PROCEEDING

PATIENT SAFETY IN EMERGENCY

INTERNATIONAL CONFERENCE AND WORKSHOP

POLYTECHNIC HEALTH MINISTRY OF MEDAN
WITH
LAERDAL, BSTI AND CHEERS

REVIEWER:
Prof. Dr. Rafidah Atan (Monash University)
Prof. dr. Gontar Alamsyah Siregar, Sp.PD-KGEH (USU)
Sandra Sandy Sanchez Montana (CHEERS)

2017
USU Press
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Jl. Universitas No. 9
Medan 20155, Indonesia

Telp. 061-8213737; Fax 061-8213737

http://ilmiah.poltekkes-medan.ac.id/
usupress.usu.ac.id

© USU Press 2017

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seluruh bagian buku ini dalam bahasa atau bentuk apapun tanpa izin tertulis dari penerbit.

ISBN 979 458 958 6

Perpustakaan Nasional Katalog Dalam Terbitan (KDT)

Proceeding Patient Safety in Emergency / Reviewer: Rafidah Atan [et.al.] – Medan: USU Press, 2017.

xii, 109 p.: ilus.; 29 cm

ISBN: 979-458-958-6

1.Emergency I. Title

Dicetak di Medan, Indonesia

ii
 AKNOWLEDGEMENT

We convey our deepest thankful for great contribution from all distinguished resource person and
sponsor in this conferences
1. The chairman of Indonesian agency for development and empowerment human resources of
health
2. All the directors of Indonesian health polytechnic of health ministry
3. The chairman of all health institution in north Sumatra province
4. The director of Hospital in north Sumatra Province
5. The chairman of KOPERTIS
6. Prof Dr Rafidah Atan (Monash University)
7. Prof dr Gontar Alamsyah Siregar. Sp.PD-KGEH (USU)
8. Sandra Sandy Sanchez Montana (CHEERS)
9. Sponsor PT Laerdal
10. Sponsor BSTI (Bandung Scinetific Technical Indonesia)

iii
 CONTENTS

Page
Acknowledgement .............................................................................................................. iii
Contents .............................................................................................................................. iv
Steering Committee and Organizing Comittee ................................................................... vi
Welcome Speech of Director ............................................................................................. viii
Report Speech of Committee Chairman ............................................................................. ix
Tentative Schedule Activities International Seminar ......................................................... xi

Maternal Behavior Relationship Weighing on Children with Nutritional Status of

Children Working Areahealth Center City Aek Habil Sibolga 2016
Rumiris Simatupang, Manotar Sinaga ................................................................................ 1

Analysis of Nutritional Status of Children in The Village Paiheme District Central

Tapanuli North Sumatra
Dimpu Tampubolon, Herlina ............................................................................................. 7

Effect of Balance Exercise Balance and Muscle Strength Against Elderly with Risk of
Falling in Puskesmas Subdistrict Kolang Central Tapanuli
Meiyati Simatupang, Ronald Sagala .................................................................................. 12

Relationship of Knowledgeof Stroke Patient with Compliance Through Physiotherapy

on Physiotherapy Clinic in Dr.Pirngadi Hospital on Year 2016
Solihuddin Harahap, Suriani Br Ginting, Dina Yusdiana .................................................. 17

The Difference in The Acceleration of Wound Healing Post Laparotomy Using 10%
Providone Iodine and Gentamicin Ointment 0.1%
Soep, Cecep Triwibowo, Zainuddin Harahap .................................................................... 25

The Effect of Early Breastfeeding Initiation on Duration of Third Stage of Delivery

Hotma Sauhur Hutagaol, Satyawati Sulubara .................................................................... 28

Warm Compress Action to Reduce Painful of Menstruation or Dysmenorrhea at SMP

N 1 Desa Baru Area Pancur Batu District Deli Serdang Regency
Dina Indarsita, Yufdel ........................................................................................................ 33

Fertile Age Couple Relationships Characteristics and Quality of Service Utilization of

Equipment Family Planning Contraception in South District Sibolga City 2016
Tina Wati Nainggolan ........................................................................................................ 38

Overview The Traffic Police Knowledge Regarding The Algorithm of Basic Life
Support (BLS) in Medan 2015
Amira Permata Sari Tarigan, Endang Susilawati, Yenny Irdayani Nasution ..................... 45

The Effectiveness Test of Stocks Galenika Aloe-Law (Sansivieria trifasciata Prain) for
The Decrease of Blood Glucose Levels in Mice with Metformin as Comparative
Masniah, Rosnike Merly Panjaitan, Masrah....................................................................... 50

iv
The Effct of Pregnancy Exercise on The Sleeping Qualityy of Third-Trimester Pregnant
Women in Klinik Pratama Niar Kecamatan Patumbak Kabupaten Deli Serdang 2016
Nurlama Siregar, Masnila ................................................................................................... 55

Quality of Life on Older People: Case Study at Kelurahan Pudak Payung and Paang
Sari in Central Java
Nina Indriyawati, Marsum, Anton Kristijono, Sugiyanto .................................................. 61

The Influence of Rest Diet and Zumba Aerobic Gymnastic to The Body Mass Index to
The Female College Student with Overweight in Department of Nutrition, Health
Politechnic Kemenkes Medan
Lusyana Gloria Doloksaribu, Amelia Rosa Kacaribu ........................................................ 66

Effect of Playing Plasticine Against Childhood Creativity 4-6 Years in Kindergarten Al

- Ikhlashiyah Medan 2016
Tiurlan Mariasima Doloksaribu, Wiwik Dwi Arianti, Elitya Bekie Foresa Siregar........... 71

The Influence of Acupressure Point Pericardium 6 Against A Decrease in The

Frequency of Nausea Vomiting The First Trimester of Pregnant Women with
Hyperemesis Gravidarum
Sri Utami ............................................................................................................................ 75

The Effect of Education Health Women of Infant Massage to Practice Massage in

Infant 0-12 Months in Kelurahan Pangkalan Dodek
Yulina Dwi Hastuty ............................................................................................................ 81

Influence of Family Psychoeducation Toward Family Ability‟s in Caring Family

Member with Schizophrenia in The Sorong City 2016
Butet Agustarika, I Made Raka .......................................................................................... 86

Relationship Between Nurse Therapeutic Communication with Anxiety Level of

Patients Family who Treated in The HCU Room at Sele Be Solu Hospital of Sorong
Maria Loihala, Ariani Pongoh ............................................................................................ 90

Benefits of Relaxation Intervention Synergy and Effective Breathing in Head Pain

Sensation of Hypertension Clients at BLUD Polyclinic of Sele Be Solu Sorong Hospital
Bambang Suparno, Wayan Badra ....................................................................................... 97

Activities and Nutrition Intake in Overweight and Obesity Adolescent in Senior High
School 2 of Sorong City
Lasupu, Irma Susan Paramita ............................................................................................. 103

v
 STEERING COMMITEE DAN ORGANIZING COMMITTE SEMINAR
DAN WORKSHOP INTERNATIONAL JURUSAN KEPERAWATAN
POLTEKKES KEMENKES MEDAN TAHUN 2017

vi
vii
 WELCOME SPEECH OF DIRECTOR

Assalamualaikum wr..wb, Good Morning

I would like to welcome all delegates to the Medan Simulation User Network Conference. The theme
for this
Year is: “Patient Safety”.

Patient safety is an issue of global concern, which is sometimes missed due to the complexity of the
healthcare systems. There is an increasing concern for negligence of patient safety in developing
countries both in education and working environment

Undergraduate medical and nursing education should continue to prepare students to appreciate the
role of systems and processes in ensuring patient safety. Students need to understand the rational for
these safety systems and processes, the importance of complying with them, and the risks to safety
associated with attempts to circumvent them. They need to understand the types and causes of errors
in healthcare and be familiar with key safety-improvement tools such as root cause analysis. They
also need to work well in teams, and to value the contribution of good team-working to safer care.
Their education should provide them with suitable motivation and skills to design, implement and
improve safety systems and processes throughout their career.

Simulation is now fast becoming an integral part of many curriculums in develop country. It has
widespread applications in undergraduate, postgraduate and continuous professional development
contexts. Simulation offers an exciting and stimulating area to keep an eye on in the coming years. It
will have applicationsin many more aspects of teaching, learning and pedagogy.
The SUN conference offers a unique platform for us to interact, share, and learn together.

Dra. Ida Nurhayati, M.Kes

Polytechnic Health Medan Director

viii
 REPORT SPEECH OF COMMITTEE CHAIRMAN

Assalamualaikum Wr. Wb/ Good Morning

The honorable guest : The Indonesian Agency for Development and Empowerment Human Resources
of Health, drg. Usman Sumantri, M.Kes.
The honorable : Director of Health Polytechnic of Health Ministry Medan
Guest of honour : All the Directors of Indonesian Health Polytechnic of Health Ministry
Guest of Honour : The Cairman of all Health institute in North Sumatera Province
Guest of Honour : The Chairman of all Health Institution in North Sumatera Province
Guest of Honour : All the speakers in this International Seminar :
- Prof. dr. Rafidah Atan From Monash University Malaysia
- Sandra Sandy Sanchez Montana From CHEERS Philiphine
- Prof. dr. Gontar Alamsyah, Sp. PD, KGEH From University of North Sumatera
- Lyana Arisanti, S.Kep, Ns, MARS from RSPAD Gatot Subroto Jakarta

 Exelency : all steering committee, colleages and all participants

Ladies and Gentleman
Good morning to everyone and thank you so much for joining us in International Seminar and
workshop. I Wish to extend a warm welcome to our eminent speakers, facilitators and all participants
from the various town and country such Malaysia, Singapore and Philiphines. Wellcome to Medan,
that is one the best province of Indonesia. We are delighted and honored to have you all here with us
to participate and share an importan and valuable information to improve the quality of our
knowledge sand skills in providing health care.

The purpuses of seminar is to determine the awareness of all parties will establish patient safety
and emphasizes the importance of the involvement of the education world to establish and develop
a culture of Patient Safety.

The Speakers of this seminar are :

- Prof. dr. Rafidah Atan (Monash University Malaysia)
- Sandra Sandy Sanchez Montana (CHEERS Philiphine)
- Prof. dr. Gontar Alamsyah Siregar ( University of North Sumatera)
- Lyana Arisanti, S.Kep, Ns, MARS (RSPAD Gatot Subroto Jakarta)
- Affandy, S.Kep, Ns, MAN (Muhammadiyah University of Yogyakarta)

ix
The Activity of Seminar are :
- Panel discussion between participants and spekaers
- Workshop
- Poster Presentation by.... article

Participants :
1. Lecturers of Nursing Departement in Indoneisa
2. Health workes ( Doctors, Nurses, Dentist, Midwives)
3, Students of health Institute in North Sumatera

And amount of all participants are one hundred fifty persons

At this special moment, I wish take an oppurtunity to say thanks for all committe members and all
those who have contributed their best effort in making this seminar succeed.

I would like to thank the Agency for Development and Empowerment Human Resources of Health,
Director of Health Polytechnic of Helth Ministry Medan, Bandung Scientific Technical Indonesia,
Laerdal for the best support in making the seminar possible.

I would like to thank all the distinguish speakers and reviewers for abstract and posters that has
submitted to this seminar.

Last but not least, I would also like to thank to all participant and delegates for your participatoin and
support for this seminar. Thank you very much for coming and your kind attention.

At last, I Encorage all delegates and particpants to participate actively in this seminar, workshop and
poster presentation. I wish we will have a very productive and meaningful seminar.

Thank you

x
 TENTATIVE SCHEDULE ACTIVITIES INTERNATIONAL SEMINAR
WEDNESDAY, 27 - 28 MARET 2017

Schedule 27thMarch
7:00 8:00 Registration(Level 2)
Opening Speech
8:00 8:30
By Mrs. Endang Susilawati, SKM.,M.Kes
Opening Address & Welcome
8:30 8:45
By Ms. Elaine Yeo, Laerdal ASEAN Managing Director
Opening Speech
8.45 9.00
PPSDM (Board for Development and Empowerment Human Resource of Health)
Keynote Speech – Challenges faced in Transition to Practice in Hospital
9:00 9:30 By: Mr. Toto S.Kep. Ns., M.Kep
Moderator By: Mrs. Amira Permata Sari Tarigan S.Kep, Ns.M.Kes
Plenary 1 - Simulation Based Education To Improve Patient Safety: Matching
9:30 10:00
Objectives With ResourcesBy Assoc Prof (P) Dr Rafidah Atan,Monash University
10.00 10.15 Tea - Break(Level 1)
Community Health Education Emergency Rescue Services
10.15 11:15
CHEERS (Philippine)
Breakout Workshops
Workshop 1 Workshop2 Workshop 3 Workshop 4

Debriefing Simulation Technology Quality of CPR OSCE:

And Scenario Objective Structured
Creation For Clinical Examination
Beginner Approach and
11:15 13:15 construct
By Mr Modh Ihwanuddin By Ms. Marlisa
Kamar S.Kep.Ns., M.Kep By dr. Hasanul Arifin
By Dr Rafidah Sp.An.KAP.KIC
Atan & Team
13:15 14:15 Lunch(Level 1)

-- (Continue) - -- (Continue) -- OSCE and

- Simulation Application Quality of CPR Simulation in
Debriefing Nursing Curriculum
And Scenario
Creation For
14:15 16:15
Beginner
Ms. Zeenat Samad by Ms. Marlisa
S.Kep.Ns., M.Kep By. Mr
Afandi,Skep.Ns.,MA
By Dr Rafidah N
Atan & Team
16:15 -- End --

Remarks:
Registration Counter : Level 2
Dining Area : Level 1, Jumpa Resto
Plenary Sessions : Level 2
Workshop 1 : Level 2, Meranti Room Workshop 3 : Level 1, Anggrek Room
Workshop 2 : Level 2, Cendana Room Workshop 4 : Level 2, Mahoni Room

xi
Challenges, Strategy and Health Treatment Approach to Nutrition and Molecular Epidemiology

Schedule 28thMarch
Plenary 2: A Case Study For Simulation Optimization Of Staffing Levels:
8:00 8:30 Massive Gastrointestinal bleeding
By Prof Dr. Gontar, Sp PD. KGEH, University of Sumatra Utara
Plenary 3: Practitioners’ views on how simulation based education has influenced their
9:00 9:30 clinical practice.
By, Ns Lyana S.Kep, RSPAD Hospital
Plenary 3 : The critical importance of effective teamwork in providing safe care
9:30 10;00
By Prof Dr. Gontar, Sp PD. KGEH, University of Sumatra Utara
10:00 10:15 Tea – Break(Level 1)
Breakout Workshops
Workshop 1 Workshop 2 Workshop 3 Workshop 4

OSCE
Debriefing And Simulation Technology Quality of CPR Objective Structured
Scenario Creation Clinical
For Beginner Examination
10:15 12:15 By Mr Modh By Ms. Marlisa S.Kep. Approach and
By Dr Rafidah Ihwanuddin Kamar Ns., M.Kep construct
Atan & Team
By dr. Hasanul
Arifin
Sp.An.KAP.KIC
12:15 13:30 Lunch(Level 1)

-- (Continue) -- -- (Continue) –
Debriefing And Simulation Application Quality of CPR OSCE and
Scenario Creation Simulationin
13:30 15:30
For Beginner Nursing
By Ms Zeenat Samad By by Ms. Marlisa Curriculum
By Dr Rafidah S.Kep.Ns.M.Kep
Atan & Team By Afandi,Skep.
Ns.,MAN
Closing Speech
15:30 17:00
By Mrs. Endang Susilawati, SKM., M.Kes
Closing Speech
By Dra. Ida Nurhayati M.Kes

Remarks:
Registration Counter : Level 2
Dining Area : Level 1, Jumpa Resto
Plenary Sessions : Level 2
Workshop 1 : Level 2, Meranti Room
Workshop 2 : Level 2, Cendana Room
Workshop 3 : Level 1, Anggrek Room
Workshop 4 : Level 2, Mahoni Room

xii
 Proceeding Patient Safety in Emergency

MATERNAL BEHAVIOR RELATIONSHIP WEIGHING ON CHILDREN WITH

NUTRITIONAL STATUS OF CHILDREN WORKING AREAHEALTH CENTER
CITY AEK HABIL SIBOLGA 2016
1.
Rumiris Simatupang, 2.Manotar Sinaga
STIKES NAULI HUSADA

ABSTRACT

Observing the growth of under five years old children through weighing each month indicated that
the percentage of 6-59 month-old children who were not weighed in the last six months tended to
increase from 25.5% in 2007 to 34.3% in 2013. The objective of the research was to find out the
correlation of women‟s behavior in weighing of under five years old children with the nutritional
status of children. The research was descriptive with cross sectional design. The population was 1,082
under five years old children in 13 integrated service post and 92 of them were used as the samples,
using purposive sampling technique and proportional random sampling technique. The result of the
research showed that 33.7% of the under five years old children had under weight, 3.3% severe
under weight, 4.3% severe stunting and 2.2% severe wasting. The variables which were correlated
with nutritional status were knowledge, based on WAZ at p-value=0.001 and WHZ at p-
value=0.002, attitude based on WAZ at p-value=0.001 and HAZ at p-value=0.011 and action base on
WAZ at p-value 0.001, HAZ at p-value=0.004, and WHZ at p value=0.001 in the working area of Aek
Habil Puskesmas Sibolga 2016. It is recommended that the Health Agency and Aek Habil Puskesmas
Sibolga, increase health service on the level of integrated service post intensively, especially in
nutrition intake by providing giving food supplement program and information about the importance
of weighing under five years old children and supporting facility for integrated service post activities.

Keywords: Nutritional Status, Women‟s Behavior, Weighing under five years old children

BACKGROUND Indonesia, 50% of children do not perform

Growth up a child can controled since
stage early, monitoring the growth of toddler
is very important to know disturbance of
growth (Growth-Wobbly) (Syafrudin et al,
2009). Growth and development of infants is
influenced by many factors, both directly and
indirectly. The direct causes that Affect the
growth and development of infants is the
consumption of food, basic health care, and
parenting, while the indirect cause was the
level of community participation in Posyandu
activities, the which in practice, people acquire
knowledge and skills. Research conducted
Sulistiyanti and Anik (2013) in Sragen 52.4%
of mothers do not actively consider a toddler
to Posyandu and the results of research
conducted by Hindus, et al (2013) in
Puskesmas Darussalam Medan (2013), the
participation of children under five mothers
weigh as much as 39.7% to neighborhood
health center.
Participation is a participation or
engagement of a person (individual or
community members) in a particular activity.
Based on the data from Riskesdas (2010) in
regularly weighing in IHC. This research also
shows the tendency of the age increase of a
toddler, then the rate of visits to neighborhood
health center for routine weighing are
declining. The level of community
participation health check babies to integrated
health service posts (Posyandu) is still low.
This condition is influenced by the way view
parents who feel their children no longer need
to be brought into Posyandu with the
increasing age. The decline visit to Posyandu
toddler caused many parents feel better
knowing her condition so unaware that they
still need guidance from health workers in
addressing nutrition and health problems in
children. In addition, the lack of confidence of
the parents on the performance of cadres.
Behavior parents like this who was
allegedly the cause of children will continue to
be in a state of malnutrition and often sick.
Posyandu viability depends on the
participation of the community itself. The low
participation of the community to come to
Posyandu is due to several factors such as age,
number of children, the distance from home to

1
Proceeding Patient Safety in Emergency
posyandu too far, the lack of attractive
facilities in Posyandu, and lack of knowledge
of mothers about the importance of a visit to
Posyandu (Ismawati, et al, 2010).
Riskesdas (2013), shows the
percentage of stunting and poor (W / A) in the
province of North Sumatra experienced
fluctuating from 2007 to 2013, the prevalence
of malnutrition children and less in North
Sumatra (2013) 22.4% of this figure over high
prevalence of malnutrition nationwide is
19.6%. The number of children under-
nourished entrance to the prone position
continues to rise following the increase of age,
21.3% of children under five in the category of
vulnerable and some are very prone to be
malnutrition, because that is a much needed
improvement in preventive nutrition.
Result of survey preliminary in
Region Public Health Center Sibolga Aek
Habil (2015), Health Center oversees Aek
Habil Village 2 Village Namely Aek Habil
Dan Village of Aek Manis Where Still got 45
infants (2.88%) that has the weighing results
under the red line OR called BGM, 15% had
less and 0.19% nutrient malnutrition. Come
mothers bring their babies Into Giving
Program Posyandu if NO FOOD Supplement.
Related It then influence Of The ADA
problems if ANY toddler NOT payed
Monitoring ON Grow blossoms will impact
the nutritional problems.
Based on the description background
above, it is necessary to do research on the
Maternal behavior relationship weighing on
children with nutritional status of children
working area health center city aek habil
sibolga 2016.
RESEARCH METHODS
This type of research is analytic study
design with cross sectional study researchers
conducted measurements of variables one
particular moment with the independent
variables (knowledge, attitudes and actions)
and the dependent variable (nutritional status)
was measured by BB /U, TB/U and BB/TB.
This research was conducted in Puskesmas
Kota Sibolga Aek Habil by reason of the
participation of a child's weight is still low and
malnutrition as much as 15% as well as the
mother came to bring their children to
neighborhood health center only if no extra
food. This study was conducted in February
2016 to July 2016. The population in this
2
study are all 6-59 months as much as 1,082
infants across 13 Posyandu. The samples in
this study conducted by purposive sampling in
which a subject is taken based on their specific
goals with some consideration. Data analysis
was performed using univariate analysis and a
bivariate analysis with chi square.
RESULTS AND DISCUSSION
The bivariate analysis performed to
determine the effect of one variable review
Tbk Against WITH dependent variables using
Chi-square test ON Level of significance α
<0.05.
Table 1. Distribution of Nutritional Status
(BB / U) based Knowledge Capital in
Weighing Toddler
Nutritional status
Amount Pvalue
Knowledge Nutrition Nutriti
Normal on less
n % n % n %
Good 71 84.5 13 15.5 84 100 0.001
Minus 1 12.5 7 87.5 8 100
Table 1 shows that the respondents
were knowledgeable both indicate the
nutritional status of babies that are in the
normal nutrient and as much as 84.5% of
respondents were knowledgeable about the
nutritional status of children under five is less
by 7 infants (87.5%). The analysis result was
obtained p <0.05 means there is a relationship
of mother knowledge in a child's weight to the
nutritional status of children.
Table 2 Distribution of Nutritional
Status (TB / U) based Knowledge Capital in
Weighing Toddler.
Nutritional status
Amount Pvalue
Knowledge
Normal Short
n % n % n %
Good 76 90.5 8 9.5 84 100 0.209
Minus 6 75.0 2 25.0 8 100
In Table 2 shows that the respondents
were knowledgeable good show short
nutritional status exist 8 toddlers (9.5%) and
respondents were knowledgeable about the
nutritional status of children under five short 2
(25.0%). Results of analysis p> 0.05 means
 Proceeding Patient Safety in Emergency

that there is no relationship of mother Table 5 shows that the positive

knowledge in a child's weight to the nutritional attitude of respondents who indicate its
status of children. nutritional status is at normal nutrition as
much as 76 infants (92.7%) and respondents
Tabel 3. Distribusi Status Gizi (BB / TB) with a negative attitude normal nutritional
berbasis Pengetahuan Capital di Beratnya status balitanya No 6 infants (60%). The
Balita. analysis result was obtained p <0.05 means
Nutritional status there is a relationship between the attitude of
Amount the mother in a child's weight to the nutritional
Knowledge Normal Thin Pvalue
status of children based on height for age.
n % n % n %
Good 68 81.0 16 19.0 84 100 0.002 Table 6. Distribution of Nutritional
Minus 2 12.5 6 75.0 25 100 Status (BB / TB) based on attitude Mrs.
hearts Weighing Toddler.
Table 3 shows that the respondents Attitude Nutritional status Amount Pvalue
Normal Thin
were knowledgeable good show her nutritional
n % n % N %
status is at normal nutrition were 68 infants
Positive 65 79.3 17 20.7 82 100 0.055
(81.0%) and less knowledgeable mothers who Negative 5 50.0 5 50.0 10 100
have a toddler who lean as much as 5 infants
(62.5). The analysis result was obtained p Table 6 shows that respondents
<0.05 means there is no relation between positive attitude showing his nutritional status
knowledge mother in a child's weight with is at normal nutrition as much as 65 infants
nutritional status by weight according to (79.3%) and respondents with a negative
height. attitude normal toddler nutritional status by 5
toddlers (50%). The analysis result was
Table 4. Distribution of Nutritional Status obtained p> 0.05 means that there is no
(BB/ U) by Attitude Women in Weighing relationship in the mother's attitude child's
Toddler. weight with nutritional status by weight
attitude Nutritional status Amount Pvalue according to height.
Normal Minus
n % n % n % Table 7. Distribution of Nutritional Status
Positive 70 85.4 12 14.6 82 100 0.001 (BB/ U) based on Capital Measures in
Negative 2 20.0 8 80.0 10 100 Weighing Toddler.
Action Nutritional status Amount Pvalue
Table 4 shows that the positive
attitude of respondents who indicate the Normal Less
nutritional status of babies that are in the n % n % n %
normal nutrition as much as 70 infants Good 6 97. 2 3.0 6 10 0.001
(85.4%) and respondents with a negative 5 0 7 0
attitude only normal nutritional status toddler Minus 7 28. 1 72. 2 10
2 toddlers (20.0%). The analysis result was 0 8 0 5 0
obtained p <0.05 means there is a relationship
mother's attitude in a child's weight with Table 7 shows that mothers who
nutritional status based on weight for age. brings a toddler to be weighed at Posyandu ≥ 4
times in the last 6 months shows the
Table 5. Distribution of Nutritional Status nutritional status of babies that are in the
(TB / U) based Attitude Women in normal nutrient as many as 65 infants (97.0%)
Weighing Toddler. and mothers carrying toddlers to be weighed at
Attitude Nutritional status Amount Pvalue Posyandu <4 times in 6 Last month showed
Normal Short the nutritional status of babies that are in the
n % n % N % normal nutrition as much as 7 infants (28.0%).
Positive 76 92.7 6 7.3 82 100 0.011 The analysis result was obtained p <0.05
Negative 6 60.0 4 40.0 10 100 means there is a relationship mother's behavior
in a child's weight with nutritional status based
on weight for age with OR: 0.012.

3
Proceeding Patient Safety in Emergency
Table 8. Distribution of Nutritional Status
(TB / U) based on Capital Measures in
Weighing Toddler.
Action Nutritional status Amount Pvalue
Normal Short
n % n % n %
Good 64 95.5 3 4.5 67 100 0.004
Minus 18 72.0 7 28.0 25 100
Table 8 shows that mothers who
brings a toddler to be weighed at Posyandu ≥4
times in the last 6 months shows her
nutritional status is at normal nutrition as
much as 64 infants (95.5%) and mothers
carrying toddlers to be weighed at Posyandu
<4 times 6 months showed its nutritional status
is at normal nutrition as much as 18 infants
(72.0%). The analysis result was obtained p
<0.05 means there is a relationship mother's
attitude in a child's weight to the nutritional
status of children based on height for age with
OR: 0.121.
Table 9. Distribution of Nutritional Status
(BB / TB) based on Capital Measures in
Weighing Toddler.
Action Nutritional status Amount Pvalue
Normal Thin
n % n % n %
Good 64 95.5 3 4.5 67 100 0.001
Minus 6 24.0 19 76.0 25 100
Table 9 shows that mothers who
brings a toddler to be weighed at Posyandu ≥4
times in the last 6 months shows her
nutritional status is at normal nutrition as
much as 64 infants (95.5%) and mothers
carrying toddlers to be weighed at Posyandu
<4 times 6 months showed the nutritional
status of babies that are in the normal nutrition
as much as 6 infants (24.0%). The analysis
result was obtained p <0.05 means there is a
relationship mother's attitude in a child's
weight to the nutritional status of children is
based on body weight for height with OR:
0.015.
Weighing Knowledge Relationships
Respondents in Toddlers with Toddler
Nutritional Status.
According Notoadmodjo (2007) that
the results of the study was conduct based
knowledge more lasting than the behaviors
that are not based on knowledge. Knowledge
will make it easier for someone to absorb the
4
information and implement it in their behavior
and everyday lifestyle, therefore the mother's
knowledge must be improved so that the
knowledge will be increased.
This knowledge can be enhanced
through ongoing counseling either through
leaflets, posters and can also be through the
medium of electronic media. Maternal
knowledge about a child's weight in this study
the majority of good and according to the
researchers this is due to the assumption of the
study site is located not far from the city center
so that respondents more easily and quickly
obtain health information, especially in
improving the nutritional status of children.
Attitudes relationship with mother in
Weighing Toddler Toddler Nutritional
Status
Attitude will put someone into a
thought like or dislike something, through
action and learning, a person will gain
confidence and attitude towards something
which in turn will affect their behavior.
Attitude is the evaluation, and the feeling of
someone who is relatively consistent tendency
of an object or idea. The attitude of the mother
in the weighing infants could affect the
nutritional status of a toddler indirectly. The
best knowledge is about the attitude of the
mother stating if weight infants are below the
red line, will soon bring a toddler to the clinic /
health workers, but the attitude of the mother
follow up that weight infants who do not go
up, there is still incorrect.
According Notoatmodjo (2007)
attitude is a reaction or response from
someone who is still closed to the stimulus or
object. Reaction or response in the form of
understand, respond to, respect and
responsible, other than that attitude is the basis
for making a response, or behave in a certain
manner it chooses.
Based on research Pristiani, et al
(2016) about the relationship of knowledge,
attitudes, and employment status mothers with
the frequency of a child's weight to
neighborhood health center in Puskesmas
Pamandati South Konawe stating that there is
a relationship between the attitude of mothers
with the frequency of a child's weight to
posyandu with p = 0.025, but in contrast to
studies conducted Yunidar (2012), which
states there is no relationship between
maternal attitude to the mother's visit to

neighborhood health center levThe analysis
showed that the attitude of mothers have a
relationship with the child's weight to
posyandu action, it can be associated with the
mother's knowledge. In this research, there are
mothers who have less existing knowledge, it
can affect the mother's attitude. Mothers with a
positive attitude but have actions toddlers
weighing less this is due to a complete infant
immunization has become a reason for the
mother so that less active and weigh bring
their babies to posyandu.Sikap not necessarily
materialize in action, for the measures
necessary for the realization of other factors,
such as the facilities or infrastructure that can
attract attentionel.
Weighing Actions relationship mother in
Toddlers with Toddler Nutritional Status
A child's weight is to measure how
often or active toddler weighed every month to
the Posyandu. Measures considered good if a
child's weight infants weighed at least 4 times
over the last 6 months, infants weighing data
can be seen in the book KMS brought every
visit to Posyandu.
The research result Ramadani, et al
(2013) which states there is a relationship a
child's weight to the nutritional status of
children, and there are differences in the
proportion of infants fail to thrive based on
regularity weigh toddlers to Posyandu and
research conducted Vicka, et al (2014) which
stated that there is a relationship of parenting
mother with status nutrition in Puskesmas
Ranotana Wanae Weru District of Manado
City. In this research, there is still a toddler
having a frequency weighing less, the low
activity of mothers bring their babies,
Khomsan (2007) advises the public to make
regular visits to the Posyandu toddler because
Posyandu is an invaluable tool for monitoring
weight toddlers made through weighing is
done every month. If weight loss occurs below
the red toddler then posyandu expected to
provide nutritional advice or provide
additional food (PMT) so that the weight
decrease can be prevented or, if not
insurmountable then made reference to be
followed up by a health worker at a local
clinic.
Proceeding Patient Safety in Emergency
CONCLUSION
1. There is a relationship between the
knowledge of the mother in a child's
weight with nutritional status based on
BB / U and TB / TB in Puskesmas city
Sibolga Aek Habil 2016.
2. There is a relationship between the
attitude of the mother in a child's weight
with nutritional status based on BB / U,
TB / U in Puskesmas city Sibolga Aek
Habil 2016.
3. 3. There is a relationship between the
actions of the mother in a child's weight
to the nutritional status of children by
BB/U, TB/U and BB/TB in Puskesmas
city Sibolga Aek Habil 2016.
SUGGESTION
It is expected that the City Health
Department and Community Health Center
Aek Habil Sibolga Sibolga in order to further
improve the level of health care in an intensive
posyandu especially health care to improve
nutrition and provide socialization /
importance of parenting toddlers information
including a child's weight to the Posyandu.
REFERENCES
Devi, M. 2010. Analisis Faktor-faktor yang
Berpengaruh terhadap Status gizi Balita
di Pedesaan. Jurnal Teknologi dan
Kejuruan, Vol.33, No.2: 183-192.
Hasan,N.O. 2013. faktor – faktor yang
berhubungan dengan partisipasi ibu
balita dalam kegiatan posyandu di
kelurahan kayumerah kecamatan
limboto kabupaten gorontalo.
Hindu, S.M.; Santosa, H.; Firia.M. 2013.
Faktor-Faktor yang Berhubungan
Dengan Tingkat Partisipasi Ibu dalam
Penimbangan Balita ke Posyandu di
Wilayah Kerja Puskesmas Darussalam
Kecamatan Medan Petisah Tahun 2013.
Jurnal Gizi,Kesehatan Reproduksi dan
Epidemiologi, Vol 2,No.6 (2013) : 8-9.
Hutagalung, Sihol P, 1992. Faktor – Faktor
yang Mempengaruhi Perilaku Ibu dalam
Menimbang Anaknya di Posyandu
Kotip Palu Provinsi Sulawesi Tengah.
Tesis Universitas Indonesia.
Julita Nainggolan,; Zuraida,R. 2011.
Hubungan antara Pengetahuan dan
Sikap Gizi Ibu dengan Status Gizi Balita
di Wilayah Kerja Puskesmas Rajabasa
Indah Kelurahan Rajabasa Raya Bandar
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Lampung. Medical Journal Of Lampung
University.Vol 1.No.1.2012.
Kartini, A,; Asdhany,C. 2012. Hubungan
Tingkat Partisipasi Ibu dalam Kegiatan
Posyandu dengan Status Gizi Anak
Balita (Studi di Kelurahan Cangkiran
Kecamatan Mijen Kota semarang).
Journal Of Nutrition College,I(1).
Kementerian Kesehatan Republik Indonesia,
2013, Laporan Hasil Riset Kesehatan
Dasar (Riskesdas) Indonesia Tahun
2007, Jakarta: Badan Penelitian dan
Pengembangan Kesehatan Depatemen
Kesehatan RI.
Lemeshow,S.; David W.H.Jr, 1997. Besar Sam
pel dalam Penelitian Kesehatan (terjema
han), Gadjahmada University Press,
Yogyakarta.
Pristiani.E;Junaid.;Paridah. 2016. Hubungan
Pengetahuan, Sikap dan Status
pekerjaan Ibu Balita dengan Frekuensi
Penimbangan Balita ke Posyandu di
Wilayah Kerja Puskesmas Pamandati
Kabupaten Konawe Selatan.
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Puskesmas Aek Habil. 2015. Laporan
Pendataan Sasaran Balita 0-59 Bulan
Puskesmas Aek Habil tahun
2015.Sibolga.
Reihana.;Duarsa.A.B.S. 2014. Faktor- faktor
yang berhubungan dengan partisipasi
ibu untuk menimbang balita ke
posyandu.Jurnal Kedokteran
Vicka.L.R; Rompas.S; Ismanto.A.Y.2014.
Hubungan Pola asuh Ibu dengan Status
Gizi Balita di Wilayah Kerja Puskesmas
Ranotana Weru Kecamatan Wanea Kota
Menado.
Yunidar. 2012. Faktor faktor yang
berhubungan dengan tingkat kunjungan
ibu ke posyandu Sinar M keluarga
Gampong IE Meulee Kecamatan
Sukajaya Kota Sabang. STIKES
Kebidanan Universitas budyah Banda
Aceh.
 Proceeding Patient Safety in Emergency

ANALYSIS OF NUTRITIONAL STATUS OF CHILDREN IN THE VILLAGE

PAIHEME DISTRICT CENTRAL TAPANULI NORTH SUMATRA
1.
Dimpu Tampubolon,2.Herlina
STIKES NAULI HUSADA

ABSTRACT

The nutritional status of children under five years in Indonesia is still cause for concern, because of
5,119,935 children under five of 17,983,244 children under five in Indonesia (28.47%) include in
group of malnutrition. Nutritional problems in Indonesia and developing countries in general are still
dominated by protein energy malnutrition, iron anemia problems, interference problems caused by
lack of iodine, the problem of lack of vitamins and the problem of obesity, especially in big cities and
remote areas. The low nutritional status of children in West Sorkam subdistrict Sipeapea Paiheme
village public health center (PHC) work area related to knowledge, income, education, occupation,
status of diarrhea and exclusive breastfeeding. This is a descriptive analytic study with cross-sectional
analysis is to determine the nutritional status of infants in Middle Tapanuli District West Sorkam
subdistrict Sipeapea Paiheme PHC work area. The study population was mothers who have children
under five, with a large sample of 96 mothers. Data was collected by interview using a questionnaire.
Analysis of data using simple logistic regression test at 95% confidence level. The result showed that
most of the good nutritional status of 67.7% and malnutrition status of 32.3%. Factors knowledge,
education and status of children under five with diarrhea had a significant association with the
nutritional status of children in which the value of p-values <0.05. While the factor income,
employment and exclusive breastfeeding did not have a significant relationship with the nutritional
status of children in which the value of p-value> 0.05. From the multiple logistic regression test
results concluded that the education variable is the dominant with score OR = 8.271, which means
mother of higher education have the opportunity to her children good nutritional status than mothers
with low education after the controlled variable knowledge, job, status of children under five with
diarrhea and exclusive breastfeeding. Suggested for health workers in the district of West Sorkam in
order to further improve counselling about nutrition to the public and counselling on how to prevent
diarrhea to reduce the incidence of diarrhea and to increase the knowledge of the mother in providing
good nutrition for children.

Keywords: Nutritional, Children, Paimehe

BACKGROUND main causes of infant mortality. WHO data in

Nutritional problem is a public health problem,
but penanggulangnya can not be done with the
approach of medical and health services alone.
The cause of the nutritional problems are
multifactorial, therefore mitigation approach
must involve all factors (Ibn et al, 2002).
Report of the World Health Organization
(World Health Organization / WHO, 2002)
also showed that the public health Indonesia is
the lowest in Asean and ranks 142 out of 170
countries. WHO data, it mentions the
prevalence of malnutrition and lack of the
children under five in 2002 respectively
increased to 8, 3% and 27, 5%, and in 2005
had risen again to each of 8, 8% and 28%. The
condition is quite alarming. The reason, in
addition to impact on growth and development
of children, malnutrition is also one of the
2002 showed 60% of infant and child
mortality linked to malnutrition cases.
According to the World Health Organization
(WHO, 2002), more than 30% of infants in the
world's population is malnourished .. In our
country the prevalence of chronic malnutrition
varies, according to data from the National
Health and Nutrition Survey (PNSN), between
8.1% and 27.3%, depending on the study area.
While the prevalence of malnutrition
according to the grouping of the World Health
Organization (WHO), Indonesia is a country
with high nutrient status in 2004. Because of
17,983,244 5,119,935 toddler toddlers
Indonesia (28.47%) belongs to a group of
malnutrition and malnutrition , Formulation of
the problem Based on the data obtained from
health Sipeapea Sorkam Western District of

7
Proceeding Patient Safety in Emergency
toddlers found 96 people in the village
Paiheme Sorkam District of Central Tapanuli
and 37 preschoolers who did not gain weight
this month in accordance with KMS found.
Nutritional status of children strongly
influenced by the readiness of parents in
caring for the toddler. There are various
factors that influence that far less attention by
the public, especially the parents of the
toddler. Based on the description above,
researchers are interested in knowing:
Analysis of nutritional status of infants at
Paiheme village sub-district Puskesmas
Sipeapea Sorkam West Central Tapanuli the
Year 2015? ". General purpose To study and
clarify the picture of factors associated with
the Nutritional Status in Toddlers village
Puskesmas Paiheme Sipeapea Sorkam Eastern
District of Central Tapanuli 2015 Special
purpose a) To study and explain the relation
between knowledge and nutritional status in
Toddlers village Puskesmas Paiheme Sipeapea
Sorkam Eastern District of Central Tapanuli
2015. b) To study and explain the correlation
between income and nutritional status in
Toddlers village Puskesmas Paiheme Sipeapea
Sorkam Eastern District of Central Tapanuli
2015. c) To study and explain the relation
between education and nutritional status in
Toddlers village Puskesmas Paiheme Sipeapea
Sorkam Eastern District of Central Tapanuli
2015. d) To study and explain the employment
relationship with nutritional status in Toddlers
village Puskesmas Paiheme Sipeapea Sorkam
Eastern District of Central Tapanuli 2015. e)
To study and explain the relationship status of
children under five suffer from diarrhea and
nutritional status in Toddlers village
Puskesmas Paiheme Sipeapea Sorkam Eastern
District of Central Tapanuli 2015. f) To study
and explain the relationship of exclusive
breastfeeding and nutritional status in Toddlers
village Puskesmas Paiheme Sipeapea Sorkam
Eastern District of Central Tapanuli 2015. g)
To determine the dominant factors associated
with nutritional status in Toddlers village
Puskesmas Paiheme Sipeapea Sorkam Eastern
District of Central Tapanuli 2015 Benefits of
research As an input or consideration for
health centers and mother Toddler in
improving the nutritional status of children.
And the research is expected to improve
services to better education about good
nutrition for toddlers.
8
RESEARCH METHODS
This is a descriptive study, using cross
sectional design. The research location is in
the village Puskesmas Paiheme Sipeapea
Sorkam Western District of the Year 2015.
When the study started January to July 2015.
The population of this research is all mothers
with children under five as many as 96 people,
with a total population technique. Data
Retrieval Techniques 1. Primary Data Primary
data is data obtained directly from the
respondent (mothers) in which data collection
was conducted by questionnaire given to
respondents for getting answers to questions.
At the time of the study conducted by
researcher with distributing questionnaires. 2.
Secondary Data Secondary data is data
obtained directly from the clinic associated
with the number of mothers. Data analysis
techniques with Chi-Square test.
RESEARCH RESULT
univariate 1. Known from 96 respondents
surveyed found that most of the categories of
good nutritional status of children under five
(67.7%). 2. Known from 96 respondents
surveyed found that most knowledgeable high
(53.1%). 3. The note of 96 respondents
surveyed found that most low-income
(76.0%). 4. The note of 96 respondents
surveyed found that the vast majority from the
education level is low (84.4%). 5. The note of
96 respondents surveyed found that most
mothers do not work that (76.0%). 6. The note
of 96 respondents surveyed found that most
toddlers've got diarrhea (63.5%) 7. known
from 96 respondents surveyed found that most
infants are not exclusively breastfed (60.4%).
BIVARIATE
1. Given the results of the analysis of the
relationship between knowledge of mothers
with infant nutritional status obtained 78.4%
of women are high knowledgeable balitanya
good nutritional status. While lower among
mothers who are knowledgeable, there are
44.4% of the nutritional status of children
under five are less. Statistical test results
obtained by value p = 0,030, it can be
concluded no difference in the proportion of
incident balitanya good nutritional status
among women with a high knowledge mothers
who are knowledgeable low (there is a
significant relationship between knowledge of
mothers with infant nutritional status). From

the results obtained by analysis of the value of
OR = 2.909 means high knowledge mothers
toddler has a chance of 2.9 times for the
nutritional status of children better than low
knowledge mothers. 2. Given the results of the
analysis of the relationship between income
mothers with nutrition status was obtained that
there are as many as 73.9% of women with
low incomes balitanya good nutritional status.
Whereas among mothers with low incomes,
there are 65.8% better nutritional status of
children under five. Statistical test results
obtained by value p = 0.635 it can be
concluded there was no difference in the
proportion of children under five nutritional
status events between high-income mothers
with low income mothers (there is no
significant relationship between income
mothers with infant nutritional status). 3.
Given the results of the analysis of the
relationship between mother's education with
infant nutritional status is obtained that there is
as much as 100% higher educated mothers
balitanya good nutritional status. Whereas
among mothers with low education, there are
61.7% better nutritional status of children
under five. Statistical test results obtained by
value p = 0.009, it can be concluded no
difference in the proportion of incident
balitanya good nutritional status among
women of higher education with mothers with
low education (no significant relationship
between mother's education with infant
nutritional status). From the results obtained
by analysis of the value of OR = 1.620 means
that higher education mother toddler has a
chance of 1.6 times for good nutritional status
than mothers with low education. 4. Given the
results of the analysis of the relationship
between the mother's occupation with the
nutritional status of children shows that there
are as many as 82.6% of working mothers
balitanya good nutritional status. Whereas
among women who do not work, there are
63.6% better nutritional status of children
under five. Statistical test results obtained by
value p = 0.134 it can be concluded there was
no difference in the incidence proportion of
poor nutritional status among children under
five working mother with mothers who did not
work (there is no significant relationship
between maternal employment with the
nutritional status of children). 5. Given the
results of the analysis of the relationship
between the status of children under five with
Proceeding Patient Safety in Emergency
diarrhea in infant nutritional status is obtained
that there is as much as 82.1% children with
diarrhea never balitanya good nutritional
status. Whereas among toddlers who've got
diarrhea, there are 41.0% less nutritional status
of children under five. Statistical test results
obtained by value p = 0.029 it can be
concluded no difference in the incidence
proportion of poor nutritional status among
children under five babies never diarrhea with
toddlers who've got diarrhea (there is a
significant correlation between the status of
children under five with diarrhea in infant
nutritional status). From the results obtained
by analysis of the value of OR = 3.356 means
that infants with diarrhea never have a chance
of 3.35 times for the nutritional status of
children under five is better than ever with
diarrhea. 6. known the results analysis of the
relationship between exclusive breastfeeding
with infant nutritional status is obtained that
there are as many as 76.3% of infants
exclusively breast-fed babies good nutritional
status. Whereas among infants who are not
breastfed exclusively, there are 37.9% less
nutritional status of children under five.
Statistical test results obtained by value p =
0.216 it can be concluded there was no
difference in the proportion of children under
five nutritional status events between infants
breast-fed exclusively with toddlers who are
not breastfed exclusively (no significant
relationship between exclusive breastfeeding
with infant nutritional status.
MULTIVARIATE
Last modeling variables obtained knowledge,
education and the status of diarrhea have a
significant relationship in which each variable
has a value p-value <0.05, with a dominant
variebl education is variable so that the
variable where the value OR the largest among
the other variables, so that the dominant
variable is education. The analysis of
educational variables obtained value OR =
8.271 means that mothers are higher education
opportunity as much as 8.2 times for good
nutritional status than women with low
education. Variables controlled with variable
knowledge education, employment, status of
children under five with diarrhea and
exclusive breastfeeding
9
Proceeding Patient Safety in Emergency
CONCLUSION
1. Most of the village Puskesmas Paiheme
Sipeapea Sorkam Eastern District of Central
Tapanuli North Sumatra Province in 2015
good nutritional status (67.7%). Also obtained
malnutrition status of 32.3% which is still
relatively high compared to the national
percentage is 17.9%. 2. Factor maternal
knowledge, maternal education, maternal
employment status of children under five with
diarrhea and had no significant relationship
with the nutritional status of children in the
village Puskesmas Paiheme Sipeapea Sorkam
Eastern District of Central Tapanuli, North
Sumatra. 3. Of the factors that influence the
nutritional status of children, education
Mother dominant in influencing the nutritional
status of children with OR = 8.271, meaning
that mothers are higher education's likely as
much as 8.2 times better nutritional status than
mothers with low education , Education
variable controlled variable job knowledge,
the status of children under five with diarrhea
and exclusive breastfeeding.
SUGGESTION
a) It is expected that the health workers in sub-
district Puskesmas Sipeapea Sorkam West to
further enhance the nutritional counseling to
the community to improve the knowledge of
the mother in the provision of good nutrition
for toddlers. b) It is expected that providing
health education in villages Paiheme Sorkam
District of the West, especially on how the
prevention of diarrhea to reduce the incidence
of diarrhea.
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11
Proceeding Patient Safety in Emergency

EFFECT OF BALANCE EXERCISE BALANCE AND MUSCLE STRENGTH

AGAINST ELDERLY WITH RISK OF FALLING IN PUSKESMAS SUBDISTRICT
KOLANG CENTRAL TAPANULI

Meiyati Simatupang, Ronald Sagala

STIKES NAULI HUSADA

Abstract

Total growth of elderly population in the world is increasing, the results of a study published by the
United Nations Population Fund - United revealing the number of elderly in the world can reach the
amount of 1 billion people within the next 10 years. Predictions for 2020 are approximately 28.8
million people or about 11:34% of the total population (Sutriyanto, 2012). Prasansuk, (2004) also
concluded that one advantage or influence balannce exercise is to improve postural balance the
elderly. Aristo research results Farabi (2007) conducted at Hospital Dr. Kariadi that is not found
patient falls with TUG test time of less than 10 seconds. A significant association between TUG test
time with the frequency of falls (p <0.05). This research is a quantitative research design is quasi-
experimental design with two-group pretest-posttest control group design. Statistical test in this
research use test Independent t test to see differences in balance and muscle strength before and after
the intervention in the control group and the intervention group. Paired samples test to test the level of
significance of the effect of exercise on the balance balance and muscle strength in the elderly with
fall risk sub-district Puskesmas Kolang Central Tapanuli and eta squared values to assess the effect
size. squared = 0.51), with p = 0.003. This indicates a balance effect of exercise on the balance. The
decline of the musculoskeletal system of the elderly have a very big role to teterjadinya falls on or it
can be said that the factors decrease musculoskeletal system is purely belongs elderly who have an
influence on postural balance. Terjdadi muscle wasting in the elderly causes decreased muscle
strength, especially the muscles of the lower extremities. Eksterimitas muscle weakness below can
cause postural balance disorders. This may result in inaction move, in short steps, decrease the
rhythm, the foot can not tread firmly and tend to look shaky, difficult or delayed mengantisispasi
outages like slipping and tripping. Some of these indicators can increase the risk of falls in the elderly
(Darmojo 2011).

Background fall is a hip fracture. Another type of fracture

Total growth of elderly population in the
world is increasing, the results of a study
published by the United Nations Population
Fund - United revealing the number of elderly
in the world can reach the amount of 1 billion
people within the next 10 years. Predictions
for 2020 are approximately 28.8 million
people or about 11:34% of the total population
(Sutriyanto, 2012).
In the elderly there is a change in body
composition in the form of drop in fatfree
mass or increased fat mass. In the process of
aging the percentage of muscle mass
decreases, resulting in decreased muscle
strength by 30-40%. Muscle strength muscle
strength in the elderly is also associated with
problems of balance so that the elderly at risk
to fall over (Herman, et al, 2011).
Fall can lead to various kinds of injuries,
psychological fisikdan damage. Physical
damage is the most feared of the events of the
that often occur from falls are fractures of the
wrist, arm and pelvis as well as soft tissue
damage. The psychological impact is that
although physical injury does occur, shock
after falling and fear of falling. The Benefits
Research Helping the elderly in improving
knowledge for improving postural balance so
as to avoid instances of falling.
RESEARCH METHODOLOGY
3.1 Research Design
This research is a quantitative research design
is quasi-experimental design with two-group
pretest-posttest control group design. In this
study experimental treatments for the
provision of balance exercises to prevent the
risk of falls in the elderly.
3.2 Location and Time Research
This research was conducted in the region
of Central Tapanuli Kolang health centers. The

12

timing of this study is planned to start in June-
September, 2016.
3.3 Population and Sample
The population in this study were all
elderly in Puskesmas Kolang Central Tapanuli
as many as 240 people composed of 78 men
and 163 women. Samples that meet the
inclusion and exclusion criteria are as many as
31 people were divided into two groups: 16
the treatment group and 15 control group,
where there are two people in the treatment
group drop out because they do not follow the
practice of the complete (<9x meetings) and in
the control group also No two people drop out
because of actively participating in gymnastics
lansai, so the number of remaining sample as
many as 27 people, 14 intervention and 13
control group.
3.4 Data Collection Methods
Screening and data collection on the
research to be conducted using questionnaires
/ questionnaire and measures that will be used
to measure the risk of falling out of the subject
using the Fall Risk for Older People -
Community setting (FROP-Com), which has
been modified and the number of samples in
screening 40 respondents. This instrument was
originally used for the elderly in the hospital
(the Fall Risk for Older People hospitalized -
the FRHOP) (Rahayu, 2013).
3.5 Data Analysis Techniques
Statistical test in this research use test
Independent t test to see differences in balance
and muscle strength before and after the
intervention in the control group and the
intervention group. Paired samples test to test
the level of significance of the effect of
exercise on the balance balance and muscle
strength in the elderly with fall risk sub-district
Puskesmas Kolang Central Tapanuli and eta
squared values to assess the effect size.
3.6 Ethical Considerations
Research carried out with an emphasis on
ethical issues that refer to The American
Association for Public Opinion Research
(AAPOR) adapted from Rachman, (2009)
which includes:
Approval Sheet Being Respondents (Informed
Consent), anonimity (Untitled),
Confidentiality (Confidentiality)
Proceeding Patient Safety in Emergency
RESEARCH RESULT
Table 4.1 Analysis Test Results Mean
Paired Samples Test Changes in muscle
strength On Intervention Group and
Control Group in District Kolang Central
Tapanuli
Observatio Intervention p Eta Kontrol p
ns Muscle the Mean square Rerata
Strength (SD)
Pre 26.643(5.440) 0.000 0.63 29.31(9.3 0.467
26)
Post 32.179 (8.898) 28.54(10.
738)
N 14 13
Source: Primary Data: 2013 p: probability paired
with dample test.
Table 4.1 shows that after a given intervention
obtain meaningful results where the value of p
= 0.000 <0.05 thus Ha received and the results
obtained 0.63 square eta (strong effect). While
the control group showed no significant where
the value of p = 0.467> 0.05 thus Ha, it
indicates that there is a balance the influence
of exercise on muscle strength.
DISCUSSION
Effect of exercise balance to the balance
with the risk of falling Results of t-test was no
difference before and after the change in the
balance given the balance exercise regularly in
the intervention group there is an increase in
the average balance of total -9.429 (eta
squared = 0.51), with p = 0.003. This indicates
a balance effect of exercise on the balance.
The decline of the musculoskeletal system of
the elderly have a very big role to teterjadinya
falls on or it can be said that the factors
decrease musculoskeletal system is purely
belongs elderly who have an influence on
postural balance. Terjdadi muscle wasting in
the elderly causes decreased muscle strength,
especially the muscles of the lower
extremities. Eksterimitas muscle weakness
below can cause postural balance disorders.
This may result in inaction move, in short
steps, decrease the rhythm, the foot can not
tread firmly and tend to look shaky, difficult or
delayed mengantisispasi outages like slipping
and tripping. Some of these indicators can
increase the risk of falls in the elderly
(Darmojo 2011). That must be considered is
the monitoring and maintenance of optimal
tehadap elderly who naturally already
decreasing musculoskeletal system
13
Proceeding Patient Safety in Emergency

(Hadhisuyatmana, 2012). This is in accordance 6. There is a balance influence of exercise on

with the opinion of the King (2009) that muscle strength (p = 0.000)
strength training will increase the balance and 7. showed strong effect (eta squared = 0.63).
delay the speed of contraction that leads to the 8. There is a difference of balance and muscle
improvement of the balance after strength strength between the intervention group
training. This is in accordance with the and the control group.
opinion expressed by Kaesler (cited in Kloos,
2007) that the balance exercise is a series of SUGGESTIONS
movements designed to improve postural 1. For Elderly
balance, both for the balance of static and We recommend that the elderly do balance
dynamic balance. At the time of this exercise at least three times a week so that
movement there is a series of processes in the the body of the elderly is stable and not
brain, called the central compensation, the easily fall.
brain will attempt to adjust their signal 2. For Nurses
changes as a result of a series of movements to PHC Kolang provide balance policies do
adapt. This study was supported by research exercise regularly in order to avoid instances
conducted Rahayu (2013) which aims to of elderly falls.
observe the phenomenon of giving balance 3. For Educational Institutions
exercise in improving postural balance of Making balance exercise as a reference for
older results showed that 5 respondents elderly the development of nursing science gerontik.
women after a given balance exercise exhibit a 4. For Further Research
phenomenon that balance posturalnya Future studies are recommended to increase
experienced an average increase in value berg the duration of exercise and balance are
32 before being given a balance scale balance advised to increase research time for the
exercise to 47.8 after the given balance results obtained more leverage and
exercise. From research conducted Dharmika should be in agreement if there are
(2007) that exercises improve balance the respondents who exercise outside contracted
body's postural stability in patients with lower time to be controlled.
limb diabetic polyneuropathy.
REFERENCES
CONCLUSIONS Achmanagara, A. A. (2012). Hubungan faktor
1. An overview of the balance of the elderly before exercise
internal dan eksternal dengan
balance in the intervention group showed keseimbangan lansia di Desa Pamijen
more than half of respondents (71.4%) Sokaraja Banyumas. Fakultas Ilmu
were in the medium risk category falls. In Keperawatan Universitas Indonesia:
the control group half of respondents Depok.
(53.8%) are in the low risk category falls. Budiharjo, S. (2013). Pengaruh senam bugar
2. An elderly balance after exercise balance in the intervention
lansia terhadap
group showed
kekuatan
mostotot
respondents
wanita (85.7%) are in th
3. Overview of elderly muscle power before exercise balance
lanjutinusia
the tidak
intervention
terlatih group
di Jogjakarta. showed all the el
almost all respondents (92.3%) are in the Diakses tanggal 20 Januari 2014
20-38 kg category. santosa-2097-lansia
4. Overview of elderly muscle strength after http://digilib.litbang.depkes.go.id/go.ph
exercise balance in the intervention group p?id=jkpkbppk-gdl-res-2003 .
showed allrespondents are in the categories Carpino, Chris. (2016). New ideas in
of muscle strength scores increased less but belance and falls 3 ed. Diakses tanggal
that is more than half the respondents 09 Januari 2014.
(64.3%) are in kategri 22-32. In the control http://www.apta.org/BalanceFalls/.
group also showed respondents in the Ceranski, S. (2006). Fall prevention and
category. modifiable risk factor. Diakses tanggal
5. There is a balance exercise influence on the 10 Agustus 2013.
balance (p = 0.003), which shows the Tyyp://www.rfw.org/AgingCont/2006/
strong effect (eta squared = 0.51) less Handouts/12_FallPrevention_Ceran
muscle strength almost all respondents ski.pdf.
(92.3%) are in the 20-38 kg category. Dachlan, L. M. (2009). Pengaruh back
exercise pada nyeri punggung bawah.

14
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Magister Kedokteran Keluarga Semarang. Fakultas

Universitas Sebelas Maret: Surakarta. KedokteranUniversitas Diponegoro:
Darmojo, B. (2011). Buku ajar geriatri; ilmu Semarang.
kesehatan usia lanjut edisi ke-4, cetakan Janssen I, Heymsfield SB, Wang ZM, Ross R.
ke-3. Fakultas Kedokteran Universitas (2010). Sceletal Muscle Mass and
Indonesia: Jakarta. Distribution in 468 Men and Woman
Dharmmika, Susanti. 2015. Pengaruh latihan Aged. Journal of Applied
stabilitas postural terhadap Physiologi.Diakses tanggal 9 Januari
keseimbangan fungsional pada pasien 2014.
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bawah. Program Studi Ilmu Kedokteran 1.
Fisik dan Rehabilitasi Medik FKUI: Jowir. (2009). Balance exercise. Diakses
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Effendi, F. (2008). Latihan keseimbangan http://id.scribd.com.
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15 september 2013. hatha yoga modifikasi selama 12
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keseimbanganpostural- pada-lansia/. Fakultas Kedokteran Universitas
________. (2011). Keperawatan kesehatan Diponegoro: Semarang.
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keperawatan). Salemba Medika: novel balance exercise program for
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Gunarto, S. (2015). Pengaruh latihan four study. Diakses tanggal 08
square step terhadap keseimbangan Januari
pada lasnia. Program Pendidikan Ilmu 2014.http://files.carellipilates.webnode.c
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Guyton, CA. & Hall, JE. (2009). Buku ajar Kusharyadi. (2010). Asuhan keperawatan
fisiologi kedokteran. Edisi: 11. EGC: pada klien lanjut usia. Salemba Medika:
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Hapsari, P. W. (2011). Faktor-faktor Kusnanto. (2007). Peningkatan stabilitas
yang berhubungan dengan daya tahan postural pada lansia melalui balance
otot yang diukur menggunakan sit-up exercise. Media Ners. PSIK FK
selama 30 detik pada anak sekolah UNAIR: Surabaya, diakses tanggal 15
dasar di SDN Pondok Cina 03, Depok. Agustus 2013,
Fakultas Kesehatan Masyarakat http://ejournal.undip.ac.id/index.php/me
Universitas Indonesia: Depok. dianers/article/view/716
Henwood T.R, Riek S, Taaffe D.R. (2008). Lee, I. H. (2013). Balance improvement by
Strenght Versus Muscle Power-Specific strength training for the elderly.
Resistance Training in Community- Physical Therapy Science. Diakses
Dwealling Older Adults. The tanggal 18 Februari 2014.
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Biological Sciences and Medical es/PMC3885846/
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http://www.researchgate.net/publication keseimbangan tubuh laansia di Panti
/5605959_Strength_versus_muscpowers Sosial Tresna Werdha DKI Jakarta.
pecific_resistance_training_in_commun Diakses tanggal 10 Oktober 2013.
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Hidayat. A.A.A. (2007). Metode penelitian Nugroho, W. (2008). Keperawatan gerontik
keperawatan dan tekhnik analisa dan geriatri. EGC: Jakarta.
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Jalalin. (2010). Hasil latihan keseimbangan Perbedaan keseimbangan tubuh lansia
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dan Elim Semarang. Diakses tanggal 08 Rahayu, U. B., & Masitoh, I. (2013).
Januari 2014. Fenomena balance exercise untuk
http://ejournal.stikestelogorejo.ac.id/ejo meningkatkan keseimbangan postural
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berhubungan dengan kejadian cidera berjalan dengan keseimbangan berdiri
fisik akibat jatuh pada lansia di desa satu tungkai pada para lanjut usia di
benteng gajah, kecamatan tompobulu. panti sosial Tresna Werdha Semarang .
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Yarsi. Diakses tanggal 20 agustus 2013.
http://journal.lib.unair.ac.id/index.php/Y
rs/article/download/295/305.

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 Proceeding Patient Safety in Emergency

RELATIONSHIP OF KNOWLEDGEOF STROKE PATIENT WITH COMPLIANCE

THROUGH PHYSIOTHERAPY ON PHYSIOTHERAPY CLINIC
IN DR.PIRNGADI HOSPITAL ON YEAR 2016

Solihuddin Harahap, Suriani Br Ginting, Dina Yusdiana

Nursing Department of Poltekkes Kemenkes Medan

ABSTRACT

Stroke is a clinical syndrome due to brain blood vessel disorders, sudden onset and usually affects
patients aged 45-80 years. Generally men are affected slightly more often than women. There are
usually no symptoms prodrama or sudden onset of early symptoms. After a stroke a few patients have
disorders such as paralysis, decreased communication skills, mental changes due to
depression. Therefore, stroke patients need to undergo rehabilitation as much as possible in order to
restore the function of the body. One type of care given is physiotherapy. Physiotherapy is essential to
prevent stiffness and immobility. Stroke patients considers incurable disease and stroke will suffer a
lifetime, while the good treatment of post-stroke disability can be minimized, thus the need to undergo
physiotherapy stroke patient compliance. Post-stroke patient compliance in undergoing physiotherapy
Installation Medical Rehabilitation Hospital in Sleman, known in category obedient as many as 13
people (65.5%). This research is an analytic that aims to determine the relationship of patients'
knowledge about stroke with compliance with physiotherapy in the physiotherapy room Hospital
RSUD Dr.Pirngadi on year 2016, with cross sectional study. Respondents in this study as many as 32
people by using accidental sampling.Results showed that the majority of 15 respondents (46.9%) are
knowledgeable enough [and as many as 21 respondents (65.5%) do not comply with physiotherapy
and 9 respondents (28.1 %) dutifully undergoing physiotherapy. Based on an analysis using the chi-
square test showed no significant relationship between the knowledge of stroke patients with
adherence to undergo physiotherapy, ie, p-value = 0.021 (p <0.05).

Keywords: Stroke, Physiotherapy

Background stroke worldwide. Two-thirds of strokes occur

Stroke is a clinical syndrome due to
brain blood vessel disorder, sudden onset and
usually affects patients aged 45-80 years.
Generally men are affected slightly more often
than women. There are usually no symptoms
prodrama or sudden onset of early symptoms
(Jusuf misbach 2011). According to
WHO,stroke is the presence of clinical signs
of growing quickly due to focal brain
dysfunction (or global) with gejal symptoms
lasting for 24 hours or more which causes
death in the absence of any other obvious
cause other than vascular (Judha, 2011)
Based on WHO data, every year there
are 15 million people worldwide suffer a
stroke. Among them are found the number of
deaths by 5 million people and 5 million more
people experiencing disability in adulthood
and is one cause in the world. Stroke ranks as
the third leading cause of death after coronary
heart disease and cancer in developing
countries. Developing countries also
accounted for 85.5% of total deaths from
in countries that are developing. There are
approximately 13 million new stroke victims
each year, of which about 4.4 million of them
died within 12 months (WHO, 2010).
Based on data collected by the Stroke
Foundation of Indonesia (Yastroki), stroke
issues more important and urgent because now
the highest number of stroke survivors and
ranks first in Asia. The number of diseases
caused by stroke ranks second in over 60 years
and fifth in the age of 15-59 years (Yastroki,
2012). In Indonesia estimated that each year
500,000 people suffered a stroke, about 2.5%
or 12.5000 people died, and the rest is mild or
severe disability. In general, one can say the
numbers kejadia stroke is 200 per 100,000
population. In one year, between 100,000
population, 200 people will suffer a stroke.
The incidence of ischemic stroke or transient
ischemic attack shortly (Transient Ischemic
Attacks, TIA) approximately 80% of the total
cases of stroke, while the incidence of
hemorrhagic stroke is only about 20% of the

17
Proceeding Patient Safety in Emergency
total cases of stroke (Yastroki, 2012).
Based Health Research (Riskesdas) National,
the national prevalence of stroke was 0.8%
(based on the diagnosis of health personnel
and symptoms). A total of 11 of 33 provinces
in Indonesia have prevalence above national
prevalence, including West Sumatra province
with prevalence of 6.9% in the 10th highest in
Indonesia. From the data available on the
National Stroke Hospital (RSSN) Bukit Tinggi
as much as 30% - 40% of ischemic stroke
patients treated in neurology aged 30-50 years
(National Riskesda, 2007).
Having suffered a stroke a few pesien
trending disorders such as kelumpahan,
decreased mental change communication
capabilities to depression. Therefore, stroke
patients need to undergo a rehabilitation
process as much as possible in order to restore
the function of the body. Stroke rehabilitation
is the process whereby stroke patients
undergoing treatment to help him return to
normal life. During rehabilitation, stroke
patients learn to move, think and care for
themselves (Sec Health, 2013).
One type of treatment provided are
Physiotherapy. Physiotherapy is essential
given to prevent stiffness and immobility. The
results obtained in 25-50% of cases patients
are stroke, the first time the patient did not
achieve independence back and in need of
intensive care (Davey, 2006). From the
viewpoint of physiotherapy, will be a lot of
complications that arise if not handled
properly (Rujito, 2007 ). Acts of service
physiotherapy in patients with stroke with a
Functional Limitation (functional limitations)
that the decline in the ability to move the
upper limbs of the body, for example, take out
or grab something. The aim of physiotherapy
in stroke patients is, improve the functional
ability of patients to carry out everyday
activities to reduce morbidity (morbidity) and
the potential occurrence of the disability by
secondary prevention measures as well as
handle the accompanying disorder (Suhardi,
2007).
Stroke patients considers incurable
disease and stroke will suffer a lifetime, while
with good care disability after a stroke can be
minimized, thus the need to undergo
physiotherapy stroke patient compliance, so
that stroke patients dependency on others can
be minimized (Irdawati, 2009). Compliance in
carrying out physiotherapy for patients with
18
post-stroke is important, because
physiotherapy is one of the ways in which to
optimize and maximize the body's functions
and capabilities limbs remaining in post-stroke
patients, thereby reducing dependence on
others. Post-stroke patient compliance in
undergoing fosioterapi Medical Rehabilitation
Hospital in Sleman installation, known in
category obedient as many as 13 people
(65.5%). The results showed that patients in
compliance with physiotherapy as per
instructions of health workers (Rosiana, 2012).
In connection with the large number of
morbidity and mortality caused by stroke
patients, then conducted research in the field
of medical science as the means of
physiotherapy increasingly sophisticated and
the discovery of drugs that could treat stroke
patients.
Therefore, today many open means of
physiotherapy in various regions that aims to
help stroke patients in the healing process, so
the result of many stroke patients who suffered
paralysis of almost 85% can be cured with
physiotherapy and can do the job as before,
although time is it takes a very long time
ranging from weeks, months to years duration
(Suhardi, 2007).
Based on the results of a preliminary
survey conducted in the Hospital Dr. Terrain
Pirngadi obtained storke number of patients
undergo physiotherapy in the physiotherapy
room in the period January to December 2015
a total of 120 patients, with Compliance
Stroke Patients Undergoing Physiotherapy
room Physiotherapy at Hospital Dr. Pirngadi
Medan.
Based on the above, the research to
prove Relationship With Compliance
Knowledge Stroke Patients Undergoing
physiotherapy in Space Physiotherapy
Hospital Dr. Pirngadi Medan.
Problem Formulation
Based on the above the formulation of
this research is How the Relationship
Knowledge about the disease Stroke Patients
Undergoing With Compliance Physiotherapy
room Physiotherapy at Hospital Dr. Pirngadi
Medan 2016.
Objective
General purposeTo determine the
relationship of patients' knowledge about
stroke with mejalani compliance

physiotherapy in Space Physiotherapy
Hospital Dr. Pirngadi Medan 2016.
Special purpose
1. To determine the patients' knowledge about
stroke in Space Physiotherapy
2. To determine the adherence of stroke
physiotherapy in Space Physiotherapy
3. To determine the relationship of patients'
knowledge about stroke with compliance
with physiotherapy in Space Physiotherapy
Benefits Research
1.For Researchers
This research is helpful to enhance the
learning experience and insight in research on
the relationship of knowledge about stroke
patients with adherence to undergo
physiotherapy.
2. For Hospital
As input for hospital managers to improve
health care for people, especially for stroke
patients to physiotherapy
Hypothesis research
There is a relationship of knowledge about
stroke patients with adherence to undergo
physiotherapy.
RESEARCH METHODS
a. Design Research
This type of research is analytical, that is to
find the relationship between the dependent
and independent variables. The research
design used in this study was a cross sectional
study design is a method which is the study
design with measurement or observation at the
same time / once upon a time (Notoatmodjo,
2010).
b.Location and Time Research
Location of the study will be conducted at
room Physiotherapy Hospital Dr. Pirngadi
Medan, when researchers began in December
2015 - July 2016.
c.Population and Sample Research
Population
The population in this study were all stroke
patients who underwent physiotherapy and
outpatient in Space Physiotherapy Hospital Dr.
Terrain Pirngadi 2015 as many as 120 people.
Samples.
The sample size in this study were 32
respondents. How sampling in this research is
to use accidental sampling technique, done by
taking the case or the respondent accidental or
provided somewhere within the context of
research.
Proceeding Patient Safety in Emergency
Sample size formula used is as follows
n = N / (1 + N (d ^ 2))
n = 120 / (1 + 120 (0:15 〖〗 ^ 2))
n = 120 / (1 + 120 (0.0225))
n = 120 / (1 + 2.7)
n = 120 / 3.7
n = 32.4
n = 32
information :
N: Large population
n: number of samples
d: The level of the desired provision
(Nursalam 2008)
The inclusion criteria are criteria or
characteristics that need to be met by each
member of the population that can be taken as
a sample and exclusion criteria are
characteristics of members of the population
that can not be taken as a sample
(Notoatmodjo, 2012).
Criteria for inclusion in this study are:
1. Stroke patients who underwent
physiotherapy who are willing to be used as
a sample.
2. Stroke patients who underwent
physiotherapy at room Physiotherapy Dr.
Pirngadi Medan
3. Stroke patients who can not communicate
and can read and write. D. Types and Data
Collection Method
d. Data Types
Data used in this study is a type of primary
data that researchers obtain data directly to the
target (the respondents) and secondary data is
data obtained from space Physiotherapy Dr.
Pirngadi Medan.
e. How Data Collection
Data collection is done by direct interview to
the respondents to the questionnaire as a
measuring tool. This data collection is done
first briefed about the purpose of the study
respondents. If willing to become respondents,
are welcome to sign an agreement and then
given an explanation of the questionnaires.
f. Processing and Data Analysis
1. Data Processing
a. Primary data
Primary data is processed by means of
computerized be determined by the category
of each instrument used and subsequently
analyzed to determine the relationship of
knowledge of stroke patients with compliance
with physiotherapy, the researchers asked 10
19
Proceeding Patient Safety in Emergency
questions for compliance, 10 questions for
knowledge, in the questionnaire of compliance
and knowledge assessment is carried out by
using Guttman scale with scoring as follows:
a. For every question answered and was rated
1.
b. For questions not answered or wrong then
given a 0.
Criteria for the respondents' knowledge
according to Arikunto (2006), divided into
three categories, namely:
1. The level of knowledge of "good" if the
respondent can answer as many as 75-100%
with a total of 15-20.
2. The level of knowledge "enough" if the
respondent can answer as many as 55-74 with
a total of 11-14.
3. The level of knowledge "less good" if the
respondent can answer as many of <55% with
a total of 1-10.
b. secondary data
The data collected is processed by the data
processing steps as follows:
1. Editing
Results of interviews or questionnaires
obtained or collected through questionnaires
need to be redacted (edited) in advance. If
there are still no data or information that is
incomplete, and re-interview is not possible,
then the questionnaire is issued (droup out).
2. Cooding
Sheet or card code is an instrument in the form
of columns to record data manually. Sheets or
code card contains the number of respondents,
and the numbers question.
3. Tabulating
Namely create data tables, according to the
research or desired by the researcher.
g. Data Analysis
1. Univariate analysis
This analysis aims to explain or describe the
characteristics of each variable penelelitian.
The data collected was analyzed descriptively
by looking at the percentage of the collected
data and produce a proportion of each of the
variables measured and presented in tabular
form distribution
2. Bivariate analysis
Bivariate analysis conducted on two variables
were related. This analysis uses statistical tests
chi squere with significance level α = 0.05 by
the formula:
X ^ 2 = Σ ((fo-fe) ^) / fe
20
Information :
X = chi-square count
Σ = sum
O = The observations of each cell
E = Expected value
Results of statistical analysis considered
significant if p <0.05 ha acceptable means
there is a significant correlation between the
two variables studied and the relationship is
not significant if p. 0.05 Ha rejected.
RESULTS AND DISCUSSION
Research after collecting data on patients'
knowledge about stroke relation to compliance
with physiotherapy in the Physiotherapy
Hospital Dr. Terrain Pirngadi 2016
respondents who are stroke survivors 32
people, the obtained results are then processed
and analyzed and presented in a frequency
distribution table. The results of this study
were divided into two parts, the stroke patient
knowledge and compliance of stroke in
patients undergoing physiotherapy. Here is a
frequency distribution and percentage of
respondents.
1. Univariate Analysis
Univariate analysis was conducted to see the
frequency distribution of knowledge and
compliance of stroke patients undergoing
physiotherapy at room Dr.Pirngadi
Physiotherapy Hospital Medan in
Table 4.1
Respondents Frequency Distribution of
Knowledge Based Stroke Living in Space
physiotherapy Physiotherapy Hospital Dr.
Terrain Pirngadi 201
Knowledge Frekuensi Persentase
Good 8 25.0
Enough 15 46.9
Less 9 28.1
Total 32 100.0
Based on table 4.1 above in mind that the
majority of respondents berpengetahun simply
by the number of respondents as many as 15
respondents (46.9%) and respondents were
knowledgeable about as many as 8
respondents (25%).
 Proceeding Patient Safety in Emergency

Table 4.2 3. Chi-Square Analysis

Respondents Frequency Distribution Based Chi-square analysis is said to be significant if
Compliance Knowledge of Stroke with the results of the analysis showed statistically
Undergoing physiotherapy at room Fisioterpi significant correlation between the variables,
Hospital Dr. Terrain Pirngadi 2016 with a value of p <0.05. Based on the research
Obidience Frekuensi Persentase that has been done, the obtained results of chi-
square analysis recapitulation of knowledge of
Submissive 11 34.4
stroke patients with adherence to undergo
Not obey 21 65.6 physiotherapy in the hospital room Dr.
Total 32 100.0 Pirngadi Terrain Physiotherapy 2016, as table
4.4 below
Based on table 4.2 above note that respondents
were obedient as many as 11 respondents Table 4.4
(34.4%) and respondents who do not comply Chi-Square Analysis recapitulation of
as much as 21 respondents (65.6%) Knowledge of Stroke Patients Undergoing
2. The Bivariate Analysis Compliance Physiotherapy room
Bivariate analysis was conducted to determine Physiotherapy at Hospital Dr. Terrain Pirngadi
the relationship between patients' knowledge 2016
about stroke with compliance with Asymp. Sig. (2-
physiotherapy in hospital physiotherapy room Value Df sided)
Dr.Pirngadi Terrain, 2016. Pearson Chi-
7.730a 2 .021
Square
Table 4.3 Likelihood Ratio 10.408 2 .005
Respondents Frequency Distribution Based on Linear-by-Linear
7.227 1 .007
Association
Stroke Patient Knowledge With Compliance
Undergoing physiotherapy in Space N of Valid Cases 32
Physiotherapy Hospital Dr. Terrain Pirngadi a. 2 cells (33.3%) have expected count less than 5. The
minimum expected count is 2.75.
2016
Obediance
Based on the results of Chi-square analysis of
Submassive Not obey Total patient knowledge about stroke relation to
Good 5 3 8 compliance with physiotherapy, obtained p-
Enaugh 6 9 15 value = 0.021 (p <0.05) suggesting that there
Less 0 9 9 is a statistically significant correlation between
patients' knowledge about stroke with
11 21 32 adherence to undergo physiotherapy.
Total
B.Discussion
4.3 Based on the above table it is known that 1. Knowledge of physiotherapy Stroke
the respondents were knowledgeable both with Patients
compliance with physiotherapy as many as Stroke patients' knowledge about
five respondents (15.6%) of respondents who physiotherapy is all the information has been
are knowledgeable both with non-compliance obtained about the patient physiotherapy.
with physiotherapy as many as three Increased knowledge can lead to changes in a
respondents (9.4%), respondents were person's perception and habits. Knowledge
knowledgeable enough to compliance with will influence someone to do something,
physiotherapy as much 6 respondents (18.8%), where the higher the person's knowledge of
respondents were knowledgeable enough to compliance in carrying out physiotherapy
noncompliance with physiotherapy as much as getting better.
9 respondents (28.1%), respondents were From the results obtained from the
knowledgeable about the compliance with respondents, namely, good knowledge of
physiotherapy as 0 respondents (0%). stroke patients as much as 9 respondents
Respondents who are knowledgeable about the (28.1%), stroke patients who are
non-compliance with physiotherapy as much knowledgeable enough as many as 15
as 9 respondents (28.1%) respondents (46.5%), stroke patients who are
knowledgeable about as many as 8

21
Proceeding Patient Safety in Emergency
respondents (25% ). In this study found as
many as 8 respondents (25%) were less
knowledgeable. With the knowledge that less
can be inhibitors of stroke patients in carrying
out physiotherapy therapy that has been
determined.
From the results of the study conducted by
researchers when seen from the characteristics
of knowledge, respondents were
knowledgeable both majority are in the age of
56-65 years of elementary education.
Respondents were knowledgeable enough
majority are at the age of 56-65 years of junior
high school education. Less knowledgeable
respondents are in the age of 56-65 years high
school educated. In Irdawati study (2009), that
knowledge dipengeruhi by the individual's
background and experience and insight, it also
relates to a person's age. The longer a person
undergoing the process of life, will be
followed by increasing one's knowledge.
In accordance with the theory Erfandi (2009)
that, knowledge of stroke patients can be
affected by several things, namely: age,
increasing age will be growing also capture
power and the mindset of someone so that the
knowledge gained, the better. However IQ
decline with age, especially some abilities
such as vocabulary and general ability.
Education can also affect the knowledge, the
higher one's education the easier person to
receive information, but someone with little
education does not mean absolute
bepengetahuan also lower.
2. Compliance Stroke Patients Undergoing
Physiotherapy
Adherence is the extent to which the behavior
of stroke patients in the running of
physiotherapy. From the results obtained
respondent obedient researchers have
physiotherapy as many as 11 respondents
(34.4%) and respondents who do not comply
with physiotherapy as many as 21 respondents
(65.6%).
Compliance patients about stroke can be
influenced by patients' knowledge about
stroke, where the better knowledge about
stroke patients then underwent physiotherapy
stroke patient compliance will be better as
well. In accordance with the theory of Niven
(2012).
From the results of a preliminary survey has
been done the cause of stroke patients do not
comply with physiotherapy because they
assume their stroke disease can not be cured.
22
This is in line with Irdawati (2009) in his
research said stroke patients assume stroke can
not be cured and will suffer a lifetime, while
with good care disability after a stroke can be
minimized, thus the necessary compliance
stroke patients undergoing physiotherapy so
that dependence stroke patients against others
can be minimized.
3. Relationship Knowledge of Stroke Patients
Undergoing Compliance Physiotherapy.
Based on this research, it is known that the
respondents were knowledgeable good and
obedient to undergo physiotherapy as much as
five respondents (15.5%), respondents were
knowledgeable enough and compliant with
physiotherapy 6 (18.8%), respondents were
less knowledgeable and compliant undergo
physiotherapy from 0 respondents (0%). There
are 3 respondents (9.4%) were knowledgeable
good and not obedient to undergo
physiotherapy. This is because the respondents
said that the disease can not be cured anymore
with physiotherapy treatment, respondents also
have been aged 38 years, 40 years and 41
years of high school educated, respondents
came unaccompanied by family. There are
also nine respondents (28.1%) were
knowledgeable enough not obedient to
undergo physiotherapy. This is due to the
majority of respondents who are
knowledgeable enough to be at the age of 56-
65 years of junior high school education, it can
affect respondents' knowledge and compliance
in undergoing physiotherapy. Thus there were
respondents who are knowledgeable enough
not obedient to undergo physiotherapy
This is consistent with the theory
Notoadmodjo (2007), that knowledge is the
establishment of compliance in the health
domain. According to research by Munro
(2007), that the higher knowledge of the
patient, the better the acceptance of
information about pengebotan it receives so
that stroke patients would be obedient in the
treatment of disease.
The results of Bivariate analysis using Chi-
square test was obtained p-value = 0.021 (p
<0.05). Statistically significant p value
indicates that there is a relationship of
knowledge about stroke patients with
adherence to undergo physiotherapy.
Knowledge of physiotherapy is needed by
patients with stroke in the running of
physiotherapy. By knowing about the
physiotherapy treatment of stroke patients to

be noncompliant with physiotherapy, so it can
maximize the function of the patient's limb,
thereby reducing dependence on others
CONCLUSIONS AND
RECOMMENDATIONS
A.Conclusion
Based on the results of researchers who have
conducted research on the relationship stoke
patients' knowledge about compliance with
physiotherapy in the physiotherapy room
Hospital Dr. Terrain Pirngadi 2016 with 32
respondents, it could be concluded as follows:
1. The majority of stroke patients who
underwent physiotherapy in the
physiotherapy room have enough
knowledge with the number of respondents
as many as 15 respondents (46.9%)
2. The majority of stroke patients who do not
comply with physiotherapy in the
physiotherapy room has a 21 respondents
(65.5%).
3. There is a significant relationship between
knowledge of stroke patients with
adherence to undergo physiotherapy in the
physiotherapy room Hospital Dr. Pirngadi
Medan Year 2016. The majority of
knowledgeable enough not comply with
physiotherapy with the number of
respondents was 9 respondents (28.1%).
B. Suggestions
1. For further research is expected to provide
health care to stroke patients who are
undergoing physiotherapy to improve the
knowledge and compliance of stroke
patients undergoing physiotherapy.
2. For Hospital Dr. Pirngadi Medan,
particularly physiotherapy officers in order
to improve health services through health
education on physiotherapy treatment to
stroke patients who underwent
physiotherapy.
3. For institutions / academic is expected to
enhance the knowledge of students in order
to provide health care education memalui
quality healthcare to patients.
4. For patients expected to increase the
knowledge and obedient to undergo
physiotherapy.
REFERENCES
Corwin, E, J., 2009. Buku Saku Patofisiologi.
Jakarta : EGC
Proceeding Patient Safety in Emergency
DetikHealth, 2013. Perawatan Fisioterapi
detik.com
/index.php?query=perawatan+f
isioerapi&siteid=55&fa
Erfandi, 2009. Pengetahuan dan Faktor-faktor
yang mempengaruhi.
http://forbetterhealth.wordpress.com/2
009/04/19/pengetahuan-dan-faktor-
faktor-yang-mempengaruhi
Fisiosby, 2013. Pengertian Fisioterapi.
fisiosby.com/profil/pengertian-
fisioterai/
Heri, P., Makalah Fisioterapi. Medan :
Akademi Fisioterapi
Irdawati, 2009. Hubungan antara Pengetahuan
dan Sikap Pasien Stroke dengan
Perilaku Dalam Meningkatkan
Fungsional Pasca Stroke di Wilayah
Kerja Puskesmas Kartasura.
http://publikasiilmiah.ums.ac.id/bitstre
am/handle/123456789/2038/BIK_BIK
_VOL_2_NO_2_3_Irdawati.pdf?seque
nce=1
Iskandar, j., 2006. Stroke A –Z. Jakarta : BIP
______________, 2011. Stroke : Waspadai
Ancamannya. Jakarta : Andi
Judha, 2011. Sistem Persarafan. Yogyakarta :
gosyen Publishing
Lyna, s., 2011. Unit Stroke. Jakarta : FKUI
Mutaqqin, A., 2008. Asuhan Keperawatan
Klien dengan Gangguan Sistem
Persarafan. Jakarta : Selemba Medika
Nasution, 2007. http:// repository .usu.ac.id
/bitstream/ 29435/4/ Chapter%
20II.pdf
Niven, N., 2012. Psikologi Kesehatan. Jakarta
:Kedokter. EGC
Notoatmodjo, S., 2010. Metode Penelitian
Kesehatan. Jakarta : Rineka Cipta
______________, 2007. Promosi Kesehatan
dan Ilmu Perilaku. Jakarta : Rineka
Cipta
Pinzon, R., 2010, Awas Stroke. Yogyakarta :
ANDI
Price, S. A., 2006. Patofisiologi. Jakarta : EGC
Rosiana, E., 2012. Hubungan Dukungan
Keluarga dengan Kepatuhan
Menjalani Fisioterapi pada Klien
Pasca Stroke di Instalasi
RehabilitasiMedik RSUD Sleman.
Yogyakata. e-
journal.respati.ac.id/.../Jurnal%Eka%2
0Rosiana
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Proceeding Patient Safety in Emergency

Rujito, 2007. Pengaruh Fisioterapi dan Utami, P., 2009. Solusi Sehat Mengatasi
Kekuatan Stroke. Jakarta Selatan : AgroMedia
Otot.http://portalgaruda.org/download WHO, 2010.
_article.php/article-81441&val=4928 http://Keperawatan.unsoed.ac.id/sites/
Suharsimi, A., 2006. Prosedur Penelitian. default/files/BAB%250I_4.pdf
Jakarta : Rineka Cipta Yastroki, 2012. Prevalensi Stroke
Susanto, 2010. Cekal Penyakit Modern. Repository.usu.ac.id/bitstream/…/5/ch
Yogyakarta : ANDI apter%20I.pdf

24
 Proceeding Patient Safety in Emergency

THE DIFFERENCE IN THE ACCELERATION OF WOUND HEALING POST

LAPAROTOMY USING 10% PROVIDONE IODINE AND GENTAMICIN
OINTMENT 0.1%

Soep1, Cecep Triwibowo1, Zainuddin Harahap1

Nursing Department of Poltekkes Kemenkes Medan

Abstract

Background: The Post-operative wound is a wound with particular care to avoid the risk of infections
that could impede the healing process. Gentamicin 0.1% ointment is an aminoglycoside antibiotic,
used to treat different types of bacterial infections, while 10% is providone Iodine is a chemical
substance which has antiseptic properties.
Purpose : the aimed of this study is to determine the difference in the acceleration of wound healing
post-laparotomy using iodine providone 10% with 0.1% gentamicin ointment.
Method : This is a pre-experimental research study. Samples in this study amounted to 28 who were
divided into two groups: group 1 intervening with iodine providine 10% and 2 intervention groups
with gentamicin ointment 0.1%. Statistically using Mann-Whitney test (P <0.05).
Result: in the intervention group with 0.1% gentamicin ointment laparotomy wound heal faster post
as many as 10 people (71%), while the intervention group with 10% iodine providone only 2 (14%)
with a P value of 0.000 (P <0.05)
Conclusion: gentamicin ointment 0.1% accelerating wound healing in patients with post-laparotomy

Keyword: wound healing, gentamicin salap 0,1%, providone iodine 10%

A. Background nosocomial 12.0%, followed by Enterococcus

The Post-operative wound is a wound
with particular care to avoid the risk of
infection that can hinder the healing process
(Potter & Perry, 2004). Research conducted by
WHO showed that about 8.7% of the 55
hospitals which came from 14 countries in
Europe, the Middle East, Southeast Asia and
the Pacific are postoperative wound infections
by as much as 10% of Southeast Asia (Ducel,
2002).
Wound healing is a complex process
involving many cells. An infection of the
wound after surgery is a serious problem for
patients both in the presence of wound
complications both locally and systemically.
Local complications include damage to the
network while systemic complications may
include bacteremia (Suriadi, 2004).
Problems on postoperative wound
Enteric generally caused by gram-negative
microorganisms. Microorganisms are often
found as nosocomial infection include
Escherichia coli, Pseudomonas aeruginosa,
and Staphylococcus aureus. In reporting
Center Of Disease (CDC) in 2003 found
Escherica Coli and Staphylococcus aureus as
the most common cause of infection
Pseudomonas 10.02% 9.02% (Yesti R. 2010).
Wound healing involves the
integration of physiological processes. Wound
healing properties all the same, with variations
depending on the location, severity, and extent
of the injury. There are various ways to
prevent complications in the surgical wound.
One way is to provide an antiseptic or
antibiotic in the treatment of surgical wounds
(Potter & Perry, 2004).
Gentamicin 0.1% ointment is an
aminoglycoside antibiotic, used to treat
different types of bacterial infections,
especially those caused by Gram-negative
organisms. With an indication for the topical
treatment of primary and secondary infections
of the skin caused by bacteria susceptible to
gentamicin (Syamsiah. 2012).
Providone Iodine 10% is a chemical
substance which has antiseptic (kills germs)
both gram-positive and negative so that in this
case, betadine better than rivanol, but betadine
more irritating and more toxic when entering
into a blood vessel (PSIK UGM, 2004).
Wound care techniques that correct
and proper use of medications that can help
accelerate wound healing and reduce the
treatment period and will automatically reduce

25
Proceeding Patient Safety in Emergency

costs. In the post-operative wound care categorized slow if more than 5 days.
Dr.Fauziah Inpatient Surgical Hospital of Statistical analysis Mann-Whitney test was
Bireuen using Iodine providone 10% as an used to determine differences in the
antiseptic and Gentamicin 0.1% as an effectiveness of the treatment of wounds using
antibiotic ointment to prevent complications of gentamicin ointment providone iodine 0.1%
the surgical wound. BLU RSD Dr. and 10% (P <0.05).
FauziahBireuen a referral hospital in Aceh
Health Insurance (JKA) so that the drug C. Result
supply is still fixated on the National Essential Characteristics of respondents
Drugs List (DOEN), especially surgical wound All respondents in this study aged 25-
care room, especially for still using both types 46 (100%) in both groups of gentamicin
of these substances and it is free of charge ointment providone iodine 0.1% and 10%. The
provided by the government. However, the majority of respondents were female 71.5%.
mechanisms and effectiveness of antiseptics Most respondents have private jobs by
and antibiotics are in the acceleration of 57.16%. (Table 1).
wound healing has not been investigated. The Table 1. Characteristics of Respondents
results of this study are expected to provide Gentamicin Providone
input to the knowledge of nurses in ointment 0,1% iodine 10%
implementing interventions for postoperative Characteristics
wound care hospital environment and can of Respondents
F % F %
become a standard of the Operations
Procedures in treating wounds. Age (years)
Results of a preliminary study
0-14 0 0 0 0
conducted by researchers at the Public Service
25-46 14 100 14 100
Board Regional Hospital Dr. FauziahBireuen
>50 0 0 0 0
data showed patients who entered the
operating room from January to June 2012 Sex
recorded 670 patients treated in the SMF Male 10 71.5 10 71.5
Surgery room, and of these 280 people Female 4 28.5 4 28.5
postoperative laparotomy medical diagnosis. Occupation
With the amount of treatment time which Farmer 3 21.42 3 21.42
varies from one patient to another patient, the Private 8 57.16 8 57.16
diagnosis with other diagnoses also there are Civil servant 3 21.42 3 21.42
differences in treatment period, although the
use of antiseptics and antibiotics are the same. Differences acceleration of wound
healing post-laparotomy using gentamicin
B. Method ointment 0.1% and 10% iodine providone
This type of research is the study Pre- The analyses were performed to
experimental research design with one shot determine the difference providone Iodine
case study. The population in this study are Wound Healing Using Gentamicin ointment
patients with postoperative laparotomy in the 10% with 0.1% in patients Post laparotomy in
BLU RSD SMF Surgery Dr. FauziahBireuen, the Surgery room Dr. FauziahBireuen hospital
amounting to 280. The number of samples by Using the Mann-Whitney test.
with the provisions of 10% of the total
population (Arikunto 2010) of 28 patients with Table 2. Test Results Difference Statistics Post
inclusion criteria namely laparotomy patients laparotomy Accelerate Wound Healing Using
postoperative day two, patients received Iodine providone 10% with 0.1% Gentamicin
treatment of wounds using Gentamicin ointment
ointment 0.1% and providone Iodine 10 %, Gentamicin
Providone
and patients there are no other complications. Wound ointment P
iodine 10%
In this study, divided into two groups: group 1 healing 0,1% Value
with intervention providone iodine F % F %
administration, 10% and 2 by administering Faster 2 14% 10 71%
0.000
gentamicin ointment 0.1%. Categorized Slower 12 85% 4 21%
wound healing faster if less than 5 days and Total 14 100 14 100%

26
 Proceeding Patient Safety in Emergency

Based on the above table the majority F. Reference

of respondents who receive wound care with Bertram G. Katzung. (1998). Farmakologi
ointment Gentamicin 0.1% faster in dasar dan Klinik. Edisi VI. Jakarta: EGC
Accelerating Wound Healing laparotomy as publisher.
many as 10 people (71%) compared with the Ducel G. Infeks Nasokimial didunia. accessed
use providone Iodine 10% with a P value of through http://Suparno.blogspot.com.
0.000 (P <0.05) Potter, Patricia A. (2005).Buku Ajar
Fundamental Keperawatan. Edisi 4.
D. Discussion Volume 2. Jakarta: EGC publisher.
Based on the above results, the Post Suriadi. (2004). Perawatan Luka. Edisi 1.
laparotomy wound healing using Iodine Jakarta: CV. SugengSeto.
providone 10% is slow, which is 12 people Yessi Rahardjo, dkk. (2009). Kumpulan
(85%) of the 14 respondents (100%). This is in KuliahFarmakologi. Jakarta: EGC
line with the theory raised by YessiRahardjo publisher.
and Tim Teachers PSIK UGM (2004), that Yessi Rahardjo, dkk. (2004). Providone Iodine
providone Iodine 10% are chemical substances 10% AntiseptikdiRumahSakit. accessed
that have anti-septic (kills germs) either gram- through
positive or negative, so in this case providone http://www.psikugm2004.comyr.com/inde
Iodine 10 % better than rivanol but this is x.php
more irritating substances (create pain and
more toxic when entering into a blood vessel
and the particular circumstances of these
substances can prevent granulation).
While the Post laparotomy wound care
Using Gentamicin ointment 0.1% are cured
faster at 10 (71.42%) out of 14 (100%) of the
respondents. This is in line with the theory
raised by Syamsiah (2012), ie 0.1%
Gentamicin ointment is an aminoglycoside
class of antibiotics used to treat different types
of bacterial infections, especially those caused
by gram-negative organisms with an indication
of the topical treatment of primary and
secondary. In line with the theoretical
described by Kartzung (1998) who said
Gentamicin 0.1% ointment was working to
penetrate Gram-negative through Porin, bind
to the ribosome, thus inhibiting protein
synthesis and the preparation of ointment to
keep the moisture from the wound surface.

E. Conclusion
After an examination of the 28
respondents about the difference in the
acceleration of wound healing post-
laparotomy using iodine providone 10% with
gentamicin ointment 0.1% in the Inpatient
Surgery SMF BLU RSD. Dr. FauziahBireuen
NAD then the conclusion Post laparotomy
wound healing using Gentamicin ointment
0.1% majority recover faster than using iodine
providone 10%.

27
Proceeding Patient Safety in Emergency

THE EFFECT OF EARLY BREASTFEEDING INITIATION ON DURATION

OF THIRD STAGE OF DELIVERY

Hotma Sauhur Hutagaol, Satyawati Sulubara

Prodi Kebidanan Padangsidimpuan

Abstract

The risk of postpartum hemorrhage will occur that could endanger the lives of mother when the
contraction is not good and lengthening of the third stage of labor. Hence Early breastfeeding
initiation is expected to affect the smooth muscle tissue of the uterus to contract thus speeding up the
release of the placenta from the uterine wall and help reduce bleeding after delivery. This study aims
to analyze the effect of early breastfeeding initiation on the duration of third stage of labor. This study
is a cross-sectional comparatif study. The tools used in the research is digital stopwatch, weight scales
and tape meter. Observations of newborns with normal deliveries were implemented early
breastfeeding initiation or not, then measuring the duration of third stage of labor and the duration of
the placenta discharge in both groups. Data were analyzed using the Mann-Whitney test, and the p-
value of <0.05 was considered statistically significant. A total of 32 women were studied (16 in
observation group, 16 in control group). The average duration of third stage of labor in early
breastfeeding initiation group for 08,15 ± 0.3 minutes and the average duration of third stage of labor
in the non early breastfeeding initiation group for 10.23 ± 1.3 minutes. The average duration of the
placenta discharge at early breastfeeding initiation group for 02.15 ± 0.3 minutes and in non early
breastfeeding initiation group for 02.45 ± 1.8 minutes. There is a significant relationship between
early breastfeeding initiation on the duration of third stage of labor with p value 0.030 (<0.05). There
was no significant relationship between early breastfeeding initiation with the duration of placenta
disccharge with p value> 0.05. From the results of this study concluded that early breastfeeding
initiation affect the acceleration duration of third stage of labor. Duration of the placenta discharge
was lower with the early breastfeeding group, though not statistically significant.

Keywords:Early Breastfeeding Initiation, Duration of third stage of labor, Duration of placenta

discharge

INTRODUCTION Early initiation of breastfeeding

The third stage of labor is the part
of labor from the birth of the baby until the
placenta (afterbirth) and fetal membranes are
delivered, also called the placental stage.
Normally the third stage occurs during
10-15 minutes. Lengthening duration of third
stage of labour because of contraction disorder
and un appropriate management could rise the
risk of postpartum hemorrhage and will
endanger the women (Fraser, 2010).
Early initiation of breastfeeding has
great benefits for the baby and the mother who
just gave birth. Beat of the baby's head on the
mother's chest, hands touch and licking of the
baby on the mother's nipple will stimulates the
hormone oxytocin, which will also affect the
smooth muscle tissue of the uterus to contract
thus speeding up the release of the placenta
from the uterine wall and help reduce bleeding
after childbirth (Moore , 2012).
(IMD) is the process of feeding the baby
immediately after birth with his mother's
breastmilk in the first hour of birth. Based on
Riskesdas data in 2010, found the percentage
of early initiation of breastfeeding for less than
one hour as much as 29.3 percent (Riskesdas,
2010; WHO, 2013).
From the above data shows that the
implementation of early initiation of
breastfeeding is still very far from the
expected target. Though the benefits of early
breastfeeding iniatiation at one hour after birth
is very much if done properly. One of which is
in the acceleration speeding expulsion of the
placenta. Marin in the Moore in 2012 says
when skin to skin contact between the baby
and the mother's abdomen happen, the knee
and the baby's legs will suppress the mother's
abdomen like movements to massage will
stimulate uterine contractions that will lower
the risk of postpartum hemorrhage and

28

accelerating the time of placenta delivery
(Marin, 2010; Moore, 2012). Skin to skin
contact has been shown to reduce the length of
the third stage (Marin et al. 2010) and other
authors have proposed that reducing the
duration of the third stage may be the key
indicator in reducing the risk of post partum
haemorrhage (Magann et al. 2005).
So the aim of this study is to analyze
the effects of early breastfeeding initiation on
duration of the third stage of labor.
METHODS
1. Statement of the problem
To analyze the effects of early
breastfeeding initiation on duration of the third
stage of labor.
2. Operational Definition
a. Early Breastfeeding Initiation
Definition : the process of feeding the
baby immediately after birth with his
mother's breastmilk in the first hour of birth
(Roesli, 2008).
b. Duration Of Third Stage Of Labor
Definition : duration of the end of second
stage until the end of third stage of labor.
c. Duration of placenta disharge
Definition : duration of placenta and its
membranes discharge from the sign of its
released.
3. Hypothesis
a. There is significant difference of duration
of third stage of labour between
observation and control group after early
breastfeeding initiation.
b. There is significant difference of duration
of placenta discharge between observation
and control group after early breastfeeding
initiation.
4. Research design
A quantitative paradigm was used in the study.
A cross sectional design which involves both
observation and control group design, an
observation group was used to study the effect
of early breastfeeding initiation on duration of
third stage of labor and placenta discharge and
no intervention in control group.
5. Sample
The sample chosen for the study was women
who fullfilled inclusion criteria; primiparous
women with normal delivery on the third
stage, and exclusion criteria; newborn with
breech presentation, prolong labor, newborn
with complication. Control group was women
Proceeding Patient Safety in Emergency
who fullfilled inclusion and exclusion criteria
but refuse to do early breastfeeding initiation.
6. Tool used
Digital Stopwatch was used to measure the
duration of third stage of labor, Weight Scales
was used to measure the newborn weight and
Tape Meter was used to measure the newborn
length.
7. Procedure
Post partum primiparous women were
approached by the researcher for participation
in the study through interview. The
participants were enrolled for the study based
on their willingness to do early breastfeeding
initiation. 32 women who fullfilled inclusion
and exclusion were be selected and 16
participant were assigned to observation group
with early breastfeeding initiation and 16 to
the control group who refuse to do early
breastfeeding initiation. The researcher
observated the observation group and control
group and measured the duration of third stage
of labor and the duration of placenta
discharge. Active management was used to
both group and had the same midwife.
DATA ANALYSIS
Mann_Whitney-test was used to compare the
observation group and control group data.
RESULTS AND DISCUSSION
Results
Table 1 showing the results of mann_whitney
test of the effect of early breastfeeding
initiation between observation group and
control group on duration of third stage of
labor
Duration of Third Mean ± SD p
Stage of Labor
Observation Group 8.15 ± 0.3
(IMD) 10.23 ± 1.3
0.001
Control Group (Non
IMD)
There is a significant difference between the
observation group (M=8.15 ± 0.3) and control
group (M= 10.23 ± 1.3) of early breastfeeding
initiation on the duration of third stage; p =
0.001.
29
Proceeding Patient Safety in Emergency

12 leading to a reduction on duration of third

10 stage of labor.
8
Lower reduction of duration of
placenta discharge compare to control group,
6
however there is no significant difference
4
between the two grup.
2
Table 1 and 2 shows that early
0 breastfeeding initiation on the observation
IMD Non IMD
group on duration of third stage of labor is
Series1 8.15 10.23 higher than control group, indicating a
figure 1. Mean of duration of third stage of reduction in the duration of third stage of labor
labor between observation group and control with early breastfeeding initiation. The
group. duration of third stage of labor between the
observation group is lower compare to the
Table 3 showing the results of mann_whitney control group and with the Mann_Whitney
test of the effect of early breastfeeding test, statistically siginificant. Based on this,
initiation between observation group and the hypothesis which states that there is
control group on duration of placenta significant difference in the duration of third
discharge stage of labour in the observation group
compare to control group is accepted.
Duration of Mean ± SD Sig
Hence, based on these results, a
Placenta Discharge
conclusion can be drawn that early
Observation Group 2.15 ± 0,3
breastfeeding initiation has a significant effect
(IMD 2.45 ± 1,8
0,2 on the reduction of duration of third stage of
Control Group (Non
labor.
IMD)
Previous studies showed that early
breastfeeding initiation speeding the duration
There is no significant difference between the of third stage of labor. The duration depend on
observation group (M=2.15 ± 0,3) and control the contraction. The contraction will press
group (M= 2.45 ± 1.8) of the early blood vessel and will stop bleed throug
breastfeeding initiation on the duration of arteriola in placenta insertion. With the
placenta discharge; p = 0.2. speeding of third stage of labor duration can
2.5 reduce the potential of post partum
2.4 haemorrage. Third stage of labor occur
2.3
because of uterine contraction which
stimulated by oxytocine hormone. The baby
2.2 will crawl on mothers chest and breast and
2.1 will massage the uterine, babies touch on
2 mother‟s nipple and breast will stimulated
IMD Non IMD production of oxytocine hormone which
Series1 2.15 2.45 stimulated uterine contraction and speeding
duration of third stage of labor (Roesli, 2008;
figure 2. Mean of duration of placenta Purwarini, 2011).
discharge between observation group and Kolifah in her studies showed early
control group. breastfeeding initiation has siginificant effect
in speeding of the placenta discharge (81.8%
DISCUSSION participants). However, there was no
The purpose of the present research significant effect statistically by Mann-
was to study the effectiveness of early Whitney techniques with p value> 0.05, the
breastfeeding initiation on duration of third average time discharge of the placenta was
stage of labor and duration of placenta lower in the early breastfeeding initiation
discharge. group compare to non early breastfeeding
The results of the study indicate that initiation group.
early breastfeeding initiation has had a The sign of placenta discharge are
significant effect on the observation group, starting from signs such as changes in the

30

shape and height of the fundus after the baby
is born, the umbilical cord is seen poking out
through the vulva, their sudden bursts of blood
accompanied by the release of all parts of the
placenta and membranes (Kolifah, 2012).
Early breastfeeding initiation will
stimulate oxytocin hormone which will
stimulated the endometrial cells of the uterus,
causing contractions and reflexs flow is called
the let down reflex oxytocin which will cause
the uterus to contract, helping the release of
the placenta more quickly and reduce the risk
of bleeding (Roesli 2008; Zuhro, 2015).
The same result was showed in sari 2012,
that the risk of post partum haemorrage is
lower with early breastfeeding initiation (Sari,
2012).
If the uterus does not contract
immediately after delivery of the placenta, the
mother can bleed around 350-500 ml / minute.
Uterine contractions will press uterine blood
vessels of the myometrium and stop the blood
flowing through the arteriola of placental
implantation (Purwarini, 2011).
Marin in the Moore in 2012 says the time
of skin to skin contact between the baby and
the mother's abdomen, the knee and the baby's
legs will suppress the mother's abdomen like
movements to massage will stimulate uterine
contractions that will lower the risk of
postpartum hemorrhage and accelerating the
delivery of the placenta (Marin, 2010; Moore ,
2012).
The previous studies by Sari (2013)
showed that 53.8% of respondents with early
initiation of breastfeeding experience the
acceleration process of the third stage
compared with respondents who did not do
early initiation of breastfeeding. Acceleration
of the third stage of labor is influenced by
several factors including injection oxytocin
hormone immediately, controlling traction on
the umbilical cord, uterine massage
immediately after delivery of the placenta
(Sari, 2013).
CONCLUSION
Thus the hypotheses which stated that there is
significant difference between the observation
group and the control group on duration of
third stage of labor were accepted. However,
the hypotheses which stated that there is
significant difference between the obsrvation
group and control group on placenta discharge
were rejected. Thus, it can be concluded from
Proceeding Patient Safety in Emergency
the results of the present study that early
breastfeeding initiation has a significant effect
in reducing the duration of third stage of labor
and an optional choice to reduce the duration
of placenta discharge.
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American Academy of Pediatrics.
Breastfeeding and the use of human
milk. Pediatrics. 2012; 129:e827.
American Academy of Pediatrics, Committee
on fetus and newborn. Hospital stay for
healty term newborns. Pediatrics. 2010;
125-145.
Bergman N. Restoring the original paradigm
for infant care and breastfeeding.
Kangaroo mother care. Niels and Jill
Bergman Production. 2005
Bergstrom A, Okong P, Arvdson RAB.
Immediate maternal thermal respons to
skin to skin care of newborn. Acta
paediatr. 2007: 96(5):655-8. http://
onlinelibrary.wiley.com/doi/10.1111/j.1
6512227.2007.00280.x/abstract;jsessio
nid.
Fraser DM, Cooper MA. Buku ajar bidan
myles. Ed 14. Jakarta: EGC; 2009. Hal.
690-693.
Heinig MJ. Host defense benefit of
breatfeeding for the infant, effect of
breastfeeding duration and exclusivity.
Pediatr clin North am. 2001; 48:105-
123.
JNPK-KR. Paket pelatihan pelayanan obstetri
neonatal emergensi dasar (PONED).
Jakarta; 2008. Hal. 8.7-8.8.
JNPK-KR/POGI. Asuhan persalinan normal &
Inisiasi menyusui dini: Buku Acuan
dan panduan. Ed 3. Jakarta: Jaringan
Nasional Pelatihan Klinik; 2012.
Johnson R, Taylor W. Buku ajar praktik
kebidanan. Editor bahasa Indonesia:
Kurnianingsih S, Ester M. Jakarta;
EGC: 2005. Hal.29-45.
Karlsson H. Skin to skin care: heat balance.
Sweden: Archives if disease in
childhood. 1996; 75:F130-F132.
Kliegman RM. Janin dan bayi neonatus.
Dalam: Ilmu kesehatan anak nelson.
Edisi ke-15, vol.1. Editor edisi bahasa
Indonesia: Wahab AS. Jakarta: EGC;
2012. Hal. 535-541.
Kolifah , Ainun N , Heri Wibowo. Hubungan
Inisiasi Menyusui Dini Terhadap
Kelancaran Proses Pengeluaran
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Plasenta Di Vk Ponek Rsud Jombang.
2012.
McHugh MK. Transisi fisiologis ke kehidupan
ekstrauteri. Dalam: Varney H,Kriebs
JM, Gegor CL, editor. Buku ajar
asuhan kebidanan. Ed 4. Jakarta: EGC;
2008.
Moore ER, Anderson GC, Bergman N,
Dowswell T. Early skin-to-skin contact
for mothers and their healthy newborn
infants (Review). The Cochrane
Library 2012. Issue 5. Diunduh dari:
http:// www. thecochranelibrary.com.
PP RI No.33. Pemberian ASI Eksklusif.
Jakarta. 2012.
Purwarini J, Rustina Y, Nasution Y. Pengaruh
Inisiasi Menyusu Dini Terhadap
Lamanya Persalinan Kala III dan
Proses Involusi Uteri Pada Ibu Post
Partum Di RSUD Kota Jakarta dan
RSUD Kota Bekasi. J. Keperawatan
dan Kebidanan (JIKK), Vol I, No.5
Desember 2011. 251-258
Riskesdas. Riset Kesehatan Dasar. Jakarta:
Badan Penelitian Dan Pengembangan
Kesehatan Kementerian Kesehatan RI.
2010.
Roesli U. Inisiasi menyusui dini plus ASI
eksklusif. Jakarta: Pustaka Bunda;
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Sari NMM, Handayani S. Pengaruh Inisiasi
Menyusui Dini Terhadap Jumlah
Perdarahan Kala IV Persalinan Di
Klinik BPS Ny.Endang Purwati-
Megangsang-Yogyakarta. Jurnal
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02, Juli 2012.
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penelitian klinis. Jakarta: CV.Sagung
seto; 2011.
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 Proceeding Patient Safety in Emergency

WARM COMPRESS ACTION TO REDUCE PAINFUL OF MENSTRUATION

OR DYSMENORRHEA AT SMP N 1 DESA BARU AREA PANCUR BATU
DISTRICT DELI SERDANG REGENCY

Dina Indarsita, Yufdel

Nursing Department of Poltekkes Kemenkes Medan

Abstract

Painful of menstruation or Dysmenorrhea is the imbalance of progesterone in the blood and it can
cause pain, psychological factors also contributed of dysmenorrhea in some women. There were 90%
women had dysmenorrhea problem. This problem is at least disturbing 50% women in reproductive
age and 60-85% girls in teen age, which made many absences at school or office. According Sulastri
research shows that dysmenorrhea had effectted for daily activities and it was caused absences more
than 3 days at school. Poureslami research (2001) in Sulastri research (2006) shows that almost 10 %
teens had „absence rate‟ during one till three days a month or discapable teens to doing daily activities
because of high pain. Many female students who had dysmenorrhea, experienced decrease of
concentration in class and many female students had absences because of dysmenorrhea. The nursing
techniques to reduce dysmenorrhea with uses a warm compress the abdomen, the abdomen masase,
keep body posture being good, exercises or sports,and balanced nutrition. The aim and purpose of this
dedication is to help the female students to doing Warm Compresses Action which can reduce painful
of menstruation or dysmenorrhea. This research had hold on 5th August 2016 at SMP N 1 Desa Baru
Area Pancur Batu District Deli Serdang regency. The objects of this research are the female students
SMP N 1 on 8 and 9 grade as many as 40 students and using demonstration method. After the
demonstration of Warm compresses Action, all of the students were able to doing a warm compress to
reduce painful of menstruation or dysmenorrhea.

Keywords: Warm Compress Action

Introduction problem. This problem is at least disturbing

The adolescence is a phase of dynamic
development in a life. This period is a period
of transition from childhood to adulthood and
marked by growth the development of
physical, mental, emotional, and social (F.J
Monks, Koers, Haditomo, 2002).
The earliest change that appear is the
development of biological. One sign of
adolescent biologically is started a teenage had
menstruation. Menstruation begins at puberty
and the ability of a woman to conceive a child
or reproductive age. Menstruation usually
begins between ages 10 and 16 years,
depending on various factors, including
women's health, nutritional status and body
weight relative to height. However, in reality
many women had experienced menstrual
problems including painful of menstruation or
ordysmenorrhea (Sumudarsono, 1998).
Painful of menstruation or
Dysmenorrhea is the imbalance of
progesterone in the blood and it can cause
pain, psychological factors also contributed of
dysmenorrhea in some women. There were
90% women had experienced dysmenorrhea
50% women in reproductive age and 60-85%
girls in teen age, which made many absences
at school or office (Annathayakheisha, 2009).
Sulastri research (2006) shows that
dysmenorrhea had effectted for daily activities
and it was caused absences more than 3 days
at school. Poureslami research (2001) in
Sulastri research (2006) shows that almost 10
% teens had „absence rate‟ during one till three
days a month or discapable teens to doing
daily activities because of high pain. Many
female students who had dysmenorrhea,
experienced decrease of concentration in class
and many female students had absences
because of dysmenorrhea.
According to Rakhma Astrida
research (2012) shows that female students
who had experienced low pain level
dysmenorrhea were 60 girls (46.5%), medium
pain level dysmenorrhea were 44 girls
(34.1%) and high pain level dysmenorrhea
were 25 girls (19.4%). The non-
pharmacological treatment by using distraction
techniques doing as many as 65 girls (50.4%),
pharmacological treatment by consuming anti-

33
Proceeding Patient Safety in Emergency

pain drugs from small shop doing as many as
16 girls (12.4%). And there was no one of
student doing treatment by consuming the anti
dysmenorrhea pain prescription.
To reduce the dysmenorrhea,
consumed prescribe non-steroidal anti-
inflammatory (eg, ibuprofen, naproxen and
mefenamic acid). This drugs are most effective
if consumed two days before menstruation and
continued until 1-2 days of menstruation.
Beside consumed the drugs, the
dysmenorrhea can also be reduced by: enough
of rest, regular exercises (especially walking),
massage, yoga, warm compresses on the
abdominal area.
The program study of Nursing
Poltekkes Kemenkes Medan is an institution
that participated and support the development
of public health through increased knowledge
about health. The program study of Nursing
Poltekkes Kemenkes Medan is also has a
program Dedications to the Community which
one of them is giving a demonstration about
Warm Compresses Action to reduce painful of
menstruation or dysmenorrhea in SMP N 1
Desa Baru Area Pancur Batu District Deli
Serdang Regency
Method Dedication
Demonstration
Respondent
The female students of SMP N 1 Desa Baru
Area Pancur Batu District Deli Serdang
Regency with total 40 students with details 20
students on 8 grade and 20 students on 9
grade.
Demonstration Procedure
Before doing the dedication activities, the first
thing that should to do was filled the absent
and then filled the Approval Letter
interviewed and filled out questionnaires about
the actions taken when experiencing menstrual
pain, provide materials on the Standard
Operating Procedure (SOP) of Warm
compresses on the pain by using the poster

Standard Operating Procedure (SOP) of Warm Compress in Pain

Meaning
Warm compresses are giving a sense of warmth on
specific areas of body parts that need the warmth by
using liquid or device that causes warm. The warm
compress indicated to arthritis, muscle spasms,
flatulence, and chills.
Purpose
1. Improving blood circulation
2. Lowering the body temperature
3. Reduces pain, relieves pain, possibly by increasing
relaxation on muscle, improves circulation, increases
psychological relaxation, and feel comfortable; worked
as counterirritant
4. Give a sense of warm, comfortable and calm for client
5. Stimulating intestinal peristalsis

Tools and materials Warm Compress Action Procedure

1. Water Warm Zeil 1. Prepare the tools.
2. A thermos of hot water 2. Wash hands.
3. Hot water thermometer 3. First perform the installation of Water Warm Zeil by: filling Water Warm Zeil with
4. Wipe cloth hot water, tighten the lid then flipped positions of Water Warm Zeil repeatedly, and
then empty the contents. Prepare and measure the water (50-60ºc).
4. Fill the Water Warm Zeil with hot water as much as approximately half of the Water
Warm Zeil. Then remove the air by:
 Put the Water Warm Zeil on a table or flat place.
 Fold the top of Water Warm Zeil until the surface of the water is visible in the
Water Warm Zeil neck.
5. Then close the Water Warm Zeil tightly/properly.
6. Check if the Water Warm Zeil is leaking or not and then dry it with a wipe cloth
and insert it into the glove of Water Warm Zeil.
7. Bring the Water Warm Zeil close to the client.
8. Place the Water Warm Zeil or plug in required area.
9. Assess client's condition regularly to know if there are disorders arising by giving
compress with the Water Warm Zeil, such as redness, lack of comfort, leakage, etc.
10. Replace the Water Warm Zeil after 30 minutes in pairs with hot water again, as you
needed.
11. Organize tools when finished.
12. Wash hands.

34
 Proceeding Patient Safety in Emergency

RESULTS
The actions female student of SMPN1 Pancur Batu Deli Serdang Regency took when experiencing
menstrual pain, can be seen in the table below:

Tabel.1
The Actions Female Student of SMPN I Pancur Batu Took when Experiencing Menstrual Pain
NO Action when experiencing menstrual pain Yes % No %
1 Drinking pain reliever medicine 8 20 32 80
2 Drinking hormonal medicine - - 40 100
3 Massage 4 10 36 90
4 Doing warm compresses with Water Warm Zeil 1 2,5 39 97,5
5 Doing warm compress with warm water bottle 1 2,5 39 97,5
6 Doing a cold compress - - 40 100
7 Diverting pain by singing 9 22,5 31 77,5
8 Diverting pain by listening to music 27 67,5 13 32,5
9 Deep breathing techniques 4 10 36 90
10 Gymnastics / Sports 6 15 34 85
11 Drinking herbal medicine 13 32,5 27 67,5

Tabel.2
The Satisfaction of Female Student of SMPN I Pancur Batu on Warm Compress Action
SATISFACTION
NO STATEMENT NO % SATI %
SFIE
D
1 Giving information about warm compresses - - 40 100
2 There is demonstration of warm compresses - - 40 100
3 Time show for 4 hours - - 40 100
4 Conveying a warm compress demonstration - - 40 100

35
Proceeding Patient Safety in Emergency
DISCUSSION
Based on Table 1 above there were 27
female students (67%) which diverts the pain
by listening to music while using water warm
zeil and use a warm water bottle only 1 student
(2.5%).
Looking at the data above this activity
is necessary in SMPN I Batu Pancur. It is due
to that heat or cold compress, which is one of
the nonfarmakologi methods, considered
highly effective in reducing pain cases.
Warm compress is the act by using warm
compress which aims to meet the needs of a
sense of comfort, reduce or relieve pain,
prevent muscle spasms, and gives a sense of
warmth (Uliyah & Hidayat, 2006). According
Asmadi (2008) a warm compress is the
maintenance of body temperature method that
causes warm or cold on body part. The heat
that distributed through hot compresses can
relieve the pain by getting rid of the
inflammation products, such as bradykinin,
histamine and prostaglandins which would
cause local pain. The heat also stimulates
nerve fibers that close the gate so implus
transmission of pain to the spinal cord and the
brain can be inhibited (Price, 2006). In
general, the heat is quite useful for the
treatment and increase the blood flow by using
a hot compress to the tense and painful area
deemed to be able to relieve the pain.
Heat reduces muscle spasm which
caused by ischemia that stimulate neurons that
blocks the further transmission of pain stimuli
caused vasodilation and increased blood flow
to the area that using the compress (Nicholas
and Zwelling, 1997; Simkin, 1995, in Walsh,
2007). The advantage of using dry heat
compresses by Smeltzer & Bare (2002) was
able to increase blood flow to an area, which
can potentially contribute to reduce the pain.
Based on Table 2 above all the female students
expressed satisfaction for this activity. They
said their experience grew especially on warm
compress action by using water warm zeil to
reduce menstrual pain.
Conclusion
After following the demonstration of warm
compress action using water warm zeil, all
female students of SMPN 1 Pancur Batu Deli
Serdang Regency are capable to perform the
warm compress actions with water warm zeil.
36
Suggestion
1. It is hoped that this demonstration and
counseling use an appropriate and easy
language for the female students of SMPN1
Pancur Batu Deli Serdang to make the
female students know more about
preparations for menstrual pain. So the
warm compress actions can perform more
well.
2. It is expected to male students of SMPN 1
Pancur Batu Deli Serdang Regency to
convey information about the warm
compress actions using water warm zeil to
their family and relatives who experience
menstrual pain.
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ajar keperawatan medikal bedah Walsh, V.L. (2007), Buku Ajar Kebidanan
Brunner & Suddarth (Brunner & Komunitas, Jakarta : EGC.
Suddarth‟s text book of Medical William F Rayburn, M.D., 2001. Obstetri dan
Surgical Nursing). Diterjemahkan oleh Ginekologi. Jakarta: Widya Medika.
Agung Waluyo, dkk. Volume III.
Jakarta : EGC.
Sulastri. 2006. Tesis: Perilaku Pencarian
Pengobatan Keluhan Dysmenorrhea
pada Remaja Di Kabupaten
Purworejo Propinsi Jawa Tengah.
Yogyakarta : Universitas Gadjah
Mada. Website :
http//digilib.ugm.ac.id. Diakses
tanggal 17 Juni 2011.

37
Proceeding Patient Safety in Emergency

FERTILE AGE COUPLE RELATIONSHIPS CHARACTERISTICS AND QUALITY

OF SERVICE UTILIZATION OF EQUIPMENT FAMILY PLANNING
CONTRACEPTION IN SOUTH DISTRICT SIBOLGA CITY 2016

Tina Wati Nainggolan

STIKES NAULI HUSADA

ABSTRACT

In the last decade Population program, Family Planning and Family Development stagnated.
Utilization of family planning services still low. North Sumatra province has remained high TFR =
3.0, CPR = 42.8%, and 16.2% Unmet need. Sibolga City in 2015 the amount of Eligible Couples as
many as 12 189 people with an active family planning participants as much as 7920 (64.98%), instead
of as many as 4,269 people planning participants (35.02%) and unmet need as many as 1,809 people
(14.84%). This research is a cross-sectional analytical study design (cross-sectional) with a qualitative
approach to the case that the population of Eligible Couples in the district of South Sibolga as many
as 4,455 people. The sample size was calculated based on the formula samples Lemeshow (1997)
(2013) as many as 260 people. Data analysis method by means of univariate, bivariate analysis (chi-
square) and multivariate analysis (multiple logistic regression) at the 95% significance level. Results
of bivariate analysis, there were 7 variables that have a significant effect, namely education, science,
employment, income, affordability, fairness and sustainability. Results of the logistic regression
analysis there are five variables that significantly affect the incidence of utilization of contraceptive
use that knowledge (OR = 6.347; 95% CI = 2.776 to 14.509), work (OR = 5.331; 95% CI = 2.145 to
13.248), revenue (OR = 4.471; 95% CI = 2,164- 9.236), affordability OR = 3.764; 95% CI = 1.327 to
10.674) and sustainability (OR = 2.740; 95% CI = 1.245 to 6.030). The most dominant variable is
knowledge. Suggested for health workers should be more active to improve the information of
contraceptives through education and counseling. Providers also need to further enhance the quality of
contraceptive services provided to satisfy the people who use contraceptives.

Keywords: Characteristics Eligible Couples, Family Planning Service Quality and Utilization Use of
Contraceptives

BACKGROUND development results will not mean, therefore,

Health development is essentially
directed towards the achievement of
awareness, willingness, and ability healthier
for everyone, involving physical, mental, and
social, cultural and economic.To achieve
optimal health status of various efforts made
comprehensive healthcare services, targeted
and sustainable. Reproductive problems in
Indonesia has two dimensions, namely the first
latent maternal mortality and infant mortality
rates are still high due to various factors
including health care relatively less well
(Kepmenkes RI No 369, 2007).
Program planning services are very
useful in setting a wanted pregnancy and the
prevention of unwanted pregnancy or not
timely, because the program planning services
aimed delay, space or limit pregnancy when
the child is old enough, and cultivate Norma
The small Happy and Prosperous (NKKBS). If
family planning was not done simultaneously
economic development, it will concern the
families are expected to receive the NKKBS
oriented balanced growth (Andhyantoro,
2013).
Indonesia's population growth rate
has decreased in the last three decades.
Between 1980 and 1990, average annual
population growth was 1.98 percent. Between
1990 and 2000 fell to 1.44 percent, but
between 2000 and 2010 slightly increased to
1.49 percent. Maternal Mortality Rate (MMR)
of 359 maternal deaths per 100,000 live births
for the period 2008 - 2012. The maternal
mortality ratio indicates the decrease from
1994 to SDKI 2007, but increased in the SDKI
2012. The latest data the population of
Indonesia in 2013, according Statistics
Indonesia (2014) as many as 248.818 million
while for the North Sumatra province
population was 13.590 million.
The high rate of maternal mortality
due to many factors. One of the indirect causes
of maternal death is the condition of the

38

mother who is not ready to get pregnant, there
are ± 65% due to the condition of 4 too (4T) is
too young (age less than 20 years), too old
(age over 35 years), too often ( Last delivery
distance with early pregnancy is now less than
2 years), and too much (the number of children
more than 4 people) in the hope that the
program of family planning services capable
of reaching the condition. Another factor that
resulted in maternal deaths due to unsafe
abortion complications result in an undesirable
kekamilan unmeet pair neet (couples who do
not want to have children but are not using
contraception) (Manuaba, 2002).
In the last decade this program for
Population, Family Planning and Family
Development stagnated. This is due to
population issues have not been fully
integrated and is not used as a reference in
planning various development sectors in
Indonesia, including in North Sumatra
province, this can be seen from the TFR North
Sumatra province is still high = 3.0, CPR =
42.8%, unmet need is still about 16.2%
(Mulyanto et al, 2014).
In Sibolga city that achievement is
still low acceptors, namely: in 2012 the
number of Eligible Couples as many as 12 115
people with an active family planning
participants as much as 7475 (61.70%) and not
FP many as 4,640 votes (38.30%) and unmet
need as many as 2,407 people (19.87%), in
2014 the number of PUS many as 12 168
people with an active family planning
participants as much as 6,838 (56.20%) and
not FP many as 5,330 votes (43.80%) and
unmet need as many as 2,722 people (22.37
%), in 2015 the number of EFA as many as 12
189 people with an active family planning
participants as much as 7920 (64.98%) and not
FP many as 4,269 votes (35.02%) and unmet
need as many as 1,809 votes (14.84%) .Kota
Sibolga is composed of four sub-districts,
districts where coverage remains low
acceptors for 2015 is South Sibolga districts
with as many as 4,455 the number of Eligible
Couples, where the number of family planning
acceptors Eligible Couples not as much
1.635orang (36.70%), and its need as much as
705 unmeet people (15.82%).
Central Tapanuli, achievement of
acceptors is still higher than the achievement
in Kota Sibolga whose benefit is actually not
in accordance with the target of government:
that in 2013 the number of Eligible Couples as
Proceeding Patient Safety in Emergency
54 112 people, as many as 37,300 active
family planning acceptors (68.9%) of people
and acceptors new participants as many as 11
940 people (22.06%), in 2014 with as many as
54 861 people the number of PUS, active
family planning acceptors as much as 40 702
(68.9%) people and acceptors new participants
as many as 16 683 people (22.06%), the 2015
by the number of Eligible Couples as much as
56 328 people, an active family planning
acceptors as much as 48 803 (68.9%) people
and acceptors new participants as much as 13
616 people (22.06%).
The data above shows that the
utilization of contraceptives in Kota Sibolga is
not as expected, it is seen from the low
coverage of family planning acceptors, the
high level of non FP as well as the high level
of unmet neet at couples of reproductive age
(Eligible Couples) is. Based on the survey, this
is caused by the performance of contraceptive
use in the town of Sibolga such as in health
centers, hospitals or institutions planning
services belonging to other Government not
charged, but in the clinic independently or
practice a private provider is still charged,
Eligible Couples in Kota Sibolga still more use
private facilities planning services, and also in
the particular facility planning services Family
planning services belong to the City of Sibolga
more offers Long Term Contraception method
(LTM) that does not comply with the request
Eligible Couples in Kota Sibolga
Based on the above, the problem in
this research is the correlation characteristics
of couples of reproductive age (Eligible
Couples) and the quality of family planning
services to the utilization of contraceptives in
the District of South Sibolga 2016
The purpose of this study was to
determine the relationship characteristic of
couples of reproductive age (Eligible Couples)
and the quality of family planning services to
the utilization of contraceptives in the District
of South Sibolga 2016
RESEARCH METHODS
This research is a survey of analytic
using cross sectional design (cross-sectional),
which aims to determine the relationship
characteristic of couples of reproductive age
(Eligible Couples) and the quality of family
planning services to the utilization of
contraceptives in the District of South Sibolga
2016.
39
Proceeding Patient Safety in Emergency
Research will be conducted in South
Sibolga Sibolga City South. The study was
conducted in June 2016.
The population in this study were all
couples of reproductive age (Eligible
Couples), which has become acceptors (FP
active) and not neet Unmeet FP and in the
District of South Sibolga City Sibolga as many
as 4,455 people (Sibolga BKKBN).
RESULTS AND DISCUSSION
Respondents Utilization Characteristics
relationships Contraceptives in the District
of South Sibolga City Sibolga
The results showed that most
respondents have an education with High
category (high school / equivalent and college
/ PT) as many as 222 respondents (85.4%).
Most respondents stated that the utilization of
family planning services in the District of
South Sibolga City Sibolga is not used (not
users) that as many as 136 respondents
(52.3%).
The results of analysis of the
relationship of education to the utilization of
Contraception found that less educated
respondents more likely to not be Acceptor as
many as 31 respondents (11.9%), highly
educated respondents more likely to be
Acceptor as many as 117 respondents (45%) ,
chi-square test results obtained by value p =
0.000 <0.05, meaning that there is a
relationship of education to the utilization of
Contraception
Education is a basic human need
that is very important to develop themselves,
because with higher education one can have a
better knowledge. The results of this study
prove that maternal education has a close
relationship with the utilization of
Contraception. This shows that the higher the
mother's education, the more knowledgeable
knowledge and insights, so that the role of
mothers' education greatly affects family
behavior towards utilization of Contraception.
But from the regression analysis
found that the variable education with p value
0.527 (p> 0.05) did not affect the utilization of
contraceptives in Kota Sibolga. This can be
explained that even though higher education
respondents no relation to utilitasi
penggunanaan contraceptives. It can be seen
from the interviews that the majority of
respondents did not support the higher
40
education of knowledge and understanding
about contraception.
"Officers KB, cadres, types - types
of contraceptives as much as to be ready,
but the lack of knowledge or a wrong
perception so many who do not want
family planning. But strangely education
that the average PUS herein minimal
education high school graduates
"(Informant 1)
The results showed that most
respondents had a good knowledge of the
category as many as 185 respondents (71.2%).
Most respondents stated that the utilization of
family planning services in the District of
South Sibolga City Sibolga is not used (not
users) that as many as 136 respondents
(52.3%).
According to Green that the
formation of behavior is strongly influenced
behavior in themselves (behavior cause) and
external behavior (behavior causes), the
formation of human behavior one of them as a
result of the trust and confidence even though
she already knew (Notoatmodjo, 2007)
Results Logistic regression analysis
found that the variable most dominant
influence the utilization of contraceptives in
Kota Sibolga is variable knowledge with OR
of 6.347 (95% CI = 2.776 to 14.509) means
that respondents who have a good knowledge
6.347 times the tendency to be Acceptor KB
compared to respondents who have less
knowledge. Low utilitasi penggunana KB can
be influenced by the knowledge that is still
less than the respondent in accordance with the
results of the interview.
"Officers KB, cadres, types - types
of contraceptives as much as tbe ready, but
the lack of knowledge or a wrong
perception so many who do not want
family planning. But strangely education
that the average PUS herein minimal
education high school graduates
"(Informant 1)
"It's been a lot of activity of family
planning services is that Eligible Couples
was like family planning, tool - a tool
contraseption everything fitting together
take free, I think Eligible Couples ga
willing family planning was the reason they
were from the first that he dilaranglah,
abstinence he use birth control because it
inhibits the fortune of God, fear of family
planning use, want to have children again.

Eligible Couples I think it has a wrong or
mistaken understanding of family planning.
(Informant 2)
The results showed that most
respondents have the status of a job working
as many as 192 respondents (73.8%). Most
respondents stated that the utilization of family
planning services in the District of South
Sibolga City Sibolga is not used (not users)
that as many as 136 respondents (52.3%).
The results of the analysis of the
employment relationship to the utilization of
Contraception found that respondents who do
not work more that do not become Acceptor
KB namely 60 respondents (25%),
respondents who work more are becoming
Acceptor as many as 116 respondents (44.6%),
chi-square test results obtained by value p =
0.000 <0.05, meaning that there is a
relationship of work on utilization of
Contraceptives
The results showed that most
respondents have incomes with high category
that 170 respondents (65.4%). Most
respondents stated that the utilization of family
planning services in the District of South
Sibolga City Sibolga is not used (not users)
that as many as 136 respondents (52.3%).
The results of the analysis of the
relationship of income to the utilization of
Contraception found that lower income
respondents were more who did not become
Acceptor KB as many as 70 respondents
(26.9)%, both high-income respondents more
likely to be Acceptor as many as 104
respondents (40% ), chi-square test results
obtained by value p = 0.000 <0.05, meaning
that there is a relationship of income to the
utilization of Contraception.
Table 1. Characteristics of Eligible Couples
Anticipated Distribution Influence
Contraceptive Utilization in District South
Sibolga City Sibolga 2016
Karakteristik
Penderita yang
Diduga
Frekuensi Persentase
Berpengaruh
No. (n) (%)
terhadap
Utilisasi Alat
Kontrasepsi
1 Pendidikan
Rendah (SD, 38 14,6
SLTP/sederajat)
Tinggi 222 85,4
(SMA/sederajat
& akademi/PT)
Proceeding Patient Safety in Emergency
2 Pengetahuan
Kurang baik 75 28,8
Baik 185 71,2
3 Pekerjaan
Tidak bekerja 68 26,2
Bekerja 192 73,8
4 Pendapatan
Rendah 90 34,6
Tinggi 170 65,4
Total 260 100
Based on the above table it can be
seen that most respondents have an education
with High category (high school / equivalent
and college / PT) as many as 222 respondents
(85.4%), Most of the respondents have good
knowledge with as many as 185 categories of
respondents (71, 2%), Most of the respondents
have the status of a job working as many as
192 respondents (73.8%), Most of the
respondents have incomes with high category
that 170 respondents (65.4%)
Relationship Quality planning services to
the utilization of Contraceptives in the
District of South Sibolga City Sibolga
The results showed that most
respondents stated that family planning
services in the District of South Sibolga City
Sibolga is affordable at a total of 220
respondents (84.6%). Most respondents stated
that the utilization of family planning services
in the city of Sibolga that is not used (not
users) that as many as 136 respondents
(52.3%).
The results of the analysis of the
utilization Affordability relationship
Contraception found that respondents who
consider affordable family planning services
are not more not being Acceptor KB as many
as 33 respondents (12.7)%, respondents who
consider family planning services are
becoming more affordable KB acceptors as
many as 117 respondents (45%), chi-square
test results obtained by value p = 0.000 <0.05,
meaning that there is a connection to the
utilization Contraceptive Affordability.
Logistic regression analysis results
obtained that there are significant affordability
of utilization of contraceptives. Affordability
Family planning services are services that are
accessible to the Eligible Couples in terms of
cost, which means the service is not expensive.
It is also supported by the results informant
interviews that family planning services
assume Kb does not burden the family.
41
Proceeding Patient Safety in Emergency

Informants who did not participate Kb also Table 2. Distribution of Quality of planning
hoped that the cost of KB free. services in the District of South Sibolga City
"If the problem of cost, I think for Sibolga 2016
family planning is not too burdensome Frekuens Persentas
No Kualitas
financial and midwife and there is i e
. Pelayanan KB
always a place" (Informant 5) (n) (%)
"Tools his kontrsepsi free, not pay 1 Keterjangkauan
and are available in clinical practice Tidak terjangkau 7 5,6
midwife" (Informant 6) Terjangkau 117 94,4
"So that all family planning service 2 Kewajaran
is free" (Informant 9) Tidak wajar 17 13,7
The results showed that most Wajar 107 86,3
respondents stated that family planning 3 Kesinambungan
services in the District of South Sibolga City Tidak 20 16,1
Sibolga is felt reasonable that as many as 210 berkesinambunga
respondents (80.8%). Most respondents stated n
that the utilization of family planning services Berkesinambunga 104 83,9
in the District of South Sibolga City Sibolga is n
not used (not users) that as many as 136 Total 124 100
respondents (52.3%).
The results of the analysis of the Based on the above table it can be
utilization of the Fairness relationship seen that the majority of respondents stated
Contraception found that respondents who that family planning services in the District of
consider family planning services more South Sibolga City Sibolga affordable as many
unnatural not being Acceptor KB as many as as 117 respondents (94.4%), Most of the
33 respondents (12.7)%, respondents who respondents stated that family planning
consider family planning services are services in the District of South Sibolga City
becoming more reasonable KB acceptors as Sibolga is felt reasonable that as many as 107
many as 107 respondents (41.2%), chi-square respondents (86.3%), Most of the respondents
test results obtained by value p = 0.031 <0.05, stated that family planning services in the
meaning that there is a relationship of Fairness District of South Sibolga City Sibolga
to the utilization of Contraception. sustainable as many as 104 respondents
"There were paired contraception (83.9%).
mother was not menstruation, or menstrual
out a bit and not smooth, or some are Relationship Continuity planning services
complaining of dizziness" (Informant 3) to the utilization of Contraceptives in the
"Menstruation not regular, weight District of South Sibolga City Sibolga
gain" (Informant 4) The results showed that the majority
Quality health services is health care of respondents stated that the majority of
that can satisfy every health care service users family planning services in the District of
in accordance with an average satisfaction South Sibolga City Sibolga sustainable as
level of residents, as well as the many as 197 respondents (75.8%). Most
penyelengaraannya accordance with the code respondents stated that the utilization of family
of ethics and standards of professional services planning services in the District of South
that have been set (Anwar, 1995). Health care Sibolga City Sibolga is not used (not users)
as better quality services if such services are that as many as 136 respondents (52.3%).
reasonable, in the sense that can address the The results of the analysis of the
health problems faced relationship Continuity utilization
Contraception found that respondents who
consider family planning services are not
sustainable over many not be Acceptor KB as
many as 43 respondents (16.5%), respondents
who consider family planning services are
becoming more sustainable KB acceptors as
many as 104 respondents (40%), chi-square

42

test results obtained by value p = 0.004 <0.05,
meaning that there is a relationship Continuity
of the utilization of Contraception
Logistic regression analysis results
obtained that there are significant continuity of
the utilization of contraceptives. Continuity
planning services are services provided at any
time both in terms of personnel planning
services and availability of contraceptives. It
can be seen from the results of interviews with
informants that affect the sustainability factor
acceptor to use contraceptives
"If any want to place KB midwife
and there is always a place" (Informant 5)
"Contraceptive tool available in clinical
practice midwife" (Informant 6)
Quality health services is health care
that can satisfy every health care service users
in accordance with an average satisfaction
level of residents, as well as the
penyelengaraannya accordance with the code
of ethics and standards of professional services
that have been set (Anwar, 1995).
Table 3. Distribution of Contraceptives in
the District of South Sibolga City Sibolga
2016
Utilisasi Alat Frekuensi Persentase
No
Kontrasepsi (n) (%)
1 Tidak akseptor 110 42,3
(tidak
dimanfaatkan)
2 Unmeet need 26 10,0
3 KB aktif 124 47,7
(dimanfaatkan)
Total 260 100
Based on the above table it can be
seen that the majority of respondents stated
that the utilization of family planning services
in the District of South Sibolga City Sibolga is
not used (not users) that as many as 136
respondents (52.3%).
CONCLUSION
From the research that has been
done it can be concluded as follows:
1. Variables that affect the utilization of
contraceptives is knowledge, employment,
income, affordability and sustainability.
2. The majority of respondents have a good
knowledge ie 71.2% of the utilization of
Contraceptives in the District of South
Sibolga 2016.
Proceeding Patient Safety in Emergency
3. From the variable job that Eligible Couples
majority of work is as much as 73.8% in
the District of South Sibolga 2016.
4. From the income variable that
PUSmayoritas have a high income is as
much as 65.4 5 in the district of South
Sibolga 2016.
5. There is the influence of the quality of
service affordability as many as 84.6% of
the utilization of Contraceptives in the
District of South Sibolga 2016.
6. There is the influence of service quality that
is as much as 75.8% continuity of the
utilization of Contraceptives in the District
of South Sibolga 2016.
SUGGESTION
Based on the research that has been done, as
for that are suggestions in this study are:
For the Department of Health and BKKBN
Sibolga city.
a. Based on this research, it is known that
knowledge is the most dominant variable
related to utilization of contraceptives in the
district of Sibolga South, therefore it is
necessary to improve knowledge of the EFA
on contraception through counseling,
counseling as well as through other media to
increase users of contraceptives in the district
of Sibolga South and the health workers who
provide family planning services should be in
providing information about contraceptives
need to communicate and socialize on a
regular basis, for example in health seminars
or through other media such as brochures and
electronic media.
b. Based on the results of the study, that the
quality of service in terms of affordability
largely been covered by the Eligible Couples,
but we recommend the installation of
contraception is free at the health care facility
as a whole, both in facilities owned by the
Government and independent health facilities.
c. Based on the results of the study, that the
quality of service in terms of sustainability is
expected that supplies of contraceptives is
always available whenever needed by Eligible
Couples in health care facilities
For Further Research
Suggested for further research
conduct research related to the utilization of
services of contraceptives with different
research methods that diharpkan capable of
more peeling and deep understanding of the
utilization of contraception and about the
43
Proceeding Patient Safety in Emergency

quality of family planning services, besides
further research can also apply theories of
utilization of health services, especially
services tool contraception
For the Community
It is recommended that people
continue to support the program of the
Government is to reduce population growth,
and motivate spouses of fertile age (PUS) to
use contraceptives.
Mulyanto, 2013, Keluarga Berencana dan Alat
Kontrasepsi, Cetakan I Nuha Medika,
Jakarta.
Notoadmodjo S, 2012, Metodologi Penelitian
Kesehatan, Cetakan ke –IV Rineka
Cipta Jakarta.

DAFTAR PUSTAKA
Azwar A, 1995, Pengantar Administrasi
Kesehatan, Edisi III, Bina Rupa
Aksara, Jakarta.
Hidayat, Alimul Azis, 2010, Metode
Penelitian dan Teknis Analisis Data,
Jakarta Salemba Medika.
Manuaba, 2004, Ilmu Kebidanan, Penyakit
Kandungan dan Keluarga Berencana
Untuk Pendidikan Kebidanan, Edisi I
Buku Kedokteran EGC, Jakarta.

44
 Proceeding Patient Safety in Emergency

OVERVIEW THE TRAFFIC POLICE KNOWLEDGE REGARDING

THE ALGORITHM OF BASIC LIFE SUPPORT (BLS)
IN MEDAN 2015

Amira Permata Sari Tarigan, Endang Susilawati, Yenny Irdayani Nasution

Nursing Department of Poltekkes Kemenkes Medan

Abstract

Traffic accident will be the seventh biggest human killer in the world, so that intervention Basic Life
Suppeort with a good algorithm is very important to reduce the death rate of victims of accidents.
This study aimed to look at the level of knowledge of traffic police on the algorithms of Basic Life
Support in Medan Police Traffic Unit. The method used in this research is the deskriptive method
with cross sectional study design. The sampling technique used was purposive sampling with number
of sample was 36 respondents. The results of this study indicate the level of knowledge of traffic
police in the poor category is 23 respondents (63.9%), respondents who have enough category was 13
respondents (36.1%) and no respondents who have good category. Therefore we can concluded that
the level of knowledge of traffic police in Medan was poor category.

Keywords: Algorithm of basic life support, knowledge, traffic police

Background event in 2012 increased to 117. 949 in 2013

A comfort of transport is the most
important thing for the community, so that the
progress of technology continues to grow to
balance out the many types of motorized
vehicles to date. It raised the likelihood that
the number of vehicles within a certain time
continues to increase, but not worth the
additional infrastructure or traffic
infrastructure. According to data from the
Central Statistics Agency in 2015, the official
number of registered motor vehicles in
Indonesia in 2013 was 104 118 969 units. An
increasing number of motor vehicles is one of
the biggest causes of the high rate of traffic
accidents.
Traffic accidents are terrible things
happening in many countries. World Health
Organization (WHO) predicts that by 2030
traffic accidents will be the seventh biggest
human killer in the world. WHO noted that
1.25 million people died in traffic accidents
every year and between 20-50 million people
was injured by traffic accident with much
cause disability.
According to the Department of
Transportation, traffic accidents became the
number three cause of death in Indonesia after
a heart attack and stroke. Indonesia reported to
increase the number of traffic accidents by
more than 80 percent. The Indonesian Central
of Statistics Agency reported that the traffic
accident number was increased from 108.696
and caused 26. 416 severe injuried and
110.448 minor injuried, material losses
reached 255 864 million (Office of Police
Indonesia).
North Sumatra Province is a province
of the accident figures are still relatively high.
Changes in the number of accidents last 3
years the incidence decreased significantly. In
2011 there were 17.137 traffic accident scene,
decreased in 2012 there were 8.188 incident,
and further declined in 2013 to 4,954 events
(Central of Statistics Agency).
A preliminary survey conducted in
Medan Police Traffic Unit, founded that the
number of traffic accidents in Medan annually
changing. In 2013 there were 1,339 cases of
accidents, decreased in 2014 to 1,326 cases of
accidents, and the increase in 2015 is still
running into 1,467 cases of accidents. By
2015 consisted of 227 deaths, 848 severe
injuries, 823 minor injuries.
Condition of accident victims can be
further terminal if not treated quickly. The first
hour is a very important time in the handling
of rescue accident victims that can hit up to
85% of deaths. Handling here was meant
Basic Life Support or BSL. BLS can be
interpreted as an effort to maintain a person's
life is being threatened his life (Frame, 2003,
in Suharty Dahlan). Frame also said that the
BLS should be given to victims who suffered
respiratory arrest, cardiac arrest, and bleeding.

45
Proceeding Patient Safety in Emergency
BLS skills can be taught to anyone.
Every adult should have the skills of . All
levels of society should also be taught about
the basic life support especially for workers
with regard to the safety of aid delivery. Skills
and application BLS depending on the
training, experience, and confidence (AHA,
2015). For the success of basic life support,
should know what to do first by knowing the
algorithm of BLS. BLS algorithm is a scheme
that is carried out systematically and can be
easily understood.
Witness (people who were near the
incident) is a vital relationship between
medical care and victims. Usually a Witness
was the first to recognize a situation as an
emergency and act to help the victims. To
assist in an emergency, the first witness should
be noticed that there is something wrong,
usually the appearance or behavior of someone
or surrounding indicate that something unusual
has happened.
At any given moment, each person
must decide whether to help others. Likely to
be more involved if previously thought of to
help others. Therefore, the most important
time in making the decision to help is before
ever find emergency situation.
WHO recommends to the government
to prevent traffic accidents in order to take
action to address road safety in a holistic
manner, which requires the involvement of
various sectors of transport, police, health and
education in order to discuss about the safety
of roads, vehicles and road users themselves.
The traffic police is the principal element of
the implementation of which is under the
Chief of Police, who carry out the task of
implementation of the highway patrol and the
handling of a traffic accident as stated in the
Regulation of the Head of Indonesian Police
No. 15 of 2013 about procedures for the
handling of a traffic accident. It shows that the
BLS skills be important to be known by the
police in an effort to carry out tasks that have
been entrusted to the traffic police.
Research that conducted by Elda Hutapea
Lunera in 2012 entitled overview of the
level of knowledge of traffic police on basic
life support, showed the results of most of the
traffic police in Depok have a level of
knowledge of Basic Life Assistance (BLS) in
the poor category.
Preliminary results conducted by
researcher at the Traffic Police Medan in
46
December 2015 showed 181 traffic police are
still actively working in the Traffic Police of
Medan, which consists of 20 people on duty in
the unit Accidents and has been getting a
seminar on first aid on the victim accidents
collaboration with Ministry of Health.
The result of interviewed with some
of the traffic police when preliminary studies,
when an accident and there were reports of
police community closest to the scene of the
crime will go directly to the crash site and
rescue the accident victims by providing first
aid needed by the victim. Researchers also
informed that the National Police Academy
has been given learning about first aid.
Knowledge of te traffic police regarding the
fisrt aid to accident victims need to be
investigated whether using the correct
techniques and methods in an attempt to save
the lives of victims of traffic accidents.
Research conducted by Ambarwati in
2015 entitled relationship between the level of
knowledge with the attitude of traffic police on
basic life support (BLS) showed most of the
traffic police in the Traffic Accident Unit had
the level of knowledge about Basic Life
Support (BLS) in the fair category.
According the background, researcher
interested in conducting research titled
"Overview The Traffic Police Knowledge
regarding the algorithm of Basic Life
Supports at Medan in 2016.
Method
This research method is descriptive
with cross sectional design. This method was
designed to make measurements or
observations to determine the internal factors
that affected the level of knowledge of traffic
police on the Algorithm of Basic Life Support.
Result
Tabel 3.1
Caracteristics of respondent's education at
Medan Traffic Police Unit
No Education Frekuency Percent
1. High School 32 88,9
2. 3 year Diploma 0 0
3. Bachelor Degree 4 11,1
4. Postgraduate 0 0
Total 36 100,0
 Proceeding Patient Safety in Emergency

From the table above showed that the majority Diagram 3.1
of respondents have a high school education Caracteristics of respondent's level of
level knowledge based on education at Medan
Tabel 3.2 Traffic Police Unit
Caracteristics of respondent's work period
100%
at Medan Traffic Police Unit
No. Work Frekuenc 72%
Percent Good
Period y
1. < 5 years 2 5,6 28% Fair
2. 5-10 years 1 2,8
0 Proor
3. > 10 years 33 91,7
Total 36 100,0
High School Bachelor degree
Tabel 3.3 From diagram 3.1.above, we know that
Caracteristics of respondent's age at Medan majority of level of knowledge of high school
Traffic Police Unit respondents was poor.
No Age Frekuenc
Percent
(years) y Diagram 3.2
1. 20-44 26 72,2 Caracteristics of respondent's level of
2. 45-59 10 27,8 knowledge based on work period at Medan
Total 36 100,0 Traffic Police Unit
100% 100%
From the table, it can be seen that the majority
of respondents work period is more than 10 69%
years Good
Tabel 3.4 31%
Caracteristics of respondent's informations Fair
resources at Medan Traffic Police Unit 0 0
Poor
No. Information
Frekuency Percent < 5 years 5-10 > 10
Resources
years years
1. Training 7 19,4
2. Reading From diagram 3.2. above, we know that all of
29 80,6
resources the respondents who had worked less than 10
Total 36 100,0 years have a poor knowledge regarding the
algorithm of BLS
Fram the table 3.4., we knowed that Majority
of respondents informations resources is Diagram 3.3
Reading Caracteristics of respondent's level of
Tabel 3.5 knowledge based on age at Medan Traffic
Caracteristics of respondent's level of Police Unit
knowledge at Medan Traffic Police Unit 73%
No. Knowledge Frekuency Percent
60%
1. Good 0 0
2. Fair 13 36,1
3.. Poor 23 63,9 40% Good
Total 36 100,0 27% Fair

From the table above, it can be seen that the Poor2

majority of respondent have a poor
knowledge, and no one have a good
knowledge. 20-44 years 45-59 years

47
Proceeding Patient Safety in Emergency
From diagram 3.3, we know that the older
respondent have a better knowledge than the
younger respondents
Diagram 3.4
Caracteristics of respondent's level of
knowledge based on reading resources at
Medan Traffic Police Unit
100%
79%
Good
Fair
21%
0 Poor
Training Reading
From diagram 3.4, we know that the
respondents who got informations from
training have a better knowledge regarding
the algorithm of BLS than the respondents
who got the informations with reading
Discussion
The level of knowledge regarding
BLS based on this research was vary greatly.
The results of this study also had a gap where
no respondents who have a good level of
knowledge. Respondents with sufficient
knowledge of as many as 13 people and
respondents with less knowledge of as many
as 23 people. The results of this study indicate
that the general level of knowledge about
algorithms BHD included in the poor category.
According Notoatmojo 2003,
knowledge is the result of "know" and this
occurs after the hold sensing to a particular
object. Sensing the object occurs through the
human senses of sight, hearing, smell, taste
and touch with his own. At the time of sensing
to generate such knowledge is strongly
influenced by the perception of the intensity of
attention to the object. Most human knowledge
is obtained through the eyes and ears (A.
Henry and Dewi M., 2011).
Researchers found the level of
knowledge of traffic police largely categorized
less, it is influenced by the respondents'
education level. Overall less knowledgeable
respondents who have a high school education
background. Education affected the learning
process, the higher one's education the easier
the person receiving the information.
48
Knowledge is closely related to education
where a highly educated person it will be more
knowledgeable knowledge (Henry and
Goddess, 2011).
Lack of knowledge about the
algorithm of BLS addition affected by
education can also be influenced by the source
of information. Most of the traffic police have
the resources through the reading materials
they get that information when the period of
police education and so most of the traffic
police said it was not given information about
the algorithms of BLS. The more information
obtained will increase one's knowledge
because the knowledge will lead to the
awareness that a person will act in accordance
with his knowledge (Notoadtmojo, 2007).
Based on the source of the respondents
are only 7 police got the information about
BLS through training of health workers. The
result of the respondents' knowledge through
training resources have sufficient knowledge
level. Respondents said they get the training is
long enough and when there is an accident of
respondents rarely found the victim at the
scene directly, so the respondents did not held
BLS. Knowledge of respondents with
resources through training higher than
respondents with resources knowledge through
reading sources. Results of the training-related
research according to the research results
Ambarwati 2015 stating that there is
influenced theoretical BLS training on the
level of knowledge.
Conclusion
The results illustrated that 63.9% of traffic
police in Medan traffic Police unit have a
poor knowledge regarding the algorithm of
basic life support
References
American Heart Asosiation. 2015. Fokus
Utama Pembaruan Pedoman American
Heart Asociation untuk CPR dan ECC.
Guildelines.
Ambarwati. 2015. Hubungan Antara Tingkat
Pengetahuan dengan Sikap Polisi Lalu
Lintas tentang Bantuan Hidup Dasar
(BHD) di Unit Laka dan Patroli Satlantas
Polresta Surakarta. Program Studi S-1
Keprawatan, Stikes Kusuma Husada
Surakarta.
 Proceeding Patient Safety in Emergency

Badan Pusat Statistik. 2015. Jumlah Satlantas Polresta Medan. 2015. Data Laka
Kecelakaan, Koban Mati, Luka Berat, Lantas Kota Medan.
Luka Ringan, dan Kerugian Materi yang Saputra, dr Lyndon. 2013. Keterampilan
Diderita Tahun 1992-2013. Dasar Perawatan dan Bidan.
http://www.bps.go.id/linkTabelStatis/vie Tanggerang: Binapura Aksara.
w/id/1415, [accessed 10 Desember 2015] Sartono & dkk, 2014. Basic Trauma Cardiac
-------------------. Perkembangan Jumlah Life Support. Indonesia: Gadar Medik
Kendaraan Bermotor Menurut Jenis Setiadi, 2013. Konsep dan Praktik Penulisan
tahun 1987-2013. [online] Available Riset Keperawatan. Yogyakarta:
at:http://www.bps.go.id/linkTabelStatis/vi Graha ilmu.
ew/id/1413, [accessed 10 Desember Sukardi, Prof, 2011. Metodologi Penelitian
2015] Pendidikan. PT Bumi Aksara. Jakarta.
Berita Republik Indonesia. 2013. Peraturan Soekidjo, Notoatmodjo. 2012. Metodologi
Kepala Kepolisian Negara Republik Penelitian Kesehatan. Jakarta: Rineka
Indonesia Nomor 15 Tahun 2013 Tentang Cipta.
cara Penanganan Kecelakaan Lalu Undang-undang Republik Indonesia. 2002.
Lintas. Undang-undang Republik Indonesia
Dahlan, Suharty & dkk. 2014. Pengaruh Nomor 2 Tahun 2002 tentang
Pendidikan Kesehatan Tentang Bantuan Kepolisian Negara Republik
Hidup Dasar (BHD) terhadap Tingkat Indonesia.
Pengetahuan Tenaga Kesehatan Di Wawan A. & M. Dewi, 2011. Teori
Puskesmas Wori Kecematan Wori Pengukuran Pengetahuan, Sikap dan
Kabupaten Minahasa Utara. Fakultas Prilaku Manusia. Yogyakarta: Nuha
Ilmu Keperawatan, Universitas Sam Medika.
Ratulangi Manado. WHO. 2015. Road Traffic Injuries. [online]
FK Unsila. 2012. Buku Panduan Skill Lab Available at:
Kegawat Daruratan Medik. http://www.who.int/mediacentre/facts
Hardisman. dr, 2014. Gawat Darurat Medis heets/fs358/en/, [accessed 27
Praktis. Yogyakarta: Gosyen Publishing. Desember 2015]
Hutapea, Elda Lunera. 2012. Gambaran
Tingkat Pengetahuan Polisi Lalu Lintas
Tentang BHD di Kota Depok. Depok:
Fakultas Ilmu Keperawatan, Universitas
Indonesia.
Kamus Besar Bahasa Indonesia. 2016. Polisi
Lalu lintas. [online] Available at:
http://kbbi.web.id/polisi. [accessed 08
January 2016]
Muwarni, Arita. 2009. Keterampilan Dasar
Praktek Klinik Keperawatan. Yogyakarta:
Fitramaya.

49
Proceeding Patient Safety in Emergency

THE EFFECTIVENESS TEST OF STOCKS GALENIKA ALOE-LAW (Sansivieria

trifasciata Prain) FOR THE DECREASE OF BLOOD GLUCOSE LEVELS IN MICE
WITH METFORMIN AS COMPARATIVE

Masniah, Rosnike Merly Panjaitan, Masrah

Lecture Staff in Polytechnic Health Ministry of Medan, Pharmacy Department

ABSTRACT

Diabetes mellitus is caused by a deficiency of the insulin hormone functions utilize glucose for energy
and the synthesis of fat, so the lack of insulin can lead to increased the levels of glucose in the blood.
Traditionally Aloe-law (Sansivieria trifasciata Prain) used for cough medicine, diarrhea and diabetes,
respiratory infections and also can treat hemorrhoids . The purpose of this research is to test the
effects anti- diabetic galenika dosage preparation of stew of Aloe-Law (rdlm), infuse of Aloe-law
(idlm) and ethanol extract of Aloe-law (edlm) in mice which were given solution of glucose 30%.
Type of this research is true experimental, with design pretest-posttes with control group. This
research includes the preparation of material, 20% rdlm, 20% idlm and 20% edlm, measurement of
blood glucose levels of mice and data analysis. Animals were divided into six groups of test : negative
control group were given distilled water and CMC 0.5 %, a positive control by the suspension
Metformin 65mg / kgBB and three test groups 20 % RDLM, 20 % EDLM and 20 % IDLM. Data
were analyzed by ANOVA and the different of average analyze by Duncan test. The results of this
research, indicates that the leaves can lower blood glucose levels in mice. Ethanol extract of the
leaves gives the greatest effect in reducing the concentration of blood sugar in mice compared with 20
% Aloe-law decoction and 20 % Aloe-law infuse.

Keywords : Aloe-law, Glucose and diabetes mellitus

PREFACE plant suspected of being efficacious.

Diabetes mellitus is a condition in
which the concentration of blood glucose is
chronically higher than the normal value
(hyperglycemia) due to lack of insulin body or
function insulin ineffective. (Tjay, 2010)
Indonesia now ranks as the fourth
highest number of people with diabetes after
the United States , China and India . Based on
data from the Central Statistics Agency (BPS),
the number of people with diabetes in 2003
was 13.7 million based on the pattern of
population growth is expected in 2030 there
will be 20.1 million people with diabetes with
a prevalence rate of 14.7 percent for urban
areas and 7 , 2 percent in rural .
World Health Organization (WHO)
reckon increase in the number of diabetics
mellitus in Indonesia from 8.4 million people
in 2000 to about 21.3 million by the year 2030.
While the International Diabetes Federation
(IDF) in 2009 estimated that the increase in
the number of people with diabetes mellitus
7.0 million in 2009 to 12.0 million in 2030 .
Some of the ways can be done for
the treatment of diabetes that is by using
chemical drugs and natural materials, such as
Indonesian society know and use the plant as
one effort to reduce health problems.
Medicinal plants have a function in the
treatment or prevention of disease. Various
medicines has done research to be used as an
alternative medicine. One of the herbs that are
beneficial for health is a Aloe-law (Sansivieria
trifasciata Prain ) .
Aloe-law or Sansevieria is one type
of ornamental plants that are familiar and
already known by many people . Aloe-law is
often planted as a fence . Inside this plant there
are many substances that can treat diseases,
such as Flavonoid , Saponin , Polifenol, Gallic
Acid, Stearic Acid, Vitamin C. ( Irianto, 2009
). Polyphenol compounds, namely gallic acid,
ease digestive system the human body that
organ pancreas can be active producing insulin
hormone again in line the body needs.
(Widyaningrum,2011)
Generally, people use medicinal
herbs to overcome health problems in the form
of decoction, boil the herbs using a regular pot
at an unspecified time .Researchers tried to
make preparation galenika medicinal plants in
the form of decoction, infusa and extract.

50

Decoction is a liquid preparation made by
extracting bulbs at a temperature of 900C for
30 minutes. Infusa is a liquid preparation made
with extract simplisia on the temperature 900C
for 15 minutes and extract is intensely
preparations obtained by means extract
simplisia using solvent appropriate .
That has been done research by
suciyati ramadhani of the effectiveness of
decoction Aloe-law with three different
concentrations , finally in even research results
that the concentration of 20 % decoction of the
Aloe-law is the maximum result has the same
effect with metformin in reducing blood
concentrate of mice .
In this case we want to continue the
research of Suciyati Ramadhani in testing the
effectiveness of Aloe-law galenika
preparations with concentrations of
respectively 20% in the form of decoction,
infusion and Aloe-law extract to mice with
metformin as a comparison. Mice used were
male mice , the condition of hormones in male
mice tend to be normal, while to keep effect
hipoglikemi in mice, metformin as
comparison.
Issues
The number of diabetics in
Indonesia , and the plant that can be used as
blood glucose levels lowering in diabetics and
former investigation that Aloe-law can be
used as lowering blood glucose levels. The
research problems are preparations Which of
the preparation galenika ( decoction , infuse
and extract ) 20% Aloe-law have the
effectiveness anti- diabetic of the greatest in
lowering blood concentrate in mice .
Research Purposes
To determine the effectiveness of
the dosage form which of these three stocks
galenika ( stew, infuse and extract ) 20% Aloe-
law of the decline in mice blood concentrate
with metformin as a comparison.
Hypothesis
The preparation of ethanol extract of
20 % Aloe-law have the greatest effectiveness
in lowering mice blood concentrate compared
to infuse preparations and decoction of the 20
% Aloe-law.
Proceeding Patient Safety in Emergency
Benefit of Research
1. Provide information and knowledge to the
public about the benefits of Aloe-law to
decline blood concentrate (diabetics
treatment).
2. Supporting the government program in
the development of traditional medicine
and science technology development.
RESEARCH METHODOLOGY
A kind of the research is true
experimental,with the purpose of examining
the effects of galenika preparations ( decoction
, infusion and extract ) Aloe-law ( Sansivieria
trifasciata Prain ) to decline the blood
concentrate in mice ( Mus musculus ) as a
experiment and the sample collection was
purposive.
Research Design
Design this research is randomized
by Salomon Four Group , this design can
overcome the external validity of the existing
weaknesses in the design of randomized
control group pretest posttest . If the pretest
may affect the subject so that they become
more sensitive to treatment (X) and they react
differently than subjects who did not have a
pretest , the external validity of disturbed and
we can not generalize from this study to the
population. Similarly, if there is an interaction
between the pretest to the treatment ( X ).
Salomon 's draft can fix the problem by adding
a third group ( with treatment, without pretest )
and fourth ( without treatment without pretest )
. The form of design, as follows:
- (Experiment group)
- (Control group )
- (Control group )
- (Control group )
(Noto Atmodjo, 2010)
Framework concepts
Independent variables Dependent variable
Parameters
PREPARATION Decrease of
GALENIKA OF ALOE-
BLOOD
glucose levels
CONCENTRATE IN
LAW ( stew , infusa ,
extract )
MICE on mice
Tools and Materials
Tools
A beaker glass, stir bar, glucometers,
measuring cups, woodfilter, flannel,
lumpingandstamper, balance of electricity,
51
Proceeding Patient Safety in Emergency

oralsonde1ml, pansinfuse/stew pot, RESULTS AND DISCUSSION

pipettevolume of25ml, a water bath, blood 1. The result of blood sugar levels based
sugar stripcheck, weightandthermometer. on the different of Based on Time
Difference Observations
Materials Observation the average blood
-Aloe-law stew with 20% concentration in mice were performed for
concentration(Sansivieria trifasciataPrain) each solution and change blood concentration
-Aloe-lawinfusewith 20% concentration measured starting at the beginning of the
-Aloe-law extractwith 20% concentration study, fasting, 15 minutes, 30 minutes, 45
-30% glucose solutio minutes, 60 minutes, 90 minutes, 120 minutes
-0.5%CMCsolutio after the treatment solution. Furthermore, the
-Metformin suspension observations for each treatment solution can
-Aquadest be seen in the table below.

Table 1. The results of the distinction the average blood sugar levels based on the observation time is
different for each treatment solution.
Time Aquadest 0,5%CMC Metformin 20% Aloe- 20% Aloe- 20% Aloe-
Suspension Suspension law stew law infuse law extract
Fasting 88,80 ± 90,00 ± 89,00 ± 90,20 ± 91,60 ± 88,40 ±
3,114 3,873 2,000 4,207 3,050 4,336
Early 160,40 ± 147,20 ± 150,00 ± 164,60 ± 161,80 ± 157,20 ±
7,701 13,989 10,488 6,504 11,511 11,692
15’ 152,40 ± 141,20 ± 146,60 ± 156,80 ± 142,6 ± 159,60 ±
6,107 12,795 11,567 11,454 9,343 7,701
30’ 141,60 ± 136,60 ± 129,20 ± 133,40 ± 119,60 ± 131,80 ±
9,940 14,605 6,261 13,390 26,745 11,713
45’ 132,00 ± 131,20 ± 117,00 ± 123,80 ± 113,20 ± 123,00 ±
7,348 13,217 5,701 15,802 27,869 19,647
60’ 126,40 ± 135,00 ± 104,80 ± 124,60 ± 109,00 ± 116,80 ±
6,542 16,047 5,404 14,011 20,335 15,611
90’ 122,80 ± 132,00 ± 94,80 ± 112,60 ± 109,60 ± 109,20 ±
11,713 23,022 2,683 16,303 18,716 21,040
120’ 115,20 ± 131,00 ± 88,00 ± 103,8 ± 108,40 ± 98,00 ±
6,723 23,441 5,831 14,394 19,501 20,012
p. 0,0001* 0,0001* 0,0001* 0,0001* 0,0001* 0,0001*

Table 1aboveis a descriptionblood Blood concentrate decline in the

concentratetest resultsineach treatmentsolution
consistof: Aquadest, 0.5% CMCsuspension,
Metformin suspension, 20% Aloe-law
decoction and20% Aloe-law extractwitha
differentobservation time(early ,fasting,
15minutes, 30minutes, 45minutes, 60 minutes,
90 minutes, 120 minutes). The different
inaverage blood concentrate performedby
Anovaone direction(i.e, the difference on
averagemore thantwogroups ofobservations),
if the result ofa significantANOVA test, it will
be followedby Duncan test. Duncanis
amultiple comparisontest that can beused to
testthe average differencebetweenall of
treatment possible without regard to the
numberof existing treatment of such
trialsandstillbe able tomaintain the level
ofsignificance was set. (Gaspersz, V.1991)
overall treatment of the solution presented in
the line graph below (figure 4.1). At a
discussion above have shown that of all
aquadest, 0.5 % cmc suspension metformin
suspension.20% Aloe-law decoction, 20%
Aloe-law infuse, and 20% Aloe-law extract
can reduce blood concentrate in mice (p.
<0.05). At minute 120 can be seen in the
average blood sugar levels the lowest are
Metformin Suspension (88.00 ± 5.831 g / dl),
followed by 20% Aloe-law extract (98.00 ±
20.012 g / dl), 20% Aloe-law decoction
(103.80 ± 14.394 g / dl), Aquadest (115.420 ±
6.723 g / dl) and 0.5% CMC suspension
(131.00 ± 23.441 g / dl).
Charts the measurement of blood
concentrate each treatment solution based on
the time different observation.

52
 Proceeding Patient Safety in Emergency

2. Blood Sugar Test Results Between The 30 minutes, 30 minutes, 45 minutes, 60

Treatment Solution Is Based On The
Time Difference Observations
Observations average of mice blood
concentrate conducted between treatments and
changes blood concentration solution
measured from the time of fasting, 15 minutes,
minutes, 90 minutes, 120 minutes after
administration of treatment solution. Further
observations among treatment solution can be
seen in the following table.

Table 2. Test Resultsof blood concentrate average and the differenceineach treatmentsolution with
adifferentobservation time.
Solutio Fasting Early 15‟ 30‟ 45‟ 60‟ 90‟ 120‟
Aquadest 88.80 ± 160.40 ± 152.40 ± 141.60 ± 132.00 ± 126.40 ± 122.80 115.20
3,114 7,701 6,107 9,940 7,348 6,542 ± ±
11,713 6,723
0,5%CMC 90.00 ± 147.20 ± 141.20 ± 136.60 ± 131.20 ± 135.00 ± 132.00 131.00
Suspension 3,873 13,989 12,795 14,605 13,217 16,047 ± ±
23,022 23,441
Metformin 89.00 ± 150.00 ± 146.60 ± 129.20 ± 117.00 ± 104.80 ± 94.80 88.00 ±
Suspension 2,000 10,488 11,567 6,261 5,701 5,404 ± 5,831
2,683
20% Aloe- 90.20 ± 164.60 ± 156.80 ± 133,40 ± 123.80 ± 124.60 ± 112.60 103.80
law 4,207 6,504 11,454 13,390 15,802 14,011 ± ±
decoction 16,303 14,394
20% Aloe- 91.60 ± 161.00 ± 142.60 ± 119.60 ± 113,20 ± 109.00 ± 109.60 108.40
law infuse 3,050 11,511 9,343 26,745 27,868 20,335 ± ±
18,716 19,501
20% Aloe- 88.40 ± 157.20 ± 159.60 ± 131.80 ± 123.00 ± 116.80 ± 109.20 98.0 ±
law extract 4,336 11,692 7,701 11,713 19,647 15,611 ± 20,012
60’ 21,040
p. 0,731 0,109 0,039* 0,338 0,437 0,021* 0,039* 0,008*

Table 2. is a picture of blood decoction 5 108.40 108.40

concentrate test results among treatment
solution consist of: Aquadest, 0.5% CMC
suspension, Metformin suspension, 20% Aloe-
law decoction, 20% Aloe-law infuse, and 20%
Aloe-law extractin a different time (time of
fasting, early, 15 minutes, 30 minutes, 45
minutes, 60 minutes, 90 minutes, 90 minutes
and 120 minutes). The average difference in
blood sugar levels performed by Anova one
way (i.e, the difference on average more than
two groups of observations), if the result of a
significant ANOVA test, it will be followed by
Duncan test. (Gaspersz, V., 1991).
Results of different test average
Duncan to KGD mice on a glucose tolerance
test in the 120th minute.
Type of solutio N Subset for alpha = .05
1 2
Duncana Metformin 5 88.00
Suspension
20% Aloe- 5 98.00 98.00
law extract
20% Aloe- 5 103.80 103.80
law
20% Aloe-
law infuse 5 115.20 115.20
Aquadest
0,5% 5 131.00
CMC
Suspension
Sig .083 .142 .141
Means for groups in homogeneous subsets are
displayed
a. Uses Harmonic Mean Sample Size = 5.000
Blood concentrate,s decline in the
overall treatment of the solution presented in
the line graph below (figure 4.2). In above
discussion it has been shown that the average
reduction among blood concentrate treatment
solution occurred at minute 15, 60, 90, and
120. At the 15th minute of the lowest blood
3
concentrate to 0.5% CMC suspension with
141.20 ± 12.795 gr / dl followed by 20% Aloe-
law infusewith 142.60 ± 9.343 gr / dl. In the
60th minute of the lowest levels of blood sugar
in Metformin suspension with 104.80 ± 5.404
gr / dl followed by 20% Aloe-law infusewith

53
Proceeding Patient Safety in Emergency
109.00 ± 20.535 g / dl.Blood concentrate
measurement chart in each treatment solution
with a different observation time.
th
In the 90 minute of the lowest levels of blood
sugar in Metformin suspension with 94.80 ±
2.683 g / dl followed by 20% Aloe-law extract
with 109.20 ± 21.040 g / dl. Then, in the 120th
minute of the lowest levels of blood sugar in
solution Metformin suspension of 88.00 ±
5.831 g / dl followed by 20% Aloe-law extract
with 98.00 ± 20.021 g / dl.
Conclusions and suggestions
Based on observations and research
statistical tests test the effectiveness of the
dosage galenika Aloe-law(Sansivieria
trifasciata Prain)to KGD decline in mice with
metformin for comparison, obtained some
conclusions as follows:
1. Aloe-law can lower the levels of blood
glucose in mice.
2. 20% Aloe-law ethanol extract, give the
greatest effect in reducing blood
concentrate in mice compare with 20%
Aloe-law decoction and 20% Aloe-law
infuse.
3. Based on the above conclusions, it is
recommended to further research to test
54
the toxicity and content of Aloe-law
(Sansivieria trifasciata Prain).
LITERATURE
B Laurence, P, Keith, B, Donald dan lain, B,
Goodman and gildman‟s Manual of
Farmacology and Therapeutics,
Boston, Graw-Hill, 2008.
Dalimartha,S.(1999).Atlas Tumbuhan Obat
Indonesia, Jakarta. Penerbit Trubus
Agriwidya.
Departemen Kesehatan RI, Farmakope
Indonesia, Edisi IV, Jakarta 1995.
Ditjen POM.(1989). Materia Medika
Indonesia, Jilid VI. Jakarta ;
Departemen Kesehatan Republik
Indonesia.
Direktorat Jendral Bina Kefarmasian dan Alat
Kesehatan, Jakarta, 2010.
Ganiswara S.G.,dkk, Farmakologi dan Terapi,
Edisi IV, Jakarta, 1996.
Notoatmodjo Soekidjo, Metodologi Penelitian
Kesehatan, Rineka Cipta Jakarta,
2010.
Penelitian dan Pengembangan
Kesehatan,1991.
 Proceeding Patient Safety in Emergency

THE EFFCT OF PREGNANCY EXERCISE ON THE SLEEPING QUALITYY OF

THIRD-TRIMESTER PREGNANT WOMEN IN KLINIK PRATAMA NIAR
KECAMATAN PATUMBAK KABUPATEN DELI SERDANG 2016

Nurlama Siregar, Masnila

Nursing Department of Poltekkes Kemenkes Medan

Abstract
Pregnancy is a condition of being pregnant starting from the last menstrual period until the time
of delivery and it normally occurs for 40 weeks or 280 days. When a woman has reached 7 to 9
months of pregnancy, the major complain of a pregnant woman is difficult to sleep. Sleeping
difficulty is caused by some factor, such as getting tummy bigger, the movement of the fetus in the
womb, feeling discomfort in the pit of the stomach, and so on. Pregnancy exercise is a kind of sport or
a structural exercise that makes pregnant women becoming more relaxed and calm so they can sleep
easily and calmly. The hypothesis of this study; there is an effect of pregnancy exercise on sleeping
quality of third-trimester pregnant women in Klinik Pratama Niar Kecamatan Patumbak Kabupaten
Deli Serdang. The purpose of this study is to figure out the effect of pregnancy exercise on the
sleeping quality of third-trimester pregnant women in Klinik Pratama Niar Kecamatan Patumbak
Kabupaten Deli Serdang. It is a quasi-experimental study without control group by using one group
pre test-post test method. The sample of this study is all the population, they are 20 respondents. The
data are analyzed by using computer program of Statistical Package for the Social Science (SPSS).
The sleep quality of third-trimester pregnant women before having exercise is good about 45% and
bad 55%. After having pregnancy exercise, the sleep quality becomes good about 80% and bad 20%.
The data are analyzed by using equation pre-test and post-test one group design and the level of
significance (α) = 0.05 and applying t-test on the pair group. The result of statistic t-test shows
p=0.000 < 0.05, it means there is distinction of sleeping quality of third-trimester pregnant women
before and after having pregnancy exercise. It is suggested to pregnant women to do pregnancy
exercise to improve sleeping quality and suggested to the staff of Klinik Pratama Niar Kecamatan
Patumbak Kabupaten Deli Serdang to recommend pregnant women to do pregnancy exercise.

Keyword: pregnant women, third trimester I

References: 15 (2001-2012)

Pregnancy is a condition of being vomit, the increasing of bladder frequency, the

pregnant starting from the last menstrual
period until the time of delivery and it
normally occurs for 40 weeks or 280 days
(Bobak et al, 2005). When a woman has
reached 7 to 9 months of pregnancy, the major
complain of a pregnant woman is difficult to
sleep. Sleeping difficulty is caused by some
factor, such as getting tummy bigger, the
movement of the fetus in the womb, feeling
discomfort in the pit of the stomach, and so
on(Ronald, 2010).
The result of a polling about sleeping
in America by NSF (National Sleep
Foundation) is found that actually most
women have sleeping disorder than men, they
are about 63% : 37% (National Sleep
Foundation, 2007). One of the conditions
which causes sleeping disorder is physical
changes and emotion during pregnancy. The
physical changes occur such as nausea and
enlarged of uteri, back pain and the movement
of the fetus, whereas emotion changes involve
anxiety, scare and depression (Rafknowldge,
2004). Irmayana (2008) stated the sleeping
pattern of the third-trimester pregnant women
in RSU Dr.Pirngadi Medan showed that they
had sleeping pattern disorder because they
often woke up (50%) and they were not
satisfied with their sleeping or lack of sleeping
(31%) and about 19% of them felt
uncomfortable.
They overcame the sleeping difficulty
during pregnancy by seeking a comfortable
sleeping position, bathing with warm water,
avoiding too much meal before sleep, drinking
a glass of hot milk, musical therapy, making
love, setting breathing technic and having
relaxation. To have breathing technic and
relaxation well, they performed pregnancy
exercise (Ronald, 2010).

55
Proceeding Patient Safety in Emergency
Pregnancy exercise is an important
methed to keep and to improve physical
balance of pregnant women and it is an
exercise therapy that given to pregnant women
that aims to achieve a fast easy and safe
delivery. This pregnancy exercise is not a
must.
During the development, pregnancy
exercise creates controversy. It caused by a
mitos in the past that pregnant women cannot
work, travel, and eat fish and many others.
Those really harm because pregnancy exercise
has a big benefit if it is applied to all pregnant
women. It can train breathing and relaxation,
strengthen stomach and pelvic muscle, and
train the way of pushing correctly also.
Scientific finding shows that having exercise
during pregnancy can reduce length of labour
and minimize delivery complication.
Except those benefits above, there
many more benefits of pregnancy exercise,
they are to stretching the joints that connecting
to delivery process, forming a healthy body, so
it can solve some complains such as fetus
malposition, reducing difficulty in breathing,
making elastic muscle and joint of the pelvic,
correcting body gesture, managing contraction
and relaxation, arranging breathing technic.
Based on Riadinni Alita (2011) about the
correlation of pregnancy exercise of third-
trimester pregnant women and the feeling
comfort during sleep in Puskesmas Kecamatan
Kramat Jati Jakarta showed that there was a
correlation between pregnancy exercise and
sleeping quality of third-trimester pregnant
women. The result of study of Yuniarsi about
pregnancy exercise and sleeping quality of
third-trimester pregnant women in Klinik
Bidan HJ Uut S Rahayu showed pregnancy
exercise influenc sleeping quality of third-
trimester pregnant women.
The result of prior survey that was
conducted in Klinik Pratama Niar Kecamatan
Patumbak Kabupaten Deli Serdang showed the
numbers of visitation of pregnant women was
high about 30 pregnant women each month.
Based on the interview with health staff and
pregnant women have not been conducted
training of pregnancy exercise. During
interview with 5 third-trimester pregnant
women, 1 pregnant woman (20%) stated sleep
tight and 4 pregnant women (80%) stated hard
to sleep, the reason are bladder when sleeping,
uncomfort sleeping position, and having
breathing difficulty.
56
Based on the phenomena, the writer
was interested to conduct a study about the
effect of pregnancy exercise on sleeping
quality of third-trimester pregnant women in
Klinik Pratama Niar Kecamatan Patumbak
Kabupaten Deli Serdang.
The Problem of the Study
Based on the background above, the
problem of the study is whether there was an
effect of pregnancy exercise on sleeping
quality of third-trimester pregnant women in
Klinik Pratama Niar Kecamatan Patumbak
Kabupaten Deli Serdang
The Purpose of The Study
General Purpose
To figure out the effect of pregnancy
exercise on sleeping quality of third-trimester
pregnant women in Klinik Pratama Niar
Kecamatan Patumbak Kabupaten Deli
Serdang.
Particular Purpose
a. To find out of pregnancy exercise on
sleeping quality of third-trimester
pregnant women in Klinik Pratama Niar
Kecamatan Patumbak Kabupaten Deli
Serdang.
b. To find out sleeping quality of third-
trimester pregnant women in Klinik
Pratama Niar Kecamatan Patumbak
Kabupaten Deli Serdang.
c. To find out the distinction of sleeping
quality of third-trimester pregnant women
before and after having pregnancy
exercise in Klinik Pratama Niar
Kecamatan Patumbak Kabupaten Deli
Serdang.
The Urgency of the Study
It can improve life quality of pregnant
women that will certainly give relaxation for
them and will facilitate an easier delivery
process.
THE METHOD OF THE STUDY
The design of the study
It was a quantitative study which was
used quasi experimental research method
without control group with one group pre test-
post test design. It only used one sample group
that observed twice; firstly answering the
questioneire before experiment called as the
 Proceeding Patient Safety in Emergency

pre test and secondly answering the 35 years old about 3 respondents (15,0%).
quesioneire after experiment called post test. Mostly respondents were entrepreneur about 9
respondents (45,0%), housewives were 6
The Location of the Study respondents (30,0%) and civil servants were 5
The location was choosen by respondents (25,0%).
considering the area that it was easily reached, b. Sleeping Quality of Third-Trimester
many pregnant women, and the writer was Pregnant Women
interested to conduct a study about the effect Table 2. Sleeping Quality of Third-
of pregnancy exercise on sleeping quality of Trimester Pregnant Women in Klinik
third trimester of pregnant women. Pratama Niar Kecamatan Patumbak
Kabupaten Deli Serdang before having
The Length of the Study pregnancy exercise
The study was conducted in October No Sleeping Quality f %
2015 until October 2016 1 Good 9 45.0
2 Bad 11 55.0
Population Total 20 100.0
The population was a group of subject
that became an object or the target of the study Based on the table, it can be figure out that
(Notoatmodjo, 2005) that examined herself in sleeping quality of third-trimester pregnant
Klinik Pratama Niar located in Kecamatan women in Klinik Niar Kecamatan Patumbak
Patumbak of Kabupaten Deli Serdang. Based Kabupaten Deli Serdang before having
on the prior survey that it has been done by the pregnancy exercise was bad about 11
writer, there were 20 pregnant women in third- respondents (55,0%) and fewer have a good
trimester of pregnancy that lived surrounding sleeping quality about 9 respondents (45,0%).
Klinik Pratama Niar in Kecamatan Patumbak
Kabupaten Deli Serdang. Table 3. Sleeping Quality of Third-
Sample Trimester Pregnant Women in Klinik
The sample of the study were all the Pratama Niar Kecamatan Patumbak
population, they are 20 respondents. Kabupaten Deli Serdang after Having
The Findings Pregnancy Exercise
a. Respondents Characteristics No Sleeping Quality f %
Table 1. Distribution of Frequency of 1 Baik 16 80.0
Third-Trimester Pregnant Women 2 Buruk 4 20.0
Characteristics in Klinik Pratama Niar
Total 20 100.0
Kecamatan Patumbak Kabupaten Deli
Serdang
No The Pregnant f % Based on the table, it was founded that
Women sleeping quality of third-trimester pregnant
Characteristics women in Klinik Niar Kecamatan Patumbak
Kabupaten Deli Serdang after having
Aged
pregnancy exercise was good about 16
1 20-35 years old 17 85,0
respondents (80,0%) and 4 respondents had
2 > 35 years old 3 15,0
bad sleeping quality (20,0%).
Total 20 100,0
Occupation
1 Housewife 6 30.0
2 Civil Servant 5 25.0
3 Entrepreneur 9 45.0
Total 20 100,0

Based on the table above, it can be seen that

mostly third-trimester pregnant women in
Klinik Pratama Niar Kecamatan Patumbak
Kabupaten Deli Serdang were 20-35 years old
about 17 respondents (85,0%) and more than >

57
Proceeding Patient Safety in Emergency

c. The Effect of Pregnancy Exercise on Disorder 0

the Sleeping Quality of Third- The use of 1.55 1.3 0.20
Trimester Pregnant Women in sleeping 5
Klinik Niar Kecamatan Patumbak pills
Kabupaten Deli Serdang Daytime 1.65 1.3 0.35
Table 4. The Effect of Pregnancy Exercise dysfunction 0
on the Sleeping Quality of Third-Trimester over the last
Pregnant Women in Klinik Niar month
Kecamatan Patumbak Kabupaten Deli
Serdang
Based on the table, it was founded the
deviation of mean (average) of sleeping
quality of third-trimester pregnant women
before and after having pregnancy exercise in
Klinik Pratama Niar Kecamatan Patumbak
Kabupaten Deli Serdang was subjective
component of sleeping quality about 0,05,
latency of sleeping about 0,20, the duration of
sleeping about 0,20, efficiency of sleeping
about 0,25, sleeping disorder about 0,35, the
use of sleeping pills about 0,20 and daytime
dysfunction over the last month about 0.35.
From the result of deviaton of mean
(average), it was figured out that the more
Based on the table, it can be seen the result of influenced component against sleeping quality
statistic t-test in pairs that it was founded value of third-trimester pregnant women in Klinik
p=0,000 < 0,05 so it can be concluded there Pratama Niar Kecamatan Patumbak
were a distinction of sleeping quality of third- Kabupaten Deli Serdang were sleeping
trimester pregnant women in Klinik Niar disorder and daytime dysfunction over the last
Kecamatan Patumbak Kabupaten Deli Serdang month, each component has deviation about
before and after having pregnancy exercise. 0,35.
To perceive which component more
effective influenced the sleeping quality of Discussion
third-trimester pregnant women in Klinik 1. Sleeping Quality of Third-Trimester
Pratama Niar Kecamatan Patumbak Pregnant Women in Klinik Pratama
Kabupaten Deli Serdang can be seen on Table Niar Kecamatan Patumbak Kabupaten
5: Deli Serdang before having pregnancy
Table 5. The Components that More exercise
Effective Influenced the Sleeping Quality of From the findings of the study, it was
Third-Trimester Pregnant Women in gained that sleeping quality of third-trimester
Klinik Pratama Niar Kecamatan Patumbak pregnant women in Klinik Niar Kecamatan
Kabupaten Deli Serdang Patumbak Kabupaten Deli Serdang before
Components Mean Mea Deviation having pregnancy exercise was bad, they are
before n Before about 16 respondents (55,0%). It showed that
after and after third-trimester pregnant women tend to have a
Subjective 1.30 1.2 0.05 bad sleeping quality.
of sleeping 5 According to Rafknowldge (2004) a
quality condition that caused sleeping disorder is
Latency of 1.60 1.4 0.20 physical and emotion change during
sleeping 0 pregnancy. The physical changes occurred
Duration of 1.55 1.3 0.20 such as the increasing of bladder frequency,
sleeping 5 the enlargement of uterus, back pain and the
Efficiency of 1.65 1.4 0.25 movement of the fetus, whereas emotion
sleeping 0 changes such as, scared and depresion.
Sleeping 1.65 1.3 0.35

58

This is in accordance with Irmayana
(2008) founded that sleeping pattern of third-
trimester pregnant women in RSU Dr.Pirngadi
Medan had disorder because they often woke
up (50%) and they had lack of sleeping
satisfaction (31%) and less comfortable (19%).
2. Sleeping Quality of Third-Trimester
Pregnant Women in Klinik Pratama
Niar Kecamatan Patumbak Kabupaten
Deli Serdang after having pregnancy
exercise
The findings were founded that
sleeping quality of third-trimester pregnant
women in Klinik Niar Kecamatan Patumbak
Kabupaten Deli Serdang after having
pregnancy exercise was good, they are about
80%. It showed that third-trimester pregnant
women tended to increase their sleeping
quality. The increase of percentage of sleeping
quality of third-trimester pregnant women
after having pregnancy exercise about 35%.
This situation is quite encouraging that
pregnancy exercise can increase sleeping
quality of pregnant women.
Pregnancy exercise is an important
method to improve and to keep physical
balance of pregnant women and it was
exercise theraphy for pregnant women to
achieve a fast easy and safe delivery, and to
maintain relaxation of the muscles so it can
improve sleeping quality. It is not a must to
do. If pregnancy exercise was applied to all
pregnant women, it could train breathing and
relaxation, to strengthen pelvic muscle and
abdomen, and to train the way of pushing well.
This scientific finding showed that sport could
reduce the length of labour and labour
complication (Rafknowldge, 2004).
3. The Effect of Pregnancy Exercise on
the Sleeping Quality of Third-
Trimester Pregnant Women in Klinik
Niar Kecamatan Patumbak Kabupaten
Deli Serdang
The statistic t-test in pairs found that
value of p=0,000 < 0,05 then it was concluded
that there was a distinction of sleeping quality
between third-trimester pregnant women
before and after having pregnancy exercise in
Klinik Pratama Niar Kecamatan Patumbak
Kabupaten Deli Serdang. Based on the test
result, it was clear that the more pregnant
women do pregnancy exercise the better
sleeping quality pregnant women have and
Proceeding Patient Safety in Emergency
vice versa pregnant women who do not do
pregnancy exercise can cause sleeping
disorder so they will have bad sleeping
quality.
Potter & Perry (2005) stated regularly
exercise is so good to expedite the blood, and
sleepy usually comes easily when the body is
exhausted. Having exercise a couple minutes
before time to sleeping can make cooling body
and the feeling exhausted can increase
relaxation. Moreover, Wulandari (2006) said
that physiologically relaxation training in
pregnancy exercise will cause relaxation effect
that involves parasympathetic nerves in central
nerves system. The function of
parasympathetic nerves is to reduce the
production hormone adrenalin or epinefrin
(stress hormone) and increase secretion of
hormone noradrenalin
or norepinefrin (relaxation hormone) so the
anxiety and tension of pregnant women
become more relaxed and calm to sleep.
Pregnancy exercise which is done in the study
can prove hypothesis of study that there is an
effect of pregnancy exercise on the sleeping
quality of third-trimester pregnant women.
Pregnancy exercise is hoped to be a choice in
solving sleeping disorder in pregnant women.
The improvement of sleeping quality
hopefully can avoided pathofisiological impact
that cause bad effect to the mother and the
fetus.
In accordance with Riadinni Alita
(2011) about the correlation between
pregnancy exercise for third-trimester
pregnant women and the feeling comfortable
during sleep in Puskesmas Kecamatan Kramat
Jati Jakarta showed that there was a correlation
between pregnancy exercise sleeping quality
of third-trimester pregnant women. A research
by Yuniarsi about the effect of pregnancy
exercise on the improvement of sleeping
quality of third-trimester pregnant women in
Klinik Bidan HJ Uut S Rahayu showed that
pregnancy exercise influenced to improve
sleeping quality of third-trimester pregnant
women.
Conclusion
1. Sleeping quality of third-trimester
pregnant women before having pregnancy
exercise in Klinik Niar Kecamatan
Patumbak Kabupaten Deli Serdang was
bad about 55,0%.
2. Sleeping quality of third-trimester
59
Proceeding Patient Safety in Emergency

pregnant women after having pregnancy Mass. (2003). Power Sleep. Bandung:
exercise in Klinik Niar Kecamatan Penerbit Kaifa.
Patumbak Kabupaten Deli Serdang was Notoadmodjo. (2005). Metodologi Penelitian
good about 80,0%. Kesehatan. Edisi Revisi. Jakarta: PT.
3. There was a distinction of sleeping Rineka Cipta.
quality of third-trimester pregnant women Potter, & Perry. (2005). Buku Ajar
before and after having pregnancy Fundamental Keperawatan. Jakarta :
exercise in Klinik Niar Kecamatan EGC. Rafknowledge. (2004).
Patumbak Kabupaten Deli Serdang. Insomnia dan Gangguan Tidur
Lainnya. Jakarta: PT. Elex Media
Suggestion Komputindo.
1. To improve sleeping quality of third- Riadinni Alita. (2011). Hubungan Senam
trimester pregnant women, it is need to Hamil pada Ibu Hamil Trimester III
perform pregnancy exercise. dengan Rasa Nyaman pada Saat
2. Pregnant women is suggested to do Tidur di Puskesmas Kecamatan
pregnancy exercise to improve their Kramat Jati Jakarta, Jakarta: Skripsi
sleeping quality. Universitas Pembangunan Nasional
3. Medical staffs in Klinik Pratama Niar Veteran.
Kecamatan Patumbak Kabupaten Deli Ronald. (2010). Pedoman & Perawatan
Serdang is suggested to promote pregnant Kehamilan yang Sehat dan
women to do pregnancy exercise. Menyenangkan. Bandung: CV Nuansa
Aulia.
REFERENCES Syafei. Senam Hamil Mempermulus
Arikunto. (2010). Prosedur Penelitian. Edisi Persalinan. 2006. http:// Syafei-info-
Revisi. Jakarta: Rineka Cipta. Bobak, kesehatan. blogspot.com/2006/12/
dkk. 2005. Buku Ajar Keperawatan senam-hamil-mempermulus-
Maternitas. Jakarta : EGC. Hidayat. persalinan.html. Diperoleh pada
(2006). Kualitas Tidur. Jakarta: Sinar tanggal 20 November 2012.
Jaya. Sofian, A. (2012). Sinopsis Obstetri. Jakarta:
----------. (2009). Metode Penelitian ECG.
Keperawatan dan Teknik Analisa University Of Pittsburgh, Sleep Medicine
Data.Jakarta: Salemba Medika. Institute, Pittsburgh Sleep Quality
Irmayana, A. (2008). Pola Tidur Ibu Hamil Index (PSQI). (2012). Available at
Trimester Tiga di Poliklinik Ibu http ://www. sleep.pitt.edu/
Hamil RSU Dr.Pirngadi Medan, content.asp.id 1484 &subid=2316.
Medan: Skripsi PSIK USU. Yuniarsi, D, 2015, Pengaruh Senam Hamil
Lilis, C.,Taylor. C., & Lemone, P. (2001). Terhadap Peningkatan Kualitas Tidur
Fundamentals Of Nursing: The art Pada Ibu Hamil Trimester III Di
and science of nursing care (4th ed), Klinik Bidan HJ. Uut S
Philadelphia: J. B. Lippincott. Rahayu,www.repository unissula,
Mandriwati. (2008). Asuhan Kebidanan Ibu ac.id
Hamil. Jakarta : EGC.
Maryunani, A., & Sukaryati, Y. (2011).
Senam Hamil Senam Nifas dan Terapi
Musik. Jakarta: TIM.

60
 Proceeding Patient Safety in Emergency

QUALITY OF LIFE ON OLDER PEOPLE:

CASE STUDY AT KELURAHAN PUDAK PAYUNG AND PAANG SARI
IN CENTRAL JAVA

Nina Indriyawati, Marsum, Anton Kristijono, Sugiyanto

Politknik Kesehatan Kemenkes Semarang
Email: ninagading@hotmail.com

Abstract

Background: Elderly often regarded as a vulnerable group and need less attention, it is also necessary
pay attention to quality of life for the elderly because many elderly people who still live with less
quality of life.
Methods: This study is a description that aims to explain the level of quality of life of the elderly. The
research was conducted in two villages namely Pudak village and the village of Padang Payung Sari.
Research was conducted during the six months from March to August 2016. The study population is
the elderly who live in the Village and Padang Sari Pudak umbrellas are willing to become
respondents were 70 elderly. Quality of life was measured by five doamain elderly are mobility, self
care, usual activities, pain and stress. Data were analyzed using descriptive statistics.
Results: The majority of the elderly health of a routine health examination results showed in healthy
condition. Health education given to the elderly showed keantusiaan and curiosity more. Elderly
showed a good level of quality of life (71%).
Suggestions: Quality of life of the elderly should be regularly monitored to see the level of quality of
life, because the elderly have to enjoy life with good quality in his old age.

Keywords: Quality of Life, older people, health

Background and environmental factors affect the quality of

The problems faced by the elderly is
often due to the influence of the aging process
is the emergence of various problems of
physical, biological, mental, social and
economic. With the growing elderly person,
they would decline mainly physical abilities
that can lead to a reduction in their social
roles. This will result in disturbance to make
ends meet so as to increase the dependency of
needy people (Hutapea, 2005).
Elderly often regarded as useless
people, the burden of family and society,
sickly and unproductive, and in need of care
should be turned into a humane and positive
approach, because the fact the field showed
that 60- 65% of the elderly are still working
and became head of the family (Susilo W ,
2005). Efforts should be undertaken to achieve
and maintain optimal health status of elderly
fixed so that the elderly can afford to meet
their own needs through empowerment of the
elderly (Ismunimgrum, 2006).
For the elderly already decreased
quality of life, it is in line with the results of
research is conducted show that physical
factors, psychological factors, social factors
life (p = 0.004). While most dominant factor
influencing quality of life is the psychological
factor (Rohmah, Purwaningsih, Bariyah,
2012). Quality of life is used as a tool to assess
the results of a treatment or balancing the risk
factors and the benefits of a treatment option.
WHO notes that from 2000 to 2050, the
world's population aged 60 years and over
elderly will be more than tripled, and it is
estimated by 2050 about 80% of older people
will live in developing countries.
The purpose of this study was to
determine the quality of life of the elderly in
the village Pudak umbrellas and Sub puppetry.
Research Method
This research is a description that aims
to explain the level of quality of life of the
elderly. The research was conducted in two
villages namely Pudak village and the village
of Padang Payung Sari. Research was
conducted during the six months from March
to August 2016. The study population is the
elderly who live in the Village and Padang
Sari Pudak umbrellas are willing to become
respondents were 70 elderly. Quality of life

61
Proceeding Patient Safety in Emergency

was measured by five doamain elderly are B. Monitoring the Health of the health
mobility, self care, usual activities, pain and examination
stress. Data were analyzed using descriptive The medical examination conducted
statistics. once a month to check blood pressure, Weight,
gout and Blood Sugar During. This can be
1. Flow diagram of the study quality of life seen from the table below:
in the elderly can be seen in the chart Table 2. Monitoring of Health inBlood
below: Pressure, Weight, Uric Acid and Blood Sugar
No. Health Frekwensi Prosentage
Elderly Assessment (n) (%)
1 Weight
a. Ideal 47 81
b. Fat 11 19
exercise Health Educati 2 BloodPressure
a. Low 12 21
b. Normal 35 60
assessment on c. High 11 19
Quality of Life 3 Uric Acid
a. Normal 41 71
b. High 17 29
4 Blood Sugar
a. Normal 48 83
Go Enou less b.High 10 17

Result From Table 2 it can be seen that the elderly

A. od
Demographicgh have more weight as many as 11 people
Elderly characteristics include gender, (19%), blood pressure is relatively high as
age, creed / religion, and marital status are many as 11 people (19%), levels of uric acid is
described in Table 1. relatively higher than normal were 17 (29%)
and Blood Sugar When relative Issuer normal
Table 1. Characteristic of elderly as many as 10 people (17%).
No. Characteristic Frekwensi (n) Percentage (%)
1 Gender C. Health Education
A. Men With4 increasing age, the6,9structure and function
B. Women of 54
the human body system
93,1 will be changed
2 Age physically, mentally, socially and emotionally.
A. 40-50 years This
12will certainly affect
20,7the quality of life of
B. 51-60 years the19elderly. Therefore32,8there is need for an
C. > 61 years effort
27 to maintain or even
46,6 improve the quality
3 Religion of life elderly person. Efforts to do that is with
a. Islam health
51 education. Health 87,9education that can be
b. Christian done5 include: 8,6
c. Chatolic 1. 2Health education 3,4 on reproductive health
4 Marital Status in elderly
a. Mariage 40 69,0
b. Widow 18 31,0

From Table 1 it can be seen that the active

adalan Most elderly women with age> 61
years as many as 27 people (47%), the
majority of Muslims (88%) and the majority
still have a spouse (69%);
Fig. 1. Reproductif health education

62
 Proceeding Patient Safety in Emergency

2. Health education on yoga exercises to b. Moderate 5 7,1

improve health in the elderly c. Good 38 54,3
5 stress
a. Less 2 2,9
b. Moderate 20 28,6
c. Good 48 68,6

From Table 3 shows that the domain

Fig 2. Yoga Exercise
3. Health education about first emergency
treatment of elderly at home
mobility in the elderly whose quality is -
sedang is as much as 19 elderly (27.1%). The
quality of care is still lacking self-being as
much as 20 elderly (28%). Activitiesnya less-
usual level was as much as 20 elderly (28%),
have experience with pain 32 elderly (46%)
and the quality of life of less-being due to a
stress range from 22 (32%).

fig 3. First emergency Treatment for

Fig 4. Assessment of health and life quality
Elderly

D. Elderly Quality of Life

Quality of life of elderly people is
measured by the five domains, namely
mobility, self care, usual activities, pain
and stress experienced and felt by the
elderly.

Table 3. Elderly Quality of Life

No. Quality of Frekuensi Presentage
Life (n) (%)
1 Mobility
a. Less 14 20,0 Tabel 4. Deskriptife of Elderly Quality of Life
b. Moderate 5 7,1
c. Good 51 72,9
No Quality of Frekuensi Presentage
2 Self Care
Life (n) (%)
a. Less 19 27,1
1 Less 13 18,6
b. Moderate 1 1,4
2 Moderate 7 10,0
c. Good 50 71,4
3 Good 50 71,4
3 Usual
Activities
From Table 4 it can be seen that most
a. Less 19 27,1
of the elderly have a good quality of life for as
b. Moderate 1 1,4
many as 50 people (71.4%), while the elderly
c. Good 50 71,4
who have the quality of life was as much as 7
4 Pain
a. Less 27 38,6

63
Proceeding Patient Safety in Emergency
people (10%), and the elderly who have less
quality sleep as many as 13 people (18.6%).
4. Discussion
The problems faced by the elderly is
often due to the influence of the aging process
is the emergence of various problems of
physical, biological, mental, social and
economic. The complexity of the problems
that dihdapai by the elderly can affect the
quality of life of the elderly themselves.
According to the World Health Organization
Quality of Life (WHOQOL), quality of life of
the elderly is a functional condition of elderly
includes physical health are daily activities,
dependence on medical assistance, the need
for rest, sleep anxiety, disease, energy and
fatigue, mobility, activities of day-to day,
work capacity, psychological health is a
positive feeling, appearance and description of
physical, negative feelings, thinking, learning,
concentration, memory, self-esteem and
confidence of individuals, social relationships
elderly is social support, personal
relationships, and sexual activity, and
condition lingkunganyaitu home environment,
freedom, physical safety, activity on the
environment, transport, security, financial
resources, health and social care.
Quality of life is affected by the level
of independence, physical and psychological
condition, social activity, social interaction
and family functioning. In general, the elderly
have limitations, so that the quality of life for
the elderly be decreased (Yuliati et al, 2014).
To achieve the conditions necessary efforts so
that the quality of life of the elderly can be
maintained or increased. Efforts to do them
with health education. Health education can
maintain or improve the quality of life among
which health education on reproductive health
of the elderly, yoga exercises to improve
fitness in the elderly, and the first handling
emergencies elderly at home.
The results of the data after the elderly
are given health education on how to maintain
or improve the quality of life quality of the
elderly showed that the urban region of Ivory
and puppetry Pucang well. This shows that
most of the elderly in the village Pucang ivory
and puppetry have a level of independence,
physical and psychological condition, social
activity, social interaction and family
functioning so well that the elderly in running
64
their lives Pudak umbrellas and puppetry are
not overly trouble.
5. Conclusion and Suggestion
a. Conclusion
1. The majority of the elderly health of a
routine health examination results showed
in a healthy condition.
2. Health education given to the elderly
showed keantusiaan and curiosity more.
3. Elderly indicate the level of quality of life
(71%).
b. Suggestion
1. memandirikan elderly in the prevention and
health monitoring.
2. Health education must continue to be given
to the elderly, especially is a health
information related to problems of
degenerative disease and is not contagious.
3. Quality of life of the elderly should be
routinely monitored to see the level of
quality
of life, because the elderly have to enjoy life
with good quality in his old age.
6. References
Azwar, A. (2006). Pedoman pembinaan
kesehatan usia lanjut bagi petugas
kesehatan. Depkes: JawaTimur.
Bappeda Kota Semarang dan Badan Pusat
Statistik Kota Semarang. (2012).
Kecamatan banyumanik dalam angka
2011. Diaskes pada tanggal 24
Februari
2016.bappeda.semarangkota.go.id/v2/
wp-
content/uploads/2013/08/zzBANYU
MANIK2011.pdf.
Hutapea, Ronald. (2005). Sehatdan Ceria
Diusia Senja. PT RhinekaCipta:
Jakarta.
Kusumawatidan Hartono. (2010). Buku ajar
keperawatan jiwa. Jakarta: Salemba
Medika.
Nugroho, W. (2000). Keperawatan gerontik &
geriatric. Edisi 3. EGC: Jakarta.
Prawirohusodo, Soejono. (1991). Perubahan
Psikuatik dan Neurologik pada Lanjut
Usia. Makalah Yogyakarta.
FakultasKedokteran UGM.
Setiowati, ErniWahyu (2012). Analisa konsep
diri pada lanjut usia yang di rawat di
panti werdha darmabakti Surakarta,
(Skripsi). Universitas
 Proceeding Patient Safety in Emergency

Muhammadiyah. Surakarta. Diakses Suparyanto. (2010). Konsep lanjut usia.

Pada Tanggal 25 Februari 2016. Diaskes pada tanggal 26 Februari
http://eprints.ums.ac.id/20214/15/NA 2016. http://dr-
SKAH_PUBLIKASI.pdf. suparyanto.blogspot.co.id/2010/07/ko
Soekidjo Notoatmojo. (1992). Pengembangan nsep-lanjut-usia-lansia.html.
Sumber Daya Manusia. Yogyakarta: UNDIP. (2014). Perencanaan wilayah dan
Rineka Cipta. kota: Peta administrasi dan profil
Suardiman, Siti Partini. (1995). Psikologi wilayah kelurahan Pedalangan
Perkembangan. FIP IKIP. kecamatan Banyumanik Kota
Yogyakarta. Semarang Tahun 2014. Diaskes pada
Sumodiningrat, Gunawan. (1996). tanggal 25 Februari 2016.
Pembangunan Daerah dan http://www.academia.edu/10155925.
Pemberdayaan Masyarakat. Jakarta:
Bina Reka Pariwara.

65
Proceeding Patient Safety in Emergency

THE INFLUENCE OF REST DIET AND ZUMBA AEROBIC GYMNASTIC

TO THE BODY MASS INDEX TO THE FEMALE COLLEGE STUDENT
WITH OVERWEIGHT IN DEPARTMENT OF NUTRITION,
HEALTH POLITECHNIC KEMENKES MEDAN

Lusyana Gloria Doloksaribu, Amelia Rosa Kacaribu

Nutrition Department of Poltekkes Kemenkes Medan

ABSTRACT

Nutrition problem in Indonesia is a nutrition multi problem in which the malnutrition has not yet
eliminated totally, there is an over nutrition problem. Overweight and obesity is susceptible to the
young adults specially to the female adolescent. This is caused by the change of sedentary lifestyle
and eating poattern to the western food. According to the World Health Organization (WHO) data in
2011, the obesity rate in the world is increase for twice in 1980. Almost 43 million of child under five
have overweight in 2010. One of efforts in solving the overweight and obesity problem is by diet.
The alternative diet will be introduced in the society is REST (Regulated balancing lower energi) diet.
The application of diet must be followed by physical activities. The physical activities is such as
sports or practice. One of suggested sport for the lower of body weight is aerobic gymnastic. The
objective of this research is to study the influence of REST diet andZumba Aerobic Gymnastic to the
BMI to the female college student with the overweight in Department of Nutrition of Health
Polytechnic of Kemenkes Medan.This research is a quasi experiment with pre and post test design.
The number of sample in this research are 40 samples that chosen with inclusion criteria. REST diet is
implemented in each day and Zumba aerobic gymnastic in duration of ≥ 200 minutes in a week.The
result of research indicates that the average of BMI to the female college student of 40 sample with
overweight before the Diet REST intervention and Zumba aerobic gymnastic is 29.30 kg/m2 while the
average of BMI to the female college student with overweight after REST diet intervention and
Zumba aerobic gumnastic is 25.81 kg/m2 so it indicates the lower of BMI for 3.49 kg/m2 in 3
months.Based on the statistical test with T test Dependent, it obtain that p = 0.001 < 0.05 means there
is influence of REST diet and Zuma aerobic Gymnastic to the BMI of the female college student with
overweight in Department of Nutrition of Health Polytechnic of Kemenkes Medan.

Keywords : Overweight, REST diet, Zuma Aerobic Gymnastic, Body Mass Index
Reading List : 14 (2000-2014)

BACKGROUND percentage of the adult population (> 18 years)

Nutritional problems in Indonesia is
now entering multiple nutritional problems.
Wherein, the problem of malnutrition is still
not fully resolved, as it appears more
nutritional problems. Being overweight can
occur both in children up to adulthood (Jahari
A, 2004). Overweightand prone to obesity in
young adults, especially young women. This is
due to changes in lifestyle sedentaryand eating
patterns that lead to dietwestern food.Yet
without them knowing it fast food is high-
calorie foods, high in fat, carbohydrates,
cholesterol and sodium but low in fiber
(Hidayati at al, 2006).
Organitation According to data from
the World Health Organization (WHO) in
2011, the rate of obesity in the world has
increased more than doubled since 1980. The
in North Sumatra that have more weight
(overweight) amounted to 11.9%, while the
cumulative percentages throughout Indonesia
at 10.00%. For overweight (obesity), the
percentage of the adult population in North
Sumatra amounted to 13.5%, while the
cumulative percentages throughout Indonesia
by 11.7% (Department of
HealthRepublikIndonesia,2010).
One effort in addressing overweight
and obesity problem is with the diet. Diet is a
weight loss method that is most often
performed by young women. This is because
the appearance of being a perfect measure of
the social environment (Alwisol, 2009).
Alternate current diet was introduced in the
community is that REST Diet (Low Energy
Balanced Regular). REST diet is one form of

66

arrangement of food, physical activity and
psychological against everyday foods so
expect a lifestyle. One advantage of REST diet
is not changing daily eating habits, both in
terms of quantity but replace it using a high-
fiber foods such as fruits and vegetables. Total
energy adjustableby height and age.Women
with a height of 148-165 cm with 19-29 years
of age ± 1500 kcal energy needs.Frequency of
eating with three main meals and two times
interlude (Ramayulis, 2014).
Application of the diet should be
followed by physical activity. Physical activity
that can be done is with sports. One exercise is
recommended for weight loss is aerobics.
Aerobics is now much in demand by the
women that exercise Zumba. The researchers
found that Zumba burns an average of 369
calories, or about 9.5 kcal
Zumbapermenit.Senam do 32-52 minutes in a
workout. With Zumba exercise three times a
week in a month can reduce the weight of 3kg
(M, Luettgen, et al 2012).
Various methods of body
anthropometric measurements may be used in
determining the nutritional status of
overweight and obesity, one of them is to
weigh and measure height in calculated into
the body mass index (BMI). With the
overweight category ≥ 23kg / m2, obese I
24,9-29,9kg / m2, obese II ≥30,0kg / m2
(WHO, 2000).
Based on the results of a preliminary
survey conducted a recall of food consumption
10 students who have more weight it turns out
the average number of days energiper
consumption of 2550 kcal or 121.4% of the
RDA (more categories), which is characterized
by consuming a lot of foods that contain fat
example-fried food. In addition to excessive
energy intake, found 40 female students from
150 female students college (26.6%)
overweight BMI status.
RESEARCH PURPOSES
1. Assess the student BMI before and after
diet and aerobics Zumba REST
2. Assessing the energy and fiber intake
before and after the diet REST
3. Analyze the effects of diet and aerobic
Zumba REST towards BMI
Proceeding Patient Safety in Emergency
RESEARCH METHODS
Design, Subject, and Time
This study is quasi experiment with the design
of the Pre and Post Test designs. To determine
differences in BMI before and after diet REST
and Zumba Aerobic Gymnastics on College
Female Student Nutrition Department of
Ministry of Health Polytechnic Medan
(Notoadmojo, 2012).
Determination of the subject based on the
inclusion criteria were obtained as many as 40
people.
The research was conducted from October
2015 through July 2016.
Types and Data Collection Method
The data were divided into two, namely
primary data and secondary data. Primary data
includes identity data samples, include weight,
height, age, BMI (Body Mass Index) before
and after the intake of nutrients (energy and
fiber), while secondary data is data general
overview of research locations obtained from
the college administration.
Processing and analysis of data
Analysis of data obtained using statistical test
calculation using the program SPSS.
Univariate analysis, to describe each variable
of the study. Bivariate analysis, conducted to
examine the effect before and after treatment
on the students.
RESULTS AND DISCUSSION
A. Characteristics of Sample
1. Age
There are four critical period of obesity,
namely: prenatal, infancy, adolescence and
adiposity rebound. Obesity occurs in
adolescence, 30% will continue to mature into
a persistent obesity. In this study sampled
student between the ages of 17-22 years.
Distribution of samples at most in the age
group of 16-18 years with a percentage of
55%. Seen from a range of age, nutritional
problems of obesity in teenagers need
attention, because obesity arises when children
and teenagers when then continues into
adulthood will be difficult to overcome.
Moreover, obesity in adolescents is not only a
health problem later in life, but also bring
problems for social and emotional life are
significant in adolescents (Virgianto and
Purwaningsih, 2006).
67
Proceeding Patient Safety in Emergency

2. Weight Overview of the results of the pre and post

Weight loss is a common body size were testfemale student can be seen in Table 3
weighed in a state of minimal dressing to below:
assess nutritional status. Weight loss is also
one parameter that provides an overview of Table 3.
body mass. Body weight was measured in Results of Pre & Post Test
kilograms (MS SyoergawiBoby, 11: 2014). Female College Student
Overview of weight before and after the n Min Mak Mean SD
intervention diet and aerobic Zumba REST Pre test 40 40 80 57,50 7,76
can be seen in Table 1. Post 40 70 90 77,25 5,98
Table 1 shows the average weight before the test
intervention in female college students 69.9 kg
while the average student weight 61.58 kg Table 3 shows the average value of pre-test
after intervention so that it appears the weight counseling a female student before being
loss on average by 8.34 kg for 3 consecutive given a 57.50 while the average value of post
months. test counseling student is given after 77.25.
It shows the female student can receive
Table 1. counseling given and eligible to run Diet
Weight Loss Before and After REST.
The Intervention Diet and
Aerobics Zumba REST C. Intake of Energy and Fibers Before and
n Min Mak Mean After Diet Intervention Guide REST
Weight 40 57,60 87,00 69,92 AndZumba Aerobics Gymnastics
before Results of interviews to determine energy
Weight after 40 49,30 78,00 61,58 intake and fiber intake before and after the
Difference 8,3 9,0 8,34 intervention was conducted using the 24-hour
food recall for three days in a row earned the
3. Height average intake (energy and fiber).
According toRudiyanto (2012) height is the
distance from footwear to the highest point on Table 4.
the head and body stand tegak.Tinggi Energy & Fiber IntakeBefore
measured in centimeters. and After Intervention
Height illustration female College Student Nutrient Min Mak Mean SD
Nutrition Department of Ministry of Health Before Energy 2308,10 2604,30 2478,43 95,03
Intervention
Polytechnic Medan can be seen in Table 2 Fiber 4,90 16,20 12,28 3,47
below. After Energy 1364,47 1606,80 1528,21 58,20
Table 2. Intervention
Height Female College Student Nutrition Fiber 15,57 36,97 31,31 3,16
Department of Ministry of Health
Polytechnic Medan Table 4 shows the average energy
N Min Mak Mean intake before intervention 2478.43 kcal while
Height 40 147,00 163,20 154,65 the average energy intake after intervention
with decreased caloric 1528.21 950.22 kcal
Table 2 shows the average female student kcal. For the average intake of fiber before the
Department of Nutrition height 154.6 cm by intervention of 12.28 grams while the average
147 cm minimum value and a maximum value fiber intake of 31.31 grams after intervention
of 163.2 cm. by the increased consumption of 19.03 grams
fiber.
B. Results of Pre & Post Test This is due to compliance of samples
Pre and post test is used to look at the level of in adhering to the principle of Diet REST,
student knowledge before and after running which is characterized by a good diet and the
the Diet counseling for REST. frequency of eating the food consumed
teratur.Jenis already leads to low energy and
high in fiber such as fruit and vegetable
consumption with the amount as needed.

68

D. BMI Before And After Diet Intervention
REST And Zumba Aerobics Gymnastics
Centers for Disease Control (CDC) in
2011, BMI is a reliable indicator for assessing
body fat for most people and is used to detect
weight can lead to health problems.
BMI describe excess fat tissue
throughout the body which can be calculated
by dividing weight in kilograms (kg) by height
in meters squared (m2). BMI interpretation
depending on age and gender, because men
and women have different body fat (GA Bray,
2007).
Overview BMI (Body Mass Index)
before and after intervention REST Diet and
Aerobic Gymnastics can be seen in Table 5
below:
Table 5.
BMI Before and After Intervention Diet
REST and Zumba Aerobics Gymnastics
n Min Mak Mean SD
BMI Before 40 23,20 38,16 29,30 3,97
Intervention
BMI After 40 20,08 34,21 25,81 3,77
Intervention
Difference 3,12 3,95 3,49 0,5
Table 5 shows the average value of
BMI before intervention REST Diet and
Aerobic Gymnastic Zumba 29.30 kg / m2
while the average BMI after intervention
REST Diet and Aerobic Gymnastic Zumba
25.81 kg / m2. So it appears the reduced BMI
by an average of 3.49 kg / m2 for 3 months.
The reduction in BMI that occurred
can be caused by physical activity performed
by the student Zumba aerobics are conducted
with duration ≥ 200 minutes a week. This is in
line with the opinion of the investigators that
Zumba can burn on average 369 calories, or
about 9.5 kcal per minute. The combination of
salsa dancing, ramba and menengue make
Zumba quickly burn calories and fat in the
body (M, Luettgen et al, 2012).
As for diet REST own views on the
recall conducted by the student that decrease
energy intake and increase fiber intake
conducted by the student. It is characterized by
an average of 24-hour recall for the student
after the intervention of 1528.21 kcal energy
intake and to an average of 31.31 grams fiber
intake.
Proceeding Patient Safety in Emergency
E. Effect of Dietary intervention REST and
Zumba Aerobics Gymnastics Against
BMI
To see the effect before and after the
intervention to changes in BMI in overweight
student with BB can be seen in Table 6 below:
Table 6. Effect of Dietary Intervention
Against Aerobic Gymnastics REST and
BMI
BMI categories n Min Mak Mean SD pvalue
BMI Before
Intervention Diet
REST and 40 23.20 38.16 29.30 3.97
Zumba Aerobics
Gymnastics
0,001
BMI After
Intervention Diet
REST and 40 20.08 34.21 25.81 3.77
Zumba Aerobics
Gymnastics
From the statistical test using the Test
Paired T test obtained by value p = 0,001
<0,05 seen any significant difference before
and after the intervention, meaning that the
effect of diet intervention Rest and Zumba
Aerobics Gymnastics against the student with
a BMI in the overweight BB Nutrition
Department, then by running a REST Diet and
aerobic Zumba contributed to changes in BMI.
BMI changes occur due to the
intervention given that REST Diet and aerobic
exercise Zumba. The decrease in BMI was
seen during the three months ranged from 2.22
to 4.85 kg / m2. This is caused by physical
activity Zumba is aerobics in the morning and
afternoon with a duration ≥ 200 min /
minggu.Sejalan with Agik research, (2012)
concluded their influence low impact aerobics
to weight loss in mothers beginners
Karangasem in 2012.
As for diet REST seen from the level
of student knowledge is the result of the pre
and post testyang carried out that an increase
in student knowledge after being given
counseling on how to run Diet REST so that
when the intervention is visible decrease in
energy intake on the students as well as
increased fiber intake. Student consumption
patterns has led to reducing the food sources
of energy and fat tinggi.Hal is in line with the
results of research on adolescent Yogyakarta
and Bantul that the higher the energy and fat
intake the higher the likelihood of obesity.
This study also supports no relationship to the
69
Proceeding Patient Safety in Emergency
total energy contribution of fat to obesity
(Medawati et al., 2005)
In principle, the REST diet is to lower
total energy intake while
mengenyangkan.Tetap consuming foods with
the appropriate volume, containing a complete
and balanced nutrition, as well as the
frequency of eating at least 3 times
sehari.Selain the regular feeding distance and
the type and amount of food in accordance
with needs. REST proper diet will make you
lose weight every week a minimum of 0,5kg
(Ramayulis, 2014).
CONCLUSION
1. The average BMI of the student with the BB
overweightsebelum intervention REST Diet
and aerobic Zumba is 29.30 kg /
m2sedangkan the average BMI of the
student with the BB overweightsesudah
intervention REST Diet and aerobic Zumba
is 25.81 kg / m2
2. The average rate of energy intake and fiber
before intervening Diet REST and aerobics
and Zumba is 2478.43 kcal 12,28g while
the average rate of energy intake and fiber
after intervention REST Diet and aerobic
Zumba is 1528,21kcal and 31,31g
3. There was a significant effect of diet and
aerobic Zumba REST to changes in BMI (p
value 0,001 <0,05)
SUGGESTION
1. The effort should be made to disseminate
information about the benefits of REST
Diet and aerobic gymnastics in adolescents
in an effort to lose weight.
BIBLIOGRAPHY
Alwisol, 2009,
PsikologiKepribadianEdisiRevisi,
Malang: UMM Press, e-Journal
Psikologi, 2(2): 163-170
Centers for Disease Control and Prevention,
(2011) About BMI for children and
teens.http: // www.cdc.gov/health
weight/ assessing/ bmi/ children bmi /
about childrensbmi. Html.
Diunduhpadatanggal 13 Maret 2011.
Jahari A. Penilaian Status
GiziBerdasarkanAntropometri. Bogor:
PuslitbangGizidanMakanan, 2004.
JurnalKesehatan, 15(1):37-43
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Luettgen M, Foster C, Doberstein S, Mikat R,
and Porcari J. Zumba: Is the “fitness-
party” a good workout?.Journal of
Sport Science and Medicine. 2012;
11:357-58
Medawati, A., Hadi, H., danPramantara. I.
2005. “HubunganAsupanEnergi,
AsupanLemak,
danObesitasPadaRemaja SLTP di
Kota Yogyakarta
danKabupatenBnatul.”
JurnalGiziKlinik Indonesia 1(3):119-
29
Notoatmojo, Soekidjo. 2012.
MetodologiPenelitianKesehatan.
RinekaCipta. Jakarta.
ProverawatiAtikah. (2010).
ObesitasdanGangguanPerilakuMakan
padaRemaja. Jakarta: MuhaMedika.
Ramayulis, Rita. (2014), 101 Tips Berhasil
Diet REST ala Rita Ramayulis. PT
Gramedia Pustaka Utama, Jakarta.
Ramayulis, Rita. 2014. Slim is Easy.
PENEBAR SWADAYA GRUP,
Jakarta Timur.
Riskesdas. 2010.
LaporanHasilRisetKesehatanDasarNas
ional 2010.
BadanPenelitiandanPengembanganKe
sehatanDepartemenKesehatanRepubli
k Indonesia. Jakarta.
Sudargo, Toto, Harry Freitag LM, Felicia
Rosiyani dan Nur Aini Kusmayanti.
(2014), Pola Makan dan Obesitas.
Gadjah Mada University Press,
Yogyakarta
Virgianto, G., san Purwaningsih, E., 2006.
Konsumsi Fast Food
SebagaiFaktorResikoTerjadinyaObesit
asPadaRemaja.http://www.m3undip.or
g/diakses tanggal 19 April 2008
World Health Organization. Obesity:
Preventing and managing the global
epidemic.WHO Obesity Technical
Report series 894.World Health
Organization.Geneva, 2000.
World Health Organization.Obesity and
Overweight.WHO Regional Office for
South-East Asia.WHO Department of
Sustainable Development and Healthy
Environments, 2011.
 Proceeding Patient Safety in Emergency

EFFECT OF PLAYING PLASTICINE AGAINST CHILDHOOD CREATIVITY 4-6

YEARS IN KINDERGARTEN AL - IKHLASHIYAH MEDAN 2016

Tiurlan Mariasima Doloksaribu, Wiwik Dwi Arianti, Elitya Bekie Foresa Siregar
Nursing Department of Poltekkes Kemenkes Medan

Abstract

Creativity is the general ability to create something new , to results new ideas or solutions , whether in
the form of new product or idea that can be applied to problems solving, or as the ability to look at the
elements that already exists. The child has unlimited ability within himself to be able to think
creatively and productively. The purpose of this study was to analyze Effect after playing plasticine
Against Childhood Creativity 4-6 years In kindergarten Al - Ikhlashiyah Medan 2016. The game is
one of the media that can develop creativity, increase motivation , and can relieve tired and bored at
the time of learning . Plasticine is soft dough with a variety of colors that can be made into a variety
of forms . Kids can express their creativity by playing plasticine and find the unique shapes of each
mode of expression. This type of research is analytic design quasy experimental with pretest - posttest
design study with one group. sampling method is sampling saturated / total sampling, the number of
samples in this study were 30 children. The results of the study with paired t-test at a level of 95%,
showed a significant influence before and after playing plasticine in child's creativity with Pvalue =
0.01 (< 0.05). From the results of this study concluded Ho is rejected or Ha is accepted, it‟s mean that
there is influence in child's creativity after playing plasticine in kindergarten Al - Ikhlashiyah Medan
2016. It is suggested to educational institutions TK Al - Ikhlashiyah Medan to apply the method of
playing with plasticine in order to further enhance the creativity of student or student in creative and
imaginative in order to further develop their talents and abilities of children in creativity.

Keywords : Creativity , Playing Plasticine

Reading List : 14 ( 2010-2013 )

BACKGROUND problems. Aspec motoric such as gross motor

Pre school age is step of children
growth is the age before school age and call is
the children new age (Gunarsa, 2002). The
children of pre school among 4-6 years age
(Biechler and Snowman, 1993 in Hartati L,
2011). This age usually call is “usia emas”
(the golden age), and very influence to growth
of the children quality (Keith Osborn, Burton
L, White, and Bloom, 1993). The children of
pre school usual very active, they was have
authority himself and very interesting theyself
for activity (Snowman, 1993 at Hartati L,
2011).
Pre school education goal to support
emotional, social, fisic and creativity and
intelectual children development (Marrison,
2009). Pre school education is an educational
to support growth and development prepare
primery high school before. The inteligent
growth during pre school age has improved
from 50% to 80% (Syafaruddin, 2011).
Growth aspec for the children pre
school such as fisic and motoric aspecs. Aspec
motorik is very tight for the growth fisical
skills and fine motor skills (Nielsen, 2008).
The growth of fine motor skills for the pre
school include the growth and fungtion of
small muscle to move specific bodys part like
write, pleat, string up, to make clothes button,
cut with scissor and another (Nielsen, 2008).
Montolalu (2008) said that the play for the
childrens have bigger effec, because when
children play can distribution all activity and
imajination, cause it children can make
creative more by playing activity. Research
(Berretta dan Privette, 1990 at Howard-Jones
dkk, 2002) said the childrens participation in
the activity play showed the higher creativity.
The one kinds of playing such as with
the constructive play (Dynna Wahyu, 2013).
Plasticine is the one of instrument to
constructive play (Gesell dan Cohen, 2006).
Khotimah, (2010) said that constructive play is
very often tipe for playing during pre school
age. Constructive play occur when the children
can created product (Santrock, 2007 dalam
Dynna Wahyu, 2013). Plasticine is soft mixed
some colours with can create for some form.

71
 Proceeding Patient Safety in Emergency

Howard-Jones at al (2002) for 52 Table 2.

children 6 year show the plasticine play during Frequency Distribution of Creativity
25 minute can improved their creativity for According to Age Factor after Post-Test at
high. The benefit of play plasticine media to Kindergarten AL-Ikhlashiyah Medan 2016
fingers coordination, warped the fingers Age Kreatifitas Postest Total
muscle, tenacity exercise and patient, to (Year) Not Creative Creative Very
Creative Lack Creative
improve the children imajination and creativity n % n % n % n % n %
(Sujarwo, 2014). 4 1 8.4 1 8.3 8 66.7 2 16.7 12 40
Munandar (2012) define the creativity is 5 1 7.1 2 14.2 9 64.2 2 14.2 14 46.7
capability to new combines, associates new 6 0 0 0 0 3 75 1 25 4 13.3
creations be base on substance, information, Total 30 100
data or the elements before to create
something rewarding and useful. Tabel 2. Responden proportion creativity 5
year is creative as many as 9 person (62,2%)
RESEARCH METHODS and second 4 year as many as 8 person
Type of analytical research is quasi (66,7%). Pada tingkat kreatifitas sangat
experimental with one group pre – post test creative masing-masing 2 orang pada umur 4
design to know the difference analyze of dan 5 tahun sedangkan pada umur 6 tahun 1
childrens creativity play before and after at the orang (25%)
Kindergarten Al-Ikhlashiyah Medan.
Sampling using total sampling. Univariate 2. Bivariate analysis
analyze of data by means of frequency
distribution table, then made a conclusion Tabel 3.
using the paired t – test with 95% degree of Frequency Distribution of Creativity before
confidence, α 0,05 with Ha hypothesis is and after Playing Plasticine at
accepted if p ≤ 0,05. Kindergarten AL-Ikhlashiyah Medan 2016
Kreativitas
Interventi Not Lack Creative Very
RESEARCH RESULT on Creative Creative Creative
1. Univariate analysis MeanSD P MeanSD P MeanSD P Mean SD P
Table 1. Value Value Value Value
Frequency Distribution of Creativity Pretest 0,900,300,00 0,330,470,01 0,760,430,01 0,10 0,00 0,01
According to Age Factor before Playing Posttest0,930,25 0,900,30 0,330,47 0,83 0,37
Plasticine at Kindergarten AL-Ikhlashiyah
Medan 2016 Tabel 3. According to the table above shows
Age The Level Creativity at Pretest Total that there is a statiscally rare difference before
(Year) – after Playdough Play for each creativity level
Not Creative Creative Very the result is mean value not creative = 0.03 (α
Creative Lack Creative
n % n % n % n % n %
<0.05), lack creative = 0.57 (α <0.05), creative
4 2 16.7 6 50 4 33.4 0 0 12 40 = 0.43 (α <0.05) and very creative = 0.73 (α
5 1 7.1 11 78.5 2 14.2 0 0 14 46.7 <0.05).
6 0 0 3 75 1 25 0 0 4 13.3
Total 30 100 Table 4.
Creativity Differences Before and after
Tabel 1. Majority respondent aged 5 year as Playing Plasticine in TK Al-Ikhlashiyah
many as 14 person (46,7%). Responden Medan 2016
proportion creativity higher creative lack as Creativity Mean SD P Value
many as 11 person (78,5%). Not found
respondents with a level of creativity is very Creativity before playing
1.13 0,57
creative in all age groups. plasticine
0,01
Creativity after playing
1.93 0,73
plasticine

Tabel 4. Childres creativity before

intervention, mean value = 1,13, and after
intervention increase to 0,8 times greater with

72

Pvalue = 0,01, there is an influence on the
creativity of children playing plasticine
DISCUSSION
1. Relationship between age factor with
creativity before Playing Plasticine
Results showed show of 12 respondents were
4 years old, has not been as much creative
creativity level 2 (16.7%), less creative 6
(50%) and creative 4 (33.4%). Of the 14
respondents creativity yet creative level 1
(7.1%) and lack creative 11 (78.5%) and 4
respondents from the age of 6 years, 3 (75%)
are less creative). From the table results of
data analysis showed that age affects children's
creativity in play, namely with the increasing
age, the child's creativity is increasing. Along
with theoretical Munandar Utami (2012), that
children aged 4-5 years old in need of care and
good guidance so that cargo can be powered
optimally creativity. On the scale of this age,
children easily absorb all the information that
is around. Based on the theory (Akbar-Hawadi
in Revelation Dynna Journal, 2013) also said
that some critical periods of development of
creativity of one of them appeared at the age
of 4-6 years.
2. Relationship between age factor with
creativity after Playing Plasticine
After playing plasticine, at the age of 4 and 5
years old at the creative level of creativity yet
are each one respondent. Of the 12
respondents aged 4 years, 1 (8.3%) less
creative, 8 respondents (66.7%) and 2
respondents creative very creative (17.7%). Of
the 14 respondents age of 5 years, 2 (14.2%)
less creative, 9 (64.2%) kreative and 2 (14.2%)
are very creative while 4 respondents age of 6
years, 3 (75% ) creative and 1 person (25%)
very creatif
According to Smilansky (Winarsih 2010), fine
motor children who show creativity based on
age is 4-5 years old. Play activities can be seen
in preschool children through play, children
will be able to develop fine motor skills.
Plasticine form the game is important for fine
motor development of children, because with
this game, children will feel happy and keen to
learn. This type of game is the type of game
that can turn on the nerves tactile hands with
through the game plasticine flexible, and
according to Puri Aquarisnawati et al (2011)
also explained that the lack of stimulation or
activity of a physical nature, especially motor
Proceeding Patient Safety in Emergency
hakus in kindergarten will lead children have
concentration problems when the child was in
elementary school are caused by fine motor
immature.
Fine motor indicators based on levels of
achievement in the development of 58-year
Permendiknas 2009 contains activities such as
tracing, cutting, forming with plasticine,
playing blocks, folded, and others, which
should be implemented and achieved in order
to develop the fine motor skills of children.
(Journal Febrianingsih, Renita, 2014.
3. Relationship between age factor with
creativity before and after Playing
Plasticine
Creativity respondents 4 years relationship
with the level of lack creativity as many as 2
person (16.7%) with the pre-test become 1
person (8.4%) after playing plasticine. At the
level of creativity less creative as much as 6
pretest reduced to 1 when the post-test, the
level of creativity creative increase of 4 pretest
be 8 after the post-test. Respondents aged 5
years experienced an increase in the level of
creativity in the creative level of 2 (14.2%)
pretest to 9 people (64.2%) at post-test.
Respondents age of 6 years, the overall
increased level of creativity where the current
pre-test 3 (75%) are less creative be creative
when the post-test and 1 (25%) with creative
creativity become very creative when post-
test. Respondents aged 4 and 5 years old,
when the pre-test any have reached a level of
creativity is very creative and post-test when
there are respectively 2 respondents with a
level of creativity is very creative. From the
results of the research data obtained before and
after the effect of plasticine play to the
creativity of children, which is an increase of
less creative creativity be creative.
The play has an influence on the development
of children, one of whom stimulus for
creativity. Each child has different interests
play depending on the child's development. In
line with the results of the Howard-Jones
(2010) were performed on 52 children aged 4-
6 years, most children were given modeling
clay for 25 minutes. The results showed that
children who play clay have a higher value of
creativity after playing. It is also the same as
research conducted by Rochayah (2012) who
found that an increase in creativity
kindergarten child playing plasticine.
73
Proceeding Patient Safety in Emergency
4. Level of Creativity before and after
plasticine playing
The level of creativity before and after the
intervention showed yet creative play
plasticine P (0.00) <0.05), less creative P
(0:01) <0.05), creative P (0:01) <0.05), and
very creative P (0:01) <0:05). Statistical test
results Paired-sample T-test of the level of
creativity is (p <0.05), so it was concluded
there was no significant difference before and
after the intervention playing plasticine. From
the analysis of the research data it can be seen
that there is an average difference of creativity
before and after the intervention. Children who
were given a plasticine play therapy increased
creativity 0.8 times higher than children who
were not given the intervention of playing
plasticine. It concluded their influence on the
creativity of children playing plasticine (p
value = 0.01). Baretta and Privette study
(2010) that children who participate in the
game show a higher level of creativity.
CONCLUSION
From the results of research conducted on
Playdough Play Effect Against Children Aged
4-6 Years Creativity at TK Al-Ikhlashiyah
Medan 2016 it could be concluded as follows:
1. Before plasticine play, majority respondent
aged 5 years as many as 14 person (46,7%).
Responden proportion creativity higher
creative minus as many as 11 person
(78,5%). Not found respondents with a
level of creativity is very creative in all
agegroups..
2. After plasticine play, responden proportion
creativity 5 year is creative as many as 9
person (62,2%) and second 4 year as many
as 8 person (66,7%). At the level of
creativity, very creative each 2 people at
the age of 4 and 5 years, while the age of 6
years is 1 person (25%).
3. Childrens creativity before intervensi, mean
value = 1,13, and after intervention
increase to 0,8 times greater with Pvalue =
0,01, there is an influence on the creativity
ofchildren playing plasticine an increase of
0.8 times creativity in children by playing
plasticine intervention than children who
were not given the intervention plasticine.
4. The results of the statistical test t-test
showed that an increase in creativity before
and after the intervention differed
significantly ie p value <0.05, which means
74
that Ho is rejected and Ha accepted. So it
can be stated that the implementation of
plasticine play to give effect to increase
children's creativity.
BIBLIOGRAPHY
Alimul, A. 2007. Riset Keperawatan dan
Tehnik Penulisan Ilmiah. Salemba :
Mudika
Frankenburg W. K dan Dodds J. B. 1987.
Denver II.
Hartati L, Widiana Herlina. 2011. Pengaruh
Bermain Play Dough Terhadap
Kreativitas Anak TK. Fakultas Psikolofi
Universitas Ahmad Dahlan. Yogyakarta.
Diakses 11 November 2015.
Hurlock, Elizabeth B. 2010. Psikologi
Perkembangan. Jakarta. Erlangga
Latif, Mukhtar, dkk. 2013. Pendidikan Aak
Usia Dini. Jakarta. Kencana.
Munandar, U. 2012. Pengembangan
Kreativitas Anak Berbakat. Jakarta.
Rineka Cipta.
Mutiah, Diana. 2010. Psikologi Bermain
Anak Usia Dini. Jakarta. Kencana.
Notoatmodjo, Soekidjo. 2012. Metodologi
Penelitian Kesehatan. Jakarta. Rineka
Cipta.
Patmonodewo, Soemiarti. 2012. Pendidikan
Anak Prasekolah. Jakarta. Rineka Cipta.
Risang, Sutawijaya. 2013. Super Creative
Game. Yogyakarta. Cemerlang
Publishing.
Santrock, J. W. 2007. Perkembangan Anak:
Jilid 1. Jakarta. Erlangga.
Sari, Dynna Wahyu. 2013. Pengaruh Bermain
Plastisin Terhadap Kreativitas Anak Usia
5-6 Tahun Ditinjau dari Bermain Secara
Individu dan Kelompok. Fakultas
Psikologi Universitas Airlangga.
Surabaya. Diakses 11 November 2015.
Sujarwo, Kartini. 2014. Penggunaan Media
Pembelajaran Plastisin Untuk
Meningkatkan Kreativitas Anak Usia
Dini. Universitas Negeri Yogyakarta.
Yogyakarta. Diakses 11 November.
Susanto, Ahmad. 2011. Perkembangan Anak
Usia Dini. Jakarta. Kencana.
Syafaruddin, dkk. 2011. Pendidikan
Prasekolah. Medan. Perdana Publishin
 Proceeding Patient Safety in Emergency

THE INFLUENCE OF ACUPRESSURE POINT PERICARDIUM 6 AGAINST A

DECREASE IN THE FREQUENCY OF NAUSEA VOMITING THE FIRST
TRIMESTER OF PREGNANT WOMEN WITH HYPEREMESIS GRAVIDARUM

Sri Utami
PSIK, Riau University

Abstract

The purpose of this research is to know the influence of acupressure point pericardium 6 against a
decrease in the frequency of nausea vomiting in the first trimester of pregnant women with
hyperemesis gravidarum, using design research quasy alphabets experiment. This research was
conducted against the 30 respondents mother with hyperemesis gravidarum who are being treated at
Petala Bumi Hospital Pekanbaru with 15 people as the experimental group and 15 people as the
control group. Sampling technique was purposing sample. The instruments used in the study is a
questionnaire and observation. Univariate analysis in the study exposed the frequency distribution and
percentage data about demographics and bivariate analysis that is used to view the difference between
the nausea and vomiting when pretest and post-test between the experimental and control group
differences as well as nausea vomiting when pretest and post-test in experimental group T-test is a test
used by are Two Independent Sample Test (Mann-Whitney U Test) the results of the research value of
the P value 0.84 > real adequate (α = 0.05) so that HO failed rejected and it can be inferred that There
is no significant difference in the value of the nausea vomiting when post-test on a control group and
experimental. As well as the influence of treatment on experimental groups before and after
therapeutic acupressure given on point pericardium 6 is Two Related Sample Test (Mann-Whitney U
Test where analysis indicates P value = 0, 0l4 < a (0.05)) so that it can be concluded that there is a
significant difference in the value of nausea vomiting of pregnant women before and after the
acupressure point pericardium 6 Group experiments.

Keywords: acupressure, hyperemesis gravidarum, point pericardium 6

INTRODUCTION complaints often arise and cause discomfort on

Pregnancy is a continuous process that begins
with conception, ovulation, implantation and
development of the embryo in the uterus until
the age of pregnancy. Each process is a
condition in pregnancy crisis requiring
psychological and physiological adaptation
against the influence of the hormone.
Mechanical pressure resulting from pregnancy
and uterine enlargement and other networks
(Bobak, 2005). In accordance with the
physiological condition, pregnant women will
experience changes in each semester. In the
first trimester increase secretion of the
hormone Human Chorionic Gonadotropin, in
large quantities derived from the placenta, the
rapid invasion of tropoblast to the
endometrium and large amounts of estrogen
secretion from the placenta, where
circumstances are circumstances that go with
nausea and vomiting in pregnant women
(Artika, 2006). Physiological changes in
pregnancy first trimester many raises
complaints in pregnancy. One of the
the pregnant mother is nausea and vomiting in
pregnancy are usually referred to as nausea
gravidarum (Artika, 2006). If the nausea and
vomiting that interfere with daily activities or
cause complications, this State is called
hyperemesis gravidarum. Complications that
can occur is ketonuria, dehydration,
hypokalemia, and weight loss of more than 3
kg or 5% of body weight (Jueckstok, 2010,
and Gunawan dkk, 2011 in BKMT, 2013).
Nausea and vomiting in pregnancy
usually begins on the 9th week of pregnancy
until the 10th week of pregnancy, the more
weight on the 11th until the 13th and ending
on Sunday the 12th until the 14th. Only 1-10%
of pregnancies continues past the week 20th to
the 22nd. At 0.3%-2% of pregnancy
hyperemesis gravidarum occurs which causes
the mother should be styled as with inpatient
(Gunawan dkk, 2011 in BKMT, 2013).
Initial governance and for nausea and
vomiting without complications is rest and
avoid food that stimulates, such as spicy foods,

75
Proceeding Patient Safety in Emergency
fatty foods, or iron supplements. Simple diet
changes, i.e., consume foods in small portions
but often quite effective to overcome a mild
degree of nausea and vomiting. Whereas,
hyperemesis gravidarum patients should be
treated at home when ill is dehydrated and
done with liquid sodium chloride or lactate
ringer. Pharmacological and non
pharmacological therapy which has been
researched for the treatment of nausea and
vomiting in pregnancy are alternative therapies
such as acupuncture or acupressure, and
Ginger (Gunawan dkk, 2011 in BKMT, 2013).
One of the interventions for the
treatment has no side effects is the technique
of Acupressure for not using chemicals, so it is
believed there is no negative effect on the
mother or the baby (Bratman, 2001, in Artika
2006). Acupressure methods have long been
applied in Chinese as written in the book of
Acupuncture Without Needle Dr. Cerney. The
first trimester is the most sensitive period of
the fetus to be exposed a result of trauma,
herbs or other-medication, so the acupressure
that do not use the drug safe to do it yourself
by the treatment procedures (Artika, 2006).
Acupressure therapy for the treatment
of nausea vomiting is to do an emphasis on
point pericardium 6 located approximately 6
cm above the wrist of the front. Stimulation at
acupoints include doing acupressure point
pericardium 6 cause reactions of the nervous
system that is local. According to the research
of in 2002, stimulation at that point
pericardium 6 can enable system modulation
on opioid system, system of non opioid and
inhibition on sympathetic nerves which
hopefully will decline the frequency of nausea
(Artika, 2006).
The research results of Artika (2006)
influence of acupressure point pericardium 6
against a decrease in the frequency of
vomiting in first trimester primigravida with
nausea gravidarum in Wingi Malang village
test results obtained from the value of the p
value 0.00 < decline shows means 0.05
frequency of vomiting in meaningful on the
respondents after the acupressure point
pericardium 6.
Based on explanation above,
compilers are interested to do the
implementation of evidence based on the
“influence of the acupressure point
pericardium 6 towards a decrease in the
frequency of nausea vomiting in first trimester
76
of pregnant women with hyperemesis
gravidarum in Petala Bumi Hospital
Pekanbaru.”
RESEARCH OBJECTIVES
The purpose of this research is to
know the application of evidence based on the
influence of acupressure point pericardium 6
towards a decrease in the frequency of nausea
vomiting in first trimester of pregnant women
with hyperemesis gravidarum.
RESEARCH METHODS
This research is quantitative research
using design research quasy alphabets
experiment. Research of the correlation is a
descriptive research that examines the
relationship between two variables in a given
situation or a group of subjects.
(Notoatmodjo, 2005). This research was
conducted in Petala Bumi Hospital of the
population in this study are all mothers who
were treated with hyperemesis gravidarum.
The sample was pregnant first trimester with
hyperemesis gravidarum who have met the
criteria, namely:
1. Experiencing nausea and vomiting
2. Do not have complications
3. Never a miscarriage
The total number of samples is 30
people with details of 15 people as a group of
15 people and experiments as a control group.
Sampling technique was purposive sampling.
The instruments used were
questionnaires and observation. To obtain data
characteristics (data General) pregnant women
trimester I data collection, researchers used to
discover the intensity of nausea and vomiting
is the observation sheet with structured
interview techniques.
RESEARCH RESULTS
Research on the influence of the
acupressure point pericardium 6 towards a
decrease in the frequency of nausea vomiting
in first trimester of pregnant women with
hyperemesis gravidarum. This research was
conducted against the 30 respondent mother
with hyperemesis gravidarum treated in Petala
Bumi obtained the following results:
A. Univariate Analysis.
Univariate analysis in the study
exposed the frequency distribution and
demographic data about the percentage
 Proceeding Patient Safety in Emergency

examined from 30 respondents mother with Table 2

hyperemesis gravidarum treated in Petala The average distribution of nausea vomiting of
Bumi Hospital Pekanbaru. As for the results of pregnant women trimester I when pretest on
the univariate analysis can be seen in the the group control experiment
following descriptions: No Group Mean SD Min Max
1. Control 2.73 1.624 1 6
1. Characteristics of respondents 2. Experiment 3.87 1.407 2 6
From the 30 respondents treated in Petala
Bumi hospital obtained data the following From table 2 it is known that the average
characteristics of the distribution of nausea vomiting before intervention in the
respondents according to age described in the control group of 2.73 with standard deviation,
table below: while 1.624 to experimental group averaged
his nausea is 3.87 with standard deviation
Table 1 1.407. The value of nausea vomiting at least
Frequency distribution of respondents based appear on the group control is on point I while
on their age, tribe, gravid (pregnancy) the experimental group is on point 2. The
No Age Frequency Presentation value of nausea vomiting most often appear in
(%) the control group or the experimental group is
1. Age < 20 on the point of 6. To know the characteristics
y/o 1 3.3 of the changes of nausea vomiting, then
20-30 y/o 16 53.3 pregnant women given acupressure therapy
>30 y/0 13 43.3 intervention on point p6. After completion of
2. Tribes the intervention, the nausea and vomiting
Malay 2 6.7 return measured. Results of the study are
Minang 22 73.3 outlined in table 3 below:
Batak 0 0
Java 6 20.0 Table 3
3. Pregnancy The average distribution of nausea vomiting of
Primigravida 7 23.3 pregnant women first trimester when pretest
Multigravida 23 76.7 on the group control experiment
No Group Mean SD Min Max
Table 1 shows that most pregnant women are 1. Control 2.47 1.5 1 6.25
at the age range of 20-30 years that is as much 2. Experiment 2.78 1.75 0.75 6.5
as 16 (53,3%). Pregnant women aged less than
20 years amounts to 1 people (3.3%). Based From table 3 it can be seen that the average
on the tribe most respondents came from value of post-test nausea vomiting after the
Padang with a total of 22 people (73,3%)). intervention of the experiment and control
While the Malays is the least that is as much experiments are likely to be dropped from the
as 2 people (6%). On the table is also visible first day until the fourth day. The average
imagery that most pregnancy respondents are value of post-test experimental group was 2.78
on the group with a total of 23 people with standard deviation of 1.75 while the
multigravida (70.7%)) and the rest are in the average value of the post test control group is
Group of 7 people (primigravida 23.3%). 2.47 with standard deviation of 1.50. The
value of nausea vomiting at least appear on the
2. Characteristics of nausea vomiting pregnant group control is on point 1 and the value that
1st trimester appears most often is the point of 6.25. The
The results showed that nausea vomiting of value of nausea vomiting at least appeared in
pregnant women trimester I at the time of experimental group was on the point of 0.75
pretest can be seen in table 2. and value the most frequently appearing 6.5 is
on point.

B. Bivariat Analysis
Analysis bivariat used to see the difference
between the nausea and vomiting when pretest

77
 Proceeding Patient Safety in Emergency
and post test between control and experimental
as well as the difference in nausea vomiting
when pre-and post test-test in experimental
group T-test is a test of known normality.
Based on the results of the P value (0.05) à <
and seen that the Gaussian data is not normal
so that terms of use T test is not met.
Statistical techniques that became the choice
for this research is a non-parametric statistics
(Mann-Whitney U Test and Wilcoxon).
1. Two Independent Sample Test
To analyze the difference between the nausea
vomiting when pretest and post test on a
control group and experimental, testing used
are Two Independent Sample Test (Mann-
Whitney U Test).
Table 4
To avoid nausea vomiting of pregnant women
first trimester when pre-test on a control group
and experimental
No Group Mean SD Mann P 2. Post-test 2.78 1.75 5.25
Whitney value
1. Control 12,23 1.601 65 0.05
2. Experiment 18,67
From table 4 can be seen that the average
value of rank in the control group and the
experimental group was 12.33 is 18.67. The
Mean value of the control group and
experimental is 3.30 with standard deviation
1.601. The value of the Mann Whitney U are
65 and P value is the real extent of 0.05 < (a =
0.05) so that we can reject HO, it means there
is a significant difference in the value of the
nausea vomiting when pre-test on a control
group and experimental.
Table 5
The difference in nausea vomiting of pregnant
women first trimester when post-test on a
control group and experimental
No Group Mean SD Mann P 16 (53,3%), and the majority of respondents
Whitney value
1. Control 8.00 1.61 107,5 0.84
2. Experiment
Table 5 shows the average value of rank when
the post-test on a control group from the first
day until the 4th day is 14.53; 15.00; 14.83; a
group of experiments while 14.90 16.47;
16.00; 16.17; 16.10. Indigo average Mann
Whitney 107 with a standard deviation of 1.61.
The value of the P value 0.84 > real adequate
78
(α = 0.05) so that HO failed rejected and it can
be concluded that there is no significant
difference in the value of the nausea vomiting
when post-test on a control group and
experimental.
2. Two Independent Sample Test
The analysis is used to find out the influence
of treatment on experimental groups before
and after therapeutic acupressure given on
point p6 is Two Realated Sample Test (Mann-
Whitney U Test).
Table 6
The difference in nausea vomiting on the
experimental group before and after the given
intervention on the pregnant women first
trimester
No Group Mean SD Mean P
rank value
1. Pre-test 3.87 1.41 7.32 0.014
Based on table 6 above we can see the average
rating for nausea vomiting on the experimental
group when pretest is a time value and 3.87
post-test is 2.78. The difference in nausea
vomiting also looks at the average rank when
pretest of 7.32 and when post-5.25 test. The
results of the analysis show the P value = 0,
0l4 < a (0.05) so that it can be concluded that
there is a significant difference in the value of
nausea vomiting of pregnant women before
and after the acupressure point pericardium 6
Group experiments.
DISCUSSION
A. Characteristics of respondents
Based on the results of research in
Petala Bumi hospital Pekanbaru obtained most
of the respondents are in the age range of the
safe in the age of pregnancy (20-30 years) of
are Minang with number of 22 people
(73,3%). The habit of every tribe mainly
eating patterns will have an effect on the
incidence of nausea and vomiting. Robert and
Pepper (2006), analyze 56 pregnant women
from 21 countries. They study the incidence of
nausea vomiting that occurs in pregnant
women. They link eating habits in each
country and estimated that nausea vomiting
that occurs in pregnant women has to do with
eating habits.

Maulana (2008), suggests that nausea
vomiting will not develop good when a
pregnant mother consuming a healthy diet.
The results of research they mention that
nausea vomiting that occurs in pregnant
women is associated with high intake of
caffeine, sugar, vegetables, milk and eggs.
Liputo (2005) added that on the Minang, the
main ingredients for most types of cuisine is
pepper, herbs and coconut. Coconut fat value
saturated fatty acids almost 90%. So pregnant
women who came from the tribe of minang
have greater risk for experiencing nausea
vomiting events.
In addition to the tribal factor, a factor
also affects the incidence of gravida nausea
vomiting. Tyrant (2008) revealed an increase
in the incidence of nausea vomiting occurs in
women who have experienced several times of
pregnancy (multigravida) than women who are
first-time pregnant (primigravida). This is
caused by the pregnancy hormone production
differences in the two groups. In some cases,
symptoms can be used as a way of attracting
attention or as a way of asking for help on the
issue of a woman's life.
Lack of knowledge, information and
poor communication among expectant mothers
and families undertook to affect perceptions of
pregnant women against the severity of the
symptoms. It underlies the woman requires
looking hospitahsasi primigravida than women
multigravida. In women multigravida, mind
against the severity of the symptoms of nausea
vomiting can be overlooked because women
multigravida will be more preoccupied with
the other kids.
B. Hyperemesis Gravidarum
Based on the results obtained by
research that the average nausea vomiting
experimental groups prior to granting of 3.87
ginger drink. The National Cancer Institute
(NCI)/(2009), classify those values in the
category of nausea vomiting. The Group
experiments with value of nausea vomiting
most appears is 6, according to NCI (2009),
the value of the vomiting nausea is severe
vomiting nausea in the category. While, the
average nausea vomiting in the control group
was 2.73. According to NCI (2009), nausea
vomiting category is being. The value of
nausea vomiting most appear in the control
group was 6, according to NCI (2009) nausea
vomiting is severe vomiting nausea category
Proceeding Patient Safety in Emergency
after being given the intervention therapy on
point p6 on the Group experiments, worth
nausea vomiting on the two groups was
measured again. Average nausea vomiting
decreased in the control group when post-test
day one until day 4 with the value of the 2.8;
2.53; 2.4; 2.13. According to NCI (2009), the
average value of post-test day one until day 4
is on the category of nausea vomiting. The
average value of nausea vomiting on the
experimental group when post-test also
experienced a decline from the first day until
day 4 with value 3.27; 2.93; 2.67; 2.27. NCI
(2009) enter those values in the category of
nausea vomiting.
The above data shows that the rest of
the respondents experienced nausea vomiting
at both the control group and group
experiments. Vutyavanich (2001) States that
nausea vomiting is common problems that
occur on the 1st trimester of pregnant women.
Symptoms of nausea vomiting is not life
threatening, but the symptoms can be the
source of a stressor for pregnant women and
families. Wesson (2002), adding that 70-90%
of pregnant women experience nausea and
vomiting experienced 50% at least 1 time.
Nausea and vomiting of pregnancy
due to physiological reactions is the influence
of the hormone of pregnancy as progesterone,
HCG, etc. Nausea and vomiting severe
(Hyperemesis Gravidarum) can be a symptom
of several health problems such as mola
hidatidosa, hipertiroid, deficiency of vitamin B
complex or heavy stress (Moeloek, et al.,
2006).
According to Quinlan (2003), the
cause of nausea and vomiting in pregnant
women is still not Known with certainty but
there are various things that become factors
predisposing factors such as psychological and
hormonal changes. Pregnant women with
hysterical personality type and an excessive
dependence on mother tend to suffered nausea
and vomiting. Other factors that influence is
the hormone progesterone and HCG is causing
an increase in gastric motility and gastric acid
so that arise from the reaction of nausea
vomiting.
C. The effectiveness of acupressure therapy
intervention on point pericardium 6.
Based on the results of the analysis,
there was a decrease in the average nausea
vomiting before and after the granting of a
79
Proceeding Patient Safety in Emergency
therapeutic intervention acupressure point
pericardium 6. Average nausea vomiting
before a given intervention is given after the
intervention and 3.87 is 2.78.
The results of Two Related Sample
Test showed the value of Pvalue 0.014 < a
(0.05). Acupressure therapy means on point p6
is effective in lowering the nausea vomiting in
pregnant women first trimester show that
happens to drop in the frequency of nausea
vomiting after done action acupressure. This
happens due to the effect of the stimulation at
that point Pericardium 6 is believed to be able
to increase the release of beta-endorphin and
ACTH in hypophysis along the chemoreceptor
trigger zone (CTZ) to inhibit vomiting Center.
This stimulation is also able to help release the
neurotransmitter as endorphin, serotonin, and
norepinephrine which is able to block pain and
release of neurotransmitters also affects
system and immune system antinociceptive
(BKTM, 2013).
A decrease in the frequency of
vomiting after the acupressure point
pericardium 6 in accordance with the results of
the study in the Journal of Reproductive
Medicine stating that the acupressure point
pericardium 6 for 3 to 15 minutes can reduce
nausea vomiting in pregnancy and also nausea
vomiting due to chemotherapy and travel
sickness (Artika, 2006).
At the time the research was
conducted, researchers found the phenomenon
of inflammatory clinic on the respondent as
the respondent complained of pain and redness
in the area of emphasis. This is in accordance
with the theories expressed by Shier, et al.
(2004) that the stimulation of the pain caused
by the intense pressure and extreme
temperatures can lead to changes in vascular
permeability and the opening of Na+ channel
that will produce nervous system activation on
nociceptor on the ends of the nerve endings of
the skin (Artika, 2006).
The difference in frequency of
vomiting in pregnant women affected by the
mechanism of the body that cannot be
controlled by researchers and are individually
on each of the respondents. Pregnancy
hormone levels change affecting nausea
gravidarum as HCG and estrogen and increase
the motility of the intestine decreases
progesterone cause hyperemesis gravidarum
complaints time difference.
80
Conclusion
The influence of the techniques of acupressure
point pericardium 6 lowers the frequency of
nausea vomiting in pregnant women with
hyperemesis gravidarum.
Nausea vomiting overload will result in a
person becoming anemic. Especially for
pregnant women with excessive vomiting
nausea, pregnant mothers will result in
shortages of a variety of nutrients and will
abort the fetus, resulting in a premature, low
birth weight or even result in the death of a
fetus. During handling of this nausea vomiting
dominant use of drugs, but with handling
without drugs has been found, such as with the
technique of acupressur at the point the
pericardium 6 can decrease the frequency of
nausea vomiting in first trimester of pregnant
women with hyperemesis gravidarum
Acknowledgments
The authors would like to thank the University
of Riau for supporting this work through
URIAPDHG RP002F-13ICT
References
Artika. (2006). The influence of acupressure
point Pericardium 6 towards a
decrease in the frequency of Vomiting
on First Trimester Primigravida with
Emesis Gravidarum
BKMT (2013). The effectiveness of
Acupressure Against complaints of
Nausea Vomiting in first Trimester of
pregnant women in the city of
Makassar 2013
Bobak, I.M., et al. (2005). Nursing Maternitas.
Ed. 4. Jakarta: EGC
Doenges, M.E. (2000). Nursing Care Plan:
guidelines for planning and
Documenting patient care. Issue 3.
Jakarta: EGC
Hanifa w. (2006). Obstetrics. Jakarta: Yayasan
Bina Sarwono Prawirohardjo Library
Rustam Jonathan. (2002). Synopsis of
Obstetrics. Issue 2, vol. 1. Jakarta:
EGC
Roberts and Pepper G. (2006). Rates of
nausea and vomiting in pregnancy and
dietary characteristics across
populations
Wikinson, j. m. & Aherrn, N.R. (2011).
Nursing Diagnosis Handbook, Edition
9. Jakarta: EGC.
 Proceeding Patient Safety in Emergency

THE EFFECT OF EDUCATION HEALTH WOMEN OF INFANT MASSAGE TO

PRACTICE MASSAGE IN INFANT 0-12 MONTHS IN KELURAHAN
PANGKALAN DODEK

Yulina Dwi Hastuty

Midwifery Department of Poltekkes Kemenkes Medan

ABSTRACT

Implementation monitoring and stimulation the growth and development of infants and children can
be done by any health worker. One form of stimulation of growth and development is to do infant
massage. currently, there are still many parents of infants who do not know the benefits of baby
massage and how to massage the baby with true so do not know how to massage the babies
independently. This study aims to determine the effect of Health Education On Mother about the
infant massage to the the practice of infant massage in kelurahan Pangkalan Dodek Kabupaten
Batubara. This research is quasi-experimental design with one group pretest-posttest. The population
in this study were 108 mothers who had children aged 1 year residing in kelurahan Pangkalan Dodek
Kabupaten Batubara. The data were analyzed using paired t test (Paired T-Test). The results showed
that the average score pretest practice infant massage was 5.6 and the average score of posttest
practice infant massage is 20.27. Results of paired t test -45.79 tcount with p = 0.000 and the
percentage increase from pretest to posttest amounted to 60.95%, it means that there is a significant
difference in average scores between before and after health education about infant massage , so it can
be concluded that health education to mothers about infant massage have the effect on the practice of
massage in infants aged 0-12 months.

Keywords: health education, practice, infant massage

BACKGROUND is essential in the growth and development of

The process of birth is a traumatic
experience for the baby because the baby was
born must be leave the womb a warm, safe,
comfortable, and with limited room to move
toward a world with freedom of movement
without limits, scary, without touches
comfortable and safe around him , as when a
baby is in the mother's womb (Roesli, 2009).
After the baby was born, there will be
changes in her body. While in the womb, the
fetus is very dependent on his mother. Any
changes experienced by the infant is related to
the mother's condition. After birth, the baby
must be be able to adapt to the surrounding
environment. Such changes can affect the
growth and development of babies later (Lee,
2009)
Since birth, the baby has three
requirements that must be met by the parents,
the physical-biological needs which are useful
for the growth of the brain, sensory systems,
as well as the motor. Emotional needs
affection for emotional intelligence,
interpersonal and intrapersonalnya, as well as
the need stimulation to stimulate all the
sensory and motor systems work. Stimulation
children (Ngastiah , 2005)
Implementing the monitoring and
stimulation of growth and development of
infants and children can be done by anyone
not just health workers but also involves
family and community. One form of
stimulation of growth and development has
been done by the people is to do infant
massage.
Infant massage is a massage
performed with a sweep-sweep smooth on the
surface of the baby's skin, made by hand
which aims to produce effects on the nervous,
muscular, respiratory system and blood
circulation and spleen. Touch and massage the
baby after birth can guarantee their sustained
body contact to maintain the feeling of safety
in infants (Subakti, 2008).
Actually, infant massage has been
practiced almost all over the world since
ancient times, including Indonesia. Taught the
art of infant massage hereditary although it is
not clear how the massage and touch can be a
positive influence on the human body. Infant
massage is an ancient tradition exhumed with
a touch of health sciences and scientific review

81
Proceeding Patient Safety in Emergency

that comes from the researches of benefits further from baby massage and do not
neonatologists, neurological and child understand how infant massage right so it can
psychology. The oldest reports about the art of not do massage independently and more trust
massage for treatment recorded in the Ebers baby for a massage at the TBAs alone. The
Papyrus, which records medicine in ancient reason mothers want massaging her baby
Egypt (Riksani, 2011). because the baby was sick, cranky and fell.
Benefits of infant massage is with this
massage can improve the immune system, RESEARCH METHOD
increase the flow of lymph fluid throughout This research is a quasi experimental
the body to clean up hazardous substances in research where experiments on human subjects
the body, brain waves alter positively, improve with the device of one group pretest-posttest
blood circulation and breathing, stimulates design. The population in this study are all
digestion and disposal, increasing weight gain mothers with babies 0-12 months who live in
, reduce depression and tension, making a deep Kelurahan Pangkalan Dodek as much as 108
sleep, relieve pain, reduce bloating and colic women, and the whole population is used as a
(abdominal pain), increases the inner research subject. Data taken by primary and
connection between parents and baby, secondary. Primary data were obtained from
increasing the volume of breast milk, develop the practice directly to the mother by using a
communication, understanding the baby sign, checklist sheet, secondary data obtained from
increase confidence first. recording and reporting by midwives in
Results of research conducted by Kelurahan Pangkalan Dodek .
Zuleika (2007) 6, found the results of 30
respondents found that based on the analysis RESULT
value of P value 0.000> α 0.05. This means 1. Analisa Univariat
that there is influence between massage Table 1. Frequency Distribution of Infant
newborn babies against the bounding Massage Practice Score Before The Give
attachment. Health Education About Infant Massage
However, there are still many parents No Pretest Score amount %
who do not understand about baby massage, 1. 0 4 3,7
especially regarding the latest developments. 2. 1 2 1,9
Most of them assume that infant massage is 3. 2 10 9,3
done only on the sick infants and conducted by 4. 3 11 10,2
a shaman or medical personnel who mastered 5. 4 13 12
baby massage. This is not entirely wrong,
6. 5 14 13
through certain techniques, infant massage is
7. 6 17 15,7
believed to be able to cope with temporary
8. 7 12 11,1
colic, constipation and a fussy baby. However,
9. 8 5 4,6
the main benefit of baby massage is to help
optimize the growth and development of 10. 9 6 5,6
infants (Roesli, 2009). 11. 10 6 5,6
Lack of proper information about the 12. 11 4 3,7
latest developments of infant massage in the 13. 12 4 3,7
community also make parents afraid of Total 108 100
"touching" her baby. Soedjatmiko said, "Infant average 5,64
massage is better to do the elderly, especially Median 5,5
in the first 3 years. While most beneficial, in Standar Deviasi 2,95
the first six or seven months of age babies Varians 8,7
where the massage can be done two times a X min 0
day, which is important in a cozy atmosphere
X max 12
and is a part of parenting is not a treatment
(Riamelani, 2006)
From the results of the initial survey From the table above it can be seen
will be undertaken in the Village Base Dodek that the pretest scores practice infant massage
Coal County found that there are many before doing health education about infant
mothers who have babies who do not know the massage is an average value of 5.64 with a

82
 Proceeding Patient Safety in Emergency

median value of 5.5, the standard deviation of The results of analysis by paired t test
2.22 and variance of 8.7 result on the pretest that contained an average
score of 5.64 and on treatment with posttest
Table 2. Frequency Distribution of Infant there is an increase in the average score
Massage Practice Score After The Give becomes 20.27, p = 0.000 means that the
Health Education About Infant Massage scores pretest to posttest scores are
No Post test Score Amount % enhancement health education meaningful and
1. 15 1 0,9 significant in which the value of p <0.05.
2. 16 1 0,9 Percentage achievement pretest score as many
3. 17 9 8,3 as 23.5% and the percentage of achievement
4. 18 13 12 posttest score as many as 84.45%, thus the
5. 19 14 13 increase in average health education about
6. 20 20 18,5 infant massage from pretest to posttest
amounted to 60.95%. It can be concluded that
7. 21 15 13,9
an increase in health education about infant
8. 22 19 17,6
massage significantly in the group pretest and
9. 23 12 11,1
posttest.
10. 24 4 3,7
Total 108 100 DISCUSSION
Average 20,27 1. Infant Massage Practice Before
Median 20 Provided Health Education About
SD 2,03 Infant Massage
Varians 4,14 From Table 1 it can be seen that the
X min 15 pretest scores practice infant massage before
X max 24 doing health education about infant massage is
an average value of 5.64 with a median value
of 5.5, the standard deviation of 2.22 and
From the table above it can be seen that
variance of 8.7. It shows the average mothers
the practice of infant massage posttest scores
with infant massage correctly as 6 practice.
after doing health education about infant
According to the World Health Organization
massage is the average value of 20.27 with a
(WHO) in Ali (2010) 8, health education is an
median value of 20, standard deviation and
approach to health that aims to make health
variance of 4.14 to 2.03.
something of value in the community, helping
individuals to be able to independently or in
2. Analisa Bivariat
groups held activities to achieve the goal of
Statistical hypothesis tested was Ho: μ1 ≤
healthy living, and to encourage and
μ2 Ha: μ1> μ2. Hypothesis testing is done by
developed a proper health care facilities there.
testing the significance or different test (t test)
The practice of infant massage before being
with a confidence level α = 0.05. The
given health education about infant massage is
hypothesis put forward their knowledge score
still low. This can be caused by lack of
difference before and after health education
information and counseling given by health
about massage in infants aged 0-12 months in
professionals about the practice of infant
the Village of Coal County Dodek Base Using
massage in Kelurahan Pangkalan Dodek.
Paired T Test analysis that aims to see the
differences increase given health education
2. Practice of Infant Massage After
about infant massage then RESULTS as
Provided Health Education About
follows:
Infant Massage
From table 2 it can be seen that the
Table 3. Paired T Test Analysis About
practice of infant massage posttest scores after
Infant Massage Health Education in
doing health education about infant massage is
Kelurahan Pangkalan Dodek
the average value of 20.27 with a median
Treatment N Mean Standar t P
value of 20, standard deviation and variance of
Deviasi
4.14 to 2.03. It shows the average mothers
Pretest 108 5,64 2,95 - 0,000
with infant massage correctly about 20
Posttest 108 20,27 2,03 45,79
practices. According to Mubarak (2007) 9,

83
Proceeding Patient Safety in Emergency
health education is a process of behavior
change that dynamic, which changes not only
the transfer of the material / theory from one
person to another, nor a set of procedures, but
these changes occur a lack of awareness from
within the individual, group or people
themselves
According to Sanjaya (2009) 10, the practice
has several levels, including a perception that
is to know and choose a variety of objects in
relation to the action to be taken, the response
guided that it can do things in the right order
in accordance with the example, a mechanism
that if someone has been able to do something
settings automatically / has become the custom
and practice or adaptation is an action that is
already well developed. Such actions have
been modified without compromising the truth
of such action. The practice of infant massage
after a given health education about infant
massage seen a significant increase. It could
be due to maternal health have received
education about infant massage practice in
Kelurahan Pangkalan Dodek so that the
mother can practice infant massage properly
3. Effect of Health Education Against
Infant Massage Practice In Sub Base
Dodek Coal County
The research results of statistical tests
with paired T test there is an increase in the
average score for health education about infant
massage respondents before given health
education (pretest) pre test score average of
5.64. And the results of the study after being
given health education (posttest) obtained an
increase in the average score becomes 20.27, p
= 0.000 means there a meaningful and
significant improvement of infant massage
Based on the analysis of statistical test
score difference to improve the practice of
infant massage can be evidenced by the value t
calculation results where Ho is rejected and
thus can be pulled interpretation that there are
differences before and after administration of
health education about infant massage. This is
because the curiosity of respondents to the
way the baby massage is good and right so that
the mother can massage their babies at home
independently without the need to massage the
baby to the midwife.
The results are consistent with the
results of research conducted by Oktabriani
(2010) 11 where the results of the study found
that tcount> t table (29.231> 2.040) or a p-
84
value <a (0.000 <0.05). This means that there
are significant differences between the
practices of mothers in infant massage before
and after the health education given by health
education.
The results are consistent with the results of
research conducted by Nia Trisnawati (2012)
12. Research results obtained show that the
results of independent sample t test obtained
no effect of counseling on infant massage on
baby boys - men and women aged 3-4 months
(p value = 0.000 <0.05).
Results of the study showed better
posttest than pretest results it is due to the
existence of a treatment that is given before
posttest maternal health education. This is
consistent with the theory that after a person
experiences health stimulus or object, then
hold a vote or opinion on what is known, the
next process is expected to implement or
practice what is known and disikapinya 13.
Meanwhile, according Machfoed (2009) 14,
health education is a process changes, which
aims to change individuals, groups and
communities towards positive things that are
planned through the learning process. The
amendment covers the knowledge, attitudes
and skills through the process of health
education. In essence can be an emotion,
knowledge, thoughts, desires, real action of
individuals, groups and communities. Health
education about infant massage is an important
aspect in improving people's skills because
doing routine infant massage will get
substantial benefits, especially to optimize the
development of the child so that they can
become qualified human resources.
The results of this study are also in
accordance with the opinions expressed
Mubarak (2007) 9 that health education is a
process of behavior change that dynamic,
which changes not only the transfer of the
material / theory from one person to another,
nor a set of procedures, but those changes
occurred their awareness from within the
individual, group or society itself.
Based on the results that there is a
significantly increased percentage of its
achievements on the pretest to posttest. It is
found in the percentage of achievement pretest
score as many as 23.5% and the percentage of
achievement posttest score as many as
84.45%, thus the increase in average health
education about infant massage from pretest to
posttest amounted to 60.95%.

REFERENCES
1. Ali, M. 2010. Penelitian Kependidikan
Prosedur Dan Strategi. Bandung:
Angkasa
2. Lee Naurah, 2009. Cara Pintar
Merawat Bayi 0-12 Bulan. CV Solusi
Distribusi: Yogyakarta
3. Machfoedz, I. 2009. Pendidikan
Kesehatan Bagian Dari Promosi
Kesehatan. Yogyakarta: Fitramaya
4. Mubarak, dkk. 2007. Promosi
Kesehatan Sebuah Pengantar Proses
Belajar Mengajar Dalam Pendidikan.
Yogyakarta: Fitramaya
5. Ngastiah, 2005. Perawatan Anak
Sakit. Jakarta: EGC
6. Nia Triswanti, 2012 Pengaruh Pijat
Bayi Terhadap Peningkatan Berat
Badan Pada Bayi Usia 3 – 4 Bulan Di
Posyandu Wilayah Kerja Puskesmas
Kedaton Bandar Lampung Tahun
2012, Jurnal Dunia Kesmas
7. Notoatmodjo, S. 2010. Promosi
Kesehatan Teori Dan Aplikasi.
Jakarta: PT. Rineka Cipta
8. Oktabriani, 2010. Pengaruh
Pendidikan Kesehatan Tentang Pijat
Bayi Terhadap Praktik Pijat Bayi di
Polindes Harapan Bunda Sukoharjo
Tahun 2010.
http://id.scribd.com/doc/96909674/Kti
-Oktabriani
Proceeding Patient Safety in Emergency
9. Riamelani, 2006. Pijat
Mengoptimalkan Tumbuh Kembang
Bayi. 22 Desember 2006.
http://riamelani.multiply.com/journal/i
tem/6 di unduh 4 maret 2014
10. Riksani, 2011. Cara Mudah dan Aman
Pijat Bayi. Jakarta: Dunia Sehat
11. Roesli Utami, 2009. Pedoman Pijat
Bayi. PT Trubus Agri Widia: Jakarta.
12. Sanjaya Wina, 2008. Strategi
Pembelajaran Berorientasi Standar
Proses Pendidikan. Prenada Media
Group: Jakarta
13. Subakti dan Deri Rizky, 2008.
Keajaiban pijat bayi dan Balita.
Wahyu Media:Jakarta
14. Zulaika Desi, 2007. Pengaruh Pijat
Bayi Terhadap Berat Badan Neonatus
Dini di RB Sehat Ngargoyoso. Karya
Tulis Ilmiah, DIV Kebidanan Fakultas
Kedokteran. UNS: Surakarta
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Proceeding Patient Safety in Emergency

INFLUENCE OF FAMILY PSYCHOEDUCATION TOWARD FAMILY ABILITY’S

IN CARING FAMILY MEMBER WITH SCHIZOPHRENIA
IN THE SORONG CITY 2016.

Butet Agustarika, I Made Raka

Nursing Department of Poltekkes Kemenkes Sorong

ABSTRACT

Law No. 36 of 2009 on Health Section 144 paragraph (1) states that mental health efforts aimed at
ensuring that everyone can enjoy a healthy mental life, free from fear, stress, and other disorders that
can damage the health of the soul. The prevalence of mental emotional disorder in family members
over the age of 15 years of 140 per 1000 in the province of West Papua by 13.2% (Survey 1995).
While the prevalence of Mental Disorders Emotional in Sorong 7.1% (Basic Health Research, 2008).
The increasing prevalence of mental disorders in the world, in Indonesia even in the region can not be
dammed Sorong Kingdom along with the increasing demands of life in society in the era of
globalization and multi-dimensional crisis. The purpose of this study was to determine Influence the
ability of family psychoeducation Toward Family in Caring Family Members with Schizophrenia in
the Sorong city. The research design used in this study is "Quasi-experimental pre-post test with
control group" with the family psychoeducation intervention. The number of samples in this study is
total population that all patients who have mental disorders as a group intervention, 32 respondents.
The analysis used was Mann Whitney U Test. The results showed that There is a significant increase
between the family's ability to care for their family members who have schizophrenia before getting
Family psychoeducation therapy and after therapy, family psychoeducation in the Sorong city (p
value of 0.000, which is less than 0.005).

Key Words: Family psychoeducation therapy, Schizophrenia

BACKGROUND Government, local government and

WHO, 2010 states that there are two
essential components into a single entity in
defining the meaning of a healthy, that is of
sound mind who emphasizes the physiological
function and mental health is more emphasis
on the mental state that is stable in the absence
of excessive pressure. WHO also describes the
criteria that are owned by someone who is
mentally healthy is always relaxed, satisfied
with what there is in him, can get along very
well, tolerance, not easily offended and can
control the state of emotions to himself.
Law No. 36 of 2009 on Health Section
144 paragraph (1) states that mental health
efforts aimed at ensuring that everyone can
enjoy a healthy mental life, free from fear,
stress, and other disorders that can damage the
health of the soul. Mental health efforts as
referred to in paragraph (1) shall consist of
preventive, promotive, curative, rehabilitative
patients with mental disorders and
psychosocial problems. Mental health efforts
as referred to in paragraph (1) is the joint
responsibility of the Government, local
government, and society. Section 145: The
community efforts to ensure mental health
preventive, promotive, curative, and
rehabilitative services, including ensuring
mental health efforts in the workplace as
referred to in Article 144 paragraph (3)
The WHO data in 2003 on mental
health issues in the world 1 of 4 families at
least have a family member with mental health
disorders. In Indonesia, one person / family
experiencing mental health problems, (Bahar,
1995). Mental Health Survey Household
conducted in 11 cities by the Indonesian
Psychiatric Epidemiology Network in 1995 to
get the proportion of 185 per 1,000 adult
household population show symptoms of
mental health disorders. The prevalence of
mental emotional disorder in family members
over the age of 15 years of 140 per 1000 in the
province of West Papua by 13.2% (Survey
1995). While the prevalence of Mental
Disorders Emotional in Sorong 7.1% ( Riset
Kesehatan Dasar, 2008). The amount is is
expected to rise with the increasing needs of
the economy and natural disasters that

86
 Proceeding Patient Safety in Emergency

frequently occur in West Papua, such as followed by a posttest. The therapist carrying a
earthquakes, floods, landslides and others. book worksheet as guidelines for the
implementation of therapy, while the family is
RESULT AND DISCUSSION given a worksheet as a guide to caring for
The result of effects family family members who have mental disorders.
psychoeducation therapy toward the family's Furthermore, families are given the
ability to care for family members with opportunity for 3 days to care for family
schizophrenia and Sorong City in 2016 were members who have mental disorders according
conducted in November and December 2016. workbook given.
The number of respondents 32 people
according to criteria of inclusion. Of the 32 RESULT
respondents divided into two groups: 16 1. Frequency Distribution of
people as responder control group (no Respondents by Gender, Age,
treatment Family psychoeducation) and 16 Education and Employment
respondents intervention group (Family The results of the analysis of Table 4.1 of the
psychoeducation therapy). Both groups respondents amounted to 32 people mostly
performed pre-test and post-test results are female as many as 25 (78.1%), including older
compared. The results of this study consists of age group were 26 (81.2%), most of the
four parts which will be described below: educational level SMTA have as many as 23
A. The implementation process on family (71, 9%), the majority of respondents do not
psychoeducation therapy work as many as 17 people (53.1%).
1. Preparation of Implementation Therapy
Family psychoeducation Table 1. Distribution of respondents by
Preparation to implement psychoeducation gender, age, education and employment in the
therapy in families who have family members intervention group and the control group in the
with schizophrenia who were working area Region and District Health Center. Sorong.
and Sorong Health Center, which includes six Karakteristik Kelompok Kelompok Jumlah
(6) Health Center: PHC Tanjung cassowary, intervensi kontrol (n = 86)
(n = 16) (n = 16)
Malawei health centers, health centers Remu, N % n % n %
Malanu health centers, health centers and 1. Jenis kelamin
health centers Klasaman Malawili. begins with a. Laki-laki 4 25 3 18,8 7 21,9
socializing proposal and explanation of the b. Perempuan 12 75 13 81,2 25 78,1
implementation of psychoeducation therapy to TOTAL 16 100 16 100 32 100
2. Umur
the health center. a. Dewasa Awal 1 6,2 0 0 1 3,1
b. Dewasa Akhir 4 25 1 6,2 5 15,6
2. Implementation of family psychoeducation c. Lansia 11 68,8 15 93,8 26 81,2
Therapy TOTAL 16 100 16 100 32 100
Researchers visited families who have family 3. Pendidikan
a. Pendidikan 0 0 1 6,2 1 3,1
members with schizophrenia who are in the Dasar
working area of the health center and the City b. Pendidikan 4 25,0 3 18,8 7 21,9
of Sorong regency that includes six (6) Health SMP
Center: PHC Tanjung cassowary, Malawei c. Pendidikan 11 68,8 12 75,0 23 71,9
SMA
health centers, health centers Remu, Malanu d. Perguruan 1 6,2 0 0 1 3,1
health centers, health centers and health Tinggi
centers Klasaman Malawili. TOTAL 16 100 16 100 32 100
Implementation of psychoeducation therapy in 4. Pekerjaan
families who have relatives with mental a. Bekerja 8 50 7 46,7 5 46,9
b. Tidak 8 50 9 52,9 7 53,1
disorders in a group family psychoeducation bekerja
intervention therapy as much as 2 sessions in 2 TOTAL 16 100 16 100 2 100
visits. The first visit begins with a pretest was
followed by one session of therapy, while the
second session is done on the second visit

87
Proceeding Patient Safety in Emergency

2. Frequency Distribution of a. The ability of the family before

Respondents Based Capabilities therapy Family psychoeducation
Caring for Family Members Who Scores ability to care for family
Have schizophrenia members who have schizophrenia
before therapy, family
Table 2. Frequency Distribution Capabilities psychoeducation mostly in the range
Caring for Family Members Families who of quite as many as 13 (81.2%), either
experience schizophrenia before and after the intervention group or the control
treatment given to the family psychoeducation group.
intervention group and control group in This is in accordance with the opinion
Regional & District Health Center Sorong. of Kembaren 2011 that one function
Kemampuan Kelompok Kelompok Jumlah of the family is health care, which is in
Merawat intervensi kontrol (n = 32) the form of the practice of caring for
(n = 16) (n = 16) family members, including the
N % n % n % family's ability to improve and
1. Pre maintain mental health of family
a. Cukup 13 81,2 13 81,2 26 81,2
members who have schizophrenia.
b. Baik 3 18,8 3 18,8 6 18,8
TOTAL 16 100 16 100 32 100
Researchers assumption that the
2. Post ability of the family are quite as care
a. Cukup 1 6,2 13 81,2 14 43,8 giver may be increased to a good
b. Baik 15 93,8 3 18,8 18 56,2 ability when administered in the form
16 100 16 100 32 100 of therapy psychoeducation
TOTAL intervention.
Instead the family's ability may be
Test Statisticsb decreased or remained without being
offered any treatment or intervention.
Post_Intervensi
Mann-Whitney U 13.000 B. The ability of the family after family
Wilcoxon W 149.000 psychoeducation therapy
Z -4.358 ability Scores to care for family
members who have schizophrenia
Asymp. Sig. (2-tailed) .000 after therapy, family psychoeducation
Exact Sig. [2*(1-tailed mostly well capable of 15 (93.8%) in
.000a
Sig.)] the intervention group and most
capable pretty much as 13 (81.2%) in
Analysis of the family's ability to care for the control group
family members with schizophrenia after Theories about the function of the
therapy Family psychoeducation showed that family to care for its members who
the ability to care for the intervention group have schizophrenia explained that the
increased significantly compared to the control increase in the ability of members of
group (p value <0.05). the family as a care giver at home in
this study affected the implementation
DISCUSSION of therapy psychoeducation, where the
This study aimed to get an idea of the therapist first identify the family's
influence of family psychoeducation therapy ability to care for its members who
on the ability of families in caring for their have schizophrenia and teach family
family members who have schizophrenia in members how to take care of personal
Sorong. Knowing upgrades given family hygiene family members, know the
therapy and family psychoeducation are not symptoms of mental disorders in
Family psychoeducation get therap family members, as well as cope with
mental illness recurrence family
1. Effect of Therapy Toward Family members.
psychoeducation family ability in
caring for their family members who
have schizophrenia

88

CONCLUSION
There is a significant improvement
between the family's ability to care for
their family members who have
schizophrenia before getting Family
psychoeducation therapy and after
therapy, family psychoeducation
SUGGESTION
1. For the nurse who has received
training on CMHN (Community
Mental Health Nursing) is
expected to provide therapy
Family psychoeducation to family
members who have schizophrenia
as a care giver
2. For health workers in health
centers health program jiwaq
holders are advised to increase
home visits to families who have
patients with schizophrenia that
health services provided more
efficient
REFERENCES
Baron, R.A. dan Donn Byrne. 2003. Psikologi
Sosial. Jakarta : Erlangga.
Jhonson,C.L. 1988. Ex Familia. New
Brunswick : Rutger University Press.
Kembaren, L. 2011. Psikoedukasi Keluarga
Pada Pasien Skizofrenia. Jakarta.
Lemeshow, S. Hosmer, D., Lwanga, S. (1997).
Besar sampel dalam penelitian
kesehatan. Yogyakarta :Gadjah Mada
University Press.
Maramis, W.E. 2005. Ilmu Kedokteran Jiwa.
Surabaya : Erlangga University Press.
Proceeding Patient Safety in Emergency
Muin, Idianto. 2013. Kelompok Peminatan
Ilmu-Ilmu Sosial. Jakarta : Erlangga,
Hal.156-172
Psikoedukasi Keluarga Pada Pasien
Schizofrenia. Available from:
http://www.lahargokembaren.com/2009/
11/psikoedukasi-keluarga-pada-
pasien.html. Diunduh tanggal 30 Mei
2016.
Peran Keluarga dalam Penanganan Pasien
Schizofrenia. Avaiable from :
http://www.wulansih.com/2015/peran-
keluarga-dalam-penanganan-pasien-
schizofrenia.html Diunduh tanggal 2
Juni 2016
Richard, R. Clayton. 2003. The Family,
Mariage and Social Change.hal 58.
Sastroasmoro,S., dan Ismael, S. (2008). Dasar-
dasar metodologi penelitian klinis (edisi
ke-3). Jakarta : CV Sagung Seto
Sormin & Sulastri. (2016). Psikoedukasi
Keluarga Meningkatkan Pengetahuan
Mengontrol Perilaku Kekerasan Orang
Dengan Gangguan Jiwa di Wilayah
Kerja Piskesmas Kedaton, Bandar
Lampung. (Jurnal).
Stuart, G.W., & Laraia, M.T. (2005).
Principles and practice of psychiatric
nursing. (8th edition). St Louis: Mosby
Sugeng Iwan. 2009. Pengasuhan Anak Dalam
Keluarga. Avaiable from :
http://www.sugengiwan.com/2009/peng
asuhan-anak-dalam-keluarga.html.
Diunduh tanggal 30 Mei 2016.
89
Proceeding Patient Safety in Emergency

RELATIONSHIP BETWEEN NURSE THERAPEUTIC COMMUNICATION WITH

ANXIETY LEVEL OF PATIENTS FAMILY WHO TREATED IN THE HCU ROOM
AT SELE BE SOLU HOSPITAL OF SORONG

Maria Loihala, Ariani Pongoh

Nursing Departement of Poltekkes Kemenkes Sorong

Abstract

Anxiety or anxiety will be more clearly seen in patients and families of patients who entered the
hospital. Therapeutic communication is planned communication consciously, aims and activities
focused on recovery therapeutic. The aims of communication is to develop towards more private
patients positive or adaptive and aimed at the growth of the patient. Objective was to determine the
relationship of nurse therapeutic communication with family anxiety levels of patients who are
treated in HCU room of Sele Be Solu Sorong hospital. This study uses analytic method with cross
sectional approach. The population in the study were 30 respondents. Instrument research using
questionnaires. Data collection techniques are primary and secondary data. Data analysis by
univariate and bivariate. The data were processed using SPSS version 18.00. Research using chi-
square statistical test obtained significant level with p value = 0.001 ≤ α = 0.05 then Ho is rejected or
no relationship between nurse therapeutic and family anxiety levels of patients who are treated in
HCU room Sele Be Solu Sorong hospital. Conclusions from the study showed that there is a
relationship nurse therapeutic communication with family anxiety levels of patients who are treated
in HCU room Sele Be Solu Sorong hospital. Suggestions to the hospital is expected that nurses can
provide health education or counseling in the form therapeutic effective communication to
individuals, families and communities about the disease suffered by so that the patient or family will
not anxiety when patients is at admission or outpatient.

Keywords: Therapeutic Communication, Nurse, Anxiety

A. Background family members against family anxiety in

Anxiety or anxiety will be more
apparent in patients and families of patients
who were hospitalized in intensive room.
Anxiety in patients and families are often
caused by fear of death, the failure of
medication complications and cost issues
(Dual, 2009).
Communication is a means of
connecting in socialization. So that
communication science is growing rapidly
now. One study of science communication is
health communication, that which is always
done when dealing with patients, families and
other health professionals (Setiawati, 2007).
Sri Asih Rusmini Research, (2012) on
Doris Sylvanus Hospital Palangkaraya found
that the behavior of nurses especially in
communicating is poor. Meanwhile research
by Hj. Indirawaty in Haji Sukolilo Surabaya
hospital that patient satisfaction with nurse
communication 54, 2% dissatisfied, 16, 7%
fairly satisfied and 29, 2% very satisfied.
Vivin Sulastri research results, (2009)
suggest a link nurse communication with
patients treated in the critical care unit (ICU)
at Hospital of Dr. Moewardi Surakarta. Their
relationship can be interpreted that the
communication established between the nurse
with the family members did not go well make
the onset of anxiety of family members who
were waiting for patients in critical care. For
family members, the missing information the
higher the resulting anxiety, but out of 30
respondents, 66.7% had moderate anxiety.
Rusmini Research, (2006) about the
relationship of therapeutic communication
with family anxieties in Doris Sylvanus
Hospital Palangkaraya found that the behavior
of nurses especially in communicating poorly.
Also research conducted Prihatiningsih (2012)
showed therapeutic communication is done in
Kebumen Hospital Bed room is good enough
is obtained (53.3%). The anxiety level of the
patient's family in Kebumen Hospital Bed
Lounge categorized the majority of moderate
(62.7%). There is a relationship of therapeutic
communication with the patient's anxiety level

90

in Kebumen Hospital Bed Room with p =
0.003 (<0.05)
From the observations of the writer in
the room HCU RSU Sele Be Solu Sorong the
tendency is evident in the interpersonal
relationship of nurses with patients and their
families indicated by the communication
between nurses who often are not therapeutic
when interacting with patients and their
families, there are few complaints of patients
and their families to services given that should
be addressed by the communication of nurses.
Many factors that cause anxiety or
anxiety in the patient and his family for the
patient in the hospital, one of which is a factor
of therapeutic communication nurse. Families
will experience feelings of anxiety and
disorganization when his family members get
sick should be treated in the hospital and will
be more clearly found in the critical care unit.
Patients treated in the Critical Care Unit
requires not only technology and therapy but
also requires a humanistic care of his family
(Rusmini, 2006).
In general, patients who come in the
critical care unit are in a state of sudden and
unplanned, which is why the families of
patients present with a face that is loaded with
a variety of stressors, namely fear of death, the
uncertainty of results, changes in patterns,
concerns about the cost of care situation and a
decision between life and death, routine
irregular, helplessness to keep or always
stands beside a loved one with respect to the
regulation of stay tight, not familiar with the
equipment or the environment in the critical
care unit, personnel or staff in the infirmary,
and exercise room. All these stressors cause
the family fell under crisis conditions where
coping mechanisms used becomes ineffective
and the feeling of giving up or apathy and
anxiety will dominate the behavior of the
family. At such times the nurses lack or can
not implement an effective therapeutic
communication so that the family will
continue to decline in this situation and in the
end the nursing care that we provide a
comprehensive and holistic manner will not be
achieved by either (Dual, 2009).
According to the data of the HCU
room of Sele Be Solu Sorong hospital that
patients were treated in 2013 amounted to 301
or a monthly average of 25 patients and 2014
patients treated amounted to 360, or an
average of 30 patients per month. While the
Proceeding Patient Safety in Emergency
number of nurses who provide nursing care in
HCU room of Sele Be Solu Sorong hospital as
many as 12 nurses.
Based on the above phenomenon, the authors
are interested in studying the relationship of
nurse communication made to decrease the
level of anxiety families of patients
undergoing treatment in HCU room of Sele
Be Solu Sorong hospital.
B. Research Objectives
1. General Purpose
To know the relationship therapeutic nurse
communication with family anxiety levels
are treated in RSU HCU room Sele Be Solu
Sorong.
2. Special Purpose
To know the relationship therapeutic nurse
communication with family anxiety levels
are treated in RSU HCU room Sele Be Solu
Sorong.
C. Benefits Research
1. Scientific
The results of this study can add insight and
knowledge of nurses in providing services
to the community, especially in the
application of communications teraupetik
nurses to patients and families.
2. Institutions
We hope this research can be used as a
baseline in conducting subsequent research
by developing a broader research variables.
3. Practical
The results of this study provide input for
health personnel in this case the nurse to
further improve the therapeutic
communication to patients and families so
there is no anxiety.
D. Types of Research
This type of research is a quantitative study
using cross sectional study design, which in
this study cause or risk variables and effect or
the case with the object of research is
measured or collected simultaneously or in the
same time (Hidayat, 2009).
E. Population and Sample
1. The population using the total sampling that
all the families of patients hospitalized in the
room HCU RSU Sele Be Solu Sorong totaling
30 respondents.
2. The sample in this study is the total
population of families who were treated for
91
Proceeding Patient Safety in Emergency

one month totaling 30 respondents, by meeting < 25 tahun 3 10

the inclusion and exclusion criteria. 25-30 tahun 8 26,7
Inclusion criteria: >30 tahun 19 63,3
a. Respondents who have family members
who are hospitalized in HCU room of Sele Be Pekerjaan
Solu Sorong hospital. Bekerja 16 53,3
b. Respondents who can read Tidak bekerja 14 46,7
c. Families of patients willing to be the
respondent and for patients treated> 1 day
Exclusion criteria: Sumber : Data Primer 2015
a. Patients who live alone
b. Outpatient Polyclinic Table 2. Distribution of therapeutic
communication relationships with family
F. Data Collection Techniques anxiety levels are treated in RSU HCU room
The collection of data used in this study using Sele Be Solu Sorong.
a questionnaire covering teraupetik Komunikasi Kecemasan Total
communication questionnaire consisting of 14 Ringan Sedang Berat
statements and anxiety questionnaire consisted f % f % f % f %
of 10 questions. Tidak 2 12,5 3 18,8 11 68,8 16 100
terapeutik
Terapeutik 3 21,4 4 28,6 7 50,0 14 100
RESULT & DISCUSSION
Total 5 7 18 100
Results
characteristics of Respondents
Discussion
Table 1 shows the characteristics of the baby
1. Communication teraupetik HCU room nurse
in Puskesmas Remu Sorong city. Of the 31
at RSU Sele Be Solu Sorong.
respondents, most babies are 2 months old at
The results showed that respondents
13 (41.79%) and at least 1 month old, 4
who use communication to no avail larger
months and 5 months respectively which 3
teraupetik that 16 (53.3%) compared to those
(9.7%). And of the 31 respondents, most
using therapeutic communication successfully
babies who are female is 19 (61.3%) and least-
with 14 (46.7%). But Sri Asih Rusmini
sex male is 12 (38.7%).
research, (2012) in Doris Sylvanus Hospital
Based on the results of the univariate analysis
Palangkaraya found that the behavior of nurses
showed that out of 31 respondents, the least is
especially in communicating poorly.
the respondents were knowledgeable good
Meanwhile research by Hj. Indirawaty in RSU
mother at 13 (41.9%), and the most
Haji Surabaya Sukolilo that patient satisfaction
knowledgeable of less that 18 (58.1%). And of
with nurse communication (54, 2%) are not
the 31 respondents, most mothers agree that
satisfied, (16, 7%) are quite satisfied, and (29,
the attitude of 20 (64.5%), and the least
2%) are very satisfied.
disapproval that 11 (35.5%).
According setianti (2007), said
communication is a means of connecting in
Table 1. Sample Characteristics Distribution
bersosial. One study of science
diruangan HCU RSU Sele Be Solu Sorong
communication is health communication, that
Variabel Jumlah (%)
which is always done when dealing with
Jenis Kelamin patients, families and other health
Laki-laki 8 26,7 professionals. Communication between the
Perempuan 22 73,3 nurse and the patient is referred to as
Pendidikan communication teraupetik. Therapeutic
communication is a communication made or
SD 1 3,3
designed for therapeutic purposes. A helper or
SMP 0 0
nurse can help patients overcome its problems
SMA/SMK 20 66,7
through communication (Pham, 2005). It
D.III 6 20
further by Mundakir (2006), that the
S1 3 10
therapeutic communication is planned
Umur communication consciously, aims and

92

activities focused on healing. Furthermore Siti
Fatmawati (2010) said basically therapeutic
communication is a professional
communications that lead to the goal of
healing the patient.
While Mubarak & Chatain, (2009)
stated that the communication teraupetik give
a clear picture to the nurse about the patient's
condition being treated, the signs and
symptoms displayed and perceived grievances.
Teraupetik communication occurs when
preceded by a trusting relationship between
the nurse-patient.
Therapeutic communication is
communication, a nurse with certain
techniques that have a healing effect.
Therapeutic communication is one way to
build a trusting relationship to patients and the
provision of accurate information to patients,
which is expected to affect change for the
better in patients in running therapy and help
patients in order to address the problems faced
at this stage of treatment.
In conducting a communication one
therapeutic communication can be influenced
by several things, among others:
a. Human development affect the forms of
communication in two aspects, namely
the level of development affects the
body's ability to use communication
techniques.
b. Perception of one's personal view of an
event or events. Perception shaped by
expectations or experience. Differences in
perception can result in delays in
communication.
c. gender; Men and women show different
communication styles and have different
interpretations of a conversation
(Tamsuri, 2005) states that women use
communication techniques to seek
confirmation, minimize differences, and
increase intimacy, while men show more
independency and status in the group.
d. Working period is a time when one
begins to work in the workplace. The
longer a person works the more
experience he has, the better its
communication so (Tamsuri, 2005).
2. Anxiety Family at room HCU RSU Sele Be
Solu Sorong.
The results showed that respondents
who experienced severe anxiety level is 18
(60.0%) is greater than the respondents who
Proceeding Patient Safety in Emergency
experienced a moderate anxiety level is 7
respondents (23.3%) and lightweight five
respondents (16.7%). However, according to
research conducted Prihatiningsih (2012)
showed that the level of anxiety in the patient's
family Kebumen Hospital Bed Lounge
categorized the majority of moderate (62.7%).
Anxiety caused pathophysiologic
factors and situational factors (Sutrimo, 2012).
No specific cause of anxiety is not even
known by the individual. Feelings of anxiety is
expressed directly through physiological and
behavioral changes, can also be expressed
indirectly through the onset of symptoms and
coping mechanisms in an effort to combat
anxiety (Stuart 2007).
Anxiety is identified to be 4 levels,
namely, mild, moderate, severe and panic
(Stuart and Laraia 2005). The higher the level
of anxiety people it will affect the physical and
psychological conditions. Anxiety differs from
fear, which is an intellectual assessment of the
danger. Anxiety is the most frequent
psychiatric problems occur, stage anxiety level
will be described as follows (Stuart, 2007).
a. Mild anxiety associated with tension in
everyday life: anxiety cause the
individual to be vigilant, sharpens the
senses and enhance the perception airy.
b. Anxiety was allowing individuals to focus
on one thing and narrow the field of
individual perception. Individuals become
selective attention but can focus on more
areas.
c. Severe anxiety, reduced field of
individual perception. Individual focusing
on something that is detailed and specific,
and do not think about anything else. All
behaviors aimed at reducing tensions,
people need more direction to focus on
other areas.
d. Panic level (very severe) of the anxiety
associated with startled, fear, and terror. It
detailed split of proportion, because of a
loss of control. Individuals who achieve
this level are not able to do anything even
with the directives. Panic include
personality disorganization and lead to an
increase in motor activity, decreased
ability to relate to others, distorted
perception, and loss of rational thought.
Anxiety caused pathophysiologic
factors and situational factors (Sutrimo, 2012).
No specific cause of anxiety is not even
known by the individual. Feelings of anxiety is
93
Proceeding Patient Safety in Emergency
expressed directly through physiological and
behavioral changes, can also be expressed
indirectly through the onset of symptoms and
coping mechanisms in an effort to combat
anxiety (Stuart 2007).
3. Relationship therapeutic communication
with family anxiety levels are treated in RSU
HCU room Sele Be Solu Sorong.
Communication teraupetik give a clear
picture to the nurse about the patient's
condition being treated, the signs and
symptoms displayed and perceived grievances.
Teraupetik communication occurs when
preceded by a trusting relationship between
the nurse-patient.
Based on the statistical test showed
that 0.05 ≤ p = 0.001 shows that there is a
relationship between therapeutic
communication with family anxiety levels are
treated in RSU HCU room Sele Be Solu
Sorong. This research together with research
Vivin Sulastri, (2009) which indicates that the
relationship nurse communication with family
members against family anxiety in patients
treated in the critical care unit (ICU) at
Hospital Dr. Moewardi Surakarta. Rusmini
Research, (2006) about the relationship of
therapeutic communication with family
anxieties in Doris Sylvanus Hospital
Palangkaraya found that the behavior of nurses
especially in communicating poorly.
Their relationship can be interpreted
that the communication established between
the nurse with the family members did not go
well make the onset of anxiety of family
members who were waiting for patients in
critical care.
According to the Double (2009) that
anxiety or anxiety will be more apparent in
patients and families of patients who were
hospitalized in intensive room. Anxiety in
patients and families are often caused by fear
of death, the failure of medication
complications and cost issues. While Stuart
(2007) explains that anxiety is a subjective
emotion that makes people uncomfortable,
vague fear and anxiety, and accompanied by
autonomic response.
Anxiety is also a concern that is not
clear and spreads associated with feelings of
uncertainty and helplessness. Meanwhile,
severe anxiety, reduced field of individual
perception. Individual focusing on something
that is detailed and specific, and do not think
94
about anything else. All behaviors aimed at
reducing tensions, people need more direction
to focus on other areas. Individuals with low
self esteem susceptible to severe anxiety.
Anxious experience of each individual
varies depending on the situation and
interpersonal relationships. There are two
factors that affect the precipitation of anxiety
that external factors and internal factors.
Internal factors include education where
individual education affects the ability to
think. The higher the level of education, the
individual is getting easier to think rationally
and capture new information. Analysis
capabilities will facilitate individuals in
outlining a new problem, this is in accordance
with the findings that most of the respondents
had high school / vocational school with 20
(66.7%) were educated DIII which 6 (20%)
compared to respondents who educated S1 is 3
( 10%).
In addition to other factors educational
factor is sex where the level of panic anxiety
disorders are more common in women than
men. The negative impact of anxiety is
excessive worries about real or potential
problem. Anxiety state will make people spend
energy, causing anxiety and inhibits
individuals perform its function adequately in
situations of interpersonal and social relations,
it is similar to the results of research that
shows that respondents most respondents the
female sex is 22 respondents (73.3% ). A
further factor is age. A young age are prone to
anxiety than individuals with older age, this is
different from the findings that the majority of
respondents aged> 30 years on the
respondents, 19 (63.3%).
Conflict theory looked anxiously as a
conflict between two competing interests.
Anxiety occurs because of the reciprocal
relationship between conflict and anxiety.
Conflicts cause anxiety, and anxiety cause
feelings of helplessness, which in turn
increases the perceived conflict. Besides the
theory of family studies say that the family
Studies show that anxiety disorders occur in
families. Anxiety disorders also overlap
between anxiety disorders and depression
(Stuar, 2007).
According to Helena (2006) that 35-
40% of patients are often not satisfied with the
quality and amount of information that
patients receive from health workers, as well
as a lack of communication between the

hospital staff to patients is one of the reasons
the common complaint of patients in hospitals.
In addition Smet (2007) explains that nurses
rarely interpersonal communication with the
patient, and put forward by Ellis (2009) that it
was caused by (1) a lack of self-awareness of
nurses, (2) lack of interpersonal skills training
that is systematic, (3) lack of conceptual
framework and, (4) lack of clarity of purpose.
According to Abraham (2007) that the
inability of nurses in applying therapeutic
communication will negatively impact the
quality of nursing care in the hospital and will
cause dissatisfaction of patients to nursing
services provided. Patients who were treated
either in the operating room, space or room of
disease in children have a sense of anxiety due
to the process of hospitalization. If the
concerns are not communicated it will disrupt
the relationship nurse - patient, and will
increase patient anxiety. Patients in a state of
anxiety, are more likely to experience physical
sensations and signs of danger. If continued
anxiety can affect health status and changing
the predetermined diagnostic procedure. In
order to increase the confidence of the patient
in the face of an act of care one teraupetik the
nurse-patient communication needs to be
established so that the patient can choose an
alternative coping positive for him (Stuart,
2007).
Conclusions and Suggestions
Based on the research results, it can be
concluded that there is a therapeutic nurse
communication links with the family anxiety
levels are treated in RSU HCU room Sele Be
Solu Sorong. Suggestions that can provide
health education or counseling in the form
teraupetik effective communication to
individuals, families and communities about
the disease suffered by so that the patient or
family so as not to experience anxiety at
admission or outpatient.
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Alimul, Aziz., 2009. Metode Penelitian
Keperawatan dan Teknik Analisis Data.
Salemba Medika : Jakarta
Aswar. S., 2000. Skala Psikologi. Penerbit
Pustaka Pelajar : Yogyakarta
Atkinson, R.L. at all., 2000. Pengantar
Psikologi. Alih bahasa : Wijaja
Kusuma. Interaksara : Batam
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Ellis, R.B. et al., 2000. Komunikasi
Interpersonal dalam Keperawatan Teori
dan Praktik, Alih bahasa : Susi
Purwoko, Editor : Setiawan, EGC :
Jakarta
Elsa Roselina.,dkk.,2009, Buku saku
Komunikasi Keperawatan, Jakarta,
Penerbit Trans Info Media TIM
Ganda.., 2009. Petunjuk Praktis Cara
Mahasiswa Belajar di Perguruan Tinggi
[online].ed.Canada: Thomson. http://
books.google. co.id/books?id=
atD2wBku45YC&pg=PA5&dq=mahasi
swa+adalah&hl=id&ei=v9yrTom4IM3
wrQf0-5TjDA&sa =X&oi=
book_result&c t=result&resnum=
6&ved=0CEIQ6AEwBQ#v=on
epage&q=mandiri&f=fals.. Jakarta:
Grasindo. (Akses 12 Mei 2015)
Hidayat., 2007. Metode Penelitian
Keperawatan dan Teknik Analisis Data.
Jakarta : Salemba Medika
Mubarak, W.I., Chayatin, N., 2009. Ilmu
Kesehatan Masyarakat Teori dan
Aplikasi. Jakarta : Salemba Medika.
http://digilib.unimus.ac.id/files/disk1/11
9/jtptunimus-gdl-caturhardi-5908-4-
daftarp-a.pdf (Akses 4 April 2015)
Mulyana, D., 2000. Ilmu Komunikasi ; Suatu
Pengantar. Editor : Muchlis. PT
Rermaja Rosdakarya : Bandung
Nurjannah,I., 2011. Hubungan Terapeutik
Perawat Dan Klien. Program Studi Ilmu
Keperawatan Fakultas Kedokteran
UGM. Yogyakarta.Scott, B..
Ketrampilan Berkomunikasi. Bina Rupa
Aksara : Jakarta
Nursalam & Siti Pariani., 2000. Metodologi
Riset Keperawatan. CV Sagung Seto:
Jakarta
__________., 2008. Konsep dan Penerapan
Metodologi Penelitian Ilmu
Keperawatan. Salemba Medika :
Surabaya
Pratiknya,. 2000. Dasar-Dasar Metodologi
Penelitian Kedokteran dan Kesehatan,
PT. Raja Gravindo Persada : Jakarta
Priharjo., 2007., Pengkajian Fisik
Keperawatan. EGC : Jakarta.
http://www.belbuk.com/pengkajian-
fisik-keperawatan-edisi-2-p-4176.html
(Akses 2 Juni 2015)
Rahmat, J., 2000. Psikologi Komunikasi. PT
Remaja Rosdakarya : Bandung
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Rusmini., 2006. Perkembangan anak dan Sugiono,. 2006. Metode Penelitian

remaja. Jakarta : PT. Rineka Cipta. Administrasi. CV. Alfabeta : Bandung
http://digilib.unimus.ac.id/files/disk1/13 Suparyanto.,2014. Tahapan Komunikasi
4/jtptunimus-gdl-odefandier-6682-5- Terapeutik. http://dr-
daftarp-3.pdf (Akses 4 April 2015) suparyanto.blogspot.com/2014/01/tahap
Setiawati, A., Suyatna, F.D., dan Gan, Sulistia. an-komunikasi-terapeutik.html.
2007. Farmakologi Dan Terapi. Suprajitno,. 2004. Asuhan Keperawatan
Jakarta:Departemen Farmakologi dan Keluarga. EGC : Jakarta
Terapeutik FKUI. Suryani. 2005. Komunikasi Terapeutik : Teori
http://repository.usu.ac.id/bitstream/123 dan Praktik. Buku Kedokteran EGC :
456789/25624/2/Reference.pdf (Akses 2 Jakarta
Juni 2015) Tamsuri., 2005. Komunikasi dalam
Siti Fatmawati., 2010., Komunikasi Keperawatan. EGC : Jakarta
Keperawatan Plus materi Komunikasi Vivin Sulastri., 2009. Hubungan Komunikasi
Terapeutik, Jogjakarta: Medical Book. Terapeutik Perawat dengan Anggota
http:// repository. Keluarga Terhadap Tingkat Kecemasan
usu.ac.id/bitstream/123456789/34273/1/ Keluarga pada Pasien yang Dirawatn
Reference.pdf (Akses 4 April 2015) di Unit Perawatan Kritis di RSUD Dr.
Stuart., 2007. Buku saku keperawatan jiwa. Moewardi Surakarta. https://
Jakarta: EGC http:// repository.usu. publikasiilmiah.ums. ac.id/bitstream/
ac.id handle/11617/3629/VIVIN%20CANDR
/bitstream/123456789/34273/1/Referenc A%20IKAWAT-SULASTRI%
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Stuart and Sunden., 2007. Buku saku 2015)
keperawatan jiwa. edisi 3 (alih bahasa).
EGC : Jakarta

96
 Proceeding Patient Safety in Emergency

BENEFITS OF RELAXATION INTERVENTION SYNERGY AND EFFECTIVE

BREATHING IN HEAD PAIN SENSATION OF HYPERTENSION CLIENTS
AT BLUD POLYCLINIC OF SELE BE SOLU SORONG HOSPITAL

Bambang Suparno, Wayan Badra

Nursing Departement of Poltekkes Kemenkes Sorong

Abstract

Hypertension cases often cause symptoms of perceived patient with headache, neck tension, insomnia,
emotional stress. This has resulted in symptoms of irritable client and can not wait for medical help.
Such a time is this nurse needs to be more sensitive / responsive and caring to take immediate action
treatment. The purpose of this research is want to implement the intervention synergism between
relaxation and breathing effectively in patients to reduce the sensation of pain and lowers
hypertension in nursing (non-medical). The study design using the design of the engineering
experiment Quasi one group pre and posttest study, which means using a single group of respondents
were observed before in observations by the intervention and after the intervention experiment.
Population and Sample This study is numbered 30 people. Analysis results of pre and Post pulse
treatment with the study results obtained T test p value = 0.001 <of α 0.05. Statistical test results
showed the p value of = <α 0.05 less than the value α of 0.05. Tensions pre and post analysis: X 1 =
159.45 / 83.9 mmHg X2 = 152 / 83.2 mmHg. Statistical test results using T test, blood pressure test
results obtained before the intervention and after the intervention is obtained p value 0.147> 0.05 α.
The conclusion of this study obtained data on indicators of pain sensation, value = 0.000 <α 0.05,
which means reject Ho and accept Ha. Tensions pre and post analysis: X 1 = 159.45 / 83.9 mmHg X2
= 152 / 83.2 mmHg 'according to the statistical test using t test, blood pressure test results obtained
before the intervention and after the intervention examination results obtained p value 0.147> 0.05 α.
Suggestions are expected to respondents who seek treatment at the emergency could be patient
unemotional. Because with patience and relaxation to reduce tension and to conserve oxygen.

Keyword: Relaxation Intervention Synergy and Effective Breathing, Head Pain Sensation,
Hipertension Clients

Background and increased burden, because they can not

The increase in non-communicable
disease is increasingly perceived and create
anxiety for the public. Especially hypertension
in Sorong. An estimated 80% increase in cases
of hypertension, especially in developing
countries in 2005 amounted to 639 million
cases. It is expected to increase to 1.15 billion
by 2025. The prediction is based on patient
morbidity and hypertension current population
growth at this time (Anas, 2006).
According to the science of the
pathophysiology of the disease have a risk of
severe hypertension, which can lead to
complications Headache, disability, paralysis
and sudden death. Increased blood pressure
can cause symptoms: dizziness, headache,
neck tension, insomnia, and so on. It is caused
due to increased tissue perfusion due to
pressure systolic and dyastolic passing through
the normal threshold. Symptoms are felt make
the client become more iritable and irritability
break. In circumstances such as these need to
be given immediate intervention by the
nursing staff before doctors provide therapy.
According Meizack and wall, 1959
stated that the pain can be inhibited and
controlled by controlling the gate of pain
towards cranial. The mechanism of this gate
can be modified and alter the sensation of pain
that spreads before stimulation pain got
cerebral cortex so it does not feel pain.
Hypertension is a disease that is
sensitive, which means that blood pressure
rises suddenly unexpectedly low, or from low
abrupt me-ningkat be high. This is most
people do not understand. A dangerous
situation if not controlled, thus resulting in the
case kompli-cation heart attack or stroke and
kidney failure.
Of the total cases reported in Sorong
City hospital in 2014 amounted to 783 patients
with hypertension, and in 2015 amounted to

97
Proceeding Patient Safety in Emergency
988 cases Hipertansi. Saw an increase from
year to year increase. Therefore need attention
and need further research lebiuh.
Problem Formulation
Severe hypertension cases keenly felt
by the patient. Increasing cases of
hypertension is a result of socioeconomic
change, changing diets, decreased activity, and
the level of knowledge that is lacking.
Complications that may arise can be a pain,
sleep disorders, and emotional stress increase.
If emotional stress and the resulting
uncontrolled anger can lead to lack of oxygen.
For that we need need intervention How can
patients do not stress and excessive oxygen
deficiency.
Objective
1. General Purpose:
To find out the benefits of intervention
Relaxation techniques combined with deep
breathing Hypertension Clients who
experience the sensation nye-ri.
2. Specific Objectives:
a. Knowing the difference in blood pressure
before and after the relaxation and
breathing effectively.
b. Knowing the pulse frequency difference
before and after the effective relaxation
techniques and breathing.
c. Analyzing the size difference of blood
pressure before dansesudah relaxation and
breathing effectively.
d. Knowing pain degree change before and
after treatment
Benefits of Research
1. Theoretical: Help improve the theory of
intervention in the problems that occur on
Hypertension client to be able to control
their emotions before getting therapy from
a doctor.
2. Methodological: This study is
methodologically rarely applied and
hospital campus environment, so as to
provide a model action on klienHipertensi
who experience the feeling of pain.
3. Technical Benefits: The technology
intervention and breathe for pain- so
hypertension patients do not feel bored and
long intervention, need to be updated.
98
Research Hypothesis:
1. Ho accepted: no intervention effect of
relaxation on pain sensation of
hypertension
2. Ho rejected: receive alternative hypothesis
(ha): There is a relaxation intervention
effect on pain sensation of hypertension.
RESEARCH METHODS
Study Design
the study design using the design of the quasi
experiment with one group pre and posttest
study, which means using a single group of
respondents were observed before in
observations by the intervention and after the
intervention.
Framework Concepts
respondents:
O 1 XO 2
Information :
O 1 = Observation before intervention
X = Intervention Relaxation
O2 = Observation after intervention
C. The operational definition
1. O 1 = Observation before intervention is the
measurement of blood pressure and pulse and
sensation (feeling) the discomfort felt by
respondents.
2. O 2 = observation after intervention by
measuring blood pressure, Nadi and changes
in pain sensation (feeling) of respondents felt a
sense of comfort.
3. X = Intervention Relaxation is a treatment
intervention carried out by invite and
encourage / guide renponden for relaxation.
The stages of relaxation are:
a. Adjust the position of the respondent
semifowler or half-seated physical
relaxation.
b. Advise the respondent to close her eyes and
imagine something beautiful and
comfortable experiences. (Such as sitting
off the coast of me-nyaksikan waving palm
trees are very beautiful).
c. Advocate took a deep breath as she counted
1- 2-3-buskan ago menghem breath slowly
while researchers calculate 1 - 2-3 - and
repeated sighed softly as he counted 1 s / d
3 will continue until 5 syklus respiration.
d. Ask how you feel now to the respondent,
the respondent submits data that the
perceived subjectivity after the
intervention.

e. Observing blood pressure and pulse
counting.
Done intervention. Researchers noted the
results of checking vital signs.
Place and Time of Research
Place of research conducted at the BLUD
Polyclinic of Sele Be Solu Sorong hospital.
The study was conducted in July 2016.
Population and Sample Research
The population in this study is the
proportion of patients with hypertension who
came for treatment at BLUD polyclinic of
Sele Be Solu Sorong hospital in June 2015.
According to the data of monthly visits a
month ago April amounted to 30 people.
Sampling Method: How to take a
sample of this research is purposive sampling,
which used the formula proportion of study or
at the Polyclinic as respondents come and do
the process and came for treatment in the
hospital.
1. Signed informed consent
2. Measurement of vital signs
3. Intervention
4. Measurement of vital signs
Data collection and analysis of data:
Collecting data in this study using passive case
findings means investigators waited
respondents in polyclinic of hospital. Data of
respondents listed as the respondent in the
record using the format of the study, which
contains the column name, column vital signs
(blood pressure - pulse- respiration- subjective
symptoms of pain), the intervention column,
and the column heading to intervention
(treatment).
Processing Data in this study were
processed using a computer SPSS16 to
examine differences in the data pre and post
intervention in the respondents Hypertension.
Results see test results Hipotesis. If
hypothesis Ho is rejected when P value <α
(0.05) If the hypothesis Ho is accepted, then
accept hypothesis Ha: No effect on pain
sensation of relaxation intervention
Hypertension
Research Ethics:
1. Informed Consent Statute is signed by
respondents to be studied. Informed
consent describes the respondent's
willingness to follow the research
Proceeding Patient Safety in Emergency
procedures according to the title
contained in it. So that when the subject
refused, this study should not be resumed.
Researchers should not force and must
respect rights of research subjects or
respondents.
2. Anonimity (no name): the name of the
subject is not listed on the check Lyst.
This is to maintain confidentiality by not
mentioning respondent's name, but the
code on the check sheet Lyst.
3. Confidentiality: This study will be kept
confidential respondents.
RESULTS AND DISCUSSION
A. Results:
1. Overview Location: This study room is
located in Medicine Clinic Regional General
Hospital (Hospital) Sele Be Solu Sorong. The
hospital was founded in 1957- 1963 by the
Dutch government, dr. Vander Kou-we as
leadership and coordinated directly dr. Zulder
Hock (Pe-nyakit expert Leprosy)
Based Sorong Regency Decree No. 47 In
1999, Leprosy Hospital entrusted to serve the
non-leprosy patients and by the plenary
session of Parliament Sorong on August 11,
2002 was changed to Hospital Selebe solu
meaning Lautnan shade.
Since 2003 has been submitted Asset
management and ownership of the RS Sele Be
Solu from Sorong Local Government of City
of Sorong to government in 1 commencing
from January 2004 by Decree No. 99 Sorong
Regent in 2003 at August 21st 2003 Then it is
formed the organizational structure and
working procedures of the Sele Be Solu
Sorong hospital by Decision Mayor Sorong
No. 1 of 2004 dated January 5, 2004,
Chairman RS sequence led by: dr. Subargat,
dr. Prabowo, dr.Tang Seng Huang, dr. Kamal,
dr. Tou, dr. RHU Suhud and 1998, led by dr.
Felix Duwit. Since 2008 -2012 led by dr.almh.
Adriani Lazarus and in 2013 chaired by dr.Hj.
Pahimah Iskandar as deputy mayor of Sorong.
Since March 2014, Dr. Maria Ch Huwae
appointed Director of Definitive.
Hospital set as RS type C according to the
Decree of the Minister of Health of the
Republic of Indonesia No. 1247 / Menkes / SK
/ XII / 2009 dated December 22, 2009 on the
establishment of hospitals Class Sele Be Solu-
owned Government of Sorong.
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Proceeding Patient Safety in Emergency

Characteristics of Respondents: This table describes the frequency of

1. Age: The result of the distribution of the pulse before treatment frequency 80-90,
respondents by age is reported as totaling 26 = 92.85%, while the entirety of
follows: both treatments pd pulse rate of 100% on the
Distribution of Respondents by Age at scale 1 while on a scale of 2 to 0. With the
BLUD Polyclinic of Sele Be Solu Sorong statistical test showed the p value of = <
Hospital 0,05lebih α smaller than 0.05 α value. Which
No Age Frequency Percentage means statistically significant. The need for
1 < 30 years 1 3,57 effective breathing and relaxation to reduce
2 31 – 60 16 57.14 the sensation of pain and can lower blood
3 61 – 70 7 25.00 pressure.
4 >71 4 14,28
Total 28 100.00 Distribution of respondents according to Head
Pain
From table above showed that mostly the No Pain Category Frequency Frequency
respondents is at 31 to 60 years old amounted P1 PII
% %
to 57.14%. and 61-70 years old amounted to 7
1 I 0 0 8
or 25% of total respondents. The oldest age>
28,58
71 amounted to 4 or 14.28%. 2 II 6 16
21,42 57,14
2. Gender 3 III 13 4
Distribution of Respondents by Gender 46,42 14,28
Patients with Hypertension. 4 IV 8 0 0
At the BLUD Polyclinic of Sele Be Solu 28,57
Hospital Total 28 28
No Gender Frequency Percentage 100 % 100 %
1 Female 14 50 %
2 Male 14 50% B. Discussion.
Total 28 100 % Hypertension is a disease that contributes
to 13.5% of all deaths (Brook et al, 2013).
From the table in there is same frequency Hypertension often does not cause
between the genders male and female above symptoms, so often the sufferer is not
shows the amount of each numbered 14 people aware of his condition until organ damage
or 50%. In the study of hypertension there is occurs, so it is often called the silent killer.
no difference between the sexes female or Hypertension symptoms are usually
male gender male. vague, such as headaches and neck pain so
often overlooked part neck (LeMone &
Analisis Univariate: Burke, 2008). Hypertension is a common
N n 2 X15134/1 X2 X1= X2= 3,5 1,86 cause of damage of vital organs of the
8 310 4716/ S1 1962=70 S1=96 S2=5 body either directly or indirectly, such as
X1= X2 = 2394=8 ,07 = 3,5 2 heart (coronary heart disease, heart failure
159,43/ 152,8 5,5 S2²= S²=12, S²=3, and dysrhythmias), kidney
83,4 3,2 S²1= 108 25 46
mmHg 278
(Nephrosclerosis, insufficiency, renal
failure), brain (stroke), as well as
peripheral arterial and retinopathy.
1. Respondent Distribution
1. Relaxation:
Distribution of respondents according to First
Muscle relaxation is a method to help
Pressure Pulse Measurement
lower the voltage so that the body
No. Freq/Minute Heart rate I Heart rate
% II (%)
becomes relaxed muscles. This relaxation
1 80 - 90 26 92, 85 28 100,00 was introduced by Edmund Jacobson, a
2 91-100 2 7,15 0 physician from the United States,
Total 28 100. 00 28100 % Destination relaxation exercises is to
generate a response that can combat stress
response (Smeltzer and Bare, 2001). The
benefits of this relaxation is to reduce

100

anxiety, conserve the body's oxygen
consumption, helping to speed the
metabolism, effective respiratory rate,
reduce muscle tension, lowers systolic and
diastolic blood pressure, effecting
premature ventricular contraction and an
increase in alpha brain waves (Synder &
Lindquist, 2010).
Progressive muscle relaxation is done by
contracting and relaxing the muscle
groups in sequence, namely the hand
muscles, upper arms, forearms, forehead,
face, jaw, neck, chest, shoulders, upper
back, abdomen, thighs and calves. 5-10
seconds of muscle contraction and
relaxation done for about 20-30 seconds.
Attention is directed to the patient can feel
the difference between when the muscles
contracted and when direlaksasikan.
Exercises performed in a quiet tendency
on a chair or a comfortable bed that
supports the body well. Patients are
encouraged to wear comfortable clothing,
not tight, shoes, glass and contact lens
amta released. An important point of this
exercise is to do it regularly every day for
at least 15 minutes (Synder & Lindquist,
2010).
Let all the tightness and pain flow out of
the muscles when exhaling
simultaneously. In this example, imagine
tightness and pain will flow out of hand by
the fingertips when exhaling. Feel the
muscles relax and become loose and limp,
the tension flowing out like water from a
faucet. Focus on feeling by looking at the
difference between tension and relaxation.
2. Blood Pressure
In physiology, state of stress involves the
hypothalamus, which in turn control two
indokrin nervous system, the sympathetic
system and the adrenal cortex system. The
sympathetic nervous system responds to
nerve impulses from the hypothalamus is
to involve various organs and smooth
muscles that are under its control, for
example, increase the heart rate, raises
blood pressure, increases blood flow to the
muscles and dilate the pupil (Smeltzer and
Bare, 2001).
The sympathetic nervous system also provides
stimulation to the adrenal medulla to release
epinephrine and norepinephrine into the blood
stream. Fight or flight response is stresdi
Proceeding Patient Safety in Emergency
reaction in the body that include increased
heart rate, breathing, blood pressure, and
serum cholesterol. The philosophy of the fight
or flight response is: when confronted with a
threat, the body prepares itself to; whether it
will remain in place against such threats
(fight), or will run away from the threat
(flight).
There is a statistically significant difference in
systolic blood pressure (p <0.01), diastolic
blood pressure (p = 0.05) and heart rate (p
<0.05), a significant reduction after JPMR
session.
3. Heart Rate
Relaxation in the intervention in this study is
expected to yield data on changes in the pulse
frequency of respondents before being given a
breathing relaxation and effective intervention.
The pulse indicator informs us that high blood
pressure with an increase in pain Head impact
pulse frequency. Therefore, a decrease in pulse
rate post intervention relaxation are an
important indicator for the unknown. In
accordance with other studies written in
(Smeltzer & Bare, 2002) that the purpose of
relaxation exercises is to generate a response
that can combat stress. Will decrease both the
secretion of these hormones causes the activity
of the sympathetic nerves decreases so that the
expenditure of adrenaline and noradrenaline is
reduced, resulting in decreased heart rate,
dilated blood vessels, vascular resistance
decreases and the decrease in heart pumps so
that the arterial blood pressure decreased heart
(Sherwood, 2011) (in Nasution, IK, 2007).
In this study obtained data that significans
refuse hypothesis zero. Interpreted that
interventions effective relaxation and
breathing was very helpful with indicator.
CONCLUSION & SUGGESTIONS
A. Conclusion
1. Intervention relaxation can lower the
sensation of pain on respondents of
Hypertension, it reduce pain after the
intervention of relaxation and
breathing effectively, the significance,
the probability value 0.000 <α 0.05
reject Ho.
2. Intervention relaxation and breathing
effectively able to provide frequency
of heart rate after intervention with
probability value 0,001 <α 0,05 reject
Ho.
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Proceeding Patient Safety in Emergency

3. Indicators of tension reduction Bhisma Murti, 1997, Prinsip dan Metode Riset
according to this study there was no Epidemiologi, Gajah Mada University
difference between pre and post Press, Jogyakarta.
treatment, so it needs more patience Bruner dansuddart (1996, Keperawatan
and time needs to be longer. Tensions medical bedah,
were no differences with a probability penerbitbukukedokteran., Jakarta ,
value 0.147> 0.05 α and accept Ho; EGC
B. Suggestions Doengoes M.E.,1984, Nursing Care Proses
1. For Hypertension respondents Guidlines for planning Patient Care,
recommended to be more patient and ed 2, davis Company, Philadelphia.
relaxed and do relax and breathe Harisson, 2000, Prinsiples of Internal
effectively while waiting for the Medicine , ed.9, terjemah:
actions of doctors. S.Kartoleksono : Sari Ilmu Peny
2. Headache caused by hypertension Dalam, EGC press, Jakarta.
sufferers to get help doctors often take Nasution I. K., 2007, Asuhan keperawatan
a long time. Thus making impatient. Klien dengan Stress,
Thus the need an action by nurse by Nursalam, 2003, Metodologi Penelitian Ilmu
encouraging relaxation and breathing Keperawatan: Pedoman Skripsi, Tesis
effectively. dan instrumen Penelitian Keperawatan,
3. The results of the blood pressure jld I , Edisi 1,Salemba Medica, Jakarta.
results were not statistical significance M0h.Haryadi, 2009, Statistik Pendidikan
of this analysis is used the Panduan Lengkap, ISBN,Jakarta
measurement of systolic and diastolic. Suryano, 2010, Kumpulan Instrument
Supposedly analyzed by systolic and Penelitian Kesehatan, Mulia Medika,
diastolic measurements alone. Bantul.
Stang,2003, Biostatistik II,
REFERENCES FakultasKesehatanMasyarakatuniversit
Anas Tamsuri, dkk., 2006, Konsep dan asHasanudin, Makasar.
Penatalaksanaan Nyeri, Penerbit Buku Ganongwiliam dkk.,2002, Buku Ajar
Kedokteran, Jakarta. FisiologiKedokteran,
Abu Farhan,2015, Bogspot.go.Id penerbitbukukedokteran, Jkarta, EGC
Arif Mansyur, Kuspuji Triyani, Rakhmi
Safitri, 1999, Kapita Selekta,EGC,
Jakarta.
Barbara Enggran, 1998, Rumusan Asuhan
Keperawatan Medikal Bedah, EGC,
Jakarta.

102
 Proceeding Patient Safety in Emergency

ACTIVITIES AND NUTRITION INTAKE IN OVERWEIGHT AND OBESITY

ADOLESCENT IN SENIOR HIGH SCHOOL 2 OF SORONG CITY

Lasupu, Irma Susan Paramita

Nutrition Department of Poltekkes Kemenkes Sorong

ABSTRACT

Obesity is a problem worldwide due to increasing prevalence in adults and adolescents both in
developed countries and in developing countries. Many studies show the tendency of obese children
and adolescents to remain obese in adulthood which may result in an increased risk of diseases and
disorders related to obesity during the next life. The purpose of this study was to determine the
effect of nutrition education to changes in knowledge, sedentary activity and nutrient intake in
adolescents at senior high school 2 of Sorong. This type of research is pre-experimental design.
Sampling was done by purposive sampling using the formula Lameshow. The research sample of 38
categories of nutritional status of overweight and obesity. Then performed a pretest for all respondents
and given nutrition education using slides, leaflets and sms (short message service). Data measured
respondents' knowledge at the time of pre-test and post test using questionnaires knowledge. Data
food intake was measured using 24-hour recall questionnaire. Neither the sedentary lifestyle
measurement data using questionnaires sedentary life style. The results showed Providing nutrition
education significantly influence changes in knowledge adolescent overweight and obesity SMA N 2
Sorong city with an increase of 0.72 ( mean) with score p = 0.12. the provision of nutrition
education influence the change sedentary activity adoloscent overweight and obesity SMA N 2
Sorong city with a drop of 0,1 ( mean) but the result was not significant (p=0,210). The provision of
nutrition education had no effect on changes in energy intake (p = 0.06), carbohydrates (p = 0.35) and
fat (p = 0.07) adolescent overweight and obesity SMA N 2 Sorong city . The provision of nutrition
education affect the changes in fiber intake adolescent overweight and obesity SMA N Sorong City to
increase fiber intake of 0.16 (mean) but the result was not significant (p = 0.12)

Keywords: Nutrition Education, Knowledge, sedentary activity, intake of nutrients, Overweigth

Background data between 2003-2006, the results show that

The success of national development,
especially in the fields of nutrition and health,
in recent years be good for decreasing the
number of people with cases of malnutrition in
Indonesia and the world. But this success was
followed by an increase in the prevalence of
overweight in the community (staggers et.al,
2012).
Obesity is one of the most serious
problem in public health of the 21st century.
The problem is global and continues to affect
many countries of low and middle income,
especially in urban areas. The prevalence has
increased at an alarming rate (WHO, 2013).
The prevalence of obesity is
increasing from time to time. Not only in
developed countries but also spread to
developing countries. Not only in adults but
also occurs in children and adolescents
(Masyita, 2015).
National Health and Nutritional
Examination Survey (NHANES) collected
in the United States, in adolescents aged 11-19
years the prevalence of overweight was 31.4%
and the prevalence of obesity was 17.6 %
(Odgen in Masyita, 2015).
Data from Riskesdas in 2007 showed
the prevalence of obesity in adolescents aged
15 years and over in Indonesia is 19.1%.
The prevalence of overweight in West
Papua province in adolescents over 15 years
old is 9.6%, while the prevalence of obesity in
adolescents over 15 years old is 13.4%. This
prevalence is above the national prevalence
Indonesia which is 8.8% overweight and
10.3% Obesity.
SUBJECT AND METHOD
Research Design
This study is a pre-experimental study
to see the effect of education given to changes
in knowledge and nutrient intake in
overweight and obese adolescents.

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Proceeding Patient Safety in Emergency
The research design is quasi-
experimental using one group design pretest-
postest, in which high school students (teens)
with the nutritional status of overweight and
obesity were given nutrition education. This
education is expected to have a positive effect
on changes in knowledge, sedentary activity
and nutrient intake
Research Location
The research location is at SMAN 2 in Sorong
City in November 2017
Sample
The sample in this research is adolescent with
nutritional status of overweight and obesity
amounted to 38 students
The sampling technique were taken by
purposive sampling.
Operational Definition
The operational definition is to limit the scope
or meaning and the variables studied or
observed (Notoatmojo, 2012).
1. Obesity
A state of excessive accumulation of energy in
the form of body fat as measured by body
mass index (BMI) (The Asia-Pacific
Perspective: Redefinising Obesity and its
Treatment, 2000)
2. Intake of energy
A number of the energy content of foods and
beverages consumed by teenagers.
3. Carbohydrate Intake
A series of compounds Karbohidrat of food
and beverages consumed by teenagers
4. Fat Intake
A number of fat content of foods and
beverages consumed by teenagers.
5. The fiber intake
Some fiber content of foods and beverages
consumed by teenagers.
6. Knowledge of respondents
What is respondents know about overweight,
eating behavior, and sedentary activities
7. Sedentary Activities
Activities that tend to be quiet and sit down or
in front of the screen without a lot of moves
made by the respondent in a day such as
watching television or vidio, playing computer
or video games, sit and listen to music, sitting
and talking on the phone / cell (Norman,
Gregory J, et al, 2005)
104
Instruments and Data Collection Method
The research instrument used in this study is
the format cartridge containing all the data
required in the study filled in by the
researcher.
Result
1. Overview of Research Sites
This research has been conducted at senior
high school 2Sorong. Senior high school 2 is
one public school that is accredited A. The
school is located on the river road Maruni,
District East Village Sawagumu Sorong.
The total number of students of SMAN 2
Sorong is 280 students, and the total
population of which amounts to 280 students.
2. General Data
General data is data about the characteristics
of the respondents summarized in several
criteria, characteristics of respondents based
on characteristics of the parents of respondents
(parents education level, of parents work
level), respondents pocket money.
3. Custom Data
a. univariate analysis
Univariate analysis was to analyze the data of
independent variable and the dependent
variable and then distributed into the
frequency distribution table. The specific data
as follows:
1) Distribution Frequency based on Nutritional
Status of Respondents.
Table 1 shows the number of respondents who
nourished overweight (obese) is 14
respondents (38.9%) and the nutritional status
of obese (very overweight) is 22 respondents
(61.1%).
Table 1 Distribution of respondents based
on the Nutritional Status (IMT / U)
Variable N= 36 %
Nutritional status
Overweight 14 38,9
Obesity 22 61,1
Sources: Primary data, in 2016
2) Distribution Frequency based on knowledge
of Respondents.
Table 2 shows that before the administration
of nutrition education as much as 13
respondents (36.1%) have sufficient
knowledge and increased to 19 respondents
(52.8%) after administration of education.
 Proceeding Patient Safety in Emergency

Respondents who have less knowledge as Fat

much as 23 respondents (63.9%) decrease into Less 5 13,9 9 25,0
7 respondents (19.4%) after administration of Enough 9 25,0 12 33,3
education. No respondents had a good Over 22 61,1 15 41,7
knowledge (0%) before administration of Fiber
education but after education there was 10 Less 22 61,1 18 50,0
respondents with good knowledge (27.8%) Enough 7 19,4 12 33,3
Table 2 Distribution of Respondents Over 7 19,4 6 16,7
Knowledge Levels Before and After the Sources: Primary data, in 2016
Nutrition Education
Value Pre test Post test 4. Distribution frequency based sedentary
N= 36 % N= 36 % activity
Less 23 63,9 7 19,4 Table 4 shows that respondents who had
Enough 13 36,1 19 52,8 sedentary activity before nutrition education
Good 0 0,0 10 27,8 were 23 respondents (63.9%) and decreased to
Sources: Primary data, in 2016 19 respondents (52.8%) after nutrition
education. Respondents who did not have
3) Distribution Frequency based Substance sedentary activity before nutrition education
Nutrient Intake were 13 respondents (36.1%) and increased to
Table 3 illustrates the majority of respondents 17 respondents (47.2%) after nutrition
sufficient energy intake before the education.
administration of nutrition education as many Table 4 Distribution of Respondents
as 18 respondents (50.0%) and decreased to 11 Sedentary Activities Before and After the
respondents (30.6%) after administration of Nutrition Education
nutrition education. Sedentary Pre test Post test
Carbohydrate intake of respondents largely Activities N= 36 % N= 36 %
sufficient before nutrition education as many
as 22 respondents (66.7%) and decreased to 21 ≤ 4 hours 13 36,1 17 47,2
respondents (61.1%) after administration of (Not
nutrition education. sedentary)
Fat intake of respondents before the >4 hours 23 63,9 19 52,8
administration of nutrition education is over in (sedentary)
22 respondents (66.1%) and decreased to 15 Sources: Primary data, in 2016
respondents (41.7%) after administration of
nutrition education. b. Bivariate Analyzes
Fiber intake of respondents mostly less before Bivariate analyzes show the relationship
administration of nutrition education as many between the independent variables and the
as 22 respondents (66.7%) and decreased to 18 dependent.
respondents (50.0%) after administration of 1. Analysis level of knowledge before and
nutrition education. after Nutrition Education
Table 3 Distribution of Substance Nutrient Table 5 shows there is an increase in
Intake Respondents Before and After knowledge after the administration of
Nutrition Education education as much as 0.72. The p-value
Intake of Pre Test Post Test showed that there were significant
Nutrient N=36 % N=36 % differences between knowledge before and
Substance after administration of nutrition education
Energy with a value of p = 0.000 (p <0.05).
Less 10 27,8 11 30,6
Enough 18 50,0 11 30,6
Over 8 22,2 14 38,9
Carbohydrate
Less 7 19,4 6 16,7
Enough 24 66,7 22 61,1
Over 5 13,9 8 22,2

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Proceeding Patient Safety in Emergency

Table 5 Analysis level of knowledge Discussion

before and after Nutrition Education. 1. Respondents knowledge
Knowledge Mean SD  P Tables 4.5 and 4.6 showed the influence of
mean value education to respondents, knowledge changes
Pre Test 1,36 0,48 0,72 0,000 with an increase in knowledge after the
Post Test 2,08 0,69 administration of education as much as 0.72.
Sources: Primary data, in 2016 The p-value showed that there were significant
2. Analysis Results of Substance Nutrient differences between knowledge before and
Intake in Respondents Before and after after administration of nutrition education with
Nutrition Education. a value of p = 0.000 (p <0.05). According to
Table 6 shows no increase in energy intake the researchers the increased of knowledge on
as much as 0.36, (p = 0.06) increase in the respondent caused by the possibility for
carbohydrate intake of 0.11 (p = 0.35), researchers to maximize the print media
increased fat intake of 0.11 (p = 0.07) and (educational leaflet) and electronic media
increased fiber intake as much as 0.16 (p = (slides and text) in the provision of nutrition
0.12) after administration of nutrition education on adolescent obesity in high school
education, but the results are not 2 Sorong.
significant. Knowledge is the result of knowing and this
Table 6 Substance Nutrient Intake happens after a person perform sensing to a
Analysis Results Respondents Before particular object. This sensing occurs through
and After the Nutrition Education the five senses are the senses of sight, hearing,
Intake of Mean SD  P smell, taste and touch. Most human knowledge
Nutrient is obtained through the eyes and ears.
mean value
Substance Knowledge is the domain that is essential for
the formation of a person's behavior
Pre Test
(Notoatmodjo, 2010).
Energy 1,72 0,81 0,36 0,06
Often problems arise due to ignorance of
Carbohydrate 1,94 0,58 0,11 0,35
respondents nutrition and lack of information
Fat 1,62 0,87 0,11 0,07
about nutrition. The formation of the new
Fiber 1,68 0,80 0,16 0,12
behavior of knowledge to stimulation material
Post Test
or object about something that will lead to new
Energy 2,08 0,84 0,36 0,06
knowledge on the subject and further raises
Carbohydrate 2,05 0,62 0,11 0,35
further response in the form of action.
Fat 1,94 0,76 0,11 0,07
However, considerable knowledge does not
Fiber 1,84 0,83 0,16 0,12
guarantee a person behave the same as what is
Sources: Primary data, in 2016
known. It can be said that the results of this
3. Analysis result of Respondents Sedentary
study, the level of knowledge in the category
Activities Before and After the Nutrition
knows (know) that is interpreted as
Education
considering a material that has been studied
Table 7 showed there was decrease in
previously. Included in this is the level of
sedentary activity after the administration
knowledge recall (recall) to something specific
of education as much as 0.1 but that there
to the whole material is learned or stimuli that
was no significant difference between
have been received (Notoatmodjo, 2010).
knowledge before and after administration
2. Substance Nutrient Intake
of nutrition education with a value of p =
Table 4.8 showed there was an increase in
0.210 (p> 0.05).
energy intake as much as 0.36, (p = 0.06)
Table 7 Analysis of Respondents
increase in carbohydrate intake 0.11 (p =
Sedentary Activities Before and After
0.35), increased fat intake 0.11 (p = 0.07) and
the Nutrition Education
increased fiber intake as much as 0.16 (p =
Sedentary Mean SD  P 0.12) after administration of nutrition
Activities mean value education, but the results are not significant.
Pre Test 1,63 0,48 0,1 0,210 The energy consumption of the food needed to
Post Test 1,52 0,50 perform everyday activities. The energy needs
Sources: Primary data, in 2016 of the food in addition to daily physical
activity is also a process of rapid physical

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growth and changes in the shape and
composition of body tissues that require a lot
of energy.
There are three sources of energy in the body,
namely carbohydrates, fats, and proteins. In
the body, these nutrients are broken down into
energy and energy generated from each gram
of carbohydrate is four calories, fat nine
calories, and protein four calories (Devi,
2010).
Energy in the body's basal metabolic function,
ie the energy required at the time of rest, then
specific dynamic action (SDA), which is the
energy needed to process the food itself, for
physical activity, thought, growth, and
disposal of food waste. Energy shortages will
inhibit all activities in the body (Devi, 2010).
Excess energy occurs when energy
consumption through food exceeds energy
expenditure. This excess energy is converted
into body fat. Consequently, there is
overweight or obese. Obesity can be caused by
overeating in this kind of carbohydrate, fat and
protein. (Almatsier, 2009).
Carbohydrates are the main energy source for
humans. Each one gram of carbohydrate
produced four calories. According to WHO
recommendations (1990) is 55-75 per cent of
total energy consumption preferably derived
from simple sugars. Grains, tubers, legumes
dried and processed products such as
vermicelli, noodles, bread, and flour can be
used as a source of carbohydrate (Achadi,
2007).
One of the causes of overweight in children is
the selection of foods that are less precise,
such as high-fat foods. Other factors that may
also influence is family consumption habits.
Consumption of high fat found more
consumed by the upper middle class. This
could be due to their more consumption and
more likely to follow the trend which is now
very much a trend that lifted high fat foods
such as fast foods are very low content of
nutritional value.
WHO recommends consumption of fat around
15-30 percent of its total energy needs. The
amount is considered to meet the needs of
essential fatty acids and helps the absorption
of fat soluble vitamins. Of these needs at most
10 per cent came from 3-7 percent saturated
fat and no saturated fat and cholesterol intake
is recommended for less than 300 mg a day
(Guthrie, H.A, 1989 in Achadi, 2007).
Proceeding Patient Safety in Emergency
Someone with diets containing fiber, rare
overweight. Children who are overweight or
obese need more fiber-containing foods such
as vegetables and fruits. Function fiber weight
control because fiber does not contribute much
energy. Fiber also gives full effect longer so
fast not arise hunger (Yuliarti, 2008).
Daily fiber needs according to the American
Cancer Society recommends 20-30 grams a
day. Indonesia's population diet is generally
rich in fiber from nuts, vegetables, and fruits
(Achadi, 2007). The goal is to avoid excess
fat, saturated fat and cholesterol, sugar and
sodium, and help control weight.
3. Respondents sedentary activities
Table 4.9 shows there is a decrease in
sedentary activity after the administration of
education as much as 0.1 but the value of p,
shows that there was no significant difference
between knowledge before and after
administration of nutrition education with a
value of p = 0.210 (p> 0.05).
The results based on a few studies on
sedentary activity and obesity in children and
adolescents showed that the intervention in
sedentary activity decline is an effective
intervention to reduce the activity and weight
control in children and adolescents (DeMattia,
et al, 2007)
Research on the relationship between physical
activity and sedentary indicate that in
adolescents, a positive correlation was found
between the sexes (male) and a sedentary
activity, whereas an inverse relationship was
found between gender and adequate physical
activity. Ethnicity (Caucasian), socioeconomic
status, and education of parents were also
found inversely related to sedentary activity in
adolescents (Van Der Horst, et al, 2007)
Research on the characteristics that can be
modified and linked to sedentary activity in
adolescents showed that in addition to BMI,
other factors associated with sedentary
activities include physical activity, parental
encouragement and support for physical
activity, behavior of a close friend of physical
activity, and smoking status. This study found
that students are very involved in activities in
front of the screen, but spent limited time on
more productive sedentary activities, such as
reading and doing homework. Developing a
better understanding of sedentary behavior is
very important to prevent and reduce obesity
in the adolescent population (Leatherdale, and
Wong, 2008).
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Proceeding Patient Safety in Emergency
LIMITATIONS OF RESEARCH
Limitations of the study explained things or
actual variables included in the vastness of the
scope of research but because of
methodological difficulties or certain
procedural and therefore can not be included
in the study and control of the researcher.
Limitations in this research that the
researchers did not directly control food intake
and physical activity of respondents, so the
effect of nutrition education provided does not
provide maximum effect.
CONCLUSION
1. The provision of nutrition education
significantly influence changes in
knowledge adolescent overweight and
obesity SMA Negeri 2 Kota Sorong with
an increase of 0.72 with p = 0.000.
2. The provision of nutrition education
influence the change sedentary activity
adolescent overweight and obesity in high
school 2 of Sorong with a decreased of
0.1 but the result was not significant (p =
0.210)
3. The provision of nutrition education had
no effect on changes in energy intake (p =
0.06), carbohydrates (p = 0.35) and fat (p
= 0.07) in adolescent with overweight and
obesity at senior high school 2 of sorong.
4. Provision of nutrition education influence
the change of fiber intake of adolescent
with overweight and obesity at senior
high school 2 of Sorong to increase fiber
intake of 0.16 but the result was not
significant (p = 0.12).
SUGGESTION
For future studies should also be controlled
food intake and physical activity directly so
that the effect of nutrition education can
provide maximum results.
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