. Therefore, the
body (Lalage, 2015). Meanwhile salt authors are interested in doing a case study
solutions at high concentrations can kill to see how the description of Nursing Care
bacterial growth by drawing water from the in the Elderly with Hypertension using Soak
bacterial cells and causing lysis. This is Foot Therapy Warm Salt Water Meanwhile
related to the high osmotic pressure of salt salt solutions at high concentrations can kill
59
bacterial growth by drawing water from the cardiac output is related to changes in
bacterial cells and causing lysis. This is afterload.
related to the high osmotic pressure of salt Nursing orders. Nursing care plans
water. Salt solution with warm temperatures in the elderly with a diagnosis of pain are a)
can increase local blood flow, causing Perform a comprehensive pain assessment
vasodilation of blood vessels. Therefore, the that includes location, characteristics, onset
authors are interested in doing a case study / duration, frequency, quality, intensity or
to see how the description of Nursing Care severity of pain and precipitating factors.
in the Elderly with Hypertension using Soak Teach the use of non-
Foot Therapy Warm Salt Water. pharmacological techniques: distraction
(listening to music), b) Provide information
MATERIALS AND METHODS about pain such as the cause of pain, how
This scientific paper uses long the pain will be felt and anticipation of
experimental case studies with quantitative discomfort due to the procedure. c) Control
results. By doing an Observer to find out the the environmental factors that can affect the
relationship about blood pressure using the patient's response to discomfort and d)
Salt Warm Soak Foot Therapy by making Encourage the patient to monitor pain and
measurements and measuring blood treat pain appropriately. In diagnosing the
pressure before and after therapy. The risk of decreased cardiac output after a
method of collecting data is by observing change in afterload are: a) Perform a
(observing the elderly). The case study comprehensive assessment of the
subject in scientific writing is Elderly Ny. hemodynamic status (ie, check blood
M is 77 years old who has hypertension. pressure, heart rate, pulse) appropriately, b)
The material in this paper is a blood Reduce anxiety by providing accurate
pressure gauge that is a spygmomanometer information and correcting any
and the tools and materials used are warm misunderstanding, c ) Perform salt warm
water, salt, basin water foot bath therapy, d) Explain the
treatment goals and how progress will be
RESULT measured,
Assessment. Based on the results of Implementation.At the stage of
the study, it was found that the client's main implementing priority diagnoses, acute pain.
complaint was that it was a bit dizzy, but Implementation in accordance with the case
not too dizzy. The client says stiff in the is with pain management. Namely by
neck area. Pain scale 4. The client looks conducting a comprehensive pain
grimaced, the client's eyes appear red and assessment including, location, duration,
less radiant, appear chaotic, TD: 150/80 characteristics, frequency, quality, intensity
mmHg. The pattern of the client's daily or severity of pain, also by conducting
habits is good, the client's physical distraction or diversion techniques (inviting
examination results are good, there are no clients to listen to music).Diagnosis of risk
abnormalities. Good mental status, good of decreased cardiac output. Implementation
independence, no cognitive impairment, no in accordance with the case is measuring
depression. History of drug use; the client vital signs, creating a comfortable
consumes high blood pressure medication environment, and conducting salt warm
(Kaptopril) if the blood pressure is high. water foot soak therapy. This therapy is
Nursing diagnoses. From the carried out for 30 minutes. The tools and
analysis results obtained nursing diagnoses materials used are a basin, salt, and warm
in the elderly are 1)Acute pain associated water with a temperature of 38 oC and a
with biological injury agents: ischemia, thermometer to measure temperature. For 3
2)Knowledge deficiency is related to lack of days the implementation of salt warm water
information, and 3) The risk of decreased foot soak therapy the author found a
60
decrease in blood pressure. On the first day relaxation and vasodilation (dilation of
before the salt warm water foot bath blood vessels) which can make blood flow
therapy, the client's BP is 150/80 mmHg, smooth
and after the client's blood pressure therapy
is 130/70 mmHg. On the second day, before REFERENCE
therapy, the client's BP is 140/70 and after 1. Kholifah, SN 2016. Print Teaching
therapy is 130/70 mmHg. On the third day Materials Module: Gerontik Nursing.
before TD client therapy is carried out Jakarta: Ministry of Health Republic of
140/70 mmHg to 130/60 mmHg. This Indonesia.
shows that there is an effect of warm salt 2. Asan, Y. (2016). Difference in Blood
water therapy on the client's blood pressure. Pressure Before and After Therapy of
At least a decrease of approximately 10-20 Soaking Foot Warm Water in the Elderly
mmHg for systole and approximately 5-10 in the Elderly Social Care Institution of
mmHg for diastole. This is caused by the Budi AgungKupang.CHMK HEALTH
effect of warm water which can make JOURNAL, 1 (1).
relaxation and vasodilation (dilation of 3. Kholifah, SN 2016. Print Teaching
blood vessels) which can make blood flow Materials Module: Gerontik Nursing.
smoothly, and the workload of the heart Jakarta: Ministry of Health Republic of
becomes lighter. Indonesia.
Evaluation. In conducting salt warm 4. Ministry of Health, RI (2018).National
water therapy, the authors found that there Riskesdas Report 2018. Jakarta: Ministry
was an influence on the decrease in client of Health Republic of Indonesia, 154-66.
blood, at least 10-20 mmHg for systole and 5. Vitahealth, 2014.Hypertension. Jakarta:
5-10 mmHg for diatol. From the writer's Gramedia Main Library
observation, the client seemed calm and 6. Sunaryo, 2015.Gerontik Nursing Care.
relaxed during the therapy process. Yogyakarta: Andi
Supporting factors that we found were
openness from the client regarding the
perceived condition and cooperative client
making it easier for the writer to do salt
warm water therapy.
CONCLUSION
From the results of TD
measurements for 3 days, a decrease was
obtained after doing salt warm water
therapy for 30 minutes, the first day before
TD client therapy was 150/80 mmHg, and
after the client's blood pressure therapy was
130/70 mmHg. On the second day, before
therapy, the client's BP is 140/70 and after
therapy is 130/70 mmHg. On the third day
before TD client therapy is carried out
140/70 mmHg to 130/60 mmHg. This
shows that there is an effect of warm salt
water therapy on the client's blood pressure.
At least a decrease of approximately 10-20
mmHg for systole and approximately 5-10
mmHg for diastole. This is caused by the
effect of warm water which can make
61
Improving The Quality Of Living Age (Lansia) In Depok City With Balance Training
IMPROVING THE QUALITY OF LIVING AGE (LANSIA)

IN DEPOK CITY WITH BALANCE TRAINING
Wilsari Buulolo
[email protected]
Abstract
The quality of life of the elderly is affected by various factors such as physical health,
psychological health, social relations and the environment. This study aims to determine the
effect of balance training on the quality of life of the elderly in the city of Depok. This quasi-
experimental study was conducted in two groups; 30 elderly as a control group and 30 elderly
as a treatment group. The sampling technique used is multistage random sampling. The results
showed that balance training had a significant effect, improving the quality of life of the elderly
(p <0.001). This is because balance training can improve physical health, psychological health,
social relations and the environment. Elderly balance training can be used as an effort to
improve the quality of life of the elderly in the community.
Keywords: elderly, exercise balance, quality of life
INTRODUCTION has three characteristics of health risks,

The elderly population is increasing namely, biological
very fast. In 2020, the number of elderly is Stanhope and Lancaster (2016)
predicted to equal the number of children revealed that biological risks include risks
under five. Eleven percent of the 6.9 billion related to age in the elderly, namely the
people in the world are elderly (WHO, occurrence of various declines in biological
2013). Indonesia's population is the fourth function due to aging. Social and
largest population after China, India and the environmental risk in the elderly is the
United States. According to 2013 World presence of an environment that triggers
Health Statistics data, China's population is stress. The economic aspect of the elderly is
1.35 billion, India is 1.24 billion, the United the decrease in income due to retirement.
States is 313 million and Indonesia is fourth Risk of behavior or lifestyle such as the
with 242 million population (WHO, 2013). pattern of lack of physical activity and
According to the projection of the Central consumption of unhealthy foods can lead to
Statistics Agency (2013) in 2018 the illness and death. Miller (2012) in his theory
proportion of the population aged 60 years functional consequences said the decline in
and over is 24,754,500 people (9.34%) of various bodily functions is a consequence of
the total population. increasing age .ansia is synonymous with
Elderly is one group or population at various declines in health status, especially
risk (population at risk) which is increasing physical health status. Various theories
in number. Allender, Rector, and Warner about the aging process show the same
(2014) say that population at risk is a thing. Health status of the elderly decreases
collection of people with health problems with age will affect the quality of life of the
have the risks including risks related to age, elderly. Increasing age will be accompanied
social and environmental risks as well as by the emergence of various diseases,
behavioral or lifestyle risks.possibility of decreased body function, body balance and
developing worse because of the risk factors the risk of falling. The declining health
that influence. Stanhope and Lancaster status of the elderly is contrary to the wishes
(2016) say the elderly as a population at risk of the elderly to remain healthy,
independent and able to carry out activities
62
as usual, for example bathing, dressing, with their expectations can even cause the
moving independently. Discrepancy in the elderly to experience depression. The results
condition of the elderly with their of the research of Brett, Gow, Corley,
expectations can even cause the elderly to Pattie, Starr, and Deary (2012) show that
experience depression. The results of the depression is the biggest factor affecting
research of Brett, Gow, Corley, Pattie, Starr, quality of life (p = 0,000). Some of these
and Deary (2012) show that depression is things can cause a decrease in the quality of
the biggest factor affecting quality of life (p life of the elderly. The declining health
= 0,000). Some of these things can cause a status of the elderly is contrary to the wishes
decrease in the quality of life of the elderly. of the elderly to remain healthy,
Increasing age will be accompanied by the independent and able to carry out activities
emergence of various diseases, decreased as usual, for example bathing, dressing,
body function, body balance and the risk of moving independently. Discrepancy in the
falling. The declining health status of the condition of the elderly with their
elderly is contrary to the wishes of the expectations can even cause the elderly to
elderly to remain healthy, independent and experience depression. The results of the
able to carry out activities as usual, for research of Brett, Gow, Corley, Pattie, Starr,
example bathing, dressing, moving and Deary (2012) show that depression is
independently. Discrepancy in the condition the biggest factor affecting quality of life (p
of the elderly with their expectations can = 0,000). Some of these things can cause a
even cause the elderly to experience decrease in the quality of life of the elderly.
depression. The results of the research of and Deary (2012) showed that depression
Brett, Gow, Corley, Pattie, Starr, and Deary was the biggest factor affecting quality of
(2012) show that depression is the biggest life (p = 0,000). Some of these things can
factor affecting quality of life (p = 0,000). cause a decrease in the quality of life of the
Some of these things can cause a decrease elderly. and Deary (2012) showed that
in the quality of life of the elderly. depression was the biggest factor affecting
Increasing age will be accompanied by the quality of life (p = 0,000). Some of these
emergence of various diseases, decreased things can cause a decrease in the quality of
body function, body balance and the risk of life of the elderly.
falling. The declining health status of the Physical exercise is very important for
elderly is contrary to the wishes of the the elderly in improving quality of life.
elderly to remain healthy, independent and Regular exercise can improve social
able to carry out activities as usual, for relationships, improve physical health and
example bathing, dressing, moving mental health. Exercise also plays an
independently. Discrepancy in the condition important role in reducing the risk of
of the elderly with their expectations can disease and maintaining the functioning of
even cause the elderly to experience the body of the elderly (Ko& Lee, 2012).
depression. The results of the research of Exercise can prevent physical fatigue
Brett, Gow, Corley, Pattie, Starr, and Deary because it improves cardiovascular
(2012) show that depression is the biggest function, the central nervous system, the
factor affecting quality of life (p = 0,000). immune system and the endocrine system.
Some of these things can cause a decrease Exercise can also reduce symptoms of
in the quality of life of the elderly. The depression (Chung, 2008).
declining health status of the elderly is Various studies on the effectiveness of
contrary to the wishes of the elderly to balance exercises have been conducted.
remain healthy, independent and able to However, little research has been done to
carry out activities as usual, for example determine the effectiveness of balance
bathing, dressing, moving independently. training on the quality of life of the elderly.
Discrepancy in the condition of the elderly Therefore, this study was conducted with
63
the aim to determine the effect of balance components namely the physical,
training on the quality of life of the elderly psychological, social and environmental
in the city of Depok. components (WHO, 2012a). This
instrument consists of 26 question items that
Materials and Methods have represented components to be
The research design used in this measured from the quality of life. This
study is a quasi experiment with a pre and questionnaire uses a Likert scale with a
post with control group design approach. rating scale of 1–5. Consisting of 26
The sampling technique used in this study is question items (WHO, 2012b). Caballero, et
multistage random sampling. The selection al. (2013) said the WHOQOL instrument
technique is as follows; from 11 sub- has the reliability shown by Cronbach's
districts in Depok City were chosen alpha values between 0.84-0.88. The
randomly namely, Pancoran Mas District; validity value indicates the value of r =
Pancoran Mas Village was chosen as a 0.75. This research has passed the ethical
control group; Depok Jaya Kelurahan was test by the University of Indonesia health
chosen as the intervention group ethics committee. The number that passes
(treatment); RW 01 is selected from 21 the ethical test is 0205.UN2.F12.D /
RWs in Pancoran Mas Kelurahan as a HKP.02.04 / 2015.
control group; RW 02 was selected from 14 Data analysis uses data analysis
RWs in Depok Jaya sub-district as the software. Paired t-test (dependent t-test) is
treatment group. Samples were 60 elderly used to compare the quality of life before
(30 controls from Pancoran Mas and 30 and after treatment in both the treatment
treatments from Depok Jaya). and control groups, while the t-independent
The inclusion criteria in this study test (pooled t-test) is used to analyze the
were willing to be respondents, aged 60–74 mean difference after treatment at treatment
years, able to walk, not using walking aids, and control groups (Dahlan, 2009).
able read and write, Mini Mental State
Exam (MMSE) more than 23, no having Results
visual impairment, not experiencing hearing The average quality of life of the
loss, not experiencing postural hypotension, elderly in the treatment group after
not following routine exercise. treatment was 6.10 higher than before.
Balance training performed by the Further test results using paired t-test
elderly consists of 8 main movements, obtained p value <0.001. This shows an
namely: (1) heating; (2) rotate the shoulder; increase in the quality of life in the elderly
(3) running around to ping; (4) crossing after giving balance training. The average
over; (5) walking with heels and fingers; (6) quality of life of the elderly in the control
standing one foot; (7) getting up from group was lower 0.83 compared to before
sitting; (8) cooling. This exercise was treatment. Further test results using paired t-
modified from the National Health test obtained p value = 0.147. This shows
Services-United Kingdom (NHS-UK) and that there is no difference
the Center for Disease Control and
prevention (CDC). This balance training is Table 1. Differences in Mean and
conducted twice a week, Monday and Significance Before and After Intervention
Wednesday every 09.00 WIB for eight in Both Groups
weeks. Each exercise is 30 minutes long Group Mean difference p
with each heating and cooling done for 5
minutes. Treatment 6.10 <0.001
Control -0.83 .147
Quality of life in the elderly is
measured by using WHOQOL-BREF. This
instrument measures 4 important
64
Table 2. Effects of Balance Training on (2015) states that to improve the quality of
Quality of Life of Elderly in Depok City life in the elderly in the community, it is
The Elementary very important to do this by maintaining
Group mean school 95% CI p health.
Treatment 65.02– Healthy life. Park, Han, and Kang
(n = 30) 68.39 9.01 71.75
Control (n = 51.17- <0.001
(2014) say that the exercise program in the
30) 54.22 8.17 57.27 elderly is effective in improving quality of
* SD: Standard Devias life, self-esteem and reducing depression
symptoms. Lai, Leung, Kwong, and Lee
et al. (2012) showed that balance training (2015) conducted a study in Hong Kong, the
combined with flexibility and toning or results showed that pain is one of the factors
FlexToBa ™ can improve functional that can reduce the quality of life of the
performance, limited bodily functions, elderly in nursing home residents. Tavares,
quality of life. Taracki, Yeldan, Dias, Santos, Hass, and Miranzi (2013) say
Huseyinsinoglu, Zenginler, and Eraksoy that the decline in quality of life is caused
(2013) studied 110 elderly (analyzed of only by limited bodily functions, illness,
99 elderly due to dropout) with multi-pel education, low income and less related to
sclerosis. The exercise is carried out for 12 others.
weeks which is guided by a physiotherapist. Research conducted by Tse, Tang,
The results of the analysis show that Wan and Vong (2014) in Hong Kong shows
balance training can improve significant on the effect of muscle strength training,
the average quality of life of the elderly streching and balance on pain and
after receiving balance training in the psychosocial well-being or quality of life
control group. (happiness, solitude, life satisfaction, and
Statistical test results used an independent t- depression). The average age of respondents
test to compare the effect of balance was 85.44 years. The treatment group
training between the treatment and control consisted of 225 elderly while the control
groups. The results showed a significant group consisted of 171 elderly. After eight
difference (p <0.001). weeks of exercise by physiotherapists and
nurses showed significant results in the
Discussion treatment group compared with the control
Balance training improves the group where pain decreased (p <0.05).
quality of life of the elderly. This is in line Whereas psychosocial well-being / quality
with Hewitt, Refshauge, Goodall, Henwood, of life increased significantly (p <0.05).
and Clemson (2014) stating that balanced Balance exercise can compensate for the
training conducted on 300 elderly people for decrease in the function of the
six months in Australia showed a significant musculoskeletal system. Physiologically,
influence on the quality of the life of the balance training can increase range of
elderly in nursing homes. The reduced motion, muscle strength, total body calcium,
quality of life due to aging can be improved improve body coordination, prevent loss of
by this exercise. Santos, Dantas, and muscle mass and improve body function
Moreira (2011) said that the exercise which (Miller, 2012). This will improve the quality
included balance training performed by 323 of life because the elderly feel healthier for
elderly women (average 69 years) could activities.
improve the quality of life by 9.19% (p = Campos, Ferreira, Vargas, and
0.001). Albala (2014) conducted research with
Research conducted by McAuleythe WHOQOL-BREF on elderly people living
quality of life of the elderly (p = 0.006). in communities in the Brazilian region
Furthermore, research conducted by Sun, showing that women who have good
Aodeng, Tanimoto, Watanabe, and Han physical and psi-cosocial health have a
65
higher quality of life. While,the best life is for elderly people who were previously
related to high social economy and good alone at home to get together in a way that
physical condition and psychosocial health. the elderly are physically healthier than
Healthy elderly people do have a better before participating in balance training. In
quality of life. According to Strupeit, Wolf- vain become more satisfied with the ability
Ostermann, Buss and Dassen (2014), the to carry out daily activities. This makes
elderly QOL as measured by WHOQOL- sleep calmer. Cheon et al. (2014) said that
BREF when entering rehabilitation facilities sleep is highly influenced by one's health.
in Hamburg, Germany was 57.85 but after Regular physical activity is very good for
six months the function status improved and maintaining health. Miller (2012) said that
its QOL became 67, 85 This approached through an active lifestyle the decline in the
QOL in research on balance training. function of the musculoskelatal system can
Another study was carried out by be compensated. Physiologically, exercise
Alexandre, Cordeiro and Ramos (2009) of can increase range of motion, increase
120 elderly people in the cities of Sao Paulo muscle strength, increase total body
and Sao Jose dos Campos, parts of the calcium, improve body coordination,
south-east of Brazil. The instrument used prevent loss of muscle mass and improve
was WHOQOL-BREF. The results of his body function. Therefore, balance training
study showed the average quality of life of is very beneficial for the elderly. improve
the elderly in the physical domain of 62.11. the body's choir, prevent loss of muscle
The average psycho-logical domain is mass and improve body function. Therefore,
62.22. The average domain of social balance training is very beneficial for the
relations was 72.15, while the elderly. improve the body's choir, prevent
environmental domain was 66.30. This loss of muscle mass and improve body
average quality of life is almost the same as function. Therefore, balance training is very
the average quality of life in this research beneficial for the elderly.
about balance training. The similarity in Balance training also increases
average quality of life is caused by the psychological play. This is because balance
physical and psychological health status that training increases the ability to concentrate,
tends to be the same. The results of the pre- increases the body's acceptance of
test research on balance exercises obtained a appearance, makes the life of the elderly
physical domain re-average of 64.38. The more meaningful, increases satisfaction
average psycho-logical domain for the with self, reduces anxiety, loneliness,
elderly is 65.42. The average social despairand depression. Miller (2012) says
relations domain of the elderly 58, 33 and exercise increases neuromuscular
the environmental domain average of 61.04. coordination. The elderly are more able to
The difference lies in the domain of social concentrate. Marques, Sánchez and Vicario
relations. (2014) mentioned that 48 elderly who
The domain of social and participated in their research in Portugal
environmental relations in the elderly in the said that quality of life means having a
Brazilian region is higher than that of the healthy body, getting peace, harmony of
elderly in Depok, Indonesia. This shows life, feeling happy, life satisfaction,
that the quality of life of the elderly in the engaging in happiness, having relationships.
Brazilian region in terms of social and with friends and neighbors.
environmental relations is better compared In general, balance training
to the elderly in Depok, Indonesia. This is improves the quality of life of the elderly.
due to the fact that in Brazil the health Improving the quality of life of the elderly
service system is more advanced compared proves that balance training is a good
to Indonesia. With the existence of balance intervention to be applied in the community.
training conducted in Brazil, it is possible Mauk (2014) says that successful seniors
66
are those who are active and participate in addition, the ability of the elderly to carry
many activities. Elderly synonymous with a out daily activities increases. The elderly
decrease in various bodily functions. say their ability to increase in some daily
Therefore, so that body function does not activities such as lifting flower pots,
continue to decline the elderly need to sweeping and dressing. It means balance
interact. training so that the elderly remain healthy
The elderly who meet and interact and of high quality.
make them support each other, motivate and
need. It is different with what happens in Conclusion
developing countries, elderly people always Balance exercise affects the quality of life
meet every day, often exchanging greetings of the elderly. The quality of life of the
so that aspects of social relations that treatment group was better than the control
include satisfaction with personal or social group after treatment. The quality of life of
relationships and satisfaction with support the elderly increases because balance
from friends increases not as much as an training has an influence on physical
increase in the domain of the elderly in function, psychology, social relations and
Brazil (Gomes, et al., 2014). This means the elderly environment. The domain of the
that social relations have become a habitual highest quality of life improvement is
pattern in developing countries so that these physical health and the lowest is the
aspects are not too highly elevated. environment (AF, AYN, TN).
The improvement of the
environmental domain includes feeling of Reference
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68
THE RELATIONSHIP OF MATERNAL KNOWLEDGE OF THE

COMPLETE BASIC IMMUNIZATION IN INFANTS AT THE PUBLIC
HEALTH CENTER OF KUTAMBARU SOUTHEAST ACEH IN 2019
Putri Yani br Siahaan1, Sabarita br. Selian2

[email protected]
Abstract
Basic Immunization is an immunization that must be given to infants and children from birth so
that the body is protected from harmful diseases. Immunization Program in Indonesia requires a
complete basic Immunization for each infant (age 0– 11 months) consisting of 1 dose of
Hepatitis B, 1 dose of BCG, 3-dose DPT-Hib, 4 doses of polio, and 1 dose of measles.This
Research aims to know the relationship of maternal knowledge about the with the complete
basic immunization in infants at the care center of Kutambaru Southeast ACEH in 2019.Cross
Sectional Analytic Survey Research method is a study to learn the dynamics of correlation
between factors and effects, through the observation/data collection at one time, that each
subject is only observed one time and the measurement of the subject variable is done at the
time of the study.The results of the statistical analysis using the Chi Square Test stated that
there is a mother of knowledge about immunization with basic the treatment in the baby at the
health center of Kutambaru southeast ACEH year 2019 with p-value 0.015 (P-value <
0.05). The conclusion of this study is that there is a relationship of maternal knowledge about
basic immunization in infants at the care center of Kutambaru Southeast Aceh in 2019 years, so
it is advised to health workers who are concerned to do health counseling to mothers to improve
the access to basic immunization.
Keywords: Knowledge, basic immunization
Introduction tahun2017 complete basic immunization in

Immunization comes from the word Indonesia amounted to 91.12, this figure is
immune, immune or resistant. Children are slightly below the target of Renstratahun
immunized, which means being given 2017 by 92%. According to the province,
immunity to a particular disease. The child there are 15 provinces that reached
is immune or resistant to a disease but not targetRenstra in 2017 (Health profile of
necessarily immune to other diseases. Indonesia RI, 2017).Immunization Program
Immunization is an attempt to raise/increase 2012 – 2016, the achievement of antigen
the person's immunity actively against a administration was decreased, but in 2014,
disease, so that when a time is exposed with BCG immunization coverage, Polio 4
the disease will not be sick or only suffer danCampak had increased but not for
mild illness (Hadianti, 2015). The global DPT3/HB3. In the year 2015, the measles
child immunization prevalence in 2012 IS cakupanimunization suffered considerable
DPT 83%, Polio of 84%, measles of 84%, decline of 95.69% (2014) menjadi89, 4%
Hepatitis B of 79%, AND BCG amounting (2015); Similarly, the DPT3/HB3 coverage
to > 80%. The global immunization declined from 89.5% (2015) menjadi88,
percentage continues to increase from 5%(2015). In 2016 the number of
previous years (WHO, 20The complete immunization coverage increased to BCG,
basic immunization coverage in Indonesia DPT1/HB1, DPT3/HB3, and measles except
in the last five years has always been above for Polio 4 there was a decline of 97.77%
85%, but has not yet reached the specified (2015) to 90.30% (2016). Because of the
ministry of Health Renstra's target, in the reduction of Polio 4 immunization
69
coverage, it causes the average drop out rate complete basic .The population is an area
to increase and reach sekitar7%. This of generalization that has a specific
condition is very far above the number of quantity and characteristic set by the
tolerance which is 3.55% (Dinkes researcher to be studied and then pulled in
sumut,2016).Immunization administration is its conclusion. That is the definition of the
a preventive measure so that the body is not population in research (Siyoto, 2015). The
infected with certain infectious diseases population in this study is a mother who
such as tetanus, whooping cough has children or infants aged 0-1 years in the
(pertussis), measles, polio and tuberculosis month, amounting to 40
or if exposed does not give a fatal effect to respondents.Samples are part of the
the body, while infants who do not get number and characteristics owned by the
immunization will be susceptible to diseases population, or small portions of population
such as lung tuberculosis, diphtheria, members taken according to certain
pertussis, tetanus and also measles. From procedures so that they can represent their
the health office data in a baby in the population. The sampling techniques used
province of South Sumatera, Lampung, in this study were total sampling. The total
Jambi and West Nusa Tenggara have sampling technique is sampling techniques
obtained complete basic immunization. when all population members are used as
While the lowest achievement province is samples,samples from the study used a
North Kalimantan (66.2%), Papua (68.6%), saturated sample of all populations as
and Aceh (70.0%). Data and information samples amounting to 40 samples.The data
related to basic immunizations in infants collection techniques are conducted by the
detailed according to the provinces in 2017 researchers directly using the primary data,
(Dinkes RI, 2017)From the introductory the interview techniques with respondents
survey conducted by researchers obtained and the use of the questionnaire with the
results from 10 mothers who have babies, 8 questions that have been compiled by
babies do not get complete basic researchers. The Association of
immunization, still a lack of knowledge of Questionnaire is open based on the concept
the importance of basic immunization of Mother knowledge theory on basic
complete in the baby. Based on the problem immunisation in infants. Before the
above researchers are interested to raise the Rsponden record first to seek approval
title of "Mother's knowledge about basic from the leadership of the Puskesmas by
immunisation in the infant in the care center submitting a letter from the institution.
of Kutambaru southeast ACEH year 2019
General purpose of this research to know Result
the relationship of maternal knowledge Table 4.1
about immunization with the provision of Frequency distribution of respondents
basic immunization in infants at the care characteristics by age in health care
center Kutambaru southeast ACEH year center Kutambaru ACEH Tenggara Year
2019. 2019
Age Amount %
Method
This study uses desain's descriptive < 20 years 8 20
research of collation with a cross sectional 20-35 year 19 47.5%
approach which is a research relationship > 35 years 13 32.5%
between the DUA variable in a situation or
a group of subjects conducted to see the Amount 40 100%
relationship between the variable satu with
the other variables, which aims to know the Based on the table 4.1 above, it is revealed
Mother's knowledge relation to 2019 the that from a total of 40 respondents studied,
70
the result of the majority of the respondents Based on the table 4.4 above, it is revealed
was 25-35 years, which 19 respondents that from a total of 40 respondents studied,
(47.5%) and minority respondents < 20 the majority of respondents did not get a
years of age: 8 respondents (20%). complete basic immunization of 23
respondents (57.5%)
Table 4.2
Frequency distribution of respondents Table 4.5
characteristics based on the health center Frequency distribution of respondents
of Kutambaru ACEH Tenggara year based on knowledge of the health care
2019 center of Kutambaru Aceh Tenggara
Job Amount % year 2019
Work 16 40,% Knowledge Amount %
Not working 24 60% Good 14 35%
Amount 40 100% Enough 2 5
Less 22 60%
Based on the table 4.2 above, it is revealed Amount 40 100%
that from a total of 40 respondents studied,
the majority of respondents did not work Based on the table 4.5 above, it is known
for 24 respondents (60%). that from a total of 40 respondents were
studied, the result of the majority of the
Table 4.3
knowledgeable respondents was 22
Frequency distribution of respondents
respondents (60%), and the minority
characteristics based on the Educative
received results of enough knowledgeable
Health center of Kutambaru ACEH
respondents 2 respondents (5%)
Tenggara year 2019
Education Amount %
4.2.3 Bivariate Analysis
Sd 13 32.5% Table 4.7
Junior 23 57.5% Knowledge relationship with the
Sma 3 7.5% completeness of immunization of the
Pt 1 2.5% Health Care Center Kutambaru ACEH
Amount 40 100% Tenggara Year 2019
Immunization
Total
Based on the table 4.3 above, it is revealed completeness
P-Value
that from a total of 40 respondents studied, Knowledge Complete Not
the result of the majority of respondents N % N % N %
with junior secondary education is 23
respondents (57.5%), and the minority of Good 10 25 4 10 14 35
0.015
Enough 2 2.5 2 2.5 4 5
respondents PT is 1 respondent (2.5%). Less 5 12.5 17 42.5 22 60
Total 32 40 13 60 40 100
4.2.2 Univariat Analysis
Table 4.4 The results of the statistical analysis using
Frequency distribution based on the the Chi Square test stated that there is a
completeness of Immunization Medical mother of knowledge about immunization
Health Center Kutambaru ACEH with basic immunisation treatment in the
Tenggara Year 2019 baby at the health center of Kutambaru
Immunization ACEH Tenggara year 2019 with p-value
Amount %
completeness 0.015 (P-value < 0.05).
Complete 17 42.5%
Incomplete 23 57.5%
Amount 40 100%
71
Discussion knowledge are less likely to provide a

Knowledge is an understanding of some complete basic immunization than a high-
information and an objective introduction to level mother (goddess, 2013).
objects or things. Knowledge can also be
gained through the experience of a person Conclusion
and through the results of learning a person Based on statistical tests concluded
formally or informally knowledge can be that:
influenced by fear so as to know more about 1. Characteristics of the age of majority
it. The deeper the knowledge gained, the respondent 25-35 years, which is 19
more wise the mother will be in perception respondents(47.5%), the majority of
of things and making decisions. The respondents do not work is 24
behavior that is founded by knowledge will respondents (60%), and the majority of
be prolonged or persistent compared to the SMP-educated respondents are 23
behavior that is based on compulsion respondents (57.5%).
(Toruntju, 2013).According to the theory of 2. Distribution based on completeness of
Achmadi 2016 Explains that knowledge basic immunization i.e. the majority of
about immunization is very important for infants do not get a complete basic
mothers, especially for mothers who have immunization of 23 respondents
just given birth to their babies. (57.5%).
Immunization-giving vaccines in infants so 3. Distribution of the knowledge of mothers
that infant immunization can be increased about the complete and comprehensive
and immune to disease. Because when they majority of the less knowledgeable of 22
are born, immunization in the body of respondents (60%).
babies is still very weak and very easy to 4. There is a relationship of maternal
attack various diseases that are not even a knowledge about immunization with the
little that leads to infant death. Maternal introduction of basic immunization in
education is one of the factors affecting infants at the care center of Kutambaru
basic immunization completeness. The Southeast Aceh in 2019.
higher the education of a mother, then the
knowledge of mothers about immunization Reference
better. This research shows that maternal 1. Ariani, A.P. 2014.application of
education does not affect children's basic Obstetrics and health research
immunization.The results of this research methodology. Yogyakarta:Nuha
also in accordance with the research Medika.
conducted by Sari in the year 2015 in the 2. Darmawati, I. (2017). Integration
Bendo Puskesmas District Magetan. In this coordinated School health Model
study, the results of 52.3% of mothers have (CSH) and family centered Nursing
good knowledge, of which 49.2% of them (FCN) to reduce and prevent
have complete immunization status. childhood obesity (vol. 2) Hadianti,
Meanwhile, there are 30.8% of infants with et al. 2015. Immunization. South
incomplete immunization status with poor Jakarta: Health workers Education
maternal knowledge. The Research results and Training center.
in line with the research Puspita (2018) 3. Dewi A. P., Darwin, E., & Edison.
stating that the lower the knowledge of 2014. Knowledge level relations of
mothers, the more contributing to the mothers with basic immunization
incompleteness of immunization. Poor provision in infants in the village of
knowledge about immunization also relates Parupuk Tabing work area
to the role of mother in completing her baby Puskesmas of the Jakarta City of
immunization. The research of Dewi, DKK Padang year 2013. Health Care
(2013) states that mothers with low Andalas. 3 (2), 114-118.
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4. Jamil SN, Sukma Feby, Hamidah. toddlers, and Pre school children.
2017. Obstetrician Orphanage in Jakarta: HR Center health
neonatal, infant, toddler, and 14. Toruntju Sa. 2013. Socio-economic
preschool children, Jakarta: Faculty factors related to mothers in the
of Medicine and Health University Gaky endemic region. Thesis.
of Muhammadiyah Jakarta. Yogyakarta: UGM
5. Kemenkes RI. Health Profile of 15. Warrohmah, Berliana, S. M.,
Indonesia 2017. Jakarta Nursalam, N., Efendi, F., Haryanto,
http://www.depkes.go.id. (accessed J., has, E. M. M., Wahyuni, S. D.
20 march 2019). (2018). Analysis of the survival of
6. Marimbi, M. 2017. Growing children under five in Indonesia and
flowers, nutritional Status, and basic associated factors. Paper presented
immunization in infants. at the IOP Conference series: Earth
Yogyakarta: Nuha Medika. and Environmental science. Wawan,
7. Momomuat, S., Ismanto, A. Y., & et al. 2018. Human knowledge,
Kundre, R. (2014). The relationship attitudes and behaviors. Yogyakarta:
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the importance of measles 16. WHO. Maternal Mortality: World
immunization with adherence to Health Organization; 2014
implementing immunization in 17. Organization, W. H. (2012). Third
Kawangkoan Puskesmas. Mulyani meeting of the South-East Asia
Nursing Journal , N. 2017. Regional Immunization Technical
Immunisation for children. Advisory Group (sear Itag): WHO
Yogyakarta: Nuha Medika. Regional office for South-East Asia.
8. Nurhidayat. 2016. Contact mother 18. Yuniar, D., & Darmawati, I. (2017).
about basic immunisation of basic Family support relates to adolescent
immunisation in the working area of emotionalintelligence.
South Tangerang City. Comprehensive Nursing Journal,
9. Health profile of Indonesia (2017) in 3(1), 9-17.
Access on 29 March 2019
10. Health profile of North Sumatra
province (2016) in Access on 29
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factors causing incompleteness of
basic immunization in infants.
Thesis. Surabaya: Faculty of Public
Health of Airlangga University
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guidelines in Indonesia:
Immunization task Force,
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2016. Childcare neonatal infants,
73
Medan City

HIPERTENS IN THE KWALA BEKALA VILLAGE MEDAN JOHOR
SUB-DISTRICT, MEDAN CITY
Siti Nur Fadila

[email protected]
ABSTRACT
Aim/Objective: health development is an effort to fulfill one of the basic rights of the
community, namely the right to obtain health services in accordance with the 1945 Constitution
Article 29 H paragraph 1 and Law Number 23 of 1992 concerning health. This study aims to
determine the general picture of a Case Study of Mrs. M. with hypertension in the kwala Bekala
village,Medan Johor sub-district Medan city The research method used is the case study method
is a study that explores a nursing problem in detail, has in-depth data collection and includes
various sources of information. The results of the study after an assessment of Mrs. M. found
that the lack of knowledge of hypertension and lack of information about one of the diseases
that always occur in the elderly. After the Family Gerontik Nursing Care Actions were taken,
Ms. M. could understand the importance of how to overcome hypertension problems by using
herbal medicines or visiting community service centers that were available, Healt Education
became an important factor in the application of Gerontik Nursing Care for Ms. M.'s family.
Key words: Family Nursing, Gerontik, Hypertension
INTRODUCTION patients with hypertension and secondary

Health development is an effort to hypertension (Yolanda 2017).
fulfill one of the basic rights of the Sugiharto (2007) in Masriadi (2016),
community, namely the right to obtain argues that secondary hypertension is
health services in accordance with the 1945 hypertension whose causes can be
Constitution Article 29 H paragraph 1 and identified, often associated with several
Law Number 23 of 1992 concerning health. diseases such as kidney, coronary heart
Health development must be viewed as an disease and diabetes, central nervous system
investment to improve the quality of human disorders.
resources which, among others, are a major Meanwhile, according to Brunner &
component for education and the economy Suddart, (2015), the causes of primary
and health which also has a role in poverty hypertension are emotional disturbances,
reduction (Santosa, 2011 in Nurhikmah obesity, excessive alcohol consumption,
2016). coffee, drugs, heredity. Generally new
Hypertension is a condition where symptoms are seen after complications
systemic pressure is above 140 mmHg and occur. Complications that occur when high
diastolic pressure is above 90 mmHg blood pressure is not treated and treated,
(Brunner & Suddarth (2005) in Wijaya & then in the long run will cause damage to
Putri (2013). the arteries in the body until the organs that
Hypertension is also one degenerative get blood supply from these arteries.
diseases that occur a lot and have a fairly Complications of hypertension can occur in
high mortality rate and affect one's quality heart, brain, kidney and eye organs, which
of life and productivity. Hypertension can can lead to heart failure, risk of stroke,
be classified as primary hypertension or kidney damage and blindness (Yolanda,
essential hypertension which is 95% of all 2017).
74
Medan City
High blood pressure or hypertension Limitation of the elderly

kills 9.4 million people worldwide every a. WHO (1999) explains the limits of the
year. World Health Organization (WHO) elderly as follows:
Figures estimate, the number of people with 1. Elderly (elderly) between the ages of
hypertension will continue to increase along 60-74 years.
with an increasing population. In the next 2. Old age: 75-90 years.
2025, it is projected that around 29% of the 3. Very old age is> 90 years.
world population will be affected by
hypertension. The highest percentage of b. The Indonesian Ministry of Health
hypertension sufferers is currently found in (2005) explains that the boundaries
developing countries. Global Status Report of the elderly are divided into three
on Noncommunicable Disesases 2010 data categories, namely:
from WHO said that 40% of developing 1. Presenilis advanced age is
economies have hypertension, while between the ages of 45-59 years
developed countries only 35%. Africa holds 2. Old age is 60 years and above.
the top position of hypertension sufferers as 3. Elderly at risk, namely the age
much as 46%. While the American region of 70 years and over or age 60
occupies a distended position with 35%. For years and over with health
the Asian region, this disease has killed 1.5 problems
million people each year.
MATERIALS AND METHODS
Theory Study on gerontik nursing care Hypertension can be defined as
The assessment process is characterized by persistent blood pressure where the systolic
continuous information gathering and pressure is above 140 mmHg and diastolic
professional decisions that contain meaning pressure above 90 mmHg. Hypertension is a
to the information collected. Family data major cause of heart failure,referred to as
collection comes from a variety of sources: "the silent killer"because people with
interviews, observations of family homes hypertension often do not show symptoms
and facilities, experiences reported by (Brunner & Suddart, 2015).
family members. Meanwhile according to Sheps (2005)
in Masriadi (2016), hypertension is a
Understanding gerontik or elderly disease with signs of systolic and diastolic
Gerontik is the study of aging processes that blood pressure disorders that rise above
occur in humans at the age of 60 years pressure.n normal blood. Systolic blood
(Sofia, 2014). Diana is someone who has pressure is the peak pressure that is reached
reached the age of 60 years and over. Aging when the heart contracts and pumps blood
is not a disease, but it is a process that out through the arteries. Diastolic blood
gradually results in cumulative changes, it is pressure is taken when the heart drops to the
a process of decreasing endurance in lowest pressure when the heart relaxes and
dealing with stimulation from within and fills the blood again (Yolanda, 2017).
outside the body. Many among the elderly Hypertension is a condition where a
are still productive and able to play an person experiences an increase in blood
active role in social, national and state life. above normal as indicated by the systolic
Efforts to improve social welfare of the number (upper part) and diastolic number
elderly are essentially the preservation of (lower part) in blood pressure examination
national religious and cultural values (Siti using a blood pressure measuring device in
Nur Khalifah, 2016). the form of mercury cuff
(Sphygomanometer) or other digital devices
(Irwan, 2016).
75
Medan City
Research methods consist of various ways of lifestyle

Case study research is a study that explores modification to reduce hypertension.
a nursing problem with detailed, has deep The second diagnosis is Acute Pain
data retrieval and includes various sources b / d family's inability to care for a sick
of information. Case study research is family this data is supported by Ny.M says
limited by time and place, and cases studied the head feels pain, dizziness, pain in the
are events, activities or individuals. neck and feels heavy, pain scale 5-6, Ny.M
The method in preparing this case says pain disappear arises . While the
study is descriptive which is a form of case objective data that supports are: TD: 160/90
study in implementing nursing care in a mmHg, pulse 88 x / minute, Mrs. M. looks
case using the nursing process approach and grimaced.
describes nursing care actions given to The third diagnosis is in accordance
families with elderly hypertension starting with the theory that obesity, emotional
from assessment, nursing diagnosis, disorders. Excessive alcohol consumption,
intervention, implementation and evaluation coffee drugs and heredity, reducing sodium
(Nursalam, 2015). intake, new symptoms appear after
complications occur. Complications that
RESULT occur if high blood pressure is not treated
Assessment and overcome, then in the long run will
Ny.M said that she often consumed cause damage to the arteries in the body
excessive salt, consumed salted fish and until the organs that get blood supply from
never followed hypertension gymnastics these arteries. Complications of
and exercising, and stated that the causes of hypertension can occur in heart, brain,
hypertension were in accordance with kidney and eye organs, which can lead to
(Brunner & Suddart, 2015) namely heart failure, risk of stroke, kidney damage
emotional disturbances, obesity, excessive and blindness. (Brunner & Suddart, 2015).
alcohol consumption, coffee , medication,
heredity, renal artery narrowing, renal Nursing Interventions
parenchymal disease, various drugs, organ Family nursing interventions are made
dysfunction, tumors and pregnancy. based on assessment, nursing diagnosis,
Another case according to (Black & Hawks, family statements, and family planning, by
2014) risk factors for hypertension that formulating goals, identifying alternative
cannot be changed are family history, age, intervention strategies and sources, and
gender and ethnicity. While the risk factors determining priorities, interventions are not
that cannot be changed are diabetes routine, random, or standard, but it is
mellitus, stress, obesity, nutrition designed for certain families with whom the
(consuming excessive salt) and drug abuse. family nurse is working (Friedman, 2010).
Next treat family members by
Diagnosis demonstrating relaxation techniques (deep
The first diagnosis is that there is a gap breathing). Furthermore, counseling and
between the theories which the theory states motivating families to be able to modify a
Nonpharmacological countermeasures of comfortable environment and Utilize health
hypertension according to (Brunner & services to overcome the problem of
Suddart, 2015) namely by reducing weight, hypertension. Third diagnostic intervention
limiting alcohol, sodium and tobacco, High risk of complications occurring b / d
exercise and relaxation are mandatory family inability to care for sick families In
interventions that must be performed on accordance with the task of the first family
every anti-hypertension. (Ridnamirudin, care namely recognize the problem by
(2007) in Wijaya & Putri, (2013) also said reviewing family knowledge about the
that nonpharmacological countermeasures aftermath of hypertension, and discussing
76
Medan City
the aftermath of hypertension. Next take a program for each patient is prevent
decision by discussing the actions that must occurrence morbidity and Accompaniment
be taken if there are problems in the family. mortality by achieving and maintaining
Furthermore, caring for family members by blood pressure below 140/90 mmHg. The
demonstrating traditional medicine (grated effectiveness of each program is determined
cucumber juice). Furthermore, counseling by the degree of hypertension,
and motivating to be able to modify a complications, cost of care and quality of
comfortable environment and Utilize health life in relation to therapy (Brunner &
services to overcome the problem of Suddart, 2015).
hypertension
Nursing Evaluation
Nursing implementation Family nursing evaluation is a processto
The implementation of the first diagnosis is assess the success of the family in carrying
in accordance with the theory according to out their health duties so as to have high
Ridwanamiridin (2007) in Wijaya & Putri productivity in developing each family
(2013) where in the management of non- member. As the fifth component in the
pharmacology consists of various ways of nursing process, evaluation is the stage that
lifestyle modification which is very determines whether the goals set will
important in preventing the increase in high determine the ease or difficulty of carrying
blood pressure, which is a diet containing out the evaluation (Sugiharto, 2012).
climates and calcium, reducing sodium
intake, reducing stress, avoiding smoking. CONCLUSION
Supported by Situmorang research (2015). After the authors do Nursing Care
Implementation of the second directly to Mrs. M with Hypertension In the
diagnosis of Acute Pain b / d family's kwala Bekala village,Medan Johor sub-
inability to care for families who are aware district Medan city, several conclusions can
of Ny.M recognizing the problem is done by be drawn as follows; after an assessment of
assessing family knowledge about pain and Mrs. M. was obtained that the lack of
discussing the causes of pain felt, then knowledge of hypertension and the lack of
deciding the actions to be done, subsequent information about one of the diseases that
implementation further demonstrating always occur in the elderly, after taking
relaxation techniques (deep breaths). action to care for the family Gerontik
Followed by modifying a comfortable Nursing Mrs. M. can understand the
environment and utilizing health services. importance of how to overcome the problem
Implementation of the third of hypertension by using herbal medicines
diagnosis High risk of complications arising or visiting an available community service
from the inability of the family in caring for center, Healt Education is an important
a sick family. In Mrs. recognizing the factor in the application of Gerontik
problem is done by reviewing family Nursing Care for the Family of Mrs.M
knowledge about the continued
consequences of hypertension and REFRENCE
discussing the further consequences of 1. Ahmadi, 2008. Basic Concepts of
hypertension, then deciding the actions to Nursing. Jakarta: EGC
be taken, subsequent implementation 2. Irwan, 2016. Epidemiology of non-
demonstration of traditional medicine for communicable diseases.
grated cucumber juice. Followed by Yogyakarta: Budi Utama
modifying a comfortable environment and 3. Nurhikmah, 2016. The Old
utilizing health services. Implementation of Relationship between Smoking and
the third diagnosis is in accordance with the the Degree of Hypertension in
theory where the purpose of each treatment
77
Medan City
Rannaloe Village, Bungaya District,

Gowa Regency
4. Nursalam, 2015. Concept and
Application of Nursing Science
Research Methodology. Jakarta:
Salemba Medika
5. Ministry of Health Profile. South
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6. Citation on May 24, 2018. At 22.00
wit
7. Sofia Rhosma, 2014. Textbooks on
Nursing Gerontik. Yogyakarta: Budi
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8. Sunaryo, 2015. Gerontik Nursing
Care. Yogyakarta: Andi
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Care. Jakarta: EGC
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78
The Importance Of Raising Individual Awareness To Improve Reproductive Health As An Emergency Management Of Corana
Virus (Covid 19)
THE IMPORTANCE OF RAISING INDIVIDUAL AWARENESS TO

IMPROVE REPRODUCTIVE HEALTH AS AN EMERGENCY
MANAGEMENT OF CORANA VIRUS (COVID 19)
Kartini Nainggolan
[email protected]
ABSTRACT
This article will discuss about individual awareness in the 2019 Corona Virus Disease
pandemic (Covid-19), namely the formation of individual awareness as citizens. In addition,
this article also discusses the reproductive health of citizens in the management of Corona Virus
Disease 2019. The key concept in raising individual awareness during the covid 19 pandemic is
Mindfulness. In its implementation, mindfulness is believed to be one of the ideal meditation
efforts and attains the right attitude for you during the Covid-19 pandemic. Data is obtained
using three research tools, namely; live and online interviews, observations and analyzes
obtained from news searches on television, online media and social media (documentation) to
explore more deeply the phenomena that occur. Online interviews are conducted through social
media; Whatsapp, Instragram, and Facebook for several residents who have different
occupational, educational and residential backgrounds. Direct observations on the environment
of community members during the pandemic were also carried out. The results of the study,
showed that Mindfulness. in the emergency period Covid-19 encouraged the formation of a
shared awareness and obedience of Indonesian citizens to the appeal of the country. Community
observance is driven by; the choice to obey because of the threat of a pandemic, the
strengthening of social solidarity and human values, togetherness in the community at the RT
and RW levels, in addition to the rule of law that contains sanctions. In addition, this study
found the importance of raising awareness among citizens to adhere to the health protocol in
facing the spread of Covid-19 through social capital in the form of social nets within the
community
Keywords: pandemic, Covid-19, mindfulness, reproductive health
Introduction community welfare, social, cultural, and

The Indonesian nation is struggling defense and security. This stipulated
with the spread of corona virus disease 2019 Presidential Decree pays attention to the
(Covid-19). This global pandemic occurred contents of Law Number 6 Year 2018
and spread throughout the world in various regarding Health Quarantine. The 1945
countries, causing the Indonesian Constitution, Article 12 and Article 22, has
government to adopt Covid-19's emergency provided a basis if a situation of danger and
policy. Although it was rather late, various compulsion arises. The 1945 Constitution of
efforts were made in dealing with various the Republic of Indonesia, protecting all
problems that occurred during the citizens and bloodshed of Indonesia, and the
emergency. government is obliged to guarantee the
Covid-19 Emergency is determined safety of its citizens.
based on Presidential Decree (Keppres) No. Specifically, to describe what is meant
11 of 2020 concerning the Implementation by coercive urgency, the Constitutional
of Public Health Emergency, considering Court ruled that there are three categories of
that the number of deaths due to Covid-19 coercive urgency in the Constitutional Court
has increased and spread across regions and Decision No. 38 / PUU-VII / 2009, namely;
impacted on political, economic, (1) there are conditions, conditions where
79
Virus (Covid 19)
an urgent need to resolve legal issues awareness that arises from the hearts and
quickly based on the law, (2) if there is a minds of people to behave and take action.
legal vacuum, when the required law does Awareness of their rights and obligations as
not exist, or if there is but the rule is citizens so that a sense of responsibility as a
inadequate, (3) if The legal vacuum cannot citizen emerges. Building citizen awareness
be overcome by making laws due to the is really not easy, influenced by many
urgent time. things. Especially in the past decade, the
Based on these rules, an emergency is Indonesian nation was confronted with
a disaster emergency Those considered many things that often divide people into
threatening and disrupting people's lives are opposing interest groups. The Covid-19
caused by nature, non-nature which is disaster should have been the driving force
dangerous, resulting in casualties, damage, for each group to place conflicts between
and psychological impacts (Elnizar, 2020). various parties that had been occurring
The coercive urgency that is the basis for between community groups, and the
determining health emergencies and various community and the government.
anticipations that have been made, but can The public is called upon to help
not control the situation. The Covid government efforts to stop the spread of
Pandemic on April 13, 2020 was designated Covid-19 silently at home, and each
a National Disaster, with the Non-Natural individual implements a preventative
Disaster Determination of the Corruption protocol. In subsequent developments, the
Virus Disease 2019 (Covid-19) taking into reality is that the number of positive
account the contents of Law No. 24 of 2007 sufferers of Covid 19 is increasing every
concerning Disaster Management. day (data from April 1 to May 5, 2020 is
Facing a pandemic caused by the seen in http://Covid-19.go.id). This was
spread of Covid-19, government alacrity is allegedly due to the lack of law-abiding
needed as well as public awareness and culture in the community which could
obedience to all elements. In the beginning, extend the period of handling the pandemic.
the government was less prepared to In fact, disobedience that can be seen from
educate the public. Government elites, undisciplined, can lead to other regulations
through their comments in the media, do not that are more pressing and have a more
try to provide sufficient knowledge to the difficult impact on this society itself. Until
public, even if they do not consider the the beginning of May 2020, 3 (three)
distribution of Covid-19 to be dangerous. provinces have established a PSBB (Large-
Even the impression shown to the public scale Social Limitation) policy which had
seems to be indifferent to the problems to be previously been regulated in Government
faced, for example the statement of the Regulation No. 21 of 2020 at the end of
Minister of Health (in m.detik.com (02 March 2020.
Meret 2020); Suara.com (4 March 2020); This research also discusses the
m.liputan6.com (10 March 2020), It seems implementation of covid 19 management
that the government has not prepared with individual awareness namely
enough to anticipate the safety of its Mindfulness and will simultaneously
citizens, however, the determination of the improve reproductive health in the
national health emergency status was community where the covid pandemic 19
carried out and finally the government and is expected to reduce mortality due to
inevitably had to be ready to fight the covid 19.
spread of the virus, and the state in an
emergency, fear and social panic increased. Method
In the current context, awareness as This study uses a qualitative method
part of a mutually supporting society, with an exploratory approach. Data is
awareness as citizens is needed as a sense of accessed using three research tools, namely;
80
Virus (Covid 19)
online interviews, observations, and can be done to overcome stress is through

analysis obtained from news searches on mindfulness.
television, online media, and social media Mindfulness is an individual condition
(documentation). that has full awareness of the things that
happen around him. Individuals who are in
Result and Discussion a mindful condition become more aware,
Basic Concepts of Mindfulness and Their sensitive, able to balance themselves, and
Implementation in the Field able to position themselves to the situation
Mindfulness is believed to be an ideal that is happening.
meditation effort and attains the right Mindfulness acts as an individual
attitude for us during the Covid-19 psychological effort to correct confusion in
pandemic. the thoughts and feelings of worry that are
According to Meidy Marsella L. being experienced.
Panglewai, a psychologist from the Faculty Mindful individuals will be able to
of Psychology, Atma Jaya University take rational actions, be able to analyze
Makassar in the journal Scientific situations clearly, and have a more open
Psychology Consortium, said that Covid-19 mind. Individuals are also able to be fully
since it first appeared in Indonesia has aware of the context and situations that
indeed created impulsive community occur around them.
actions, for example panic buying or The advantage of having mindfulness
stockpiling important material stocks. is that individuals will tend to have lower
Meidy assessed that these forms of stress levels. So that it can reduce anxiety
behavior arose because of the people's and anxiety that is too excessive which can
confusion in responding to new and actually worsen physical condition or
threatening things. It can be said that the endurance.
COVID-19 virus has caused mass stress. steps that can be taken to achieve
When humans experience stress, there mindfulness in the midst of the current
are two primitive responses in dealing with situation:
it, the response is" fight-or-flight, " The 1. Look for a quiet place to do focused
concept developed by Cannon in 1932 meditation.
meant that a "fight-or-flight" response was a Focused meditation is done in a comfortable
condition in which an individual sitting position while focusing on
instinctively would take a series of something, for example to relax stiff
aggressive actions to protect himself (fight) muscles and relieve stress, then calm
or withdraw or be apathetic to avoid yourself by closing your eyes then slowing
situations that were considered dangerous down the breath while imagining stiff
(flight) . muscles becoming relaxed. It can also be
Meidy assessed that aggressive done with your eyes open while looking at
responses and efforts to be calm were both certain objects that provide a sense of
not to blame, because they were a set of comfort while giving positive suggestions to
natural responses that existed in humans. yourself.
However, in the Covid-19 case there were 2. Wash your hands mindfully.
some individuals who responded You need to do the process of washing your
inappropriately because of concerns. Meidy hands slowly, starting from opening the
asserted, the impact of actions without water tap, scrubbing soap, and rinsing it.
proper thought will lead to psychological Feel and enjoy the sensation in the hand
symptoms, such as excessive anxiety, easy while giving positive suggestions to
to receive wrong information without being yourself that the body will stay healthy and
digested, and others. Thus, one effort that the viruses will disappear after washing
hands.
81
Virus (Covid 19)
3. Enjoy the food mindfully. segmented. Coronavirus belongs to the

Prepare food that is good for the body order Nidovirales, Coronaviridae
dannikmati slowly. See the shape, inhale the family.The structure of the coronavirus
aroma of the food, feel the texture, then forms a cube-like structure with the S
imagine that the body is grateful for the protein located at the surface of the virus. S
nutritious intake that has been given. Don't protein or spike protein is an antigen protein
forget, convince yourself that the body will main virus and is the main structure for
be healthy. writing genes. This S protein plays a role in
the attachment and entry of viruses into host
4. Calm down when you panic. cells (protein interactions S with its receptor
When the body feels the symptoms of panic in the host cell) (Wang, 2020).
the first thing to do is calm yourself in Coronavirus is heat sensitive and can
accordance with the manner and comfort of effectively activated by disinfectants
each individual. For example, the way to do containing chlorine, lipid solvents with a
this is by hugging yourself, taking a deep temperature of 56 ℃ for 30 minutes, ether,
breath, rubbing your arms gently, and so on. alcohol, perioxyetic acid, non-ionic
5. Give a positive suggestion detergent, formalin,oxidizing agent and
Talk to yourself to give positive chloroform. Chlorhexidine is not effective
suggestions. In this way the individual will in deactivating the virus (Wang, 2020;
always be aware of the thoughts and Korsman, 2012).
feelings that he is experiencing so that he Early symptoms of Corona virus
can analyze the situation appropriately. This infection or COVID-19 can resemble flu
method can also increase self-respect. symptoms, namely fever, runny nose, dry
cough, sore throat, and headache. After that,
Basic Concepts of Reproductive Health the symptoms can disappear and heal or
and Their Implementation in Covid even aggravate. Patients with severe
Pandemic 19 symptoms can experience high fever, cough
Reproductive health according to the with phlegm and even bleeding, shortness
World Health Organization (WHO) is of breath, and chest pain. These symptoms
physical, mental and social well-being as a appear when the body reacts against the
whole and not only the absence of disease Corona virus. In general, there are 3 general
or weakness, in all matters relating to the symptoms that can indicate a person is
reproductive system and its functions and infected with the Corona virus, namely:
processes (Harahap, 2003). Fever (body temperature above 38 degrees
In the era of globalization and Celsius) Coughing, Shortness of breath.
modernization, there have been changes and The symptoms of COVID-19
progress in all aspects in dealing with the generally appear within 2 days to 2 weeks
development of the environment, health and after the patient is exposed to the Corona
hygiene, where people are required to virus.
always maintain physical and organ hygiene Fever is the most common symptom,
or organs. One of the organs of the body although some older people and those who
that is important and sensitive and requires have other health problems experience a
special care is a reproductive tool. Good fever later in life. In one study, 44% of
knowledge and care is a determining factor people had a fever when they came to the
in maintaining reproductive health. If the hospital, while 89% had a fever at some
reproductive organs are not kept clean it point during their stay in the hospital.
will cause infection, which can eventually Corona virus infection or COVID-19
lead to disease (Harahap, 2003). can not be treated, but there are several
Coronavirus is a single positive, steps that doctors can take to reduce
encapsulated and non-strained RNA virus
82
Virus (Covid 19)
symptoms and prevent the spread of the virus infection or COVID-19. Therefore, the
virus, namely: best way to prevent it is to avoid the factors
1. Referring patients with severe COVID- that can cause you to be infected with this
19 to undergo treatment and caratina in a virus, namely:
referral hospital 1. Apply physical distancing, which is to
2. Provide a fever and pain reliever that is maintain a minimum distance of 1 meter
safe and in accordance with the patient's from other people, and do not leave the
condition house unless there is an urgent need.
3. Encourage sufferers of COVID-19 to do 2. Use a mask when on the move in public
independent isolation and adequate rest places or crowds, including when going
4. Encourage sufferers of COVID-19 to grocery shopping.
drink lots of water to maintain body fluid 3. Routinely wash your hands with water
levels and soap or hand sanitizer containing at
In severe cases, Corona virus least 60% alcohol, especially after doing
infection can cause the following activities outside the home or in public
complications: places.
Pneumonia (lung infection) Secondary 4. Don't touch your eyes, mouth, and nose
infection in other organs Renal failure, before washing your hands. Increase
Acute cardiac injury Acute respiratory endurance with a healthy lifestyle.
distress syndrome Death. 5. Avoid contact with sufferers of COVID-
In some people, this disease can 19, people suspected of being positively
develop into pneumonia, multi-organ infected by the Corona virus, or people
failure, and death. Neurological who are sick with a fever, cough, or
manifestations including seizures, strokes, runny nose.
encephalitis, and Guillain-Barré syndrome. 6. Cover your mouth and nose with tissue
Complications related to cardiovascular when coughing or sneezing, then throw
may include heart failure, irregular the tissue in the trash.
electrical activity, blood clots, and 7. Keep clean objects that are often touched
inflammation of the heart. and environmental cleanliness, including
In some people, COVID-19 can affect cleaning the house.
the lungs that cause pneumonia. In those
most severely affected, COVID-19 can Conclusion
quickly develop into an acute respiratory COVID-19 is a virus that damages the
distress syndrome (ARDS) that causes respiratory system and can cause several
respiratory failure, septic shock, or multi- complications due to infection until death.
organ failure. Don't feel too depressed and
Complications related to COVID-19 overburdened during this pandemic
including sepsis, abnormal clotting, and outbreak, because what is needed is a strong
damage to the heart, kidneys, and liver. immune system or metabolism and can
Clotting abnormalities, specifically an increase immunity by exercising and eating
increase in prothrombin time, have been healthy foods.
explained in 6% of those who are Apply how to prevent the spread of
hospitalized with COVID-19, while COVID-19 in everyday life.
abnormal kidney function is seen in 4% of And also the concept of Mindfulness
this group. About 20-30% of people who is the condition of individuals who have full
present with COVID-19 show an increase in awareness of the things that happen around
liver enzymes(transaminase). Liver injury them. Individuals who are in a mindful
as indicated by a blood marker of liver condition become more aware, sensitive,
damage is often seen in severe cases. Until able to balance themselves, and able to
now, there is no vaccine to prevent Corona
83
Virus (Covid 19)
position themselves to the situation that is

happening.
The concept of Mindfulness goes
hand in hand with reproductive health
during the Covid 19 pandemic, and it is
endeavored to be able to carry out all
procedures to avoid covid 19 by avoiding
direct contact with others, and try not to
leave the house except at the crucial
moment. meeting with people who are sick,
avoid sharing the use of eating and drinking
utensils, toiletries, and sleeping equipment
with others, wear masks and gloves when in
a public place or are with other people, use
tissue to cover mouth and nose if you cough
or sneeze, then immediately throw the tissue
in the trash.
References
1. Manuaba. Penyakit Kandungan ibu
nifas dan Menyusui. Jakarta: EGC;
2010.
2. Peraturan Menteri Kesehatan
Republlik Indonesia No.
HK.02.02/Menkes/068/I/2010
3. World Health Organization. Drug and
therapeutics committees, A practical
guide. Switzerland: World Health
Organization; 2004.
4. Heryani Reni. Asuhan Kebidanan Ibu
Nifas dan Menyusui. Yogyakarta: TIM;
2015.
5. World Health Organization. Progress in
the rational use of medicines.World
Health Organization; 2007.
6. Notoatmodjo S. Metodologi Penelitian
Kesehatan. Jakarta. Rineka Cipta.; 2013.
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penelitian 4: Ukuran sampel rumus
Slovin. Erlangga, Jakarta; 2011.
84
The Relationship Of Breastfeeding Technique With The Occurrence Of Blisters On Nipples Milk In Breastfeeding Mothers In
The Work Area Of The Glugur Darat Health Center In East Medan District 2019
THE RELATIONSHIP OF BREASTFEEDING TECHNIQUE WITH THE

OCCURRENCE OF BLISTERS ON NIPPLES MILK IN
BREASTFEEDING MOTHERS IN THE WORK AREA OF THE
GLUGUR DARAT HEALTH CENTER IN EAST MEDAN DISTRICT 2019
Desrima H Sihombing1, Retno Wahyuni2, Lasria Simamora3
[email protected]
Abstract
Chafed nipples are pain in the nipples, cracking when breastfeeding is caused by improper
breastfeeding or breast care. Common breastfeeding problems include engorgement, nipple
abnormalities, cracked nipples, obstructive duct, breast inflammation (mastitis) and breast
abscess. World Health Organitation (WHO) estimates mastitis in breastfeeding mothers is
around 2.6% - 33% and the global prevalence is around 10%. breastfeeding women. The aim of
the study: to determine the relationship between breastfeeding techniques and the incidence of
nipple blisters in the work area of the Medan Glugur Ground Health Center in 2019. Design:
cross-sectional with total sampling, where the population in this study was 118 people, data
collection checklist and questionnaires which were then processed Editing, Coding Scoring,
Tabulating and using the Chi Square Test. Results: Of the 54 respondents, there were 34 (63%)
respondents who had the correct breastfeeding technique and 20 (37%) respondents had the
wrong breastfeeding technique, while 37 (68.5%) had blistered nipples and those who did not
experience blistered nipples. 17 (31.5%), so that it was found that there was a correlation
between incorrect breastfeeding techniques and the incidence of blistered nipples in nursing
mothers p = (0,000) α <0.05. The conclusion of the study: that there is a relationship between
breastfeeding techniques and the incidence of nipple blisters in breastfeeding mothers in the
working area of the Glugur Public Health Center. The suggestion in this research is that it is
hoped that health workers can improve health services and counseling on correct breastfeeding
techniques for breastfeeding mothers.
Keywords: Breastfeeding Techniques, Nipples Blisters
Preliminary breastfeed so that the baby rarely

Breastfeeding problems generally breastfeeds. Reluctance to breastfeed will
occur in the first two weeks of the result in unfavorable consequences, because
puerperium, so during this period the the baby's suction is very influential in
supervision and attention of health workers stimulating further milk production.
is needed so that breastfeeding problems However, mothers occasionally do not get
can be resolved immediately and not information about the benefits of
become difficult and interfere with breastfeeding and about correct
breastfeeding. Common breastfeeding breastfeeding (Lodan, 2015). According to
problems include engorgement, nipple the World Health Organitation (WHO)
abnormalities, nipple pain (sore nipple), estimates mastitis in breastfeeding mothers
cracked nipple, obstructive duct, breast is around 2.6% - 33% and the global
inflammation (mastitis) and breast abscess prevalence is around 10%. breastfeeding
(Djamhoer, 2016). Breastfeeding technique women. Based on research (Hasanah, 2017),
is one of the factors that affect milk in Indonesia, 22.5% had blistered nipples,
production where if the breastfeeding 42% of mothers had breast milk dams, 18%
technique is not correct, it can cause nipple of mothers had blocked milk, 11% had
blisters and make the mother reluctant to mastitis, and 6.5% of mothers had breast
85
abscesses. caused by the mother's mistake in or observing at the same time between
breastfeeding her baby. In the research of factors (Notoadmodjo, 2012), which aims to
Risneni (2015) states that the results of determine the relationship of Breastfeeding
mothers who breastfeed their babies with Technique with the Occurrence of Blisters
wrong breastfeeding techniques and on Nipples Milk in Breastfeeding Mothers.
experience the incidence of blisters on the The subjects of this study were
nipples as many as 24 people or (68.6%) breastfeeding mothers from May-July 2019
The results of the statistical test can be in the work area of the Glugur Darat Public
concluded that there is a significant Health Center in Medan. The sample
relationship between breastfeeding technique used in this research is purposive
techniques. with the occurrence of nipple sampling. The number of respondents or the
blisters in postpartum mothers. The sample in this study with the Solvin
preliminary survey at Puskesmas Glugur formula, namely: n = n
Darat on May 16, 2019, obtained the results 1 + N (e) 2
of 15 mothers who breastfed and those who Information:
experienced blistered nipples with an initial n = sample size / number of respondents
survey of 8 people by observing mothers N = Population size
breastfeeding babies and seeing the E = tolerable percentage of allowance for
condition of the mother's nipples. Among accuracy of sampling error; e = 0,
them are mothers who experience peeling, So the sample in this study was 54 people.
red, and scaly nipples. Data collection was carried out
Care during the postpartum period byresearchers directly using primary data,
needs attention because around 60% of the namely a questionnaire to determine the
Maternal Mortality Rate (MMR) occurs mother's knowledge of various factors such
during this period. Midwives have a very as education, parity, occupation and socio-
important role in providing midwifery care culture which contained several questions
for postpartum and breastfeeding mothers about the correct breastfeeding technique,
(Maritalia, 2012). the characteristics of blistered nipples. and
checklists, that is, by observing the
Method techniques used by mothers in breastfeeding
The research design used in this their babies. The data obtained will be
study was cross sectional. Cross Sectional analyzed using the Chi Square test with the
Research is a research design by measuring SPSS program.
Result
Table 4.1. Frequency distribution based on the characteristics of respondents in the Work
Area of the Medan Glugur Darat Health Center in 2019
No Characteristics Measurement results Frequenci Percentage (%)
1 Age a. < 20 Years 16 29,6
b. 20-35 Years 23 42,6
c. > 35 Years 15 27,8
Total 54 100
2 Parity a. Primipara 22 40,7
b. Multipara 22 40,7
c. Grandepara 10 18,5
Total 54 100
3 Work a. IRT 20 37
b. Farmers 3 5,6
c. Private employees 19 35,2
d. PNS 12 22,2
Total 54 100
86
From table 4.1 it can be seen that The majority of respondents were aged 20-35 years as many
as 23 respondents (42.6%), at> 35 years old were 15 respondents (27.8%), and aged <20 years
were 16 respondents (29.6%), the majority of respondents Parity is Primipara as many as 22
respondents (40.7%), for Multipara as many as 22 respondents (40.7%), for Grandepara as
many as 10 respondents (18.5%). The majority of respondents whose jobs are IRT as many as
20 respondents (37%), for private employees as many as 19 respondents (35.2%), civil servants
as many as 12 respondents (22.2%), farmers as many as 3 respondents (5.6%).
Table 4.2 Characteristics of Breastfeeding Technique Variables in the Work Area of the
Medan Glugur Darat Health Center in 2019
No Breastfeding Tecnique Frequenci Percentage (%)
1 True 34 63
2 False 20 37
Total 54 100
From table 4.2 it can be seen that 34 respondents (63%) did the correct breastfeeding technique
and 20 respondents (37%) did the wrong breastfeeding technique.
Table 4.3 Characteristics of Variable Nipple Blisters in the Work Area of the Medan
Glugur Darat Health Center in 2019
No Nipple Blisters Frequenci Percentage (%)
1 Blisters 37 68,5
2 Not Blisters 17 31,5
Total 54 100
From the table 4.3 it can be seen that There were 37 respondents (68.5%) who
experienced blisters (68.5%) and 17 respondents (31.5%) who did not experience blisters.
Table 4.4 The Relationship Between Breastfeeding Techniques and the Incidence of
Blisters in the Work Area of the Medan Glugur Darat Community Health
Center in 2019
Blisters nipples Total
Breastfeeding
No Blisters % Not % Percentag
Tecniques F
Blisters e
1 True 17 31,5 17 31,5 34 63
2 False 20 37 0 0 20 37
Total 54 100
From the table 4.4 it can be seen that (0,000). If the p value α <0.05 then Ha is
20 (37%) respondents with wrong accepted where there is a relationship
breastfeeding techniques who experienced between incorrect breastfeeding techniques
blistered nipples, 0 respondents with wrong and the incidence of blistered nipples.
breastfeeding techniques, 17 (31.5%) 17
(31.5%) respondents, the correct Discussion
breastfeeding technique that did not Providing information about
experience sore nipples. This study was breastfeeding techniques to mothers will
supported by the chi square test with p value increase knowledge about correct
87
breastfeeding techniques, because Textbook of Midwifery Care for Nursing

knowledge plays a very important role so Mothers, the main cause of blisters in
that breastfeeding mothers can anticipate breastfeeding mothers is the improper
the occurrence of blistered nipples. The attachment position. With these results it is
results of this study are in accordance with necessary to make efforts to improve the
the opinion of the research journal Ulfa implementation of good breastfeeding
Farah, (2017) that in order for the techniques, namely by providing health
breastfeeding process to run smoothly, a education or counseling conducted by
mother must have breastfeeding skills so researchers and health workers, especially
that milk can flow from the mother's breast about correct breastfeeding techniques, so
to the baby effectively. Good breastfeeding that respondents can make efforts to be able
skills include position. breastfeeding and to implement good and correct
attachment of the baby to the right breast. breastfeeding techniques.
From the table 4.4 it can be seen that 20
(37%) respondents with wrong Conclusion
breastfeeding techniques who experienced From the results of the research on the
blistered nipples, 0 respondents with wrong Relationship between Breastfeeding
breastfeeding techniques, 17 (31.5%) 17 Technique and the Incidence of Blisters in
(31.5%) respondents, the correct Breastfeeding Mothers in the Work Area of
breastfeeding technique that did not the Glugur Darat Public Health Center in
experience sore nipples. This study was Medan in 2019, conclusions can be drawn:
supported by the chi square test with p value 1. Breastfeeding mothers in the working
(0,000). If the p value α <0.05, Supported area of Puskesmas Glugur Darat Medan had
by Research Results (Lodan, 2015) 34 (63%) correct breastfeeding techniques,
Breastfeeding technique is one of the factors compared to 20 (37%) mothers who
that affect milk production where if the breastfed incorrectly.
breastfeeding technique is not correct, it can 2. Breastfeeding mothers in the working
cause the nipple to become chafed and area of the Puskesmas Glugur Darat Medan
make the mother reluctant to breastfeed so had 37 more breastfeeding nipples (68.5%),
that the baby rarely breastfeeds. Reluctance compared to those who were not 17
to breastfeed will result in unfavorable (31.5%).
consequences, because the baby's suction is 3. There is a relationship between
very influential in stimulating further milk breastfeeding techniques and the incidence
production. However, occasionally mothers of blistered nipples in breastfeeding mothers
do not get information about the benefits of in the working area of the Puskesmas
breastfeeding and about correct Glugur Darat Medan, where the p value
breastfeeding. (0.000) is α <0.05.
The results of this study are in It is hoped that health workers can provide
accordance with Risneni's research (2015) counseling or counseling in order to
which states that the results of mothers who increase knowledge of breastfeeding
breastfeed their babies with wrong mothers about correct breastfeeding
breastfeeding techniques and experience techniques so that they can increase
abrasions on the nipples as many as 24 knowledge in breastfeeding and breast care.
people or (68.6%). The results of the From the results of this study, it is hoped
statistical test can be concluded that there is that it can be an input for Puskesmas to
a relationship. There is a significant provide education and health education to
difference between breastfeeding technique breastfeeding mothers about correct
and the occurrence of nipple blisters in breastfeeding techniques. It is hoped that
postpartum mothers. The theory put forward further researchers can continue this
by Sutanto (2010) in his book entitled research with different variables.
88
Reference 9. Maritalia, Dewi.2012.Asuhan

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pringsewu.ac.id/index.php/JIK/article/ 565 diunduh tanggal 16 maret 2017
view/4 diakses tanggal: 04 Juli 2015 15. Saleha.2016.Asuhan Kebidanan Pada
5. Erna Kasim. 2017, Hubungan Teknik Masa Nifas. Jakarta: Salemba Medika.
Menyusui Dengan Kejadian Putting 16. Sulistiyawati.2016.Buku Ajar Asuhan
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Kesehatan RI.Jakarta Keterampilan Teknik Menyusui
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Hubungan Perawatan Payudara Pada ibu Post Partum. Aceh. Journal
Dengan Keberhasilan Ibu Menyusui. Of Healtcare Technology and
Skripsi Ilmu Keperawatan, Fakultas MedicineVol 3 No 2. Diakses dari:
Keperawatan Universitas Katolik http://jurnal.uui.ac.id/index.php/JHT
Widya Mandala Surabaya. M/article/viewfile/275/90 diakses
8. Marmi.2015.Asuhan Kebidanan Pada tanggal 2 oktober 2017
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Care”.Yogyakarta: Pustaka Pelajar Kebidanan Masa Nifas & Menyusui.
Yogyakarta: Pustaka Baru Press
89
Nursing Care For Clients With Bone Metabolism Disorders Osteoporosis
NURSING CARE FOR CLIENTS WITH BONE

METABOLISM DISORDERS OSTEOPOROSIS
Lindang Tumanggor
[email protected]
ABSTRACT
Nurse's duty in treating osteoporosis patients to reduce the occurrence of adecrease in total bone
mass. Osteoporosis is a disorder in which there is a decrease in masstotal bone.There are
changes in bone homeostasis normal, the speed of bone resorption is greater than the speed
bone formation, resulting in a decrease in total bone mass.Bones are progressively porous,
fragile and easy broken; bones become easily fractured with stress that won't cause influence on
normal bone.This disease does not raises a fatal state but raises a limitation in sufferers.
Getknowledge about osteoporosis and treatment programs.Mention the relationship between
calcium intake and exercise bone mass. Consuming dietary calcium in an amount Adequate
Increase the level of exercise Use hormone therapy prescribed Undergo screening procedures as
directed Getting pain relief. Experiencing pain relief when rest.
Keywords :Nurse intervention, Elderly, bone pain patient
INTRODUCTION and bone tissue microarchitecture

During this osteoporosis abnormalities, with consequences increased
synonymous with parents, but the facts bone bone fragility and the risk of bone fractures.
loss can affect anyone including at a young
age.Recent research from the International MATERIAL AND METHODS
Osteoporosis Foundation (IOF) revealed Type of quantitative research,
that 1 in 4 women in Indonesia with a range analytic design with cross approach
aged 50-80 years have a risk of sectional namely using primary data.
osteoporosis. And also risks osteoporosis of Population from this study are women in the
women in Indonesia is 4 times higher than premenopausal period between the ages of
that of men.1 This is indicated by the low 40-50 year. Osteoporosis is a condition
calcium consumption of the average person where bones become porous, without
Indonesia, which is only 254 mg per day.2 changing the shape or structure of the outer
Premenopause occurs 4–5 years before bone, but the inner area the bones become
menopause, where climacteric complaints hollow so they break easily. In fact the term
arise, but the hormone estrogen is still osteoporosis has been known since ancient
formed. When estrogen levels decrease, Greek, meaning osteo bone and porosis
bleeding does not occur regularly.3 means a hole or a hollow bone. The cause of
Premenopause, this period usually occurs osteoporosis is a disturbance in metabolism
for about 4-5 years, and starting before bone. Under normal circumstances, bone
menopause itself, the first time feel cells, which are building cells (osteoblasts)
symptoms of menopause such as hot and dismantling cells (osteoclasts) work in
flushes,night sweats, irregular periods. If a turn, mutually filling, balanced, so that the
women do not experience menstruation for bones become whole. If osteoclasts work
one year with age under 50 years, then this exceeds the work of osteoblasts, then bone
is a sign of the end of premenopause and density becomes less and finally porous.
initially menopause.4 According to Bone metabolism can be disturbed by a
osteoporosis WHO is a disease variety conditions, i.e. reduced estrogen
characterized by a reduction in mass bone hormone, reduced intake calcium and
90
vitamin D, reduced mechanical stimulation examination that is; Examination analysis of

(inactive) on bone, side effects of several the activation ofm neutrons aims to check
types of drugs, drinking alcohol, smoking, total calcium and bone mass.
and so on.1 Absorpsiometry examination Computer
tomography (CT) examination Biopsy
RESULTS examination is invasive and useful for
The results of this study will describe provide information about the state of
the frequency distribution of each osteoclasts, osteoblasts, trabecular thickness
respondent's characteristics in and quality of bone mineralize. Biopsy is
premenopausal women Factors affecting done in the sternum or iliac crest.Laboratory
bone reduction in elderly:O Mass tests are blood chemistry and chemical tests
Determinants Bone Genetic Factors Genetic urine is usuall y examination is not helped a
differences have an influence on degrees lot except for the examination of osteocalein
bone density. Some people have enough biomakers examination is not helped a lot
bone the other big and small. For example, except for the examination of osteocalein
black people on generally have stronger biomakers (GIA protein bone mineralize.
bone structure / weight than pacia Biopsy is done in the sternum or iliac
Caucasian people. Jacii someone who has crest.Laboratory tests are blood chemistry
strong bones (especially Black Americans), and chemical tests urine is usually within
relatively immune to fractures due to normal limits. so that this
osteoporosis.Mechanical factor Mechanical
load affects the bone mass on the side geneti DISCUSSION
factor. Increasing weight will increase mass Health promotion, identification of
bone and reduced burden will result reduced individuals at risk osteoporosis and the
bone mass. In other words you can discovery of problems associated with
mentioned that there is a direct and tangible osteoporosis forms the basis for nursing
relationship between muscle mass and bone assessment. Interviews include questions
mass. Both of these indicate a response to about the occurrence of osteoporosis in the
work mechanics Heavy mechanical loads family, previous fractures, daily
will cause mass large muscles, and also consumption of calcium diet, training
large bone mass. As an example is a tennis patterns, onset of menopause and the use of
player or pedicab pedicab, will be found corticosteroids besides alcohol, cigarette
hypertrophy both in the muscles and bones, and caffeine intake. Every intentionally
especially in the arms or legs; conversely experienced by patients, such as pain,
atrophy both in the muscles and his bones constipation or image disturbances self must
will be found in patients who have to rest on be dug up. Physical examination sometimes
bed for a long time, poliomyelitis or on finds kyphosis fractures thoracic vertebrates
space flight. However not yet known or shortening of height. Problem mobility
exactly how much mechanical load is and breathing can occur due to changes in
needed and Food and hormone factors In posture and muscle weakness. Constipation
someone with growth hormone with can occur due to inactivity.
nutrients enough (protein and minerals), Lack of knowledge about the
bone growth will reach the maximum osteoporosis process and programs therapy
according to its genetic influence Pain associated with muscle
concerned. Excessive feeding (for example fractures and spasms Constipation related to
calcium) above the maximum requirement immobilization or occurrence ileus
during the growing period, doubt that it can (intestinal obstruction)
produce bone mass in excess the ability of Risk of injury: fracture, which is
the relevant bone growth accordingly with associated with bone osteoporotic AIM
genetic capabilities.Non-invasive general target patients can include
91
knowledge aboutosteoporosisand action When the patient can spend more time at
programs, pain reduction, improvement outdoor beds need to be recommended for
emptying of the intestine and no additional frequent bed rest reduce discomfort and
fractures Understanding Osteoporosis and reduce stress due to posture abnormal in
Action Programs. Teach the client about the weakened muscles.
influencing factors occurrence of Oral opioids may be needed for the first
osteoporosis. Advise an adequate diet or days after onset back pain. After a few days,
calcium supplement non-analytics opoid can reduce pain.
Weigh regularly and modify Improving intestinal emptying. Constipation
lifestyle like Reducing caffeine, cigarettes is a matter related to immobility,treatment
and alcohol, this can helps maintain bone and the elderly.
mass.
Encourage Exercise physical CONCLUSION
activity which is the main key to grow high- Get knowledge about osteoporosis
density, resistant bones on the occurrence of and programs handling it. State the
oestoeporosis. relationship between calcium intake and
Encourage the elderly to continue to exercise bone mass Consuming dietary
need calcium, vitamin D, sunlight and calcium in an amount Sufficient O Increases
adequate exercise to minimize the effects the level of exercise Use prescribed
osteoporosis. hormone therapy Undergo screening
Provide patient education regarding procedures accordingly suggest, activity
side effects of use drug. Because stomach everyday lif Indicates reduced pressure in
pain and abdominal distension are effects the fracture site
the side that often occurs in calcium Diligent in undergoing weight-loss
supplements, the patient You should take surgery exercises (walks every day) Rest
calcium supplements with food for reduce with lying down several times a day
the occurrence of these side effects. In Participate in activities outside the home
addition, intake adequate fluid can reduce Creating a safe home environment Receive
the risk of stone formation kidney. assistance and supervision as needed
When prescribed HRT, patients must Getting pain relief Experience pain
be taught about its importance periodic relief when rest Experience minimal
screening for breast and endometrial cancer. discomfort during activity everyday life
Relieves Pain. Indicates reduced pressure in the fracture sit
1. Relief of back pain can be done by Shows normal bowel emptying - Noisy
resting in bed on your back or side on a active intestine Regular bowel movements
few days. No new fractures Maintain good postureUse
The mattress must be solid and not supple. good body mechanics Eat a balanced diet
2. Knee flexion can increase comfort by high in calcium and vitamin D
relaxing muscle. Diligent in undergoing weight-loss
3. Intermittent heat compresses and back surgery exercises (walks every day) Rest
massage muscle relaxation. with lying down several times a day
4. The patient is asked to move the torso as Participate in activities outside the home
oneunit and avoid twisting movements. Creating a safe home environment Receive
5. Good posture is recommended and body assistance and supervision eeded
mechanics musttaught. When the
patient is helped get out of bed, Reference
6. attach the lumbosacral corset to support 1. Alwi (2004). The basic concept of
and immobilizewhile, although similar osteoporosis From
devices sometimes feel uncomfortable http://www.google.com/mediacasto
and less tolerable by most elderly people.
92
re from http://www.google.co.id/
osteoporosis disease guidelines
2. Brunner and Suddarth. (2002).
Nursing Medical-Medical
Textbook. 8th edition Volume 3.
EGC: Jakarta. MOH RI. (2002).
Guidelines for controlling
osteoporosis. Jakarta : Public health
Office.
3. D. Citra. (2002). Guidelines for
controlling osteoporosis
4. Friedman. (2002).
5. Family Nursing (Yasmin Asih
translator). Jakarta :EGC.
6. Jhonson and R. leny. (2010). Family
Nursing. Nuha Medika: Yogyakarta
7. Ministry of Health Republic of
Indonesia Thanaseelan, Rathidevi.
"Overview of Knowledge About
Osteoporosis in Women in
Premenopausal Age in Medan 2010 ".
USU FK, Sumatra utara .
8. Pieter, Z. H. 2011. Introduction to
Psychology for Midwifery. Jakarta:
Kencana.
9. RI Ministry of Health. 2015. Data and
conditions of osteoporosis in Indonesia.
Jakarta: Balitbang Depkes RI
10. Sudoyonu.(2006).Textbooks in internal
medicine. Volume II. IV Edition.
Jakarta: FKUI
11. Suprajitno. (2004). Family concept.
Jakarta: EGC
93
The Nutritional Status Of The Elderly Based On Knowledge And Physical Activity, In The Working Area Of Puskesmas
Sukawati 1, Gianyar, Bali
THE NUTRITIONAL STATUS OF THE ELDERLY BASED ON

KNOWLEDGE AND PHYSICAL ACTIVITY, IN THE WORKING AREA
OF PUSKESMAS SUKAWATI 1, GIANYAR, BALI
Vivin Febriani Lumbangaol

[email protected]
STIkes Mitra Husada Medan
ABSTRACT
Nutritional status of the elderly based on knowledge and physical activity, in the work
area of the Sukawati 1 health center, Gianyar, Bali. Increased life expectancy and the
number of the elderly population may trigger an epidemiological transition in the health sector
due to the increasing number of morbidity because of degenerative disease. Various studies
have been conducted showing that the results are still a lot of the prevalence of malnutrition in
the elderly. However, until now there has been no data collection on the nutritional status of the
elderly in Puskesmas Sukawati I. The researcher wants to assess the nutritional status of the
elderly in Puskesmas Sukawati I to know the state of nutrition of the elderly in the region. This
research uses descriptive quantitative approach to the cross-sectional design. The total sample
obtained amounted to 72 people and in their implementation in all samples was conducted
interviews and anthropometric measures. Based on the calculation of waist hip ratio, 77.8% had
central obesity, with an average waist hip ratio in the studied sample of 0.95 for men who
belong to a lower risk of obesity and 0.92 for women belonging to the high risk of obesity.
Based on the level of knowledge about nutrition, 71.4% samples are overnourished in less
knowledge group, as well as with good level of knowledge group also showed the highest
proportion 86.7% that is overnourished status. When viewed from the physical activity, the
distribution of samples have light activity mostly in "over nutrition" status (92.7%). PHC is
advised to conduct anthropometric measurement and recording of the elderly health status
comprehensively on Card Towards Healthy for the elderly as well as counseling with a
nutritionist about the health of the elderly to resolve the issue.
Keywords: Nutritional status, prevalence of obesity, elderly, physical activity, knowledge
1. Introduction namely:(middle agemiddle age) 45-59

Increased life expectancy (UHH) is years, elderly (75-90elderly) 60-74 years,
one indicator of the success of development elderly (old)years and very old age (very
in the health sector and population welfare. old) over 90 years. According to Law No.
This has an impact on increasing the 13 of 1998 which was updated from Law
number of elderly people (elderly). Based no. 23 of 1992 said that old age is someone
on the United Nations report in 2013, UHH who has reached the age of 60 years and
in 2013 was 71 years (with the percentage over. Biologically, the elderly are people
of the elderly population reaching 12%). It who experience a continuous aging process,
is recorded that the number of elderly which is characterized by a decrease in
people in Indonesia is 18,043,712 people or physical endurance, namely the increasing
around 7.59% of the entire population of susceptibility to disease attacks that can
Indonesia.1 Provinces with elderly with the cause death.3
highest proportion were DI Yogyakarta Various studies that have been
(13.20%), Central Java (11.11%), East Java conducted have shown that there is still a
(10.96%) and Bali (10.07%).2 large number of malnutrition in the elderly. 4
The World Health Organization According to WHO, malnutrition basically
(WHO) classifies the elderly into four, means wrong nutrition and clinically,
94
malnutrition is a nutritional status where Integrated Service Post (posyandu) for the
there can be a deficiency, excess or elderly, each located in the villages of
imbalance of the nutrients in a food, causing Batuan, Sukawati, Guwang and also
measurable side effects on body tissues, Ketewel. The number of elderly people in
body function and impacting health the working area of Puskesmas Sukawati I
deterioration. . Based on this definition, is 6076 people. However, the average
malnutrition can be either overnourished or number of visits by the elderly aged 60
undernourished.5,6 years and over to the elderly posyandu in
However, currently the threat of July 2015 was still very small, namely
degenerative diseases such as coronary around 418 elderly people (6.8%). The
heart disease, hypertension, and diabetes elderly who came to receive health services
mellitus has increased. This can be seen in the form of measuring blood pressure,
from WHO data, the highest cause of death weighing and general health checks.
in the world in 2012 was coronary heart However, until now there has been no data
disease.4 Risk factors that are closely related collection regarding the nutritional status of
to this degenerative disease are lifestyle, the elderly at Puskesmas Sukawati I.8
including excess body weight (obesity). The Based on preliminary calculations
prevalence of central obesity at the national made by researchers from secondary data
level is 18.8%, where there is a tendency to based on the register book of the Elderly
remain high when entering the elderly, Posyandu in Batuan Village in July 2015, it
namely 23.1% (55-64 age group), 18.9% shows that 79% of the elderly are
(group 65-74 age) and 15.8% (group 75 malnourished (based on BMI calculations).
years and over).7 Furthermore, in a preliminary survey
According to Monica in the conducted by researchers on 10 people, 6
Indonesian Ministry of Health, being people with over nutritional status were also
overweight or obese will increase the risk of found in the same village. Of course this is
suffering from coronary heart disease 1-3 seen as a gap between the prevalence of
times, hypertension 1.5 times, diabetes malnutrition which is still high and the
mellitus 2.9 times and bile disease 1-6 existence of an existing posyandu program.
times. The Indonesian Ministry of Health Therefore, the researcher wanted to assess
explained that excess nutrition in the elderly the nutritional status of the elderly in the
is usually related to a lifestyle and excessive working area of Puskesmas Sukawati I to
consumption patterns from a young age determine the nutritional status of the
even from childhood. In addition, decreased elderly in that area.
metabolic processes in the elderly if it is not
matched by increased physical activity or 2. Thismethod
decreased amount of food results in excess Researchused a quantitative
calories being converted into fat, causing descriptive approach with adesign cross-
obesity. This shows that overweight and sectional in 2015. This study was conducted
obesity should also remain a concern to obtain an overview of the nutritional
because they can spur the onset of status of the elderly (elderly) in the working
degenerative diseases.4 area of Puskesmas Sukawati I. Sampling
Based on data from Puskesmas began by selecting one of the six villages in
Sukawati I in 2014, Puskesmas Sukawati I the working area. Puskesmas Sukawati I
has six units of Supporting Puskesmas was random, and Ketewel village was
(Pustu), each of which is located in chosen. Then, the researcher got a list
Kemenuh Village, Batuan Kaler Village, ofelderly names 180 from the Village Head
Batuan Village, Sukawati Village, Guwang of Ketewel who were randomly selected
Village and Ketewel Village. In addition, from 15 banjars in the village. Then out of
Puskesmas Sukawati I has four units of 180, we systematically selected 72 samples,
95
that is, taking samples with serial numbers The majority of the sample aged 60-69
every multiple of 2.5. If the sum shows a years, are male, still have a partner, have
decimal, it will be rounded up. Then to find low education and do not work. Most
the serial number, the result is the addition samples have complaints of joint pain
of the previous decimal. This research was andeasily tingling. Asside anote, one
started from 7 August - 8 September 2015. respondent may complain of several
Assessment of nutritional status can complaints.
be done directly and indirectly. Direct Judging from the calculation of
assessment of nutritional status is divided RLPP, 77.8% have central obesity, with an
into four methods, namely: anthropometric, average RLPP in the sample studied of
biochemical, biophysical and clinical. 0.95doing household chores. This shows
Meanwhile, indirectly divided into three that most of the habits of the elderly are
methods, namely: food consumption survey, less active.
vital statistics and ecological factors. 9 RLPP Based on the level of knowledge
was chosen in the measurement method about nutrition, the distribution of the
because RLPP can be used as a simple sample that had the least knowledge on the
indicator to determine the risk of nutritional status was 71.4%, as shown in
degenerative diseases. Additionally waist Table 4. Fairly lame with those who had
hip ratio can also be used as an alternative normal nutritional status, namely 28.6%.
to the Body Mass Index (BMI) in predicting Likewise, the group with a good level of
obesity in adults 6 knowledge also showed the largest
Respondents are elderly aged ≥ 60 proportion of over nutritional status, namely
years who lives in Puskesmas and registered 86.7%.
as a resident of the village of Ketewel and When viewed from physical activity,
not suffering from physical disabilities or the distribution of samples that had the most
mental disorders on examination. The light activity was in excess nutritional status
nutritional status variable was determined (92.7%). The group that did moderate
by calculating the ratio of waist activity also showed the highest proportion
circumference and abdominal of over nutritional status at 86.7%. This is in
circumference. Other variables that were contrast to strenuous activity, where this
also assessed were physical activity and category has the highest proportion of
knowledge of nutrition. Data collection in normal nutritional status.only 23.1%. This is
this study was carried out by interviewing different because 87.5% of respondents
the sample, which was then carried out by when interviewed said that in a day, they ate
anthopometric measurements (abdominal three times or more. However, most of the
circumference and waist circumference). physical activities carried out by
Data collection was carried out for 20 respondents were included in light activity.
minutes and the results were recorded in a This is in accordance with the theory
questionnaire that had been provided. The expressed by Beck that obesity usually
data obtained were analyzed descriptively occurs as a result of not reducing energy
quantitatively using SPSS 17.0 and input when physical activity has decreased.
presented in tabular and narrative form. Obesity is usually caused by eating a lot
from a young age. Many detrimental things
3. Results The can arise due to obesity in the elderly,
Total sample obtained was 72 people including the movement of obese elderly
and in practice interviews andwere carried people will be even more difficult and will
out in all samples anthropometric be more susceptible to degenerative
measurements. From Table 1, it can be seen diseases.10
that the distribution of samples based on As a primary service provider in this
age obtained an average age of 65.54 years. research area, Puskesmas Sukawati I needs
96
to make efforts to overcome the high 4. Discussion

prevalence of excess nutrition through the According to the results of the
elderly posyandu program. In this program, calculation of the ratio of waist to hip and
comprehensive anthropometric monitoring more, it is included in central obesity
and health status of the elderly is carried (RLPP> 1 for men and RLPP> 0.9 for
out. This program can be integrated with a women). The proportion of central obesity
nutrition program to allow for counseling is higher than the 2007 Basic Health
with nutritionists regarding their nutritional Research data, which states that the
status. It is hoped that with this, each elderly prevalence of obesity in the elderly group
person can achieve ideal nutrition and isonly 23.1%. This is different because
reduce disease morbidity. 87.5% of respondents when interviewed
Based on the data from the Sukawati said that in a day, they ate three times or
I Health Center Profile, the highest more. However, most of the physical
prevalence rate of disease in the elderly is activities carried out by respondents were
hypertension.8 Several studies stated that the included in light activity. This is in
risk of hypertension with a pattern of excess accordance with the theory expressed by
salt consumption is 2.643 times compared Beck that obesity usually occurs as a result
to a low salt consumption pattern.11 This of not reducing energy input when physical
supports the results of this study that the activity has decreased. Obesity is usually
lack ofknowledge about reducing salt caused by eating a lot from a young age.
consumption is probably related to the high Many detrimental things can arise due to
prevalence rate in the working area of this obesity in the elderly, including the
Puskesmas. movement of obese elderly people will be
Several studies stated that the level even more difficult and will be more
of knowledge was not related to nutritional susceptible to degenerative diseases.10
status, such as the Thakur study which As a primary service provider in this
stated that there was no significant research area, Puskesmas Sukawati I needs
difference in knowledgeamongstudents to make efforts to overcome the high
obese and non-obese. This is because the prevalence of excess nutrition through the
knowledge they have is only information elderly posyandu program. In this program,
that does not encourage them to have an comprehensive anthropometric monitoring
ideal weight.12 Research by Brien and and health status of the elderly is carried
Davies out. This program can be integrated with a
nutrition program to allow for counseling
Table. Cross tabulation of RLPP based on with nutritionists regarding their nutritional
knowledge level about nutrition, physical status. It is hoped that with this, each elderly
activity, and number of teeth person can achieve ideal nutrition and
waist hip ratio reduce disease morbidity.
Normal More Based on the data from the Sukawati
F% F%
Nutrition
I Health Center Profile, the highest
prevalence rate of disease in the elderly is
Less than 1 28.6 30 71.4 hypertension.8 Several studies stated that the
2 risk of hypertension with a pattern of excess
Good 4 13.3 26 86.7
salt consumption is 2.643 times compared
Physical Activity
to a low salt consumption pattern.11 This
Light 3 7.3 38 92.7
supports the results of this study that the
Medium 2 13.3 13 86.7
lack ofknowledgeabout reducing salt
Weight 1 68.8 5 31.3 consumption is probably related to the high
1
prevalence rate in the working area of this
Puskesmas.
97
Several studies stated that the level 2. Central Bureau of Statistics. 2013
of knowledge was not related to nutritional Elderly Population Statistics.
status, such as the Thakur study which Jakarta: Central Bureau of Statistics.
stated that there was no significant 2013.
difference in knowledgeamongstudents 3. Kuswardani, Irvinda Hadi.
obese and non-obese. This is because the Description of the Role of Families
knowledge they have is only information on Healthy Lifestyle Behavior for
that does not encourage them to have an the Elderly in the Work Area of the
ideal weight.12 Research by Brien and Darussalam Puskesmas, Medan
Davies in Ireland also stated that there was Petisah District, 2009. Medan:
no significant relationship between Faculty of Public Health, University
knowledge and BMI. Knowledge about of North Sumatra. 2009: 1-131.
nutrition is considered important, but does 4. Ministry of Health of the Republic
not change behavior because behavior of Indonesia. Guidelines for Elderly
change is more influenced by personal, Nutrition Services. Jakarta:
habit, and environment.13 However, this is Indonesian Ministry of Health. 2012.
different from the theory put forward by 5. World Health Organization. Water
Darmojo, which explains that the risk related disease (malnutrition).
factors for malnutrition in the elderly are Geneva, World HealthOrganization.
due to lack of knowledge about nutrition http://www.who.int/water_sanitation
and research from Sakamaki, et al, which _health / diseases / malnutrition / en
states that knowledge and awareness of /. 2001
nutrition in Chinesestudentsis 6. World Health Organization. Waist
relatetoweightgain.ideal.14,15 Circumference and Waist-Hip Ratio:
Report of WHO Expert Consultation.
5. Conclusion Geneva, World Health Organization.
Based on the level of knowledge 2008
about nutrition, the distribution of the 7. Ministry of Health. Basic Health
sample that had the least knowledge on over Research (Central Obesity
nutritional status was 71.4%, as well as the Prevalence
group with a good level of knowledge also Above15Years).http://www.litbang.d
showed the highest proportion at over epkes.go.id. 2007.
nutritional status, namely 86.7%. When 8. Sukawati Health Center I. Profile of
viewed from physicalactivity, the Sukawati Health Center I. 2014
distribution of samples that had the most 9. Setiani, Yuli. The Relationship
light activity was in excess nutritional status Between Nutritional Status and
(92.7%). Puskesmas are advised to take Stress with the Ability of Activity
anthropometric measurements and record Daily of Living for the Elderly in the
the health status of the elderly in a Work Area of the Elderly Posyandu
comprehensive manner on the Card at the Sumbersari Health Center,
Towards Healthy for the elderly as well as Jember Regency. 2011
counseling with nutritionists regarding 10. Bec, Bernard. Neuropeptide and
elderly health to overcome these problems. Obesity. Nutrition 2000.
11. Adhyanti, et al. Risk Factors for
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99
Pengaruh Penyuluhan Terhadap Pengetahuan Dan Sikap Ibu Hamil Tentang Hypnobirthing Di Klinik Pratama Vina
Kecamatan Medan Baru Tahun 2018
PENGARUH PENYULUHAN TERHADAP PENGETAHUAN DAN SIKAP

IBU HAMIL TENTANG HYPNOBIRTHING DI KLINIK PRATAMA VINA
KECAMATAN MEDAN BARU TAHUN 2018
Desy Kristina Damiani Malau

[email protected]
Abstract
Material and method is quasi experiment dengan desain one group pre test and post test design.
Results : there is an influence of counseling on the knowledge of pregnant women about
hypnobirthing p value 0.037 <0.05 and there is an effect of counseling on the attitude of
pregnant women about hypnobirthing p value 0.014 <0.05. Conclusion : There is a difference in
the average knowledge of pregnant women about hypnobirthing before and after intervention
through counseling at the Pratama Vina Clinic, Medan Baru District with an average difference
of 0.500. There is a difference in the average attitude of pregnant women about hypnobirthing
before and after intervention through counseling at Pratama Vina Clinic, Medan Baru District
with an average difference of 1,400. There is an influence of counseling on the knowledge of
pregnant women about hypnobirthing in Pratama Vina Clinic, Medan Baru District with a p
value of 0.037 <0.05. There is an influence of counseling on the attitude of pregnant women
about hypnobirthing in Pratama Vina Clinic, Medan Baru District with a p value of 0.014
<0.05.
Keywords: Counseling, Knowledge, Attitude, Hypnobirthing
INTRODUCTION of 170,000 per live birth, and the Infant

Pregnancy and childbirth are chain Birth Rate (IMR) of 1.3 live births. Nearly a
reactions that cannot be separated in a third of maternal and infant deaths occur in
normal woman's life. When we prepare Asia (Dewi, 2018).
thoroughly (body, mind and spirit), the Indonesia's Demographic and Health
process of pregnancy and childbirth can Survey (SDKI) in 2012, the maternal
take place safely and comfortably. mortality rate (MMR) in Indonesia is still
However, not a few mothers experience high at 359 per 100,000. Based on data from
childbirth problems and even death of the Indonesian Midwives Association (IBI),
mothers and babies (Kuswandi, 2013). the causes of AKI include bleeding, which
Data from the World Health is 30% of the total cases of death, eclampsia
Organization (WHO) report in 2014 the (pregnancy poisoning) that is 25%, infection
maternal mortality rate (MMR) in the world is 12%, abortion is 5%, parturitionduration
is 289,000. The United States is 9300 is 5%, obstetric embolism is 3%,
people, North Africa 179,000 people and complications of the puerperium is 8% and
Southeast Asia 16,000 people. The maternal other causes are 12%. The main cause of
mortality rate in Southeast Asian countries AKI is bleeding. One of the bleeding that
is Indonesia 214 per 100,000 live births, the occurs in pregnant women is caused by
Philippines 170 per 100,000 live births. placenta previa (SKDI, 2012).
Vietnam 160 per 100,000 birthslife, District / city health profile report
Thailand 44 per 100,000 live births, Brunnei the number of maternal deaths in 2016 was
60 per 100,000 live births and Malaysia 39 reported as many as 239 deaths. Based on
per 100,000 live births. (Rohfiin, 2015). the results of the Maternal Mortality Rate
Meanwhile, according to ASEAN in (MMR) &Infant Mortality Rate (IMR)
2010, the Maternal Mortality Rate (MMR) conducted by the North Sumatra Provincial
100
Health Office with the Faculty of Public that the number of pregnant women from
Health (FKM) of the University of North January to April 2018 amounted to 60
Sumatra in 2016, it states that the MMR in people including 30 people entering the
North Sumatra is 268 per 100,000 live third trimester of pregnancy. The number of
births. Based on these estimates, the women giving birth to as many as 15 people
maternal mortality rate has not decreased included 10 normal births, and 5 old
significantly until 2016 (North Sumatra parturition. Hypnobirthing method is taught
Health Profile, 2016). to pregnant women in dealing with and
The benefit of the hypnobirthing preparing for labor. This situation is the
method for mothers is to relax deeper so reason researchers want to know the
that all stress and fears & worries before knowledge and attitudes of pregnant women
birth that can cause tension, pain and pain about hypnobirthing. Based on the
during childbirth can be eliminated. For the background description, the researchers felt
fetus it is useful for healthier growth interested in conducting research on the
because calm conditions will provide Effects of Counseling on Knowledge and
balanced hormones to the fetus through the Attitudes of Pregnant Women about
placenta. For husbands / childbirth Hypnobirthing at the Pratama Vina Clinic in
companions, the husband / childbirth Medan in.
companion becomes calmer in
accompanying the childbirth process MATERIAL AND METHODS
(Aprilla, 2010). This research is a quasi-
Hypnobirthing teaches breathing, experimental study with the aim of finding
relaxation, affirmation and visualization out the effect of the independent variable
techniques, and deepening. In breathing (counseling) on the dependent variable
techniques, mothers can saveenergy during (knowledge and attitude). According to
the depletion phase during cervical opening. Arikunto (2012) the experimental design is
Slow breathing that is taught can thin and research carried out in the absence of a
open the cervix which can shorten the comparison class or a control class.
duration of labor. Relaxation, visualization, The design used is a one group pre-
and affirmation help mothers deal with test and post-test design, a research design
tension, stress, and discomfort during labor. that is used by providing a preliminary test
Deepening techniques are also very useful and a final test of a single group research
during the advanced phase of labor. sample. One group research design pre-test
Hypnobirthing method can accelerate the and post-test design
first stage of labor (± 3 hours in primipara 1. Population
and 2 hours in multipara), reduce the risk of The population in this study were all
complications, and accelerate the healing pregnant women who visited the
process in post partum (Aprilia, 2010). Pratama Vina Clinic Medan in
The effectiveness of an extension January - June 2018.
method will also depend on the size of the 2. Sample
target and the media used. Good health 3. The sample is the object to be
education media are media that are able to studied and is considered to be
provide information or health messages in representative of all research.So the
accordance with the level of acceptance of sample in this study were pregnant
the target, so that the target is willing and women who visited the Pratama
able to change behavior in accordance with Vina Clinic Medan in January - June
the message delivered (Notoatmodjo, 2010). 2018 as many as 40 people.
Based on preliminary surveys at the
Pratama Vina Clinic in Medan, it is known
101
RESULT Respondents' Knowledge of

Tabel 4.1 Hypnobirthing Before Intervention (Pres
Distribution of Respondent Test) at the Pratama Vina Clinic, Medan
Characteristics atKlinik Pratama Vina Baru District, 2018
Kecamatan Medan Baru Table 4.2
Tahun 2018 Frequency Distribution of Respondents'
No. Variable Total Percentage Knowledge about Hypnobirthing Before
(n) (%) Intervention (Pre Test) at the Pratama
1. Age
Vina District ClinicMedan New Year
< 30 tahun 33 82,5
≥ 30 tahun 7 17,5 2018
Total 40 100,0 No. Knowledge Total Percentage
2. Pendidikan (n) (%)
Junior high school 4 10,0 1. Less 19 47,5
High school 31 77,5 2. Enough 16 40,0
Bachelor 5 12,5 3. Well 5 12,5
Total 40 100,0 Total 40 100,0
3. Pekerjaan
Housewife 21 52,5
Laborer 8 20,0 Based on table 4.2, the results of the
Traders 6 15,0 study indicate that the respondent's
Employees 5 12,5 knowledge of hypnobirthing before the
Total 40 100,0 intervention was carried out by giving
4. Paritas Extension (pre test) had the least knowledge
Pirigravida 9 22,5
Multigravida 31 77,5 of 19 people (47.5%) and the least
Total 40 100,0 knowledge was good as many as 5 people
(12.5%).
Based on table 4.1, the results show
that the characteristics of respondents 4.1.1 Attitude of Respondents about
according to age are at most under 30 years Hypnobirthing Before Intervention (Pres
old as many as 337 people (82.5%) were Test) at the Pratama Vina Clinic, Medan
over or equal to 30 years old (17.5%). The Baru District, 2018
results also showed that the characteristics Table 4.3
of respondents according to formal Frequency Distribution of Respondents'
educational background that were Attitudes about Hypnobirthing Before
completed were the highest number of Intervention (Pre Test) at Pratama Vina
Senior High School (SMA) as many as 31 Clinic, KecamatanMedan New Year 2018
people (77.5%) and the least number of No. Attitudes Total Percentage
junior high school graduates (SMP) was 4 (n) (%)
people (10%).Most respondents do not have 1. Negatif 26 65,0
2. Positif 14 35,0
a job or as housewives as many as 21
Total 40 100,0
people (52.5%) and at least 5 people work
as employees (12.5%). Respondents at most
Based on table 4.3, the results showed
had given birth to babies, namely 1 or 5
that the attitude of the respondents about
times or called multigravida as many as 31
hypnobirthing before the intervention by
people (77.5%) and the rest were pregnant
providing counseling (pre test) had the most
for the first time (primigravida) as many as
negative attitude as many as 26 people
9 people (22.5%).
(65%) and the least positive attitude as
many as 14 people (35%).
102
Respondents' Knowledge of direction.

Hypnobirthing After Intervention (Post
Test) at the Pratama Vina Clinic, Medan Table 4.6
Baru District, 2018 The Effect of Education on Knowledge of
Table 4.4 Pregnant Women about Hypnobirthing
Frequency Distribution of Respondents' Before and After Intervention at the
Knowledge about Hypnobirthing After Pratama Vina Clinic, Medan Baru
Intervention (Post Test) at Pratama Vina District in 2018
Clinic, KecamatanMedan New Year 2018 Variabel Extension
No. Knowledge Total Percentage Mean
Sd Mean p
(n) (%) Diff Value
1. Less 15 37,5 KnowledgeBefore 11,08 3,092 -0,500 0,037
2. Enough 19 47,5 after 11,58 2,763
3. Well 6 15,0
Total 40 100,0 Based on table 4.6, the results of the
study using the paired t test show that there
Based on table 4.4, the results of the is a difference in the knowledge of the
study show that the knowledge of respondents before the intervention through
respondents about hypnobirthing after counseling with a mean value of 11.08 and
intervention by providing counseling (post after the intervention the train has increased
test) has the most sufficient knowledge of to 11.58. Respondents' knowledge increased
19 people (47.5%) and at least 6 people after intervention through counseling with a
(15%) have less knowledge. An increase in mean difference of 0.500 and a p value of
respondents' understanding of 0.037. This is meaningful Statistically, there
hypnobirthing. is an effect of counseling on pregnant
women knowledge about hypnobirthing
Attitudes of Respondents about before and after intervention.
Hypnobirthing After Intervention (Post
Test) at the Pratama Vina Clinic, Medan Table 4.7
Baru District in 2018 The Effect of Education on Attitudes of
Table 4.5 Pregnant Women about Hypnobirthing
Frequency Distribution of Respondents' Before and After Intervention at the
Attitudes about Hypnobirthing After Pratama Vina Clinic, Medan Baru
Intervention (Post Test) at Pratama Vina District in 2018
Clinic, KecamatanMedan New Year 2018 Variabel Extension
No. Attitudes Total Percentage Mean Sd Mean p
(n) (%) Diff Value
1. Negatif 19 47,5 Attitudes Before 35,40 7,844 1,400 0,014
2. Positif 21 52,5 After 36,80 7,254
Total 40 100,0
Based on table 4.7, the results of the
Based on table 4.5, the results show study using the paired t test showed that
that the respondent's attitude about there were differences in the attitudes of
hypnobirthing after the intervention was respondents before the intervention through
carried out by providing counseling(post counseling with a mean value of 35.40 and
test) with the most positive attitude as many after the intervention the mean attitude
as 21 people (47.5%) and the least positive increased to 36.80. The attitude of the
attitude as many as 19 people (47.5%). respondents increased after intervention
There was a change in the respondent's through counseling with the mean
attitude about hypnobirthing in a good difference (mean difference) of 1,400 and p
103
value was 0.014. This means that District with an average difference of
statistically there is an effect of counseling 0.500.
on the attitudes of pregnant women about 2. There is a difference in the average
hypnobirthing before and after the attitude of pregnant women about
intervention. hypnobirthing before and after
intervention through counseling at
PEMBAHASAN PratamaVina Clinic, Medan Baru
4.3.1 Knowledge of Pregnant Women about District with an average difference of
Hypnobirthing Before and After 1,400.
Intervention at the PratamaVina Clinic, 3. There is an influence of counseling on
Medan Baru District, 2018 Based on the the knowledge of pregnant women
results of the study, it is known that before about hypnobirthing in PratamaVina
intervention through counseling about Clinic, Medan Baru District with a p
hypnobirthing, the respondent's knowledge value of 0.037 <0.05.
tends to be less than 19 people (47.5%), and 4. There is an influence of counseling on
good as many as 5 people (12.5%). Once the attitude of pregnant women about
doneintervention with counseling occurred hypnobirthing in PratamaVina Clinic,
decreasing the respondents with less Medan Baru District with a p value of
knowledge to 15 people (37.5%) and an 0.014 <0.05.
increase in good knowledge to 6 people
(15%). This shows that the delivery of REFRENCE
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through counseling effectively increases the Penelitian Kesehatan Paradigma.
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Medan Baru District, 2018 Bhuana IlmuPopuler.
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known that before intervention through Nyaman dan Aman Saat Hamil dan
counseling about hypnobirthing, 26 people Melahirkan. Jakarta Selatan: Salemba
(65%) tended to have a negative attitude Medika.
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kind increased to 21 people (52.5%). This Hypnobirthing: Nyeri Persalinan dan
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105
Menstrual Cycle Disorders During The Covid-19 Pandemic
MENSTRUAL CYCLE DISORDERS DURING THE COVID-19

PANDEMIC
Veny Adenina
[email protected]
ABSTRACT
Menstrual disorders are very common in adolescence, and can be the cause of a significant
amount of stress to both the patients and their parents. Variations of the menstrual cycle in this
age are very broad and are mainly caused by the immaturity of the hypothalamic-pituitary-
ovarian (HPO) axis. Amenorrhea (either primary or secondary), abnormal uterine bleeding and
dysmenorrhea are conditions that require careful evaluation through a stepwise and logical
manner. The term primary amenorrhea refers to the condition when menarche fails to occur,
while secondary amenorrhea refers to the cessation of menses once they have begun. The
occurrence of irregular, prolonged or heavy abnormal uterine bleeding is one of the most urgent
gynecological problems in adolescence and the diagnosis of dysfunctional uterine bleeding
should be used only when all other organic and structural causes of abnormal vaginal bleeding
have been ruled out. Dysmenorrhea refers to painful menstruation and is the most common
reason for which a young girl may refer to a gynecologist. It is characterized as primary in the
absence of an underlying organic disease, and as secondary when there is evidence of pelvic
pathology. Appropriate and early management of the patient is necessary in order to minimize
the possibility of future complications regarding woman’s reproductive ability. Data shows that
50% of women in the world experience menstrual disorders. In Indonesia, the rate of menstrual
disorders reached 55% and 64.25% experienced dysmenorrhea. The process of colecting data is
done by interviewing on the assessment of menstrual disorders. A qualitative research using
focus group discussions (FGD) and questions and answers. The data can be analyzed using
models or object. Menstrual disorders in women are still fairly frequently especially during the
covid-19 pandemic, there are menstruation comes 2 months and some even don’t menstruate for
5 months. Therefore, health services must provide health education and approach the
community so that they receive advice or input from health services. This research was
conducted in Suka Maju Village, Sunggal Sub-District, Deli Serdang District .From the
research conducted, many women experience menstrual disorders due to PSBB,
lockdown,quarantine, during the covid-19 pandemic.
Keyword : Menstrual disorders, teenage women, adult women, women who aren’t yet
menopause, Covid-19
Pendahuluan Menstrual disorders can be in the form of

Menstruation is bleeding from the disturbances in the length and amount of
uterus that occurs periodically and menstrual blood, menstrual cycle disorders,
cyclically. This is due to the release bleeding disorders outside the menstrual
(desquamation) of the endometrium due to cycle and other disorders related to
ovarian hormones (estrogen and menstruation. The normal length of
progesterone) which change in levels at the menstruation occurs between 4-8 days. If
end of the ovarian cycle, usually starting on menstruation occurs for less than 4 days, it
day 14 after ovulation. Menstruation is a is said to be hypomenorrhea and if it is
natural process commonly experienced by more than 8 days it is said to be
women but this will become a problem if hypermenorrhoea. Women usually have
menstrual disorders 2 menstrual cycles between 21-35 days. It is
106
called polimenorrhea if the menstrual cycle Sarah Toler, a nursing health doctor
is less than 21 days and oligomenorrhea if and science writer in women’s health
the menstrual cycle is more than 35 days. applications, Clue says this is because stress
Non-menstrual bleeding is bleeding that activates certain hormone pathways that
occurs between 2 periods. In women who release cortisol, also known as stress
have menstrual cycles of more than 90 days, hormones. Excess cortisol release can
they are said to have amenorrhoea. Other suppress normal reproductive hormone
disorders related to menstruation can levels. Potentially causes abnormal
include dysmenorrhea and premenstrual ovulation, which can interfere with your
syndrome (PMS). Dysmenorrhoea is pain or (menstrual) cycle. One of the health
discomfort in the lower abdomen that conditions that might occur is amenorrhea,
occurs during menstruation that can which is when a person doesn’t experience
interfere with daily activities. Premenstrual menstruation at all. Toler explained, this
syndrome (PMS) appears before condition is common in people who have
menstruation and disappears when recently experienced certain trauma.
menstruation.The symptoms can be However, daily stress can also affect how
physical, psychology 4 long a person’s menstrual cycle. So, there
Menstrual disorders can be serious. will be several factors that can cause a
Irregular menstruation can be a sign of the person really doesn’t menstruate in certain
absence of ovulation (anoluvatoir) in the months 5
menstrual cycle. This means that a woman
is infertile (tends to find it difficult to have Method
children). Menstruation with a large amount Research conducted using
of bleeding that occurs over a long period of qualitative research. Research
time can cause anemia in adolescents. Other implementation at Suka Maju Village. This
disorders such as PMS and dysmenorrhoea research is an exploratory study with a
can interfere with productivity. Complaints qualitative approach, which explores and
related to physical conditions such as pain reviews information about how menstrual
around the head and pain in the lower cycles occur each month. This qualitative
abdomen that can disrupt the routine. approach is carried out to obtain rich
Emotional impacts can be in the form of descriptions and conclusions about the
uncontrolled emotions, anxiety, irritability, context under study and understand the
panic and in the end, they will cry easily 1 meaning that underlines people’s behavior.
The average menstrual cycle lasts The location of Suka Maju Village, Sunggal
for 28 days. However, sometimes there are Sub-District, Deli Serdang District. The
irregularities that can be caused by health data collection is done through Face to Face
conditions such as endometriosis or and Door to Door techniques conducted by
polycystic ovary syndrome (PCOS). But researchers who are assisted by trained and
during the corona virus pandemic, many capable staff 4,11
women also experience menstrual cycle With the consideration of these
disorders due to stress 5 rules, the number of informants for women
According to a poll of 5,677 women is 10 , including teenage women. Other
in the UK conducted by obstetrician Anita informants are 5 adult women. To complete
Mitra, as quoted by Independent.co Sunday, the results of the question and answer, in
May 17, 2020 , menstrual cycle disorders depth interviews with midwife (1 person).
are quite common. When asked if women Especially for ages 14-18 years 9
had seen changes in menstrual cycle or Data analysis in this study uses an
hormonal symptoms during lockdown, more interactive analysis model in qualitative
than half (65%) of respondents answered research, data analysis is carried out since
yes 7 the beginning of the research and
107
throughout the research process. Data is cause menstrual delays, but also even cause
obtained, then collected for systematic stalling, shortening their time, or
processing. Start from interviews, experiencing more severe periods 8,10
observations the presenting activity data and For that, to overcome this is to
concluding data 7 rebalance the hormones in the body.
Result Frodsham advised to practice yoga, adjust
Based on the results of the research focus and meditation, in addition to doing
conducted, it can be seen that of the 98 regular aerobic exercise 6
respondents, it was found that the
respondents' ages ranged from 14-18 years, Reference
including adolescents. It can be seen in table 1. https://id.m.wikipedia.org/wiki/Suka
1, most of the respondents were 16 years _Maju_Sunggal_Deli_Serdang
old, amounting to 42.9%. 2. https://rs-
alirsyadsurabaya.co.id/begini-
Tabel 1. Karakter Responden Berdasarkan penjelasan-bagaimana-kondisi-
Usia pandemi-dapat-mempengaruhi-
Characteristic n % siklus-menstruasi/
Age 3. https://kotasumut.com
14 years old 4 4,10 4. Jurnal Keperawatan Jiwa “Faktor-
faktor Yang Mempengaruhi Siklus
15 years old 22 22,40
Menstruasi pada Remaja Putri
16 years old 42 42,90 Tingkat III” Aesthetica,Farida ,
17 years old 27 27,60 Vol.7, 2019
18tahun 3 3,10 5. Deligeoroglou E, Tsimaris P,
Total 98 100,00 Deliveliotou A, et al: Menstrual
disorders during adolescence.
The results of the study indicate that Pediatr Endocrinol Rev
there is a relationship between the pandemic 2006;3:(suppl 1)150-159
period and the menstrual cycle. Menstrual 6. World Health Organiation, W.
disorders are an important clue in seeing the 2014.Mortality dan Morbidity.
reproductive system dysfunction associated 7. Sarwono, P. Ilmu Kebidanan.
with risks. (Yayasan
8. Bina Pustaka Sarwono
Conclusion Prawirohardjo, 2011).
Lockdown which is applied in a 9. Suparji. Dampak Faktor Stress Dan
number of countries and regions or known Gangguan Waktu Menstruasi Pada
as PSBB in Indonesia due to the COVID-19 Mahasiswa. J. Kesehat. 10, 40–44
corona virus pandemic apparently can also (2017). Available from
have an impact on the menstrual cycle. This 10. http://ejournal.poltekkesternate.ac.id
impact is in the form of menstrual cycle /o
disorders due to stress experienced by js/index.php/juke/article/view/31/4.
women 10 11. Irianto, K. Kesehatan Reproduksi
When in isolation due to this Teori dan Praktikum. (Alfabeta,
pandemic, many women experience 2015).
menstrual cycle disorders caused by stress.
This stress certainly occurs not apart from
factors of financial instability, social
isolation and phsycological difficulties.
These general changes that women may
experience as a result of stress not only
108
Elderly Compliance With Hypertension In Diet Fulfillment Hypertension
ELDERLY COMPLIANCE WITH HYPERTENSION IN DIET

FULFILLMENT HYPERTENSION
Elvina Vandinata1
[email protected]
ABSTRACT
The purpose of this study was to know about the pursuit of elderly hypertension in complience
hypertension diet. The research was conducted in the working area of Sidomulyo health care
center, in the Village of West Sidomulyo, Pekanbaru City. The respondents in this study are 60
people with a purposive random sampling method. This study is the simple descriptive design
with a Cross-Sectional approach. The data is collected by questionnaires.The data analysis by
univariate in frequency distribution to know the pursuit of elderly hypertension in complience
hypertension diet. The result is a study that found that 26 people (43.3%) the hypertension
elderly are pursuance in the hypertension diet and 34 people (43.3%) the hypertension elderly
are not pursuance in the hypertension diet. Recommendations to health workers to provide
counseling about hypertension specifically about diets of hypertension, so the incidence of
hypertension can be significantly reduced.
Keywords: elderly, pursuance, diet of hypertension
INTRODUCTION high blood pressure, which is being

Modernization is currently causing overweight followed with a lack of exercise,
changes in lifestyle in the community, such and eating fatty and fatty foods high salt
as excessive eating habits, too much (Palmer, 2007). So many causes of
activity, lots of smoking, and lack of rest. hypertension that causes hypertension is a
These patterns and lifestyle cause heart disease with many sufferers.
disease many blood vessels attack, Nearly 1 billion or about a quarter of
especially residents aged over 40 years. the world's adult population has high blood
False one of them is the emergence of high pressure, and this number tends to increase.
blood pressure or often referred to as The disease is estimated to affect more than
hypertension (Wiryowidagdo, 2002). 16 million people in the UK, with 34% of
Hypertension or better known as high men and 30% of women having high blood
blood pressure is a circumstances where a pressure above 140/90 mmHg. In the
person's blood pressure is above the normal elderly population, the number of people
or optimal limit 120 mmHg for systolic and with high blood pressure is even more,
80 mmHg for diastolic. This disease is experienced by more than half the
categorized as the silent diseasebecause the population of people aged over 60 years. In
patient did not know he had hypertension 2025 it is estimated that sufferers of high
before check his blood pressure. blood pressure reach nearly 1.6 billion
Hypertension that occurs in a long time and people in the world (Palmer, 2007).
can continuously trigger a stroke, heart Based on data from the Indonesian
attack, and heart failure the main cause of Ministry of Health, the prevalence of
chronic kidney failure (Purnomo, 2009). hypertension in Indonesia reaches 31.7% of
Hypertension is not yet known the cause, the population aged 18 years and over.
but several factors are found risks that can About 60% of people with hypertension end
cause high blood pressure are old age and a in stroke. While the rest resulted in heart
history of high blood pressure in the family. disease, kidney failure, and blindness.
In addition there are also factors can cause Riskesdas data (2007) mentions
109
hypertension as the number 3 cause of death hypertension is still high in the community.
after stroke and tuberculosis, the number Therefore it is necessary to do research on
reaching 6.8% of the proportion of causes of how to describe the compliance of elderly
death at all ages in Indonesia (Yoga, 2009). hypertension sufferers in fulfilling the
This phenomenon is caused by changes in hypertension diet in Sidomulyo Barat
people's lifestyles globally, such as the ease Village, Handsome Pekanbaru City ". The
of getting ready meals to make consumption purpose of this study was to determine the
of fresh vegetables and fiber is reduced, description of adherence of elderly people
then the consumption of salt, fat, sugar, and with hypertension in meeting the
calories continues to increase so it plays a hypertension diet.
major role in increasing the incidence of
hypertension. MATERIAL AND METHODS
Foods that are eaten directly or The research design used in this
indirectly affect the stability of blood study was a simple descriptive study using a
pressure. The content of nutrients such as cross sectional approach. The sample in this
fat and sodium have a close relationship study amounted to 60 people with
with the emergence of hypertension. hypertension over the age of 40 years who
Implementation of a regular diet can were taken by purposive random sampling
normalize hypertension, namely by in the village of West Sidomulyo. Data was
reducing foods with high salt, fatty foods, collected using a questionnaire containing
eating foods that are high in fiber and doing the characteristics of respondents (age, sex,
sports activities (Julianti, 2005). occupation, education) and data on the
Patients with hypertension in the city fulfillment of a daily hypertension diet
of Pekanbaru as many as 12781 people, the using a Likert scale (very often, often,
highest number of people with hypertension rarely, and never). Data collection tools
are in the Work Area Sidomulyo Puskesmas have been tested for validity and reliability.
Pekanbaru City as many as 3723 people Data that can be categorized into obedient
(Pekanbaru City Health Office, 2010). Data and not compliant. Data retrieved, analyzed
obtained from the Sidomulyo Community using univariate analysis which is displayed
Health Center in January to May 2011 in the form of frequency distribution tables
reported the number of hypertension (%)
sufferers as many as 1734 people. The
highest number of hypertension sufferers is RESULT
in West Sidomulyo Village, as many as 963 Characteristics of Respondents
people. Most hypertension sufferers are in Respondent characteristics (age, sex,
the age of 40-65 years, as many as 591 education, occupation), knowledge, attitude
people. and compliance. The results of each
The results of interviews with univariate analysis are described as follows:
hypertension sufferers at the Sidomulyo 1. Age
Health Center in Pekanbaru City in March Table 1. Frequency Distribution of
2011, found that sufferers said they had Respondents by Age of Patients with
received information from Puskesmas staff Hypertension in Sidomulyo Barat Village,
to reduce salty and high-fat foods. After Pekanbaru City
being confirmed directly by the puskesmas No Age Total Percentage
officer, it turned out that the officer had 1 40-50 years 27 45
given a suggestion to reduce salty and high- 2 51-65 years 33 55
fat foods to hypertensive sufferers.
total 60 100
Although health workers have
recommended to go on a diet for
hypertension sufferers, the numbers are Table 1 shows the distribution of
respondents according to the age of
110
hypertension sufferers in Sidomulyo Barat 3. Education

Village, Pekanbaru City, found that Table 3. Distribution of Frequency of
respondents aged 40-50 years were 27 Respondents by Education of Patients with
people (45%) and respondents aged 51-65 Hypertension in Sidomulyo Barat Village,
years were 33 people (55%). Handsome, Pekanbaru City
Sugiharto et al (2003), the incidence No Education Total Percentage
of hypertension is directly proportional to 1 Elementary 13 21.7
the increase in age. Arterial blood vessels school
lose elasticity or flexibility with age, most 2 JSS 18 30
people have increased blood pressure when
3 SLTA 22 36.7
they are 50-60 years and older. Nursalam
(2002) states that the more a person is of 4 PT 7 11.7
age, the level of maturity and one's ability to total 60 100
think will be better. However, one's level of
maturity and thinking is also influenced by Table 3 shows the distribution of
experience and information in daily life. respondents according to the education of
Researchers can conclude that age does not hypertension sufferers in Sidomulyo Barat
guarantee a person to have good knowledge Kelurahan in Pekanbaru City, it was found
and a positive attitude if it is not supported that the highest number of respondents
by factors such as level of education, having high school education was 22 people
personal experience, or information from (36.7%) and the respondents who were the
the surrounding environment. least educated PT were 7 people (11.7%).
Sugiharto et al (2003), the level of
2. Gender education can affect one's ability and
Table 2. Frequency Distribution of knowledge in implementing healthy living
Respondents by Gender of Hypertension behaviors, especially in preventing
Patients in Kelurahan Sidomulyo Barat hypertension. The higher the level of
Handsome Pekanbaru City education, the higher the ability someone in
No Gender Total Percentage maintaining a healthy lifestyle. According
1 Male 25 41.7 to Nursalam (2002), that the higher a
person's education, the easier it is to receive
2 Girl 35 58.3
information so that the more knowledge he
Total 60 100 has. Respondents who are highly educated
will easily absorb information and will have
Table 2 shows the distribution of better knowledge than respondents with low
respondents according to the sex of levels of education. The higher education
hypertension sufferers in Sidomulyo Barat the respondent has, the easier it is to receive
Kelurahan in Pekanbaru City, it was found the information provided so that he can
that there were 35 female respondents carry out a hypertension diet properly.
(58.3%) and 25 male respondents (41.7%).
Female sex is more prominent than 4. Work
men, this can be associated with greater Table 4. Frequency Distribution of
hormonal factors found in the body of Respondents by Occupation of
women compared to men. These hormonal Hypertension Patients in Sidomulyo Barat
factors cause an increase in body fat or Village, Pekanbaru City
obesity. In addition to hormonal factors that No Profession Total Percentage
cause obesity in women, obesity is also
1 Private 8 13.3
caused by lack of activity in women and
more often spends time relaxing at home. 2 entrepreneur 10 16.7
(Junaidi, 2010). 3 Civil 7 11.7
servants
111
No Profession Total Percentage Table 5 shows the distribution of

4 Trade 16 26.7 respondents according to the dietary
5 IRT 19 31.7 compliance of hypertension sufferers in
Sidomulyo Barat Village Pekanbaru City, it
total 60 100
was found that respondents in the category
of non-compliance were 34 people (56.7%)
Table 4 shows the distribution of and respondents in the obedient category
respondents according to the work of were 26 people (43.3%).
hypertension sufferers in Sidomulyo Barat In general, respondents are not
Kelurahan in Pekanbaru City, it was found compliant to go on a hypertension diet. This
that the most respondents worked as IRTs can be influenced by the knowledge or
as many as 19 people (31.7%) and the attitude of hypertension sufferers
respondents who worked the least as civil themselves. Lack of knowledge due to lack
servants were 7 people (11.7%). of information obtained by sufferers, both
Women who do not work or only as from health workers and print or electronic
housewives are at higher risk of suffering media. The factor of negative attitudes that
from hypertension compared to women who often arises is due to the saturation and
work. This is probably caused by the lack of unfamiliarity of hypertension sufferers to
activities carried out by housewives, where follow a hypertension diet, which is caused
most just stay at home with routines that by the respondent's own culture which is
make it too late. Unlike working mothers, inherent from birth so it is very difficult to
there are more activities and take time to do eliminate.
sports. In addition, usually working mothers Kharisna research (2008), which
are more active than mothers who do not links cucumber juice with hypertension,
work or only as housewives. Individuals shows that patients who are diligent in
whose activity is low are at risk of consuming cucumber juice regularly can
developing hypertension 30-50% of active lower blood pressure. The results of
individuals (Waren, 2008). research conducted by Mardiyati (2009)
Modern life makes people lazy to also showed that compliance with
move, time is spent watching TV or hypertension sufferers in implementing a
working at the dining table until every day. hypertension diet such as a low salt diet can
Likewise with hypertension sufferers who prevent the onset of hypertension. From
work as housewives, because being busy these studies it can be concluded that,
with household chores makes mothers behavior is related to habits that can
become lazy. After the work is finished, the produce something that is positive or
mother stays more at home by watching TV, negative. So that the behavior of
eating food (snacking) is not according to hypertensive sufferers who regularly
the diet, taking a long nap, and rarely doing consume cucumber juice can reduce blood
sports so that the implementation of the pressure in the body of hypertension
hypertension diet does not work properly. sufferers, and the behavior of patients who
avoid salt consumption every day can
5. Compliance prevent hypertension. Likewise in this
Table 5. Distribution of Respondents study,
Frequency Based on Compliance of Patients A behavior is also influenced by the
with Hypertension in Sidomulyo Barat belief that, the behavior will bring the
Village, Handsome, Pekanbaru City desired or undesirable results that are
No Obedience Total Percentage normative and motivate to act in accordance
1 Obedient 26 43.3 with expectations. These normative
2 Not obey 34 56.7 expectations form subjective norms in
Total 60 100 individuals. This is determined by past
112
experiences and experiences of people Counseling materials provided to

around and individuals about how difficult hypertension sufferers must vary, meaning
or easy it is to carry out the behavior. that not only prohibits salty and fatty foods
The results of Ginting's research but must be informed in detail about the use
(2006), entitled "the relationship between of salt of less than 1 teaspoon / day, as well
knowledge and adherence to the diet of as what foods are recommended for
hypertension in the elderly in Medan Johor hypertension sufferers. Media delivery of
District" states that there is a significant material should use written media such as
relationship between knowledge and leaflets or brochures so that patients will
hypertension diet compliance. In the easily understand and not forget what was
research, it was found out that the elderly said before.
who have good knowledge obediently It is recommended for further
follow the hypertension diet. This means, researchers to conduct research on the
the decision of hypertension sufferers to influence of the role of hypertension
adhere to a hypertension diet will also be sufferers' families on the compliance of
better if their knowledge is high. Vice versa, diets of hypertension sufferers and the effect
if the patient's knowledge is low, then the of providing health education to
decision of hypertension sufferers to adhere hypertension sufferers compliance with
to a hypertension diet will also be reduced. hypertension diets.
CONCLUSION REFRENCE
The results showed that as many as Ginting, F, 2006, Relationship Between
34 people (56.7%) of respondents were not Knowledge and Compliance with
compliant in fulfilling the hypertension diet Hypertension Diet in the Elderly in
and as many as 26 people (43.3%) were Medan Johor District, University of
compliant in fulfilling the hypertension diet. North Sumatra
This is the cause of the increasing number Julianti, D, et al., 2005, Free of
of hypertension sufferers and the recurrence Hypertension with Juice Therapy,
of hypertension in hypertensive patients. Puspa Swara, Jakarta
Food factors (diet compliance) are Junaidi, I., 2010., Hypertension:
important things to consider in patients with Introduction, Prevention, and
hypertension. Patients with hypertension Treatment, PT Bhuana Ilmu Populer,
should adhere to a hypertension diet in Jakarta
order to prevent further complications. Kharisna, D., 2010, The Effectiveness of
Patients with hypertension must continue to Consumption of Cucumber Juice
run a hypertension diet every day, with the Against the Decreased Blood
presence or absence of pain and symptoms Pressure in Hypertension Patients.
that arise. This is so that the blood pressure Riau University
condition of hypertension sufferers remains Mahdiana, R., 2010, Preventing Chronic
stable so that they can avoid hypertension Disease Early on, Tora Book,
and its complications. Yogyakarta Mardiyati, Y., 2009,
It is recommended for health Relationship of Knowledge Levels of
workers to more often provide counseling People with Hypertension and
and socialization about hypertension to Attitudes Underwent a Hypertension
hypertension sufferers, especially about Diet at Ngawen I Health Center in
hypertension diet that is good and right. Gunung Kidul Regency, DIY
Counseling should be done not only when Province muhammadiyah Surakarta
patients come for treatment at the health university
center but will immediately go down to the
field to meet patients with hypertension.
113
Nursalam. 2002. Nursing Management, Yoga, T., 2009, Avoid Hypertension,

Application in Professional Nursing Consumption of Salt 1 Teaspoon Per
Practices. Jakarta: Salemba Medika Day. Accessed in March 2011, from
Nursalam., 2008, Concept and Application http / www.depkes.go.id
of Nursing Science Research
Methodology, Salemba Medika,
Jakarta
Palmer, A & Williams, B. Simple Guide.,
2007, High Blood Pressure.
(Yasmine, Translator), Erlangga:
Jakarta
Potter, P & Perry, A., 2005, Nursing
Fundamental Textbooks. Issue 4,
Volume 1, EGC, Jakarta
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Treatment of the Most Deadly
Diseases, Buana Pustaka,
Yogyakarta
Sarwiji, B & Paramita, 2011, Nursing
Understanding Various Diseases, PT
Index, Jakarta
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Grade II Hypertension in the
Community (Case Study in Karang
Anyar District). Accessed in June
2011, from http /
www.eprints.undip.ac.id
Utomo, P., 2005, Appreciation of
Traditional and Modern Medicine for
Diseases, PT. Rineka Cipta, Jakarta
Waren, A, et al., 2008, Factors Related to
the Occurrence of Hypertension in
Patients Who Are Treating at Adult
Polyclinics in Bangkinang Health
Center. Accessed June 2011, from
http / www.scribd.com
Wawan, A & Dewi, M., 2010, Theory and
Measurement of Knowledge,
Attitudes, and Human Behavior,
Nuha Medika, Yogyakarta
Wiryowidagdo, S & Sitanggang, M., 2002,
Medicinal Plants for Heart, High
Blood Pressure, & Cholesterol, PT
Agromedia Pustaka, Jakarta
Wiryowidagdo, S & Sitanggang, M., 2008,
Medicinal Plants for Heart, High
Blood Pressure, & Cholesterol.
Prints 13, Revised edition, PT
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114
The Effect Of Classical Music Therapy On The Level Of Labor Pain In Active 1-Phase Inpartu Mother In BPM Village Sawit
Seberang Kabupaten Langkat 2018
THE EFFECT OF CLASSICAL MUSIC THERAPY ON THE LEVEL OF

LABOR PAIN IN ACTIVE 1-PHASE INPARTU MOTHER IN BPM
VILLAGE SAWIT SEBERANG KABUPATEN LANGKAT 2018
Evi Rosida Sihombing, Try Mely Cristiani Pinem
ABSTRACT
Labor pain is a physiological condition, labor pain begins to appear in the first stage of labor.
Pain during labor is 30-40 out of 50 scores set by Wall &Mellzack. This score is higher than
clinical pain syndromes such as chronic back pain, pain due to cancer, leg pain and others. Pain
during the first stage of labor occurs due to dilatation of the cervix, lower uterine segment, the
presence of opposing resistance, pulling and injury to the muscle tissue and ligaments that
support the structures above it (Asrinah, 2010)
Key words: labor pain intensity, classical music therapy
Premiliary primiparous and 2-4 hours for multiparous

Childbirth is the process of removing (Reeder, et al. , 2011).
the product of conception from the uterus Labor pain can cause stress which
through the vagina to the outside world. causes excessive release of hormones such
Normal delivery is a process of vaginal as catecholamines and steroids. This
discharge that occurs at term (37-42 weeks), hormone can cause smooth muscle tension
born spontaneously with a percentage of the and vasoconstriction of blood vessels. This
back of the head, without complications can result in decreased uterine contractions,
from either the mother or the fetus. There decreased uteroplacental circulation,
are several factors that influence the labor reduced blood flow and oxygen to the
process, namely the strength of his and uterus, and the emergence of uterine
pushing (power), the birth canal (passage), ischemia which makes pain impulses
the fetus and the placenta (passenger), increase (Marpaung, 2011). Labor pain can
psychological and helper (provider). These also lead to hyperventilation so that oxygen
factors greatly affect whether or not the demand increases, blood pressure increases.
delivery is good (Rohani, 2016). Various attempts have been made to
Labor pain is a physiological reduce pain in labor, both
condition, labor pain begins to appear in the pharmacologically and non-
1st stage of labor. Pain during labor is 30-40 pharmacologically. Pharmacological pain
out of 50 scores set by Wall &Mellzack. management is more effective than non-
This score is higher than clinical pain pharmacological methods, but
syndromes such as chronic back pain, pain pharmacological methods are more
due to cancer, leg pain and others. Pain expensive, and potentially have unfavorable
during the first stage of labor occurs due to effects. Meanwhile, non-pharmacological
dilation of the cervix, lower uterine methods are cheap, simple, effective, and
segment, the presence of opposing without any adverse effects. Non-
resistance, pulling and injury to the muscle pharmacological methods can increase
tissue and ligaments that support the satisfaction during delivery if the mother
structures above (Asrinah, 2010). With can control her feelings and fears.
increasing both the volume and frequency Relaxation techniques, breathing
of uterine contractions, the pain felt will get techniques, movement and position
stronger, the peak of pain occurs in the changes, massage, hydrotherapy, hot / cold
active phase, where the complete opening is therapy, music, guided imagery,
up to 10 cm and lasts about 4-6 hours for acupressure, aromatherapy are some
115
nonpharmacological techniques that can active phase of intercourse showed that

increase maternal comfort during labor and there was a significant reduction in pain
have an effective influence on the perception by using music as therapy
experience of labor (Yuliatun, 2008). compared to groups who did not receive this
The labor pain experienced by the therapy and music therapy is also an
mother will cause the mother to switch to effective technique for women who
labor by cesarean section. The World experience coping disorders with pain
Health Organization (WHO) estimates the problems. Music used as therapy should be
standard average cesarean section in a simple, soothing, regular tempo, and have
country is 5 to 15 percent per 1,000 live soft strains (Potter, 2006). Somoyani's
births. The incidence of cesarean section in study, 2015 also states that Mozart's
Indonesia has increased in 2000 the number classical music has a good impact on
of mothers giving birth with cesarean reducing labor pain,
section 47.22%, 2001 as much as 45.19%,
in 2002 as much as 47.13%, in 2003 as Method
much as 46.7%, in 2004 as many as 53.2%, Initial survey conducted by
in 2005 as much as 51.59% and in 2006 as researchers at 4 BPM DesaSawitSeberang.
much as 53.68% and in 2007 there was no The average number of delivery assistance
significant data (Depkes RI, 2012). was 4-5 cases / week of application related
Music therapy is a method of to non-pharmacological pain management
relaxation techniques that is rarely applied that has not been implemented yet. Even if
in nursing and midwifery practice, even there is an effort to reduce pain non-
though music therapy is an effective pharmacologically, it is only done as a
distraction technique that can reduce routine without clearly knowing the
physiological pain, stress and anxiety by effectiveness of the actions the midwife is
distracting someone from pain (Potter, taking. Given the importance of efforts to
2006). reduce pain in labor as an effort to care for
Research conducted by Oktifa et al, the mother's love and remember that non-
2012 shows that of 15 respondents after pharmacological pain reduction is the most
doing Birthing Ball and Music therapy, 10 preferred effort by mothers in labor.
respondents (66.7%) experienced a decrease Based on the above problems, the
in pain intensity and 5 respondents (33.3%) authors are interested in researching the
did not experience changes in pain intensity. effect of classical music therapy on the level
In addition, one method for relaxation of pain in active phase I stage I in BPM
techniques, which is rarely applied in DesaSawitSeberang, Langkat Regency in
nursing and midwifery practice, is music 2018.
therapy. The Independent Practice Midwives
Music also functions as a controller used were 5 BPM, namely the Rusnah
and is a technique to create a comfortable Midwife Practice, Am.KebDusun I Banyu
environment when women give birth in the UripSawitSeberang, Midwife Dawiyah
delivery room. Music for healing does not Practice, AM.KebDusunLingkungan V
need to be favorite music, but it should be Vegetable Garden Seberang, Midwife
clear and pleasant (Campbell, 2003). Practice Ranti, AM.KebDusun VII
Instrumental music (classical) is preferred SeiLiturSawitSeberang, Practice of Midwife
by mothers in labor, compared to other Eli RustikaDusun Fractionation
types of music (Jordan, 2006) and is the SawitSeberang, and Practice of Midwife
choice for women (Birth Organization Nila, AM.Keb Environmental Tax Center of
Resources and Networks, 2007). Research Palm Oil Seberang. This clinic consists of
conducted by Kathryn Fulton (2005) on several rooms and is equipped with
women who experienced pain during the complete equipment, namely an
examination room (outpatient treatment,
116
pregnant women, family planning), delivery Based on Table 4.3 above, it can be seen
room, postpartum room, baby room, that of the 32 respondents, the majority have
inpatient room and medicine room high school education as many as 13
respondents (40.6%) and the minority have
Result a tertiary education as many as 4
TABLE 4.1 Frequency Distribution of respondents (12.5%).
Stage I Inparticular Motherhood in
Active Phase in BPM DesaSawitSeberang TABLE 4.4 Distribution of the Frequency
in 2018 Intensity of Stage I Intensive Mother
Total Pain in the Active Phase Before and After
No. Age
F % Classical Music Therapy in the
1 <20 years 10 31.2 Intervention Group
2 20-35 years 17 53,1 Pain Before After
3 >35 years 5 15,7 No. Intensity F % F %
Total 32 100
1 Mild pain 0 0 8 50
Based on Table 4.1 above, it can be seen 2 Moderate
5 31,2 8 50
that of the 32 respondents, the majority pain
were 20-35 years old as many as 17 3 Severe pain 11 68,8 0 0
respondents (53.1%) and the minority aged> Total 16 100 16 100
35 years were 5 respondents (15.7%).
Based on Table 4.4 above, it can be seen
TABLE 4.2 Frequency Distribution of that of the 16 respondents in the
Stage I Partition Parity in Active Phase intervention group before being given
in BPM DesaSawitSeberang in 2018 therapy the majority felt severe pain as
Total many as 11 respondents (68.8%) and after
No. Paritas being given classical music therapy the
F %
1 Primipara 8 25 majority felt mild and moderate pain
2 Secundipara 12 37,5 respectively as many as 8 respondents
3 Multipara 10 31,2 (50%).
4 Grandemultipara 2 6,3
Total 32 100 TABLE 4.5 Distribution of the Frequency
Intensity of Stage I Intensive Pain in the
Based on Table 4.2 above, it can be seen Active Phase Before and After Non-
that of the 32 respondents, the majority Classical Music Therapy in the Control
were 12 respondents (37.5%) and the Group
Grandemulitipara minority were 2 Pain Before After
No.
respondents (6.3%). Intensity F % F %
1 Mild pain 2 12,5 3 18,7
TABLE 4.3 Frequency Distribution of 2 Moderate
12 75 6 37,5
Stage I Inparticular Mother Education in pain
the Active Phase of BPM 3 Severe pain 2 12,5 7 43,8
DesaSawitSeberang in 2018 Total 16 100 16 100
Total
No. Education Based on Table 4.5 above, it can be seen
F %
1 SD 7 21,9 that of the 16 respondents in the control
2 SMP 8 25 group before being given the therapy, the
3 SMA 13 40,6 majority felt moderate pain as many as 12
4 Higher Education 4 12,5 respondents (75%), the minority felt mild
Total 32 100 and severe pain respectively 2 respondents
117
(12.5%) and after being given non-classical therapy was 6.09 and after being given
music therapy , the majority felt severe pain therapy was 4.62. The results of statistical
as many as 7 respondents (43.8%), the tests showed that p (sig) was 0.004 <0.05, it
minority felt mild pain as many as 3 can be concluded that there was a
respondents (18.7%). significant difference in pain intensity in the
first stage of the active phase in the
TABLE 4.6 Results of the T-Test intervention group and the control group.
Independent T-Test for the Intensity of
Pain in the Intervention and Control Discussion
Group Stage I Partial Mother in the Labor pain is a physiological
Active Phase condition, labor pain begins to appear
p- during the 1st stage of labor. Pain during
Group N Mean SD SE value labor is 30-40 out of 50 scores set by Wall
Pain intervention 16 7.31 1.662 .416 &Mellzack. This score is higher than
before kontrol 16 4.88 1.962 .491 clinical pain syndromes such as chronic
back pain, pain due to cancer, leg pain and
0,01
Pain intervention 16 3.69 1.138 .285 others. Pain during the first stage of labor
after kontrol 16 5.56 2.421 .605 occurs due to dilatation of the cervix, lower
uterine segment, the presence of opposing
resistance, pulling and injury to the muscle
Based on Table 4.6, it can be seen that the tissue and ligaments that support the
average intensity of the intervention group structures above (Asrinah, 2010).
was 7.31 and after being given classical Music therapy is a non-
music therapy it decreased to 3.69. In the pharmacological method for relaxation
control group the average pain intensity in techniques that is rarely applied in nursing
the intervention group was 4.88 and after and midwifery practice, even though music
being given non-classical music therapy, it therapy is an effective distraction technique
increased to 5.56. The results of statistical that can reduce physiological pain, stress
tests showed that the p value (sig) was 0.01 and anxiety by diverting one's attention
<0.05. This may imply that there is an effect from pain.
of pain intensity on mothers during the first Instrumental music (classical) is
stage of the active phase who are given preferred by mothers in labor, compared to
classical music therapy and non-classical other types of music (Jordan, 2006) and is
music therapy. the choice for women (Birth Organization
Resources and Networks, 2007). Music
TABLE 4.7 Paired Sample T-Test Results used as therapy should be simple, soothing,
for the Intervention Group and the regular tempo, and have soft strains (Potter,
Control Group for Stage I Particular 2006). Research (Somoyani, 2015) also
Women in the Active Phase states that Mozart's classical music has a
p- good impact on reducing labor pain.
Mean N SD SE value This research was conducted on
Active Phase I Inpartu Women in BPM
Pain
6.09 32 2.176 .385 DesaSawitSeberang 2018 with 32
before
0,004 respondents in the first stage of the active
After phase, consisting of two groups, namely the
4.62 32 2.091 .370
pain intervention and control groups with 16
respondents each indicating compatibility
Based on Table 4.7, it can be seen that the with the theory. , that classical music can
average pain intensity in the intervention reduce the intensity of pain in active phase I
and control groups before being given stage I inpartum mothers.
118
The results of this study indicate that 1. From the results of the study, it was
the average pain intensity of the found that out of 32 respondents, the
intervention group was 7.31 and after being majority were 20 -35 years old as many as
given classical music therapy it decreased to 17 respondents (53.1%), a minority aged>
3.69. In the control group the average pain 35 years were 5 respondents (15.7%), the
intensity in the intervention group was 4.88 majority of skundipara were 12 respondents
and after being given non-classical music (37, 5%), a minority of grandemulitipara as
therapy, it increased to 5.56. The statistical many as 2 respondents (6.3%), the majority
test results showed that the p value (sig) was had a high school education as many as 13
0.01 <0.05, meaning that there was an effect respondents (40.6%), and a minority with a
of pain intensity in the active phase of the tertiary education education as many as 4
inpartum mother who was given classical respondents (12.5%).
music therapy and non classical music 2. From the results of the study, it was
therapy. found that of the 16 respondents in the
This is in line with the research control group before being given therapy
conducted by HendriTobing with a research the majority felt moderate pain as many as
sample of 40 respondents who were divided 12 respondents (75%), a minority felt mild
into 2 groups of 20 respondents each with a and severe pain respectively 2 respondents
sampling technique using the Slovin (12.5%), and after being given non-
formula and the results of the T-Test Classical music therapy, the majority felt
statistical test sig value. 0.428 shows that severe pain as many as 7 respondents
there is an effect of birthing ball and music (43.8%), the minority felt mild pain as
on the decrease in the level of pain during many as 3 respondents (18.7%).
the active phase of labor. 3. From the research results, it was found
Furthermore, the results of research that the average pain intensity of the
conducted by WardatiHumaira to mothers intervention group was 7.31 and after being
during the first stage of the active phase given classical music therapy it decreased to
showed that the mean intensity of labor pain 3.69. In the control group the average pain
in the intervention group on a scale of 5.09 intensity in the intervention group was 4.88
and in the control group on a scale of 7.05. and after being given non-classical music
Based on the statistical test with the T - therapy, it increased to 5.56. The results of
Independent Test, it was found that there statistical tests showed that the p value (sig)
was an effect of music therapy on reducing was 0.01 <0.05. This may imply that there
the intensity of labor pain with p = 0.001. is an effect of pain intensity on mothers in
Then the research conducted by the first stage of the active phase who are
HerniAstuti to 30 active phase I stage I given classical music therapy and non-
mothers with each intervention and control classical music therapy.
group as many as 15 respondents. The 4. From the results of the study, it was
results showed that the pre-test mean value found that the average pain intensity in the
was 7.0 and the post-test decreased by - 1.4. intervention and control groups before
The calculated value obtained from the being given therapy was 6.09 and after
paired t-test with the sig value. 0.000, this being given therapy was 4.62. The results of
shows that there is an effect of giving music statistical tests showed that p (sig) was
therapy on the level of labor pain in mothers 0.004 <0.05, it can be concluded that there
in labor. was a significant difference in pain intensity
in the first stage of the active phase in the
Conclusion intervention group and the control group.
Based on the research results, the following
conclusions can be drawn:
119
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Asrinah, et al, 2010. Midwifery Care Mozart Classical Music Therapy on
During Childbirth. Yogyakarta: Pain Intensity in Post-Section
Graha Science. Surgery Patients at Siti Fatimah
Campbell, D. The Mozart effect, harnesses Makassa's Mother and Child
the power of music to sharpenmind, Hospital.
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body. Jakarta: Gramedia Pustaka Faculty of Medicine, Brawijaya
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Yogyakarta: NuhaMedika Practice.Edition 4.Volume 1. Translation:
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NuhaMedika. of Nursing: Concepts, Process and
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Marpaung, L, M, 2011. Description of Guidelines for Midwifery Using
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Primigravida Women at Sally Sulistyawati, Ari, 2010. Midwifery Care for
Maternity Clinic, KTI, Medan: Maternity Women. Jakarta:
University of North Sumatra, SalembaMedika
Faculty of Nursing. Yanti, 2009.Childbirth Midwifery Care.
Nike, 2010.The difference between Mozart Yogyakarta: PustakaRihama.
Classical music and traditional Yuliatun L, 2008. Handling of labor pain
Javanese gamelan music in reducing using non-pharmacological methods.
labor pain during the active phase of Malang: Bayumedia Publishing
labor. Bandung: Padjadjaran
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Rohani, Saswita, R., &Marisah. (2016).
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Jakarta: SalembaMedika.
Rukiah, A, Y, 2009. Midwifery Care II
(Childbirth). Jakarta: Trans Info
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Somoyani, 2014. Classical Music Therapy
and Balinese Music Reducing the
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Active Phase. Husada Scale Journal,
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Sulistyawati, A., &Nugraheny, E, (2010).
Midwifery Care for Maternity.
Jakarta: SalembaMedika.
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Intensity in Stage I Primigravida
Mother's Active Phase of
Labor.Forikes Journal of Health
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120
Relationship Of Midwifery Service Excellent Service With Maternity Satisfaction At Tanjung Pura Regional Hospital
RELATIONSHIP OF MIDWIFERY SERVICE EXCELLENT SERVICE

WITH MATERNITY SATISFACTION AT TANJUNG PURA REGIONAL
HOSPITAL
Ainun Syahfitri1, Eka Falentina Tarigan, Sari Nduma Ambarita3

[email protected]
STIKesMitraHusada Medan
ABSTRACT
The National Health System (SKN) states that the goal of health development is the
achievement of the ability to live a healthy life for every population in order to achieve an
optimal health degree as an element of general welfare, one of the efforts to achieve this goal is
to make comprehensive, integrated and equitable health efforts that can be achieved. accepted
and reached by all people with an active role in the community, namely hospital referrals.
Customer satisfaction can be improved by improving service quality by using customer
analysis, including reliability, credibility, competence, tangible and responsiveness. This study
aims to determine the Relationship between Excellent Service Midwifery Services and
Maternal Patient Satisfaction at the Tanjung Pura Regional Hospital in 2018. The population in
this study were all women giving birth at the Tanjung Pura Hospital in 2018. The number of
samples in this study were taken randomly. 63 people. The results obtained in this study on 63
respondents at the Tanjung Pura Regional Hospital in 2018 stated that there were 35 people
who were dissatisfied with good service towards maternal satisfaction who were dissatisfied
with 35 people (83%) and for service excellence. %). There is a variable reliability with good
service with bad patient satisfaction as many as 34 people (83%) and good service with good
patient satisfaction as many as 7 people (17%). There is a variable credibility with good service
with bad patient satisfaction as many as 18 people (53%) and good service with good patient
satisfaction as many as 16 people (47%). There is a Competance variable with good service
with bad patient satisfaction as many as 33 people (80%) and good service with good patient
satisfaction as many as 8 people (19%). There is a Tangible variable with good service with bad
patient satisfaction as many as 35 people (83%) and good service with good patient satisfaction
as many as 7 people (17%). There is a responsiveness variable with good service with bad
patient satisfaction as many as 34 people (83%) and good service with good patient satisfaction
as many as 7 people (17%).
Keywords: Midwifery Service, Excellent Service, Maternal Satisfaction
PRELIMINARY Health services in hospitals are

The national health system (SKN) is said basically public service organizations. The
that the goal of health development is the hospital has a mission to provide quality
achievement of the ability to live a healthy and affordable health services to the
life for each population so that optimal community in order to improve community
health status can be realized as one of the health status. In addition, the hospital also
elements of general welfare, one of the implements health service efforts in an
efforts to achieve these objectives is a efficient and effective manner in order to
comprehensive, integrated and equitable prioritize the healing and recovery of
health effort that can accepted and patients in an integrated manner, therefore
affordable by all people with an active hospitals need to have excellent service
community role, namely hospital referrals quality characteristics in accordance with
(Sornauli, 2008). patient expectations (Adenan, 2016).
121
According to the results of research RESEARCH RESULT

conducted by Wulandari (2012) conducted From the results of the study titled "The
on December 23, 2012 on 10 outpatients by Relationship of Excellent Service
conducting a short interview at RSIA Aura Midwifery Services and Maternal
Syifa showed that 6 patients (60%) were Satisfaction at Tanjung Pura Regional
satisfied and 4 patients (40%) felt Hospital with a total of 63 respondents with
dissatisfied with the services provided, due the following results.
to the lack of communicative officers in
responding to patient complaints, and based A. Characteristicsof Respondents
on the results of research on 32 patients 1.Univariat Analysis
RSIA Aura Syifa Gampengrejo Kediri can be seen that respondents based on
known satisfaction as a large respondent to the age of the majority of respondents aged
the services provided by midwives at RSIA 28-32 years were 19 people (31%) and the
Aura Syifa Gampengrejo Kediri are minority aged 18-22 years were 12 people
satisfied, (31 %) feel very satisfied, (63%) (19%). Based on education the majority of
feel satisfied, (6%) feel dissatisfied with the respondents have an elementary education
services provided by RSIA Aura Syifa of 32 people (51%) and a minority of PT
Gampengrejo Kediri. education respondents are 10 people (16%).
Based on preliminary surveys Based on work, the majority of respondents
conducted at Tanjung Pura Hospital there have 22 employees (17%) and the minority
were 178 maternal patients, from January to as IRT are 10 people (32%).
June 2018. Where researchers interviewed 2. Bivariate Analysis
several patients at Tanjung Pura Regional can be seen that based on midwifery
Hospital to find out the satisfaction of services most respondents rated it in the
maternity patients about Midwifery Services good category of 41 people (65%). The
Excellent Service in the Tanjung Pura results of the Bivariat analysis stated that
Regional Hospital, apparently from a there was a relationship between midwifery
number of patient opinions the researcher services and patient satisfaction with a p
got, Kuarang patients were satisfied with value <of 0.05 (p = 0,000).
the midwifery services at the Tanjung Pura 3. Multivariate Analysis
Regional Hospital. Tabel : Frequency Distribution of
Relationship of Midwifery Service
RESEARCH METHODS Excellent Service and Maternal Patient
This study uses analytic obsevational Satisfaction in Tanjung Pura Regional
research. This research is to find out the Hospital in 2018
relationship between midwifery services
and satisfaction of maternity patients in independent B Wald Sig Exp 98%
variable (B) Confidence
Tanjung Pura Regional Hospital in 2018 Interval
with analytical observational research, with Lower Upper
a sample of 63 people Reability 0.128 0.000 0.001 0.131 0.044 0.462
Credibility 0.152 1.557 0.005 0.163 1.598 19.430
The location chosen as a place of Tangible 0.731 0.000 0.000 0.740 0.037 0.408
research on the relationship of midwifery Competance 0.262 0.000 0.004 0.269 0.065 0.632
service is excellent and the level of Responsiveness 0.128 0.274 0.001 0.131 0.044 0.462
satisfaction of maternal patient satisfaction

is in Tanjung Pura Regional Hospital, while Shows the influence of the
the reason for selecting a research site are : independent variables on related variables
The location is easy to reach, Availability of using logistic regression analysis with the
sampel sources expected by researchers, enter method. The analysis shows that there
Time cost and energy efficiency. is one variable whose value is <0.05, this
means that statistically has an influence on
the dependent variable.
122
4.2.4 DISCUSSION 4.2.2 Frequency Distribution Based on

From the results of research conducted Variable Reability With Maternal
on the relationship of excellent service Satisfaction in Midwifery Services
midwifery service with maternal patient Excellent Service at Tanjung Pura
satisfaction at the Tanjung Pura Hospital Hospital in 2018
2018, the discussion is as follows: Based on the results of the research, the
4.2.1 Frequency Distribution of number of cases in the delivery room of the
Respondents Characteristics in the Tanjung Pura Hospital in 2018 was 63
Delivery Room at the Tanjung Pura mothers giving birth and respondents based
Hospital in 2018 on the reliability above it can be seen that in
Based on the results of the study, the good service there are 41 people, of which
number of cases in the delivery room of the 41 people are good service with bad
Tanjung Pura Hospital in 2018 were 63 satisfaction 34 people, 7 people feel service
mothers giving birth and 19 respondents good with good satisfaction. There are 22
based on the age of the majority aged 29-33 bad knowledge, where 13 people have good
years (30.2%), and a minority 18-23 years satisfaction and 9 people have bad
of 12 people (19, 0%). Based on the results satisfaction. The majority of good service
of the study, the number of cases in the relationships with patient satisfaction were
delivery room at the Tanjung Pura Hospital not good as many as 34 people (83%), the
in 2018 were 63 mothers giving birth and minority of good service relations with good
respondents based on education, the patient satisfaction were 7 people (17%).
majority of respondents had elementary This study is in line with Tjiptono's research
education, namely 30 people (50.8%) and a (2004) in Wira DIA (2014) which states that
minority of respondents from high school the main factors that can determine patient
and university education (universities) as satisfaction are reliability, trust, ability,
many as 10 people 15.9%). physical evidence and responsiveness.
This research is in line with the Based on the research, there were 7
research of Arisa Wulandari (2016), with respondents (30%) who had bad perceptions
the title Patient Perception Relationship in and were not satisfied with the services
inpatient administrative services with family provided there were 11 respondents (11%)
satisfaction of patients participating in who had good perceptions but were still not
national health insurance, it is known that satisfied with the services provided by the
there are most respondents, there are 18 hospital.
respondents (30%) who expressed This study is in line with the research of
dissatisfaction with the services provided. Sondang (2007), in his research on 95
This could have an effect on hospital inpatients at the Bhayangkara Hospital
services. Medan stated that patient satisfaction on the
According to the assumptions of the reliability dimension which stated
researcher, seeing from the data taken from satisfaction was 41.1% and 34.75%
the research questionnaire conducted at the dissatisfied.
Tanjung Pura Regional Hospital, there are According to the research assumptions,
still many ages and education who do not seeing from the data taken from the research
understand about the excellent service questionnaire conducted at the Tanjung
midwifery services available at the Tanjung Pura Regional Hospital, there are still many
Pura Hospital. patients who do not understand about the
excellent service midwifery services
available at the Tanjung Pura Regional
Hospital in the category of reliability.
123
4.2.3 Frequency Distribution Based on knowledge amounted to 33 people where 13

Credibility Variables With Maternal people with good satisfaction and 8 people
Satisfaction in Midwifery Services with bad satisfaction. The majority of good
Excellent Service at Tanjung Pura service relations with patient satisfaction
Hospital in 2018 were not good as many as 35 people (83%),
Based on the results of the research, the the minority of good service relations with
number of cases in the delivery room at the good satisfaction were 7 people (17%).
Tanjung Pura Hospital in 2018 was 63 This research is in line with Arisa
mothers giving birth and respondents based Wulandari's research (2016), with the title
on the credibility above it can be seen that The Relationship Between Perceptions of
in good service there are 34 people, where Inpatient Administration Services and
34 people are good service with bad Family Satisfaction of Patients Participating
satisfaction 18 people, 16 people feel good in National Health Insurance, it is known
service with good satisfaction. Knowledge that 18 respondents (30%) expressed
is not good amounted to 29 people where 4 dissatisfaction with the services provided.
people with good satisfaction and 25 people This could have an effect on services in
with bad satisfaction. The majority of good hospital services.
service relationships with patient This study is in line with the research of
satisfaction were 18 people (53%), the Sondang (2007), in his study there were 95
minority of good service relationships with inpatients at the Bhayangkara Hospital
good satisfaction were 16 people (47%). Medan who stated that 60% of patients'
This study is in line with Sangadji's satisfaction on the Tangible dimension
(2013) research, which states that most of stated that they were satisfied and 35.8%
the respondents, there are 11 respondents were dissatisfied.
(11%) who have a good perception but are According to the research assumptions,
still not satisfied with the services provided seeing from the data taken from the research
by the hospital. questionnaire conducted at the Tanjung
According to the assumptions of the Pura Regional Hospital, there are still many
researcher, seeing from the data taken from patients who do not understand about the
the research questionnaire conducted at the excellent service midwifery services
Tanjung Pura Regional Hospital, there are available at the Tanjung Pura Hospital in
still many patients who do not understand the Tangible category (reliability).
the excellent service midwifery services
available at the Tanjung Pura Hospital in 4.2.5 Frequency Distribution Based on
the category of Credibility. Competance Variables With Maternal
Satisfaction in Midwifery Services
4.2.4 Frequency Distribution Based on Excellent Service at Tanjung Pura
Tangible Variables With Maternal Hospital in 2018
Satisfaction in Midwifery Services Based on the results of the research, the
Excellent Service at Tanjung Pura number of cases in the delivery room of the
Hospital in 2018 Tanjung Pura Hospital in 2018 was 63
Based on the results of the research, the mothers giving birth and respondents based
number of cases in the delivery room at on the above competencies can be seen that
Tanjung Pura Hospital in 2018 was 63 in good service there are 41 people, where
mothers giving birth and respondents based 41 people are good service with bad
on the above tangible can be seen that in satisfaction 33 people, 8 people feel good
good service there were 67 people, where service with good satisfaction. Bad
67 people were good service with bad knowledge amounted to 22 people where 12
satisfaction 35 people, 7 people felt good people with good satisfaction and 10 people
service with good satisfaction. Bad with bad satisfaction. The majority of good
124
service relationships with patient people (83%), the minority of good service
satisfaction were not good as many as 33 relations with good satisfaction were 7
people (80%), the minority of good service people (17%).
relations with good satisfaction were as This study is in line with the research of
many as 8 people (19%). Sondang (2007), in his research there were
This research is in line with Arisa 95 inpatients at the Bhayangkara Hospital
Wulandari's research (2016), with the title Medan who stated that patient satisfaction
The Relationship Between Perceptions of on the responsiveness dimension who
Inpatient Administration Services and expressed satisfaction was 72.6% and
Family Satisfaction of Patients Participating 49.4% dissatisfied.
in National Health Insurance, it is known According to the research assumptions,
that 18 respondents (30%) expressed seeing from the data taken from the research
dissatisfaction with the services provided. questionnaire conducted at the Tanjung
This could have an effect on services in Pura Regional Hospital, there are still many
hospital services. patients who do not understand the excellent
This study is in line with the research of service midwifery services available at the
Sondang (2007), in his study there were 95 Tanjung Pura Hospital in the
inpatients at the Bhayangkara Hospital Responsiveness category.
Medan who stated that 60% of patients'
satisfaction on the competence dimension CONCLUSIONS AND
stated that they were satisfied as much as RECOMMENDATIONS
60% and 35.8% who were dissatisfied. 1. Based on maternal satisfaction in
According to the research assumptions, excellent service midwifery services
seeing from the data taken from the research in Tanjung Pura Regional Hospital
questionnaire conducted at the Tanjung in 2018 the majority of service
Pura Regional Hospital, there are still many excellent service Good to the
patients who do not understand the excellent satisfaction of dissatisfied maternity
service midwifery services available at the mothers there were 35 people (83%)
Tanjung Pura Hospital in the category of and minority in excellent service
Competance services Good satisfaction of
satisfied maternity satisfaction there
4.2.6 Frequency Distribution Based on were 7 people (17%)..
Responsiveness Variables With Maternal 2. Based on the variable Reability with
Satisfaction in Midwifery Services maternal satisfaction in excellent
Excellent Service at Tanjung Pura service midwifery services in
Hospital in 2018 Tanjung Pura Regional Hospital in
Based on the results of the research, the 2018, it can be seen that the majority
number of cases in the delivery room at the of good service relationships with
Tanjung Pura Hospital in 2018 was 63 bad patient satisfaction are 34
mothers giving birth and respondents based people (83%), the minority of good
on the responsiveness above, it can be seen service relationships with good
that in good service there are 41 people, patient satisfaction is 7 people (
where 41 people are good service with bad 17%).
satisfaction 34 people, 7 people feel good 3. Based on the variable credibility
service with good satisfaction. Bad with maternity satisfaction in
knowledge numbered 22 people, where 13 excellent service midwifery services
people with good satisfaction and 9 people in Tanjung Pura Regional Hospital
with bad satisfaction. The majority of good in 2018, it can be seen that the
service relationships with patient majority of good service
satisfaction were not good as many as 34 relationships with bad patient
125
satisfaction are 18 people (53%), excellent service and provide adequate

minority good service relationships facilities.
with good patient satisfaction are 16 5.2.3. For Further Researchers
people ( 47%). It is hoped that the next researchers can
4. Based on the variable Competance continue this research with more and
with maternal satisfaction in more in-depth variables
excellent service midwifery services
in Tanjung Pura Regional Hospital REFERENCES
in 2018 1. Adenan. (2016). Hubungan Antara
5. it can be seen that the majority of Persepsi Pada Pelayanan
good service relationships with bad Administrasi Rawat Inap Dengan
patient satisfaction are 33 people Kepuasan Keluarga Pasien Peserta
(80%), the minority of good service Jaminan Kesehatan Nasional. Jurnal
relationships with good patient publikasi kesehatan masyarakat
satisfaction are 8 people (19%). Indonesia, Vol. 3 No 2
6. Based on the Tangible variable with 2. Aji, I. B. (2016). Mutu Pelayanan
maternal satisfaction in excellent Kebidanan Dengan. Fakultas Ilmu
service midwifery services in Kesehatan , UMP, 34
Tanjung Pura Regional Hospital in 3. Akademi Kebidanan Palapa Husada
2018 it can be seen that the majority Medan, (2015), Standart Pelayanan
of good service relationships with Kebidanan.
poor patient satisfaction by 35 4. Jenny, dkk (2013). Mutu Pelayanan
people (83%), minority good service Kesehatan dan Kebidanan. Salemba
relationships with good patient Medika
satisfaction by 7 people ( 17%). 5. Musafaah. ( 2016). Hubungan
7. Based on the variable Antara Persepsi Pada Pelayanan
Responsiveness with maternal Administrasi Rawat Inap Dengan
satisfaction in excellent service Kepuasan Keluarga Pasien Peserta
midwifery services in Tanjung Pura Jaminan Kesehatan Nasional. Jurnal
Regional Hospital in 2018, it can be publikasi kesehatan masyarakat
seen that the majority of good Indonesia.
service relationships with bad 6. Notoatmodjo, (2010). Metodologi
patient satisfaction are 34 people penelitian kesehatan. PT RINELKA
(83%), the minority of good service CIPTA, Jakarta
relationships with good patient 7. Nurmawati, (2019). Mutu Pelayanan
satisfaction is 7 people ( 17%). Kebidanan. Trans Info Media,
Jakarta
SUGGESTION 8. Paradise, S. (2014). Pelayanan
5.2.1. For Health Workers Prima Di Rumah Sakit Stikes Bhakti
It is hoped that health workers can Husada Alawi, 6
provide information or counseling in 9. Permenkes, nomor 28 Tahun 2017.
order to increase maternal knowledge Jakarta : PMKR Indonesian. dIdapat
about good and correct service Dari : Ditjenpp. Kemenkes.go.id>
excellent midwifery services so that 10. Profil Kesehatan Indonesia, 2016.
satisfactory results can be obtained by Data dan informasi Profil Kesehatan
patients. Indonesia. Jakarta: Kemenkes Ri.
5.2.2. For Tanjung Pura Hospital 2017. Didapat dari
It is hoped that Tanjung Pura Hospital :www.Depkes.go.id
will improve its midwifery service 11. Saragih, S. (2008). Analisi Pengaruh
Faktor-Faktor Kecerdasan Emosi
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Terhadap Komunikasi Interpersional

Perawat Dengan Pasien Di Unit
Rawat Inap Rsud Dr. Amino
Gondohutomo, Usu. 14
12. Saragih, S. (2008) Hubungan
Kualitas pelayanan dan kepuasan
pasien dengan kunjungan di balai
pengobatan gigi puyskesmas kota
pecan baru. USU Repository, 16
13. Syafruddin, dkk , 2009. Buku Ajar
Ilmu Kesehatan Masyarakat Untuk
Mahasiswa. CV.Transinfo media :
Jakarta
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Antara Persepsi Pada Pelayanan
Administrasi Rawat Inap Dengan
Kerpuasan Keluarga Pasien Peserta
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Publikasi Kesehatan Masyarakat
Indonesia, I5
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Pelaksana Pelayanan Prima Oleh
Bidan Dalam Dimensi Interpersonal
Relation Dengan Kepuasan Pasien.
Akademi Kebidanan Pamenang
Pare Kediri, 10
16. Wikipedia, “Peran Teknologi Dalam
Bidang Kesehatan”
Choirun Nisa, Yunita “Peran
Teknologi Dalam Bidang
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127
Relationship Type Of Labor To Postpartum Depression Risk In The Midwifery Room Of The Public Hospital Muhammad Ali
Kasim District Gayo Lues Year 2020
RELATIONSHIP TYPE OF LABOR TO POSTPARTUM DEPRESSION

RISK IN THE MIDWIFERY ROOM OF THE PUBLIC HOSPITAL
MUHAMMAD ALI KASIM DISTRICT GAYO LUES YEAR 2020
1
Fadhilah Husnah, 2Febriana Sari, Normal Anita3
1 Mahasiswa STIKes Mitra Husada Medan, Medan – Indonesia
2
Dosen STIKes Mitra Husada Medan, Medan – Indonesia
[email protected]
ABSTRACT
Background: Depression most experienced by the community. Depression is a real disease or
real public health problem. The incidence of depression in the world is very high, reaching
18%, from 2005-2015 there were 300 million of the world's total population who experienced
depression in their lives. The high incidence of depression has caught the attention of the world
community, so the world health organization (WHO) has made depression the theme of the
2017 World Health Day commemoration (Kemenkes RI, 2017).
Methods: This type of research is an analytical survey with a retrospective cohort design. The
population in this study were all postpartum mothers who gave birth at the General Hospital
Muhammad Ali Kasim, Gayo Lues Regency, the obstetrics room. The population in this study
were all postpartum mothers who gave birth at the Muhammad Ali Kasim General Hospital,
Gayo Lues Regency, the obstetrics room from June 1 to July 14, 2020. The population in this
study were all postpartum mothers on days 7-14 who gave birth at Muhammad Hospital. Ali
Kasim.
Results: The results of univariate analysis were conducted to determine the distribution of
research subjects by calculating the frequency and percentage of each research variable. The
results of statistical tests show that mothers with cesarean delivery have a 3.7 times greater risk
of postpartum depression than mothers who deliver vaginal deliveries.
Conclusion: The type of delivery affects the risk of postpartum depression because the
mother's bad experience during childbirth and physical trauma during childbirth will affect the
mother's psychology. The risk incidence of postpartum depression in postpartum mothers at
Muhammad Ali Kasim General Hospital is 36.3%, with 3.7 times greater risk of postpartum
depression in cesarean delivery than vaginal delivery.
Key words: Type of Labor, Psychology, Postpartum Depression, Childbirth Sc and vaginal
delivery
BACKGROUND 2017). Part of the depression rate is

Depression is one of the problems or depression experienced by mothers during
mental health problems that most people the postpartum or childbirth period. The
experience. Depression is a real disease or postpartum period is a critical period in the
real public health problem. The incidence of survival of mothers and newborns. Most of
depression in the world is very high, maternal and newborn deaths occurred
reaching 18%, from 2005-2015 there were within the first 1 month after delivery.
300 million of the world's total population Infant mortality rate (IMR) 24 deaths per
who experienced depression in their lives. 1,000 live births. The percentage of women
The high incidence of depression has caught who received their first postnatal care after
the attention of the world community, so the giving birth to a child with a birth order of 6
world health organization (WHO) has made or more (65%) was lower than that of
depression the theme of the 2017 World women who had had their first child (88%).
Health Day commemoration (Kemenkes RI, The percentage of women who receive
128
postnatal care at health care facilities (94%) data was obtained that the incidence of
is higher than that of women who give birth postpartum depression was between 15-20%
elsewhere (56%) (IDHS, 2017). (Elvira, 2011). In 2007 in Indonesia, the
The incidence of postpartum depression incidence of postpartum depression found at
globally is between 10-15%, a meta- 6 weeks postpartum was 6.6% and 6 months
analysis study conducted in 23 developing postpartum was 8.2% (Rommruangwong,
countries in 2016 with 38,142 participants, 2011).
it was found that the incidence ofdepression Women who do not adapt to their new
postpartum was 19.7% (16.9-22.8%). roles and activities are likely to experience
During the postpartum period, mood psychological disturbances in a variety of
disorders are common in women up to 85%, symptoms called postpartum depression .
although only 10-15% of women experience WHO predicts depressive disorder will be
significant clinical symptoms (Sylven et al., the second highest problem in 2020. Based
2017). However, 10-15% of mothers who on several studies, the postpartum period or
experience further symptoms and until they what is known as postpartum is a high risk
get worse are diagnosed with postpartum period for depressive disorders in women
depression (Cirik et al., 2016). The (Khojinayati, 2017). WHO states that the
prevalence ofdepression incidence is factors that contribute to the occurrence of
postpartum 10-15% in developed countries postpartum depression are stress conditions,
and about 20% -40% in developing negative behavior during pregnancy and
countries.depression Postpartum has a lack of social support (Ayoub, 2014;
significant negative impact on cognitive, Norhayati et al., 2016).depression
social and developmental children. The Postpartum poses a risk to postpartum
effects of depression are not only on mothers because of the length of labor, type
mothers, but babies on depressed mothers of delivery, and medical interventions
will experience delays in cognitive, during labor.depression Postpartum in
psychological, neurological and motor mothers will affect children's behavior
development (Diniyah, 2017). The disorders, low thinking functions and
prevalence of postpartum depression in the cognitive impairment and children's growth
world varies from 6.5% to 15% during 1 (Ariyanti, et al, 2017).
year after delivery (Misri et al., 2016; Other studies suggest that a decrease in
Rambelli et al., 2010; Tang et al., 2016). the ratio of Luteinizing Hormone (LH) -
The prevalence of postpartum depression in Follicle Stimulating Hormone (FSH)
developing countries ranges from 2% -74% postpartum is associated with an increased
with the greatest prevalence in Turkey risk of postpartum depression (Raji et al.,
(Norhayati et al., 2016). Research 2016). A decrease in this ratio can be used
conducted in Brazil states that the as a chemical predictor of postpartum
prevalence of postpartum depression depression. The existence of problems with
increases every year with the predictor sleep patterns and fatigue in the legs during
factor being the mother's lack of pregnancy have contributed to the
understanding to check the condition of symptoms of postpartum depression (Okun,
herself and the baby so that screening and 2016; Sarberg et al., 2016). Postpartum
preventive efforts can be made (Correa et depression poses a risk to postpartum
al., 2016). mothers because of the length of labor, type
Previous research has revealed that of delivery, and medical interventions
postpartum depression is also experienced during labor. Postpartum depression in
by women in Indonesia, however national mothers will affect the child's behavior
data cannot yet be explored for the disorders, low thinking function and
prevalence rate. In Indonesia (Jakarta, cognitive impairment and child growth.
Yogyakarta and Surabaya), in 1998-2001 Knowing the effect of the type of delivery
129
on the risk of postpartum depression in it is necessary to conduct research on the

postpartum mothers. The incidence of risk relationship between the type of delivery
of postpartum depression in postpartum and the risk ofdepression postpartum in the
mothers in Sleman Hospital was 36.3%. midwifery room of the General Hospital
Type of delivery had a significant effect on Muhammad Ali Kasim, Gayo Lues Regency
the risk of postpartum depression with a to find out how the effect of the type of
value (OR = 3,716, 95% CI 1,620-8,522) delivery on the risk of postpartum
(Ariyanti et al, 2017). depression.
Muhammad Ali Kasim General Hospital
is the only hospital in Gayo Lues Regency METHOD
to date and accepts patients via the BPJS This study was an analytical survey
line and the public route. Muhammad Ali with a retrospective cohort design. The
Kasim General Hospital is a referral place population in this study were all postpartum
from 11 sub-districts and 136 villages who mothers who gave birth at the General
make referrals. There are quite a lot of visits Hospital Muhammad Ali Kasim, Gayo Lues
to deliveries at the Muhammad Ali Kasim Regency, the obstetrics room. The type of
General Hospital, because it accommodates data in this study is primary data. The data
referrals for each sub-district in Gayo Lues collection technique was done by giving
Regency. The survey results obtained that questionnaires to respondents according to
the number of vaginal deliveries amounted the criteria that had been made. Univariate
to 42 people and 32 deliveries by cesarean analysis of data obtained from the collection
section in 2018. The data obtained in 2019 results can be presented in the form of a
of maternity patients increased from the frequency distribution table. In this bivariate
previous year. The number of patients analysis, statistical tests were carried out on
giving birth by vaginal delivery was 313 interrelated variables, the correlation
and the number of patients giving birth by statistics used were using the chi-square
cesarean section was 163 people. There are test. The number of questions on the EPDS
some patients who look gloomy, and do not instrument has 10 items, where the
have passion during direct contact with their questions are easy to understand, which
babies, in the midwifery room of allows clients to fill them out and does not
Muhammad Ali Kasim General Hospital, make clients tired when answering the
this is the background for the author to questionnaire. Questions in the instrument
conduct research, whether the signs and are classified with a sign (*) and without a
symptoms experienced by postpartum sign (*). For questions without a sign (*),
mothers in the midwifery room are namely questions 1,2 and 4, the top answer
postpartum depression or still level of baby box is given a value of zero (0) and the
blues or worse postpartum psychosis. lowest answer box is given a value of three
Because in the midwifery room there are 2 (3). Questions with a sign (*), namely the
types of delivery, both vaginal delivery and number 3,5,6,7,8,9,10, the top answer box is
by cesarean section, so the authors want to given a value of three (3) and the lowest
know whether there is an influence and answer box is given a value of zero (0). The
relationship between types of delivery that maximum value of EPDS is 30 with interval
are at risk of depression inmothers 0-9 normal, ≥ 15 depression.
postpartum. Based on the description above,
130
RESULTS (93.9%) had family support, 65 respondents

Characteristics of Respondents (98.4%) married status, 48 respondents
Table 1 Frequency distribution of (72.7%) planned pregnancy, 34 respondents
respondents based on age, education, (51.5%) gave birth vaginal discharge and 22
occupation, parity, type of delivery, respondents (33.3%) who experienced
economic status, family support, married postpartum depression for 7 days after
status, planned pregnancy and incidence of delivery.
postpartum depression at Muhammad Ali
Kasim General Hospital in 2020 Table 2 Effect of independent variables
Variable Frequency % with dependent variables
Education Type of EPDS I Frequency
P. Low: SD-SMP 28 42.4 Labor EPDS II
P. High: SMA-PT 38 57.5 Frequency
Work DP TDP DP TDP
Mother is working 23 34.8 Vaginal 9 25 11 23
Mother does not 43 65.1 Sectio 13 19 13 19
work Total 22 44 24 42
Parity
Primipara 30 45.4 Based on the table above 9
Multipara 36 54.5 respondents experienced postpartum
Economic status depression during vaginal delivery with
Low 42 63.6 EPDS examination the first stage, during
Medium 12 18.1 the postpartum period 7 days postpartum.
High 12 18.1 11 respondents who experienced vaginal
Family support delivery postpartum depression at the
Yes 62 93.9 second EPDS examination at the
None 4 6.0 postpartum period. Among respondents who
status gave birth by section by section, there was
MarriedMarried 65 98.4 no change in the EPDS I examination with
Unmarried 1 1.5 the EPDS II examination, but the rate of
Pregnancy postpartum depression was more in
Planned 48 72.7 postpartum mothers who gave birth by
Unplanned 18 27.2 section section.
Type of delivery The relationship between the type
Pervaginam 34 51.5 of delivery and the risk of postpartum
Sectio by 32 48.4 depression. Theanalysis in this study aimed
Postpartum to determine the relationship between the
depression 22 33.3 type of delivery and the incidence of
Yes 24 36.3 postpartum depression at Muhammad Ali
No Kasim General Hospital in 2020. Statistical
testing using chi-square with a confidence
Based on the results of statistical level of 95% and a p-value less than 0.05.
tests, it is known that the frequency The results of the analysis are presented as
distribution of the respondent variables. A follows:
total of 28 respondents (42.4%) with low
education ranging from elementary to junior
high school level, 23 respondents (34.8%)
working mothers, 30 respondents (45.4%)
primiparous parity, 42 respondents (63.6%)
economic UMR ≤3,165,031, 62 respondents
131
Table 3 Cross table of research subjects times compared to vaginal deliveries, thus
based on the type of delivery with the preventing the mother from fulfilling her
incidence of postpartum depression at new role as a mother which makes mothers
Muhammad Ali Kasim General Hospital with cesarean delivery more at risk of
in 2020 postpartum depression. Conduct early
Type of delivery OR 95% CI detection to see the risk of postpartum
Vaginal 3,716 1,620- depression in postpartum mothers so that
Sectio 1 8,522 they can immediately get treatment that has
not been done at the Obstetrics and
The results of statistical tests show Gynecology Poli Muhammad Ali Kasim
that mothers with cesarean delivery have a Hospital, Gayo Lues Regency.
chance the risk of postpartum depression According to a study by Patel et al.,
was 3.7 times greater than that of mothers (2005) in the UK on the analysis of the
who had vaginal delivery. effect of operative delivery with postpartum
depression in postpartum mothers, which
DISCUSSION was conducted in a prospective cohort, it
This study found 66 respondents. was found that vaginal delivery had a 9.3%
The factors in the incidence of postpartum risk of postpartum depression, while for
depression in this study were age, type of mothers who did cesarean delivery has a
delivery, level of education, employment 10.1% risk of developing postpartum
status, social support, parity, family support, depression, so mothers who deliver cesarean
planned pregnancy, economic status, and delivery have a greater risk of developing
married status. postpartum depression.
The incidence of the risk of Research by Goker et al., (2012), in
postpartum depression in postpartum Turkey, analyzed whether the type of
mothers at Muhammad Ali Kasim General delivery was a risk factor for postpartum
Hospital is 36.3%, the type of delivery has a depression, it was found that the type of
significant effect on the risk of postpartum delivery influenced the occurrence of
depression with a value of OR = 3.7 This postpartum depression with vaginal delivery
means that mothers with cesarean delivery having a 27.6% risk of suffering from
have a 3.7 times the risk of postpartum postpartum depression. Research by
depression. greater than mothers who gave Bahadoran et al., (2014), in Iran with a
vaginal delivery. Experience during meta-analysis of the type of delivery on
childbirth, responsibility for the role of postpartum depression, shows that mothers
mother, the existence of a new family who have had a cesarean delivery have a
member (baby) and a new role as a mother risk of postpartum depression that is two
are psychological changes that occur in times greater than vaginal delivery, or
mothers during the postpartum period whether or not postpartum depression in the
(Maryuani, 2009). The type of delivery mother has an effect. The occurrence of
affects the risk of postpartum depression postpartum depression due to the type of
because the mother's bad experience during labor experienced by postpartum mothers is
childbirth and physical trauma during influenced by other variables. The results of
childbirth will affect the mother's this study conclude that the type of delivery
psychology. This is in accordance with the has an influence on the risk of postpartum
opinion of Kruckman in Marni (2014), that depression so that routine screening during
postpartum depression is a risk to postpartum visits can identify the risk of
postpartum mothers because of the length of postpartum depression effectively, simply
labor, the type of delivery, and medical and easily, so that mothers at risk of
interventions during labor. Mothers with postpartum depression can immediately get
cesarean delivery have longer recovery optimal midwifery care. Apart from being
132
able to be immediately referred to a Brazilian women. Journal of Affective

psychiatrist for further diagnosis and Disorders, 204, 214-218.
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134
Knowledge's Relationship With The Attitude Of The Mother Weeking Babies Under 1 Year In The Region The Work Of
Puskesmas Medan Johor
KNOWLEDGE'S RELATIONSHIP WITH THE ATTITUDE OF THE

MOTHER WEEKING BABIES UNDER 1 YEAR IN THE REGION THE
WORK OF PUSKESMAS MEDAN JOHOR
Marliani1, Kamelia Sinaga 2
1,2
Lecturer STIKes Mitra Husada Medan
[email protected]
ABSTRACT
A good weaning time is done when the child reaches 2 years of age. Weaning that is done at the
age of less than the year causes problems in children. The causative factor for weaning less than
2 years is knowledge with the mother's attitude about weaning time. Information is very
important given to increase knowledge and give a positive attitude. This study aims to
determine the relationship between knowledge and attitudes of mothers who love babies under
1 year of age. The research design used survey analytic and cross sectional approach. The study
population of mothers who weaned infants under 1 year of age were 31 mothers, a sample of 31
respondents in the work area of Medan Johor Public Health Center with a total sampling
technique. The data analysis used is the Chi Square test. The results showed that the knowledge
of mothers who weaned babies under 1 year of age were mostly in the Less category as many as
15 (48.38%) respondents, most of the negative attitudes were 1 (3.22%) respondents, the results
of the analysis concluded that there was a significant relationship. between knowledge and the
attitude of mothers who wean (p-value = 0.817 <α (0.05) or it can be concluded that the
hypothesis is rejected, the significant value is less than 0.05, the correlation value is significant,
meaning that there is a relationship between the level of knowledge and attitudes of mothers
who Weaning a 1 Year Old Baby in the Work Area of the Medan Johor Health Center. It is
hoped that the mother will give exclusive breastfeeding to her baby until the age of 6 months
and breast milk until the age of 2 years so that the child gets the best food from the mother so
that the baby is not prone to infection.
Keywords: Relationship between Knowledge and Attitude of Weaning Mothers Under 1 year
of age
PRELIMINARY baby's staple food. The WHO / UNICEF

Babies are the most beautiful gifts given recommendations at the 1979 meeting in
by the creator to humans. For some humans, Geneva on infant and child food included:
caring for a baby may be very difficult, if they “Breastfeeding is an integral part of the
only think about the expenses that will be given reproductive process that provides the
to the baby. But if you think about it logically,
biological and psychological blood needed
caring for a baby is very easy. By only giving
breast milk to babies, it does not need a lot of for growth. Providing additional formula
expenditure and energy (Rizki Natia Wiji, milk for any reason in newborns must be
2015). avoided ”(Maritalia, 2012).
According to the World Health Infant Mortality Rate (IMR) is the
Organization (WHO), a baby during the womb number of people who die before reaching
has undergone a process of growth and the age of 1 year which is expressed in
development in such a way that when he is born 1,000 live births in the same year. Infant age
his body weight has reached a normal weight. is a condition that is prone to both illness
The growth and development of the baby and death. According to the results of the
continues into adulthood. Growing processThis Indonesian Health Demographic Survey
flower affects the food given to children. (IDHS) there was a sharp decrease in IMR
The appropriate food is breast milk, because between 1991 and 2003, from 68 per 1000
breast milk is intended for babies as the
135
live births to 35 per 1000 live births. The Weaning can increase the risk of
IMR 32 achievement in 2012 is less than infection, especially the effects of diarrhea.
encouraging compared to the Ministry of This is because babies are not consuming
Health Strategic Plan target to be achieved, breast milk that contains anti-infective
namely 24 in 2014 as well as the MDG factors. Some communities do not wean
target of 23 per 1000 live births in 2015. babies before they are six months old, and
IMR decreased which slowed down this can last until they are more than two
between 2003 to 2012, from 35 to 32 per years or four years old. However, some
1,000 births life, requires access of all people wean their babies early (Prasetyono,
infants to key interventions such as 2012).
exclusive breastfeeding or basic Based on the initial survey that was
immunization, while based on Riskesdas conducted in the Medan Johor Health
2010 the coverage of exclusive Center Work Area, that the 10 mothers of
breastfeeding is 15%. children under five had the most knowledge
(htpp://www.kematian bayi 2012.//reseach of good early weaning by 4 respondents.
menkes.com.). Mothers with the most attitudes about early
International guidelines that weaning were good, namely 4 respondents.
recommend exclusive breastfeeding for the Based on the above background, I as the
first 6 months are based on scientific author is interested in conducting research
evidence of the benefits of breastfeeding for on the relationship of knowledge with the
a baby's survival, growth and development. attitudes of mothers who wean their babies
Breastfeeding provides all the energy and under 1 year in the work area of the
nutrients (nutrients) a baby needs during the Puskesmas Medan Johor.
first 6 months of his life. reduce infant
mortality due to various diseases commonly METHOD
afflicting children, such as diarrhea and This type of research is analytic
pneumonia, and speed up recovery when observational, which means that this research
sick and help sparse pregnancies (Arini, was conducted to determine the magnitude of
2012). the problem of the relationship between
knowledge and attitudes of mothers who wean
According to the Indonesian
babies under the age of 1 year in the working
Demographic and Health Survey (IDHS) area of the Medan Johor Health Center.
data for 2002-2003, the coverage of Observational research is research in which the
exclusive breastfeeding for babies up to four researcher only makes observations, without
months is only 55%, and up to 6 months of giving intervention on a variable to be studied.
age is 39.5%, whereas the target for healthy The design of this research is that this
Indonesia in 2010 is 80%, babies are given researcher uses a cross sectional design, which
ASI. exclusive for up to 6 months means that the independent variable and the
(Maryunani, 2012). Basic Health Research dependent variable are examined
Data (Riskesdas) in 2010, the percentage of simultaneously and at one time using primary
babies who were exclusively breastfed for data. After the data is processed further
up to 6 months was only 15.3%. This is analyzed by univariate analysis. In this
because public awareness in encouraging univariate analysis, analysis was carried out
increased breastfeeding is still relatively for the results of tabulation of data on the
low. Low level of understanding of its attitudes of mothers who weaned babies
importance his parents and it really needed under the age of 1 year, each of which was
the child and made him feel full of entered into a frequency distribution table
affection. Independence is what the parents then proceeded to bivariate analysis used to
taught them, not because they are always determine whether there was a relationship
breastfed (Arini, 2012). between independent and dependent
variables then followed by chi-squere ( X2).
136
RESULTS mothers who wean babies under 1 year old in

Based on research conducted on "The the Medan Johor Health Center Work Area.
relationship between knowledge and attitudes of
Distribution Based on Mother Demographic Characteristics of Respondents Weaning
Infants Under 1 Year In The Work Area Puskesmas
Medan Johor
Respondent Characteristics N %
Age
<20 years 0 0
20-35 years 22 71
>35 years 9 29
Parity
Primipara 5 16,2
Skundipara 8 25,8
Multiparaous 18 58,0
Grandemultipara 0 0
Education
Tidak Sekolah 1 3,2
SD 3 9,7
SMP 21 67,7
SMA 5 16,2
PT 1 3,2
Profession
IRT 7 22,6
Petani atau buruh 3 9,7
Pegawai swasta 20 64,5
PNS 1 3,2
Total 31 100
Based on age group, the majority of respondents are in the age range of 20-35 years as
many as 22 people (71%). Based on parity skundipara as many as 18 people (58.0%), based on
junior high school education as many as 21 people (67.7%). Based on the occupation of 20
private employees (64.5%).
In table 4.1.2 it can be seen that the distribution of maternal characteristics is below
Frequency Distribution of Mother's Knowledge Level of Weaning Infants Under 1 Year of

Work in the Work Area Puskesmas Medan Johor
Knowledge F Persentage (%)
Baik (7-10) 4 12,9%
Cukup (4-6) 11 35,5%
Kurang (1-3) 16 51,6%
Total 31 100
Based on the results of categorizing the mother's attitude, data obtained from 31 mothers
were more likely to be kind, namely as many as 4 people (12.9%), and being sufficiently as
many as 11 people (35.5%) and less (51.6%).
137
Frequency Distribution of Attitude of Mothers Who Weaned Underage 1 Years in the

Work Area Puskesmas Medan Johor
Sikap Frekuensi Presentase
Positif 29 93,5 %
Negatif 2 6,5 %
Total 31 100%
Based on the table above, it can be seen that the highest respondent has a Positive
Attitude 29 (93.5%) respondents and the lowest has a Negative Attitude 2 (6.5%) respondents.
Cross-Tabulation of Frequency Distribution of Based Knowledge Age in the working area

of Medan Johor Health Center
Knowledge
Total
Baik Cukup Kurang
Age f % f % f % f %
20-35 Count 2 6,45% 9 29,03% 11 35,48% 22 70,96%
>35 Count 2 6,45% 2 6,45% 5 16,12% 9 29,03%
Total Count 4 12,90% 11 35,48% 16 51,62% 31 100%
Based on the table above, data is obtained based on age, the highest knowledgeable is less at the
age of 20-35 years as many as 11 (34.58%) respondents, and the lowest knowledgeable well at
the age <20 as much as 2 (6.45%) and> 35 years as many as 5 (16.12%) respondents.
Cross-tabulation of Knowledge Frequency Based on Parity

In the working area of the Medan Johor Health Center
Pengetahuan
Total
Baik Cukup Kurang
Paritas
f % f % F % f %
Responden
Primi 1 3,22% 2 6,45% 2 6,45% 5 32,24%
Skundi 1 3,22% 2 6,45% 5 16,12% 8 25,07%
Multi 2 6,45% 7 22,58% 9 29.03% 18 58,07%
Total Count 4 12,90% 11 35,48% 16 51,62% 31 100%
Based on the table above, it was obtained from 31 respondents, the highest had less
knowledge of Multiparity Parity as many as 9 (29.03%) respondents and the lowest had Good
Knowledge on Primiparous Parity and Skundipara as many as 1 (3.22%) respondents.
Cross Tabulation of Knowledge based Frequency Distribution

Education in the Work area Puskesmas Medan Johor
Knowledge
Total
Baik Cukup Kurang
Education
F % F % f % f %
Tidak
Respondent 1
Sekolah 3,22% 1 3,22% - - 2 6,45%
SD - - 1 3,22% 2 3,22% 3 9,68%
SMP 2 6,45% 7 22,58% 12 38,70% 21 67,45%
SMA 1 3,22% 2 6,45% 2 6,45% 5 16,12%
Total Count 4 12,90% 11 35,48% 16 51,62% 31 100%
138
Based on the table above, it was obtained from 31 respondents with the highest knowledge
of respondents with less knowledge with junior high school education as many as 12 (38.70%)
and the lowest with good knowledge with PT education as many as 0 (0%) respondents.
Cross Tabulation of the Distribution of Knowledge Frequency by Occupation In the

working area of the Puskesmas Medan Johor
Knowledge
Total
Baik Cukup Kurang
Pekerjaan
f % F % f % f %
Respondent IRT - - 3 9,68% 4 12,90% 7 22,58
Petani/ Buruh - - 2 6,45% 1 3,22% 3 9,68
Pegawai
3
Swasta 9,68% 6 19,36% 11 35,48% 20 67,45%
PNS 1 3,22% - - - - 1 3,22%
Total Count 4 12,90% 11 35,48% 16 51,62% 31 100%
Based on the table above, it was obtained from 31 respondents with the highest knowledge
of less with private employees as many as 11 (35.48%) respondents, and the lowest
knowledgeable either on IRT 0 (0%) and Farmers / Laborers as many as 0 (0%) respondents.
Tabulasi Silang Frekuensi Sikap Berdasarkan Usia Di WilayahCross-tabulation of

Attitude Frequency Based on Age in RegionPuskesmas Medan Johor
Sikap
Positif Negatif Total
umur
Responden f % f % f %
20-35 years 20 64,51% 2 6,45% 22 70,96%
>35 years 9 29,04% - - 9 29,04%
Total Count 29 93,55% 2 6,45% 31 100%
Based on the table above, data is obtained based on age, the highest has a positive attitude
at the age of 20-35 years as many as 20 (64.51%) of respondents, and the lowest has a positive
attitude at the age> 20 years as many (0%) of respondents and > 35 years as many as 9
(29.04%) respondents, and have negative knowledge at the age of 20-35 years as many as 2
96.45%) of respondents.
Cross tabulation of the distribution of attitudes based on parity in the working area of
the Puskesmas Medan Johor
Sikap
Paritas
f % f % F %
Responden
Primipara 5 16,13% - - 5 16,13%
Skundipara 7 22,59% 1 3,22% 8 25,81%
Multipara 17 54,83% 1 3,22% 18 58,06%
Total Count 29 93,55% 2 6,45% 31 100%
Based on the table above, it was obtained from 31 respondents, the Pling High had a
Positive Attitude at Multipara parity as many as 17 (54.83%) respondents, and the lowest had a
Positive Attitude on Grandemultipara parity as many as 0 (0%) respondents, as well as negative
knowledge. in Multipara and Skundipara parity as much as 1 (3.22%) respondents.
139
Tabulation of Attitude Frequency Distribution Based on Education in the Region Work

Sikap
Pendidikan
f % f % f %
Responden Tidak Sekolah 2 6,45% - - 2 70,96%
SD 3 9,68% - - 3 29,04%
SMP 19 61,29% 2 6,45% 21 100%
SMA 5 16,12% - - 5 16,12%
Total Count 29 93,55% 2 6,45% 31 100%
Based on the table above obtained from 31 respondents, the highest has a positive attitude
with junior high school education as many as 19 (61.29%) respondents and the lowest has a
positive attitude with no school education as many as 2 (6.45%) respondents, and the lowest 2
(6.45%) respondents have a negative attitude with junior high school education.
Tabulation of Attitude Frequency Distribution by Occupation

In the working area of the Puskesmas Medan Johor
Sikap
Responden
Pekerjaan Positif Negatif Total
F % f % f %
IRT 7 22,59% - - 7 22,59%
Petani/Buruh 3 9,68% - - 3 9,68%
Pegawai Swasta 18 58,06% 2 6,45% 20 64,51%
PNS 1 3,22% - - 1 3,22%
Total Count 29 12,90% 2 35,48% 31 100%
Based on the table above, it was obtained from 31 respondents who had the highest
positive attitude with private employee jobs as many as 18 (58.06%) respondents, and the
lowest had a positive attitude with civil servant work as many as 1 (3.22%) respondents, as well
as those who have negative attitudes with private employees as much as 2 (6.45%) of
respondents.
The Relationship Between Knowledge and Mother's Weaning Attitude

Variable r p-value
Pengetahuan
0,817 0,404
Sikap
Results of Analysis of Mother's Knowledge and Attitudes About Knowledge of Mother's

Attitudes Who Weaned Infants Under 1 Year In The Work Area Puskesmas Medan
Johor
Sikap
Knowlodge Positif Negatif Total
KK r p-value
f % f % F %
Baik 4 9,67% 0 0 4 12,90%
Cukup 10 32,25% 1 3,22% 11 35,48%
p>0,817 0,817 0,404
Kurang 15 48,38% 1 3,22% 16 51,62%
Total 29 93,55% 2 6,45% 31 100%
140
From the table above, we can see better than those with high parity
that of the 31 respondents, the highest level (Notoatmodjo, 2012).
of knowledge is less and a positive attitude 2. Education
is 15 (48.38%) of respondents, and the The highest percentage of respondents'
lowest is good knowledge and a negative education has junior high school education
attitude is 1 (3.22%) respondents . To see as many as 21 (67.7%) of respondents, and
the relationship between knowledge and the lowest is in PT education as many as 1
attitudes of mothers who weaned babies (3.2%) respondents. According to (Ariani,
under 1 year of age in the Medan Johor 2014), education is an activity or guidance
Health Center Work Area, a significant test by someone for the development of others
was carried out with Chi-Squere. The towards certain ideals to fill life so as to
results of the Chi-Squere Correlation achieve happiness. From the results of the
Analysis obtained p value> 0.817 (0.817 research, the authors conclude that this is in
<0.05) which indicates that Ho is rejected, accordance with the theory because
which means that there is a relationship education is a persuasive effort or learning
between knowledge and attitudes of to society to take actions or practices to
mothers who wean babies under 1 year of maintain and improve their health.
age in the work area. Puskesmas Medan 3. Work
Johor From the research results, the highest
number of mothers who weaned their babies
DISCUSSION worked as private employees as many as 20
Based on the number of respondents, (64.5% (respondents) and the lowest
31 mothers who weaned were the highest worked as civil servants as many as 2
age at 20-35 years as many as 22 (71%) (3.2%) respondents. According to
respondents. The lowest age is at the age of (Mubarak, 2012), work is an environment
<20 as many as 0 (0%) respondents and> 35 which can make a person gain experience
years as many as 9 (29%) respondents. and knowledge, either directly or indirectly.
According to (Mubarak, 2012), with The results of the research are carried out in
increasing age a person will experience accordance with the theory which says that
changes in physical and psychological working someone is able to gain knowledge
(mental) aspects. On the aspect, physical and experience from other people, either
growth consists of four categories of directly or indirectly.
change, namely change in size, change in 4. Knowledge of Mothers Weaning Infants
proportion, loss of old characteristics, and Under 1 Year Old
emergence of new characteristics. In this study, of the 31 respondents of
From the results of the research, the mothers who weaned babies under 1 year of
authors conclude that this is in accordance age, it can be seen that the highest
with the respondent's theory of age respondent has less knowledge as many as
according to the research results. 15 (48.38%) of respondents, thus this
1. Parity condition shows that the respondent of
The number of respondents as many as 31 mothers who wean in the work area of the
mothers who weaned their babies, the health center has lack of knowledge about
highest in the Parity category was Multipara weaning. According to the author's
with 18 (58.0%) respondents and the lowest assumption, this knowledge is influenced by
in Skundipara as many as 8 (25.8%) several factors, including parity and
respondents. The level of parity has education. Knowledge is the result of
attracted the attention of researchers in the knowing humans who simply answer
relationship between the health of mothers questions (Notoadmojo, 2012).
and children, there is a tendency for the
health of mothers with low parity to be
141
5. Mother's Attitude Towards Weaning between the knowledge and attitudes of

Infants Under 1 Year Old mothers about weaning babies under 1 year
The results of the study obtained a old in the work area of the Medan Johor
description of the attitude of the respondent Health Center of r = 0.817
with the highest positive attitude for 29
(93.55%) respondents. The supportive SUGGESTION
attitude of the weaning mother can be seen Based on the results of research
from the 16 questions that were given, many carried out in accordance with the
of which answered that led to agreement. conclusions obtained from the results of the
According to (Notoadmojo, 2012) Attitude research and discussion, the researcher
is a reaction or response that is still closed wants to provide suggestions to various
from someone to a stimulus or object. parties related to this research, including:
Meanwhile, according to (Ariani, 2014), book. It is hoped that health workers,
Attitude is the feeling or view of a person especially midwives, can further increase
who is accompanied by a tendency to act on their knowledge about weaning during
an object or stimulus. Attitude is the most posyandu and other activities. It is
important concept in social psychologists necessary to conduct further research on the
who discuss elements of attitude both as relationship between knowledge and
individuals and groups. attitudes of mothers who wean babies under
6. The Relationship between Knowledge 1 year, considering this is a limited scope.
and Early Weaning Mother Attitudes
The results of the cross tabulation of this REFERENCE
study indicate that mothers who wean under Arikunto, S. (2013). Prosedur Peneitian
the age of 1 year are adequate and have a Suatu Pendekatan Praktik.
positive / supportive attitude about weaning. JakartaRineka Cipta.
7. Research Limitations Arini, 2012. Mengapa Seorang Ibu Harus
Collecting data in this study using a Menyusui. Yogjakarta :
questionnaire, while conducting direct FlashBooks.
interviews. In addition, there is still the Astuti, Puji, Hutari, (2015). Buku Ajaran
possibility of respondents answering Asuhan Kebidanan Ibu!
dishonest questionnaires because a lie-test (KEHAMILAN). Yogjakarta :
was not carried out from the respondents so Rohima Press.
that it can affect the accuracy of the DAI (UKK Perinatologi) (2012).
research so that the respondent's data Manajemen Masalah Bayi Baru
collection is very limited. Limited research Lahir Untuk Dokter, Bidan, dan
time so that the respondent's data collection Perawat di Rumah Sakit, Jakarta:
is very limited. Departemen Kesehatan Indonesia.
Khamzah, Siti Nur, 2015. Segudang
CONCLUSION Keajaiban ASI yang Harus Anda
Based on the results of the research Ketahui. Yogjakarta : FlashBooks.:
that has been carried out, the following Salemba Medika.
conclusions can be formulated: Mothers Mubarak, 2012. Promosi Kesehatan
who have the most knowledge about Kebidanan. Jakarta : Salemba
weaning babies under 1 year are less, Medika
namely 16 (51.6%) respondents. The most Maryunani, (2012). Asi Eksklusif. Jakarta
mothers had attitudes about weaning babies Notoatmodjo, Soekidjo. (2012).Metode
under 1 year, which were 11 (35.5%) and Penelitian Kesehatan. Jakarta : PT.
good, namely 4 (12.9%). After the chi Rineka Cipta.
square test was carried out, the results
showed that there was a relationship
142
Prabantini Dwi. (2013). A to Z Makanan

Pendamping ASI. Yogyakarta:
Andi Yogyakarta.
Sudaryanto, Gatot. (2014). Makanan
Pendamping Asi
Sitompul, Molika, Ewa. (2014). Variasi
Makanan Bayi. Jakarta:Kunci
Aksara
. Walyani, Elisabet Siwi. (2014). Materi
Ajaran Lengkap Kebidanan
Komunitas. Yogyakarta : Pustaka
Baru.
Wawan A, M Dewi. (2016). Teori dan
pengukuran Pengetahuan Sikap
dan Prilaku Manusia. Yogyakarta :
Nuha Medika.
Wiji, Rizki, Natia, 2015. ASI dan Panduan
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Medika.
(htpp://www.kematian bayi 2012.//reseach
menkes.com.).
143
The Effect Of Counseling On The Knowledge And Attitudes Of Pregnant Women About Hypnobirthing At Pratama Vina
Clinic, Kecamatan Medan Baru 2019
THE EFFECT OF COUNSELING ON THE KNOWLEDGE AND

ATTITUDES OF PREGNANT WOMEN ABOUT HYPNOBIRTHING AT
PRATAMA VINA CLINIC, KECAMATAN MEDAN BARU 2019
Siska Suci Triana Ginting 1, Nopalina Suyanti Damanik2, Isyos Sari Sembiring3
Sekolah Tinggi Ilmu Kesehatan Mitra Husada Medan
Email: [email protected]
ABSTRACT
Counseling can increase the knowledge of pregnant women about hypnobirthing is an
effort to use hypnosis to obtain a smooth, safe and comfortable delivery. Data from the Medan
Vina Pratama Clinic in 2018, the number of pregnant women from January to April was 60
people, of which 30 were entering their third trimester of pregnancy. The number of mothers
giving birth as many as 15 people with normal delivery 10 people, and 5 people long time
delivery.
The research objective was to determine the effect of counseling on the knowledge
and attitudes of pregnant women about hypnobirthing at Klinik Pratama Vina Medan. This type
of research is a quasi experiment with one group pre test and post test design carried out in
August 2018. The population is pregnant women who visited 40 people and all of them were
used as research samples. Collection using a questionnaire and analyzed using the paired
sample t test at the significance limit α = 0.05.
The results showed that there was an effect of counseling on the knowledge of
pregnant women about hypnobirthing p value 0.037 <0.05 and there was an influence of
counseling on the attitudes of pregnant women about hypnobirthing p value 0.014 <0.05.
It is recommended that the clinical leadership provide health education about
hipnobirthing regularly with other methods to increase the knowledge and attitudes of pregnant
women. Health workers can provide brochures and leaflets as a source of health information to
supportive mothers.
Keywords: Counseling, Knowledge, Attitude, Hipnobirthing
INTRODUCTION abortion is 5%, prolonged labor is 5%,

Pregnancy and childbirth are obstetric embolism is 3%, complications of
inseparable chain reactions in a normal the postpartum period were 8% and other
woman's life. When we prepare thoroughly causes were 12%. The main cause of AKI is
(body, mind and spirit), the process of bleeding. One of the causes of bleeding that
pregnancy and childbirth can take place occurs in pregnant women is placenta previa
safely and comfortably. However, not a few (SKDI, 2012). One of the efforts to
women who give birth experience labor maintain uterine contractation at delivery is
problems and even death of mothers and using hypnobirthing techniques.
babies (Kuswandi, 2013).. The 2012 Hypnobirthing method is a
Indonesian Demographic and Health Survey combination of natural birth processes with
(IDHS), the Maternal Mortality Rate hypnosis to build positive perceptions and
(MMR) in Indonesia is still high at 359 per self-confidence as well as reduce fear,
100,000. anxiety and tension, and panic before,
Based on data from the Indonesian during and after childbirth). One of the
Midwives Association (IBI), the causes of techniques is autohypnosis (self-hypnosis)
AKI include bleeding, namely 30% of the or self-suggestion in dealing with and
total cases of death, eclampsia (pregnancy undergoing pregnancy and preparation for
poisoning) which is 25%, infection is 12%, childbirth so that pregnant women are able
144
to go through pregnancy and childbirth in a The side effects caused by using this
natural, smooth, and comfortable way method are very small, apart from being
(without pain), and more importantly to safe, practical and also more economical,
mental health of the baby it is carrying. when compared to other methods such as
When a woman giving birth is free from music or murotal where you need a tool to
fear, her body muscles, including the uterine play music and need money to buy the
muscles, will experience relaxation which instrument, and not everyone likes music.
makes the birth process easier and stress certain. In addition, this method is without
free (Kuswandi 2013) the use of drugs, surgery and medical
The benefit of the hypnobirthing devices. This method only uses the power of
method for the mother is to relax more suggestion which will immediately relax the
deeply so that all stress and fears & worries patient's condition so that it can be more
before birth that can cause tension, pain and comfortable in a short time (Marliana,
pain during childbirth can be eliminated. 2016).
For the fetus it is beneficial for healthier However, many pregnant women
growth because calm conditions will still do not know about the hypnobirthing
provide balanced hormones to the fetus method in dealing with childbirth due to a
through the placenta. For husbands / birth lack of counseling from health personnel.
attendants, they are husbands / birth Extension is a health education activity that
attendants who become calmer in is carried out by spreading messages and
accompanying the delivery process (Aprilla, instilling confidence. Thus, people are not
2010). only aware, know and understand, but also
Hypnobirthing teaches breathing want and can make recommendations
techniques, relaxation, affirmations and related to health (Maulana, 2009).
visualization, and deepening. In this The effectiveness of an extension
breathing technique, the mother can save method will also depend on the size of the
energy during the thinning phase during the target and the media used. A good health
cervical opening. The taught slow breathing education media is a medium that is able to
can thin and open the cervix which can provide health information or messages
shorten the duration of labor. Relaxation, according to the target acceptance level, so
visualization, and affirmations help mothers that the target is willing and able to change
cope with tension, stress, and discomfort in behavior according to the message
the face of childbirth. The deepening conveyed (Notoatmodjo, 2010). Several
technique is also very useful during the later studies have explained that health education
phases of labor opening. Hypnobirthing or counseling can increase pregnant women
method can accelerate the first stage of 's knowledge about health.
labor (± 3 hours in primiparous and 2 hours Research conducted by Fatimah
in multiparous), reduce the risk of (2017) explained that the attitudes of
complications, and accelerate the healing primigravida mothers in implementing the
process in post partum (Aprilia, 2010). hypnobirthing method before being given
Hypnobirthing exercises can be counseling were mostly negative attitudes
done from the time of pregnancy, the of 21 respondents (70.0%), positive
success of this method depends on the attitudes of 9 respondents (30.0%), after
routine of exercises that the pregnant being given counseling most of the attitudes
woman does herself. Along with the usual positive mothers 16 respondents (53.3%),
relaxation of the mother, the birth canal for negative attitudes 14 respondents (46.7%).
the fetus will open more easily so that the The Wilcoxon test results obtained a
mother will not be too tired during significance result of (0.008) so (p <0.05).
childbirth (Andriana, 2013). The conclusion of this study is that there is
the effect of counseling about hypnobirthing
145
on the attitudes of primigravida mothers in METHODS SECTION

dealing with childbirth at Kabuh Health This study is a quasi-experimental
Center, Kabuh District, Jombang Regency. study with the aim of knowing the effect of
Research by Marlina (2016) states the independent variable (counseling) on the
that the level of depression or anxiety in the dependent variable (knowledge and
first trimester of pregnancy during the first attitude). According to Arikunto (2012),
trimester of pregnancy is the same as the quasi experimental design is research
second and third trimesters, almost twice carried out without a comparison class or
and almost twice that of the first semester. control class.
Research in Sweden on antenatal care at 35 The design used was a one-group
weeks of pregnancy as much as 24% pre-test and post-test research design, which
experienced anxiety and 22% experienced is a research design that is used by giving a
depression, in Hong Kong on pregnant pre-test and a final test to a single group
women in the 1st, 2nd and 3rd trimesters, research sample. The research design of one
54% experienced anxiety, 37% experienced group pre test and post test design is
depressive symptoms, and research in described according to the concept of
Pakistan from Of the 165 pregnant women, Arikunto (2012).
70% experienced anxiety and / or
depression. RESULTS SECTION
The results of the research on anxiety Based on the results of statistical
conducted in the third trimester tests, it shows that there is an effect of
primigravida were 33.93% experiencing counseling on the attitudes of pregnant
anxiety. Another study states that normal women about hypnobirthing at the Pratama
pregnant women in the face of childbirth Vina Clinic, Medan Baru District with a
experience 47.7% severe anxiety, 16.9% value of p = 0.014 <0.05. In accordance
moderate anxiety, and 35.4% (Ranita, with Fatimah's research (2017) that there is
2016). an effect of counseling on hypnobirthing on
Based on the initial survey at the the attitudes of primigravida mothers in
Vina Pratama Clinic, Medan, it is known facing childbirth at Kabuh Puskesmas
that the number of pregnant women from Kabuh District, Jombang Regency.
January to April 2018 was 60 people, of Supriati's (2016) research shows
which 30 were entering their third trimester that the average attitude value before being
of pregnancy. The number of mothers gave given the lecture method is 37.00 with a
birth as many as 15 people, including 10 standard deviation of 2.951 and after being
normal deliveries, and 5 old labor. given a lecture there is an increase of 45.22
Hypnobirthing method is taught to pregnant with a standard deviation of 3.55, with a
women in dealing with and preparing for mean difference of -8.222 which means that
the delivery process. This situation is the on average -The average attitude of mothers
reason researchers want to know the increased by 8,222 after being given the
knowledge and attitudes of pregnant women lecture method.
about hypnobirthing. The method of extension through
Based on the background description, the lectures is a way of conveying information
researcher was interested in conducting and knowledge orally. The lecture method
research on the Effect of Education on can be said to be the most economical
Knowledge and Attitudes of Pregnant method of conveying information. What the
Women about Hypnobirthing at the Pratama participants do is listen carefully and take
Vina Medan Clinic in 2019. notes on the important points raised by the
person giving the lecture. Therefore, in this
method the participants are more passive
146
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148

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Proceeding

STIKes Mitra Husada Medan, September 11th, 2020, Friday

Condescendent (Yayasan Mitra Husada Medan)

Second edition, March 2021

chairman of the committee

Ester Simanullang, S.Tr.Keb., Bd., M.Kes

01.30-02.00 Topic from Lincoln University : Dr. Faridah Md Ester

03:30-06:30 Section 1 presenter Section 1-10 Oral

PHYSICAL ACTIVITY AND EXERCISE DURING PREGNANCY COVID-19

THE EFFECTIVENESS OF GINGER IN DEALING WITH TRIMESTER 1

HUSBAND SUPPORT RELATIONSHIP WITH THE COMPLIANCE OF antenatal

NURSING CARE IN ELDERLY WITH HYPERTENSION NURSING CARE WITH

INCREASING CONTRACEPTIVE USE DURING THE COVID-19 PANDEMIC

CONDOM USE MEASURES IN PREVENTION OF TRANSMISSION OF

RELATIONSHIP BODY MASS INDEX AND PHYSICAL ACTIVITY WITH

EFFECTS OF REPRODUCTIVE HEALTH INFORMATION SERVICES DURING

REPRODUCTIVE HEALTH IN PREGNANT AND LACTATING WOMEN

THE ELDERLY CARING NURSING CENTER: PERCEPTION OF NURSING

THE RELATIONSHIP OF MATERNAL KNOWLEDGE OF THE COMPLETE

CASE STUDY OF GERONTIC NURSING CARE IN FAMILY Ny M WITH

APPLICATION OF SALT WATER WARM TO REDUCE HYPERTENSION IN

IMPROVING THE QUALITY OF LIVING AGE (LANSIA) IN DEPOK CITY

THE RELATIONSHIP OF MATERNAL KNOWLEDGE OF THE COMPLETE

CASE STUDY OF GERONTIC NURSING CARE IN FAMILY Ny M WITH

THE IMPORTANCE OF RAISING INDIVIDUAL AWARENESS TO IMPROVE

THE RELATIONSHIP OF BREASTFEEDING TECHNIQUE WITH THE

NURSING CARE FOR CLIENTS WITH BONE METABOLISM DISORDERS

THE NUTRITIONAL STATUS OF THE ELDERLY BASED ON KNOWLEDGE

MENSTRUAL CYCLE DISORDERS DURING THE COVID-19 PANDEMIC

ELDERLY COMPLIANCE WITH HYPERTENSION IN DIET FULFILLMENT

THE EFFECT OF CLASSICAL MUSIC THERAPY ON THE LEVEL OF LABOR

RELATIONSHIP OF MIDWIFERY SERVICE EXCELLENT SERVICE WITH

RELATIONSHIP TYPE OF LABOR TO POSTPARTUM DEPRESSION RISK IN

KNOWLEDGE'S RELATIONSHIP WITH THE ATTITUDE OF THE MOTHER

THE EFFECT OF COUNSELING ON THE KNOWLEDGE AND ATTITUDES OF

PHYSICAL ACTIVITY AND EXERCISE DURING PREGNANCY

Dessy Fitri Natalia Silaban

Key word : Exercise, physical exercise, pregnancy, physical distancing

Introduction nose, eyes and mouth, applying the proper

 develop persistent pain

THE EFFECTIVENESS OF GINGER IN DEALING WITH TRIMESTER 1

Introduction et al, 2014). Vomiting nausea that is not

HUSBAND SUPPORT RELATIONSHIP WITH THE COMPLIANCE OF

Keywords: Husband support, antenatal care (ANC) Compliance visit

Antenatal care (ANC) is a population (Notoatmodjo, 2010). The

1.2 Table of respondents distribution based on ANC visitcompliance

(RISKESDA). Jakarta : Kemenkes

NURSING CARE IN ELDERLY WITH HYPERTENSION

INTRODUCTION MATERIAL AND METHODS

Pathophysiology caused by the release of ketokolamin levels.

palpitations or decreased vision, stable

INCREASING CONTRACEPTIVE USE DURING

Keywords : Women's Reproductive Health, Fertile Age Couples, Contraception, Covid-

INTRODUCTION clear proof that this virus can spread from

course, who want to re-visit, will not CONCLUSION

CONDOM USE MEASURES IN PREVENTION OF TRANSMISSION OF

Keyword :Reproductive health, Sexually transmitted diseases, CONDOM, covid 19

INTRODUCTION To be able to prevent transmission of

pregnancy by up to 90 percent if used case, the condom is a barrier to the entry of