PROCEEDINGS
RIAU INTERNATIONAL NURSING CONFERENCE (RINC) 2018
Incorporating Technology and Ethics in Advancing Nursing Education and Practice
Editor: Ns.Bayhakki, M.Kep., Sp.KMB,PhD Wan Nishfa Dewi, S.Kp, MNg, PhD Ns. Yufitriana Amir, S.Kep, MSc, PhD Ns. Agrina, M.Kep, Sp. Kep. Kom, PhD Rismadefi Woferst, M.Biomed Riri Novayelinda, MNg Erika, M.Kep., Sp.Mat Veny Elita, MN (MH) Ns. Febriana Sabrian, MPH Ns. Wasisto Utomo, M.Kep, Sp. KMB Ns. Sri Wahyuni, M.Kep, Sp. Kep. J
Cover design and lay out: Masrizal
Publisher: Faculty of Nursing, Universitas Riau Address: Campus UNRI Gobah, Jl. Pattimura No.9, Gedung G, Phone. +62 761 31162, Pekanbaru Indonesia CONFERENCE COMMITTEE
RIAU INTERNATIONAL NURSING CONFERENCE 2018 FACULTY OF NURSING, UNIVERSITAS RIAU
Advisory Board : Prof. Dr. Ir. Usman M Tang, MS Wan Nishfa Dewi, S.Kp, MNg, PhD Erwin, S.Kp, M.Kep Steering Committee : Wan Nishfa Dewi, S.Kp, MNg, PhD Ns. Agrina, M.Kep, Sp. Kep. Kom, PhD Ns. Bayhakki, M.Kep, Sp. KMB, PhD Ns. Yufitriana Amir, S.Kep, MSc, PhD Ns. Febriana Sabrian, MPH Ns. Sofiana Nurchayati, M.Kep Erika, M.Kep., Sp.Mat Ns. Sri Wahyuni, M.Kep, Sp. Kep. J
Chairperson : Ns. Agrina, M.Kep, Sp. Kep. Kom, PhD Secretary : Ns. Gamya Tri Utami, M.Kep Treasurer : Ismawati, SE Scientific Committee : Ns. Bayhakki, M.Kep, Sp. KMB, PhD (Coordinator) Wan Nishfa Dewi, S.Kp, MNg, PhD Ns. Yufitriana Amir, S.Kep, MSc, PhD Ns. Agrina, M.Kep, Sp. Kep. Kom, PhD Dr. Reni Zulfitri, M.Kep, Sp. Kom Rismadefi Woferst, M.Biomed Riri Novayelinda, MNg Erika, M.Kep, Sp.Mat Veny Elita, MN (MH) Ns. Febriana Sabrian, MPH Ns. Wasisto Utomo, M.Kep, Sp. KMB Ns. Sri Wahyuni, M.Kep, Sp. Kep. J Professor Naohiro Hohashi, PhD, RN, PHN, LSN, HS, FAAN Professor. Claudia KY Lai, PhD, RN, FAAN Professor Michael Joseph S. Dino, PhD, MAN, RN Associate Prof. Dr. Wandee Suttharangsee Prof. Dr. Datuk Bibi Florina Abdullah Assoc Prof Dr Ali Abdulbaqi Ameen Ali
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REVIEWERS
Professor Claudia KY Lai, PhD, RN, FAAN (The Hong Kong Polytechnic University, Hong Kong)
Professor Michael Joseph S. Dino, PhD, MAN, RN (Our Lady of Fatima University, Philipines)
Professor Datuk Bibi Florina Abdullah (Lincoln University College, Malaysia)
Dr. Ali Abdulbaqi Ameen Ali (Lincoln University College, Malaysia)
Professor Naohiro Hohashi, PhD, RN, PHN, LSN, HS, FAAN (Kobe university, Japan)
Associate Prof. Dr. Wandee Suttharangsee (Prince of Songkla University, Thailand)
Wan Nishfa Dewi, S.Kp, MNg, PhD (Universitas Riau, Indonesia)
Ns.Bayhakki, M.Kep., Sp.KMB,PhD (Universitas Riau, Indonesia)
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CONTENTS
Conference Committee ...... i Reviewers ...... ii Contents ...... iii Conference Program...... vi Conference Chair Message ...... xiii Greetings From Acting Rector, Universitas Riau ...... xiv Greetings From Dean Faculty Of Nursing Universitas Riau ...... xv Plenary Sessions Summaries ...... xvi
List Of Oral Presentation 1. The Relationship Between Parents’ Verbal Abuse And Emotion Regulation In Adolescents Anisa Yulvi Azni, Juniar Ernawaty, Yesi Hasneli...... 1 2. The Relationship Of The Gender With Emotion Regulation In Junior High School Students Hayatul Husna, Fathra Annis Nauli, Herlina ...... 6 3. The Effect Of Combination Spiritual Emotional Freedom Technique (Seft) Therapy And Hydrotherapy With A Mixture Red Ginger On Blood Pressure Of Patients Hypertension Risfinda, Bayhakki, Yufitriana Amir ...... 11 4. The Correlation Between Parenting Styles And Online Gaming Addiction In Junior High School Students Rodhiatul Hidayah, Safri, Ganis Indriati ...... 17 5. Relationship Between Family Support And Aggressive Behavior Among Indonesian Adolescents Reshalia, Reni Zulfitri, Bayhakki ...... 27 6. Relationship Between Students' Perception Of Problem Based Learning And Learning Outcomes Hermanto, Wan Nishfa Dewi, Veny Elita ...... 31
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7. Profiling Diabetes Mellitus (Dm) Patients: Demographic Characteristics, Disease History And Foot Grade Desty Aristiyani, Yesi Hasneli, Rismadefi Woferst ...... 35 8. Correlates Between Inhaler Type And Usage Accuracy Among Indonesian Asthma Patients Natasya Sri Zekia, Siti Rahmalia Hairani Damanik, Wasisto Utomo ...... 39 9. Caregiver’s Lived Experiences In Caring For Post-Stroke Patients: A Phenomenological Inquiry Indah Putri Irdelia, Wasisto Utomo, Rismadefi Woferst ...... 43 10. Nurses’ Understanding Of Evidence Based Practice: Knowledge, Practice And Attitude Dian Eka Lestari, Wan Nishfa Dewi, Sri Utami ...... 48 11. The Effect Of Pictorial Health Warning Labels On Smoking Intensity In Adolescents Arvilla Diana, Febriana Sabrian, Darwin Karim...... 53 12. Emergency Nurses Knowledge About Triage Vicky Setiarini, Wan Nishfa Dewi, Darwin Karim ...... 60 13. Self-Care Practice Of Congestive Heart Failure Persons Arifin Achmad Hospital Dwi Rahayu Nengsih, Wan Nishfadewi, Fathraannisnauli ...... 65 14. The Level Of Knowledge And Attitude Abouth Health Snacks With Behavior In Choosing Foot At 4th And 5th Grades In Public Elementary School 121 Pekanbaru Estri Mailinda, Raja Fitrina Lestari ...... 70 15. The Association Between Peer Conformity With Deviant Behavior In Adolescents Gilang Sri Mentari, Jumaini, Arneli Wati...... 75 16. Influence Abdominal Stretching Exercise Against Intensity Of Dysmenorrhoe Annisa Syafna, Yulia Irvani Dewi, Siti Rahmalia Hairani Damanik ...... 80
List Of Poster Presentation 1. Component Of Adolescent Self-Concept In Islamic Boarding School Reftesa Indriani, Fathra Annis Nauli, Ari Pristiana Dewi ...... 85 2. The Correlation Of Breastfeeding Pattern With The Development Of Infants Aged 612 Months Suci Hati Mumtaz, Agrina, Ari Pristiana Dewi ...... 89 3. The Relationship Between Family Support And Hypertension Stage Marya Nasti Wandira, Sofiana Nurchayati, Safri ...... 93
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4. Effects Of Foot Reflection Massage And Acupressure For Patient With Hypertension Santi Melisa, Darwin Karim, Veny Elita ...... 98 5. Description Of Community Behavior Towards Prevention Of Dengue Hemorrhagic Fever (Dhf) Ruvida Ulfa, Arneliwati, Erwin ...... 103 6. Nomophobia: Incidents And Levels Among Indonesian Teenagers Astari Rezki, Ganis Indriati, Erwin ...... 109 7. The Description Of Gymnastics Activity And Cognitive Function On Elderly Lina Maria Siagian, Arneliwati, Siti Rahmalia Hairani Damanik ...... 114 8. The Effect Of Individual Health Education Using Flipbook On Self-Efficacy Of Hypertensive Patients In Controlling Diet Nurpatri Ramadhani, Gamya Tri Utami, Juniar Ernawaty ...... 121 9. The Comparison Of Warm Water Feet-Soaking Hydrotherapy And Acupressure Massage On The Blood Pressure Of Primary Hypertension Patients Nur Sella, Erwin, Riri Novayelinda ...... 128
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CONFERENCE PROGRAM
“Incorporating Technology and Ethics in Advancing Nursing Education and Practice”
08.00 - 08.30 REGISTRATION OPENING CEREMONY - Traditional art 08.30 - 09.15 - Welcome speech of chairman RINC 2018 - Welcome speech of Dean of Nursing Faculty, UNRI - Welcome speech of Rektor UNRI 09.15 - 09.30 Coffee break PLENARY SESSIONS 1 Speaker 1 Professor Naohiro Hohashi, PhD., RN., PHN., FAAN Topic: How to Apply Technology and Ethics in Advanced Family Nursing Practice Speaker 2 Prof. Dr. Datuk Bibi Florina Abdullah 09.30 - 11.30 Topic: Role of Technonoly and Ethic in Advancing Nursing Profession Speaker 3 Professor. Michael Joseph S. Dino, PhD, MAN, RN Topic: Nursing and Health Informatics DAY 1 Speaker 4 November Wan Nishfa Dewi, SKp., MNg, PhD 14, 2018 Topic: The Importance of Ethics in Nursing Practice 11.30 - 13.00 Lunch break and expo visit 13.00 - 14.00 POSTER PRESENTATION WORKSHOP Room 1: Professor Naohiro Hosashi, PhD., RN., PHN., FAAN Topic: The Concentric Sphere Family Environment Theory and Clinical Applications in Family Nursing Room 2: Professor. Michael Joseph S. Dino, PhD, MAN, RN Topic: Technology-Driven Research Production Room 3: 14.00 – 16.00 Professor. Claudia KY Lai, PhD, RN, FAAN Topic: Brief Assessment Tools for The Detection of Cognitive Impairment Room 4: Assoc Prof Dr Ali Abdulbaqi Ameen Topic: Advance Information Technology for Nursing Educaton 2018 Room 5: Assist. Prof. Dr. Sopen Chunuan Topic:
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Ethical Dillema in Reproductive Health 16.00 – 16.30 Closing day 1 19.00 – 20.30 GALA DINNER 08.00 - 08.30 REGISTRATION PLENARY SESSIONS 2 Speaker 4 Assist. Prof. Dr. Sopen Chunuan Topic: Ethical Issues in Maternal and Child Health Nursing and Midwifery Speaker 5 Professor. Claudia KY Lai, PhD, RN, FAAN Topic: Update in Gerontological Nursing in Improving 08.30 – 10.30 Nursing Education and Practice Speaker 6 Assoc Prof Dr Ali Abdulbaqi Ameen Topic: Advance Information Technology for Nursing Educaton 2018 DAY 2 Speaker 8 November Ns. Agrina, M.Kep., Sp.Kom, PhD 15, 2018 Topic: Complementary Therapy for The Breastfeeding Mothers in Community Health Nursing Practice 10.30 – 11.00 Coffee break
11.00 - 12.00 ORAL PRESENTATION SESSIONS 1
12.00 - 13.00 Lunch break and expo visit
13.00 - 14.30 ORAL PRESENTATION SESSIONS 2
14.30 – 16.00 ORAL PRESENTATION SESSIONS 3
16.00 – 16.30 Certificate Conferment
16.30 – 17.00 CLOSING REMARK
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Schedule and Venue Map of Oral Presentation
Oral Presentation: Session I Day 2, 15 November 2018 t i m e : 11.00 – 12.00 Room 1: Siak 1 ( M floor) Room 2: Siak 2 ( M floor) O1.01 O1.02 Medical Surgical and Emergency Nursing Maternity and Pediatric Nursing Moderator: Rismadefi Woferst, M.Biomed Moderator: Riri Novayelinda, MN Evaluator: Oswati Hasanah, M.Kep, Sp.Kep.An Evaluator: Wice Purwani Suci, M.Kep Timer : Ns. Ani Constantia, S.Kep Timer: Ns. Alfian Konadi, S.Kep O1.01.01 Effect Of Combined Spiritual Emotional O3.02.02 Hemoglobin Level And Fetal Freedom Technique (SEFT) And Hydrotherapy Weight Related To Pregnant Women Among Indonesian Clients With Hypertension In Puskesmas Pagar Dewa West (Risfinda) Lampung 2018 O1.01.02 Profiling Diabetes Mellitus (DM) Patients: O1.02.02 (AryantiMaternal Wardiyah)Age And Anemia Are Risk Demographic Characteristics, Disease History Factors Of Low Birthweight And Foot Grade Newborn (Desty Aristiyani) (Juli Widiyanto) O1.01.03 Correlation Between Inhaler Type And Usage O1.02.03 Effect of Tepid Sponge on Changes Accuracy Among Indonesian Asthma Patients In Body Temperature In Infant Of (Natasya Sri Zekia) Children Who Have Fever Dr. Achmad Mochtar Bukittinggi O1.01.04 Self -Caring In Islamic Culture Of Muslim O1.02.04 ClayHospital Handbuilding (Hendrawati) Among Children Persons With ESRD And Hemodialysis: An With Spinal Cord Injuries: Towards Ethnographic Study Educational Protocol Development (Bayhakki) (Jerry Villaruel Manlapaz) 01.01.05 Effectiveness Of Using Sialang Honey On 01.02.05 Influence Abdominal Stretching Wound Bed Preparation In Diabetic Foot Ulcer Exercise Against Intensity Of (Sukhri Herianto Ritonga) Dysmenorrhoe (Annisa Syafna)
Room 3: Indragiri ( M floor) Room 4 : Rupat (M floor) O1.03 O1.04 Community and Psciatric Nursing Nursing Management, Education and Research Moderator: Febriana Sabrian, MPH Moderator: Sri Wahyuni, M.Kep, Sp.KJ Evaluator: Veny Elita, MN (MH) Evaluator: Erika, M.Kep, Sp.Mat Timer: Ns. Febby Fitriani, S.Kep Timer: Ns. Aisha Siddiqua, S.Kep O1.03.01 The Relationship Between Parents’ Verbal O1.04.01 Eliciting E-Leadership Style And Abuse And Emotion Regulation In Adolescents Trait Preference Among Nurses Via (Anisa Yulvi Azni) Conjoint Analysis O1.03.02 The Relationship Of The Gender With Emotion O1.04.02 Relationship(Christian Jay Between S. Orte) Students' Regulation In Junior High School Students Perception Of Problem Based (Hayatul Husna) Learning With Learning Outcomes (Hermanto) O1.03.03 Views About Getting Older As Predictors To O1.04.03 Nurses’ Understanding About Self-Esteem Of Professionals Nearing Evidence Based Practice: Retirement Knowledge, Practice And Attitude (Carlo Bryan C. Borrico) (Dian Eka Lestari)
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O1.03.04 Relationship Between Family Support And Aggressive Behavior Among Indonesian Adolescents (Reshalia)
Oral Presentation: Session II Day 2, 15 November 2018 time : 13.00 – 14.30 Room 1: Siak 1 ( M floor) Room 2: Siak 2 ( M floor) O2.01 O2.02 Medical Surgical and Emergency Nursing Maternity and Pediatric Nursing Moderator: Wan Nishfa Dewi, MN, PhD Moderator: Sri Wahyuni, M.Kep, Sp.KJ
Evaluator: Ganis Indriati, M.Kep, Sp.Kep. An Evaluator: Riri Novayelinda, MN
Timer: Ns. Ani Constantia, S.Kep Timer: Ns. Alfian Konadi, S.Kep O2.01.01 Caregiver’s Lived Experiences In Caring For O2.02.01 The Association Between Peer Post-Stroke Patients: A Phenomenological Conformity With Deviant Inquiry Behavior In Adolescent (Indah Putri Irdelia) (Gilang Sri Mentari) O2.01.02 The Effect of Pictorial Health Warning Labels O2.02.02 HIV/AIDS Health Education On Smoking Intensity In Adolescents Toward Enhancing (Arvilla Diana) Knowledge And HIV Prevention Efforts In O2.01.03 Emergency Nurses’ Knowledge On Triage O2.02.03 AHousehold Concept AnalysisWife Of (Vicky Setiarini) Maternal(Yulia Irvani Role Dewi) In Pregnant Adolescent
O2.01.04 Self -Care Practice Of Congestive Heart Failure O2.02.04 Empowerment(Erika) Mother To Persons Arifin Achmad Hospital Improve The Quality Of Life (Dwi Rahayu Nengsih) Against Servical Cancer Risk Through Peer Group Health 02.01.05 Experiences Of Patients Undergoing Oral 01.02.05 AEducation Qualitative Study: The Chemotherapy : What A Patient Wants From Promotion(Sri Utami) Of Exclusive Nurse Breastfeeding By Integrated (Nurul Huda) Service Post (ISP) Cadres In 01.02.06 TheSuburban Ratu Models:City (Widia A Lestari) Preventive Measure Of Postpartum Depression (Ratu Kusuma)
Room 3: Indragiri ( 2nd floor) Room 4 : Rupat (2nd floor) O2.03 O2.04 Community and Psciatric Nursing Nursing Management, Education and Moderator: Bayhakki, PhD MResearchoderator: Veny Elita, MN
Evaluator: Oswati Hasanah, M.Kep, Sp.An Evaluator: Yesi Hasneli, MNS Timer: Ns. M. Abrar, S.Kep Timer: Ns. Aisha Siddiqua, S.Kep O2.03.01 Factors Affecting The Performance Of Public O2.04.01 Perceptions Of Students, Health Nurses In Family Nursing Care Lecturers And Staff On (Sovia) Establishing A Smoke-Free Campus (Febriana Sabrian)
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O2.03.02 Spirituality And Health Status Among Elderly O2.04.02 The Experience Of Retaker In In Nursing Home In Riau, Indonesia Taken The Indonesian (Herlina) Nursing Competency Examination (INCE) (Siska Mayang Sari)
O2.03.03 Sociodemographic Characteristics And Psychosocial Wellbeing Of Elderly With Chronic Illnesses Who Live With Family At Home O2.03.04 (ReniEffectiveness Zulfitri) Of Health Education Use Audiovisual Media On Increasing Family Knowledge In Prevention Of Dengue Hemorrhagic Fever (DHF) (Arneliwati)
Oral Presentation: Session III Day 2st, 15 November 2018 time: 14.30 – 16.00 Room 1: Siak 1 ( 2nd floor) Room 2: Siak 2 ( 2nd floor) O3.01 O3.02 Medical Surgical and Emergency Nursing Maternity and Pediatric Nursing Moderator: Wan Nishfa Dewi, MN, PhD Moderator: Erika, M.Kep, Sp.Mat Evaluator: Rismadefi Woferst, M.Biomed Evaluator: Febriana Sabrian, MPH Timer : Ns. Ani Constantia, S.Kep Timer: Ns. Alfian Konadi, S.Kep O3.01.01 Foot Sensitivity And Blood Glucose Levels Post O3.02.01 Effect Of Health Education Apiyu Massage Among Diabetic Indonesians Using The Redi Game Towards Patients Knowledge In Preventing (Yesi Hasneli) Premarital Sex Behaviors Of Female Teenagers O3.01.02 Correlation Between Family Support and Quality 03.02.02 (PratiwiThe Correlation Ningsih) Between of Life Among Hypertensive Patients Parenting Styles And Online (Sofiana Nurchayati) Gaming Addiction O3.01.03 Analysis Of Electrocardiogram Recording Lead Ii O3.02.03 (RodhiatulIdentification Hidayah) Sleep Problems In Patient With Cardiovascular Disease In Epilepsy Children (Safri) (Novrita Riawan Putri) O3.01.04 An Overview Of Physical Activities Among O3.02.04 The Correlation Of Knowledge Family Members With Risk Of Type 2 Diabetes And Attitude About Healthy Mellitus In Pekanbaru Snacks With Choosing Food (Gamya Tri Utami) Behavior At Class Iv And Vi In Sd Negeri 121 Pekanbaru 03.01.05 Different Triage Categorization using Emergency 03.02.05 (EstriDoes ExclusiveMailinda) Breastfeeding Severity Index (ESI) Method In Emergency Correlate With The Infant Department Early Language Milestone? (Mariza Elsi) (Riri Novayelinda) 01.03.06 The Effectiveness Of Simulation Health Education 01.02.06 The Effect Of Oromuscular To Mother’s Breastfeeding Skill In Rural Area Of Stimulation On Neonate Latch Riau, Indonesia Score (Agrina) (Oswati Hasanah)
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RIAU INTERNATIONAL NURSING CONFERENCE 2018 SCHEDULE OF POSTER PRESENTATION DAY 1, NOVEMBER 14, 2018 13.00-14.00 POSTER EVALUATOR TITLE OF POSTER AUTHOR CODE P 01 Component Of Adolescent Self-Concept In Islamic Reftesa Indriani Boarding School P 02 The Correlation Of Breastfeeding Pattern With The Suci Hati Mumtaz BAYHAKKI, PhD Development Of Infants Aged 6 - 12 Months P 03 The Description Of Nursing Student’s Self Confidence Tiara Suci Level In Learning Method With Seven Jump Technique Iswandhie P 04 The Relationship Between Family Support And Marya Nasti Hypertension Stage Wandira P 05 Effects Of Foot Reflection Massage And Acupressure Santi Melisa Veny Elita, MN (MH) For Patient With Hypertension P 06 A Description Of People's Behavior Towards The Ruvida Ulfa Prevention Of Dengue Hemorrhagic Fever (DHF) P 07 Nomophobia: Incidents And Levels Among Indonesian Astari Rezki Teenagers P 08 Organ Failure Of Pasients With Using Ventilator Based Siti Rahmalia SRI WAHYUNI, M.Kep, Sp.KJ On The Sequency Organ Failure Assesment Score (SOFA) Who Admitted In Intensive Care Unit P 09 The Description Of Training Programs And Cognitive Lina Maria Siagian Function On Elderly P 10 Analysis Of Development Of Inter Professional Ifa Hafifah Education (IPE) Programs In Professional Students Of Faculty Of Medicine Lambung Mangkurat University P 11 The Relationship Of Physical Activity To Central Vera Permata Sari FEBRIANA SABRIAN, MPH Obesity In Adulthood P 12 The Relationship Between Mother’s Knowledge And Ganis Indriati Giving Of Complementary Food For Breast Milk In Infants Aged 6 – 12 Months P 13 The Effect Of Individual Health Education Using Nurpatri Flipbook On Self-Efficacy Of Hypertensive Patients In Ramadhani Controlling Diet RISMADEFI WOFERST, M.Biomed P 14 The Comparison Of Warm Water Feet-Soaking Nur Sella Hydrotherapy And Acupressure Massage On The Blood Pressure of Primary Hypertension Patients
P 15 Maternal And Child Health Services In Kuranji Padang Mitayani City Towards SDG’s
Prior to the session:
Evaluator should come to the Scientific Corner no later than 10 minutes prior to the session to obtain a poster presentation map and scoring rubric and fill out the presenter name, number, and presenter name on the poster presentation scoring rubric before the session begin Presenter/author should stand by at their posters display 5 minutes before poster session.
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During and at the end of the session
Presenter/author presents their posters to evaluator. Evaluator will have maximum 10 minutes to have a discussion with the presenter and to evaluate the poster according to the scoring rubric. Presenter/author will not be allowed to use computers or other electronic devices during presentation. Evaluator delivers the scoring results to the student in charge.
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CONFERENCE CHAIR MESSAGE
A warm welcome to the participant of conference. The theme of Riau International Nursing Conference 2018 (RINC 2018) is incorporating technology and ethics in advancing nursing education and practice. This conference will provide an opportunity for health researchers, health practitioners, nursing educators and nursing students to exchange research evidence, practical experiences and innovative ideas on issues related to nursing technologies and ethics through networking and mutual sharing. It is a global platform to explore issues of mutual concern as well as the exchange of knowledge, share evidence, ideas, and knowledge. The main conference aim is to improve the quality of science and profession in nursing throughout integrating technology and ethics in order to increase nurses’ competencies for services, education and nursing research. Researchers and academics from different health science backgrounds will deliver a scientific forum that enable an interactive and exchange knowledge. It is a great chance for all participants to experience the opportunity to learn from speakers who expert in various fields of the nursing science. It is an honour to serve all speakers and participants from all nations with the taste of friendly and scientific environment. We look forward to meet you at the conference.
Warm Regards,
Ns. Agrina,M.Kep.,Sp.Kom.,PhD Chairman of RINC 2018
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GREETINGS FROM ACTING RECTOR, UNIVERSITAS RIAU
WELCOME SPEECH
Distinguished participants, Ladies and Gentlemen: It gives me a great pleasure to welcome all of you to the International Conference Nursing Conference RINC 2018 in Universitas Riau, Pekanbaru: “Incorporating Technology and Ethics in Advancing Nursing Education and Practices”. Nowadays, nursing in Indonesia is tremendously developing in all aspects including academics and practices. The use of technology is undeniably significant in the work of nurse educators and practicioners. Incorporating ethics to these aspects will ensure nurses to provide best healthcare services delivery. I would like to take this opportunity to express my sincere appreciation to conference committee for organizing this remarkable event and in particular our honorable speakers. All of them have been working hard, even though they are very busy with their responsibilities. Finally, I wish all two fruitful days of interesting and beneficial conference and also that you have a pleasant stay in Pekanbaru.
I warmly welcome you again,
Dr Ir Agus Indarjo, MPhil Acting Rector, Universitas Riau
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GREETINGS FROM DEAN FACULTY OF NURSING UNIVERSITAS RIAU
WELCOME MESSEGE
On behalf of the Faculty of Nursing, Universitas Riau, Pekanbaru, I warmly welcome all distinguished invited speakers and all participants to the Riau International Nursing Conference (RINC) 2018 in the land of Malay city of Pekanbaru. The RINC 2018 is very special to Univerisitas Riau in particular to Faculty of Nursing. This conference is part of the 56th anniversary of Universitas Riau and it also allows opportunity to celebrate the existence of the Faculty of Nursing, Universitas Riau to the world. The conference theme, “Incorporating Technology and Ethics in Advancing Nursing Education and Practice”, has been wisely selected to mark nursing education and practice milestone.
This conference plays a significant role in the nursing academia, particularly for nurses, clinical nurses, nurse educators, health practitioners and nursing students in particular in Indonesia and around the globe. This is the perfect time to build research connection and share knowledge from different perspectives of nursing research, clinical and education. I am surely that the Riau International Nursing Conference 2018 brings impact and significant contributions to the development of nursing profession both locally and internationally.
My best wishes for the successful of the Riau International Nursing Conference 2018. I hope all participants have productive time during the conference and find the conference stimulating and enjoyable.
Sincerely,
Prof. Dr. Ir. Usman M. Tang, MS
Dean of Faculty of Nursing, Universitas Riau
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PLENARY SESSIONS SUMMARIES
Technology versus Humanity or Technology alongside Humanity? - Our Decision Counts
Claudia K Y Lai, PhD, RN, FHKCERN, FHKCGN, FAAN
Technology, particularly information and communications technology (ICT), has transformed our world. In the early 1990s, the Internet was something new. Yet, nowadays, to a huge number of people, life seems unimaginable without a smart phone. Humankind has reached a digital age. While human life has become much easier in numerous ways with the adoption of technological innovations, the endless pursuit of new technologies has its limitations and perils. The more we invest in technology, the more blurred the boundaries seem to become between the physical and virtual worlds. A key challenge faced by governments around the world these days is how to care for fast-ageing and increasingly large populations in a rapidly changing and digitally connected world. Most certainly there have been useful advances in using ICT in health care. For instance, the use of cloud technology has greatly enhanced the development and uptake of telemedicine and telecare. However, older adults do not necessarily need cutting- edge technology. Day-in and day-out, older adults do not always need state–of-the-art medicine to attain good health and have a better quality of life. Even in times of sickness, appropriate quality care provided in a timely manner is often more relevant and meaningful to older adults and their families than the latest medical advances. This paper will discuss current trends in gerontological nursing as well as what is needed in the daily care of this particular client population. Issues of technology versus humanity will be explored. The author suggests that health professionals and nurses need not take one stance over another. Rather, we need to become better engaged in the use of technology in the delivery of nursing care, while at the same time upholding key values in nursing to serve humanity.
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Nursing and Health Informatics in the Fourth Industrial Revolution
Michael Joseph S. Diño, PhD , MAN, RN, LPT Director, Research Development & Innovation Center, Our Lady of Fatima University, Philippines Advisory Board, Apple Distinguished Educators Vice President, Phi Gamma Chapter, Sigma Theta Tau International Honor Society in Nursing
Session Abstract
The Fourth Industrial Revolution (4IR) generated a considerable interest among scholars, informaticist and educational leaders around the globe. This industry shift brings with it exciting opportunities and inevitable challenges to various industries and professional practice including the health sciences. The fundamental framework of developing innovative learning ecosystems (e.g. big data, artificial intelligence, robotics, smart technology) poses great value as Nurses and Nursing prepares for the impact of the 4IR. Also, the long-standing notion that Informatics as a catalyst to enhance practice, study clinical problem-solving, inform policy briefing, and enrich research activities directed to improve the quality of care has been an expectation and an envision to many. Healthcare leaders, educators, and researchers have recognized the need for every practitioner to participate in Informatics, that is, the use of information and communications technologies in the collection of data, use of information and generation of knowledge to support healthcare practice. Informatics competencies are increasingly becoming a global imperative for professionals in the healthcare field. This session will highlight the historical developments in the evolution of industries, technologies in healthcare praxis and the associated discoveries and scientific work. This also aims to juxtapose current and impending trends and their impact on the healthcare sector. Grounded on the UNESCO pillars: Learning to Know, Learning to Do, Learning to be and Learning to Live Together as universal concepts, the session will recommend several creative and proactive solutions in preparing for, creating new technologies and mitigating the effects of the upcoming revolution through health and nursing informatics.
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Incorporating Technology and Ethics in Advancing Nursing Education and Practice
Prof. Datuk Dr Hjh. Bibi Florina Abdullah Pro-Chancellor, Lincoln University College
In present dynamic health systems, technology plays a vital role in education and nursing occupation. The major fundamentals are in the fields of healthcare promotion, internet, network and advanced systems. The nurses must receive essential IT training in all their respective field of specialization. Technology removes the traditional boundaries of space and time. Nurses to use these innovations to provide best proven care and knowledge from academic research. Nurses must be prepared to lead this technology-driven health care system Nurses have become competent of exploiting and disseminate the multifaceted technology into nursing caring practice from long before. Different type of machinery like ventilators and physiological monitors were used for years by nurses in intensive and critical care settings.
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Developing Successful Academic Researches in Advancing Nursing Education and Practice: Harnessing ICT, Global Databases and Research Engine
Ali ameen ª Lincoln University College, Selangor, Malaysia [email protected]
Abstract Nowadays, people deal with technology in many aspects of our life. Artificial Intelligent in various devices, Big Data the which produced every moment and Internet of that surrounded us in all our needs. There are a variety of areas where nurses can get advance practical and specialize in and they may decide they want to be qualified in one or several specialties over the course of their career. This work aims to give a brief idea about the ways for harnessing this triangulation in conducting your research in an easy and fast and accurate manner. To achieve these gals a descriptive methodology has been used for presenting the data in the various manner of troubling, chart figures and animations. The outputs have been covered a key related point which opted to be closely related to the conference slogan. These topics covered the techniques of developing successful academic researchers in advancing nursing education and practice with focusing on the Global Data and Big Databases which most important part of the academic research. In addition to the theoretical parts, the practical parts have gained the core portion of this work, especially the big databases research engines. More than five international databases have been taken as examples for creating academic evidence and support argument for finding the research gap. The popular databases were (1) The World Bank database, (2) The United Natation Data Base, (3) Global Competitiveness Index Data Base, (4) The Global Innovation Index Data Base, And (5) Trend Economic Data Base. The suggestions were emphasizing on conduct more research and deep learning on various levels of public databases for harnessing these resources for more research and monitoring our situations comparing with our neighbour countries. Keywords: ICT, Global Databases, Research Engine, Big Data, Academic Research, Nursing Education.
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How to Apply Technology and Ethics in Advanced Family Nursing Practice
Naohiro Hohashi, PhD, RN, PHN, LSN, HS, FAAN Division of Family Health Care Nursing, Graduate School of Health Sciences, Kobe University, Japan Website: https://nursingresearch.jp/
1. Current status of family nursing in Japan 1-1. Differences between individual nursing and family nursing In North America in the late 1970s, family nursing aimed at the entire family began to be advocated and since then the concept has spread throughout the world. In Japan, the Department of Family Nursing with three faculty members was newly established at the University of Tokyo in 1992, making it the starting point for family nursing in Japan. The study expanded rapidly as a practical science. I was one of those founding members. Currently family nursing studies has become established as one of the fields of specialization within nursing studies. Family health care nursing can be defined as, "With the nursing professional as the nucleus, the practical science of independently and autonomously maintaining and improving family functioning by the family system unit, and of preventative and therapeutic support to deal with family signs/symptoms in order to help enabling self- actualization of the family system unit." Nursing can be divided into the major categories of individual nursing (nursing for family members) and family nursing. Individual nursing targets individuals such as patients or users, and so on, while the paradigm of family nursing differs in that it targets the entire family. 1-2. Development of the Concentric Sphere Family Environment Theory (CSFET) From 1999, I began development of a middle-range family nursing theory. At present the Concentric Sphere Family Environment Theory (CSFET) that I proposed has become familiarized on a worldwide basis. Based on the CSFET, such tools as the Family Environment Assessment Model (FEAM) and Family Environment Care/Caring Model (FECCM) have been developed, and are widely utilized in both research and practice.
2. The role of certified nurse specialist in family health nursing 2-1. The current status of advanced practice nurse (APN) in Japan In Japan, certification of registered nurse (RN) is obtained upon completion of a four- year program at the university. In addition, RN certification can be obtained from attendance at occupational training schools and others. However this field has rapidly
xx shifted to universities, and currently 277 universities (broken down as 44 national universities, 49 public universities and 184 private universities) offer programs leading to RN. In addition degrees as advanced practice nurse (APN), including certified nurse specialist (CNS) and nurse practitioner (NP), which require two years of education at the postgraduate master's level, can be obtained. The CNS program began from 1995 with a requirement of 26 credits and currently 2,067 individuals have obtained this degree. Programs leading to an NP degree only commenced from 2016, and the method for certification and so on is presently under review. A nursing professional with CNS can be described as having outstanding practical skills in specific fields of nursing. CNS exists in the field of family nursing studies as well, where it is referred to as certified nurse specialist in family health nursing. CNS consists of six distinct roles: Excellent nursing practice, consultation, collaboration, ethical coordination, education and research. From 2011, 38 credits of training that combines curing and caring was initiated, with CNS also seeking the practice of curing. As of October 2018, 55 individuals have been certified with the degree of certified nurse specialist in family health nursing. The curriculum leading to nurse specializing in family support is offered at six universities, one of which is my institution, Kobe University, which also has the distinction of being the first in Japan to provide education offering caring and curing. 2-2. Role of certified nurse specialist in family health nursing The certified nurse specialist in family health nursing performs six roles aimed at the entire family, which are as follows. 2-2-1. Excellent nursing practice toward the family Support toward all families so as to enable the maintenance and realization family well-being. 2-2-2. Consultation toward multiple occupations (other occupations) Conduct consultation toward multiple occupations (other occupations) related to family signs/symptoms. 2-2-3. Collaboration with other individuals involved in medical treatment and welfare Perform adjustments with multiple occupations (other occupations) related to family signs/symptoms. 2-2-4. Ethical coordination of those involved To safeguard the human rights of families and family members, to have the capability to make the necessary ethical decisions, and act accordingly. 2-2-5. Education toward multiple occupations (other occupations) Conduct education toward multiple occupations (other occupations) related to family signs/symptoms. 2-2-6. Research into family health nursing Produce evidence into family health nursing and conduct practical research that contributes to advancing the family nursing theory.
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3. The technology of family support 3-1. Fusion of cure and care Family nursing is a human-oriented support that mainly deals with mutual transaction between the entire family and those who provide support to the family. The relationship between the two is deployed by means of family meetings, leading to changes in relationships within the family. This makes it a method of family support that makes possible resolution of family problems that enable the family to realize a healthy livelihood. Consequently, communication is more important than technology. The certified nurse specialist in family health nursing is not only able to provide care, but cure as well. In particular, he or she performs health assessments on family members and is required to have the ability to assist all family members in maintenance and improvement of health. To enable this, mastery in the fields of physical assessment, physiology and pharmacology is required. For this education, laboratories catering to high levels of skills are in use. 3-2. Construction of electronic family nursing studies In 1994 I established the Japanese Association of Computer Science (JACS), and served as its director. From that time how to recognize vital signs, computer-assisted instruction and others were developed. While harnessing this knowledge, in the field of family nursing I proposed electronic family nursing studies and made efforts to bring this about. At present, the following are in practice for families and nursing professionals. 3-2-1. CSFET-based Family Nurse Consultation Service For family members struggling to deal with family-related problems, a Family Nurse Consultation Service has been initiated on the campus of Kobe University. Specialized nursing professionals offer guidance to resolving problems at no charge, so please feel welcome to visit for a consultation. 3-2-2. The Society for the Study of the Concentric Sphere Family Environment Theory (SSCSFET) With the aim of upgrade of the Family Environment Assessment Model (FEAM) and Family Environment Care/Caring Model (FECCM), which are based upon the Concentric Sphere Family Environment Theory (CSFET), for use in clinical applications, empirical research and others, the SSCSFET was established in 2007. In addition to conducting seminars, case study discussions and others, programs are offered leading to certification as Certified Intermediate Specialist in Family Support (CISFS) and Certified Advanced Specialist in Family Support (CASFS). At seminars and case study discussions, when individual data is not included, Zoom video conferencing software is utilized to enable long-distance participation. 3-2-3. Family Nursing Consultation Through the use of mobile phones and video conferencing software, the service, aimed at nursing professionals having difficulties providing support to families, conduct consultations and supervision. All utilization of the consultations and contents thereof are treated with complete confidentiality. Zoom video conferencing software requires no special settings and can be utilized free of charge. Interested parties are requested to contact me via email.
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3-2-4. Family Nursing Webinars I also offer a free online seminar (webinar) on family support utilizing the CSFET via Zoom Video Webinars. The Zoom video conferencing software requires no special settings and can be used free of charge. Interested parties are requested to contact me via email. 3-2-5. Others Based on the CSFET, the Survey of Family Environment (SFE) was developed as a self-administered measurement of family functioning and family demands. There is also an electronic version of the SFE that can be accessed via mobile phones, from a web site and so on. The SFE enables screening of dysfunctional families --- which, for example, provides or use at the time of hospitalization or at the start of home visit nursing. Also, diagnosis of family functioning via the internet, and screening of problem families can be performed, enabling detection of latent family problems. Health assessment via internet telephones is important as a method for the so-called "four examinations in traditional Chinese medicine (seeing, hearing, asking, touching)." For example, for determination of facial pallor, it is important to have faithful rendering of the color. In this regard, from the year 2000 I became director of the Digital Biocolor Society, and have been conducting research.
4. Ethics for family support 4-1. Ethics toward people and groups The family support nursing professional, to safeguard the rights of families and family members, strives to resolve ethical problems and complications, and performs the role of making ethical coordination between persons related to the ethical problems and complications. Family health care nursing is aimed at the entire family, for which it is necessary to adopt a multidimensional perspective involving the family internal environment, family system unit, family external environment and family chrono environment. These contain diversity, and it can be presumed to also contain possible contradictions. Consequently, problems occur due to the opposing advantages and disadvantages or privileges. One of the roles with the highest importance performed by the family support nursing professional in particular is ethical coordination, by which, as an advanced practice nurse, carefully considers clinical decisions and ethical decisions, which is important when providing nursing. Moreover, the family support nursing professional occupies the standpoint of being the greatest protector from the family's standpoint, and is responsible for putting the family's livelihood in order, as well as the standpoint of respecting the patient/user and entire family's values and make adjustments so that these may be realized. For this purpose as well, the nursing professional him or herself, as an individual as well as a specialist, while asking questions concerning the values of the patient/user and entire family, it is important to provide and share verbal explanation so that other medical professionals can comprehend in order to resolve other ethical issues. Ethical principles or ethical problems that have not been verbalized up to now, and specialized values are verbalized by the
xxiii nursing professional him or herself, and through discussion of the ethical issues between medical professionals that involve the patient/user and entire family, and providing of care based on those results, the quality of care can also be improved.
References: Hohashi, N., Honda, J., Shimada, N., & Michigami, S. (2016). An introduction to the Concentric Sphere Family Environment Theory: Theory and intervention (N. Hohashi, Ed.). Tokyo: Editex. [In Japanese] Hohashi, N., Hinoue, E., Kobayashi, K., Yamashita, T., Nagatomi, H., Honda, J., et al. (2010). New family health care nursing: Theory, practice and research (N. Hohashi, Ed.). Tokyo: Medical Friend Sha. [In Japanese] Hohashi, N., & Honda, J. (2011). Development of the Concentric Sphere Family Environment Model and companion tools for culturally congruent family assessment. Journal of Transcultural Nursing, 22(4), 350-361. doi:10.1177/1043659611414200
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Ethical Issues in Education, Practice, and Research in Nursing and Midwifery
Asst.Prof. Dr. Sopen Chunuan, PhD., APN. (Midwifery), RN.
Ethics has been defined in many different ways. Ethics is now recognized as a major part of education, practice, and research. Ethics are the norms or standards for conduct that distinguish between right and wrong. It is a system of moral values that is concerned with the degree to which nursing care process and research procedure adhere to professional legal, and social obligations to clients or participants. Ethics and education: The nursing profession focuses on practice with human beings. Nursing means actions to people, related to caring and helping when they are sick, including rehabilitation, disease prevention and health promotion, as well as assisting physicians to perform curative treatment. In doing so, it shall be based on scientific principle and the art of nursing. Ethical education plays important role in fostering nursing students to be moral agent. The major goals of ethic teaching are enhancing students’ skills on moral sensitivities, moral judgment, moral judgment motivation, and moral action. Nursing institutions should recognize their roles in promoting ethical teaching of nurse educators based on ethical principles of beneficence, non-maleficence, respect of autonomy, just, veracity, and fidelity. In addition, nursing institutions should also provide specific ethical course with essential contents such as ethical theories, ethical principles, ethical concepts, code of ethical, moral development, values and beliefs, ethical dilemmas, and ethical decision making. These contents must be integrated in professional nursing courses throughout the nursing curriculum by applying various ethics teaching methods such as analysis, ethic conference, and ethics rounds. In order to provide effective ethics education, nurse educators must be students’ role model and having moral competence. Nursing students practice closely with nurse educators to ensure their ethical practice with professional standard which will be results in patients’ best interest and safety. The Qualifications Framework for Thailand’s higher education system is designed to support implementation of the educational guidelines set out in the National Education Act, to ensure consistency in both standards and award titles for higher education qualifications, and to make clear the equivalence of academic awards with those granted by higher education institutions in other parts of the world. Programs developed within this framework should not only lead to the knowledge, generic skills and professional expertise normally associated with studies leading to comparable awards throughout the world, but should also include particular emphases reflecting the policy priorities of Thailand. The
xxv framework groups the kinds of learning expected of students into five domains and describes learning outcomes at each level in each of these groupings. The domains are: (1) Ethical and Moral Development, (2) knowledge, (3) cognitive skills, (4) interpersonal skills and responsibility, and (5) analytical and communication skills. Ethical and moral development: Development of habits of acting ethically and responsibly in personal and public life in ways that are consistent with high moral standards; ability to resolve value conflicts through application of a consistent system of values. Learning outcomes for ethical and moral development are expected to apply at the level described for all learners, though there are also some field specific items of knowledge that should be known by students in those fields such as codes of ethical practice for nursing, medical doctors, accountants, lawyers, etc. For ethical and moral development, this involves a combination of knowledge about appropriate behavior and formal and informal codes of practice, attitudes, and maturity of judgment. Development strategies may include exposure to positive role models and analysis and reflection on their own behavior and that of others in a variety of situations. Group discussions of simple and more complex moral dilemmas can help students clarify their own values and think through general principles that they believe should guide their own behavior. The principles of transfer of learning call for discussions of a wide range of possible situations including ones that are similar to those likely to be faced by the students in later life and employment. While special attention to this domain may be given in certain courses, it is important that opportunities are taken in all courses to reinforce and apply the principles developed. In Faculty of Nursing, Prince of Songkhla University; all nursing programs have been developed and modified based on the Qualifications Framework for Thailand’s higher education system. Ethics has been taught in all subjects both theories and practicums course to prepare nursing students provide quality of care and safety to their clients. Ethics and practices: Nurses as one of the health service providers and members in health system who are responsible for giving care to the clients and patients based on ethical issues. They need ethical knowledge to conduct their appropriate function to manage situations and to give safe and proper legal and ethical care in today’s changing world. Professional practice of nursing means practice of nursing to individual, family and community in the following actions: (1) to provide education, advice counseling, as well as solving health problems; (2) the act asset individual physically and mentally, including their environment, in order to solve problems of illness, alleviate symptoms, prevent dissemination of disease and provide rehabilitation, (3) provide treatment, as mentioned in primary medical care and immunization; and (4) to assist physicians to perform treatments. These actions shall be based on scientific principle and art of nursing in performing health assessment, nursing diagnosis, planning, and nursing intervention. Nurses play a role as advocates to assist patients and families struggling with complex information and difficult decisions. In particular, the fact that nurses encounter clinical situations that require ethical judgment highlights the need for nursing staff to gain knowledge and expertise in delivering care in an ethical manner. Nurses and midwives in Thailand work following the Professional Nursing and Midwifery Act that has been
xxvi established sin 1985. Nurses have to face ethical problems and deal with moral conflicts especially in everyday practices. Nurses have responded to solve ethically problematic situations by active acting. Dealing with ethical problems nurses must blend the principles of ethics in nursing practice, an ethical decision making model and cultural competence. Ethics and research: In any research with human beings or animals, research must address ethical issues. Ethical demands can be challenging because ethical requirements sometimes conflict with the desire to produce rigorous evidence. Ethical considerations in research are critical. Research ethics involve requirements on daily work, the protection of dignity of subjects and the publication of the information in the research. However, when nurses participate in research they have to cope with three value systems; society; nursing and science which may be in conflict with the values of subjects, communities, and societies and create tensions and dilemmas in nursing. The major ethical issues in conducting research are: a) Informed consent, b) Beneficence- Do not harm c) Respect for anonymity and confidentiality d) Respect for privacy. Ethical considerations in nursing research have been grown in recent years to prevent biases and harm to participants. Thus, a formal review by ethics committee is usually required before conduction nursing research to promote and protect participant’s’ rights.
References Butts, J. B., Rich, K. L. (2013). Nursing ethics: Across the curriculum and into practice. USA: John & Bartlett Learning. Harris, D. M. (2011). Ethics in health services and policy: A global approach. San Francisco, CA: Jossey-Bass. Polit, D. F. Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing research. Philadelphia: Wolters Kluwer. Thailand Nursing and MidwiferyCouncil. (2010). Professional nursing and midwifery act B.E.2528 (1985) Revision of the act B.E 2540 (1997). Nonthaburi: Thai Nursing Council.
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The Importance of Ethics in Nursing Practice
Wan Nishfa Dewi, M.Ng, Ph.D
Vice Dean for Academic, Students and Alumni Affairs of Faculty of Nursing, Universitas Riau, Pekanbaru, Indonesia
Medical Surgical Nursing Division, Faculty of Nursing, Universitas Riau Email: [email protected]; [email protected]
Abstract
Nurses all around the world are increasingly encountered ethical challenges in their patient care practice. They are obviously faced with different ethical problems in their professional practice, therefore they must understand and familiar with ethical codes of conduct and the importance of ethical decision-making. As a professional profession, there is a need for nurses to acknowledge the important of ethics which are fundamental guidance for them. This article attempts to discuss the importance of ethics in the perspective of nursing practise. One of the focuses of this article is on the main concept of ethics to deliver nursing practice in the healthcare setting.
Keywords: Nursing, Ethics, Health care, Nursing practice, Profession
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Complementary Therapy for The Breastfeeding Mothers in Community Health Nursing Practice
Ns. Agrina,M.Kep.,Sp.Kom.,PhD Community Health Nursing Division, Faculty of Nursing, Riau University, Indonesia
Breastfeeding has several health benefits on both the mother and infant and also it recognized as the best food for the baby. In order to receive the optimum benefits from breastfeeding, a period of exclusive breastfeeding for six months, with continued breastfeeding up two years is recommended by the World Health Organization (WHO). However, many breastfeeding mother experience insufficient milk production during the breastfeeding period eventhought the rate of physiological inadequate milk production is very low. Commonly reported reason for unsuccessful breastfeeding or early weaning is perceived insufficient breast milk supply. Believing that milk production is inadequate is associated with early introduction of supplemental feeding, which ultimately leads to less frequent breastfeeding and to a decrease in milk production over time. Furthermore, since consumption of complementary baby milk is associated with increased morbidity and mortality among infants, low breastfeeding initiation and duration rates are significant concern in many countries. Although the prevalence of low of breast milk production is only experienced by a few mothers, however it can be prevented through out several complementary therapies after the beginning of birth. Some studies show that complementary therapies influence to increase milk production like herb and massages therapy. Studies evaluating show that one of the reasons for early introduction of suplementary baby milk such as lack of effective support by primary care providers besides another reasons. The primary care provider like community health nursing is the first line responder to maternal concerns about the adequacy of milk production.
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LIST OF ORAL PRESENTATION
Oral Presentation Riau International Nursing Conference 2018 RINC2018
1. THE RELATIONSHIP BETWEEN PARENTS’ VERBAL ABUSE AND EMOTION REGULATION IN ADOLESCENTS
Anisa Yulvi Azni1, Juniar Ernawaty2, Yesi Hasneli3 1Student of Faculty of Nursing Universitas Riau 2,3Faculty of Nursing Universitas Riau Email: [email protected]
Abstract
Objective: This study aims to determine the relationship between verbal abuses of parents and emotion regulation in adolescents. Method: The design of this research is descriptive correlation research with cross sectional approach. The sample was 256 students of Public Junior High School 23 Pekanbaru, that were taken using stratified random sampling technique. The instruments were verbal abuse of parents and emotion regulation questionnaires that had been tested for validity and reliability. The analyses used were chi- square and spearman tests. Results: The result showed that there is a significant relationship between verbal abuse of parents and emotion regulation in adolescents (p value < 0,05). Conclusions: It is expected for parents not to do verbal abuse, because it can impact on teenage emotion regulation.
Keywords: Emotion regulation, adolescents, verbal abuse of parents.
Introduction behavior, so it needs a strategy or a way to There has been occurred lately an be applied in dealing with the emotional apprehensive phenomenon due to lots of situation. It is usually called emotional reportages from online or printed media regulation. Emotional regulation is a about child abuse. The problem of common term used to describe a person's violence to children is really familiar to us ability to manage and respond effectively because there are still many cultures in to emotional experiences (Rolston & our society assuming that learning for Richardson, 2017). children is conducted by violence. The The purpose of this study was to rate of violence cases against children is determine the relationship between verbal increasing every year. Based on data from abuse of parents and emotion regulation in the Indonesian Child Protection adolescents. This research was expected to Commission (KPAI), the reports of add insight and knowledge, especially violence in 2014 has reached 5,066 cases. about verbal abuse of parents with (KPAI, 2015). emotional regulation in adolescents Many parents assume that violence Method against children is a general thing and do This research was carried out at not understand that verbal violence will SMP N 23 Pekanbaru which started from have a negative effect on children. February to July 2018. This study used a According to Asih (2010), there are 4 descriptive correlational research design impacts of verbal abuse, namely the with cross sectional approach. psychical, psychological, spiritual and The population in this study was the social impacts of the victim. Emotions of VIIth and the VIIth grades students of SMP teenagers that explode and in improper N 23 Pekanbaru which consisted of 709 situation will lead to inappropriate students; 332 students were from the VIIth
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Oral Presentation Riau International Nursing Conference 2018 RINC2018
grade and 377 students were from the 2. Bivariate analysis VIIIth grade. The sample was 256 students This analysis used Chi-square and taken by stratified random sampling. Spearman statistical test. Chi-square test The instruments utilized were was used to determine the relationship questionnaires about parents’ verbal abuse between independent variables (verbal and emotion regulation in adolescents. abuse of parents) and the dependent Univariate and Bivariate analyses were variable (emotion regulation in applied in this study. The univariate adolescents) in SMP N 23 Pekanbaru. analysis described the characteristics of While, Spearman test was applied to know respondents regarding age, gender, order the significance of the relationship of children, ethnic, parental work, and between variables. parents’ education level. Bivariate analysis was used to determine whether Table 3 there was a significant relationship Chi Square Test between the two variables using the Chi- The Relationship between Parents’ Verbal square and the Spearman tests. Abuse and Emotion Regulation in Result Adolescent (N=256) p 1. Univariate Analysis Parent’ Emotion Regulation Total valu Table 1 s e Frequency Distribution of Respondents Verbal Maladapti Adaptiv Abuse Based on Parents’ Verbal Abuse (N=256) ve e No Parents’ Total Percentage 80 (61,5%) 50 (38,5%) 130 (100%) High 0,000 Verbal (n) (%) Low 31 (24,6%) 95 (75,4%) 126 (100%) 145 Abuse Total 111 (43,4%) 256 (100%) 1. High 130 50,8 (56,6%) 2. Low 126 49,2 Table 3 shows the results of chi- Total 256 100 square statistical test obtained P value =
0.00 < α = (0.05) so it could be concluded Table 1 shows that the highest that there was a significant relationship respondents who experienced parents’ between verbal abuse of parents and verbal abuse in high category were 130 emotional regulation in adolescents. people (50,8%).
Table 4 Table 2 Spearman Test Frequency Distribution of Respondents The Relationship between Parents’ Verbal Based on Emotion Regulation in Abuse and Emotion Regulation in Adolescents (N=256) Adolescent (N=256) No Emotion Total Percentage Emotion Regulation of (n) (%) Regulation Adolescents Parents’ Verbal r -0,372 1. Maladaptive 111 43,4 Abuse p 0,000 2. Adaptive 145 56,6 n 256 Total 256 100
Table 6 shows the results of the Table 2 shows that the highest Spearman test obtained P value = 0,000 < respondents who used adaptive emotion α = (0,05) so it could be be concluded that regulation were 145 people (56,6%). there was a relationship between verbal
abuse of parents and emotional regulation
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Oral Presentation Riau International Nursing Conference 2018 RINC2018
in adolescents. Coefficient correlation of chi-square test obtained p-value (0,000) < Spearman test was r = -0,373 showing α (0,05), then Ho is rejected and it can be weak relationship with irregular or non- concluded that there was a relationship linear scattering position. There was a between verbal abuse of parents and negative relationship, which means the emotion regulation in adolescents at SMP higher verbal abuse of parents, the lower N 23 Pekanbaru. emotional regulation is. Based on the Spearman test results Discussion obtained P value = 0,000 <α = (0,05) it 1. Characteristics of Respondents can be concluded that there was a a. Characteristics of Parents’ Verbal relationship between verbal abuse of Abuse parents with emotion regulation in Verbal abuse occurs because parents adolescents. The coefficient correlation of assume that verbal violence has a lighter Spearman test was r = -0,373, it showed a impact than physical violence. This is weak relationship with irregular or non- consistent with the results of this study linear scattering position. There was a where there are five forms of verbal abuse negative relationship, which means the studied and denouncing the children is the higher verbal abuse of parents, the lower most experienced by adolescents. emotion regulation. According to Lestari (2016) the habit of Verbal abuse is a form of violence denouncing a child is an act like telling a that leaves no evidence comparable to child that everything that happens is their physical bruising (Noh and Talat, 2012). mistakes. Although verbal violence does not leave a b.Characteristics of Emotion sign or evidence in the victim's body, the Regulation in Adolescents victim who gets verbal abuse will suffer Adaptive emotional regulation will and has low self-esteem. It is as reported help a person to think positively in dealing by Nidya's (2014) stating that the higher with an event, while maladaptive emotion teenagers get verbal violence from their regulation will make a person tend to parents, the lower their confidence will be. think negatively when facing an event Conversely, the lower the teenagers get (Silaen & Dewi, 2015). verbal abuse from their parents, the higher Based on the results of this study their confidence will be. where of the six emotion regulation Teenagers who get verbal violence strategies studied, problem solving from their parents will experience an strategy is the strategy that are often used uncomfortable situation at home. by teenagers. Problem solving is an Teenagers will feel inferior and feel not adaptive strategy that is done by a person accepted by their parents. When a by changing the stressful / depressed teenager experiences insecure and fear, his situation by doing an action / step by biggest enemy is their self-confidence. brainstorming and planning actions to This is as stated in Asih's research (2010), find solutions (Aldao et al, 2010). This is the psychological impact felt by a good strategy because someone who adolescents when they get verbal abuse, experiences a problem will solve the namely the decreased of self-confidence problem by thinking and planning the such as shame, emotion, anger, further solution. depression, experiencing excessive fear, 2. Bivariate Analysis severe anxiety and lowering the dignity of Bivariate analysis was applied to see the victim himself. In addition to these the relationship between variables. Based impacts, the long-term impact of verbal on the data that has been processed using violence will lead to a chain of violence in a computer statistical program using the the family.
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Oral Presentation Riau International Nursing Conference 2018 RINC2018
Teenagers who experience verbal 3Yesi Hasneli N, S.Kp., MNS: Lecturer abuse will feel negative emotions when of Medical Surgical Nursing Department they get a shout from their parents. This is of Nursing Faculty of Riau University, in line with research by Putrawan, Aniroh, Indonesia and Choiriyah (2016) stating that there is a significant relationship between verbal References abuse and emotional development in Komisi Perlindungan Anak Indonesia. children. Children who get a shout or (2015). Pelaku kekerasan terhadap threat from their parents will cause anak tiap tahun meningkat. Diperoleh emotional injury to the child who pada tanggal 18 Januari 2018 dari experiences it, that it will distract the http:/www.kpai.go.id/berita/kpai- child's emotional development. The more pelaku-kekerasan-terhadap-anak-tiap- often children get verbal abuse, the less tahun-meningkat/ they will be in their emotional Asih, G. Y., & Pratiwi, M. M. S. (2010). development. This makes the child more Perilaku prososial ditinjau dari empati often confine himself, filled with sadness, dan ematangan Emosi. Jurnal fear, lack of confidence and the child will Psikologi, Volume 1, No 1. Kudus: become aggressive or angry so that the Universitas Muria Kudus. Diperoleh child's emotions become disturbed and pada tanggal 2 Maret 2018 dari tend to use harsh words on his friends. https://jurnal.umk.ac.id/index.php/PSI Later, children who experience verbal / violence will imitate similar things to their Rolston, A. & Richardson, E. L. (2017). children when they become parents What is emotion regulation and how (Munawati, 2011). do we do it?. Cornell Research Conclusion Program On Self-Injury and The results of the study showed that Recovery. Diperoleh pada tanggal 21 The respondent who experienced high Februari 2018 dari verbal abuse was as the highest number https://ejournal.undip.ac.id/index.php/ consisted of 130 people (50.8%) and 145 psikologi/article/viewFile/9801/7860 (56.6%) respondents used adaptive Lestari, T. (2016). Verbal abuse: Dampak emotion regulation. Based on the results buruk dan solusi penanganannya of chi-square statistical tests showed that pada anak. Yogyakarta: Psikosain. the P value = 0,000 < α = (0,05) it can be Silaen, A. C., & Dewi, K. S. (2015). concluded that there is a significant Hubungan antara regulasi emosi relationship between verbal abuse of dengan asertivitas. Jurnal Empati, parents with emotion regulation in Volume 4(2), 175-181. Diperoleh adolescents. pada tanggal 9 Juli 2018 dari Acknowledgements https://media.neliti.com/media/public Researchers express the highest ations/64750-ID-hubungan-antara- gratitude for the guidance and assistance regulasi-emosi-dengan-as.pdf from various parties in the completion of Aldao, A., Hoeksema, S. N., & Schweizer, this research. S. (2010). Emotion regulation strategies across psychopathology: A 1Anisa Yulvi Azni: Student of Nursing meta-analytic review. Clinical Faculty of Riau University, Indonesia. Psychology Review. Diperoleh pada 2Juniar Ernawaty, S.Kp., M.Kep., tanggal 7 Februari 2018 dari M.Ng: Lecturer of Children’s Nursing https://pdfs.semanticscholar.org/7963/ Department of Nursing Faculty of Riau 1d4ff0622f51bc4713a330707c8c17c2 University, Indonesia. 7ad2.pdf
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Oral Presentation Riau International Nursing Conference 2018 RINC2018
Noh, C. H., & Talaat, W. I. (2012). Verbal abuse on children: Does it amount to child abuse under the Malaysian law?. Asian Social Science, Vol. 8, No. 6. Diperoleh pada tanggal 13 Juli 2018 dari http://verbalabusejournals.com/pdf/re search/effects-children/verbal-abuse- child-abuse.pdf Nidya , N. S. (2014). Hubungan verbal abuse pada remaja dengan kepercayaan diri. Skripsi. Fakultas Psikologi: Universitas Sanata Dharma. Diperoleh pada tanggal 9 Juli 2018 dari https://repository.usd.ac.id/1322/2/10 9114013_full.pdf Putrawan, K. P (2016). Hubungan verbal abuse dengan perkembangan emosi anak usia sekolah kelas 3-5 di SD N Genuk 01 Ungaran Kabupaten Semarang. Skripsi (dipublikasikan). Diperoleh pada tanggal 1 Maret 2018 dari https://anzdoc.com/download/hubung an-verbal-abuse-dengan- perkembangan-emosi-anak-usia- se.html Munawati. (2011). Hubungan verbal abuse dengan perkembangan kognitif pada Anak usia prasekolah di RW 04 Kelurahan Rangkapan Jaya Baru Depok. Skripsi (dipublikasikan). Jakarta: Universitas Pembangunan Nasional “Veteran” Jakarta
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Oral Presentation Riau International Nursing Conference 2018 RINC2018
2. THE RELATIONSHIP OF THE GENDER WITH EMOTION REGULATION IN JUNIOR HIGH SCHOOL STUDENTS
Hayatul Husna1, Fathra Annis Nauli2, Herlina3 1Student of Faculty of Nursing, University of Riau 2Faculty of Nursing, University of Riau 3Faculty of Nursing, University of Riau Email: [email protected]
Abstract
Objective: Characteristics of junior high school students are not able to regulate emotions well. One of the factors that affect a person's emotions of regulation is gender. Method: this study applied a descriptive correlation study using cross sectional approach, with 165 respondents. The measuring instrument used in this research was the questionnare for gender and emotional regulation variables. Data were collected using questionnare that has been tested for its validation and reliability. Data analyzes used were descriptive analysis to see the percentage of each variable and using Chi-Square to see the correlation between variables. Results: The research of the relationship of the gender with emotion regulation behavior Showed P value = 0.073> α = 0.05, so it could be concluded that there was no significant the relationship of the gender with emotion regulation in junior high school students. Conclusions: The research can be used as a base of information and increase of knowledge about gender and emotional regulation.
Keywords: Emotional regulation, gender, students of junior high school.
Introduction Salovey and Sluyter (in Nisfiannor Emotion regulation is the process of & Kartika, 2004) says that girls are more intrinsic and extrinsic to control and adjust looking for support and protection from the emotions that arise to achieve a goal others to regulate their negative emotions, that includes the ability to manage while boys use physical exercise to feelings, physiological reactions, the way regulate their negative emotions. people think, and emotional responses Researchers conducted a such as facial expressions, mannerisms, preliminary survey on January 22, 2018 and tone of voice as well as to quickly researchers interviewed counseling cool down after losing control or emotions teachers and 10 students about the felt (Habsyi, 2015). students' emotion regulation in junior Junior high school students are high school PGRI Pekanbaru. Results students who are in the age range 12-15 counseling teacher interview, she said the years. Stage of development of secondary emotion of most students at junior high school age children is considered at this school PGRI very unstable. The students stage of adolescent development have not been able to regulate their (Desmita, 2011). Adolescence is a period emotions. They are irritable and easily of transition from childhood to repay their friends. The results of the adulthood. At this time they experienced interview on 10 students are three many emotional instability that could students said they would be patient and trigger the behavior of juvenile do not care who mock, hit or silence, and delinquency (Kartono, 2014). 7 students say immediately repay those who mocked, hit, or silence. This shows
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that most of emotion regulation in to be found suitable as a data source. students is low. (Setiadi, 2013), harvesting incidental The purpose of this study was to sampling because the study was determine the relationship of the gender conducted during the class meeting with emotion regulation in junior high where many students who did not attend school students. so that researchers can not use numbers The results of this study are merandom absent. expected to provide information on the Analysis of the data in this study development of knowledge about gender were univariate and bivariate. Univariate and emotion regulation. analysis was conducted to see the Method frequency distribution of age, gender, and The study design used is emotion regulation in junior high school descriptive correlation with cross PGRI respondents in Pekanbaru. sectional approach. In a cross-sectional Bivariate analysis using chi-square test to study, the variable causes or risk and see whether there is a relationship effect or the case happens to the object of between independent variables (sex) with research is measured and collected the dependent variable (emotion simultaneously, for a moment or just regulation). once in one time (the same time), and Result there was no follow-up (Setiadi, 2013). Based on research obtained the The population in this study were following results: all students of class VII, and VIII in A. Univariate analysis junior high school PGRI Pekanbaru. 1. Characteristics of Respondents by Number of class VII, and VIII in junior Age high school PGRI Pekanbaru is 280 table 1 students. Frequency Distribution of Respondents by The samples in this study were Age adolescents aged 12-15 years and Frequenc Percentage No. Age attending school in junior high school y (%) PGRI Pekanbaru as many as 165 1 12 years 5 3 respondents. Instruments in this study is a old questionnaire gender and emotion 2 13 years 36 21.8 regulation have tested the validity. old Data collection was conducted in 3 14 years 75 45.5 the field of junior high school PGRI old Pekanbaru simultaneously. The sampling 4 15 years 49 29.7 technique used in this study is old proportionate stratified random sampling. Total 165 100 This technique is used when the population have a member or element Based on Table 1 above shows that of that is not homogeneous and stratified the 165 respondents in junior high school proportional (Sujarweni, 2014). while the PGRI Pekanbaru, the distribution of the waysampling every class is done by majority of respondents according to age incidental capture technique sampling. ie 14 years of age who were 75 Incidental sampling is a sampling respondents (45.5%). technique based on accidental / 2. Characteristics of Respondents by incidental, that anyone who accidentally Gender met with investigators can be used as a table 2 sample, when seen people who happened Distribution of Respondents by Gender
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Percentage No Gender Frequency total 8 50.3 8 49.7 16 10 (%) 3 2 5 0 1 Male 74 44.8 2 Female 91 55.2 The results of the analysis of the Total 165 100 relationship between gender and emotion regulation found that of 165 respondents Based on Table 2 above shows that were male sex there are 38 respondents of the 165 respondents in junior high (51.4%) had high emotion regulation and school PGRI Pekanbaru, the distribution 36 respondents (48.6%) had a low of respondents by gender the vast majority emotion regulation. While 91 respondents were women with a number of 91 were female with 45 respondents (49.5%) respondents (55.2%). had high emotion regulation and 46 3. Emotion Regulation respondents (50.5%) had a low emotion table 3 regulation. Statistical analysis showed that Distribution of respondents by Emotion the P value = 0.931> α = 0.05. This means Regulation that Ho failed rejected so that it can be No. The level Frequency Percentage concluded that there is no significant of emotion (%) relationship between gender and emotion regulation regulation in junior high school PGRI 1 High 83 50.3 students in Pekanbaru. 2 Low 82 49.7 Discussion Total 165 100 A. Univariate analysis 1. Age Based on Table 3 above shows that Distribution of research results out of 165 respondents at junior high based on the age of the majority of school PGRI Pekanbaru, the distribution respondents was 14 years of age by the of respondents by most emotion number of 75 respondents (45.5%). This is regulation is the respondents who have a because characteristics junior high school high emotion regulation with the number age are at the stage of early adolescence is of 83 respondents (50.3%). the age of 12-15 years (Jahja, 2011). Jahja B. Bivariate analysis (2011) also states the characteristics of Bivariate analysis in this study to early adolescence is an increase in determine the relationship between the emotional occur quickly so that it can lead variables of gender and emotion to conflict. Emotional enhancement is the regulation. Explanation of Chi Square test result of physical changes, especially results gender relations with emotion hormones that occurs in adolescence. In regulation can be seen in the following terms of social conditions, increased this table: emotion is a sign that teens are in new Table 5 condition that is different from the Relationships Gender With Emotion previous period. Regulation 2. Gender The results showed that the Gender Emotion regulation P value distribution by gender that most are
High Low Total female with a number of 91 respondents
N % N % N % (55.2%). 0.931 Male 3 51.4 3 48.6 74 10 Salovey and Sluyter (in Nisfiannor 8 6 0 & Kartika, 2004) says that girls are more Female 4 49.5 4 50.5 91 10 looking for support and protection from 5 6 0 others to regulate their negative emotions,
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while boys use physical exercise to factors of adolescent emotional regulate their negative emotions. experience. Distribution of respondents by Conclusion gender in this study is the majority of After doing research on the respondents with female, because of 280 relationship of the gender with emotion the total number of class VII and VIII in regulation, the results show that the junior high school PGRI Pekanbaru is as distribution of respondents according to much as 149 students are female and the age at 14 years with the highest number rest male gender. So because the majority of 75 respondents (45.5), the highest of female students more, took part in the gender is female with a number of 91 sampling process to be the respondent in respondents (55.2), and most emotion the study. regulation is the respondents who have 3. Emotion regulation High emotion regulation with the number Based on the research results, of 83 respondents (50.3%). obtained a distribution based on the most In bivariate analysis using chi emotion regulation is the respondents square analysis was obtained P value = who have a high emotion regulation with 0.931> α = 0,05. This means that Ho the number of 83 respondents (50.3%). failed rejected so that it can be Emotion regulation is the ability to concluded that there is no significant realize and understand, manage and relationship between gender with balance the emotions in themselves and emotion regulation in junior high school change emotions so that they can PGRI students in Pekanbaru. motivate themselves from difficult Acknowledgement circumstances (Silaen & Goddess, 2015). For nursing particularly in the field The results of this study indicate that of nursing soul, this study can be used as there are subtle differences between information about gender and emotion respondents with high emotion regulation regulation. The results of this study can be (83 respondents) and respondents who used as a source of information for all have low emotion regulation (82 parties related to the relationship of respondents). Although the gender education with emotion regulation characteristics of the adolescent is in junior high school students. The results emotionally unstable, but there are other of this study are expected to become factors that influence adolescent emotion information and knowledge for people, regulation such as the relationship especially teens about gender relations between parents and children, with emotion regulation. environmental factors, and factors of For other researchers will continue, adolescent emotional experience. the results of this study can be used as a B. Bivariate analysis baseline in carrying out related research Based on the results of this study further. Further research should examine revealed that there was no correlation the other factors associated with emotion between gender with emotion regulation, regulation. the results of statistical tests are visible References only subtle differences between Desmita. (2011). Psikologi respondents of men and women who have perkembangan peserta didik. high and low emotion regulation. Bandung: Remaja Rosdakarya. Factor emotion regulation is not just Gunadi, T. (2011). Mereka pun bisa gender but there are still other factors, sukses. Jakarta: Penebar Plus. such as the relationship between parents Habsyi, S. A. A. (2015). Perbedaan and children, environmental factors, and regulasi emosi antara penghafal
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qur’an 1-15 juz dengan penghafal qur’an 16-30 juz. Skripsi. Universitas Islam Negeri Malang. Diperoleh tanggal 22 Januari 2018 dari http://etheses.uinmalang.ac.id Jahja, Y. (2011). Psikologi perkembangan. Jakarta: Kencana. Kartono, K. (2014). Kenakalan remaja. Jakarta: Rajagrafindo Persada. Nisfiannoor, M., & Kartika, Y. (2004). Hubungan antara Regulasi Emosi dan Penerimaan Kelompok Teman Sebaya pada Remaja. Jurnal Psikologi, 2(2), 160-178 . Diperoleh tanggal 22 Februari 2018 dari http://digilib.esaunggul.ac.id Notoatmodjo, S. (2012). Metodologi penelitian kesehatan. Jakarta: Rineka Cipta. Parkway, A. (2016). Emotional regulation: what is it and why is it important ?. Mental Health Blog. Diperoleh tanggal 23 Januari 2018 dari https://www.apibhs.com Pieter, H. Z., & Lubis, N. M. (2010). Pengantar psikologi dalam keperawatan. Jakarta: Kencana. Setiadi. (2013). Konsep dan praktik penulisan riset keperawatan edisi 2. Yogyakarta: Graha Ilmu. Silaen, A. C., & Dewi, K. S. (2015). Hubungan antara regulasi emosi dengan asertivitas. Jurnal Empati, 4(2), 175–181. Diperoleh tanggal 20 Februari 2018 dari https://media.neliti.com Sujarweni, V., W. (2014). Metodologi penelitian keperawatan. Yogyakarta: Gava Media
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3. THE EFFECT OF COMBINATION SPIRITUAL EMOTIONAL FREEDOM TECHNIQUE (SEFT) THERAPY AND HYDROTHERAPY WITH A MIXTURE RED GINGER ON BLOOD PRESSURE OF PATIENTS HYPERTENSION
Risfinda1, Bayhakki2, Yufitriana Amir3 1School of Nursing, University of Riau 2Lecturer School of Nursing, University of Riau 3Lecturer School of Nursing, University of Riau Email: [email protected]
Abstract
High blood pressure (hypertension) can quietly damage the body for years before symptoms develop. Roughly half the people with untreated hypertension die because of heart disease related to poor blood flow. Therefore, non-pharmacological treatment is a great way to recirculate blood and warmth. With combination of SEFT therapy and hydrotherapy, this research was aimed to explore the effect of SEFT and hydrotherapy with a mixture of red ginger to reduce high blood pressure in patients at Puskesmas Payung Sekaki. Quasi Experimental were used in this study using non-equivalent control group approach. Samples were 36 respondents (divided equally into 2 groups) recruited using purposive sampling technique. The intervention group received SEFT intervention combined hydrotherapy for 20 minutes per day in 6 consecutive days, while the control group was not given any treatment. The analysis used was univariate analysis to see frequency and bivariate analysis with dependent t test and independent t test. The result of statistical test showed that there was significant difference of blood pressure before and after intervention with p value 0,000 (<0,05). The results showed that the combination of SEFT therapy and hydrotherapy with a mixture of red ginger can lower blood pressure patients with hypertension. The results recommend SEFT and hydrotherapy as an adjunctive therapy to decrease blood pressure.
Keywords: Blood pressure, hydrotherapy, hypertension, SEFT
Introduction prevalence of hypertension is ≥18 years in Hypertension is a state of blood Indonesia, which is 25.8% (Riskesdas, pressure at> 120/80 mmHg. The 2013). Based on data from the Pekanbaru mechanism of increasing blood pressure is City Health Office in 2017 shows that by changing blood pressure (Muttaqin, primary hypertension is the most common 2009). Blood pressure is defined as the case of disease which ranks second in the impulse on the artery wall resulting from ten highest cases of disease. Primary the pump from the heart (Potter & Perry, hypertension in 2017 was 35,090 cases 2010). In 2015, World Health (Pekanbaru City Health Office, 2017). Organization (WHO) showed ≥ 1 in 5 Hypertension is associated with adult patients had hypertension, and this thickening of the arterial wall so that its condition could result in half of all deaths elasticity is reduced and causes increased from cardiovascular disease (WHO, peripheral resistance of the arterial wall. 2015). The heart will pump by facing great The prevalence of hypertension in resistance, consequently the blood supply the United States in 2014 was 18% with to various vital organs such as the heart, hypertension (WHO, 2015). The brain and kidneys decreases (Potter &
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Perry, 2010). Hypertension is also called to be SEFT by emphasizing aspects of "the silent killer", due to decreased blood spirituality (Zainuddin, 2009). SEFT supply to various organs, causing damage therapy is a combination of spiritual to even death silently without pain therapy and the body's energy system (Kowalski, 2010). (energy medicine) with the tapping Hypertension is caused by several method on the body's meridian points. The factors including heredity, age, excessive benefit of SEFT therapy is that it can salt consumption, obesity, smoking, overcome physical and emotional caffeine, alcohol, and stress (Pahmawati, problems (Rajin, 2012). When someone 2011). If hypertension is not treated prayed with a sincere heart and surrender, immediately, it can cause death from relaxation of the body will occur so that a cardiovascular disease (Potter & Perry, person becomes calm, breathing becomes 2010). regular, heart rate becomes regular and There are many methods for stable will accelerate blood circulation so managing hypertension, including that the body relaxes (Zainuddin, 2009). pharmacological and non-pharmacological One way to treat high blood therapies. Pharmacological management pressure is hydrotherapy. If hydrotherapy using antihypertensive drugs (Muttaqin, is done regularly, it can overcome high 2009). However, the blood pressure of blood pressure. The impact felt by the hypertensive patients is still not controlled body from warm water therapy is that it despite pharmacological therapy. This is can facilitate and stabilize blood flow related to side effects and inappropriate (Lalage, 2015). Soaking warm water has drug combinations (Sudoyo et al., 2010). the benefit of dilating vascular so that Non-pharmacological therapy is needed to blood pressure is reduced (Ilkafah, 2016). minimize the side effects of Foot baths using warm water can be pharmacological therapy. Some non combined with other herbal plants, one of pharmacological approaches in dealing which is ginger. The benefits of ginger are with hypertension are weight reduction, through the vasodilation mechanism so limiting alcohol, exercise, and relaxation that blood circulation is smooth and (Muttaqin, 2009). prevents cardiovascular disease and stroke Relaxation is a technique of (Akbar, 2015). combining repetitive mental focus with a Based on a preliminary study on calm and friendly attitude. The goal of March 15, 2018 in the Payung Sekaki relaxation therapy is that individuals Community Health Center area through an monitor and release the tension interview method, eight people who had experienced in various parts of the body. hypertension did not know about SEFT Characteristics of relaxation respondents therapy and soaking the feet of warm are a decrease in the work of the heart and water with a red ginger mixture can respiratory frequency, blood pressure, and reduce blood pressure. Meanwhile, five oxygen use as well as an increase in brain out of eight said they only consumed work and peripheral skin temperature antihypertensive drugs and three others (Potter & Perry, 2010). Relaxation therapy used non-pharmacological therapies such in overcoming hypertension recently as starfruit stew, massage the head of the developed is Spiritual Emotional Freedom neck, praying and dhikr. The result is Technique (SEFT). blood pressure drops when consumed and SEFT is an adaptation technique carried out regularly. from Emotional Freedom Technique Method (EFT) by Gary Craig (USA), and then This research was conducted at the EFT was developed by Zainuddin in 2005 Payung Sekaki Pekanbaru Health Center
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Experiment which started from February to July 2018. Pre Sistolic 158,03 11,63 142,30 181,00 18 The study used a quasy experiment design Pre Diastolic 99,11 6,31 89,70 111,00 Control with non equivalent control group design. Pre Sistolic 163,02 14,69 143,70 196,00 18 This design is where the sample is first Pre Diastolic 98,84 5,62 90,70 113,00 observed before being given intervention, Experiment Post Sistolic 18 146,83 11,06 132,30 164,70 then after the intervention is given a Post Diastolic 93,37 5,19 84,70 103,00 sample again it is observed (Hidayat, Control Post Sistolic 18 161,20 15,11 141,00 193,00 2012). The experimental group carried out Post Diastolic 97,33 4,57 90,70 109,70 blood pressure measurements before being given intervention and after being given 2. Bivariate Analysis intervention. Meanwhile, the control Table 3 group still measured blood pressure before Difference in Average Systolic Blood and after without intervention (Setiadi, Pressure Before and After Intervention in 2013). the Experimental Group Data collection tools used in this Variable Median Min Max p value study are aneroid tensimeters, Sistolic Pre test 157,85 142,30 181,00 0,000 stethoscopes, and observation sheets. Post tes 147,00 132,30 164,70 Data analysis used is univariate analysis and bivariate analysis. Bivariate Table 4 analysis was used to determine whether Difference in Average Diastolic Blood there was a significant effect between the Pressure Before and After Intervention in two variables using the Wilcoxon and the Experimental Group Mann Whitney alternative tests. Variabel Mean SD p value Result Diastolik 1. Univariate Analysis Pre test 99,11 6,31 0,000 Post test 93,37 5,19 Table 1 Distribution of Respondent Table 5 Characteristics Difference in Average Systolic and Experiment and Control Characteristics Diastolic Blood Pressure Before and After n % Age: Intervention in the Control Group Late Adult (36-45) 5 13,9 Blood Pressure Mean SD p value Early Elderly (46-55) 17 47,2 Late Elderly (56-65) 14 38,9 Control Group 1. Sistolic Gender: Pre test 163,02 14,69 0.000 Male 8 22,2 Post test 161,20 15,11 Female 28 77,8
Education: Primary School 19 52,8 2. Diastolic Junior High School 4 11,1 Pre test 98,84 5,62 0.005 Senior High School 11 30,6 Post test 97,33 4,57 College 2 5,6 Work: Work 8 22,2 Discussion Not Work 28 77,8 A. Characteristics of Respondents Long Suffering Hypertension: 21 58,3 1. Age ≤ 5 Year 15 41,7 The results of research found that >5 Year most hypertensive patients were in the age
range> 46 years as many as 47.2% (17 Table 2 people). Blood pressure increases with age Average Systolic and Diastolic Blood (Potter & Perry, 2010). In the elderly, Pressure Before and After Intervention in increased blood pressure is caused by a Experimental Groups and Control Groups Variable N Mean SD Min Max
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decrease in arterial elasticity (Kozier, Erb, years as much as 58.3% (21 people). Berman, & Snyder, 2010). Supporting study is the results of 2. Gender Wibowo's research (2011) which states Respondents mostly female, as that 65% of respondents have a long time many as 77.8% (28 people). During suffering from hypertension ≤5 years, this premenopause, women begin to lose little is influenced by respondents' compliance by little the hormone estrogen which in treating hypertension and often obtains serves to protect blood vessels from information about counseling programs on damage. During premenopause, women hypertension, complications and diet, so begin to lose little by little the hormone that hypertensive patients are obedient and estrogen which serves to protect blood know the consequences of hypertension. vessels from damage. This process B. Effect of Combination of Emotional continues where the estrogen hormone Freedom Technique Spiritual changes its quantity according to the age (SEFT) Therapy and Soak Warm of women naturally, which generally starts Water Foot with Red Ginger at the age of 45-55 years (Anggraini, Mixture on Experimental Group and Waren, Situmorang, Asputra, & Siahaan, Control Group 2009). The results showed a p value of 3. Education 0,000, meaning that the combination of Distribution based on education SEFT therapy and warm water foot soak level showed that the majority of with red ginger mixture can reduce blood respondents' education was elementary pressure. This is consistent with the school as much as 52.8% (19 people). statement of Zainuddin (2009) which According to Anggara and Prayitno states that the working principle of SEFT (2013), the relationship between education therapy is not different from acupuncture and hypertension is not only due to the and acupressure which can affect health level of education, but because the level of by stimulating 17 body meridian points. education influences healthy lifestyles. Body meridian points when repeatedly The high risk of developing hypertension tapped will neutralize the pain, both in low education is caused by a lack of physical and emotional. Another knowledge in patients with low education supportive study is Lane's (2009) study on health and is slow to receive which states that stimulating meridian information provided by health workers so points can control cortisol, reduce pain, that it has an impact on behavior or a slow heart rate, reduce anxiety, control the healthy lifestyle. autonomic nervous system so as to create 4. Work a sense of calm and relaxation. These Based on the employment status conditions will affect the work of the heart most respondents did not work as many as by reducing cardiac output which results 77.8% (28 people).Work is related to in a decrease in blood pressure. SEFT physical activity. Inactive people tend to therapy combined with a warm foot soak have a higher heart rate so that the heart with red ginger mixture can reduce blood muscle must work harder each pressure. This is because the warm water contraction. The harder and often the heart work system is basically increasing cell muscle pumps, the greater the pressure activity by energy flowing method imposed on the arteries (Kurniasih, 2013). through convection (flowing through a 5. Long Suffering Hypertension liquid medium) so that blood vessel Based on the duration of dilation occurs to accelerate blood hypertension are the majority of circulation throughout the body which respondents experiencing hypertension ≤5 results in a decrease in blood pressure
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(Lalage, 2015). Warm water mixed with 3Yufitriana Amir: Lecturer at the red ginger because of the warm taste of Department of Nursing at the Faculty of red ginger can suppress the release of Nursing at the University of Riau, adrenal hormones, widen blood vessels so Indonesia as to accelerate and facilitate blood flow and relieve the work of the heart, prevent References blood clots because of the content of Akbar, R. (2015). Aneka tanaman apotek gingerol which can reduce cholesterol hidup di sekitar kita. Jakarta: One levels by preventing blood vessel Books. blockage. Anggara, F. H. D., & Prayitno, N. (2013). Conclusion Faktor-faktor yang berhubungan The results of this study indicate dengan tekanan darah di puskesmas that the characteristics of respondents telaga murni cikarang jawa barat based on age obtained the highest age, tahun 2012. Jurnal Ilmiah Kesehatan, namely 46-55 years, and the sex of the 5(1), 1-6 most respondents, namely women with Anggraini, A. D., Waren, A., Situmorang, education status, mostly elementary E., Asputra, H., Siahaan. S. S. (2008). school, and based on the majority Faktor-faktor yang berhubungan employment status does not work. dengan kejadian hipertensi pada The results of this study indicate pasien yang berobat di poliklinik that there is a significant decrease in blood dewasa puskesmas bangkinang. pressure in the experimental group with p Diperoleh tanggal 18 Juli 2018 value 0,000 (p <α). Measurements were Hidayat, A. A. A. (2012). Riset obtained from the average value of keperawatan dan penulisan ilmiah. systolic blood pressure before the Jakarta: Salemba Medika intervention of 158.03 mmHg, the average Ilkafah. (2016). Perbedaan penurunan diastolic blood pressure before the tekanan darah lansia dengan obat intervention was 99.11 mmHg, the anti hipertensi dan terapi rendam air average systolic blood pressure after hangat di wilayah kerja puskesmas intervention was 146.83 mmHg, and the Antara tamalanrea Makassar, 5(2), average the average diastolic blood 228–235. pressure after intervention was 93.37 Kowalski, R. E. (2010). Terapi hipertensi mmHg. Thus it can be concluded that the program 8 minggu menurunkan combination of Spiritual Emotional tekanan darah tinggi dan risiko Freedom Technique (SEFT) therapy and serangan jantung dan stroke secara warm water foot soak with red ginger alami. Bandung: Qanita. mixture has an effect on reducing blood Kozier, B., Erb, G., Berman, A., & pressure of hypertensive patients. Snyder, S. J. (2010). Buku ajar Acknowledgement fundamental keperawatan: konsep, Unlimited thanks to all those who proses, dan praktik edisi 5 volume 7. helped, guided, and supported the Jakarta: EGC. completion of this research report. Lalage, Z. (2015). Hidup sehat dengan terapi air. Jogjakarta: Abata Press. 1Risfinda: Nursing Faculty Students Muttaqin, A. (2009). Asuhan keperawatan from the University of Riau, Indonesia klien dengan gangguan sistem 2Bayhakki: Lecturer from the kardiovaskular. Jakarta: Salemba Department of Medical Nursing, Medika. Faculty of Nursing, University of Riau, Pahmawati, Y. (2011). Penyakit pada Indonesia sistem organ manusia. Jakarta:
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Adfale Prima Cipta. Potter, P. A., & Perry, A. G. (2010). Fundamental keperawatan. Jakarta: Salemba Medika. Rajin, M. (2012). Terapi Spiritual Emotional Freedom Tehnique ( SEFT ) untuk meningkatkan kualitas tidur pasien pasca operasi, 1–5. Diakses tanggal 5 Januari 2018 dari http://www.journal.unipdu.ac.id/index .php/seminas/article/view/165 Riskesdas. (2013). Riset kesehatan dasar, 1–306. Diakses tanggal 1 Maret 2018 dari www.depkes.go.id/resources/downloa d/general/Hasil Riskesdas 2013.pdf Sudoyo, A. W., Setiyohadi, B., Alwi, I., Simadibrata, M., & Setiati, S. (2010). Buku ajar ilmu penyakit dalam. Jakarta: Interna Publishing. Wibowo, A. (2011). Hubungan kepatuhan diet dengan kejadian komplikasi pada penderita hipertensi di ruang rawat inap rs baptis kediri. Jurnal STIKES RS. Baptis Kediri, 4(1), 1-7 World Health Organization (2015). World health statistic 2015 ______. Q&As on hypertension. Diakses tanggal 6 Januari 2018 dari http://www.who.int/features/qa/82/en/ Zainuddin, A. F. (2009). Spiritual Emotional Freedom Technique. Jakarta: Afzan Publishing.
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4. THE CORRELATION BETWEEN PARENTING STYLES AND ONLINE GAMING ADDICTION IN JUNIOR HIGH SCHOOL STUDENTS
Rodhiatul Hidayah1, Safri2, Ganis Indriati3 1School of Nursing, University of Riau 2School of Nursing, University of Riau 3School of Nursing, University of Riau Email: [email protected]
Abstract
Introduction: Parenting styles influenced the adolescents behavior. Adolescents nowadays like to play online games. The aim of this reseach was to study the correlation between parenting styles and online gaming addiction in junior high school students. Method: This research used proportionate stratified random sampling involving 238 students selected based on inclusion criteria by using parenting style quistionaire for adolescents and game addiction scale. Parenting style questionaire was developed by researcher with validity test. Game addiction scale divided into positive and negative online gaming addiction. Result: This research found that 66 students who were not addicted to online games (negative) obtained authoritative parenting style (74,2%), 33 students who were addicted to online games (positive) obtained permissive parenting style (55,9%). Conclusion: Data analysis was conducted by using chi-square test and the result showed p value (0,003) < alpha (0,05) which means that there was correlation between parenting styles and online gaming addiction. This research suggest providing authoritative parenting style in adolescents to prevent them from getting addicted to online games.
Keywords: Online gaming addiction, parenting styles, junior high school students
Introduction used is through search engines as much as The number of internet users in 74.84%. In addition to the types of Indonesia is based on the results of the internet access services, surveys are also Survey Asosiasi Penyelenggara Jasa conducted in several aspects, one of which Internet Indonesia (APJII) in 2017 is lifestyle. Aspects in lifestyle that get continues to experience tremendous many portions, one of which is online growth in internet users so that the total gaming. The survey conducted by APJII number of Indonesian internet users (2017) obtained users online game reaches 143.26 million users. This result 54.13% in Indonesia. high compared to the results of the survey Online games are one of the games by APJII 2016 which showed the number that are in demand by various groups and of Indonesian internet users amounting to are a means of entertainment and activities 137.2 million users. The figure of 143.26 that can fill leisure time. Online games are million users means that it exceeds 50% games based electronics and visual (Rini, of the total population or population of 2011). Online games are available for Indonesia, precisely at 54.68%. consumption by gamers from various age Comparison of internet users based on groups and genders. Children and sex, men (51.43%) and women (48.57%). adolescents tend to be more interested in The percentage of internet users aged 13- games when compared to other age groups 18 years ranges from 75.50% and one type (Kuss & Griffiths, 2012). Teenagers of internet access service that is widely generally prefer to play online games
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because games have advantages overtypes months playing games (Lemmens, of other games, namely players game can Velkenberg & Peter, 2009). When viewed not only play with people who are next to on the duration aspects of playing online them but also can play with several games, play online games for 2-10 hours players in other locations, even players in per week used by online game addicts other hemispheres so that they increase (Kusumadewi, 2009). the possibility of children being addicted The Diagnostic and Statistical (Young, 2009). Manual of Mental Disorders (DSM 5th Teenagers are the stages of edition) part III of 2013 mentioned development from childhood to addiction problems in playing online adulthood, namely between the ages of games can cause a person to develop 13-20 years (Potter & Perry, 2010). mental disorders, one of the potential Characteristics of adolescent are additional diagnoses known as Internet competitive games and daydream contest gaming Disorder. Further research is one of which is online games needed regarding the determination of this (Hockenberry & Wilson, 2014). diagnosis. In addition, the WHO has also Teenagers generally prefer to play online included the problem of addiction to games because games have advantages playing games as one of the disorders overtypes of other games, namely players which is gaming disorder. Gaming game can not only play with people who disorder is defined in the 11th revised are next to them but also can play with draft of International Classification of several other players in other locations, Diseases (ICD-11) as a game behavior even players in other hemispheres so that pattern ("digital game" or "video game") they increase the possibility of children characterized by disruption of control of being addicted (Young, 2009). the game, increasing priority given to In Indonesia, addicted to online playing games on for other activities game occurs especially in male insofar as the game takes precedence over adolescents. Some cases reported that other daily interests and activities, and teenagers had to steal because they ran out continuation or escalation of games of money due to playing online games despite negative consequences (WHO, over a period of time (Sipahutar, 2013). 2018). Junior and senior high school student is Research conducted by Abedini, rushed to the psychiatric hospital of Zamani and Khaeradmand (2012) shows RSUD Dr. Koesnadi Bondowoso due to that there was a significant influence an addiction to devices and online games, between parenting styles on addiction to the child will bang his head against the playing computer games in adolescents. wall if not allowed to play (Astro, 2018) Based on the cases mentioned, Addicted to online games has dependence on playing online games can criteria including players thinking about be classified as problematic behavior. playing games all day, spending time Research suggests that the factors that can playing games, forgetting other activities. result in adolescents experiencing People who were addicted, tend to play addiction to online games, namely games again after a long period of adolescents with parents who are playing, players feel bad when they can divorced, lonely, and lacking parental not play games, players fight with other control (Xiuqin et al, 2010). people because players play games The research conducted by excessively, and players ignore other Nurmalisa (2015) in Pekanbaru related to important activities that ultimately cause the relationship of parental control problems to be counted for at least 6 overonline gaming addiction found an
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association between parental control Method andonline gaming addiction in school-age This study conducted at Pekanbaru children. Parental control of children is Muhammadiyah 1 Junior high school one dimension of parenting for children which began from February to July 2018. and adolescents. Factors seen indicate that This study used a descriptive correlation teenagers who are addicted to playing research design, namely descriptive online games indirectly get influence from correlational research is a study to their families, especially parenting. That is determine the relationship between parenting gives an important role to the variables with cross sectional approach. development of adolescents. Although The population of this study were all adolescents tend to prefer to be with their Muhammadiyah 1 Junior high school peers, parents still need to provide control students who played online games class and acceptance to a certain degree towards VII and Class VIII (591 students). This adolescent behavior (Baumrind, 2012). research used proportional stratified Parenting affects teen identity. Parents random sampling techniques with who provide excessive protection will inclusion criteria, namely students aged cause adolescents to lose their 11-18 years who play online games and independence while parents who are too are willing to become respondents. free will make teens grow into a The data collection tools used in this generation that is wasteful and has no study were parenting questionnaires and purpose in life (Surbakti, 2013). game addiction scale for adolescents to The results of a preliminary study find out the relationship between conducted at Muhammadiyah 1 Junior parenting styles and online gaming High School, of 30 class VIII students addiction in junior high school students. found 20 people playing online games Data analysis using univariate and with playing more than 2 hours per day. bivariate analysis. Univariate analysis Two students mentioned that they used to describes the characteristics of play online games at internet caffe after respondents related to age, sex and school and could spend up to 5 hours duration of play, characteristics of there, students reasoned to play online parenting styles, characteristics online games and not be banned by parents. The gaming addiction and dimensions of data obtained by students said that they online gaming addiction. Bivariate like to play online games because games analysis was used to determine whether that have different levels and levels, there was a significant relationship students say playing online games is more between parenting styles and addictions exciting than playing video games online game in junior high school students ordinary, students can play with other using chi-square test. people even other people who live in Result different parts of the world. The purpose 1. Univariate Analysis of this study was to determine the Description of respondent relationship of parenting styles with characteristics based on age, gender, online game addiction in junior high duration of playing online games can be school students. The results of this study seen in table 6 below: are expected to be a source of information Table 1 in developing science, especially those Frequency distribution of respondents (n = related to the relationship of parenting 238) andonline gaming addiction to junior high Respondent Frequency (n) Percentage (%) school students. characteristics Age
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Early 106 44 , 5 Distribution of Respondents Based on Adolescent Online Gaming Addiction in Junior high Middle 130 54.6 adolescents school Students Late 2 0.8 adolescents game addiction Frequency (n) (%) Percentage Total 238 100 criteria Gender Frequency (n) Percentage (%) Positive 94 39.5 male 121 50.8 Negative 144 60.5 Female 117 49.2 Total 238 100 Total 238 100
Length of play Frequency (n) Percentage( %) 1-3 hours / Table 3 showed that students who 129 54.2 day were addicted to online games (positive) 4-6 hours / 91 38.2 about 97 (40.8%) people and students who day were not addicted to online games 7-9 hours / 14 5.9 (negative) about 141 (59.2%) people. day > 9 hours / Table 4 4 1.7 day Distribution of Respondents Based on Total 238 100 Dimensions of Online Game Addiction Dimensions Positive Negative Table 1 showed the characteristics Freque Percent Frequ Percent of respondents that the majority of ncy (n) age (%) ency age (%) (n) respondents were in the middle salience 128 53.8 110 46.2 acolescents of 14-16 years 130 (50.8%) Tolerance 119 50 119 50 Mood students with the majority of respondents 139 58.4 99 41 , 6 being male 121 (50.2%) students, the most modification frequent length of playing of students was Wtihdrawal 100 42.0 138 58 Relapse 102 42.9 136 57.1 in the range 1-3 hours. Conflict 88 37 150 63 Parenting styles were obtained by Problem 93 39.1 145 60.9 adolescents in this study: Table 2 Based on table 4 showed the most Distribution of respondents based on type positive dimension was mood of Parenting styles modification 139 (58.4%). The dimension Type of Frequency (n) Percentage was the least on the dimension conflict (%) about 150 (63%) students. Authoritative 89 37,4 Permissive 59 24,8 2. Bivariate analysis Authoritarian 48 20,2 Bivariate analysis in this study to Uninvolved 42 17.6 determined the relationship between Total 238 100 parenting styles and online gaming addiction on junior high school students Table 2 showed the type of Table 5 parenting most widely received by Relations Parenting styles With Online adolescents is authoritative, which was 89 Game Addiction In junior high school (37.4%), and the least was uninvolved 42 students. (17.6%). Online gaming addiction p The results of the study on the Parenting value characteristics online gaming addiction in Positive Negative junior high school students are as follows: (n) (%) (n) (%) 0.003 Table 3 Authoritative 23 25.8 66 74.2 Permisive 33 55.9 26 44.1
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Authoritarian 21 43.8 27 57.4 (Kuss & Griffiths, 2012). Researchers Uninvolved 17 40.5 25 59.5 based on this conclusion that children in Total 94 39.5 144 60.5 adolescence tend to playmore often online games than other ages. Table 5 illustrated the relationship b. Gender of parenting styles with online gaming Research that has been carried out addiction in junior high school students. obtained data on male respondents Respondents with authoritative parenting totaling 121 (50.8%) more than female who were not addicted to online games respondents 117 (49.2%). This is were 66 (74.2%) while 23 (25.8%) supported by Jin's statement (2015), boys students were positively addicted to online tended to prefer playing online games to games. Permissive parenting has the relieve stress and forget about real-world highest percentage of positive students problems while women prefer to use addicted to online games namely 33 social media. This research is supported (55.9%). The statistical test results by research conducted by Ulfa (2016) obtained p value is 0.003 with alpha 0.05, which shows that men tend to play more so that p value < alpha, then Ho is rejected often online games to make it as a hobby and it can be concluded that there is a while women play online games to significant relationship between parenting eliminate boredom. From the researcher's styles and addictions to online games on point of view, boys tend to prefer to play junior high school students. online games because they influence their Discussion presence in the play group, some boys 1. Characteristics of Respondents choose to play online games when a. Age gathering with friends while girls tend to The results showed number of age talk about fun things with peers. of the majority of respondents were in c. Length of play middle adolescence as many as 130 The results of the study found that (54.6%) students. Entertainment Software playing the online games for the majority Association (2015) states that the number of respondents 1-3 hours were 129 of users game highest is at the age of 18 (54.2%) respondents. Kusumadewi (2009) and under (27%) of users. Teenagers with stated that online game addicts usually video games aged 13-14 years were 74% spend playing time for 2-10 hours/week and 15-17 years old were 70%. Teenagers which supports Nurmalisa's research play games with known friends as much (2015) that most school students play as 89%, play with friends known online online games for 1-3 hours / day so that if 54% and play with people who are not judged from the length of the play, it can known online as much as 52% (Lenhart, be said that most of the respondents are 2015). addicted to online games. Some studies support the results of The results of research conducted by this study, namely Rehbein, Kliem, Baier, researchers at Muhammadiyah 1 Junior Mößle and Petry (2015) research high school get the results of all conducted on junior high school students respondents who use online games 7-9 in Germany, found that 1.16% of students hours / day to more than 9 hours / day experience Internet Gaming Disorder diagnosed positively addicted to online (IGD) or are addicted to online games. games. This is in accordance with the Teenagers tend to be more interested in addiction criteria online game tolerance, games when compared to other age which is difficult to stop playing online groups, therefore their risk for being games and even increase time of playing addicted to playing games is also greater (Lemmens, Velkenberg & Peter, 2009).
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d. Parenting styles spoiled, uneducated, have free time with The results of this study found that friends but lack of family untill spend the type of parenting that was widely used time playing online games. was authoritative parenting 89 (37.4%). e. Criteria Online gaming addiction Parenting style Authoritative has a The results showed that who were dimension of control and a high warmth. positive (addicted to online games) were Related research that supports this 33 (55%) students. Efendi (2012) in his research is research by Longkutoy, study mentions the negative impact of Sinolungan, and Opod (2015) with the addicted to online games, namely children title of the relationship between parenting rarely gather with parents, skipping school style and self-confidence of junior high due to playing online games in internet school students. The results obtained by cafe, and physically can cause nerve and the majority of students using parenting, eye disorders. Diagnostic Statistical of authoritative namely 25 (50%) students Mental Disorder (DSM 5) (2013) states from 50 respondents and produce data on that adolescents who are addicted to students with authoritative parenting have online games can develop into Internet high self-confidence that is 22 (66.8%). Gaming Disorder with addiction criteria Researchers argue that authoritative online game that appear real and need to parenting has a good impact on student be taken seriously. WHO (2018) added behavior. addicted to games as a health problem Another study that supports the called gaming disorder, Gaming disorder results of this study is also a study addiction to discuss related games in conducted by Nurmalisa (2015) about the general either game online or offline. The relationship between parental control and researcher based on this opinion argues addictions to online games in school that although the number of students who children, the results showed that parents are positively addicted to online games with high control had children with low does not exceed the number of students addicted. Baumrind (2010) states that who are not addicted to online games, this parental control is one dimension of should be considered by parents. The parenting. The impact of authoritative impact caused by online gaming addiction parenting is respecting the opinions of affects both physical and psychological others, respecting differences of opinion, students. building and fostering dialogue, and f. Dimensions of addicted to online avoiding self-determination (Surbakti, game 2009). The results showed that the The researcher based on this opinion distribution of respondents based on the argues that authoritative parenting shown dimension of online gaming addiction of by the attitude of parents who are open, positive which is fulfilling was mostly in discussing rules with children, giving the mood modification dimension of 140 punishment if the child is wrong and (58.8%) respondents. Related research giving praise if the child does the right that supports is research conducted by thing. Parents with authoritative parenting Yuniza (2017) with the results of the are able to divide their childrens time in dimensions addiction of online game playing online games so that the child did mood modification is in the criteria not forget other important activities such addiction of online game that dominates. as school, hanging out with family. In Efendi (2012) mentions playing online contrast to permissive parenting, parents games is basically to eliminate stress and tend to show high warmth in children and saturation from the real world. low control so that children become
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Soehartono (2016) mentions that and online gaming addiction in junior adolescents initially only tried to play high school students. online games, this was because teenagers The results showed that students felt pressure in real life so that when teens with permissive parenting had a high started playing online games, teens drifted positive/addicted rate of online gaming away and enjoyed online gaming until addiction 33 students (55%) and they became addicted. Mood modification authoritative parenting had (negative/not is a condition where someone plays online addicted) 62 students (69.7%). The results games to forget other activities. This of this study are in accordance with the process is called a pleasant state and research conducted by Abedini, Zamani calms the mind so that it is released from and Khaeradmand (2012) which shows real life (Lemmens, Valkenberg & Peter, significantly the influence of parenting 2009). Negative dimension data (not towards addiction to playing computer fulfilling the dimensional criteria) games in adolescents in Iran. The study obtained by the majority were in the found that permissive parenting, dimension conflict as many as 150 (63%) authoritarian, and uninvolved had a respondents. The dimensions of conflict significant relationship with positive are dimensions addiction of online game online gaming addiction while that lead to interpersonal conflicts that authoritative parenting produced students occur due to playing online games with negative online gaming addiction. (Lemmens, Valkenberg, & Peter, 2009) The study was supported by the According to researchers, students research of Adwitya and Suminar (2015) are more negative (not fulfilling the which showed that treatment of parents addiction criteria) on the dimension with non-directive parenting tended to conflict because students may not have a higher level of dependence on experience conflict due to online games playing online games and the authoritative but may be due to other things such as pattern had a low dependency pattern. The cases bullying in schools that cause non-directive pattern is a division of conflicts between students, parents angry permissive parenting (Baumrind, 2010). because students are slow to go home Permissive parenting affected children can because of playing football, or students act as they wish, are not able to control who are absent because they do not do themselves, low self-awareness levels that school work due to watching the night cause them to be more susceptible to be ball. addicted to online games. g. Relationship between parenting style Efendi (2014) in his research related and online game addiction in junior to factors that influenceonline gaming high school students addiction to students is parenting errors Bivariate analysis was conducted to from parents to children. Hockenberry and see the relationship between the Wilson (2014) state that the problem that independent variables is parenting style often occurs in adolescents, especially and dependent variables is online gaming middle teens, is the problem of freedom addiction in junior high school students. and control of parents which results in a Data that has been processed using the strong urge to be free from parents and program Statistical Product and Survice join with peers. Parents in this case still Solutions (SPSS) 20 using chi-square test need to provide control and acceptance to found that the p value is 0.003 with alpha a certain degree towards adolescent 0.05, so that p value < alpha, then Ho is behavior (Baumrind, 2012). rejected and it can be concluded that there This study concluded that there was is a relationship between parenting styles a significant relationship between
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parenting styles and addictions to online parenting as the best choice in parenting games in junior high school students. This children. is caused by parenting influencing the Educator Workers behavior of adolescents, adolescents who The results of this study were are raised with authoritative parenting expected to be a source of information for tend to have adaptive behavior and are educators to monitor the type of play of able to schedule play and gatherings with students, especially online games in family while permissive parenting causes schools and evaluate school activities that children to be spoiled, not independent can reduce addiction to playing online and dependent. Authoritarian parenting games for students. causes the child disobedient because rules Further Research are hard and unresponsive to the child. The results of this study were The right parenting style is that parents expected to be information for future must balance the control and warmth researchers to examine other factors that given to adolescents like authoritative might influenceonline gaming addiction in parenting. junior high school students. Conclusion Suggestions This study was found that the Nursing Science majority of respondents were in middle The results of this study were adolescents and male respondent more expected to be an information material in than female and respondents played online developing nursing science regarding the games for 1-3 hours /day. Parenting styles relationship of parenting styles with that is widely used is authoritative. online game addiction to junior high The results of the study showed that school students. authoritative parenting showed the highest Community number of non-addictions (negative) in The results of this study were respondents and permissive parenting expected to be a source of information for showed the addictions to online games the community, especially parents, so they highest number of (positive) among can understand the relationship between respondents. Data analysis by chi-square parenting styles andaddictions online obtained p value < α so that there was a game so parents can chooseauthoritative relationship between parenting and online parenting as the best choice in parenting gaming addiction in junior high school children. students. Educator Workers Suggestions The results of this study were Nursing Science expected to be a source of information for The results of this study were educators to monitor the type of play of expected to be an information material in students, especially online games in developing nursing science regarding the schools and evaluate school activities that relationship of parenting styles with can reduce addiction to playing online online game addiction to junior high games for students. school students. Further Research Community The results of this study were The results of this study were expected to be information for future expected to be a source of information for researchers to examine other factors that the community, especially parents, so they might influenceonline gaming addiction in can understand the relationship between junior high school students. parenting styles andaddictions online game so parents can chooseauthoritative
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Acknowledgement Development, 55, 35–51. We thank you for the assistance and Efendi, NA (2014). Factors that cause guidance from various parties in playing online games and the completing this research report. negative impact on students. Thesis (unpublished). Surakarta: Surakarta 1Rodhiatul Hidayah: Student of the Muhammadiyah University Faculty of Nursing, University of Riau, ESA (Entertainment Software Indonesia Association). (2015). Essential facts 2Safri: Lecturer in the Department of about the computer and video game Medical Surgical Nursing, Faculty of industry. obtained on February 2, Nursing, University of Riau, Indonesia 2018 from http://www.theesa.com 3Ganis Indriati: Lecturer in Child Nursing Hockenberry, MJ, & Wilson, D. (2014). Department, Faculty of Nursing, Riau Wong's nursing care of infants and University, Indonesia children (9th). St. Louis: Elsevier Mosby. Jin, SY (2015). Educate children in the References Abedini, Y., Zamani, BE, & Kheradmand, digital age. Jakarta: Noura Books A. (2012). Impacts of mothers Kuss, DJ, & Griffiths, MD (2012). Online occupation status and parenting styles gaming addiction in children and on levels of self-control, computer adolescents: A review of empirical game addiction, and educational research. Journal of Behavioral Addictions, 1 (1), 3–22. progress of adolescents. Addict Health, Summer & Autumn, 4 (3). Kusumadewi, NT (2009). Relationship to Adwitiya, AB, & Suminar, DR (2015). internet online gaming addictions The difference in the level of with teenage social skills. Journal dependence on online games in terms psychology, 4, 45-52. of the perception of adolescents to Lemmens, JS, Valkenburg, PM, & Peter, parenting styles. Journal of J. (2009). Development and Educational & Development validation of a game addiction scale for adolescents. Media Psychology, Psychology. 4 (1) American Psychiatric Association. (2013). 12 (1), 77–95. Diagnostic and statistical manual of Lenhart, A. (2015). Video games are the mental disorder (5th ed.). Arlington: key elements in friendship for many American Psychiatric Association. boys. Pew Research Center: Internet APJII. (2017). Penetration and behavior of and technology. Obtained on January Indonesian internet users. Indonesian 5, 2018 from Internet Service Provider Association. http://www.pewresearch.org Obtained on 02 January 2018 from Longkutoy, N., Sinolungan, J., & Opod, https://apjii.or.id/surve2017. H. (2015). Relationship between Astro, MM (January 11, 2018). Students parenting styles and students' in Bondowoso have mental disorders confidence in the Minahasa due to addiction to devices. Antara Ranotongkor Christian Junior high News. Retrieved March 23, 2018, school. e-Biomedicine. 3 (1). from http://m.antaranews.com Nurmalisa, T., Elita, V., & Woferst, R. Baumrind, D. (2012). Differentiating (2016). Relationship between parent between confrontive and coercive control and addiction playing online kinds of parental power-assertive games for school-age children. Thesis disciplinary practices. Human (unpublished). Pekanbaru: University of Riau.
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Rehbein, F., Kliem, S., Baier, D., Mößle, T., & Petry, NM (2015). Prevalence of internet gaming disorder in German adolescents: diagnostic contribution of nine DSM-5 criteria in a state-wide representative sample. Addiction. 110, 842-851. Rini, A. (2011). Overcoming addiction to online games in children. Jakarta: Library Mina. Sipahutar, IG (2013). Minors break 2 shops because they are addicted to online games. Obtained on December 30, 2017 from www.tribunnews.com. Soehartono. (2016). Online game addicts behavior in adolescents. Jurmafist. 4. 3 Surbakti, EB (2009). Get to know your teenagers. Jakarta: PT Alex Media Komputindo. Ulfa, M. (2016). The relationship of the influence of online game addiction to adolescent behavior. Fisip. (4). WHO. (2018). Gaming disorder. Retrieved 2 February 2018 from http://www.who.int/features/qa/gamin g-disorder/en/. Xiuqin, H., Huimin, Z., Mengchen, L., Jinan, W., Ying, Z., & Ran, T. (2010). Mental health, personality, and parental rearing styles of adolescent with internet addiction disorder. Cyberpsychology, behavior and social networking, 13 (4), 401-406. Young, K. (2009). Understanding online gaming addiction and treatment issues for adolescent. The American Journal of Family Therapy, 37, 355-372. Yuniza., Elita, V., Bayhakki. Relationship to online game addiction with student learning motivation. Thesis (unpublished). Pekanbaru: University of Riau.
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5. RELATIONSHIP BETWEEN FAMILY SUPPORT AND AGGRESSIVE BEHAVIOR AMONG INDONESIAN ADOLESCENTS
Reshalia1, Reni Zulfitri2, Bayhakki3 1Student of Faculty of Nursing Universitas Riau 2,3Faculty of Nursing Universitas Riau Email: [email protected]
Abstract
Objective: Adolescence is a critical period in human development stage where aggressive behavior is common due to changes and challenges accompanying transition to adulthood. Social support from family members is considered as an appropriate promising solution to augment aggressive behavior among adolescents. Method: The study adopted descriptive- correlational research design using a sample consisting of one-hundred thirty-five (135) students of Tri Bhakti Junior High School in Pekanbaru. The data were collected using the adopted, valid and reliable Family's support and Aggression questionnaires. Results: The chi-square test showed significant relationship (p-value= 0,004; α= 0,05) between family support and aggressive behavior among adolescents. Conclusions: This research confirms the beneficial effects of family support in aggression among adolescents.
Keywords: Adolescent, aggressive behaviour, family support
Introduction see it from television and newspaper Adolescence is a very critical period (Setiawati, 2015). in human development stage. At the time Family environment is the first of this age often apppeared conflict. environment faced by teenagers both Conflicts are not resolved properly by the socially and individually. According to teenagers will have negative impacts in Lestari (2016) suggested a positive and adolescent development, one of the impact significant relationship adolescent with is psychosocial problems (Retnowati, family always provide social support and 2008). always harmonious. Psychosocial problems are problems The purpose of this study was to that make changes in the lives of both determine the relationship of social psychological and social that can be the support of families with adolescent beginning of psychiatric problems or aggressive behavior. mental health issues that have an impact The results of this study are expected to on the social environment (Keliat, 2010). add insight and knowledge, especially on Psychosocial problems is a problem in social support of family and adolescent adolescents are common in Indonesia, one aggressive behavior. of the problem is aggressive behavior. Method Aggressive behavior is a reaction of This research was took place in emotion in individuals that is displayed in SMP Tri Bhakti Pekanbaru that starting the destruction of human or objects that is from February to July 2018. This study expressed in words (verbal) and used a descriptive correlation design with behavioral (non-verbal) (Silwan, 2012). cross sectional approach. The number of aggressive behavior in The population in this study were adolescents increasing every year, we can students of class VII and VIII SMP Tri Bhakti Pekanbaru, the populations is 204
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students. The sample were 98 students Table 2 shows that the highest from VII class and 106 students from VIII respondents who have aggressive behavior class. The sample in this study was 135 in high category were 71 (52,6%). students based on inclusion criteria. 2. Bivariate Analysis Samples were taken by stratified random Table 3 sampling. Relationship Between Family Support And The data were collected using the Aggressive Behavior in Adolescents (N = adopted, valid and reliable Family's 135) support and Aggression questionnaires. Aggressive Data were analyzed using univariate and Social behavior P- Value bivariate analysis. Univariate analysis No. Support High Low Family describes the characteristics of N N n respondents relatedgender, age, religion, 1. Positive 28 42 70 ethnicity, education level of parents, the 2. Negative 43 22 65 0,004 work of parents, and the parents income. Total 71 64 135
Bivariate analysis is used to determine whether there is a significant relationship Table 3 shows the results of 70 between the two variables using chi- respondents who have received family square test. support positively, 28 respondents have Result high aggressive behavior and 42 1. Univariate Analysis respondents have a low aggressive Table 1 behavior. The results of the 65 Frequency Distribution of Respondents respondents who have received negative Based on Social Support Family (N=135) family support, 43 respondents have high aggressive behavior and 22 respondents Social Number Percentage No. Support have a low aggressive behavior. The (n) (%) Family results of chi-square statistical test showed 1. Positive 70 51,9 that the P value = 0.004 <α = (0.05) it can 2. Negative 65 48,1 be concluded there is a significant Total 135 100 relationship between family support and aggressive behavior in adolescent.
Table 1 shows that the highest Discussion respondents who have received family 1. Characteristics of Social Support support in positive category were 70 Family The results of the study on 135 people (51,9%). students found that the highest
respondents who have received family Table 2 support in positive category were 70 Frequency Distribution of Respondents people (51,9%). Family support that given Aggressive Number Percentage No. to teenagers make them feel calm, behavior (n) (%) considered, increase a sense of confidence 1. High 71 52,6 and competence. Social support from 2. Low 64 47,4 families to the youth play an important Total 135 100 role on the behavior of adolescents based on Aggressive behavior (N=135) (Santrock, 2007). The same thing was stated by Hafid and Muhid (2014) that teenagers who receive social support from family in a positive way will have more
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positive thoughts in the difficult situation. adolescents are more easily influenced by Positive thoughts can decrease the risk of mental health threat that can be aggressive behavior in adolescents. manifested in the form of aggressive b. Characteristics of Aggressive behavior. Aggressive behavior arising Behavior in adolescents from stress and depression that occur The results of the study shows that spontaneously however, the process has the highest respondents who have lasted a long time. Adolescents who aggressive behavior in high category were obtain high social support would have 71 (52,6%). The strongest influence on higher interpersonal skills so that it is shaping the behavior of adolescents is the easier to adapt to stress. family environment. Aggressive behavior Conclusion is also formed from peer environment, the The results showed that more local community, mass media, cultural respondents receive social support influences, and society at large (society). positively family of 70 people (51.9%) All of these systems interact in various and respondents more aggressive behavior ways and complex and it makes a person high category, 71 (52.6%). Based on the leads to a certain activity or behavior test results of chi-square statistic indicates (Susantyo, 2016). that the p value = 0.004 <α = (0.05) it can c. Relationship Between Family be concluded that there is a significant Support And Aggressive Behavior in relationship between social support of Adolescents families with adolescent aggressive Bivariate analysis was conducted to behavior. see the relationship between variables. Acknowledgement Based on the data that has been processed Researchers express the highest using a computer statistics program using gratitude for the guidance and assistance chi-square test was obtained p-value from various parties in the completion of (0.004) <α (0.05), then Ho is rejected and this research. it can be concluded that there is a relationship of social support of families 1Reshalia: Students of the Faculty of with adolescent aggressive behavior in Nursing, University of Riau, Indonesia SMP Tri Bhakti Pekanbaru. 2Dr. Reni Zulfitri, M. Kep., Sp.Kom: The results showed that out of 70 Lecturer at the Department of Community respondents received positive family Nursing Faculty of Nursing, University of social support, 28 respondents (40%) had Riau, Indonesia high aggressive behavior and 42 3Ns. Bayhakki, M. Kep., Sp.KMB, PhD: respondents (60%) had a low aggressive Lecturer at the Department of Medical behavior. The results of the 65 Surgical Nursing Faculty of Nursing, respondents received negative family University of Riau, Indonesia social support, 43 respondents (66.2%) had high aggressive behavior and 22 respondents (33.8%) had a low aggressive References behavior. Hafid, A., & Muhid, A. Hubungan Antara Research by Priasmoro, Widjajanto, Dukungan Sosial Orang Tua Dan and Supriati (2016) states that there is a Religiusitas Dengan Agresivitas significant correlation between increased Remaja Anggota Peguruan Pencak social support of families with a decrease Silat di Bojonegoro. Jurnal Psikologi in aggressive behavior of teenagers. This Indonesia 2014; 3(3), 205–212. study assumed because most teens do not http://download.portalgaruda.org get optimal social support from family so, Keliat, B. A. Manajemen Keperawatan
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Jiwa Komunitas Desa Siaga. Jakarta: EGC; 2010. Lestari, V. Hubungan antara Dukungan Sosial Orang Tua dengan penyesuaian diri remaja dengan Orang Tua Bercerai. Skripsi; 2016 Priasmoro, D. P., Widjajanto, E., & Supriati, L. Analisis faktor-faktor keluarga yang berhubungan dengan perilaku agresif pada remaja di Kota Malang. Jurnal Ilmu Keperawatan 2016, 4(2), 114–126. http://jik.ub.ac.id/index.php/jik/article /view/100 Retnowati, S. Remaja dan Permasalahannya. Fakultas Psikologi Universitas Gajah Mada. 2008. Retrieved from http://www.sofia- psy.staff.ugm.ac.id/home/ Santrock, J. W. Remaja. Jakarta: Erlangga; 2007. Setiawati, R. Hubungan antara Kecerdasan Emosi dengan Perilaku Agresi Remaja. Fakultas Psikologi Universitas Muhammadiyah Surakarta. 2015. Retrieved from eprints.ums.ac.id/37483/1/02. Naskah publikasi.pdf Silwan, A. Aggressive Behavior Pattern , Characteristics and Fanaticism Panser Biru Group PSIS Semarang. Journal of Physical Education and Sports 2012, 1(1), 27–28. Retrieved from http://journal.unnes.ac.id/sju/index.ph p/jpes Susantyo, B. Faktor-faktor determinan penyebab perilaku agresif remaja di permukiman kumuh di kota Bandung. Sosio Konsepsia 2016, 6(1), 1–17.
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6. RELATIONSHIP BETWEEN STUDENTS' PERCEPTION OF PROBLEM BASED LEARNING AND LEARNING OUTCOMES
Hermanto1, Wan Nishfa Dewi2, Veny Elita3 1Student of Faculty of Nursing Universitas Riau 2Faculty of Nursing Universitas Riau 3Faculty of Nursing Universitas Riau Email: [email protected]
Abstract
Objective: Problem based learning is a method of learning with student centered approach. Changing education system from teacher centered learning to student centered learning may cause different experinces for students and it creates different perception for students. Method: This study applied a descriptive correlation using cross sectional approach with 175 respondents of nursing students. Data were collected using questionnaire of PBL that has been tested for validation and reliability. Results: Students involved reported that students have good perceptions of PBL in nursing basic science (83,4%) and communication in nursing (80%). The result showed that there is a significant relationship between students' perception of PBL and learning outcomes of nursing basic science with p value (0,02) < α (0,05) and communication in nursing with p value (0,009) < α (0.05). Conclusions: A statistically significant beneficial effect of PBL was found for students in terms of learning outcomes and new learning experiences. Keywords: Learning outcomes, nursing student, nursing subject, problem based learning, school of nursing, students’ perception. Introduction said with PBL, the tutorial report Problem Based Learning (PBL) is a assignment was quite a lot and needed the method of learning with student centered latest literature, and the lack of available approach (Fathurrohman, 2016). PBL was literature facilities in the library. Some first launched in the early 1970s at the students also reported that with PBL they McMaster University of Canada's Medical were motivated to learn and thinking Faculty, as one of the solutions in critically. diagnosis by making questions according Based on preliminary information, it to existing problems (Fathurrohman, was found that each individual has a 2016). After that, many universities in the different perception of objects that see it world began to implement methods that the same. Student perceptions can suit their individual needs (Amir, 2010). influence learning outcomes (Sutrisno & Over time, PBL began to be known Siswanto, 2016). Learning outcomes are at universities in Indonesia, including the values given to students within a certain University of Riau. PBL was firstly period (Habsari, 2005). Learning introduced at the Faculty of Nursing in outcomes in this study will be seen from 2011, and it runs until now. two existing nursing subjects in the Preliminary research was conducted second semester, namely nursing basic using unstructured interviews of several science and communication in nursing. nursing students of University of Riau The purpose of this study was to received vary information. Some students identify the relationship between students’ said that PBL processes are sometimes perception of problem based learning with tedious, because more time is needed in learning outcomes in nursing subjects. their implementation compared to teacher- The results of this study are centered learning methods. Students also expected to provide information relating
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to learning-based methods that can be Table 3 seen from the values of nursing subjects Distribution of Frequency of Respondents Based on and can be a learning material for PBL Perception of PBL in Nursing Basic Science No Perception Frequency Percentage processes at the Faculty of Nursing 1 Good Perception 146 83.4% Universitas Riau. 2 Bad Perception 29 16.6% Method Total 175 100% This study used quantitative design Table 3 shows the data that of the with a cross sectional approach. The 175 respondents studied, it was found that population in this study were all of the majority of respondents had good students A 2017 using totaling sampling perceptions in nursing basic science were technique with total 175 respondents. Data 146 people (83,4%). collection instrument in this study was Table 4 questionnaire. Data analysis used in this Distribution of Frequency of Respondents Based on study was univariate and bivariate Perception of PBL in Communication in nursing No Perception Frequency Percentage analysis. 1 Good Perception 140 80% Results 2 Bad Perception 35 20% 1. Univariate Analysis Total 175 100% a. Describe of Learning Outcomes of Table 4 shows the data that of the Nursing Basic Science and 175 respondents studied, it was found that Communication in Nursing the majority of respondents had good Table 1 perceptions in communication in nursing Distribution of Respondent Frequency Learning were 140 people (80%). Outcomes of Nursing Basic Science 2. Bivariate Analysis No Learning Outcomes Frequency Percentage of Nursing Basic The Relationship of Student Perception Science to Problem Based Learning with Two 1 Enough 4 2.3% Learning Outcomes in Nursing Subject 2 Good 138 78.9% Table 5 3 Very Good 33 18.9% Relationship between Student Perception of PBL with Total 175 100% Learning Outcomes in Nursing Basic Science Table 1 shows the data that of the Perception Learning Outcomes Total P 175 respondents, it was found that the in Nursing Basic value majority of respondents received good Science Enough Very learning outcomes of nursing basic and Good Good science as many as 138 people (78.9%). Good 114 32 146 Table 2 Perception (78.1%) (21.9%) (100%) 0.02 Frequency Distribution of Respondents Based on the Bad 28 1 (3.4%) 29 Learning Outcomes of Communication in nursing Perception (96.6%) (100%) No Learning Outcomes Frequency Percentage Total 142 33 175 of Communication (81.1%) (18.9%) (100%) in nursing The results of the analysis of 175 1 Enough 2 1.1% 2 Good 128 73.1% respondents, it found that the majority of 3 Very Good 45 25.7% respondents got enough and good learning Total 175 100% outcomes in nursing basic science with Table 2 shows the data that out of good perception there were 114 people 175 respondents, it was found that the (78.1%). majority of respondents get good learning Table 6 outcomes in communication in nursing as Relationship of Student Perception to PBL with Learning Outcomes of Communication in nursing many as 128 people (73.1%). b. Describe of Student Perception of Perception Learning Outcomes Total P of Communication value PBL
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in nursing that 61 people (57.0%) respondents had a Enough Very good perception of PBL (Manggarsari, and Good 2012). Good Good 98 42 140 There are several factors that Perception (70%) (30%) (100%) 0.009 influence perception, namely needs, Bad 32 3 (8.6%) 35 knowledge, perspectives, and past Perception (91.4%) (100%) experiences. Students of A 2017 have the Total 130 45 175 same experience and perspective on the (74.3%) (25.7%) (100%) learning process of PBL method that has The results of the analysis of 175 been lived and observed for one semester, respondents, it found that the majority of so that experience and point of view respondents got enough and good learning produce a good perception of PBL outcomes in communication in nursing (Candra, Harini, & Sumirta, 2017). with good perception there were 98 people 2. Bivariate Analysis (70%). The Relationship of Student Perception Discussion to Problem Based Learning with Two 1. Univariate Analysis Learning Outcomes in Nursing Subject a. Describe of Learning Outcomes of The results of the analysis of the Nursing Basic Science and relationship of student perceptions of Communication in Nursing problem based learning with learning The results of the study illustrate the outcomes in nursing basic science using learning outcomes in two nursing subjects, Chi-Square shows p value 0.02 < α (0.05). the data obtained is that the majority of For the results of the analysis of the students get good learning outcomes, relationship between student perceptions amounting to 138 people (78.9%) for of problem based learning in the learning outcomes of nursing basic communication in nursing by using Chi- science and 128 people (73.1%) for Square shows p value 0.009 < α (0.05) learning outcomes in communication in Based on the above, it can be seen nursing . Study showed that 18 people that in both nursing subjects shows Ho is (45.0%) of respondents get good learning rejected and it can be concluded that there outcomes in medical surgical nursing care is a relationship between students' courses on PBL learning methods perceptions of problem based learning and (Musiana, 2013). Based on information, it learning outcomes in nursing basic can be concluded that the learning science and communication in nursing. outcomes obtained in the two major The results of this study are in accordance nursing subjects are good learning with the research showed found that there outcomes. This is because one of the was an effect of the problem based factors that influence learning outcomes is learning model on increasing motivation learning motivation (Daely & Manurung, and learning outcomes in basic human 2013). subjects (Puspita, 2010). b. Describe of Student Perception of Study showed that perception can PBL influence learning outcomes, where The results of the study describing perception is how a person evaluates student perceptions of PBL in two nursing something he receives (Sutrisno & subjects showed that the majority were Siswanto, 2016). This study shows that good perceptions of 146 people (83.4%) the perceptions of students on PBL for learning outcomes of nursing basic majority are good per ceptions and the science and 140 people (80%) for learning outcomes in nursing basic communication in nursing. Study showed science and communication in nursing
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obtained by students are also good. This mempengaruhi hasil belajar siswa shows that the PBL method used in this pada pembelajaran praktik learning is a good method which means kelistrikan otomotif SMK di kota that the learning method has an influence Yogyakarta. Vol. 2, No. 1, Februari or there is a relationship with learning 2016. (111-120): Diperoleh tanggal outcomes (Puspita, 2010). 10 Januari 2018 from Conclusion http://journal.uny.ac.id/index.php/jpv The results of the study illustrate the Habsari, S. (2005). Bimbingan dan learning outcomes in two nursing subjects, konseling SMA. Jakarta: Grasindo the data obtained is that the majority of Musiana. (2013). Problem based learning respondents get good of learning (PBL) dalam upaya meningkatkan outcomes, amounting to 138 people hasil belajar dan pemahaman (78.9%) for learning outcomes in Nursing mahasiswa keperawatan terhadap Basic Science and 128 people (73.1%) asuhan keperawatan medical bedah. Communication in nursing. (Vol. 9, No. 1, hlm. 43-48). ISSN: The results of the study illustrating 1907-0357. student perceptions of PBL in two nursing Daely, K., & Manurung, U. S. A. (2013). subjects, showed that the majority were Analisa statistik faktor-faktor yang good perceptions of 146 people (83.4%) mempengaruhi indeks prestasi for nursing basic science and 140 people mahasiswa (Vol. 1, No. 5, hlm. 483- (80%) for communication in nursing. 494): Saintia Matematika. Statistical test results for the Manggarsari. (2012). Persepsi mahasiswa relationship of student perceptions of PBL keperawatan universitas indonesia with learning outcomes in Nursing Basic program sarjana terhadap penerapan Science obtained p value (0.02) < α collaborative learning dan problem (0.05), and the results of statistical tests to based learning pada kurikulum relate student perceptions of PBL with berbasis kompetensi. Diperoleh learning outcomes in Communication in tanggal 10 Januari 2018 from nursing obtained p value (0.009) < α http://lib.ui.ac.id/file?file=digital/203 (0.05). This can be stated that there is a 13257-S43694- significant relationship between student Persepsi%20mahasiswa.pdf perceptions of PBL and learning outcomes Candra, I. W., Harini, I. G. A., &Sumirta, in Nursing Basic Science and I. N. (2017). Psikologi landasan Communication in nursing. keilmuan praktik keperawatan jiwa. Acknowledgements Yogyakarta: ANDI Thank you infinitely for the help and Puspita, E. (2010). Pengaruh model guidance from various parties in the problem based learning (PBL) completion of this research report. terhadap motivasi dan prestasi References belajar pada mata kuliah kebutuhan Fathurrohman, M. (2016). Model-model dasar manusia. 2(2). 5-7. Diperoleh pembelajaran inovatif. Jogjakarta: tangggal 10 Januari 2018 from Ar- Ruzz Media https://eprints.uns.ac.id/3542/1/Tesis- Amir, M. T. (2010). Inovasi pendidikan Enny_Puspita.pdf melalui problem based learning: bagaimana pendidik memberdayakan pemelajar di era pengetahuan. Jakarta: Kencana
Sutrisno, V. L. P., & Siswanto, B. T. (2016). Faktor-faktor yang
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7. PROFILING DIABETES MELLITUS (DM) PATIENTS: DEMOGRAPHIC CHARACTERISTICS, DISEASE HISTORY AND FOOT GRADE
Desty Aristiyani1, Yesi Hasneli2, Rismadefi Woferst3 1Student of Faculty of Nursing Universitas Riau 2,3Faculty of Nursing Universitas Riau Email: [email protected]
Abstract
Objective: Diabetes mellitus is a chronic desease which is identified by hyperglycemia condition and may increase the risk of microvascular and macrovascular complications due to neuropathy. The purpose of this research was to identify and analytic the grade of diabetic foot ulcer based on Meggitt-Wagner system to among the diabetes mellitus patients who got diabetic foot ulcer. Method: Observational analytic aproach with cross sectional design was employed. The subjects (N=37) were abtained through census sampling, and were observed at RSUD Arifin Achmad hospital dated july 2018. Result: The result showed majority of the respondents with diabetic foot ulcer are female (N=26; 70,3%), at the 56-65 years old bracket (N=17; 45,9%), and with a duration history of DM for less than 5 years (N=15; 40,5%). Conclusions: Majority of respondents in grade 1 with superficial wounds characteristic.
Keyword: Diabetic foot, diabetes mellitus, Meggitt Wagner grade.
Introduction increased to 19,093 in 2017 (Pekanbaru Diabetes mellitus (DM) is a chronic City Health Office, 2018). disease caused by the pancreas not Diabetic foot ulcers are found, but producing enough insulin or the body there is minimal identification in this case, cannot effectively use the insulin so there is no clarity regarding the degree produced. Uncontrolled diabetes can of ulcer experienced by the patient. The cause serious damage to many body accuracy in identifying in obtaining ulcer systems, especially nerves and blood degrees will be very helpful in the vessels (World Health Organization, treatment of ulcers and prevention of ulcer 2017). severity in a higher degree and even The IDF estimates that 212 million amputation. Control of blood glucose people are unaware that they suffer from levels, nutrition and care proper wounds diabetes, 279 million people live in and legs. middle to upper income areas, and 327 Identify and analyze diabetic foot million people with diabetes occur at the ulcer based on the Meggitt-Wagner active age of work. Indonesia ranks fourth system classification. The results of this in the world with the most diabetes study are expected to be used as a source mellitus with the number of DM patients of knowledge in the development of reaching (10,276.8 million people) after knowledge for nurses and patients, China (114,394.8 million people), India especially related to diabetic foot ulcer in (72,946.4 million people) and the United the treatment of wounds and diabetic foot States (30,187.5 million people) (IDF, ulcer feet to prevent further complications 2018). In Pekanbaru the prevalence of Method DM was recorded at 13,981 in 2016 and The research is a Analytical observational research design and total
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sampling research sampling. The research Grade 4 4 10,8 design used was a cross sectional design. Grade 5 1 2,7 This study was conducted on hospitalization in Arifin Achmad hospital. Based on the results of the study, in Arifin Achmad Hospital was choosen as table 1, it was obtained data that the the research location because it is a majority of diabetic foot ulcer respondents referral hospital from the provincial level. were late 17 respondents (45.9%), female The research starts from the proposal was 26 respondents (70.3%), had diabetes submission to the research seminar, which mellitus (DM) for less than five years. is from February 2018 to July 2018. year 15 respondents (40.5%) and most Researchers went through the ethical experienced ulcers in the first degree 15 testing stage before this research can respondents. carried out in RSUD Arifin Achmad Riau 2. Identification and analysis Province. Identification and analysis of the Result degree of diabetic foot ulcer according to 1. Univariate analysis Meggitt-Wagner. Univariate analysis in this study Table 2 describes the frequency distribution and Distribution of Frequency Characteristics percentage of demographic data and of Diabetic Foot Ulcers Based on researched variables from 37 respondents. Meggitt-Wagner Demographic data from respondents taken Derajat Meggitt- N % were age, gender, and duration of Wagner suffering from DM. Grade 0 9 24,3 Table 1 Grade 1 15 40,5 Distribution Characteristics of Grade 2 2 5,4 Respondents Grade 3 6 16,2 Character Number (%) Grade 4 4 10,8 istics Grade 5 1 2,7 Age Grade 0 26-35 1 2,7 - Closed ulcer 2 5,4 36-45 5 13,5 - History of 3 8,1 46-55 14 37,8 ulceration 56-65 17 45,9 - History of 3 8,1 Gender: amputation - Deformity 1 2,7 Male 11 29,7 Grade 1 Female 26 70,3 - Superficial 15 40,5 Long wounds suffering: Grade 2 < 1 year 5 13,5 - Wounds to the 2 5,4 < 5 years 15 40,5 structures in the 5-10 years 14 37,8 skin including > 10 years 3 8,1 tendons, joint Grade of capsules and ulcer bones Grade 0 9 24,3 Grade 3 Grade 1 15 40,5 - Deep tissue 5 13,5 Grade 2 2 5,4 abscess Grade 3 6 16,2
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- Osteomyelitis 1 2,7 increase in blood sugar levels. This can Grade 4 cause women to be more susceptible to - Gangrene on 1 2,7 diabetic foot ulcers (Goodman and Fuller, wet toes is not 2011). infected c. Long suffering from DM - Gangrene on 1 2,7 Diagnosis of DM is late to be known infected wet toes because the number of respondents who - Gangrene in the 1 2,7 are unaware of experiencing DM early dry toes is not because of the lack of knowledge and fear infected of the patient to have early detection to - Gangrene on health services. They only visit health infected dry toes 1 2,7 services after experiencing complications or injuries so that the diagnosis of DM is Grade 5 too late to be known (Smeltzer & Bare, - Gangrene whole 1 2,7 2015). foot 2. Identification and analysis of the degree of diabetic foot ulcer according to the Based on the results of the study in characteristics of Meggitt-Wagner table 3 shows that the degree of diabetic Based on the results of the study, the foot ulcer identified and analyzed based majority of the elderly aged for 17 on the degree of Meggitt-Wagner of the respondents (45.9%), female for 26 37 majority respondents experienced first respondents (70.3%), diabetes mellitus degree diabetic foot ulcer with superficial (DM) less than five years old for 15 limited injuries 15 respondents (40.5%). respondents (40.5%) and degree of injury Discussion with one degree 15 respondents (40.5%). 1. Characteristics of respondents The results of identification and analysis a. Age of the degree of ulcer characteristics Respondents aged 56-65 years old according to Meggitt-Wagner most experience chronic changes in blood respondents experienced superficial in the vessels so that they are susceptible to grade 1 for 15 respondents (40.5%). macrovascular complications dry and The majority of respondents rough skin in the epidermis area which experienced injuries that were superficial. belongs to the superficial region. It means that most of the respondents have Macrovascular complications will cause been controlling blood sugar well, neuropathy in the lower extremities, so the routinely checking and caring for their patient does not feel pain or pressure can wounds, eating nutritious foods that are cause injury. Injuries that occur are good for repairing wounds such as foods susceptible to infection if blood glucose is that contain high protein and applying the not controlled properly because high principle Type, Amount and Hour. the blood glucose levels can make germs wound must be maintained and treated so grow and spread and inhibit the supply of that it does not get worse. nutrients to the blood in the wound area Conclusion for wound healing (Smeltzer & Bare, Based on the results of the study, the 2015). majority of the elderly aged for 17 b. Gender respondents (45.9%), female for 26 Decreased estrogen and respondents (70.3%), diabetes mellitus progesterone and emotional hormones can (DM) less than five years old for (40.5%) cause obesity, thus increasing insulin and degree of injury for grade 1 for 15 resistance which is in line with the respondents (40.5%). The results of
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identification and analysis for the grade of ulcer characteristics according to Meggitt- Wagner most respondents experienced superficial ulcers and were in the grade 1 for 15 respondents (40.5%). Acknowledgement Unlimited thanks for the lecturers and various parties in the completion of this research report. References World Health Organization. (2017). Diabetes diperoleh pada tanggal 15 April 2018 dari ://www.who.int/mediacentre/factsheet s/fs312/en/ International Diabetes Federation.(2017).IDF diabetes complications and foot congress 2018 accesed 15 April 2018 dari https://www.idf.org/our- activities/congress/hyderabad- 2018.html Pekanbaru City Health Office. (2018). Pekabaru: Pekanbaru City Health Office. Goodman, C. C., & Fuller, K. (2011). Pathology For The Physical Therapist Assistant. Elsevier sunder. Smeltzer, S. C., & Bare, B. G. (2015). Buku Ajar Medikal Bedah Brunner & Suddarth. (E. Pakaryaningsih & M. Ester, Eds.) (8th ed.). Jakarta: EGC.
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8. CORRELATES BETWEEN INHALER TYPE AND USAGE ACCURACY AMONG INDONESIAN ASTHMA PATIENTS
Natasya Sri Zekia1, Siti Rahmalia Hairani Damanik2, Wasisto Utomo3 1School of Nursing, University of Riau,Indonesia 2School of Nursing, University of Riau, Indonesia 3School of Nursing, University of Riau, Indonesia Email : [email protected]
Abstract
Objective: Asthma medications are commonly administration through the nasal/nasopharyngeal route, which is typified into aerosol and powder forms. How to deliver drugs to people with asthma most often through inhalation. This type of inhalation is divided into two types, namely inhaled aerosol type and powder type. This study aims to determine the correlates between the types and usage accuracy of inhalers among asthma’s patients. Method: This study utilized descriptive-correlational with cross-sectional design. Purposive sampling was employed to generate 30 respondents. Questionnaires were developed and administered to the study subjects to evaluate the type of inhaler used. An observation sheet was also used to ascertain the accuracy of using inhalers. Data analysis included univariate analysis to analyze the frequency distribution and bivariate analysis to determine relationship between the 2 variables by using Chi-Square test. Results: indicate there is correlation between inhaler type with usage accuracy among indonesian asthma patients with p value (0,026) <ɑ (0,05). Conclusions: This research expects every public health center to perform evaluation on the type of inhalers used and accuracy of the use of inhalers on asthma patients.
Keyword: Accuracy, Asthma, Inhaler
Introduction Asthma sufferers with more than Asthma is a chronic disease that is 50% cannot use the inhaler in the right not contagious and recurrent attacks often way (Purnamasari, 2012). The use of occur (World Health Organization, 2017). improper inhalers can risk causing The Global Initiative for Asthma (2017) oropharyngeal candidiasis (thrush) and states that asthma is a chronic respiratory dysphonia (hoarseness). Errors in the use disease that commonly attacks 1-18% of of inhalation devices cause the dose of the the population in various countries. incoming drug to be inappropriate Deaths due to asthma in 2015 amounted to (National Asthma Council Australia, 383,000 people and in 2017 the number of 2016). Air flow or O2 ventilation in people with asthma reached around 235 asthmatic patients is impaired (Loscalzo, million cases (WHO, 2017). 2016). Disorders of O2 ventilation for The third highest number of asthma long periods of time can increase total morbidity out of the top ten non- lung capacity (Saminan, 2016). communicable disease cases was 3,506 An inhaler that can be used by cases in health centers throughout asthma sufferers aims to relieve and Pekanbaru City in 2015 (Pekanbaru City control recurrence. The most widely used Health Office, 2015). The number of types are metered dose inhalers (MDI) and asthmatics in 2017 increased to 3,681 Dry powder inhalers (PDI). The way to cases. use the inhaler is different so that it
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requires education for the future in its use characteristics of respondents related so that it can improve the respiratory demographics (gender, age, education, conditions of people with asthma and can occupation, and duration of use of be carried out an examination of inhalers). Analysis Bivariate is used to pulmonary capacity. identify the correlate between the two The purpose of this study was to variables using the Chi-Square test. determine the correlation between inhaler Result type and usage accuracy among 1. Univariate Analysis Indonesian asthma patients Based on characteristics of Formulation Of The Problem respondents that mayoritas of respondent Asthma is a chronic disease that can was female (63.3%) and late elderly be prevented and controlled by using an (30.0%), did not work (73.3%) with inhaler to maintain normal lung capacity. mayority of high school education level. Each type of inhaler have many According to the duration of use inhaler techniques to do. The method of using an the mayority of responden used more than inhaler is often inaccurate and not 1 year (83.3%) by used MDI and DPI is maximal due to the improper use of equal (50%) with use inhaler in several types of inhalers used. For this appropriate way is 53.3 %. reason, researchers want to know how the 2. Bivariate Analysis correlation between inhaler type and Tabel 1. usage accuracy among Indonesian asthma Correlation between Inhaler type with patients? Accuracy to use inhaler Method Inhaler Accuracy Total p-value This research used descriptive type Correct Incorre correlation with cross sectional design by ct measuring and observing only once at a N % N % N % time on each subject. This research was MDI 4 13,3 11 36,6 15 1 conducted in five health centers 6 0 0,026 (Puskesmas), namely Rejosari Health 0 Center, Harapan Raya Health Center, DPI 10 33,3 5 16,6 15 1 Senapelan Health Center, Simpang Tiga 3 6 0 Health Center, and Payung Sekaki Health 0 Center. Total 14 100 16 100 30 100 The population of this study were all asthmatics who used an inhaler that met Bivariate analysis result by using the inclusion criteria: asthmatics who use statistical test Chi-Square shows that inhalers at least twice a day in the last 1 many respondents incorrect to use MDI week, asthmatics aged more than 6 years, compare to DPI and there is significant and are willing to become respondents. correlate between Inhaler type with Sampling using non-probability sampling accuracy to use inhaler. From this test or random sampling technique by result, p-value 0,026. purposive sampling. Respondents in this Discussion study amounted to 30 people. Majority of asthma patients is female Data collection tools used in this due to hormonal factor. Estrogen hormon study were questionnaires, observation increase corticosteroid production sheets by used check list method and associated with globulin, while progesterone mobile phones. Data analysis used hormone compete with cortisol hormone to univariate analysis and bivariate analysis. associate with the side of globulin. Estrogen Univariate analysis described hormone and progesterone hormon can
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affect cortisol free level that will cause to Karina, Heru (2016) stated that purpose of total cortisol reduction. Cortisol reduction step 8 about hold breath for 5 seconds can will lead to bronchial constriction and in the create longer contact time so drugs can end it will result into bronchial asthma settle on bronchioles, however if step 8 is attack. Estrogen hormone also can increase performed not in accordance then the adhesion on endothelial cells in blood vessel effect of drugs will be not maximum and and combination between estrogen hormone lead to lower bronchial dilatation. Asthma and progesterone hormone so that it will patients with accuhaler inhaler often increase eosinophil degranulation which in forget step 4 which is breath slowly and further it will lead to bronchial asthma attack stay away from inhaler. Lorensia, Queljoe, (Saily, Adrianison, & Bebasari, 2014). Karina, Heru (2016) stated that purpose of Research conducted by Haryanti, this step is to help in self preparation to Ikawati, Andayani, dan Mustofa (2016) take a deep and strong in order to create stated that lungs and bronchial size on female good inspiration blood glow and able to is smaller than male so it may affect to air inhale drugs dosage maximally. Exhale circulation on respiratory system with normal breath but not close to mouthpiece percentage 67% compared to male. Based accuhaler because it can cause to drugs on age characteristics of respondents shows dosage will fly off or lost and create mostly respondents are from late elder with humidity in accuhaler so dry powder 9 respondents (30,0%), which is including cause to clot and difficult to inhaled. to non productive age and most of them not Conclusions working. However most of respondent The result showed that the majority used inhaler more than one year (83.3%) of respondents characteristic sex but they use incorrect 55,3%. distribution the most are women with total This result is supported by of 19 Anggraini (2011) that found 85,71 % of respondents(63.3%), age distribution of respondents use inhaler in incorrect respondents is the largest number of elderl procedure. This research is similar with y end with 9 respondents (30,0%), most Purnamasari (2012) which stated most of respondents are not working 22 responde asthma patients do not know how to use nts (73.3%) and with level education in inhaler. Inaccuracy in inhaler usage will high senior school 12 respondents (40.0%) cause to inappropriate drugs dosage. It and use inhaler majority more than one also will risk to candidiasis orofaringeal year 25 respondents (83,3%). (sprue) and dysphonia (hoarseness) The distribution of the index (National Asthma Council Australia, by the masses of the body 2016). most respondents are normal category 12 Steps in inhaler usage that is often respondents (40.0%). According to forgotten by asthma patients with MDI analysis of Chi-Square that there is inhaler is in step 3 which is 8 patients can singnificanly between inhaler type and not hold inhaler vertically and do not usage accuracy among Indonesian asthma shake inhaler tube. This result is similar patients (0.026). The result of study with Prakoso (2015) with 8 respondents concluded that expects every public health do not shake inhaler tube first before center to perform evaluation on the type using inhaler. It will cause to decreasing of inhalers used and accuracy of the use of in right amount of dosage. inhalers on asthma patients. Asthma patients with turbuhaler Acknowledgements inhaler often forget step 8 with 2 patients Thank you so much to respondents, hold their breath at least 5 seconds. public health centre employees, advisor, Research done by Lorensia, Queljoe,
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and all respondents who already National Asthma Council Australia.(2016). contribute to this study. Medicines and treatment. Retrieved at References 20 Maret 2018 from Andayani, N., & Waladi, Z. (2014). https://www.nationalasthma.org.au/. Corellate between the level Prakoso, A, J. (2015). of knowledge of asthma patients with Analysis of the precision of how the u asthma control level in the hospital of se of inhalers for asthmapatients in ho DR. Zainoel Abidin Banda Aceh. spitals in Sukoharjo Regency . Jurnal Kedokteran Syiah Kuala Retrieved at 16 Maret 2018 from volume 14 nomor 3, Desember 2014. https://anzdoc.com/queue/analisis- Anggraini,V, B. (2011). ketepatan-cara-penggunaan-inhaler- Evaluation of the use of inhalers for a pada-pasien-asma-.html. sthma patient therapy Purnamasari, R. (2012). success against out Evaluation of how to use inhalers and patient Lung Health Community Grea nebulizer in patients . Retrieved at 15 t Hall Maret 2018 from (BBKPM) of Surakarta. Retrivied at http://eprints.ums.ac.id/24255/13/naska 17 Juni 2018 from h_publikasi.pdf. http://eprints.ums.ac.id/16131/.https:// Saily, S., Adrianison, & Bebasari, E. B. www.ncbi.nlm.nih.gov/pubmed/2327 (2014). 8876. An overview of pulmonary and skorin Ganong, W. f. (2008). g faal Asthma ControlTest (ACT) ast Textbook of Medical Physiology (22 hmatic pulmonary RSUDArifin Ach ed.). Jakarta: EGC. mad Pekanbru. JOM FK volume 1 GINA. (2017). Global initiative for nomor 2, Oktober 2014 . /193732-ID- asthma. Retrieved at 12 Januari 2018 hubungan-antara-tingkat-kontrol- from http://www.wms-GINA-2017- asma-dan.pdf. main-report-tracked-changes-for- Saminan.(2016). achive.pdf. Effect on respiratory tract obstruction Guyton, A. C.(2012). against pulmonary Human Physiology and disease mech flower power. Jurnal kedokteran Syiah anism (3 ed.). Jakarta: EGC. Kuala volume 16 nomor 1, April 2016. Lorensia, A., Queljoe, D. D., Karina, B. Tao, L., & Kendall, K. (2013). L., & Heru, A. (2016). A synopsis of the organ system Pulm Study of the completeness of the desc onology. Jakarta: Karisma Publishing ription how to use thecontroller inhale Group. r dosage (a combination of corticoster WHO. (2017). Chronic respiratory oids diseases. Retrieved at 12 Januari 2018 with beta2 agonis) type of disc and tu from rbuhaler by pharmacistin pharmacy . http://www.who.int/respiratory/asthm Jurnal ilmiah manuntung volume 2 a/e/ nomor 2, 2012. Retrieved at 10 Juli 2018 from https://jurnal.usu.ac.id/index.php/gkre/a rticle/view/8591/4358. Loscalzo,J.(2016).Harrison Pulmonology and critical illness (2 ed.). Jakarta: EGC.
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9. CAREGIVER’S LIVED EXPERIENCES IN CARING FOR POST-STROKE PATIENTS: A PHENOMENOLOGICAL INQUIRY
Indah Putri Irdelia1, Wasisto Utomo2, Rismadefi Woferst3 1School of Nursing, University of Riau 2School of Nursing, University of Riau 3School of Nursing, University of Riau Email: [email protected]
Abstract
Objectives: Cognitive impairment is the problem of stroke sufferers. Cognitive impairment can lead dementia after stroke and effect patient’s life to fulfill activities of daily living, and need help from caregiver. Taking care post-stroke patients will impact to physical, psychological, and social of caregivers. Method: This research was qualitative research with phenomenological approach that aimed to explore the experiences of caregivers treats post stroke patient with cognitive impairment. This research used purposive sampling technique with three participants. Data was collected through semi-structured in-depth- interview. The method of Colaizzi used to analyzed data. Results: The research results obtained 5 themes: (1) caring-overview clients with stroke, (2) contriving-assisting in ADLs, (3) challenging-going beyond expectation to overcome challenges, (4) carving- improving oneself, (5) crafting-overall impact of the caregiver. Conclusions: Treats post stroke patient with cognitive impairment can effect to caregivers. The results of this research were expected to be able to obtain a better understanding to caregivers who have experiences treats patients with cognitive impairment in post stroke.
Keywords: cognitive impairment, experience, caregiver, stroke
Background could happen and will interfere with daily Stroke is a common neurological disease activities (6). Post-stroke patients have a that should be dealt quickly and dependency to fulfill daily needs, so appropriately (1). Stroke is the second requiring assistance from a caregiver or diseases in the world's that causes death(2). family (7). In Indonesia, the prevalence of Caregivers experiences chronic stroke based on the diagnosis of health stress that causes physical and personnel by 7 per mil (3). The prevalence psychological pressure (8). Caregivers also of stroke in Riau diagnosed based on experience social isolation, physical interviews of health workers by 4.2 per disorders, and financial problems (9), so mil (4). taking care of patients with post-stroke In patients with stroke will emerge can affect the caregiver's quality of life all sorts of problems from mild to severe, (10). such as paralysis, speech impairment, The purpose of this study was to emotional disturbance and cognitive explore caregivers experiences in caring impairment (5).Cognitive impairment in for post-stroke patients with cognitive stroke patients is a result of brain damage impairment. to the frontal lobe capacity, memory, or Methods intellectual functioning cortical (1). This study used a qualitative method Cognitive function if it is not with phenomenological approach. anticipated that dementia after stroke Participants in this study were three
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participants are families who taking care experienced by a family that is a change in for post-stroke patients with cognitive attitude, temper, anger,and temper. impairment in the area of Puskesmas 2. Contriving-Assisting in ADLs Harapan Raya in Pekanbaru City. One of the things done by the family Ethics of research used in this study, in caring for patients with post-stroke that informed consent, anonymity, family with cognitive impairment is ADLs confidentially, respect for autonomy, the to fulfill patient’s needs. ADLs of clients principle of watching well-being of with post stroke that participants assisting participants, and the principle of justice such as preparing meals, bathing, for all participants (11)(12). defecation, and medicine. Collecting data in this study using 3. Challenging-Going Beyond semi-structured interviews in the category Expectation to Overcome Challenges of in-deepth interview. The study was Barriers was found by the family conducted two meetings with samsung while caring for patients post-stroke tablet data uses as collecting tool as a patients with cognitive impairment are means of recording interviews, field notes barriers to communication. on observations during the interview 4. Caring-Improving oneself process and interview script. Family member who get sick will In this study, researchers conducted have an impact on the family. The impact a data analysis techniques using Collaizi on the family experienced by the approach. participants are physical impact, Result psychological, and social activities. For Characteristics of participants in this more details, described as follows: study can be seen in Table 1. a. Physical Results of research conducted data In treating post-stroke patients with analysis after getting five themes, namely: cognitive impairment families (1) caring-overview clients with experiencing physical health effects such stroke, (2) contriving-assisting in ADLs, as fatigue, vertigo, pain in the waist, and (3) challenging-going beyond expectation weight changes. to overcome challenges, (4) carving- b. Psychological improving oneself, (5) crafting-overall Impact of psychological changes impact of the caregiver. experienced by the family during the post- 1. Caring-Overview Clients with Stroke stroke care for patients with cognitive The results of the data analysis impairment submitted by participants are using in depth interviews conducted in tired, angry, emotional and upset. participants found that overview clients c. Social with stroke by caregivers that is memory In treating post-stroke patients with and psychological. cognitive impairment will impact on the a. Memory social lives of families who care for Memory is a information that patients is difficult to travel, but the someone get and still remember. second participants did not experience any Overview memory of clients with post impact on social life. stroke by caregivers is clients experiences forgotten. b. Psychological Psychological of post-stroke patients with cognitive impairment changes. Changes experienced by post-stroke patients with cognitive impairment
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Table 1 Characteristic of Participants Relation Type of Category Name Age Education Occupation Ethnic Religion with Duration stroke Patient 55 P1 Ny.M S1 Housewife Bataknese Islam Wife Ischemia 16 years yo 40 P2 Ny.N S1 Teacher Malayu Islam Daughter Ischemia 1 year yo 38 5,5 P3 Ny.R D1 Housewife Malayu Islam Daughter Ischemia yo years lobe capacity, memory, or cortical 5. Crafting-Overall Impact of The intellectual function (1). Caregiver Patients with cognitive impairment Caregivers when caring for patients decreased ability to fulfill the function of with post-stroke with cognitive Activities of Daily Living (ADL) and impairment have a different response. Instrumental Activities of Daily Living Based on the interviews conducted, the (IADL) and patients may need assistance response of participants when treating in the long term (14). Assting patient’s post-stroke patients with cognitive ADLs is very important for the patient, so impairment which are a positive response the patient can still carry out daily and negative response. activities (15). Based on the results of this a. Positive response study showed that one out of three Participants experienced a positive participants require total care, while the response when treating post-stroke two other participants require partial care. patients with cognitive impairment that The basic needs are identified as participants be grateful with the patient's personal hygiene, nutrition, rest, condition and accept the conditions of the mobilization, social, and medication (16). patient. The results of this research indicate that b. Negative response the family assist patients in fulfill the Participants experienced a negative needs of patients such as nutrition by response when treating post stroke preparing food, personal hygiene by patients with cognitive impairment in washing the patient, medication. which participants felt uneasy and give up Disturbances in cognitive function on patient conditon. can lead to a breakdown of Discussion communication on the sufferer, so it can All participants stated that post- be difficult for a person to communicate stroke patients with cognitive impairment (17). It is appropriate with the results found experiences forgetful and changes in in this study in which participants emotion that is characterized by experience obstacles in treating patients emotional, anger, temperamental, that is an obstacle to communicate with sensitive, and low self-esteem. patients. A person with cognitive impairment Barriers in communication with the experience changes in memory, motor patient make it difficult for participants to imbalance, anxiety, depression, understand the desire or things that want irritability, and agitation (13). The change to be delivered by post-stroke patients is due their brain damage to the frontal with cognitive impairment, so as to know the intentions and wishes of the patient, participants were only guessing and trying to ask back to the patient. To
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communicate with the patient's cognitive (RISKESDAS) 2013. 2013; Available impairment can be done by asking again from: what has been listened to, not interfere http://www.depkes.go.id/resources/do with the patient while talking, and use wnload/general/Hasil Riskesdas body language(18). 2013.pdf During taking care of post-stroke Kementrian Kesehatan Republik patients with cognitive impairment impact Indonesia. Pokok-pokok hasil riset on the physical, psychological, and social kesehatan dasar Provinsi Riau 2013. of participants. Families who care for 2013; Available from: patients with cognitive impairment will http://www.pusat2.litbang.depkes.go.i have an effect on physical health, d/pusat2_v1/wp- psychological, social isolation, and content/uploads/2015/02/Pokok- financial distress (9). Pokok-Hasil-Riskesdas-Prov-Riau- Taking care for family members .pdf with cognitive impairment giving positive National Institute of Health. Know stroke and negative response (9). The responses know the signs act in time. 2013; given by the participants depends Available from: mechanism of coping(19). This is according https://stroke.nih.gov/documents/nind to the study where there are positive and s_ks_english_4x9_brochure.pdf negative response to participants when Kementrian Kesehatan Republik treating post-stroke patients with cognitive Indonesia. Pedoman rehabilitasi impairment. kognitif dalam keputusan menteri Conclusion Kesehatan Republik Indonesia Nomor Treats post stroke patient with 253/Menkes/SK/II/2010. 2010; cognitive impairment can effect to Available from: caregivers. The results of this research http://kebijakankesehatanindonesia.ne were expected to be able to obtain a better t/images/perundangan/KMk No. 263 understanding to caregivers who have Th 2010 ttg Rehabilitasi Kognitif.pdf. experiences treats patients with cognitive Sonatha B. Hubungan tingkat impairment in post-stroke. pengetahuan dengan sikap keluarga Acknowledgements dalam pemberian perawatan pasien Thanks to Mr. Wasisto Utomo as pasca stroke. 2012; Available from: main supervisor in this research and Mrs. http://lib.ui.ac.id/file?file=digital/203 Rismadefi Woferst as the second 09163-S43198-Hubungan tingkat.pdf supervisor. Thanks to all of the Schulz R, Sherwood P. Physical and participants in this research. mental health effects of family References caregiving. Am J Nurs [Internet]. Muttaqin A. Buku ajar asuhan 2008;108(9 Supplement):23–7. keperawatan klien dengan gangguan Available from: sistem persarafan. Jakarta: Salemba http://www.ncbi.nlm.nih.gov/pmc/arti Medika; 2008. cles/pmc2791523/ AHA. Heart disease and stroke statistics at Brodaty H, Donkin M. Clinical research. J a glance. 2014; Available from: Invest Dermatol [Internet]. https://www.omicsonline.org/open- 2015;135:S32–42. Available from: access/burden-health-and-quality-of- https://www.ncbi.nlm.nih.gov/pmc/art life-of-nigerian-stroke- icles/PMC3181916/ caregivers.hccr.1000105.pdf. Co A, Ec O, Boa A, Ce M, Fa M, Ia O. Kementrian Kesehatan Republik Health Care : Current Reviews Indonesia. Riset Kesehatan Dasar Burden , Health and Quality of Life
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of Nigerian Stroke Caregivers. 2013;1(1):1–5. Available from: https://www.omicsonline.org/open- access/burden-health-and-quality-of- life-of-nigerian-stroke-
caregivers.hccr.1000105.pdf
Hidayat AA. Riset keperawatan dan teknik penulisan ilmiah. Kedua. Jakarta: Salemba Medika; 2008. Afiyanti Y, Rachmawati I. Metodelogi penelitian kualitatif dalam riset keperawatan. Jakarta: Rajawali Pres; 2014. Ramanathan s, Krishnamoorthy E. Dementia a globbal approach. Edinburg: Cambridege University
Press; Teasell R, Salter K, Faltynek P, Cotoi A, Eskes G. Post stroke cognitive disorders. 2018; Available from: http://ebrsr.com/sites/default/files/v18 -SREBR-CH12-NET.pdf Julianti E. Pengalaman caregiver dalam merawat pasien pasca stroke di rumah pada wilayah. 2013; Available from http://repository.uinjkt.ac.id/dspace/bi tstream/123456789/25548/1/ERYTH RINA%20JULIANTI%20- %20fkik.pdf. Prabasari NA, Juwita L, Maryuti IA. Pengalaman keluarga dalam merawat lansia di rumah(studi fenomenologi). 2017;5(1):56–68. Muhith A, Siyoto S. Aplikasi komunikasi terapeutik nursing dan health. Yogyakarta: CV Andi Offset; 2018. Lyden P. Using the National Institutes of Health Stroke Scale. Vol. 48, Stroke. 2017. 513-519 p. Nugraha KA, Endah R, Patriyani H. Kecerdasan emosional dan coping caregiver pada pasien stroke hemoragik di rsud soediran mangun sumarso wonogiri Kristna Adi Nugraha, Ros Endah Happy Patriyani. :97–104.
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10. NURSES’ UNDERSTANDING OF EVIDENCE BASED PRACTICE: KNOWLEDGE, PRACTICE AND ATTITUDE
Dian Eka Lestari1, Wan Nishfa Dewi2, Sri Utami3 1 Faculty of Nursing, University of Riau 2,3 Faculty of Nursing, University of Riau Email: [email protected]
Abstract
Objective: Evidence based practice (EBP) is an approach to facilitating the transfer of evidence into quality clinical practice. Method: This study is descriptive study. Using total sampling and data were nurses collected from 141 nurses in Medical-Surgical ward. The instrument used in this study was Evidence Based Practice Questionnaire (EBPQ). Result: The result of this study shows that overall nurses’ understanding of EBP is at the moderate level (53.9%). Conclusion: Based on EBP components the result of the study depicts that knowledge of EBP is at high-level comparing to practice and attitude. This study is finding gaining insight into how EBP is understood will inform the need for effective way to introduce and develop EBP in clinical practice for nurses. Therefore, the consequences of failure to understand and articulate EBP will impact on the quality of care.
Keywords: attitude, EBP, knowledge, nurses, practice, understanding of EBP
Introduction implementation of Evidence-Based EBP is a clinical practice approach Practice. The results of this study say that to solving problems with the latest best the evidence-based nurse's knowledge or evidence along with the clinical expertise, EBP is still very low. However, more than choices and values of clients in making half of the nurses who participated in this decisions about client care1.EBP is a study had a positive attitude towards combination of individual experience or evidence-based practice. professional expertise with external Research conducted by Sandofa, evidence in the process of nursing care to Rudini and Fitri5 on 26 nurses at Raden produce an appropriate nursing practices Matteher Jambi Hospital entitled that will affect positive outcomes for "Overview of Perceptions of patients or clients2. Implementing Nurses in the Intensive EBP assists nurses in providing Care Unit (ICU) regarding EBP", found nursing care and solving patient problems. that only 54.4% of nurses evaluated EBP also assists nurses in providing more nursing practice have been done. The innovative health services, exceeds quality study also showed that of the 26 nurses standards, and helps nurses provide who were respondents only 59.1% of consistent services through effective and nurses knew the term EBP, 45.5% of efficient decision-making processes3. nurses could not critically assess a In Indonesia there are several scientific work, and only 59.1% of nurses studies related to EBP, one of which is thought that EBP was important in nursing research conducted in Tanjungpura, West practice. Kalimantan by Ligita4. This study Based on the results of interviews investigated how the nurse's knowledge, conducted by researchers in the attitude, and readiness in the preliminary study on January 31, 2018 di
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3 inpatient rooms with a total of 5 nurses Ners 5 3,5 in Arifin Achmad Regional Hospital were S1 Keperawatan 96 28,4 informed that 2 out of 5 nurses knew and D3 Keperawatan Length of work understood about EBP and could explain 1-5 years 26 18,4 how the EBP was implemented. Of the 3 6-10 years 70 49.6 nurses who did not understand, 2 of them > 10 years 45 31,9 only had heard but did not know what was Total 141 100 meant by EBP, while 1 nurse understood EBP after having explained the meaning The results of this study indicate of the EBP. From interviews conducted in that most of them are at the age of 35-45 3 different inpatient rooms it was also years (early adulthood) as many as 95 found that only 1 inpatient room had people (67.4%), the sex of the majority of implemented EBP in the field in female respondents amounted to 123 accordance with what they got in training people (87.2%), the education level of and seminars, such as in the process of respondents was mostly D3 totaling 96 wound care and blood transfusion process. people (68.1%), and the most work Based on the description above, the duration of resondents is 6-11 years researcher assumes that nurses need to totaling 70 people (49.6%). understand what is meant by EBP so that Table 2 nursing practice can innovate, so that it Frequency of distributions nurses’ will provide effective and effective care. understanding about EBP based on Method knowledge, practice and attitude This research is a descriptive Characteristics of Frequency Percentage research using total sampling technique. nurses’ (F) (%) understanding Respondents in this study amounted to Knowledge 141 nurses who worked in the Medical High 88 62,4 Surgical inpatient room of Arifin Achmad Moderate 51 36,2 Pekanbaru Hospital. The instrument used Low 2 1,4 in this study is EBPQ (Evidence Based Practice High 44 31,2 Practice Questionnaire) developed by 6 Moderate 94 66,7 Upton and Upton . Low 3 2,1 Result Attitude Based on questionnaire, complete High 53 37,6 data can be seen on table 1. Moderate 58 41,1 Low 30 21,3 Table 1 Total 141 100 Frequency of distribution characteristics of age, sex, level of education and length Table 2 showed that respondents of work. had a high knowledge about EBP as much Characteristics of Frequency Percentage Respondents (F) (%) 88 person (62,4%), practice that related Age with EBP was in moderate level that is 94 21-35 years (early person (66,7%), and nurses attitude adult) 95 67,4 related with EBP was 58 person (41,1%). 36-45 years (late 39 27,7 Table 3 adult) 7 5 Frequency of distributions nurses’ >45 years (elderly) Sex understanding about Evidence Based Male 18 12,8 Practice (EBP) Female 123 87,2 Level of education S1 Keperawatan + 40 68,1
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what Evidence Based Practice means in Nurses’ Frequency Percentage order to apply the concept in nursing understanding about (F) (%) practice correctly8. High knowledge EBP regarding EBP will provide unlimited High 63 44,7 Moderate 76 53,9 access to innovative and effective nursing Low 2 1,2 interventions. EBP will improve skills and Total 141 100 improve the quality of patient care9. The results of this study also show In addition to knowledge, nursing nurses' understanding based on practice is also needed in implementing knowledge, practice and attitude. The EBP. Nursing practices carried out based study found that nurses had high on EBP will provide an effective nursing knowledge about EBP as many as 88 process that will improve the quality of people (62.4%), the practice of EBP nursing practice. Nursing practice is the related to the majority was 94 people ability of nurses to search for scientific (66.7%), and the attitude of nurses related sources in the form of the latest literature to EBP mostly had a positive attitude ( and research, critically assess these medium) as many as 58 people (41.1%). sources and their implementation2. Most And most respondents have a moderate of the nurses' understanding of the understanding of 76 people (53.9%). Very practice in this study amounted to 94 few have a low understanding of 2 people people (66.7%). (1.2%). The results of this study are in line Discussion with the research conducted by Sandofa, Based on the results of research Rudini, and Fitri5, in his study 59.1% of conducted on 141 respondents showed 26 respondents had good practices and that the level of knowledge of nurses realized that EBP was important to knowledge about EBP most nurses have practice clinical nursing. Shafiei, high knowledge, amounting to 88 Baratimarnani, Goharinezhad, Kalhor, and (62.4%). The results of this study are in Azmal10 found that nurses had good accordance with the study of Sandofa, nursing practices related to EBP compared Rudini, and Fitri5 on the description of the to attitudes and knowledge related to EBP. perception of nurses implementing in the Implementing EBP will be well Intensive Care Unit (ICU) regarding EBP, implemented if the nurse has a positive in which their research found 59.1% of 26 attitude towards EBP. A positive attitude respondents had good (high) knowledge. can be demonstrated through good support 45.5% of 26 people still have not been for the implementation of EBP so that the able to provide a critical assessment of the implementation of EBP can run literature and the latest research results. effectively. Nurses must actively Research conducted by Gerrish, Asworth, participate in finding ideas or scientific Lacey, and Bailey7 found different results evidence from existing research, and make where the knowledge held by nurses the idea as new knowledge1. The results of related to EBP was still relatively low. this study found that the attitude of nurses Knowledge of the EBP concept and related to EBP was quite positive clinical experience is important because (moderate) related to EBP, amounting to experience and knowledge are factors that 58 people (41.1%). This research is can affect the quality of nursing services consistent with research conducted by and practices. Therefore, adequate Gerrish, Ashworth, Lacey and Bailey7 knowledge is needed regarding EBP in which identifies that nurses have normal implementing EBP in nursing practice. In (moderate) attitudes related to EBP. addition nurses also need to be aware of
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Shafiei, Baratimarnani, Conclusions Goharinezhad, Kalhor, and Azmal10, EBP is nursing practice based on where EBP-related attitudes are research evidence or results from a research. EBP conducted in California by Brown et al11, is a systematic approach with rational found that attitude is the highest item of decision making. EBP will provide the EBP component, which is then unlimited access to innovative and followed by knowledge and practice. effective in nursing interventions. EBP Ligita4 in her study found that more than will improve nurses’ skill and knowledge half of nurses (respondents) had a positive and also improve the quality of patients attitude towards Evidence Based Practice care. (EBP), that is only 2/3 of the number of Results of this study showed that nurses who had attitudes that supported most of nurses had a moderate actions that were in line with EBP. understanding about EBP that is 76 person A positive attitude towards EBP is (53,9%). This is showed that not all of not only determined by the ability to nurses understand with EBP even though identify research results, but also the nurses in this study have a high level of ability to apply EBP to nursing practice. knowledge, but nurses’ practice and By applying EBP, health workers will attitudes related to EBP still to be realize that the results of research carried improved, so that the quality of nursing out are useful to be applied in nursing practice becomes more effectives. practice12. Acknowledgments The results of this study indicate Countless thanks for guidance from that the majority of nurses' understanding various parties in the completing this of EBP is 76 people (53.9%). Knowledge, research. practice and attitude in this study are References components of nurses' understanding of Melnyk B, Fineout-overholt E. Evidence- EBP. Research conducted by Upton and based practice in nursing and health Upton (2006) divides the proportion of care. Philadelphia: Lippincott each factor, namely 33.08% for practice, Wiliams & Wilkins, 2011. 17.07% for attitude, and 11.63% for Kent B, McComark, B. Clinical context knowledge, with a total of 61.77%. This for evidence based practice. West means that practice has the largest Sussex: Wiley Blackwell, 2010. proportion compared to knowledge and Courtney M, McCutcheon H. Using attitude. Research involving nurses in evidence to guide nursing practice. these general hospitals has found that Australia: Churcill Livingstone, 2010. basically they as nurses have high Ligita T. Pengetahuan, sikap dan kesiapan knowledge, but there are still gaps in perawat klinis dalam implementasi practice and attitudes, so that the evidence-based practice. Ners Jurnal understanding of nurses in this study is Keperawatan 2012, Volume 8. D. still in the medium category. This shows Sandofa T A, Rudini D, Fitri A D. that nurses' understanding is not only Gambaran persepsi perawat pelaksana influenced by the high level of knowledge ruang intensive care unit (ICU) they possess, but also influenced by the mengenai evidence based practice. practices and attitudes of nurses towards Jurnal keperawatan UNJA 2016; EBP. Therefore, EBP is a very necessary vol.1 no.1 thing to be given to health workers, Upton D, Upton P. Development of an especially nurses so that EBP can be evidence-based practice questionnaire applied in nursing practice so that it can for nurses. Blackwell Publishing Ltd. improve nursing services. 2006
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Gerrish K, Ashworth P, Lacey A, Bailey J. Developing evidence-based practice: experiences of senior and junior clinical nurs. Journal of Advanced Nursing 2008, 62(1), 62- 73. Scott K, McSherry R. Evidence-based nursing: clarifying the concepts for nurses in practice. Journal of Clinical Nursing 2009, 18 (8), 1085-1095. Potter P A, Perry A G. Fundamental of nursing. Seventh edition. Philippines: Mosby Elsevier, 2009. Shafiei E, Baratimarnani A, Goharinezhad S, Kalhor R, Azmal M. Nurses’ perceptions of evidence based practice: a quantitative study at a teaching hospital in Iran. Medical Journal of The Islamic Republik of Iran (MJIRI) 2014, vol. 28:135. Brown C E, Wicklin, Mary, Ecoff, Laurie, et al. Nursing practice, knowledge, attitudes and perceived barriers to evidence-based practice at an academic medical center.. California Digital Library, 2009. Knops A M, Vermeulen H, Legemate D A, Ubbink D T. Attitudes, awareness and barriers regarding evidence-based surgery among surgeon and surgical nurses. World Journal of Surgery 2009, 33, 1348-1355.
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11. THE EFFECT OF PICTORIAL HEALTH WARNING LABELS ON SMOKING INTENSITY IN ADOLESCENTS
Arvilla Diana1, Febriana Sabrian2, Darwin Karim3 1Student of School of Nursing,Universitas Riau 2,3School of Nursing,Universitas Riau Email: [email protected]
Abstract
Objective: Measures are needed to address adolescents’ smoking behavior.This study aimed to assess the effect of pictorial health warning labels on smoking intensity in adolescents. Method:The design of this research was quasi experiment with non-equivalent control group.The sampling technique used was proportionate stratified random sampling. This study involved 34 smoker students from a junior high school, which was chosen based on recommendation from Department of Education and Culture in Pekanbaru City. An approval letter from school principal was received prior to conducting research. Samples were divided into 17 respondents of intervention group and 17 of control group. Respondents of intervention group were shown pictorial health warning labels for 10 minutes everyday during 2-week intervention. Daily smoking intensity was measured before intervention and after 2-week intervention based on students’ report. Respondents of control group were given the same intervention after post-intervention data was collected. The data was analysed by using univariate and bivariate analysis with a computer software. Results:Before intervention was given, the mean number of cigarette smoke in experimental group was 4,65 cigarettes, and after intervention the number decreased to 3,47 cigarettes. The result showed significant decrease in smoking intensity with p value (0,000 < α (0,05)). Conclusions: Pictorial health warning labels had effect on smoking intensity in adolescents. It is suggested that school authority and school nurse to develop health promotion activitiesby using pictorial health warning labels and other printed media to lessen smoking behavior in adolescents.
Keywords: Adolescents, labels, pictorial warning, smoking intensity.
Introduction adolescents risked 9.9 times smoking Adolescence is a period behavior. characterized by the process of seeking The highest smoking age was at the self-identity and wanting to try new things age of 15-19 years (55.4%). The first that make teenagers trapped in bad smoking age for men at the age of 12-13 behavior (Ali & Ashori, 2012). years and for women at the age of 14-15 Adolescence is also called a period of years (Ministry of Health RI, 2014). The identity crisis. If adolescents cannot percentage of smokers aged 13-15 years in resolve their identity crisis properly, then men (21.4%) and women (1.5%) (WHO, adolescents will feel an inability to obtain 2017). roles and find themselves. This will cause In overcoming the increase in teenagers to behave badly (Soetjiningsih, cigarette consumption, the government 2010). Alamsya and Nopianto (2017) has issued Government Regulation No. stated that negative attitudes of 109 of 2012 concerning safeguarding
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materials containing addictive substances Results in the form of tobacco products for health. The results of research conducted on Then, this Government Regulation was May 26 - June 8 2018 for 34 respondents strengthened by the issuance of the in Pekanbaru 16 Junior High School Minister of Health Regulation No. 28 of obtained the following data: 2013 concerning the inclusion of health A. Univariate Analysis warnings and health information on the 1. Characteristics of Respondents packaging of tobacco products in the form Table 1 of pictures and writing. Distribution of Respondent Health warnings are pictures and Characteristics Characteristics Experiment Control Total p value writings that provide information about Group group Test Homogeneity the dangers of smoking. Health warnings N % N % N % Respondent Age: on cigarettes include pictures of smoking, 13 6 35,3 7 41,2 13 38,25 14 4 23,5 5 29,4 9 26,45 mouth, images of throat cancer, pictures 15 7 41,2 4 23,5 11 32,35 1,000 of people smoking with smoke forming 16 0 0 1 5,9 1 2,95 Gender of skulls, pictures of people smoking with Respondents: Man 17 100 16 94,1 33 97,05 1,000 nearby children, and images of lungs Woman 0 0 1 5,9 1 2,95 Class of blackened from cancer (Ministry of Respondents: 7th grade 8 47,1 8 47,1 16 47,1 1,000 Health, 2013). Research conducted by 8th grade 9 52,9 9 52,9 18 52,9 First Age Once Sychareun, Hansana, Phengsavanh, Smoking Respondents: Chaleunvong, and Tomson (2015) states 10 2 11,8 0 0 2 5,9 11 3 17,6 6 35,3 9 26,45 that pictorial health warnings are more 12 6 35,3 7 41,2 13 38,25 1,000 13 6 35,3 4 23,5 10 29,4 effective than written warnings because Total 17 100 17 100 34 100 pictorial health warnings can strengthen awareness of the effects of smoking and Table 1 shows the distribution of arouse fear of smoking among smokers. respondents according to the highest age Method is 13 years as many as 13 students The design in this study is Quasi (38.25%), followed by the distribution of Experiment with the research design of the most respondents by sex were male as Non-Equivalent Control Group. The many as 33 students (97.05%). In the population in the study were students who distribution of respondents according to smoked VII and VIII classes at SMPN 16 the class the most are class 8 as many as Pekanbaru. 18 students (52.9%). Whereas the The samples were divided into 17 distribution of respondents according to respondents of intervention group and 17 the first age at the most smoking was 12 of control group. Respondents of the years as many as 13 students (38.25%). intervention group were shown as 2. Intensity of Smoking Before and pictorial health warning labels for 10 After Intervention in Experiments and minutes everyday during 2-week Control Groups Not Given Intervention intervention. Daily smoking intervention Table 2 based on students' report. Respondents Smoking Intensity Distribution Before and from the control group were given the After Intervention in Experiments and same intervention after the post- Control Groups Not Given Intervention intervention data was collected. The data Variable N Mean SD Min Max Experiment was analyzed by using univariate and Pre test 17 4,65 1,935 2 9 bivariate analysis with a computer Post test 17 3,47 1,700 1 7 software. Control Pre test 17 5,35 1,656 2 3
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Post test 17 5,65 1,412 3 8 the pre-test in the control group were 5.35 stems and the post-test results were 5.65 Table 2 shows the average intensity stems. Based on the dependent t test in the of smoking in the experimental group control group obtained p value (0.096) > α before intervention was 4.65 stems while (0.05), this result means that there was no the average intensity of smoking in the significant difference between the average control group was 5.35 stems. smoking intensity of pre-test and post-test The average intensity of smoking in the control group. after intervention in the experimental 2. Difference in Intensity of Smoking group was 3.47 stems while the average After Intervention in Experimental intensity of smoking in the control group Groups and Control Groups that Are was 5.65 stems. Not Given Interventions B. Bivariate analysis Table 4 1. Difference in Intensity of Smoking Distribution of Difference in Intensity of Before and After Intervention in Smoking After Intervention in Experimental Groups and Control Experimental Groups and Control Groups Groups that Are Not Provided Interventions Table 3 Variable Mean Mean SD p Distribution of Differences in Smoking Difference value Intensity Before and After Intervention in Experiment Group Experimental Groups and Control Groups Post test 3,47 -2,3 1,700 0,000 Variable Mean Mean SD p Control Difference value Group Experiment Post test 5,65 1,412 Group Pre test 4,65 1,2 1,935 0,000 Post test 3,47 1,700 Table 4 shows that the average Control intensity of post-test smoking in the Group experimental group was 3.47 stems while Pre test 5,35 -0,3 1,656 0,096 the average intensity of smoking at post- Post test 5,65 1,412 test in the control group was 5.65 with a
difference in average difference of -2.3 stems. The independent t test test results Table 3 shows the average intensity obtained p value (0,000) <α (0,05). This of smoking after giving pictorial and shows that pictorial health warning labels written health warnings decreased, where and writings about the dangers of smoking the results of the pre-test in the affect the intensity of smoking in junior experimental group were 4.65 sticks and high school students. the post-test results were 3.47. Based on Discussion the dependent t test test in the A. Characteristics of Respondents experimental group obtained p value 1. Age (0,000) < α (0,05), these results indicate From the results of the study, the that there is a significant difference most respondents were at the age of 13 between the average intensity of smoking years, namely 13 students (38.25%). This before and after the intervention. research is supported by the theory of The table above also shows the Tarwoto et al. (2012) states that age 13 is difference in the average smoking classified as early adolescence (10-14 intensity in the control group that was not years). Early adolescents are characterized given an intervention, where the results of by demanding freedom and tend to behave
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rebelliously. Ali and Ashori (2012) aged 14-15 years. The ASEAN Tobacco mention adolescence is a phase of life Control 2nd edition 2014 the early age of which is characterized by the process of smoking in Indonesia at the age of 10-14 searching for identity. Widiansyah (2014) years. stated that the feeling of wanting to try Soetjiningsih (2010) states that each and curiosity about cigarettes is a reason cigarette contains 6-11 mg of nicotine and that encourages teenagers to smoke. 1-3 mg will be absorbed by the body. If a According to the assumption that smoker smokes a pack of cigarettes per age researchers influence a person's day, the amount of nicotine smoked is behavior. Teenagers who are in the around 20-40 mg per day. developmental stage of seeking self- According to the assumption of identity, freedom, and high curiosity make researchers the first age of smoking teenagers try new things. Teenagers are an affects one's smoking dependence. The age that is easily affected by the earlier a person smokes, the higher the surrounding environment. When teens see level of nicotine in the body that makes someone who smokes, the teenager will dependence so that it is difficult to reduce be affected to try the cigarette. the intensity of smoking and even stop 2. Gender smoking. Research on 34 people who smoked A. Effect of pictorial health warning showed that the majority of respondents labels and writing on cigarette were male as many as 33 students packaging on the intensity of smoking (97.05%). Sulistyawan (2012) states that in junior high school students male students have 10.9 times the chance a. Differences in the intensity of to smoke than women. The percentage of smoking before and after intervention smokers according to WHO (2017) aged in the experimental group and the 13-15 years in men (21.4%) and women control group. (1.5%). The measurement of the smoking According to the assumption, the intensity of the experimental group gender researcher influences a person's obtained the mean results before being habits. Boys assume that smoking is a sign given a pictorial health warning label and of masculinity, showing themselves the writing about the dangers of smoking macho, and brave. In society, boys who in the experimental group was 4.65 sticks smoke are normal, while girls who smoke and the mean result of smoking intensity are uncommon. after being given therapy was 3.47 2. First Age Smoking cigarettes. The result of dependent t test The highest distribution of obtained p value of smoking intensity respondents based on the first age of (0,000) <α (0,05). This means that there is smoking at the age of 12 years is 13 a significant effect between the mean students (38.25%) and the least at the age intensity of smoking in the experimental of 10 years is 2 respondents (5.9%). group before and after giving pictorial Students who are 12 years old generally health warning labels and writing about sit in elementary school (grade 6). Akbar the dangers of smoking. (2016) states that the first age of smoking This research is supported by is 12-15 years (50%). research conducted by Indrawani, Mailani, The Ministry of Health of the and Nilawati (2014) which states that Republic of Indonesia (2014) states that there is a positive relationship between the the age of smoking is the first time for attitude towards the packaging label men aged 12-13 years and for women warning of the dangers of smoking with
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the intention to stop smoking and there is warnings are more effective than written a positive relationship between warnings because pictorial health perceptions of behavioral control and warnings can strengthen awareness of the intention to stop smoking. effects of smoking and arouse fear of b. The difference in the intensity of smoking among smokers. The images on smoking after intervention in the the reading have an influence on reading experimental group and the control comprehension so that the reading in the group who were not given intervention. form of images is easier to remember. The independent t test test results Research conducted by Wue, et al mean that the intensity of smoking after (2015) states that there is an influence intervention in the experimental group and between graphic pictorial health warnings controls that are not intervened shows the with the intention to stop smoking. This value of p value (0,000) <α (0,05), study was reinforced by Blanton, et al meaning that H0 is rejected. It can be (2015) states that there is an influence concluded that pictorial health warning between graphic pictorial health warnings labels and writings about the dangers of on the intention to reduce cigarette smoking are effective against the intensity consumption in young adults and increase of smoking in junior high school students. smoking cessation intentions. The impact This is because respondents regularly of health warnings on cigarette packs follow the research process provided and affects smokers and nonsmokers. Health there is motivation from themselves to warnings on cigarette packaging can reduce the intensity of smoking. encourage users to think about quitting Cigarette labels act as health smoking, preventing dependence, and information to deliver health warnings and raising awareness of the dangers of increase knowledge about the dangers of smoking (GATS, 2015). smoking, reduce the desire of smokers in According to the assumption that general, especially teenagers to smoke, researchers picture health warnings in the and motivate smokers to stop smoking. form of pictures and questions about Health warning labels in the form of diseases caused by smoking will make pictures and writing have a more effective people who see it afraid. This fear will impact than just writing because the label increase one's awareness of health. Fear beruba picture can be understood by also makes someone postpone lighting a people who are illiterate or children who cigarette fire. So that cigarette are 2 groups of populations that are easily consumption can be slowly reduced. affected (Nurfadilah, 2015). Conclusions The Tobacco in Australia report in The results of the measurement of 2012 states that health warnings on smoking intensity in the experimental cigarette packs in the form of images are group with the dependent t test obtained p more likely to be effective than text value (0,000) <α (0,05) while the results warnings, including as a deterrent to new of the measurement of the intensity of smokers and as a means of increasing smoking in the control group with cessation among smokers. A warning in dependent t test obtained p value (0,096)> the form of an image is considered to α (0,05 ) The independent t test test results delay a person to smoke, thereby reducing obtained p value (0,000) <α (0,05). It was the intensity of smoking and stopping as concluded that by providing pictorial an active smoker. health warnings and writing about the Research conducted by Sychareun, dangers of cigarettes for 2 weeks it could et al (2015) states that pictorial health
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reduce the intensity of smoking (Behavior of Indonesian Society) effectively in junior high school students. Based on Risekesdas 2007 and 2013. References Obtained on January 13, 2018 from Akbar, R. (2016). The influence of posters http://www.depkes.go.id/ based on pictorial health warning on Kemenkumham RI. (2012). RI smoking cessation behavior. Government Regulation number 109 Retrieved on July 4, 2018 from of 2012. Journal of Chemical http://repository.umy.ac.id/ Information and Modeling. Retrieved Alamsyah, A., & Nopianto. (2017). 28 December 2017 from Determinants of smoking behavior in http://sipuu.setkab.go.id/ adolescents. Endurance Journal, 2 Nofrianti, N. (2016). The frequency (1), 25-30. Retrieved January 7, 2018 relationship reads health warnings from http://ejournal.kopertis10.or.id/ and health information on cigarette Ali, M., & Asrori, M. (2012). Adolescent packs with the intention to stop psychology development of students. smoking. Nursing Study Program Jakarta: PT Bumi Aksara University of Riau. Retrieved 31 Blanton, H., Snyder, L. B., Strauts, E., & December 2017 from Larson, J. G. (2014). The effect of https://jom.unri.ac.id/index.php/ graphic cigarette warnings on Nurfadilah, S. (2015). The relationship smoking intentions in young adults. between the intensity of seeing the PloS ONE, 9 (5), 1–7. Retrieved health warning label of smoking and January 4, 2018 from the smoking behavior of active http://journals.plos.org/ smokers at UIN Jakarta. Retrieved GATS. (2015). The GATS Atlas: Global July 2, 2018 from tobacco survey. Retrieved 13 http://www.repository.uinjkt.ac.id/ February 2018 from Soetjiningsih. (2010). Adolescent growth http://gatsatlas.org/ and problems. Jakarta: Sagung Seto Indrawani, S., N., Mailani, L., & Nilawati, Sulistyawan, A. (2012). Factors related to N. (2014). Intention to stop smoking: smoking behavior of junior high The role of attitudes towards school students. Obtained on July 4, warnings on cigarette packs and 2018 from perceived behavioral control, 9 (2), http://repository.uinjkt.ac.id/ 65-73. Retrieved on July 22, 2018 Sychareun, V., Hansana, V., from http://jurnal.usu.ac.id/ Phengsavanh, A., Chaleunvong, K., Ministry of Health RI. (2013). Regulation & Tomson, T. (2015). Perceptions of the Minister of Health of the and acceptability pictorial health Republic of Indonesia No. 28 of 2013. warning labels vs. text only. BMC Ministry of Health Ministry of the Public Health, 15 (1), 1–10. Republic of Indonesia, 19 (6), 631– Retrieved January 1, 2018 from 637. Retrieved 28 December 2017 https://bmcpublichealth.biomedcentra from http://www.depkes.go.id/ l.com/ Ministry of Health. (2013). Basic health Tarwoto, et al. (2012). Adolescent health: research. Retrieved 27 December Problems and solutions. Jakarta: 2018 from http://www.depkes.go.id/ Salemba Medika Ministry of Health RI. (2014). World Tobacco in Australia. (2012). What make tobacco-free day. Infodatin Center effective health warning, Facts and for Data and Information of the isues. A comprehensive online Ministry of Health of Indonesia resources. Retrieved July 2, 2018
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from http://www.tobaccoinaustralia.org.au/ WHO. (2017). WHO Report 2017. Retrieved 2 February 2018 http://www.who.int/ Widiansyah, M. (2014). Factors that cause smoker behavior in sidorejo. Retrieved July 4, 2018 dari http://ajournal.sos.fisip-unmul.ac.id/ Wua, D., et al. (2015). The effect of tobacco-related health-warning images on intention to quit smoking among urban chines smokers. Retrivied July 4, 2018 dari http://journals.sagepub.com/
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12. EMERGENCY NURSES KNOWLEDGE ABOUT TRIAGE
Vicky Setiarini1, Wan Nishfa Dewi2, Darwin Karim3 1,2,3Faculty of Nursing, Universitas of Riau Email: [email protected]
Abstract
Objective: One of the positive predictors of efficient case handling in the hospital emergency room (ER) is the nurses’ triage knowledge. This study aims to identify nurses’ emergency knowledge about triage. Method: This study was conducted in ER Arifin Achmad Hospital. Descriptive study was used with total sample of 31 emergency nurses. Triage knowledge was measured using questionnaire developed by the researcher with triage indicators: understanding of triage; the purpose of triage; triage principal and triage documentation and has been tested for its validity and reliability. Descriptive analysis was used to describe nurses’ knowledge of triage. Result: The findings of this study show that in general emergency nurses have better understanding of triage with 51,6%, but there are still 48,6% of nurses who do not understand about triage. Conclusion: This study suggests that nurses knowledge related to triage need to be impromed in order to deliver prompt quality of care.
Keywords: Emergency room, ER, knowledge, nurses, triage, Emergency nurses References: 35 (2008–2017)
Introduction and priority in handling patients The hospital is a health service (Kartikawati, 2013). Triage-related institution that organises individual health research has been carried out by several services in a comprehensive, healing, and previous researchers. Research conducted preventive to the community, where the by Hosnaniah (2014) on the hospital will provide services such as implementation of triage in the emergency inpatient care, outpatient care, and unit of the Ralu Waluyo Hospital in emergency services (DEPKES RI, 2009). Mojokerto stated that the emergency room Emergency services are services that nurses who did triage were still very require prompt and appropriate services to minimal, from seven respondents only prevent death and disability, because time four respondents conducted triage in is life. In handling emergency patients, the accordance with the House Standard ED has a triage system in performing Operating Procedure (SOP) sick. Research emergency actions (Sabrianyanti, Islam, & conducted by Ardiyani, Andri, & Eko Gaus, 2012). In the triage implementation (2015) about the analysis of the role of in the emergency department, Arifin nurses about triage of waiting time and Achmad Hospital, used the Australian length of stay in the emergency Triage Scale (ATS) assessment standard department of dr. Saiful Anwar Malang in accordance with the standards of the stated that, nurses are very influential in accreditation of the Arifin Achmad the implementation of triage towards Hospital in Riau Province, (Profile of waiting time. The suitability of waiting RSUD Arifin Achmad, 2017). time based on standards is seen especially Triage is a process of selecting in nurses who perform roles well. patients according to the level of gravity
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An ER nurse must be able to work Results in the emergency department in dealing A. Univariate Analysis with all emergency cases, therefore, with 1. Characteristics of Respondents emergency training, each emergency Table 1 nurse can seek efficiency and Respondent Frequency Distribution based effectiveness in providing services. on Demographic Data (N = 31) Nurses' knowledge and skills in handling No Characteristics Frequency Persentase patients is one of the success factors in of respondents (%) handling emergency cases (Nurhasim, 1 Age 19 61,3 21-34 years 2014). Knowledge, attitudes, and skills of old (early 12 38,7 ED nurses are needed in clinical decision adult) making so there is no fault in assessing 35-64 years triage so that in handling patients can be (middle adult) more optimal and directed. 2 Gender 13 41,9 Man 18 58,1 The preliminary study was carried Woman out in the Arifin Achmad Hospital, Riau 3 Level of Province by conducting an unstructured education 20 64,5 interview with nine ED nurses, five out of DIII 11 35,5 nine nurses who had understood well S1 about triage, but four out of nine nurses 4 Length of 10 32,3 work 21 67,7 still did not understand the classification ≤5 years of patients according to the level of > 5 years gravity and priority in handling patients. The purpose of this study was to identify Table.1 shows that most of the nurses' knowledge in the emergency room respondents were more than 21-34 years about triage. The results of this study can old (early adults) as many as nineteen be used as an information and input people (61.3%) .The majority of related to nurses' emergency care about respondents were female, amounting to triage as a reference for the development eighteen people (58.1%). The highest of nursing science, especially in level of education of respondents is emergencies. Nursing DIII, amounting to twenty people Method (64.5%). The highest number of years of This study was conducted in ER work for respondents was 5 years Arifin Achmad Hospital. Descriptive (67.7%). study was used with total sample of thirty- 2. Nurse's knowledge of emergency one emergency nurses. Triage knowledge about triage was measured using questionnaire Table 2 developed by the researcher with triage Frequency distribution of nurses' indicators: understanding of triage; the knowledge of emergency about triage (n = purpose of triage; triage principal and 31) triage documentation and has been tested No Characteristics Frequency Persentase for its validity and reliability. Descriptive (%) analysis was used to describe nurses’ 1 Good 16 51,6 2 Not good 15 48,6 knowledge of triage.
Table.2 shows that the level of knowledge of respondents about the knowledge of nurses about the triage is
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mostly good knowledge, amounting to who had knowledge good. In early sixteen people (51.6%). adulthood, health workers who already Table.3 understand triage because of adulthood is Cross tabulation of the characteristics of the time when a person reaches the peak respondents with the level of knowledge of his intellectual abilities (King, 2010). Characteristics Kategori Pengetahuan Total The results of cross tabulation on of respondents Baik Kurang the level of knowledge based on sex, Baik female respondents have a higher level of N % N % % knowledge, namely nine respondents Age 25-34 years 10 32.3 9 29.0 61.3% (29%) than men who only seven old (early respondents (22.6%), but the female adult) respondents also obtained nine 35-64 years 6 19.4 6 19.4 38.7% respondents (29%) have poor knowledge, (middle adult) meaning that female respondents have a Gender balanced amount of good and bad Man 7 22.6 6 19.4 41.9% Woman 9 29.0 9 29.0 58.1% knowledge. This may be due to the higher Level of number of female respondents than male education respondents. These results indicate that DIII 10 32.3 9 29.0 61.3% 6 19.4 6 19.4 38.7% there is no significant difference between S1 the level of knowledge of respondents Length of work 7 22.6 6 19.4 41.9% who are female or male, because between ≤5 years 9 29.0 9 29.0 58.1% the two get information from the same > 5 years source, for example from books, the internet or emergency training that has Table.3 shows that respondents who been followed. were well-informed mostly aged 25-34 Respondent's education also years (early adults) were 32.2%. influenced the level of knowledge, as seen Respondents with good knowledge are from thirteen respondents (35.5%) with S1 mostly female, as many as 29%. The level Ners education having 25.8% of of education of respondents with good respondents who had good knowledge knowledge has similarities between about triage. Respondents who have Nursing DIII and S1 Ners, namely 25.8%. Nursing DIII education are twenty respondents who have good knowledge respondents (64.5%) only 25.8% who based on length of work are mostly found have good knowledge. Ayuningtiyas in respondents who have worked more (2013) states that the higher level of than 5 years, namely 32.4%. education will affect better change, Discussion someone who has a higher level of The results of the study on education will think more objectively and knowledge showed that the level of be open to insight in making decisions. knowledge of nurses in the emergency Someone who has a high education will department about triage was mostly good get better levels of knowledge and knowledge, namely sixteen respondents productivity at work. (51.6%). The majority of respondents in The results of this level of this study were aged 21-34 years, namely knowledge are also related to the nineteen respondents (61.3%). This experience of the respondents, where there affected the results of the respondents' were twenty-one respondents (67.7%) level of knowledge and proved in the who had more than five years working cross tabulation table that there were ten experience in the ED. The results of the respondents (32.3%) of early adulthood cross tabulation of the length of work with
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the level of knowledge prove that ten Conclusion respondents (32.4%) have good Triage is a process of selecting knowledge about triage, but this result patients according to the level of gravity also shows that there are eleven and priority in handling patients. The respondents (35.5%) who have poor knowledge of nurses of the ED is very knowledge about triage. This shows that much needed in clinical decision making not all who have more than five years of so that there is no mistake in assessing experience working with good knowledge triage so that in handling patients it can be about triage, this can be caused by more optimal and directed. The results of someone who has experience is not easy the study showed that the nurses of Arifin to receive new information as well as the Achamd Hospital General Hospital mostly triage used at the place where this had good knowledge about the trainings as research has been applied for the last two many as sixteen respondents (51.6%). The years . Knowledge is obtained because of results showed that there were still the willingness of someone to receive fiveteen respondents (48.4%) who had to information and have motivation in increase their knowledge about triage. accepting new things so that one's Acknowledgements knowledge can increase, but if the 1Vicky Setiarini: Faculty of Nursing individual himself does not have the University of Riau, Indonesia. willingness to receive the information 2Wan Nishfa Dewi: Field of Scientific then it can be ascertained that his Nursing for Surgical Nursing Faculty of knowledge will not increase. Nursing Faculty, University of Riau, Knowledge is a thought that can be Indonesia. obtained from one's experience in 3Darwin Karim: Field of Scientific knowing or understanding something. Lecturer in Surgical Nursing Faculty of Some things that can be factors that Nursing Faculty, University of Riau, influence knowledge according to Indonesia. Budiman and Rianto (2014) include DAFTAR PUSTAKA education, information / mass media, Ardiyani, V. M., Andri, M. T., & Eko, R. social, cultural and economic, Analisis peran perawat triage environmental, experience and age. terhadap waiting time dan length of Education influences the learning process, stay pada ruangan triage di instansi the higher one's education, the easier it is gawat darurat rumah sakit dr Saiful for the person to receive information. Anwar Malang. Jurnal Care 2015, The results of this study also found 3(1), 39–50. https://jurnal.unitri.ac.id that there were still fiveteen respondents Budiman, & Rianto, A. Kapita selekta (48.4%) of the thirty-one respondents who kuesioner pengetahuan dan sikap had poor knowledge about triage, this dalam penelitian kesehatan. Jakarta: meant that they still had to improve their Salemba Medika.2014 knowledge about triage. This may be due Hosnaniah, J. Pelaksanaan triage di unit to the type of triage used, namely the gawat darurat. 2014. Australian Triage Scale (ATS), which was http://repository.poltekkesmajapahit.a only implemented in 2016 at the Arifin c.id Achmad Hospital General Hospital, Riau Kartikawati, D. Dasar-dasar keperawatan Province. Another factor that can cause a gawat darurat. Jakarta: Salemba lack of knowledge is low motivation and Medika.2013. self-awareness to seek information related King, L. A. Psikologi umum. Jakarta: to triage. Salemba Humanika. 2009
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Nurhasim, S. Pengetahuan perawat tentang response time dalam penanganan gawat darurat di ruang triage rsud karanganyar. Jurnal Care. 2014 digilib.stikeskusumahusada.ac.id Nursalam. Konsep penerapan metodologi penelitian ilmu keperawatan. Jakarta: Salemba Medika. 2008 Pamungkas, R. A., & Usman, A. Metodologi riset keperawatan. Jakarta: Trans Info Medika. 2017 Powers, R., & Daily, E. International disaster nursing. New York: World Association. 2010 Profil RSUD Arifin Achmad. (2017). http://rsudarifinachmad.riau.go.id Pusponegoro, A. The silent disaster bencana dan korban massal. Jakarta: Sagung Seto. 2011. Sabri, L., & Hastono, S. P. Statistik kesehatan. Jakarta: Rajawali Pres. 2014. Sabrianyanti, W. O. N. I., Islam, A. A., & Gaus, S. Waktu tanggap penanganan kasus pada response time di ruangan bedah dan non-bedah igd RS dr. Wahidin Sudirohusodo. Tesis Universitas Hasanuddin. 2012 (3), 1– 13. http//pasca.unhas.ac.id Sastroasmoro, S., & Ismael, S. Dasar dasar metodologi penelitian klinis edisi ke-5. Jakarta: Sagung Seto.2014. Setiadi. Konsep dan praktik penulisan riset keperawatan. Yogyakarta: Graha Ilmu. 2013. Siregar, S. Metode penelitian kuantitatif. Jakarta: Fajar Interpratama Mandiri.2015. Siswanto, Susila, & Suyanto. Metodologi penelitian kesehatan dan kedokteran. Yogyakarta: Bursa Ilmu.2016. Surajiyo. Filsafat ilmu dan pengembangannya di Indonesia. Jakarta: Bumi Aksara. 2016 Departemen Kesehatan RI. Undang undang Republik Indonesia No. 44 Tahun 2009 tentang rumah sakit. http://www.depkes.go.id
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13. SELF-CARE PRACTICE OF CONGESTIVE HEART FAILURE PERSONS ARIFIN ACHMAD HOSPITAL
Dwi Rahayu Nengsih1, Wan NishfaDewi2, FathraAnnisNauli3 1Student of Faculty Nursing University Riau 2Lecturer Faculty of Nursing University of Riau 3Lecturer Faculty of Nursing University of Riau Email: [email protected]
Abstract
Objective: This study aim to determine self-care for congestive heart failure. Method: The research sample was 44 patients with congestive heart failure in who were taken based using accidental sampling technique in Arifin Achmad Hospital. The measuring instrument used is the Self-care of Heart Failure Index (SCHFI) that had been tested for validity and reliability. The analysis used is descriptive analysis.Result: Findings of the study show that all of self-care dimensions are valued at good with 56,8% constitutes forself- caremaintenance; 56,9% for self-care management, and 68,2% for self-care confidence.Conclusion:It is essential to establish self-care in patient with heart failure to improve self-care behavior. Nurses play an important role in this improvement.
Keywords: Congestive heart failure, developing country, Nursing, Self-care
Introduction 2017 was 82 people and experienced an Congestive heart failure is a increase in 2018 with 437 people (Medical condition where the heart is unable to Record Arifin Achmad Hospital Riau pump enough blood to meet the needs of Province, 2018). the body's tissues caused by disruption of Congestive heart failure is a disease systolic or diastolic function, heart rhythm that requires repeated treatment and disturbances and incompatibility of treatment in the hospital (Karson, preload and afterload that can cause death 2016).Self care is important for patients (Mariyono & Santoso, 2008). with chronic diseases such as in patients The World Health Organization with congestive heart failure. Experience (WHO, 2014) states that in the world there can improve patient knowledge related to are 20 million people a year die from signs and symptoms of disease, this will cardiovascular disease problems. The affect the ability of self care (Jang, 2009). prevalence of congestive heart failure in The ability of self care obtained through the United States in 2015 was 6.6 million the experience of patients with chronic and is expected to increase by 5.3 million diseases will have an impact on lifestyle by 2030 (American Heart Association changes and can directly affect the quality (AHA, 2015). The Ministry of Health of of life of these patients (Smeltzer & Bare, the Republic of Indonesia (2013) shows 2010).Self care is a naturalistic decision- that congestive heart failure is a disease making process for maintaining behavior the cause of death in Indonesia is around to maintain physical balance and response 9.7% of all heart disease. Based on the to symptoms experienced (Riegel, Lee, Medical Record of Arifin Achmad Dickson, & Carlson, 2010). Self care from Hospital in Riau Province (2018), congestive heart failure is used to define mentioning that the total number of self-care for congestive heart failure. This patients suffering from heart failure in model includes 3 conceptual namely: self
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care maintenance, self management, self means ( 16) and is said to be less good if care confidence as the main concept. Self the value obtained is 66 Oral Presentation Riau International Nursing Conference 2018 RINC2018 married Total 44 100 widower/wid ow Table 2 shows that of the 44 6. Degree of respondents surveyed, it was found that disease 21 47,7 respondents who had self care class II 20 45,5 maintenance in the good category were 25 class III 3 6,8 people (56.8%). class IV Table 3 7. Last Ditributationself care managementon treated patients with congestive heart failure with congestiv No Self care Frequency Persentase(%) e heart 20 45,5 management failure 1 Good 29 65.9 Last three 24 54,5 2 Not good 15 34.1 months Total 44 100 >Last three Table 3 shows that of the 44 people months studied, the majority had self care management in the good category as many as 29 people (65.9%). Table 4 Based on the results of the research Ditributationself care confidance on in Table 1, showing that of the 44 patients with congestive heart failure respondents studied, the majority of respondents were at the age of 46-55 years No Self careconfidance Frequency Persentase as many as 18 people (40.9%), the (%) majority of the sexes of respondents were 1 Good 30 68.2 men totaling 23 people (52.3% ), most of the respondent's last education level was 2 Not good 14 31.8 15 people (34.1%), the majority of jobs Total 44 100 owned by respondents were 20 people (45.5%), most of the marital status of Table 4 shows that of the 44 married respondents was 37 people (84, respondents surveyed, most of them had 1%), the majority of the degree of illness self care confidences in the good category of respondents is class II as many as 21 as many as 30 people (68.2%). people (47.7%), most of the respondents Discussion who were last treated with congestive In this study, the majority of heart failure over the past three months respondentswere at the age of 46-55 years were 24 people (54.5%). as many as 18 people (40.9%)Age is an Table 2 important factor in self care. Increasing Ditributationself care maintenanceon age is often associated with a variety of patients with congestive heart failure limitations or damage to sensory function that can cause a decrease in the activity of No Self care Frequency Persentase self care in patients with congestive heart failure, in addition congestive heart failure maintenance (%) can increase with age. This is because the 1 Good 25 56.8 pathophysiological process that occurs in 2 Not Baik 19 43.2 67 Oral Presentation Riau International Nursing Conference 2018 RINC2018 patients with congestive heart failure in respondents' education levels were at the the elderly, where there is continuous high school level amounting to 34.1%, stimulation of the sympathetic nervous most of the respondents' jobs were 45.5% system which will increase plasma levels self-employed, the marital status of the of norepinephrine, the pathophysiological most respondents was married as much as changes have an impact on patients' self 84.1%, most of the respondents' illnesses care abilities (Gallagher, Luttik, & were class II totaling 47, 7%, and the Jaarsman). And The results of the research majority of respondents who were last that have been conducted show that of the treated with congestive heart failure over 44 respondents the majority of the the past three months were 24 people education level of the respondents is high (54.5%). Based on the results of research school education as many as 15 people conducted from the three dimensions of (34.1%).that a high level of education has self care, most of them are included in the a relationship with self-care ability to good category. The form of self care medication adherence. The level of maintenance that belongs to congestive education greatly determines the patient's heart failure patients in the good category ability to understand about his health (56.8%), Self management in the good condition, while individuals who possess a category (65.9%) and self care confidance low level of education will find it difficult in the good category (68.2%)(masukkan to recognize health problems. This shows saran) that the level of education influences a Acknowledgment person's adherence to the management of Researchers express the highest the treatment he is undergoing. gratitude for the guidance and assistance Based on research from the three from various parties in the completion of self dimensions, it was found that this research. respondents who had self care 1Dwi Rahayu Nengsih:Student of maintenance in the good category were 25 Nursing Faculty University of Riau, people (56.8%), based on research from Indonesia the three self dimensions, it was found 2Wan Nishfa Dewi, SKp., MNg, that respondents who had self care PhDLecturerof Medical Surgical of maintenance in the good category were 29 Nursing University of Riau, Indonesia people (65.9%), based on research from 33Ns. Fathra Annis Nauli, M.Kep., the three self dimensions, it was found Sp.Kep. J:Lecturerof Psychiatric Nursing that respondents who had self care Department Faculty of Nursing University maintenance in the good category were 29 of Riau, Indonesia people (65.9%), and based on research from the three self dimensions, it was References found that respondents who had self care American Heart Association. (2015). maintenance in the good category were 30 Hearth disease and stroke statistik. people (68,2%).so in this study the Diperoleh tanggal 08 Juni 2014 dari majority of respondents had good self care http://ahajournal.org.com Conclusion Gallagher, R., Luttik, M. L., & Jaarsman, After conducting research on T. (2011). Social support and self care "identification of self care in patients with in heart failure. Journal of congestive heart failure" it can be Cardiovascular Nursing, 26(6), 439- concluded that most of the respondents' 445. ages were at age (46-55 years) as much as Jang, Y. (2009). Dissertation: 40.9%, most of the respondents were male Comparasion of self care behaviours as many as 52.3%, the majority of the and perceived social support between 68 Oral Presentation Riau International Nursing Conference 2018 RINC2018 Korean American and caucasian American with heart failure. Washington D. C.University of America. Karson. (2016). Buku Ajar Anatomi Fisiologi Kardiovaskuler. Yogyakarta: Nuha Medika. .Kementerian Kesehatan RI. (2013). Riset kesehatan dasar. Jakarta: badan penelitian dan pengembangan kesehatan Mariyono, H., & Santoso, A. (2008). Gagal jantung. Journal Penyakit Dalam, 8(3), 85–94. Lee, C. S., Tkacs, N. C., & Riegel, B. (2009). The influence of heart failure self-care on health outcomes. The Journal of Cardiovascular Nursing, 24(3), 179–187. McGreal, M. H., Hogan, M. J., Irwin- Walsh, C., Maggio, N. J., & Jurgens, C. Y. (2014). Heart failure self-care . interventions to reduce clinical events and symptom burden. Research Reports in Clinical Cardiology, 5, 243–258. https://doi.org/http://dx.doi.org/10.21 47/RRCC.S48424 Riegel, B., dkk. (2004). Psychometric testing of the self-care of heart failure index. Journal of Cardiac Failure, 10(4). Riegel, B., Lee, C.S., Dickson, V.V., & Carlson, B. (2010). An update on the self-care of heart failure index (Vol. 24, pp. 485–497). https://doi.org/10.1097/JCN.0b013e3 181b4baa0.An. Smeltzer, S. C., & Bare, B. G. (2010). Buku ajar keperawatan medikal bedah. Jakarta: EGC. WHO. (2014). World health statistics 2012 (Vol. 27). https://doi.org/10.2307/334816. 69 Oral Presentation Riau International Nursing Conference 2018 RINC2018 14. THE LEVEL OF KNOWLEDGE AND ATTITUDE ABOUTH HEALTH SNACKS WITH BEHAVIOR IN CHOOSING FOOT AT 4th AND 5th GRADES IN PUBLIC ELEMENTARY SCHOOL 121 PEKANBARU Estri Mailinda1, Raja Fitrina Lestari2 1School of Nursing, University of STIKes Hang Tuah Pekanbaru 2School of Nursing, University of STIKes Hang Tuah Pekanbaru E-mail: [email protected]. Abstract Objective: Snacks of school children have an important role in fulfill the adequacy of energy and nutrients for the growth and development of children. The objective of this research is to know the relationship between knowledge and attitude about healthy snacks with behavior of choosing at the 4th grade and 5th grade students in public elementary school 121 Pekanbaru. Method: This research used descriptive correlational method with cross sectional approach where study independent and dependent variable are simultaneously. The Data were collected from 74 samples by distributing questionnaires using simple random sampling technique with the variables were studied knowledge about healthy snacks and attitude about healthy snacks and choosing snack behavior. Result: Most of students have good knowledge (68,9%) and have a negative attitude (55,4%) about healthy snacks and have good behavior (67,6%) in choosing snacks. Conclusions: The conclusion in this research was found that there was no correlation between knowledge about healthy snacks with the behavior of choosing snacks (p value = 1,000) and there was no relationship of attitude about healthy snacks with choosing snack behavior (p value = 0,369). It is suggested to the school, although the result of this research was no correlation, the school always need to control of all types of snacks that is sold in the school. Keywords : Knowledge, Attitude, Behavior, Healthy Snacks, Children of School Introduction due to unhygienic storage and Food is a source of energy and presentation processes (Febryanto, 2016). various nutrients to support human life. One aspect that plays an important But food can also be a vehicle for role in providing energy and nutrition as disturbing human health even can cause well as maintaining learning resistance for death. Healthy food must have nutritional children while in school is snacks. For 6-8 value and be safe for consumed. hours per day the time the child spends at According to the Minister of Health school and 90% of school children buy Regulation no. 033 of 2012, people need snacks at school. Snack food has good to be protected from the dangers of using taste on the tongue, easy to get, attractive food additives that do not meet health appearance and affordable price so many requirements. Food protection in case is children like to buy snacks. However, this an effort needed to prevent the possibility is inversely proportional to the quality of of contaminated food from biological, snacks, both in terms of the safety of the chemical and other contaminants that can composition and the cleanliness that can cause harm and endanger human health. endanger the health of children. The Lack of attention to this matter, has often results of the initial survey in Pekanbaru resulted in the impact of a decline in the 121 State Elementary School, researchers health of consumers, such as poisoning found a variety of snacks sold by vendors 70 Oral Presentation Riau International Nursing Conference 2018 RINC2018 or food vendors of street outside the fence. allowance amounts to 40 respondents The results of observations conducted by (54.1%). researchers that many school-age children 2. Research Variables who snack on food vendors outside the Tabel 2.1: Frequency distribution fence, especially during breaks and when based on knowledge about healthy snacks they go home from school. Although there for 4th grade students and 5th grade of is already a healthy canteen at the school Elementary School 121 city Pekanbaru and a ban by the school for snacks outside No. Knowledge F (%) the school fence, there are still many 1 Less 23 31,1 students who remain snacks outside of 2 Good 51 68,9 school. Total 74 100 Based on the background above, the researcher was interested in conducting a Based on table 2.1 above it can be research entitled "The Correlation concluded that the majority of respondents between Knowledge & Attitudes about have good knowledge about healthy Healthy Snacks with Behavior in snacks as many as 51 respondents th th Choosing Food at 4 and 5 Grades in (68.9%). Public Elementary School 121 Tabel 2.2: Frequency distribution based Pekanbaru". on attitudes about healthy snacks at 4th Results and 5th Grades in Public Elementary Univariate Analysis School 121 Pekanbaru 1. Characteristics of Respondents No. Attitude F (%) Table 1.1: Frequency distribution based th th 1 Negative 41 55,4 on gender of students at 4 and 5 Grades 2 Positive 33 44,6 in Public Elementary School 121 Total 74 100 Pekanbaru No. Gender F (%) Based on table 2.2 above it can be 1 Male 40 54,1 concluded that the majority of respondents 2 Female 34 45,9 have a negative attitude about healthy Total 74 100 snacks as many as 41 respondents (55.4%). Based on table 1.1 above showed Tabel 2.3: Frequency distribution based that the majority of respondents are male on behavior about healthy snacks at 4th as many as 40 students (54.1%). and 5th Grades in Public Elementary School 121 Pekanbaru Tabel 1.2: Frequency distribution based No. Behavior F (%) th th on pocket money of students at 4 and 5 1 Less 24 32,4 grades in Public Elementary School 121 2 Good 50 67,6 No. Pocket Money F (%) Total 74 100 1 Low (< Rp 6.000) 34 45,9 2 High (≥ Rp 6.000) 40 54,1 Based on table 2.3 above, it can be Total 74 100 concluded that the majority of respondents have good behavior in choosing snacks, as Pekanbaru many as 50 respondents (67.6% Based on table 1.2 above shows the majority of students' high school 71 Oral Presentation Riau International Nursing Conference 2018 RINC2018 Bivariate Analysis 1. Correlation between Knowledge about Healthy Snacks with Behavior in Choosing Food Behavior in Choosing Food Total Knowledge Less Good p Value n % n % N % Less 7 30,4 16 69,6 23 10 0 Good 17 33,3 34 66,7 51 10 1,000 0 Total 24 50 74 The results of chi square statistical tests obtained p value of 1,000. The results of this study have a value of α> 0.05 so that Ho was accepted, it is concluded that there was no correlation between knowledge about healthy snacks and behavior in choosing food. 2. Correlation between Attitudes about Healthy Snacks with Behavior in Choosing Food Behavior in Choosing Food Total Attitude Less Good p Value N % n % N % Negative 11 26,8 30 73,2 41 10 0 Positive 13 39,4 20 60,6 33 10 0,369 0 Total 24 50 74 The results of this study have a value of α> 0.05 so that Ho was accepted, it is concluded that there was no relationship between attitudes about healthy snacks and behavior in choosing food. Discussion provision of pocket money gives influence Univariate Analysis to the child to be responsible and learn to 1. Characteristics of Respondents manage the pocket money he has. Reasons In this study it was found that the that cause children to consume snacks most respondents were 40 respondents of more and more often are increasing the male (54.1%) because in each at 4th grade provision of snacks (Widyoningsih, and 5th grade male students were more. Subakti, & Ahmad, 2016). According to Utami and Waladan's (2017) 2. Knowledge of Healthy Snacks research, boys are more active in physical The majority of respondents are well activities and sports, activities that cause informed about healthy snacks. This can boys to need a lot of energy. This energy be caused by the knowledge of snacks that is obtained by children from snacks have been delivered by the teacher in the purchased at school (Utami & Waladan, elementary school. Children's knowledge 2017). can be obtained both internally and Characteristics of respondents based externally. Internal knowledge is on pocket money are known that most of knowledge that comes from itself based the students are more than Rp. 6,000 as on the child's life experience. Externally many as 40 students (54.1%). The knowledge is knowledge gained from 72 Oral Presentation Riau International Nursing Conference 2018 RINC2018 other people including family, parents, food, and washing their hands before and teachers. Knowledge gained both eating, while as a result of consuming internally and externally will increase unhealthy snacks, consuming food that is children's knowledge about healthy snacks not safe, does not have sufficient (Purtiantini, 2010). nutritional value, consuming snacks 3. Attitudes Regarding Healthy containing preservatives, flavorings Snacks excess and artificial sweeteners are not too The majority of respondents have a emphasized, children only think that the negative attitude about healthy snacks. snacks they eat can eliminate hunger so This is because children are affected by that in choosing snacks the child does not friends who have a positive attitude pay attention to the nutritional value found towards snacks. A person's attitude will in the snack (Safriana, 2012). affect his knowledge. Attitudes can School-age children have a high describe the reflection of a person's curiosity, especially in snacks, of course feelings in the form of positive and with curious, they always want to try negative values on a particular object, snacks sold in the school environment where the attitude affects the actions of a without regarded to the nutritional content person to achieve his goals (Wawan & and the dangers of current snacks Dewi, 201). (Syaodih, 2015). 4. Behavioral in Choosing Food 6. Correlation between Attitudes The majority of respondents have about Healthy Snacks with good behavior in choosing food. This can Behavior in Choosing Food be caused because the child's behavior is Based on the results of the research, not spared from the attitude and it was shown that there was no correlation knowledge he has. Food habits are part of between attitudes about healthy snacks the behavior in the form of real actions and snacking behavior. Child behavior that become a pattern of behavior that does not escape his attitude and tends to be difficult to change. School-age knowledge. The results of research children have the habit of buying food conducted show that the attitude of more they like. Children have a changing nature negative children behaves well. This is of food so that often children choose the because children who have a negative wrong snacks especially if not guided by attitude are influenced by the their parents (Utami & Waladan, 2017). environment, especially their peers. His 5. Correlation between Knowledge attitude is positive in choosing snacks and about Healthy Snacks with arises the desire to taste the food eaten by Behavior in Choosing Food his friend. The behavior that arises is Based on the results of the research imitating a friend even though it is not in conducted showed there was no accordance with the attitude he has. This correlation between knowledge about is in accordance with the characteristics of healthy snacks and behavior in choosing primary school children who like to food. Good knowledge does not imitate people around them including necessarily guarantee that the child parents, teachers and peers. behaves well. Many things affect children Conclusion in behaving. This is due to the child's The level of children's knowledge knowledge factor. In general, the about healthy snacks, the majority of knowledge gained by children is limited to children have good knowledge that is the basic knowledge of the school. equal to 68.9%. The child's attitude about Children only get knowledge about the healthy snacks, the majority of children function of food, nutritional elements of have a negative attitude that is equal to 73 Oral Presentation Riau International Nursing Conference 2018 RINC2018 55.4%. As for the behavior of children in Kabupaten Aceh Besar, FKM UI, choosing food, the majority of children Depok. have good behavior which is 67.6%. The Syaodih, E. (2015). Psikologi results of the chi square statistical test perkembangan. Bandung. showed that there was no correlation Wawan, A., & Dewi, M. (2011). Teori & between knowledge about healthy snacks pengukuran pengetahuan sikap dan and behavior in choosing food, with the perilaku manusia. Yogyakarta: Nuha acquisition of 1,000 p values. Medika. Furthermore, the results of the chi square statistical test showed that there was no relationship between attitudes about healthy snacks and behavior in choosing food with the acquisition of p value 0.369. Acknowledgements The researcher expressed their gratitude to Public Elementary School 121 Pekanbaru who gave permission to the researcher to conduct research and thank you for students at 4th and 5th Grades in Public Elementary School 121 Pekanbaru who had been willing to become respondents in this study. References Febryanto, M. A. B. (2016). Hubungan antara pengetahuan dan sikap dengan perilaku konsumsi jajanan sehat di MI Sulaimaniyah Mojoagung Jombang. Jurnal Keperawatan Muhammadiyah 1(1), 7-17. Purtiantini. (2010). Hubungan pengetahuan dan sikap mengenai pemilihan makanan jajanan dengan perilaku anak memilih makanan di SDIT Muhammadiyah Al Kautsar Gumpang Kartasura, Universitas Muhammadiyah Surakarta. Utami, W., & Waladani, B. (2017). Gambaran perilaku makanan jajanan siswa di SDN Kalibeji 2 Sempor Jurnal Keperawatan, 315-322. Widyoningsih., Subakti, E., & Kesnaeni, A. (2016). Hubungan besaran uang saku dengan pemilihan jajanan sehat. Jurnal Kesehatan Al-Irsyad (JKA), IX(2), 31-36. Safriana. (2012). Perilaku memilih jajanan pada siswa Sekolah Dasar di SDN Garot Kecamatan Darul Imarah 74 Oral Presentation Riau International Nursing Conference 2018 RINC2018 15. THE ASSOCIATION BETWEEN PEER CONFORMITY WITH DEVIANT BEHAVIOR IN ADOLESCENTS Gilang Sri Mentari1, Jumaini2, Arneli Wati3 1, 2,3 Faculty of Nursing Universitas Riau Email: [email protected] Abstract Objective: Adolescence is a very critical period in human development stage, where multi dimension change happens such as biologic, cognitive, psychological and social change. Many changes in this period make adolescent find more problems that could be a kind of deviant behavior. Method: The design of this research was descriptive correlation using cross sectional approach. The sample of this research was 201 students of SMP N 15 Pekanbaru using stratified random sampling technique. The instrument used was a questionnaire that has been tested for validity and reliability. Result: The result of chi- square test showed p value (0,000 and 0,041) < α (0,05) for light deviant behavior and medium deviant behavior. It can be conclude there were significant relationships between peer conformity with deviant behavior. Conclusions: This research statically showed there is a significant impact of peer conformity in adolescent. School has to warn and give educated punishment to student and also strengthen Counseling teacher participation, so it will decrease the risk of deviant behavior in adolescent. Keywords: Adolescent, deviant behavior, peer conformity Introduction Deviant behavior in adolescents Adolescence is a very critical period includes fighting, skipping school, lying, in human development stage, where multi wandering, reading or seeing books and dimension change happens such as films that contain pornographic elements, biologic, cognitive, psychological and riding a motorbike without a license, social change (Choudhary, 2014). speeding on the road, picking up parental According to WHO (2014) the number of goods without permission, stealing, adolescents in the world is estimated at damaging school or public facilities, using 1.2 billion or 18% of the world drugs, drinking alcoholic beverages, population. The large number of having sex out of marriage, doing adolescents and the many changes in abortion, raping, and gambling (Mubarak, adolescence cause crises and problems 2009). that lead to deviant behavior in Deviant behavior in adolescents is adolescents. influenced by various factors, one of them Deviant behavior in adolescents is is peer conformity (Saputro & Soeharto, also called juvenile delinquency. Deviant 2012; Rebellow, 2015; Nkhata & Mwale, behavior is a social problem that occurs 2016). Peer conformity factors can because there are behavioral deviations influence deviant behavior in adolescents and various social rules or from social which can shape the behavior of values and norms that apply and are adolescents to be naughty because expressed by one or more members of the teenagers get strong pressures from peers community, both consciously and so that adolescents are conformed to the unconsciously (Kartono, 2010). 75 Oral Presentation Riau International Nursing Conference 2018 RINC2018 social behavior that exists in the group Peer Number Percentage (Santrock, 2003). No. Conformity (n) (%) According to Saputro and Suharto 1. High 102 50,7 2. Low 99 49,3 (2012), data were obtained that peer Total 201 100 conformity had a relationship with delinquency tendencies in adolescents. The purpose of this study was to Table 1 shows that the respondents determine the relationship of peer who have high peer conformity were 102 conformity with deviant behavior of people (50.7%). adolescents. Table 2 The results of this study are Frequency Distribution of Respondents expected to add insight and knowledge based on Light Deviant Behavior (N=201) especially on peer conformity, and No. Light Number Percentage Deviant (n) (%) adolescent deviant behavior. Behavior Method 1 Do 128 63,7 This research was took place in 2 Not do 73 36,3 SMP N 15 Pekanbaru that starting from Total 201 100 February to July 2018. This study used a descriptive correlation design with cross Table 2 shows that the highest sectional approach. respondents who do light deviant behavior The population in this study were were 128 people (63,7%). students of class VII and VIII SMP N 15 Table 3 Pekanbaru, the populations is 406 Frequency Distribution of Respondents students. The sample in this study was 201 based on Medium Deviant Behavior students based on inclusion criteria. (N=201) Samples were taken by stratified random No. Medium Number Percentage sampling. Deviant (n) (%) The data were collected using the Behavior 1 Do 103 51,2 adopted, valid and reliable peer 2 Do not 98 48,8 conformity and deviant behavior Total 201 100 questionnaires. Data were analyzed using univariate and bivariate analysis. Table 3 shows that the highest Univariate analysis describes the respondents who do medium deviant characteristics of respondents related to behavior were 103 people (51,2%). gender, age, education level of parents, Table 4 work of parents, parents' income, and Frequency Distribution of Respondents number of family members. Bivariate based on Heavy Deviant Behavior analysis is used to determine whether (N=201) there is a significant relationship between No. Light Number Percentage the independent and dependent variables Deviant (n) (%) using the chi-square test Behavior Results 1 Do 113 56,2 2 Not do 88 43,8 3. Univariate Analysis Total 201 100 Table 1 Frequency Distribution of Respondents Table 4 shows that the highest Based on Peer Conformity (N=201) respondents who do heavy deviant behavior were 113 people (56,2%). 76 Oral Presentation Riau International Nursing Conference 2018 RINC2018 4. Bivariate Analysis conformed to social behavior in the group Table 5 (Santrock, 2003). Relationship Between Peer Conformity The results of research conducted by and Deviant Behavior in Adolescents (N = Nkhata and Mwale (2016) state that peer 201) pressure is one of the factors that contribute to deviant behavior in Aggressive Social behavior P- adolescents. Many teens engage in deviant Value No. Support High Low behavior because teens see their friends Family doing the same thing. This result is in line N N n Light with research conducted by Rebellows 1. a. Do 78 50 128 0,000 (2015) that adolescents adapt their friends' b. Not do 24 49 73 behavior so that it can be accepted in Medium groups even though it can cause harm to 2. a. Do 60 43 103 0,041 themselves and others. b. Not do 42 56 98 b. Characteristics of Deviant Behavior Heavy 3. a. Do 64 49 113 0,080 in Adolescents b. Not do 38 59 88 The results of the study on 201 Total students found that the most deviant behavior was carried out by light deviant Table 5 shows the results of the chi- behavior as many as 128 people (63.7%). square statistical test showed that the The results showed that many deviant value of P value = 0,000, 0,041 < α = behaviors carried out by respondents were (0,05), it can be concluded that there is a disturbing the opposite sex and against significant relationship between peer parents for the category of light deviant conformity with light and medium deviant behavior, wandering and seeing behavior. images/videos containing pornographic Discussion elements for the category of medium a. Characteristics of Peer Confimity deviant behavior, and fighting and The results of the study on 201 damaging other people's or public students found that respondents who had facilities for the heavy deviant behavior peer conformity in high category were 102 category. The deviant behavior mostly people (50.7%). At the stage of adolescent carried out by respondents was influenced development, adolescents really need by the characteristics of respondents who peers. Teenagers become very dependent attend school, where students who have on their friends as a source of pleasure and low grades often go to school, and the have a strong attachment to their peers. school is known as a school that has high The tendency of attachments in these juvenile delinquency. Characteristics of groups increases with the frequency of adolescents who tend to follow peer interactions among its members, followed behavior contribute to deviant behavior by conformity behavior, where that occurs in the school. adolescents will try to adjust and unite c. Relationship between Peer Conformity with the group so that they can be and Deviant Behavior accepted by the group (Soetjiningsih, The statistical test results obtained 2010). p-value < α = (0.05) for the relationship of Peer conformity has a strong effect peer conformity to light and medium on adolescent behavior that can influence deviant behavior, and p-value > α = (0.05) deviant behavior because adolescents get for heavy deviant behavior. This shows strong pressures from peers to be that there is a significant relationship between peer conformity with light and 77 Oral Presentation Riau International Nursing Conference 2018 RINC2018 medium deviant behavior, and there is no Health Nursing Faculty of Nursing, significant relationship between peer University of Riau, Indonesia conformity and heavy deviant behavior. 3Arneliwati, M.Kep: Lecturer at the The theory put forward by Santrock Department of Comunity Nursing Faculty (2003) states that peer conformity has a of Nursing, University of Riau, Indonesia strong effect on adolescent behavior that can influence deviant behavior because References adolescents get strong pressures from Choudhary, G. B. (2014). Adolescence peers to be conformed to social behavior Education. Delhi: PHI Learning in the group. This theory is in line with the Private Limited. Diperoleh dari results of research conducted by Nkhata https://books.google.co.id/books?id= and Mwale (2016) that peer pressure is Z6d2BAAAQBAJ&printsec=frontcov one of the factors that contribute to er#v=onepage&q&f=false deviant behavior in adolescents. Many Kartono, K. (2010). Patologi Sosial 2: teens engage in deviant behavior because Kenakalan Remaja. Jakarta: PT. Raja teens see their friends doing the same Grafindo Persada. thing. The results of research conducted Mubarak, W. I. (2009). Sosiologi untuk by Rebellow (2016) also stated that Keperawatan. Jakarta: Salemba adolescents adapted their friends' behavior Medika. so that they could be accepted in groups Nkhata, M. J., & Mwale, M. (2016). even though it could cause harm to Behavior An Investigation of the themselves and others. Contributing Factors to Adolescent Conlusions Deviant Behaviours in Rural The results showed that more Community Day Secondary Schools respondents have high peer confirmity of with Respect to the Social and 102 people (50,7%), 128 respondents Environmental Aspects. Journal of (63,7%) do light deviant behavior, 103 Child & Adolescent Behavior, 4(6). respondents (51,2%) do medium deviant Diperoleh tanggal 23 Desember 2017 behavior, and 113 respondents (56,2%) do dari https://www.omicsonline.org/ heavy deviant behavior . Based on the Rebellow, M. M. R. (2015). Factors results of statistical tests it can be Influencing Deviant Behaviour concluded that there is a significant Among Adolescents. Indian Journal relationship between peer conformity with of Applied Research, 5(October), light deviant behavior (p value = 0,000) 583–584. Diperoleh tanggal 23 and medium deviant behavior (p value = Desember 2017 dari 0.041), there is no significant relationship https://www.worldwidejournals.com between peer conformity and heavy Santrock, J. (2003). Adolescence deviant behavior. Perkembangan Remaja. Jakarta: Acknowledgements Erlangga. Researchers express the highest Saputro, B. M., & Soeharto, T. N. E. D. gratitude for the guidance and assistance (2012). Hubungan antara Konformitas from various parties in the completion of terhadap Teman Sebaya dengan this research. Kecenderungan Kenakalan pada Remaja. Insight, 10, 1–15. Diperoleh 1Gilang Sri Mentari: Students of the tanggal 29 Januari 2017 dari Faculty of Nursing, University of Riau, http://fpsi.mercubuana-yogya.ac.id Indonesia Soetjiningsih. (2010). Tumbuh Kembang 2Ns. Jumaini, M.Kep., Sp.Kep.J: Remaja dan Permasalahannya. Lecturer at the Department of Mental 78 Oral Presentation Riau International Nursing Conference 2018 RINC2018 Jakarta: CV. Sagung Seto. WHO. (2014). Adolescent Health. Diperoleh tanggal 23 Desember 2017 dari http://www.who.int/topics/ adolescent_health/en/ 79 Oral Presentation Riau International Nursing Conference 2018 RINC2018 16. INFLUENCE ABDOMINAL STRETCHING EXERCISE AGAINST INTENSITY OF DYSMENORRHOE Annisa Syafna1, Yulia Irvani Dewi2, Siti Rahmalia Hairani Damanik3 1School of Nursing, University of Riau 2School of Nursing, University of Riau 3School of Nursing, University of Riau Email: [email protected] Abstract Objective: This study was aimed to determine the influence of abdominal stretching exercise against intensity of dysmenorrhoe. Method: The design of this research study was "Quasi experimental" using "Non-equivalent control group" which is divided into an experimental group and a control group. The study was conducted on student Daarun Nahdhah boarding school. Total sample was 34 female students who fit the inclusion criteria and using simple purposive sampling technique. Measuring instruments are used sheets observation numeric rating scale. The analysis used univariate and bivariate analysis using independent sample T-test and dependent sample t test. Results: The results was showed a decrease in the intensity of dysmenorrhoe in the experimental group after given abdominal stretching exercise with p value (0.000) <α (0.05). Conclusions: This means that abdominal stretching exercise was effective to reduce the intensity of dysmenorrhoe. Abdominal stretching exercise can reduce dysmenorrhe in non- pharmacological which can be practiced independently, so it was suggested to students who have other family members or neighbors can use complementary therapies to reduce pain intensity of dysmenorrhoe. Keywords: abdominal stretching exercise, dysmenorrhoe, menstruation Introduction in each country. Around 60% of Adolescence is the transition period dysmenorrhea occurrence in the United between childhood and adulthood States and 72% in Sweden (Marlinda, (Hockenberry & Wilson, 2011). Teenagers 2012). While percentage figure in Indonesia will experience puberty, which is a period is still unknown. where a person experiences physical According to Anwar, Baziad, & changes, hormonal and sexual as well as the Prabowo (2008), primary dysmenorrhea can ability to conduct reproductive processes be resolve with pharmacological and non- (Mansur, 2009). pharmacological treatment. Pharmacology Dysmenorrhea occurs as a result from therapy for dysmenorrhea can be done by uncoordinated uterus contractions that giving analgesics drugs, while non- caused by an increased production of pharmacological therapy can be done with prostaglandins which are released into the the relaxation techniques, warm water blood circulation (Mitayani, 2011). compresses, acupuncture, herbal drinks Dysmenorrhea is classified as primary or consumption, and regular exercise or any secondary based on the absence or presence physical activity. of an underlying cause (Nugroho & Utama, An interview was taken with several 2014). students where 7 out of 10 students stated The prevalence of dysmenorrhea that they lack the urge to find out methods varies widely across the world with an to overcome the pain and would choose to average of more than 50 percent of women take a painkiller or suppress the pain. None 80 Oral Presentation Riau International Nursing Conference 2018 RINC2018 of the students has ever considered physical value < α (0.05), then it is proven that exercise as one of the solutions to relieve abdominal stretching exercises are effective pain. This matter concerns the urgency of on decreasing the intensity of this research where it is known that Dysmenorrhea. pharmacology treatment has a negative Results impact and a low-risk method is needed, The research results obtained as follows: which is why non-pharmacological 1. Univariate Analysis treatment is a suitable solution. Abdominal The Characteristics of Respondents stretching processes is one of the non- Based on Age and Menarche Based on table pharmacological therapy to reduce pain, 1, it is concluded that out of 34 and it is necessary to study the effect on the respondents, the highest distribution of intensity of Dysmenorrhea. respondents according to the age was Method 52.9% at the age of 16. Based on the age of The type of research design used in menarche it highest collected data was at this research is a Quasi-Experiment with the age of 12 years which was 38.2%. the research design of Non-Equivalent 2. Bivariate Analysis Control Group, which is a research design Table 1 where researchers did not randomize the The Intensity of Dysmenorrhea of grouping between the experimental group Experimental Group Before and After and the control groups. This research Abdominal Stretching Exercise involved two groups namely the Variable n Mean Mean SD p experimental group and the control groups differ (Hidayat, 2011). ence Before 1 6,47 1,179 The research location was at Daarun Intervention 7 2,64 0,000 Nahdhah Islamic Boarding School of After 1 3,82 1,237 Bangkinang with respondents from class X Intervention 7 and class XI due to the majority of their students were women. Non-probability Based on table 1, an average value of sampling with the type of purposive the intensity of Dysmenorrhea on the sampling is used as the sampling technique experimental group before being given of this research. abdominal stretching exercise is 6.47 with a The number of samples in this standard deviation of 1.179. After being research was 34 students and all samples given abdominal stretching exercise, the were part of Daarun Nahdhah Islamic average value decline to 3.82 with a Boarding School of Bangkinang from class standard deviation of 1.237. The results of X and class XI. The researcher used an the analysis obtained a p-value (0.000) < α observation sheet to collect menstrual pain (0.05), therefore it can be concluded that data which contain demographic data of the there are differences in the intensity of respondents and the Numeric Rating Scale Dysmenorrhea before and after being given (NRS) pain intensity scale. abdominal stretching exercise in the In this research, the Independent experimental group. Sample T-Test was used to compare post- Table 2 test of pain assessment on both Decreased Intensity of Dysmenorrhea in the experimental group and control group, Control Group Before and After Without while Dependent Sample T-Test was used Being Given Abdominal Stretching Exercise to compare pre-test and post-test of pain Variable N P-Value Negative assessment on both groups. The degree of Pre-test 0 statistical significance (α) used in this test is ranks 0,025 0.05. If the statistical tests obtained where ρ 81 Oral Presentation Riau International Nursing Conference 2018 RINC2018 Positive are within the range of the middle Post-test 5 ranks adolescence, aged 15-17 years. Ties 12 The results of this research showed that the highest age of menarche was found Based on table 2, there were at the age of 12 years, around 13 differences in the intensity of respondents (38.2%). The result of this Dysmenorrhea before and after the research shares similar results conducted by abdominal stretching exercise in the control Utami (2014) where the highest age of group. There were 5 respondents menarche was at the age of 12 years. experienced an increase in Dysmenorrhea One of the risk factors of intensity, while 12 respondents did not Dysmenorrhea is those who experience experience any changes in the intensity of menarche earlier. This is related to Dysmenorrhea. The results of the analysis endometrial prostaglandins and obtained where p-value (0,025) < α (0.05), leukotrienes. After ovulation occurs in therefore the Ho was denied, it can be response to an increased level of concluded that there was a difference progesterone, fatty acids will increase in between the average value of phospholipids of the cell membrane. Dysmenorrhea intensity on before and after Arachidonic acids and other omega-7 fatty without being given abdominal stretching acids are released and initiate a flow exercises in the control group. mechanism for prostaglandins and Table 3 leukotrienes in the uterus, as a result, it Dysmenorrhea Intensity Comparison in The gives a mediated effect of the inflammatory Experimental Group and Control Group response and creates a tension during Group N Mann P-Value menstruation (Novita, 2015). Whitney 2. Pain Intensity U Based on the research results, the Experimental 17 average value of Dysmenorrhea intensity 10.500 0,000 Control 17 before being given intervention in the experimental group is 6.47 points and after Based on table 3 statistical test, the being given intervention is 3.82. For the value of Mann Whitney U post-test control group, the average intensity of assessment in the experimental group and Dysmenorrhea before intervention is 6,65 control group is 10,500 with the p-value and after the intervention is 6,94. The (0,000) < α (0.05). This can be concluded average Dysmenorrhea intensity on the that abdominal stretching exercises present experimental group decreased by 2.64 an effective way of reducing Dysmenorrhea points. While the average Dysmenorrhea intensity. intensity on the control group has increased Discussion by -0.29 points which happen because the 1. Respondents Characteristics pain felt by the respondents would appear The results of the research that has and disappear periodically. been conducted on Daarun Nahdhah Dysmenorrhea tends to increase in Islamic Boarding School of Bangkinang are women who exercise less. When a woman that the highest respondents were at the age experiences Dysmenorrhea, of 16 years (52.9%). The results of this vasoconstriction takes place and the oxygen research are consistent with the research cannot be channeled into the blood vessels Arifiani (2016) and Utami (2014) where of the reproductive organs. A different case most respondents are aged 16 years. This on women who exercise regularly where result states that the majority of respondents exercises supply a doubled amount of oxygen every minute so that oxygen is 82 Oral Presentation Riau International Nursing Conference 2018 RINC2018 delivered to the blood vessels that sustained enhancement in the intensity of vasoconstriction (Anisa, 2015). Dysmenorrhea in which the Wilcoxon Test 3. The Influence of Abdominal showed no significance with p-value Stretching Exercise towards (0.025) < α (0.05), while post-test Dysmenorrhea Intensity assessment of Mann-Whitney Test results Based on the results of the study, obtained Mann Whitney U in the there was a significant difference in the experimental group and the control group mean intensity of dysmenorrhea before and as much as 10,500 with p-value (0.000) < α after the intervention of the abdominal (0.05). This means that there is a significant stretching exercise in the experimental difference in the reduction of group with p-value 0.000. This suggests Dysmenorrhea intensity between the that abdominal stretching exercise are experimental group and the control group, effective in reducing the intensity of and it can be concluded that abdominal Dysmenorrhea. Abdominal stretching stretching exercise is effective in reducing exercise is stretching exercise that focuses the intensity of Dysmenorrhea. on the abdominal muscles and exercise is Acknowledgements one of the non-pharmacological treatment Deepest thank you for the assistance that is safer to use because it uses and guidance from various parties in the physiological processes (Anisa, 2015). completion of this research report. According to Putra (2012) in Fauziah (2015) the benefits of stretching increases 1Annisa Syafna: Nursing Faculty student an athlete's physical fitness, optimizes at the University of Riau, Indonesia. responsiveness, improves mental and 2Ns. Yulia Irvani Dewi, M.Kep., Sp. physical health, increases body awareness, Mat: Lecturer at the Department of reduces the risk of joint sprains and muscle Maternity Nursing, Faculty of Nursing, injury (cramps), reduces the risk of back University of Riau, Indonesia. injury, reduces muscle pain and muscle 3Siti Rahmalia Hairani Damanik, MNS: tension and reduces menstrual pain Lecturer in Medical Nursing, Faculty of (Dysmenorrhea) for women. Nursing, University of Riau, Indonesia. Abdominal stretching exercise itself is not much different from gymnastics, References which can help increase oxygenation and Anisa, M. V. (2015). Effectiveness of cell’s carbohydrates and also stimulate the Exercise in Primary Dysmenorrhea. lymphatic drainage system flow, so that it Journal of the Faculty of Medicine, can increase muscle flexibility by restoring University of Lampung. Obtained on the muscles to their natural length and December 28, 2017 from maintain their function properly to reduce http://juke.kedokteran.unila.ac.id/index cramps in the muscles (Ningsih, 2011). .php/majority/article/download/527/52 Conclusion 8 The results showed that the age of Anugraheni, V. M. D., & Wahyuningsih, A. most respondents was 16 years old (52.9%) (2013). Effectiveness of Warm and the most menarche was 12 years old Compress in Reducing the Intensity of (38.2%). The provision of abdominal Dysmenorrhoea Pain in Student of The stretching exercise in the experimental Acadamy of Health Science Baptist group can reduce the intensity of Kediri Hospital from Dysmenorrhea in which the Paired Sample http://puslit2.petra.ac.id/ejournal/index. T-Test results showed significance with the php/stikes/article/view/18838/18533 p-value (0.000) < α (0.05). On the other hand, for the control group there is an 83 Oral Presentation Riau International Nursing Conference 2018 RINC2018 Anwar, M., Baziad, A., & Prabowo, R. P. Utami, E. E. (2014). The Effect of Stretch (2008). Gynecology. Jakarta: PT Bina Exercise Paint Technique on The Pustaka Sarwono Prawirohardjo. Intensity of Dysmenorrhea Pain in Fauziah, M. N. (2015). The Effect of Adolescents in Muhammadiyah 2 High Abdominal Stretching Exercise on The School of Yogyakarta. Obtained on Intensity of Menstrual Pain in Young January, 18 2018 from https://e- Women in Al Furqon Vocational journal.unair.ac.id/JNERS/article/view/ School of Bantarkawung from 49 repository.uinjkt.ac.id/dspace/bitstrea m/.../1/MIA%20NUR%20FAUZIAH- FKIK Hastono, S. P. (2007). Health Data Analysis. Public Health Faculty: UI. Hidayat, A. A. A. (2011). Nursing Research Methods and Data Analysis Techniques. Jakarta: Salemba Medika. Hockenberry, M. J., & Wilson, D. (2011). Wong’s: Nursing care of infants and children. (9th edition). Philadelphia: Elsevier Mosby. Mansur, H. (2011). Maternal and Child Psychology for Tocology. Jakarta: Salamba Medika. Mitayani. (2011). Maternity Nursing Care. Jakarta: Salemba Medika. Marlinda, R., Rosalina, & Purwaningsih, P. (2013). Effect of Dysmenorrhea Gymnastics on Decreasing Dysmenorrhea in Young Women in Sidoharjo Village. Journal of Academy of Health Science of PSIK Ngudi Waluyo Ungaran. Obtained on January, 14 2018 from http://jurnal.unimus.ac.id/index.php/JK Mat/article/view/998/1047 Ningsih, R. (2011). The Effectiveness of The Package Relieves Pain Intensity in Adolescents with Dysmenorrhea in Curup District High School. Indonesia University Thesis obtained on July, 17 2018 from jki.ui.ac.id/index.php/jki/article/downlo ad/4/4 Nugroho, T., & Utama, B. I. (2014). Women's Reproductive Health Problems. Yogyakarta: Nuha Medika Prayitno, S. (2014). Complete Book on The Health of Female Reproductive Organs. Yogyakarta : Saufa 84 LIST OF POSTER PRESENTATION Poster Presentation Riau International Nursing Conference 2018 RINC2018 1. COMPONENT OF ADOLESCENT SELF-CONCEPT IN ISLAMIC BOARDING SCHOOL Reftesa Indriani1, Fathra Annis Nauli2, Ari Pristiana Dewi3 1Student of Faculty Nursing University Riau 2Lecturer Faculty of Nursing University of Riau 3Lecturer Faculty of Nursing University of Riau Email: [email protected] Abstract Objective: This study aims to explore the component of adolescent self-concept in Islamic Boarding School. Method: This research uses a descriptive method. This research were using 135 adolescents for samples, based on inclusive criteria using stratified random sampling method. This research was located in SMA Babussalam Pekanbaru. This research were using 40 questionnaires that have been tested by using validity test and reability test. This research were using univariat analyze to explain the frequency table. Result: The final result of this research showed that the samples tend to be positive than negative, 69 adolescent (51.1%) have positive self-concept and 66 adolescent (48.9%) have negative self-concept. Conclusion: Based on the result of this study, it is suggested to Islamic Boarding School to maintain and developing mentality program, that adolescent tend to have a positive effect for self-concept. Keywords: Adolescent, Islamic Boarding School, self-concept Introdution parents who worry about the future of his Adolescence is a time of transition son. That is because more and more the from the child toward adulthood is case of criminality, increasing student accompanied by the development of all fights, drug abuse and drink-liquor, etc. aspects or functions to enter adulthood The various problems experienced by (Adriani & Wirjatmadi, 2012). youth, many parents who think repeated Adolescence a time considered to be about the effectiveness of public labile, where individuals trying to find his education in developing personality and true identity in the middle of his fellow morals of children, so parents choose teens. Teens experience changes both boarding schools as a means of moral physically, emotional, social, intellectual, construction of the Cubs (Hidayatulloh, or psikoseksual about her experience. 2016). Boarding schools is one of the Such changes require teens to make educational path that has the specificity in adjustments against himself as well as his the running pattern of education, that is, social environment (Aristya & Rahayu, students are placed in a boarding house 2018). under the guidance of kyai or ustad The social environment is first and responsible for education and daily foremost for children is the family according to the Novianti (2006, in Nisak, environment (Wahyuni, 2012). The family 2017). has a very important role in the education Life in boarding schools is very of children. Parents are responsible for different from life at home, students here family life and provide the right direction must conform in order to be completed his i.e. by imparting religious teachings and education in boarding schools. Students akhlakul karimah. The modern era, many work in one full day on the schedule 85 Poster Presentation Riau International Nursing Conference 2018 RINC2018 specified (Aqilah, 2015). Students must dealing with a problem (Sani & Frieda, also obey all rules set by the boarding 2015). schools, when students violate the rules that are in boarding schools will be Method punished in accordance with the violations This research was carried out in that he did (Hidayatulloh, 2016). high school Babussalam Soweto which Regulations on boarding schools such as began from February to July 2018. This should not carry handphone, boarding out study uses design research of the should only be done when the holidays population of this research are the students and parent, it is prohibited to meet with of class X and XI Babussalam High the opposite sex and a variety of other School in Pekanbaru. Sampling using regulations which are not given to stratified random sampling with inclusion adolescents at General (Aqilah, 2015). criteria, namely the students of class X Students to have obedience, endurance and XI, aged 15-17 years, and are willing and ability accept rules in self concept to be the respondent. required to behave (Sani & Frieda, 2015). Data collection tools used in this The concept of the self is not study is a questionnaire. A questionnaire heredity factors, but factors that are contains questions related to the studied and are formed through the characteristics of the youth. Questionnaire experience of the individual's relationship B contains 40 questions to measure the with others. Each individual will have a concept of self. Researchers using concept of self that positive or negative instruments developed by William h. Fitts with varying intensity. Someone has a (1965), namely Tennenssee Self Concept positive self concept, then someone will Scale, an instrument that can be used to have more confidence that able to perform measure the concept of self with the scale certain tasks so that pushed him to achieve likert. These instruments amounted to 40 success, while someone who has negative questions were modified, consists of 20 self concepts tend to have expectations the questions is positive and 20 negative success of his efforts against low questions. (Wahyuni, 2012). Result A wide range of research on teen Tabel 1 self concept in boarding schools has been The Distribution Of Respondents carried out. One research Sani and Frieda According To The Description Of Yourself (2015) about the relationship between the No Self image of Total Percenta concept of self and decision making adolescent (n) ge (%) become Modern in santri Assalam 1 Positive self 68 50,4 Temanggung pointed out that the concept image of the self which is owned by the students 2 Negative self 67 49,6 are on a positive category (p value = image 0.000). Students have a positive self concept due to feeling brave and capable, to make students be optimistic against Tabel 2 what will be chosen. Feelings about their The Distribution Of Respondents ability to adapt to the environment also According To Their Ideal Self raises self confidence in students that he No Ideal self of Total Percentage definitely succeeded in doing a task in adolescent (n) (%) boarding schools. A positive view of the 1 Positive self 78 57,8 quality of the skills possessed by the ideal students, so they will not feel the stress of 2 Positive self 57 42,2 86 Poster Presentation Riau International Nursing Conference 2018 RINC2018 ideal image is 68 of respondents (50.4 %) and youth with negative self-imagery namely 67 respondents (49.6%). Adolescents who Tabel 3 have a positive image of themselves they The Distribution Of Respondents want to receive physical state owned. According To Self-esteem Adolescents who have a negative image of No Self esteem Total Percenta themselves because of the feeling that of (n) ge (%) considers the physical condition they are adolescent now if not yet as they expect. Negative 1 Positive self 78 57,8 self picture would also affect the self esteem esteem of teens, teens will feel anxious 2 Negative 57 42,2 due to physical conditions that are not yet self esteem as they had hoped. 2. Description of ideal self Tabel 4 The results showed that most The Distribution Of Respondents adolescents have positive self ideal, i.e. as According To The Appearance On The many as 78 people respondents (57.8%). Role Adolescents who have a positive self ideal No The Total Percentage feel able to do things that are considered appearance of (n) (%) in accordance with the standards of adolescent conduct, has high expectations of himself, roles has a realistic perception of the 1 The 80 59,3 appropriate, don't worry to condition appearance of himself, as well as having a realistic self a positive role ideal. 2 The 55 40,7 3. Description of self-esteem appearance of The results showed that most a negative adolescents have positive self-esteem, that role as many as 78 people respondents (57.8%). Adolescents who have positive Tabel 5 self-esteem has the appropriate feeling of The Distribution Of Respondents precious, loving himself, capable of doing According To The Identity your job well and true, able to interact No Self identity of Total Percentage with the people around her, always adolescent (n) (%) abiding by the rules that apply, receive his 1 Positive self 68 50,4 mistakes without hurting myself, and not identity easy to run away from the problems that exist. 2 Negative self 67 49,6 4. Description of the role of identity appearance The results showed that most of the adolescents has the appearance of a Discussion positive role, that as many as 80 people 1. Description of yourself respondents (59.3%). Adolescents who The results showed that adolescent have the appearance of a positive role is in boarding schools has a picture of an able to show his ability, was able to almost balanced between self image of account for his actions, being able to themselves positive and negative self- perform its role as expected either at imagery. Adolescents with a positive self 87 Poster Presentation Riau International Nursing Conference 2018 RINC2018 school, the family, as well as the identity of the respondents have an almost environment. balanced identity identity between 5. Descriptions of identity positive and negative identity, many as 68 The results showed that adolescents people (50.4%) of respondents have a in boarding schools has an identity that is positive self-identity and 67 people nearly balanced between positive self (49.6%) respondents have negative self- identity and the identity of the negative identity. self-talk. Adolescents with positive self Acknowledgements identity is 68 of respondents (50.4 %) and Infinite thanks for the help and youth with negative self identity is the 67 guidance of the various parties in the respondents (49.6%). Adolescents who completion of this research report. have a positive self-identity knowing who References feel themselves, the extent of its ability, Adriani & Wirjatmadi. (2012). Peranan how themselves, admit to their sex, and gizi dalam siklus kehidupan. Jakarta: being able to socialize properly. Kencana Prenada Medika Group. Adolescents who have a negative identity Aqilah, F. A. (2015). Hubungan antara do not know and have not been able to optimisme dengan stress-related develop its ability as well as feel haven't growth pada santri pondok pesantren. been able to socialize properly. Skripsi. Yogyakarta: Fakultas Conclusions Psikologi, Universitas Gadjah Mada. Based on the results of research that Aristya, D. N., & Rahayu, A. (2018). has been done about the description of the Hubungan dukungan sosial dan components of the self-concept adolescent konsep diri dengan penyesuaian diri in boarding schools that are made against remaja kelas X SMA Angkasa I respondent a class person 135 X and XI Jakarta. Jurnal Ikraith-Humaniora, 2 Babussalam High School in PekanbaruS (2), 75-81. Diperoleh tanggal 01 Mei can be summed up as follows, research 2018 dari https://journals.upi- results related teen self picture shows yai.ac.id. almost balanced between self picture Hidayatulloh, A. N. M. (2016). Motivasi positive and negative self-imagery that is orang tua memilih pondok pesantren as many as 68 people (50.4%) respondents sebagai sarana pembinaan moral to picture ourselves positive and 67 people anak (studi kasus wali santri di respondents (49.6%) for the description of Pondok Pesantren Wasilatul Huda negative self-talk. The ideal associated Kecamatan Gemuh Kabupaten himself, most adolescents have a positive Kendal) tahun 2016. Skripsi. Salatiga: self ideal, many as 78 people respondents Jurusan Pendidikan Agama Islam (57.8%) and many as 57 people Fakultas Tarbiyah dan Ilmu respondents (42.2%) have an ideal Keguruan, Institut Agama Islam negative self. Associated price himself, Negeri Salatiga. most adolescents have positive self- Sani, F., & Frieda. (2015). Konsep diri esteem, that many as 78 people dan pengambilan keputusan menjadi respondents (57.8%) and as many as 57 santri di Pondok Modern Assalam people respondents (42.2%) have negative Temanggung. Jurnal Empati, 4 (4), self-esteem. While her appearance-related, 163-172. Diperoleh tanggal 20 most teens have the appearance of a Januari 2018 dari positive self, that as many as 80 people https://media.neliti.com. respondents (59.3%) and many as 55 Wahyuni, S., & Saam, Z. (2012). Psikologi people (40.7%) of respondents have a keperawatan. Jakarta: PT negative self appearance. As for the Rajagrafindo 88 Poster Presentation Riau International Nursing Conference 2018 RINC2018 2. THE CORRELATION OF BREASTFEEDING PATTERN WITH THE DEVELOPMENT OF INFANTS AGED 612 MONTHS Suci Hati Mumtaz1, Agrina2, Ari Pristiana Dewi3 1Student of Faculty of Nursing Universitas Riau 2,3Faculty of Nursing Universitas Riau Email: [email protected] Abstract Objective: Breastfeeding is one of the first early childhood development interventions, in order to prepare children for a prosperous future. This research aimed to determine the relationship between breastfeeding patterns with infants aged 6-12 months development at Payung Sekaki Health Center area, Pekanbaru City. Methods: A cross sectional correlation research design was used for this study. Purposive sampling techniques were used to a total of 85 mothers with 6-12-month-old infant. Questionnaire and a sheet of the Denver Development Screening Test (DDST) are used as child developmental assessment. Results: Univariate and bivariate analysis with chi-square test showed that 48.2% infants were partially breastfed and 63.5% had a normal development. The results of bivariate analysis showed that the majority of infants with normal development had an exclusive breastfeeding pattern (85.0%) and predominantly breastfed babies are up to 83.3% with p value (0.000) <α (0.05). Conclutions: There is a connection between breastfeeding pattern and the development of infants aged 6-12 months. Keywords: Breastfeeding Pattern, DDST, Infant Development. Introduction by giving a little water or water-based A non-optimal exclusive drinks to infants aged <6 months. While breastfeeding can be a threat to children's the partial is breastfeeding with additional growth and development. WHO (2016) foods including formula milk to infants reported that around 200 million children aged <6 months. WHO (2016) were failed to achieve their full physical, recommend to give an early initiation of mental and social potential because of breastfeeding within 1 hour of birth and negative factors that inhibit early exclusive breastfeeding for the first 6 childhood development, amongst them, months of life. not being breastfeed. The first days of life The purpose of this study was to is very important because it determines determine the relationship between further development (Soetjiningsih & breastfeeding patterns with infants aged 6- Ranuh, 2016). 12 months development. The Indonesia Ministry of Health Method (2014) classifies breastfeeding patterns The design of this research was into three categories, namely exclusive, descriptive correlation using a cross predominant and partial. Exclusive sectional approach. Respondents were 85 breastfeeding is defined as no other food mothers who had infants aged 6-12 or drink, not even water, except breast months, who were taken by purposive milk for 6 months of life, but allows the sampling technique. infant to receive vitamins, minerals and Data collection tools in this study were medicines. The predominant is a pattern questionnaires and Denver Development 89 Poster Presentation Riau International Nursing Conference 2018 RINC2018 Screening Test (DDST) sheets to assess infant development. The data was analyzing by univariate and bivariate with 4. Breastfeeding Pattern and infant’s chi-square test. Development Result Tabel 4 1. Characteristics Of Respondents Relationship between Breastfeeding Tabel 1 Pattern with infant’s Development Distribution of Respondents’s Breastfeedin Infant’s Development P value Characteristics (n=85) g Pattern Normally Suspect Characteristics Total Percent n % n % age (%) Exclusive 17 85,0 3 15,0 1. Infant Predominant 20 83,3 4 16,7 0,000 Age (Month) Partial 17 41,5 24 58,5 6 22 25, 7 19 9 Discussion 8 12 22, A. Characteristics of Respondents 9 8 4 10 13 14, The analysis results showed that the 11 5 1 majority of the infant's age was 6 months 12 6 9,4 old as many as 22 babies (25.9%). 15, Exclusive breastfeeding for 6 months is 3 the optimal way of feeding infants. 5,9 7,1 Thereafter infants should receive Gender complementary foods with continued Male 43 50,6 breastfeeding up to 12 months of age or Female 42 49,4 beyond. 2. Respondents’s Mother The gender distribution of Age (Year) respondents showed that the highest 17 – 25 29 34, 26 – 35 50 1 gender was male with 43 babies (50.6%). 36 – 45 6 58, This is in accordance with data from the 8 Pekanbaru Central Statistics Agency 7,1 (BPS) in 2018 which states that the Type of Childbirth number of men (505,769) is more than Normally 61 71,8 Cesarean 24 28,2 women (478,905). As many as 50 respondents (58.8%) 2. Breastfeeding Pattern of Infant were in the age group 26-35 years (early Tabel 2 adult). Generally, the most secure fertility Distribution of Infant’s Breastfeeding age range as 20 – 35 years of age where Pattern (n = 85) the production of milk can be stimulated Category Total Persentage (%) due to optimal breast physiology Exclusive 20 23,5 (National Population and Family Planning Predominant 24 28,2 Board, 2012). Partial 41 48,2 Distribution of respondents according to type of delivery showed that 3. Development of Infant the majority of mothers were normally Tabel 3 delivered as many as 61 respondents Distribution of Infant’s Development (71.8%). In the opinion of the researchers, (n = 85) a cesarean delivery causes the mother not Category Total Persentage (%) to give breast milk directly due to pain in Normally 54 63,5 Suspec 31 36,5 the wound after surgery. This condition causes the mother's prolactin hormone to 90 Poster Presentation Riau International Nursing Conference 2018 RINC2018 decrease so that the production of breast respondents who had developmental milk is small and causes the mother to delays was also quite high, namely 31 give prelacteal feed to the baby, thus infants (36.5%). The majority of thwarting exclusive breastfeeding. respondent mothers in this study are The results of Rosha and Utami's housewives; therefore babies are always (2013) study stated that mothers who close to their mothers. This causes the breastfeed their baby more than 1 hour mother to have enough time to stimulate after delivery had risk of 4.87 times for baby's development. give the baby prelacteal food compared In accordance with the theory with mothers who breastfeed less than 1 presented by Soetjiningsih and Ranuh hour after delivery. (2016) that children who get directed and B. Breastfeeding Pattern and Infant’s regular stimulation will develop faster Development than children who do not get stimulation. In this study, the behavior of Furthermore, the highest percentage mothers who provide additional food early was 85.0% infants had normal such as starch and fruit to the baby, is development and get exclusive caused by the habits of parents of breastfeeding in this study. Exclusive respondents who provide additional food pattern is higher percentage in normal before the baby 6 months old. Similar development than the predominant results were also obtained from research breastfeeding patterns. This shows that conducted by Arini (2012) that mothers predominantly and partially (non- who still follow their parents' parenting exclusively) breastfeeding infants are become the cause of mothers giving more suspicious of their development complementary feeding to child. compared to exclusive breastfeeding According to interviews outcomes, infants. mothers often gave additional drinks to There is rapidly complex growth babies such as honey and coffee. Based on and development on motoric and brain at their belief that coffee could prevent the age of 6-12 months. This growth and febrile seizures in infants and honey could development will run normally if the child maintain the health of the baby. In line gets adequate nutrition (Hidayat, 2014). with the research by Putri and Ilahi (2017) Breastfeeding contains enough which states that the cause of the failure of nutrients and minerals for the first six exclusive breastfeeding is the lack of months of a baby's life, breast milk also knowledge of mothers that giving drinks contains immune substances that provide other than breast milk can thwart protection against infection (WHO, 2016). exclusive breastfeeding. Indonesian Doctors Association (IDI, In researcher’s opinion, less 2017) asserts that children who get participation on attending posyandu and exclusive breastfeeding have higher IQ lack of health information were the main scores and better performance at school. reason for the low level of exclusive In this study show that exclusive breastfeeding in this study. Mothers breastfeeding more likely to infant convinced that breastfeeding alone is not development. Exclusive breastfeeding enough to meet the needs of the baby, so babies have better development than by providing complementary food was the predominantly and partially (non best choice (Agrina, Kimura, & Tsuda, exclusive) breastfeeding infants. Koiriyah 2015). (2017) in the work area of Sumbersari The results portrayed that most Public Health Center Bantul Metro babies had normal development as many Selatan explain that there is a relationship as 54 babies (63.5%), but the number of between exclusive breastfeeding and the 91 Poster Presentation Riau International Nursing Conference 2018 RINC2018 development of infants aged 6 - 12 Diperoleh pada tanggal 8 Januari months with a p-value of 0.028. 2018 dari http://www.depkes.go.id/download.ph p?file=download/pusdatin/infodatin/i Conclusions nfodatin-asi.pdf The study represented that the Khoiriyah, H. (2017). Hubungan majority of infants had exclusive pemberian ASI ekslusif dengan breastfeeding patterns as much as 85.0%, perkembangan bayi usia 6-12 bulan di while a total of 58.5% partially breastfed Kelurahan Sumbersari wilayah kerja infants had developmental suspect. Chi- Puskesmas Sumbersari Bantul Metro Square statistical test results obtained p- Selatan periode Februari-April tahun value 0.000. A significant relationship 2017. Jurnal Kesehatan Akbid Wira between breastfeeding patterns and infant Buana. Diperoleh pada tanggal 9 development in this study result. januari 2018 dari http://jurnal.akbid- Acknowledgements wirabuana.ac.id/index.php/jukes/articl Researchers express the highest e/view/20/12 gratitude for the guidance and assistance Putri, R., & Illahi, S.A. (2017). Hubungan from various parties in the completion of pola menyusui dengan frekuensi this research. kejadian sakit pada bayi. Journal of References issues in midwifery. Diperoleh pada Agrina, Kimura, R., & Tsuda, A. (2015). tanggal 21 januari 2018 dari Mother ’ s exclusive breastfeeding http://bidan.fk.ub.ac.id/wp- behavior : a cross sectional study in content/uploads/2013/08/1.3- Pekanbaru , Indonesia. International Rismaina-Putri.pdf Journal of Research in Medical Soetjiningsih & Ranuh, IG.N.G. (2016). Sciences, 3(1), 109–118. Tumbuh kembang anak edisi 2. https://dx.doi.org/10.18203/2320- Jakarta: EGC 6012. WHO. (2016). Early childhood Arini, D. (2012). Hubungan pola development begins with a mother’s pemberian ASI dengan frekuensi breast. Diperoleh pada tanggal 30 kejadian diare dan ispa pada anak. April 2018 dari Jurnal Ilmiyah Keperawatan STIKES http://www.who.int/mediacentre/com Hang Tuah Surabaya. Diperoleh pada mentaries/2016/childhood- tanggal 1 Februari 2018 dari development-breastfeeding/en/ http://studylibid.com/doc/833342/hub ungan-pola-pemberian-asi-dengan- frekuensi-kejadian-diare BKKBN. (2012). Kehamilan ideal usia 20-35 tahun. Diperoleh pada tanggal 12 juli 2018 dari http://www.bkkbn.go.id BPS. (2018). Jumlah penduduk Provinsi Riau menurut jenis kelamin dan kabupaten/kota 2016. Diperoleh pada tanggal 26 juni 2018 dari http://riau.bps.go.id Kemenkes RI. (2014). Pusat data dan informasi Kementrian Kesehatan RI: situasi dan analisis ASI ekslusif. 92 Poster Presentation Riau International Nursing Conference 2018 RINC2018 3. THE RELATIONSHIP BETWEEN FAMILY SUPPORT AND HYPERTENSION STAGE Marya Nasti Wandira1, Sofiana Nurchayati2, Safri3 1Student of Faculty of Nursing Universitas Riau 2,3Faculty of Nursing Universitas Riau Email: [email protected] Abstract Background:Hypertension is one of deadly disease, which need family supportto succeed patients disease care. Objective : this study was aimed to determine how family support (emotional, instrumental, informational, appreciation), assess hypertension stage in hypertensive patient, and examine correlation the family supportand stage of hypertension among hypertensive patient. Method: This study used descriptive correlation with cross sectional approach. Data was collected from 73 respondents by using family support questionnaire to measure condition of the hypertensive patients for the last month. Meanwhile, hypertension stage was measured by blood pressure valuesbased on the current measurement during the study. Result: Univariate analysis shown that majority of participants age 46-55 years are 27 respondents (37%), woman 48 responden (65,8%), length of hypertensive >5 years 29 respondents (39,7%), good family support 42 respondents (42%) and stage 1 hypertension are 37 respondents (50,7%). Bivariate analysis (chi-square) shownthatp value (0,014) which is less than < α (0,05), it concluded there is arelationship betweenfamily support and hypertension stage. Conclusions: It can be conclude that family support in the management of hypertension to reduce the patient's blood pressure. Keywords: Blood Pressure, Family Support, Hypertension Stage. Introduction with the number of cases 14.16% (Dinas Hypertension is an increase in a Kesehatan Provinsi Riau, 2016).) person's blood pressure above normal, Hypertension can attack anyone namely an increase in diastolic blood regardless of age (Pudiastuti, 2011). pressure or irregular systolic blood Complications and deaths due to pressure that occurs continuously hypertension can be controlled by means (Widiarti, Yudha, Wahyuningsih, Tiar, & of pharmacological treatment or by non- Ariani, 2011). The World Health pharmacological means (Pudiastuti, Organization says that cardiovascular 2011). Treatment and management of disease is the number 1 cause of death in hypertension to be successful, it is the world (WHO, 2017). Hypertension is necessary to have social support, estimated to cause 7.5 million deaths from environmental factors that support, and the total of all deaths worldwide (WHO, family support (Effendi & Larasati, 2017). 2015). The prevalence of hypertension in Efendi and Larasati (2017), in his Indonesia nationally is 30.9% research entitled family support in the (Kementerian kesehatan RI, 2017). Based management of hypertension, showed that on the illness of patients who visited the family support was instrumental in health center in Riau province, hypertension management, namely in hypertension was in the top ten most terms of adherence to medication, family cases, hypertension was in the third place harmony, financial balance, controlling 93 Poster Presentation Riau International Nursing Conference 2018 RINC2018 health, well-being, daily eating, physical 2 Gender activity, and stress management. This Male 25 34,2 shows that family support is very Female 48 65,8 necessary in patient hypertension Total 73 100 management. 3 Occupation The purpose of this study was to Government 2 2,7 determine the relationship of family employees 6 8,2 support with the hypertension stage. private employees 41 56,2 The results of this study can be used Housewife 14 19,2 as a source of information and can be used entrepreneur 10 13,7 as a reference in the development of Others nursing science related to the support of Total 73 100 families with hypertension stage. 5 Duration of Method hypertension 19 26 This study used quantitative design <1 year 25 34,2 with a cross sectional approach. The 1-5 years 29 39,7 population in this study were all of > 5 years hypertensive patients totaling 270 people Total 73 100 who were treated at the Payung Sekaki Puskesmas Pekanbaru in December 2017. Based on table 1 the distribution of The research sample was hypertensive respondents based on the highest age is patients totaling 73 people with sampling (46-55 years) with a total of 27 people using purposive sampling technique. Data (37%), the distribution of respondents collection instrumentin this study was based on the sex of the majority of questionnaire. Data analysis used in this respondents were female, as many as 48 study was univariate and bivariate people (65.8%), based on most jobs analysis. Respondents were housewife as many as Results 41 people (56.2%), and based on the A. Univariate Analysis duration of hypertension, more 1. Characteristics of Respondents respondents suffered from hypertension Table 1 more than 5 year, with 29 people (39.7%). Frequency Distribution of Respondent 1. Family Support Characteristics Table 2 No Characteristics of n (%) Frequency Distribution of Respondents Respondents Based on Family Support 1 Age No Family support n (%) Early Adult (26-35 1 1,4 1 Positive 42 57,5 years) 8 11 2 Negative 31 42,5 Late Adults (36-45 27 37 Total 73 100 years) 25 34,2 Early Elderly (46- 12 16,4 Table 3 shows the data that of the 73 55 years) respondents studied, it was found that the Late Elderly (56- majority of respondents had positive 65) family support were 42 people (57,5%). Elderly (> 65 2. Hypertension Stage years) Table 3 Total 73 100 Respondent Frequency Distribution Based on Hypertension Stage 94 Poster Presentation Riau International Nursing Conference 2018 RINC2018 showed that most of the hypertensive patients were female, as many as 48 people (65.8%). Kurniadi and Nurrahmani (2015), No Hypertension n (%) women who use oral contraceptives, Stage especially over 35 years of age, and have 1 Stage 1 37 50,7 used oral contraceptives for 5 years are 2 Stage 2 36 49,3 usually found to have an increase in mild Total 73 100 blood pressure or in people with obesity, this is due to an increase in plasma volume Table 3 shows that the more respondents due to increased renin activity - who were in stage 1 hypertension angiotensin-aldosterone that appears when compared to stage 2 hypertension were 37 oral contraceptives are used people (50.7%). 3. Occupation B. Bivariate Analysis Based on the results of research Table 4 showed that most of the work of Relationship of Family Support with hypertensive patients was as housewives Hypertension Stage as many as 41 people (56.2%). Bisnu, Hypertension Stage p Family Kepel, and Mulyadi (2017) found that the Stage 1 Stage 2 Total value Support n % n % n % most hypertensive respondent's work was Positive 27 64,3 1 35,7 42 100 as housewives as many as 34 people 5 (50%). According to him the type of work 0,014 Negative 10 32,3 2 67,7 31 100 also affects blood pressure this can happen 1 Total 37 50,7 3 49,3 73 100 because if someone who is not working or 1 just as a housewife, lacks physical activity or exercise and this will make a person Table 4 above illustrates the tends to have a higher heart rate so that it relationship between family support and will cause heart muscle work harder on stage of hypertension. The results of the each heart to contract which will cause statistical test obtained p value 0.014 <α = increased pressure on the arteries. 0.05. It was concluded that there was a 4. Duration of hypertension relationship between family support and The results of research conducted on stage of hypertension. 73 respondents, obtained results that more Discussion hypertensive patients who suffer from A. Characteristics of respondents hypertension more than 5 years as many 1. Age as 29 people (39.7%). According to Research conducted on 73 Puspita (2016), the longer a person suffers respondents found that more patients with from hypertension, the lower the level of hypertension were in the range of the adherence, this can be caused by a feeling elderly elderly age (46-55 years) as many of boredom consuming drugs while the as 27 people (37%). Udjianti (2013), men cure rate is not as expected so that a aged 35-50 years and women. post person tends not to routinely consume menopause, which is around the age of 45 antihypertensive drugs. years is at high risk for hypertension, 5. Family Support menoupausal women are prone to The results showed that most hypertension associated with a decrease in respondents had good family support, as estrogen production. many as 42 people (57.5%). This research 2. Gender is in line with the research conducted by Based on the results of research Nainggolan, Amriyati, and Supriyono conducted on 73 respondents, the results (2012). It was found that most 95 Poster Presentation Riau International Nursing Conference 2018 RINC2018 hypertensive respondents received good The results showed that the support as many as 27 people (60%). characteristics of respondents based on Friedman, Bowden, and Jones (2010), age were mostly in the age range of 46-55 family support is very influential on one's years as many as 27 people (37%), based health, family is a source of practical and on the sex of the majority of respondents, concrete help, if a person has good family namely women with a total of 48 people support, a person will tend to have a (65.8%), most of the respondents' jobs higher level of health. were The IRT is 41 people (56.2%), and 6. Hypertension Stage based on the duration of hypertension the Based on the results of research most respondents who suffer from showed that more respondents who were hypertension more than 5 years that is 29 in stage 1 hypertension were as many as people (39.7%). 37 people (50.7%). This research is in line Based on the results of the research with the research conducted by Wijaya that has been done, most of the and Sugiyanto (2011), based on the results respondents received positive family of his research, it was found that the most support as many as 42 people (57.5%), hypertensive category of respondents was and based on the stage of hypertension the in stage 1 hypertension as many as 22 most respondents were in hypertension people (73.3%), according to him this was stage 1 which was 37 people (50.7%). due to the treatment efforts by respondents Chi-Square test results of family support that is one of them by taking medicine with hypertension stage obtained p value from the health center. Bisnu, Kepel, and 0.014 <α = 0.05. It was concluded that Mulyadi (2017), in their research there was a relationship between family explained that family support is closely support and stage of hypertension. related to the degree of hypertension of Acknowledgements patients. Thank you infinitely for the help B. Bivariate Analysis and guidance from various parties in the 1. Relationship of family support with completion of this research report. stage of hypertension References Based on the results of research Bisnu, M. I. K. H., Kepel, B.J., & conducted, it was found that 42 people Mulyadi. (2017). Hubungan (57.5%) who had positive family support, dukungan keluarga dengan derajat 27 people (64.3%) were in stage 1 hipertensi pada pasien hipertensi di hypertension, and 15 people (35.7%) were Puskesmas Ranomuut Kota in stage 2 hypertension. Of the 31 Manado.Jurnal Keperawatan, 5(1). respondents who had negative family Diperoleh tanggal 4 Januari 2018 dari support, 10 people (32.3%) were in stage https://ejournal.unsrat.ac.id 1 hypertension, and 21 people (67.7%) Dinas Kesehatan Provinsi Riau. (2016). were in stage 2 hypertension.Bisnu, Profil kesehatan 2015. Pekanbaru: Kepel, and Mulyadi (2017), in their Dinas Kesehatan Provinsi Riau. research explained that family support is Diperoleh tanggal 17 Januari 2018 closely related to the degree of dari http://www.depkes.go.id hypertension of patients. This is caused by Efendi, H., & Larasati, T. A. (2017). the degree of hypertension a person is Dukungan keluarga dalam influenced by family support in the manajemen penyakit hipertensi. implementation of patient's hypertension Medical journal of Lampung management. University. 6(1), 34-40. Diperoleh Conclusions tanggal 22 Januari 2018 dari http://juke.kedokteran.unila.ac.id. 96 Poster Presentation Riau International Nursing Conference 2018 RINC2018 Friedman, Marilyn M., Bowden, Vicky R.,& Jones, Elaine. G. (2010). Buku ajar keperawatan keluarga riset teori & praktik (5th ed.). Jakarta: EGC. Kementerian Kesehatan Republik Indonesia. (2017). Profil Kesehatan Indonesia. Jakarta: Kementerian Kesehatan RI. Diperoleh tanggal 17 Januari 2018 dari http://www.depkes.go.id. Kurniadi, Helmanu & Nurrahmani, U. (2015). Stop diabetes hipertensi kolesterol tinggi jantung koroner. Yogyakarta: Istana Media. Nainggolan, D. F. P., Armiyati, Y., & Supriyono, M. (2012). Hubungan Dukungan Keluarga Dengan Kepatuhan Diit Rendah Garam Dan Keteraturan Control Tekanan Darah Pada Penderita Hipertensi di Poliklinik RSUD Tugurejo. Diperoleh tanggal 17 Juli 2018 dari http://portalgaruda.org. Pudiastuti, R. D. (2011). Penyakit pemicu stroke. Yogyakarta: Nuha Medika. Udjianti, Wajan. J. (2013).Keperawatan kardiovaskular. Jakarta: Salemba Medika. WHO. (2015). Raised blood pressure. Diperoleh tanggal 22 April 2018 dari www.who.int/gho/ncd/risk_factors/blo od_pressure_prevalence_text/en/ WHO. (2017). Cardiovaskular diseases (CVDs). Diperoleh 18 April 2018 dari http://www.who.int/mediacentre/Factsh eets/FS317/en Widiarti, Dwi., Yudha, Egi Komara., Wahyuningsih, Esty., Tiar, Estu., Ariani, F. (2011). Kapita Selekta Penyakit: dengan implikasi keperawatan (2nd ed.). Jakarta: EGC. Wijaya, S.A., & Sugiyanto. (2011). Hubungan pola makan dengan tingkat kejadian hipertensi pada lansia di dusun 14 Sungapan tirtorahayu galur kulon progo Yogyakarta. Diperoleh tanggal 30 Juli 2018 dari http://digilib.unisayogya.ac.id 97 Poster Presentation Riau International Nursing Conference 2018 RINC2018 4. EFFECTS OF FOOT REFLECTION MASSAGE AND ACUPRESSURE FOR PATIENT WITH HYPERTENSION Santi Melisa1, Darwin Karim2, Veny Elita3 1School of Nursing, University of Riau 2School of Nursing, University of Riau 3School of Nursing, University of Riau Email: [email protected] Abstract Hypertension is a risk factor of cardiovascular disease. The study aimed to evaluating the effectiveness of foot reflection massage and acupressure on blood pressure with hypertensive patient. The therapy was applied to 34 patients of foot reflection massage and acupressure are chosen by aged 30 to 60 years old attending Health Center Rejosari. Statistic analysis of bivariate was used. Approval on the study was obtained from the Ethical Review Board for Medical and Health Research, Medical Faculty, University of Riau. Mean systolic and diastolic blood pressure pre-test reflection massage (150,49/96,58 mmHg) and acupressure (156,08/102,07 mmHg) and post-test reflection massage (144,42/92,12 mmHg) and acupressure (147,18/95,54 mmHg) decreased at 15 minute after theraphy. There was significant difference of systolic and diastolic blood pressure after the two therapies (p<0,05). Foot reflection massage and acupressure can lower blood pressure in hypertensive patients and may be included in the nursing care plan for hypertension. Keywords : Acupressure, blood pressure, foot reflection massage, hypertension Introduction reducing alcohol consumption, exercise, Hypertension is an abnormal high and relaxation [9]. blood pressure and is measured at least One of the relaxation technique that three readings at different times. A person can be used as an alternative therapy for is considered to have hypertension if his hypertension is foot reflection massage. blood pressure is higher than 130/80 Foot reflection massage performed on the mmHg [2]. Hypertension is 1.13 billion soles of the feet, especially on organs that population in the world [14]. Based on have problems, will provide energy data from the Pekanbaru City Health stimulation to the nerve points associated Office in 2017, hypertension is among the with blood pressure, such as: head, top ten diseases in the city of Pekanbaru, forehead, cerebellum, pituitary gland, which ranks number 2 after upper temples, ears, thyroid gland, kidney, respiratory tract infections. The number of ureter, and the bladder to become active cases of hypertension in Pekanbaru City is so that it produces hormones optimally 35,090 cases in 2017. Alternative options through the nerve points that are on the for lowering blood pressure without drug soles of the feet that are massaged dependence and minimizing side effects appropriately [1]. In patients with are using non-pharmacological hypertension there are also symptoms of management [6]. Non-pharmacological headaches, dizziness, weakness, and treatments that can reduce blood pressure nausea. Headaches in patients with in hypertensive patients can be done in hypertension can be overcome by various ways, such as: with stress acupressure points at the meridian reduction techniques, weight loss, Governing Vessel (GV) 20 Baihui which 98 Poster Presentation Riau International Nursing Conference 2018 RINC2018 are effective for reducing pain [8]. The Foot Acupressure smooth blood in the area of this meeting reflection group Characteristics massage (n=17) Jumlah point makes blood flow to the brain and group heart fulfilled. Point GV 20 Baihui (n=17) functions as a repair of blood vessel n % n % n % circulation and dizziness or headaches due Age Late Adult 5 29,4 4 23,5 9 26,5 to massage at the point GV 20 Baihui 36-45 makes blood flow to the brain and heart Early Elderly 7 41,2 7 41,2 14 41,2 become smooth so that headaches can be 46-55 Late Elderly 5 29,4 6 35,3 11 32,4 resolved and blood pressure becomes 56-65 stable [13]. The study aimed to evaluating the 2. Bivariate Analysis effectiveness of foot reflection massage Tabel 2 and acupressure on blood pressure with Difference of Mean Systolic Blood hypertensive patient. The results of this Pressure Before and After Intervention in study are expected to provide information the Foot Reflection Massage and in the knowledge of the effectiveness of Acupressure Group foot reflexology and acupressure on blood Variable N Mean SD p pressure in hypertensive patients. value Foot Method refelction Pretest 17 150,49 12,74 0,000 This research was carried out in the maasage area of Health Center Rejosari, Pekanbaru group Posttest 17 144,42 13,25 Acupressure Pretest 17 156,08 12,64 City, which started from February to July group 0,000 2018. The study began with a pre-test of Posttest 17 147,18 12,15 blood pressure measurement before being given therapy in the experimental group A Tabel 3 and the experimental group B. In the Difference of Mean Diastolic Blood experimental group A and experimental Pressure Before and After Intervention in group B were given therapy 1 time a day the Foot Reflection Massage and for 15 minutes, after the therapy finished Acupressure Group the therapist did post-test by measuring Variable N Mean SD p value blood pressure. The same process was Foot carried out for 3 consecutive days in the refelction Pretest 17 96,58 6,50 0,000 experimental group A and experiment maasage group Posttest 17 92,12 6,13 group B. This study was used to determine Acupressure Pretest 17 102,07 15,31 0,000 the effectiveness of foot reflexology and group Posttest 17 95,54 14,41 acupressure on blood pressure in hypertensive patients. Discussion Result Respondent Characteristics 1. Univariate Analysis 1. Age Tabel 1 The results of research conducted on Distribution of Respondent hypertensive patients at the Rejosari Characteristics Health Center showed respondents according to the minimum age of 37 years of age and a maximum age of 60 years and the average age of hypertensive respondents aged 51 years. Based on the age category, the most respondents were in the elderly category 46-55 years with a 99 Poster Presentation Riau International Nursing Conference 2018 RINC2018 total of 14 people (41.2%). The results of Hasanah which concluded that foot research conducted by Gerungan, reflection can reduce systolic and diastolic Kalesaran and Akili also stated the same blood pressure in patients with thing that most hypertensive patients were hypertension [10]. in the age range ≥45 years as much as 3. Differences of mean blood pressure 65.4% [3]. before and after acupressure 2. Differences of mean blood pressure intervention before and after intervention foot The results of the Dependent t test reflexology of systolic blood pressure obtained p value The Dependent t test results 0,000 (p <0,05) and the Wilcoxon test obtained p value of 0.000 systolic and diastolic blood pressure obtained p value diastolic blood pressure (p <0.05). This 0,000 (p <0,05). This means that there is a means that there is a significant effect significant influence between the mean of between the mean systolic and diastolic systolic and diastolic blood pressure in the blood pressure of foot reflection massage acupressure group before and after being group before and after being given the given acupressure intervention. Headaches intervention. Research conducted by in patients with hypertension can be Rezky, Hasneli and Hasanah with the title overcome by acupressure points at the "The Effect of Foot Reflection Therapy on meridian Governing Vessel (GV) 20 Blood Pressure in Primary Hypertension" Baihui which are effective for reducing results in foot reflection massage can pain [8]. The smooth blood in the area of reduce systolic blood pressure by 6.29 this meeting point makes blood flow to mmHg and diastolic by 2.09 mmHg [10]. the brain and heart fulfilled. Point GV 20 Massage performed on the area of Baihui functions as a repair of blood foot reflection on the head point, forehead vessel circulation and dizziness or point, cerebellum point, temple point, ear headaches due to massage at the point GV point, ureter point and bladder point 20 Baihui makes blood flow to the brain physiologically stimulates the body to and heart become smooth so that release endorphins, which is a vasodilator headaches can be resolved and blood compound that is able to dilate narrowed pressure becomes stable [13]. Acupressure blood vessels especially blood vessels that is a complementary therapy to balance the are associated with the problematic organ nervous system and endocrine system [4]. so that it can accelerate blood circulation The results of research conducted by in the head, ear and urinary tract so that Widodo with the title "The Effect of blood pressure can go down by Acupressure Therapy on Hypertensive overcoming symptoms such as headaches, Patients in the Synergy Mind Health buzzing ears and frequent urination [11]. Clinic in Surakarta" got the results that the Emphasis on the kidney point can average blood pressure after acupressure inhibit renin production so that it inhibits was 135.6 / 82.6 mmHg lower than before the formation of angiotension II which is a acupressure that is equal to 146.5 / 92.6 strong vasoconstrictor causing increased mmHg [12]. blood pressure [5]. Emphasis on the points After an acupressure intervention, of the pituitary gland and thyroid gland is some respondents said that headaches also able to inhibit hormone release of the were reduced. This opinion is supported hormone diuretic (ADH) and thyroid by Wong which states that suppression of hormone thyroxine (T3) and acupressure at the GV 20 Baihui point triiodotyronine (T4) which trigger serves as an improvement in blood vessel hypertension [1]. This is proven through circulation, if massage is done at the point research conducted by Rezky, Hasneli and GV 20 Baihui makes blood flow to the 100 Poster Presentation Riau International Nursing Conference 2018 RINC2018 brain and heart become smooth so that Sam Ratulangi. 2016. Available from dizziness and headaches can be resolved http://medkesfkm.unsrat.ac.id/ [13]. [accessed 5 Juli 2018] Conclusions Hartono, R. I. W. Akupresur untuk Based on the results of the berbagai penyakit. Yogyakarta: effectiveness of foot reflection massage Rapha Publishing; 2012, p. 67-89. and acupressure on blood pressure in Hayuaji, G. R. Mahir pijat refleksi secepat hypertensive patients who had been kilat. Yogyakarta: Saufa; 2016, P.45- carried out at the Health Center Rejosari 60. Pekanbaru, the results showed that the Kowalski, R. E. Terapi hipertensi: majority of respondents were 46-55 years Program 8 minggu menurunkan old (41.2%). Statistical test results on foot tekanan darah tinggi dan mengurangi reflection massage and acupressure group resiko serangan jantung dan stroke showed very significant results on secara alami. Bandung: Penerbit changes in systolic and diastolic blood Qanita; 2010, p. 89-100. pressure before and after being given foot Kozier, B., Erb, G., Berman, A., & reflection massage and acupressure Synder, S. J. Buku ajar fundamental therapy with (p = 0,000). keperawatan: Konsep, proses, dan Acknowledgements praktik. 7 ed. Jakarta: EGC; 2010, p. Thank you to the University of Riau 26-90. through the University of Riau Research Kwan. Totok aura/wajah meridian 312 Institute and the Faculty of Nursing for cantik eternal beauty. Jakarta: providing the opportunity to be able to PT.Gramedia Pustaka Utama; 2011. publish this research. p. 45-79. 1. Santi Melisa: The Student of Muttaqin, A. Buku ajar asuhan Nursing Faculty, Riau University, keperawatan klien dengan gangguan Indonesia system kardiovaskuler dan 2. Darwin Karim: Lecturer in hematologi. Jakarta: Salemba Medical Surgical Nursing at Faculty of Medika; 2009, p. 56-78. Nursing, University of Riau, Indonesia. Rezky, R. A., Hasneli, Y., & Hasanah, O. 3. Veny Elita: Lecturer in Mental Pengaruh Terapi Pijat Refleksi Kaki Health Nursing at Faculty of Nursing, Terhadap Tekanan Darah pada University of Riau, Indonesia. Penderita Hipertensi Primer. JOM References Vol. 2 No. 2, 2(2), 1454–1462. 2015. Adiguna, P. Titik-titik ajaib. Yogyakarta: Available from Genius Publisher; 2016, p. 23-56. https://jom.unri.ac.id/index.php/JOM American Heart Association (AHA). PSIK/article/view/8319 [accessed 13 Hypertension highlights 2017. 2017. Maret 2018] Available from Wahyuni, S. Pijat refleksi untuk https://healthmetrics.heart.org/wp- kesehatan. Jakarta Timur: Dunia content/uploads/2017/11/Detailed- Sehat; 2014. p.45-60. Summary.pdf [accsessed 15 Mei Widodo, D. S. D. Pengaruh Terapi 2017] Akupresur pada pasien Hipertensi di Gerungan, A., Kalesaran A. F., & Akili, Klinik Synergy Mund Health R. H. Hubungan antara umur, Surakarta. Stikes Kusuma Husada. aktivitas fisik dan Stress dengan 2014. Available from kejaadian hipertensi di Puskesmas http://digilib.stikeskusumahusada.ac.i Kawangkoan. Jurnal: Fakultas d/files/disk1/12/01-gdl-danielsakt- Kesehatan Masyarakat Universitas 101 Poster Presentation Riau International Nursing Conference 2018 RINC2018 565-1-skripsi-7.pdf [accessed 12 Februari 2018] Wong, F. Smartpunktur. Jakarta: Penebar plus, 2011. p. 67-90. World Health Organization (WHO). Hypertension. 2017. available from http://www.who.int/hypertension/en. [accessed 20 Februari 2018] 102 Poster Presentation Riau International Nursing Conference 2018 RINC2018 5. DESCRIPTION OF COMMUNITY BEHAVIOR TOWARDS PREVENTION OF DENGUE HEMORRHAGIC FEVER (DHF) Ruvida Ulfa1, Arneliwati2, Erwin3 1School of Nursing, University of Riau 2School of Nursing, University of Riau 3School of Nursing, University of Riau Email: [email protected] Abstract Dengue Hemorrhagic Fever (DHF) is a disease caused by dengue virus infection which is transmitted by Aedes Aegypti mosquito which is a very dangerous disease that causes death. The highest incidence rate in Pekanbaru City is found in Bukit Raya Sub-district with 91 participants, especially in the Air Dingin Village, which are 27 patients in 2017. This study aims to find out the description of behavior consisting of knowledge, attitudes, and actions of the community towards the prevention of DHF. The study was conducted in the community using a descriptive method with a cross sectional approach. This research was conducted on 100 samples using non probability sampling techniques. The choice of area is taken according to a place that is endemic to the incidence of DHF which consists of 3 RWs which are found in Air Dingin Village. The measuring instrument used is a questionnaire sheet that has been tested for validity and reliability tests. Data analysis used in this study consisted of univariate analysis. The results showed that the community of Air Dingin Village had good majority knowledge of 54 respondents (54%), most of them had negative attitudes of 51 respondents (51%), and most of the negative community actions were against prevention of dengue as many as 55 respondents (55%). It is suggested to the community to be able to further increase their knowledge so that the community can encourage better attitudes and actions in the prevention of dengue. Keywords: Dengue Hemorrhagic Fever (DHF), behavior Introduction has spread to all provinces in Indonesia Dengue Hemorrhagic Fever (DHF) (Manalu & Munif, 2016). is a disease caused by dengue virus The problem of DHF until now still infection transmitted through the Aedes requires serious attention, especially in Aegypti mosquito (Chelvam & Pinatih, Riau Province. In 2015 the number of 2017). The incidence of DHF has dengue cases in Riau Province was increased dramatically throughout the reported as many as 3,261 people with world in recent years. Prevalence of 3.9 morbidity and mortality rates of 20 billion people in 128 countries in the people. One of the cities in Riau Province world is at risk of dengue virus infection is Pekanbaru. The increase in the number (World Health Organization [WHO], of DHF patients in Pekanbaru 2015 was 2017). reported as many as 516 cases of sufferers DHF cases in Indonesia were first and 5 deaths (MOH, 2015). discovered in Surabaya 1968, where as Based on data from the Pekanbaru many as 58 people were infected and 24 City Health Office in 2017, the number of of them died with the Case Fatality Rate dengue cases was 598 patients and 3 (CFR) reaching 41.3%. Since then, DHF deaths. The incidence of DHF is based on 103 Poster Presentation Riau International Nursing Conference 2018 RINC2018 the 12 highest endemic districts; 91 while 76.6% argue that the infectious sufferers in Bukit Raya, 83 sufferers in through Aedes Aegypti mosquitoes. High Tenayan Raya, 71 sufferers and 1 death levels of public knowledge about cases in Marpoyan prevention of dengue will influence Damai. The highest data obtained attitudes to make decisions in behaving. A from Harapan Raya Community Health person's attitude in an effort to prevent Center, Bukit Raya District are found in DHF is important because of their Air Dingin Village with 27 patients and knowledge and experience can lead them Tangkerang Selatan Village with 23 to take a proper action. patients (Harapan Raya Community Based on a preliminary study on Health Center, 2017). February 6, 2018 conducted around the The cause of DHF can be area of Air Dingin Village which was transmitted through Aedes Aegypti conducted with observations of 10 people. mosquito. Mosquito breeding sites can be Based on knowledge; there were 8 people found in humid environments, high who did not know the abbreviation of 3M, rainfall, in places that are flooded both in and 4 people did not know the homes and outdoors and scattered or piled Community Health Center program for garbage. Bad environmental situation, eradicating dengue. Based on the attitude; unhealthy community behavior, and there were 2 people who did not know the population density are another factors that effort to prevent dengue disease. Based on caused DHF (Gama & Betty, 2010). DHF behavior; there were 4 people cleaned the is also one of the diseases that can spread bath once every two weeks, 6 people did rapidly and often fatal because many not close their water storage, 4 people did patients die due to the slow treatment not use abate powder, 10 people never (Widoyono, 2011). bury their waste because the garbage was Commnunity behavior that linked collected every two days, and there were 2 on how to eradicate dengue mosquito nest people collected it to be sold. with positive behaviors such as efforts to Based from the background above, drain, close, bury (3M), while negative the researchers initiated a study on the behavior can be contradictions from those description of people's behavior towards efforts. Mosquito Nest Eradication (MNE) the prevention of Dengue Hemorrhagic of Dengue Hemorrhagic Fever (DHF) Fever (DHF) in Air Dingin Village, Bukit have not been realized optimally because Raya District, Pekanbaru. there are still many trash that is dumped The purpose of this study was to carelessly around the yard and in determine the behavior of the community residential areas such as used cans and towards the prevention of dengue in the tires that are not used (Packing & Nelwan, Air Dingin Village, Bukit Raya District, 2012). Pekanbaru. The results of Manalu and Munif's The benefits of this study are that it (2016) study of community knowledge in can be used as information related to West Java and West Kalimantan community behavior towards prevention Provinces can be said to be still poor, of dengue and as a reference for the based on the results of respondents' development of community nursing answers to whether or not they’ve ever science so that people can overcome heard about DHF, the causes, and modes dengue problems. of transmission. There were 600 Method respondents; 7.2% participants had heard The study design is descriptive with about DHF, 81.5% argue that the a cross sectional approach. The population transmission through mosquito bites, 104 Poster Presentation Riau International Nursing Conference 2018 RINC2018 was observed from Air Dingin village, the age of 26-35 years old (early adults). Pekanbaru. The majority of respondents were female, A total of 100 families were as many as 72 respondents (72%). A observed using non-probability sampling number of 42 respondents (42%) were technique with a type of purposive high school graduate, and 49 respondents sampling by taking areas that are endemic (49%) were housewives. in the Air Dingin Village, Pekanbaru. Table 2 Data collection tools using questionnaires Frequency Distribution Based on consisting of the characteristics of Community Knowledge against DHF respondents and statements about the Prevention No Frequency Percent description of people's behavior towards Knowledge prevention of dengue which consists of 3 . (n) age (%) domains of behavior, namely: knowledge, 1 Good 54 54 attitude, and action. Data analysis used is 2 Poor 46 46 univariate analysis using frequency Total 100 100 distribution. Result Based on table 5, it is known the 1. Univariate Analysis results of the analysis of 100 respondents, Frequency distribution in the most of whom had good knowledge, characteristic table of respondents. namely 54 respondents (54%). Table 1 Table 3 Distribution of Respondent Characteristics Frequency Distribution Based on the Respondent Frequency Percentage Community Attitudes towards DHF Characteristics (n) (%) Prevention. Age No Frequency Percent Attitudes 21-35 years old 49 49 . (n) age (%) (Early adult) 1 Positive 49 49 36-45 years old 17 17 (Late adult) 2 Negative 51 51 46-55 years old 23 23 Total 100 100 (Early Elderly ) 56-65 years old 11 11 (Late elderly) Based on table 3, from 100 Gender respondents, the majority of respondents Man 28 28 have negative attitudes, namely 51 Woman 72 72 respondents (51%). Education Table 4 Degree Frequency Distribution Based on SD 9 9 SMP 8 8 Community Actions against Dengue SMA 42 42 Prevention. No Frequency Percent University 41 41 Actions Occupation . (n) age (%) Entrepreneur 29 29 1 Positive 45 45 Housewive 49 49 2 Negative 55 55 Nurse 1 1 Civil Servant 4 4 Total 100 100 Lecture 2 2 Teacher 15 15 It is showned that mainly 55 Total 100 100 respondents (55%) out of 100 have negative actions. Based on table 1 shows that from Discussion 100 respondents, 49 respondents (49%) at 1. Univariate Analysis 105 Poster Presentation Riau International Nursing Conference 2018 RINC2018 a. Characteristics of Respondents of DHF will have the opportunity to 1) Age behave well compared to low knowledge. The results showed 100 respondents 2) Community attitudes towards dengue were mostly aged 21-35 years old (early prevention adults) totaling 49 respondents (49%). This study represented that most of Suryati, et al (2013) stated that the the respondents had a negative attitude, respondent's age > 35 years revealed that which amounted to 51 respondents (51%). the behavior (knowledge, attitude and This research is in line with the research practice) of a person is due to maturation by Bahtiar (2012) with the frequency where the more aged or mature one will distribution of attitudes mostly having a be very quick to adapt to the environment. negative attitude of 72.5%. It can be 2) Gender illustrated that negative attitudes tend to Out of 100 participants, 72 (72%) of show a lack of role for the character in them were females. According to Lee, controlling DHF. Fitriangga, and Nawangsari (2014) 3) Community actions to prevent DHF Distribution of respondents by gender was It is reported that mainly 55 respondents mostly female, which was 61 respondents (55%) had taken an action to prevent it. (64.2%). Research by Purba, et al (2014) 3) Education Degree stated that most of the respondents' actions Most of the respondents surveyed on dengue control were in the sufficient had a high school degree (42 respondents / category, namely as many as 42 42%). In line with Purba, Keloko, and respondents (50%). This is due to the Syahrial (2014) research that the limited time to do 3M because of the education level of participator in general amount of activity used to make a living is high school / vocational graduate, outside the home. namely as many as 35 respondents Conclusion (41.67%). Based on the results of the analysis 4) Occupation and discussion of research on the During the survey, it was dominated description of community behavior by housewives, with a total of 49 towards the Dengue Hemorrhagic Fever respondents (49%). (DHF) prevention in Air Dingin Village, In accordance to Pangemanan ad Bukit Raya district, Pekanbaru, conducted nelwan study (2012), participant’s status on 100 respondents, it can be concluded as housewives (IRT) carry out more based on the respondents' characteristics, routine activities at home such as the majority of respondents were 21-35 maintaining cleanliness and comfort at years old (early adults) as much as 49 home. respondents (49%), then the gender of the b. Representation of Community majority of women was 72 respondents Behavior against Dengue (72%), then the most educated were Hemorrhagic Fever (DHF) mostly high school with a total of 42 Prevention respondents (42%), and unemployemnt / 1) Community knowledge of dengue housewives (IRT) with 49 respondents prevention (49%). Based on people's behavior Research showed on 100 towards the prevention of dengue respondents, most of the respondents had hemorrhagic fever (DHF) which consists good knowledge, namely 54 respondents of the knowledge most of the people have (54%). The results of the study by Suryati, good knowledge, namely 54 respondents et al (2013) revealed that high knowledge (54%), then from the attitude of the community most have a negative attitude 106 Poster Presentation Riau International Nursing Conference 2018 RINC2018 with the number of 51 respondents (51%), wilayah Puskesmas Kawalu Kota and the actions of the community mostly Tasikmalaya. Aspirator, 4(2), 73-84. have negative actions with a total of 55 Retrieved on July 25th 2018 from respondents (55%). http://ejournal.litbang.depkes.go.id/in Suggestion dex.php/aspirator/article/view/3010. 1. For the Development of Nursing Chelvam, R., & Pinatih, I. G. N. I. (2017). Science Gambaran perilaku masyarakat dalam This study are expected to add more pemberantasan sarang nyamuk information and input for the development demam berdarah dengue (PSN DBD) of nursing science, especially for dan kemampuan mengamati jentik di community nurses about community wilayah kerja Puskesmas behavior towards prevention of dengue. Banjarangkan II. Intisari Sains Medis, 2. For Service Institutions 8(3), 164–170. Retrieved on Fenruay The study results are expected to always 3rd 2018 from provide counseling about the community Https://doi.org/10.1556/ism.v8i3.136 behavior towards the dengue prevention Depkes. (2015). Profil Kesehatan Provinsi so that the community gain an Ria. 1–138. Retrieved on December understanding and can periodically control 27th from the environment, and also invites the http://www.depkes.go.id/resources/downl community to actively participate in the oad/profil/PROFIL_KES_PROVINSI prevention of dengue. _2015/04_Riau_2015 3. For the Community Dinas Kesehatan Kota Pekanbaru. (2017). It is hoped that community will always Jumlah kasus terbanyak demam find out more about DHF and be able to berdarah dengue di Kota Pekanbaru. do and improve the prevention of DHF. Pekanbaru: City Health Office. 4. For Further Research Gama T, A., & Betty R, F. (2010). The data obtained are expected to use as Analisis faktor risiko kejadian demam an information for further researchers so berdarah dengue di Desa Mojosongo that further researchers can continue Kabupaten Boyolali. Eksplanasi, 5(2), research on the description of community 1–9. Retrieved on January 1st 2018 behavior towards dengue prevention. from Acknowledgements http://www.kopertis6.or.id/journal/index.p Thank you to all parties for your hp/eks/article/download/12/10 help and guidance in completing this Lee, H., Fitriangga., & Nawangsari. research report. (2014). Hubungan perilaku 1Ruvida Ulfa: Mahasiswa Fakultas pencegahan terhadap kejadian demam Keperawatan Universitas Riau, berdarah dengue pada masyarakat Indonesia Kelurahan Sungai Jawi dalam. 2Arneliwati: Nursing Lecturer of the Tanjungpura University, Pontianak. Nursing Faculty Community of Riau Retrieved on July 5th 2018 from University, Indonesia https://media.neliti.com/media/public 3Erwin: Lecturer at the Department of ations/193477-ID-hubungan-perilaku- Medical Nursing, Faculty of Nursing, pencegahan-terhadap-ke. University of Riau, Indonesia Manalu, H. S. P., & Munif, A. (2016). References Pengetahuan dan perilaku masyarakat Bahtiar, Y. (2012). Hubungan dalam pencegahan demam berdarah pengetahuan dan sikap tokoh dengue di Provinsi Jawa Barat dan masyarakat dengan perannya dalam Kalimantan Barat. Aspirator, 8, 69– pengendalian demam berdarah di 76. Retrieved on February 9th 2018 107 Poster Presentation Riau International Nursing Conference 2018 RINC2018 from Suyasa, I. N. G., Putra, N. A., & Aryanta, https://media.neliti.com/media/public I. W. R. (2012). Hubungan faktor ations/54943-ID-pengetahuan-dan- lingkungan dan perilaku masyarakat perilaku-masyarakat-dala. dengan keberadaan vektor demam Marini, D. (2009). Gambaran berdarah dengue (DBD) di wilayah pengetahuan, sikap, dan tindakan kerja puskesmas I Denpasar Selatan. mengenai dbd pada keluarga di Jurnal Ilmu Lingkungan, 3 (1), 1-6. kelurahan Padang bulan tahun 2009, Retrieved on February 24th 2018 2010. Scientific papers. Retrieved on from July 2nd 2018 from https://ojs.unud.ac.id/index.php/ECO http://repository.usu.ac.id/bitstream/h TROPHIC/article/view/2484 andle/123456789/14267/10E00022.p Vyas, M. J. (2013). Dengue fever. df;sequence=1 Retrieved on December 27th 2018 Notoatmodjo, S. (2012). Metodologi from penelitian kesehatan. Jakarta: Rineka https://medlineplus.gov/ency/article/0 Cipta. 01374.htm Pangemanan, J., & Nelwan, J. (2012). Wahyuni, R. D., & Sabir, M. (2011). Perilaku masyarakat tentang program Karakteristik penderita Demam pemberantasan penyakit dbd di Berdarah Dengue (DBD) di Rumah Kabupaten Minahasa Utara. Kesmas, Sakit Wahidin Sudirohusodo 45–50. Retrieved on February 15th Makassar Periode Januari - Desember 2018 from 2010. Inspirasi, 14. Retrieved on July http://jkesmasfkm.unsrat.ac.id/wp- 25th 2018 from content/uploads/2013/02/8. http://jurnal.untad.ac.id/jurnal/index.p Purba, D. A. M., Keloko, A, B., hp/INSP/search/authors. &Syahrial, E. (2014). Gambaran WHO. (2017). Dengue and severe dengue. perilaku masyarakat dalam Retrieved on April 27th 2018 from penanggulangan demam berdarah http://who.int/mediacentre/factsheets/ dengue di nagori rambung merah fs117/en/ kabupaten Simalungun tahun 2014. Widoyono. (2011). Penyakit tropis: Universitas Sumatra Utara. Retrieved epidemiologi, penularan, pencegahan on July 2nd 2018 from & pemberantasannya. Jakarta: https://media.neliti.com/media/public Erlangga. ations/14367-ID-gambaran-perilaku- masyarakat-dalam-penanggulangan- demam-berdarah-dengue-di-nagor. Harapan Raya Health Center. (2017). Jumlah kasus terbanyak demam berdarah dengue di Kecamatan Bukit Raya. Pekanbaru: Puskesmas Harapan Raya. Suryati, E. S., Rosidawati., & Maryam, R. S. (2013). Perilaku masyarakat dalam pencegahan demam berdarah dengue antara zona hijau dan zona merah. JKep 1, 67–76. Retrieved on July 2nd 2018 from file:///C:/Users/user/Downloads/24- 36-1-SM. 108 Poster Presentation Riau International Nursing Conference 2018 RINC2018 6. NOMOPHOBIA: INCIDENTS AND LEVELS AMONG INDONESIAN TEENAGERS Astari Rezki1, Ganis Indriati2, Erwin3 1Student of Faculty of Nursing, University of Riau 2,3Lecturer of Faculty of Nursing, University of Riau Email: [email protected] Abstract Objective: Nomophobia is a phobia of the modern era and the result from the interaction between humans and new technology, because now smartphones have taken over the cellular phone market and almost replaced cell phones.This study aims to identify nomophobia incidence and levels among teenagers. Method: This research is a quantitative research with descriptive-evaluative research design.The sample of the study consisted of 260 respondents purposively selected using proportionate stratified random sampling technique. A valid and reliable Nomophobia Questionnaire (NMP-Q) was utilized to capture data prior to analysis using descriptive statistics. Result: The study found out that (78.1%) of the respondents are moderately nomophobic. Conclusion: The study reveals initial incidence of nomophobia among a select group of Indonesian adolescents, and recommends orientation to new technologies and further studies. Keywords: nomophobia, teenager, smartphone Introduction phobia of the modern era and results from Smartphone is one of the the interaction between humans and new communication media that is in the technology, because now smartphones spotlight because it has the sophistication have taken over the cellular phone market in various things and its effective and and almost replaced cell phones. efficient functions that can be used Nomophobia has four aspects, namely, anytime and anywhere. Excessive use of inability to communicate, loss of smartphones will cause health problems connection, inability to access such as dizziness, earache, and blurred information, and comfort provided by eyes due to radiation exposure is one of smartphones (Yildirim, 2014). the most frequently debated problems. Pavithra, Madhukumar and Prabandari (2017) states that Mahadeva (2015) have also conducted smartphone addiction is called research with the title A study on nomophobia. Nomophobia or commonly nomophobia – mobile phone dependence, known as no mobile phone phobia or among students of a medical college in disease cannot be far from mobile phone Bangalore with research subjects of 200 is a disease of dependence experienced by students consisting of 47.5% of women an individual on a cellular phone, so that it and 52.5% of men man. About 23% of can bring excessive concerns if the students feel lost in concentration and cellular phone is not nearby (Hardianti, become stressed when they are away from 2016). cell phones, 39.5% of students experience In this study nomophobia will be nomophobia while 27% are at risk of discussed in relation to smartphones. As experiencing nomophobia. King et al. (2010) stated, nomophobia is a 109 Poster Presentation Riau International Nursing Conference 2018 RINC2018 The results of the preliminary study (98.8%). In a day the majority of were conducted at SMP 25 Pekanbaru, respondents use a smartphone that is 3 which is one of the schools with the most hours (40.4%) in a day. students in Pekanbaru according to the Description nomophobia in adolescents Pekanbaru City Education Agency in Table 2 2017/2018, using interview techniques for Frequency distribution of nomophobia 10 class VII and VIII students who use images in adolescents (n=260) smartphones and obtained 5 students Nomophobic level Amount Percentage using smartphones more than 10 hours a (n) (%) day, 2 dependency students with Weight 31 11,9 Medium 203 78.1 smartphones in carrying out their daily Light 26 10.0 activities and 3 students who have started Total 260 100 to feel uneasy when they are far away from smartphones. Table 2 shows that the majority of Method respondents experienced moderate This type of research is quantitative nomophobia, namely 203 respondents research using descriptive research design. (78.1%). The population in this study were all Length of use of smartphones students of class VII and VIII at SMP N Table 3 25 Pekanbaru with a population of 748 Distribution of the old frequency of people. Sampling in this study uses smartphone usage (N=260) techniques proportionate stratified Length of use of Amount Percentage random sampling. Tools data collection smartphones (n) (%) using questionnaires compiled by Yildirim Height (> 3 hours) 62 23.9 (2014), namely Nomophobia Medium (3 hours) 105 40.4 Questionnaire (NMP-Q) with a total of 20 Low (<3 hours) 93 35.8 Total 260 100 statements. Data analysis used is univariate analysis using frequency Table 3 shows that the majority of distribution. respondents use a smartphone that is 3 Result hours (40.4%) in a day. Univariate Analysis Discussion Characteristics of Respondents Characteristics of Respondents Table 1 Gender Respondent Frequency Distribution Based The results of the study found that on Demographic Data (N=260) Characteristics of Amount Percentage most of the respondents were male, as respondents (n) (%) many as 159 respondents with a Gender percentage (61, 2%). The number of Man 159 61.2 SMP N 25 Pekanbaru students is more Woman 101 38.8 male so the respondents in this study are Age dominated by men. Data obtained from 11-14 years 257 98.8 15-17 years old 3 1,2 the Pekanbaru City Education Office in Total 260 100 the academic year 2017/2018 revealed that there were 386 male students and 356 Table 1 shows that most of the female students. respondents are male, as many as 159 The results of this study are in line respondents (61.2%). The age with the research conducted by Pavithra, characteristics of the most respondents Madhukumar and Mahadeva (2015) with aged 11-14 years were 257 respondents the title A study on nomophobia – mobile 110 Poster Presentation Riau International Nursing Conference 2018 RINC2018 phone dependence, among students of a One of the important things in social medical college in Bangalore with change in adolescents is the increased research subjects of 200 students time to connect with their peers, but in consisting of 47.5% women and 52.5% of teenagers who experience nomophobia men. tend to spend their time playing This is in contrast to the results of smartphones and not caring about the research conducted by Gezgin, Sumuer, environment both family and peers. Arslan and Yildirim (2016) on Research conducted in the United nomophobia prevalence among pre- Kingdom (2008) involving 2100 service teachers: a case of tramya respondents, showed that 53% of university is known that out of 818 respondents suffered from nomophobia. respondents there were 589 respondents This study also revealed that men are (72.0%) of type female genital. more vulnerable to nomophobia than Age women, with 58% of men and 48% of The results of the study showed that women. The causes of nomophobia 260 respondents showed the highest include lack of parental supervision of respondents at the age of 11-14 years, their children, having a new smartphone, namely 257 respondents with a percentage being curious about information, and the of 98.8%. Age 11-14 years is the early many features of the smartphone. teenage age. Early adolescents, having Teenagers who suffer from nomophobia enthusiasm bring passion and passion into will have a negative impact on the social their actions. Adolescence is a time when environment, lack of confidence, felt they a person has a high sense of curiosity, thus could not leave the smartphone even encouraging them to explore something though briefly so that their daily activity through a smartphone that causes becomes disturbed, less focused, and teenagers to be far from smartphones, this insomnia. is one sign of nomophobia. The results of The phenomenon that is often found research conducted by Gezgin, Sumuer, in everyday life, adolescents often operate Arslan and Yildirim (2016) on mobile phones in an inappropriate nomophobia prevalence among pre- atmosphere, such as in the midst of family service teachers: a case of trajectory events, serious talks, when eating, and university found that there were 341 even going to the toilet (Mulyana & respondents (41.7%) who experienced Widyastuti, 2017). Although the use of nomophobia under 20 years of age. smartphones in the middle of the event or Description of nomophobia in interaction is considered normal for some adolescents and the duration of people, but the surrounding environment smartphone use will feel uncomfortable if the interlocutor The results of this study indicate uses the smartphone continuously or that 100% of respondents belong to the through out the interaction. These nomophobia category. The results of the conditions will interfere with the ongoing research have revealed that the majority of conditions. Sudarji (2017) found that respondents have a moderate nomophobia patients with nomophobia will check his level of 203 respondents (78.1%). smartphone up to 34 times a day and often Nomophobia criteria is that teenagers feel take it anywhere to the toilet. anxious when far away from a smartphone In this study there were 31 but still interact with peers. respondents (11.9%) who experienced This is consistent with the social severe nomophobia. This must be transition experienced by adolescents as overcome immediately because it will indicated by changes in social relations. have a bad impact on health such as the 111 Poster Presentation Riau International Nursing Conference 2018 RINC2018 risk of cancer because the effects of Reference radiation from the smartphone are too Ali, M., & Asrori, M. (2016). Adolescent frequent, impaired vision due to too often psychology: Development of students. staring at the smartphone screen so that Print eleventh. Jakarta : PT. Bumi eyes rarely blink causing eye muscles to Aksara. tense, decreased immune system because Asih, AT, & Fauziah N. (2017). The too often playing smartphones becomes relationship between self-control and less resting and affects the immune anxiety is far from smartphones system, and is affected by carpal tunnel (nomophobia) in students majoring in syndrome because they use smartphones communication science at the social too often (Mulyana & Widyastuti, 2017). and political sciences of the Conclusions university in Semarang. Research on nomophobia images in Journal Empathy, 6 (2), 15-20. adolescents that have been conducted on Dixit S., Shukla H., Bhagwat A., Bindal 260 respondents in SMP N 25 Pekanbaru A., Goyal A., Zaidi AK & can be concluded based on the Shrivastava, A. (2010). A study to characteristics of respondents that most evaluate mobile phone dependence respondents are male respondents as many among students of a medical college as 159 respondents (61.2%) and most of and associated hospital of central them are 11-14 years old as many as 257 India. Indian J Community Med, 35 respondents (98.8%). The results of this (2): 339-341. study indicate that of 260 respondents, 26 Gezgin. DM, Sumuer. E., Arslan. O., & respondents had nomophobia levels mild Yildirim. S. (2016). Nomophobia as much (10.0%), students who have prevalence among pre-service nomophobia levels while there were 203 teachers: a case of university training. respondents (78.1%), and students who Trakya Universitesi Egitim Fakultesi had nomophobia levels weight of 31 Dergisi, 7 (1), 86-95. respondents (11.9%). Hardianti. (2016). Interpersonal Acknowledgements communication of nomophobic The results of this study are patients in a friendly relationship, expected to be information for nursing JOM FISIP, 3 (2), 1–14. Obtained on about problems that occur in adolescents. March 14, 2018 from Research result this is also expected can https://jom.unri.ac.id/ be information and evidence based for me King, ALS, Valença, AM, Silva, AC, to do further research. Sancassiani, F., Machado, S., & Thank You Note Nardi, AE (2014). "Nomophobia" : Thanks for the helped and guide from impact of cell phone use interfering various parties in the completion of this with symptoms and emotions of research report. individuals with panic disorder compared with a control group. 1 Astari Rezki : Faculty of Nursing Pamungkas, RA, & Usman, AM (2017). University of Riau, Indonesia. Nursing research methodology. 2 Ns. Ganis Indriati, M.Kep., Sp. Kep. Jakarta CV Trans Info Media. An : Dosen Science Field Nursing Pavithra MB, Madhukumar S., & Murthy Children Faculty of Nursing, University of TS, M. (2015). A study on Riau, Indonesia. nomophobia – mobile phone 3 Erwin, M.Kep : Lecturer in Science in dependence, among students of a Medical Nursing, Faculty of Nursing, medical. National Journal of University of Riau, Indonesia. Community Medicine, 6 (2), 340–344. 112 Poster Presentation Riau International Nursing Conference 2018 RINC2018 Retrieved on March 14, 2018 from https://doi.org/ Polytechnic. (2012). Teenager's health and solution. Jakarta : Salemba Medika Potter, PA, & Perry, AG (2009). Fundamentals of nursing, 7th Ed (Adrina Ferderika, Translator). Jakarta : Salemba Medika Prabandari, RM, Muyassaroh, NA, & Mahmudi, I. (2017). Islamic Counseling for Nomophobia among Teenagers, Proceedings of SNBK (National Seminar on Guidance and Counseling) 1 (1), 189–194. http://prosiding.unipma.ac.id/ Tran, D. (2014). Classifying nomophobia as smartphone addiction disorder. UC Merced Undergraduate Research Journal, 9 (1) Obtained on 1 May 2018 from https://escholarship.org Yildirim, C. (2014) Exploring the dimensions of nomophobia : Developing and validating a questionnaire using mixed methods research. Graduate Theses and Dissertations. Paper 14005. Obtained on May 1, 2018 from https://lib.dr.iastate.edu 113 Poster Presentation Riau International Nursing Conference 2018 RINC2018 7. THE DESCRIPTION OF GYMNASTICS ACTIVITY AND COGNITIVE FUNCTION ON ELDERLY Lina Maria Siagian1, Arneliwati2, Siti Rahmalia Hairani Damanik3 1Student of Faculty of Nursing University of Riau 2,3Faculty of Nursing University of Riau Email: [email protected] Abstract Objective: The elderly experience the aging process resulting in decreased function of the body such as cognitive function. Method: The design of research was descriptive. The sample of this research was 40 respondents taken based on inclusion criteria using total sampling technique that are elderly aged over 60 years, elderly who lived in the working area of community health centers, and the elderly who do gymnastics. Montreal Cognitive Assessment sheet (MoCa-Ina) applied to measure cognitive performance and a questionnaire for their exercise program with frequency distribution statistics. Results: The results showed there were 21 respondents (52.5%) did gymnastics 3 times a week, 34 respondents (85%) did gymnastics 20-60 minutes per session, 19 respondents (47.5%) did fitness for elderly, and as much as 28 respondents (70%) had cognitive impairment. Conclusions: Based upon this studies, the researcher suggest to increasing physical activity with promoting memory exercises for elderly in order to reduce risk of poor cognition. Keywords: Cognitive function, Elderly, Gymnastics Introduction Physical exercise can have a Aging is a process of slowly positive influence on cognitive function disappearing (graduil) the ability of tissue because it improves cardiovascular risk to repair or replace and maintain normal factors and affects neurotropic factors, structure and function, resistance to both of which are responsible for brain injury, including infection. Aging will health and affect cognitive performance. cause changes in the structure and One of the physical exercises that can be physiology of various cells, tissues, done by the elderly is gymnastics organs, and systems that exist in the (Kusumowardani & Wahyuni, 2017). human body (Mubarak, 2012). According to Widianti and The aging process causes cognitive Proverawati (2010), elderly gymnastics is impairment, which is clearly seen in a series of regular and directed and memory and intelligence (Santoso & planned tone movements that are followed Ismail, 2009). Cognitive function is a by elderly people in the form of physical mental process in acquiring intelligence or exercises that affect the physical abilities ability, which includes ways of thinking, of the elderly. Knowledge of working memory, understanding, planning, and memory of the elderly increases implementation (Santoso & Ismail, 2009). effectively in old age through the active Decreasing cognitive function can cause role of the elderly in memory training. setbacks in the form of cognitive abilities Research on the effects of memory and setbacks in psychosocial aspects training in the elderly shows an increase (Tamher & Noorkasiani, 2009). in orientation in space and time (Kushariyadi, 2013). 114 Poster Presentation Riau International Nursing Conference 2018 RINC2018 Based on a preliminary study 1 Age conducted by researchers, it was found Elderly (60-74 36 90,0 that 7 out of 10 elderly experienced years old) Old (75-90 4 10,0 cognitive impairment. The results of the years old) preliminary study showed the elderly said 2 Gender it was difficult to remember especially the Male 3 7,5 things that had just been said (short-term Female 37 92,5 memory) and experienced confusion in 3 Ethnic Minang 19 47,5 place and time orientation. Melayu 16 40,0 The purpose of this study was to Batak 4 10,0 describe the cognitive function in the Jawa 1 2,5 elderly who did gymnastics. 4 Marital Status The results of this study are Married 20 50,0 Widow 20 50,0 expected to provide information in the 5 Last Education development of knowledge about the No School 2 5,0 benefits of gymnastics on cognitive Primary School 12 30,0 function in the elderly. Junior High 6 15,0 Method School Senior High 16 40,0 This research was conducted in the School Harapan Raya Health Center area, Bachelor 4 10,0 Pekanbaru City, which began from 6 Job February to July 2018. This study used Housewife 29 72,5 quantitative research methods with Trader 5 12,5 descriptive research designs. Pension 6 15,0 7 Type of Illness The population in this study were all Do not have 11 27,5 elderly people who did gymnastics at chronic diseases Harapan Raya Health Center, Pekanbaru. Hipertension 13 32,5 Sampling uses total sampling technique Diabetes 5 12,5 with inclusion criteria, namely elderly mellitus Cholesterol 6 15,0 people aged 60 years and over, elderly Uric Acid 5 12,5 who live in the working area of Harapan 8 Time Taking Raya Health Center, and the elderly who Gymnastic do gymnastics. s The data collection tool used in this <6 months 3 7,5 >6 months 37 92,5 study was the MoCA-Ina (Montreal Total 40 100 Cognitive Assessment) questionnaire to determine cognitive function in the elderly Table 1 shows that of the 40 with a sensitivity level of 90% and a respondents, the characteristics based on specificity rate of 87%. the age of the majority were in the elderly Result category (60-74 years), namely as much Univariate Analysis as 90%, based on the sex of the majority Distribution based on the characteristics of elderly women as many as 92.5%, of the respondents is explained in table 1 based on the most elderly tribe with below. Minang as much as 47.5%, based on the Table 1 marital status of the elderly as big as Distribution of Frequency of married to a widow as much as 50%, Characteristics of Respondents based on the latest education the most Frequency Percentage No Characteristics (f) (%) elderly have a high school education level 115 Poster Presentation Riau International Nursing Conference 2018 RINC2018 that is as much as 40%, based on work Frequency Distribution of Elderly most of the elderly work as housewives Cognitive Functions Conducting Gymnastics which is as much as 72.5 %, based on the type of disease suffered by the majority of elderly people experiencing hypertension, namely as much as 32.5%, and based on the duration of gymnastics, the majority of Cognitive Frequency Percentage the elderly had done gymnastics> 6 Function (f) (%) Positive (≥26 12 30,0 months as much as 92.5%. poin) Table 2 Negative (0-25 28 70,0 Frequency Distribution of Respondent poin) Training Programs Total 40 100 No Training Frequency Percentage Program (f) (%) Table 3 shows that most of the 1 Gymnastics respondents experienced impaired Frequency cognitive function as many as 28 people <3 times a 13 32,5 week (70%). 3 times a 21 52,5 Discussion week 1. Characteristics of Respondents 3-5 times a 6 15,0 a. Age week The results of the research 2 Gymnastics Duration conducted on 40 respondents found that <20 5 12,5 the majority were in the elderly age minutes/sess category (60-74 years), as many as 36 ion people (90%). The results of the Pinilih 20-60 34 85,0 study (2017), showed a positive minutes/sess ion relationship between age and decreased >60 1 2,5 cognitive function. This happens because minutes/sess the increasing age results in changes in ion anatomy, such as the shrinking of the 3 Type of brain and biochemical changes in the Gymnastics Elderly 24 60,0 central nervous system so that itself can Gymnastics cause a decline in cognitive function. Aerobic 3 7,5 b. Gender Leisurely 13 32,5 The results of research conducted on Strolling 40 respondents found that the majority of Total 40 100 the elderly who were active in exercising Table 2 shows that of the 40 were women, as many as 37 people respondents, the gymnastics frequency- (92.5%). The results of research based exercise program for the majority of conducted by Pinilih (2017), stated that the elderly did gymnastics 3 times a week women are more at risk of experiencing which was 52.5%, based on the cognitive function decline. This is due to gymnastics duration the majority of the the role of endogenous sex hormone levels elderly exercised 20-60 minutes / session in changes in cognitive function. Estrogen ie 85%, and based on the type of gym receptors are found in areas of the brain most of the elderly do elderly fitness that play a role in learning and memory exercises as much as 60%. functions, such as the hippocampus. Low Table 3 levels of estradiol in the body are 116 Poster Presentation Riau International Nursing Conference 2018 RINC2018 associated with a decrease in general Social involvement or adequate physical cognitive function and verbal memory. activity can affect neural synaptogenesis c. Ethnic so that it can stimulate nerve branching in The results of the research the hippocampus so that it can reduce the conducted on 40 respondents found that decline in cognitive abilities that increase the majority of respondents were Minang the risk of dementia. people, namely 19 people (47.5%). This is g. Type of Illness due to the research location in Riau The results of research conducted on Province, where the majority of the 40 respondents found that most population is Minang. respondents experienced hypertension as d. Marital Status many as 13 people (32.5%). Hypertension The results of research conducted on is one of the risk factors for impaired 40 respondents found the same number cognitive function in the elderly. between married and widows, namely 20 Hypertension as a risk factor for vascular people (50%). dementia, which is partly made possible According to Yuliati's research through the occurrence of stroke with the (2014), married elderly people have a size of lesions both large and small. Based higher average physical domain than on the results of a study by Masruroh widows. Elderly people who still have (2014), states that increased blood complete or married couples will pressure increases the risk of dementia in influence the health condition of the elderly men who have never been treated elderly both physically and biologically. with antihypertensive drugs. This is also in accordance with Cardiovascular disease is a risk Mongisidi's (2013) study, showing that factor for decreasing age-related cognitive respondents who had been married and function and dementia. Diabetes mellitus had children equal to or more than two is one of the diseases associated with had normal cognitive function tests. blood vessels and experienced by e. Last Education respondents as much as 12.5%. People The results of research conducted on with diabetes mellitus who are poor at 40 respondents found that the highest controlling metabolism (sedentary number of respondents had high school hyperglycemia) can experience decreased education was 16 people (40%). Based on cognitive function. Glucose is needed in Mongisidi's research (2013), it was shown all cognitive processes. The relationship that respondents who had more than 9 between cognitive impairment in diabetes years of education (high school, diploma follows a U-shaped curve, with impaired and graduate) had normal cognitive cognitive function as a result of acute function results. This is because education hyperglycemia and acute hypoglycemia is one of the most important factors in (Masruroh, 2014). preventing cognitive impairment. h. Time Taking Gymnastics f. Job The results of research conducted on The results of research conducted on 40 respondents found that the majority of 40 respondents found that most worked as respondents had exercised for more than 6 housewives as many as 29 people months as many as 37 people (92.5%). (72.5%). The results of the Mongisidi This shows that the longer the elderly (2013) study show that work that follow gymnastics the better cognitive emphasizes thinking ability has a major function. Active elderly people who influence on the neuropathology of routinely do gymnastics will increase cognitive function disorders compared to physical fitness and prevent cognitive work that emphasizes muscle strength. decline. 117 Poster Presentation Riau International Nursing Conference 2018 RINC2018 The level of fitness or the amount of efficiently in daily life. Working memory physical activity during childhood and is associated with a decrease in various adolescence adults may have a long-term cognitive tasks, especially short-term effect on the risk of cognitive impairment memory. Short-term memory involves in the future. The results of the study maintaining simple information in a short show that fitness levels (low, medium, or period of time but in the elderly it shows a high) at 18 years of age predict the risk of minimal or no decrease in short-term MCI and dimensions 42 years later in memory (Glisky, 2007). Changes in men. Low aerobic fitness at 18 years of cognitive abilities that occur in the elderly age appears as a potential risk factor for more to speed rather than ability. future cognitive decline (Barnes, 2015). This is in accordance with the 2. Training Program results the researchers got when doing The results of research conducted on research with questionnaires. Elderly most 40 respondents found that most of the difficulties in recalling words that respondents did gymnastics 3 times a have just been said and sometimes the week, as many as 21 people (52.5%), attention of the elderly can be distracted while for the duration of gymnastics, the by things around them. majority of respondents did gymnastics According to Kurnianto (2015), for 20-60 minutes / session which was as psychological exercise can improve mood, many as 34 people (85% ), and most of reduce the risk of senility, and prevent the respondents did the elderly fitness depression. The majority of studies have gymnastics as many as 24 people (60%). shown that throughout the lifetime of The results of research conducted by humans, ranging from children to the Wahyuni (2016), stated that physical elderly, higher fitness levels are associated activity and exercise carried out regularly with better performance on cognitive tasks 3-5 times a week can help increase blood (Barnes, 2015). Elderly who are active in flow to the brain, thereby increasing the exercising have better reasoning, memory, intake of nutrients in the brain which can and reaction time than those who are guarantee the perfusion of strong brain lacking or never exercise. The thing that tissue. The direct effect that occurs in the must be considered is the selection of the brain is the maintenance of nerve type of gymnastics that must be in structures and can increase the expansion accordance with the age and physical of nerve fibers in the brain and in the condition of the elderly (Dayamaes, capillaries in the brain. 2013). 3. An overview of cognitive functions Conclusion in the elderly who do gymnastics The results showed that the The results of research conducted on characteristics of the majority of 40 respondents found that most respondents were in the elderly category respondents experienced impaired (60-74 years) as much as 90%, female cognitive function because the results of gender as much as 92.5%, Minang tribe as the questionnaire were less than 26 points, much as 47.5%, marital status equal to as many as 28 people (70%), while as 50%, final education as high as 40% , the many as 12 people (30%) did not work of housewives as much as 72.5%, experience cognitive impairment. the type of illness suffered by Basic cognitive functions consist of hypertension as much as 32.5%, and the attention, working memory, long-term duration of taking exercise more than six memory, and perception. A decrease in months was 92.5%. The training program attention can have a broad effect on a found that most of them did gymnastics person's ability to function adequately and three times a week as much as 52.5%, the 118 Poster Presentation Riau International Nursing Conference 2018 RINC2018 duration of gymnastics was 20-60 minutes 3Siti Rahmalia Hairani Damanik: / session as much as 85%, and the type of Lecturer in Department of Medical elderly fitness gymnastics as much as Surgical Nursing, Faculty of Nursing, 60%. The results of the study for the University of Riau, Indonesia description of cognitive function in the elderly who do gymnastics show that most References respondents experience impaired Barnes, J. N. (2015). Exercise, cognitive cognitive function due to the value of the function, and aging. American questionnaire is less than 26 by 70%. Physiological Society 2(39), 55-62. Suggestion Diperoleh tanggal 14 Februari 2018 1. Benefits for Nursing dari The results of this study can be a source of https://www.ncbi.nlm.nih.gov/pmc/art information in the development of nursing icles/PMC4587595/ science and as a reference material in the Dayamaes, R. (2013). Gambaran fungsi development of science especially in the kognitif klien usia lanjut di Posbindu field of gerontik and community. Rosella Legoso Wilayah Kerja 2. Benefits for Health Center Puskesmas Ciputat Timur Tangerang The results of this study are expected to be Selatan. Diperoleh tanggal 04 Juli a source of information and input for 2018 dari health centers regarding the benefits of http://repository.uinjkt.ac.id/dspace/bi gymnastics for cognitive function of the tstream/123456789/25646/1/rizhsky% elderly and useful for nurses in providing 20dayamaes.%20-%20fkik.pdf health promotion about the benefits of Glisky, E. L. (2007). Brain aging: gymnastics for cognitive function of the Models, methods, and mechanisms. elderly. Winston-Salem: Taylor & Francis 3. Benefits for the Community Press The results of this study are expected to Kurnianto, D. (2015). Menjaga kesehatan provide knowledge and information to the di usia lanjut. Jurnal Olahraga public regarding the benefits of Prestasi, 11(2), 19-30. Diperoleh gymnastics as one of the activities to pada tanggal 01 April 2018 dari prevent impaired cognitive function in the https://media.neliti.com/media/public elderly. ations/115182-ID-menjaga- 4. For Further Researchers kesehatan-di usia-lanjut.pdf The results of this study are expected to be Kushariyadi. (2013). Intervensi (stimuli used as basic data and additional memori) meningkatkan fungsi information to develop further research kognitif lansia. Jurnal Ners, 8(2), and develop this research by linking to 317-329. Diperoleh tanggal 14 Maret other variables, especially ways to prevent 2018 dari https://e- impaired cognitive function in the elderly. journal.unair.ac.id/JNERS/article/vie Acknowledgements w/3836 An infinite thank you for the help Kusumowardani, A., & Wahyuni. E. S. and guidance from various parties in (2017). Pengaruh latihan fisik completing this research report terhadap kemampuan kognitif lansia 1Lina Maria Siagian: Students of the di Desa Ngesrep Kecamatan Faculty of Nursing, University of Riau, Ngemplak Kabupaten Boyolali. Indonesia Jurnal Terpadu Ilmu Kesehatan, 6(2), 2Arneliwati: Lecturer in the Department 118-240. Diperoleh tanggal 03 Mei of Community Nursing, Faculty of 2018 dari http://jurnal.poltekkes- Nursing, University of Riau, Indonesia 119 Poster Presentation Riau International Nursing Conference 2018 RINC2018 solo.ac.id/index.php/Int/article/downl Yuliati, A., Ni’mal, B., & Mury, R. oad/332/297 (2014). Perbedaan kualitas hidup Masruroh. (2014). Efek aktifitas berjalan lansia yang tinggal di komunitas kaki terstruktur dalam memelihara dengan di pelayanan sosial lanjut fungsi kognitif pada usia lanjut: Uji usia. Jurnal Pustaka Kesehatan, klinis acak tersamar tunggal. Diperoleh 2(1), 87-94. Diperoleh tanggal 18 tanggal 01 Juli 2018 dari Januari 2018 dari http://lib.ui.ac.id/file?file=digital/2016- https://jurnal.unej.ac.id/index.php/J 3/20405274-SP-Masruroh.pdf PK/article/view/601/429. Mongisidi, R. (2013). Profil penurunan fungsi kognitif pada lansia di yayasan- yayasan manula di Kecamatan Kawangkoan. Jurnal E-Clinic, 1(1), 1– 10. Diperoleh tanggal 01 Juli 2018 dari https://ejournal.unsrat.ac.id/index.php/e clinic/article/view/3297/2840 Mubarak, W. I., Chayatin, N., & Santoso, B. A. (2012). Ilmu keperawatan komunitas: Konsep dan aplikasi. Jakarta: Salemba Medika Pinilih, S. S. (2017). Hubungan antara lifestyle dengan fungsi kognitif pada lansia. Jurnal of Holistic Nursing, 5(1), 25–35. Diperoleh tanggal 03 Juli 2018 dari http://journal.ummgl.ac.id/index.php/ nursing/article/download/1876/1091 Santoso, H., & Ismail, A. (2009). Memahami krisis lanjut usia: Uraian medis dan pedagogis-pastoral. Jakarta: Gunung Mulia Sunaryo., et al. (2015). Asuhan keperawatan gerontik. Yogyakarta: ANDI Tamher, S., & Noorkasiani. (2011). Kesehatan usia lanjut dengan pendekatan asuhan keperawatan. Jakarta: Salemba Medika Wahyuni, A. (2016). Pengaruh aktivitas dan latihan fisik terhadap fungsi kognitif pada penderita demensia. Medical Journal of Lampung University, 5(4), 12–16. Diperoleh tanggal 03 Juli 2018 dari http://juke.kedokteran.unila.ac.id/index. php/majority/article/download/873/784 Widianti, A. T., & Proverawati, A. (2010). Senam Kesehatan. Yogyakarta: Nuha Medika 120 Poster Presentation Riau International Nursing Conference 2018 RINC2018 8. THE EFFECT OF INDIVIDUAL HEALTH EDUCATION USING FLIPBOOK ON SELF-EFFICACY OF HYPERTENSIVE PATIENTS IN CONTROLLING DIET Nurpatri Ramadhani1, Gamya Tri Utami2, Juniar Ernawaty3 1School of Nursing, University of Riau 2School of Nursing, University of Riau 3School of Nursing, University of Riau Email: [email protected] Abstract Objective: Health educatin is one of educationa intervention to help hypertensive patients improve their health by increasing their knowledge and behavior. Self-efficacy is a principle connection between knowledge and behavior and also can affect the choice of behavior. This research was purposed to determined the effect of individual health education using flipbook on self-efficacy of hypertensive patients in controlling diet. Method: The 34 respondents devided into two categories, randomly assigned to a control and an experimental group. Patients in experimental groups received information about Dietary Approaches to Stop Hypertension (DASH) diet. The measuring tool was a self- efficacy questionnaire which has been tested for validity and reliability. The analysis of this research were univariate and bivariate analyzes using t-test. Results: Self-efficacy was increased in experimental groups after giving health education using flipbook with p value (0,000) < α (0,05). Conclusions: The was an influence of individual health education using flipbook on self-efficacy of hypertensive patients in controlling diet. This research recommend health providers to provide individual health education using flipbook media as one of intervention in maintance patients health status. Keywords : Flipbook, health education, hypertension diet, self-efficacy Introduction reached 29.0% and increased by each age Hypertension or High blood classifications (Fryar, Ostchega, Hales, pressure is a condition in which the blood Zhang, & Moran, 2017). The Result of pressure is persistently elevating out of Basic Health Research (RISKESDAS) normal situation (Yogiantoro, 2015). (2013), showed that hypertension According to American Heart Association prevalence in Indonesia is about 26.5% (AHA) American College of Cardiology for adults at age above 18 years (ACC) (2017), hypertension as a blood (Kemenkes RI, 2013). pressure higher than systolic 130 over One of the preventive effort that can diastolic 80 millimeters of mercury be applied by people with hypertention is (mmHg) (Whelton dkk., 2017). healthy lifestyle (Kemenkes RI, 2012). Global Prevalence of hypertentionis Hypertension diet is one of the way to always increasing. Adults with reduce and maintain blood pressure to be hypertension are about 594 million in normal. Hypertension diet is also 1975. Its number increased to 1.13 billion beneficial to reduce other risks such as or around 22.1% in 2015 (World Health over weight, cholesterol level, and uric Organization, 2017). Based on the data of acid on blood (Wulandari, 2009). NCHS (National Center for Health In addition to promoting the DASH Statistics) (2017), that in 2015- 2016, the (Dietary Approaches to stop Hypertension) number of adults with hypertension diet, which is rich in fruits, vegetables, 121 Poster Presentation Riau International Nursing Conference 2018 RINC2018 whole grains, and low-fat dairy products, would spend a lot of food containing the updated guideline recommends coconut milk. Five ordinary people with a reducing sodium intake and increasing hypertensive diet can control their blood potassium intake to reduce Blood Presure pressure and they still cannot find pain in (Kurniadi & Nurrahmi, 2015). the head, neck pain which is one of the The role of nurse to influence signs and symptoms of hypertension. patients with hypertension to apply They will take drugs and balance with a hypertension diet control is by giving hypertensive diet. health education. (Notoatmodjo, 2012b). The purpose of this study was to Giving health education purpose to analyze the effectiveness of individual change patients hypertention’s behavior. health education by using flipbook media One of the determining factor or on self-efficacy of hypertensive sufferers determinants in behavior change is self- in controlling diet. efficacy (Induniasih & Ratna, 2017). Methods Before the occurrence of behavioral This study uses a quasy experiment changes in patients with hypertension, design with non randomized pretest first seen the extent of self-efficacy of posttest control group design. The patients with hypertension so that it can sampling technique uses purposive affect the behavior of hypertensive sampling, which is sampling based on patients in controlling hypertension diet. consideration in accordance with the Self-efficacy means belief about the criteria desired by the researcher. The ability they have toachieve a goal that instrument used is a questionnaire that has gives influence for them (Salam, 2017). been tested for validity and reliability According to Hendiarto & Hamidah which amounts to 16 statements of self- (2014), self-efficacy can motivate people efficacy in controlling diet. The study was where the stronger the self-efficacy means conducted in the Working Area of Payung the more large individuals to adopt, Sekaki Public Health Center in Pekanbaru maintain, and improve healthy behavior. City in June-July 2018. The sample was Based on the results of interviews used by 34 people. for 10 hypertensive patients in a Result preliminary study conducted in the work A. Univariate Analysis area of Payung Sekaki Public Health 1. Respondent characteristics and Center, get there still from hypertension supporting factors for self-efficacy sufferers who have never received Table 1 information about hypertension and Distribution of Respondent hypertension diet diet by using flipbook Characteristics (n=34) Experiment media and only get information and Control group Count Characteristics group information from the doctor where, N % n % n % friends and family who have received Age: Middle age 7 41,2 8 47 15 44,1 information about hypertension. Five of (45-59 years) several hypertensive sufferers said that Eldery 8 47 9 53 17 50 (60-74 years) dietary settings for hypertensive patients Old age 2 11,8 0 0 2 5,9 who applied were still hesitant to control (75-90 tahun) Count: 17 100 17 100 34 100 their health because hypertension had to Gender: be done every day. They also said that to Male 7 41,2 11 64,7 18 52,9 fulfill their special dietary needs they Female 10 58,8 6 35,3 16 47,1 Count: 17 100 17 100 34 100 wanted to do because they had to change food from family members and they would do other events like them, they 122 Poster Presentation Riau International Nursing Conference 2018 RINC2018 Table 2 Table 5 Respondent Distribution based on Self- Difference in Mean Self-efficacy Value of efficacy Supporting Factors (n = 34) Hypertensive Patients in Controlling Diet Experiment Control group Count Before and After Providing Individual Characteristics group N % n % n % Health Education in Experimental Groups Lasr education: and Control Groups SD 6 35,3 5 29,4 11 32,4 Mean p Variable Mean SD SMP 5 29,4 3 17,7 8 23,6 Difference value SMA 6 35,3 7 41,1 13 38,2 Self-efficacy Pendidikan terakhir 0 0 2 11,8 2 5,8 experiment group: 3,17 0,012 Count: 17 100 17 100 34 100 Pre test 43,65 3,690 Works: Post test 46,82 3,575 PNS 0 0 3 17,7 3 8,8 Self-efficacy control Wiraswasta/swasta 4 23,5 6 35,3 10 29,4 group: 0,12 0,840 IRT 10 58,8 4 23,5 14 41,2 Pre test 42,12 3,389 Lain-lainnya 3 17,7 4 23,5 7 20,6 Post test 42,00 2,398 Total: 17 100 17 100 34 100 The duration of suffering from hypertension: 3. Ratio of mean self-efficacy of <1 tahun 0 0 1 5,8 1 2,9 hypertensive patients in controlling 1-5 tahun 3 17,7 8 47,1 11 32,4 >5 tahun 14 82,3 8 47,1 22 64,7 the experimental group diet and Count: 17 100 17 100 34 100 control group Table 6 2. Mean Self-efficacy Value of Ratio of Average Self-efficacy of Hypertensive Patients Hypertensive Patients in Controlling Diet Table 3 After Given Individual Health Education Distribution of mean Self-efficacy Values Using Flipbook Media in Experimental for Hypertensive Patients Before and Groups and Control Groups Self-efficacy of Mean SD p value After Intervention Given to Experimental hypertension patients Groups and Control Groups Experiment group 46,82 3,575 0,000 Variable N Mean SD Min Max Control group 42,00 2,398 Self-efficacy Experiment group: Pre test 17 43,65 3,690 34 49 Discussion Post test 17 46,82 3,575 39 51 A. Characteristics of Respondents Self-efficacy control group: 1. Age of respondent Pre test 17 42,12 3,389 36 47 Researchers divided the age of Post test 17 42,00 2,398 39 46 respondents into 4 categories of groups based on age division, according to WHO, B. Bivariate analysis namely middle age (45-59 years), elderly 1. Homogeneity Test Pre test self- (60-74 years), elderly (75-90 years), and efficacy in the experimental groups very old age (> 90 years) The results of and the control groups the analysis of the age characteristics of Table 4 respondents conducted on 34 respondents, Homogeneity Test of Pre Test Self-efficacy obtained that half the age of respondents in Experimental Groups and Control in the elderly (60-74 years) is 17 people Groups Self-efficacy N Mean SD p (50%). value According to Iswari, Windyastuti, & Experiment group 17 43,65 3,690 0,892 Priambodo (2017) that one of the factors Control group 17 42,12 3,389 that cannot be modified by the occurrence of hypertension is age, where the more a 2. Difference in Average Self-efficacy person ages, the risk of hypertension will Value of Hypertension Patients in also increase. This is consistent with the Controlling Diet 123 Poster Presentation Riau International Nursing Conference 2018 RINC2018 theory that hypertension is more common besides having other risk factors such as in people aged 45 years and over. stress that can trigger an increase in 2. Gender of the respondent sympathetic nerve activity that can trigger The results of research conducted on an increase in one's blood pressure. 34 respondents, obtained the majority of 5. The duration of suffering from respondents male sex is 18 people hypertension (52.9%). The results of this study were The results of research conducted on supported by Kartikasari (2012) research 34 respondents, the majority of which showed that 47.2% of respondents respondents have experienced male sex had more hypertension than hypertension more than 5 years, as many those without hypertension and were at as 22 people (64.7%). According to risk of developing hypertension 3,052 (Saragih, 2017) explains that the long times compared to women. According to condition of high blood pressure will Iswari, dkk (2017) said that the possibility result in the workload of the heart and of hypertension in men due to smoking arteries. Hypertension that does not get habits, where smoking is one of the good treatment will cause various factors causing the risk of hypertension. complications. Complications that arise 3. Last respondent's education depending on the magnitude of the The results of the study conducted increase in blood pressure and the length on 34 respondents, obtained the of the condition of hypertension occurs respondents' level of education is mostly (Kemenkes RI, 2017). high school with the number of 13 people B. Differences in self-efficacy in (38.2%). According to Notoatmodjo hypertensive patients in controlling (2012), said that one of the factors that diet affect a person's health is the level of 1. Experimental Group education. Education is closely related to The results of the analysis of the knowledge and not one of the causes of effectiveness of health education hypertension, but one's education will individually using flipbook media on self- affect a person's lifestyle. efficacy of hypertensive patients in The level of high school education controlling the diet has known the mean is a high level of education, according to value of the results after the intervention Arisandi (2016) said that the better or the has increased, this is because in the higher the level of education of a person, experimental group given individual they have more ability to maintain his health education about the concept of lifestyle so that he remains healthy, such hypertension and hypertension diet during as maintaining and adhering to a approximately 30 minutes using flipbook hypertension diet. media. 4. Respondent's work Statistical test results using paired- The results of the study on 34 samples t test, test in the experimental hypertensive patients showed that most group before and after being given an respondents were as housewife as many as individual health education obtained p 14 people (41.2%). According to value (0.012) <α (0.05) and the difference Pramestutie & Silviana (2016) said that in the mean self-efficacy value of pre-test this type of work is closely related to and post-test is 3.17 so that there is an physical activity carried out by a person, increase in self-efficacy in hypertensive where physical activity can affect the patients in controlling the diet after being occurrence of hypertension. Working as a given an individual health education using housewife has mild physical activity so it flipbook media. has a higher risk factor for hypertension, 124 Poster Presentation Riau International Nursing Conference 2018 RINC2018 According to Kamtono, Nurhayati, difference in mean self-efficacy of & Wulandari (2016) health education has a hypertensive patients in controlling diet significant effect on increasing one's self- between the experimental group and the efficacy. The provision of health control group. After being given education will help someone in individual health education using flipbook overcoming the problem and they can media, self-efficacy of hypertensive realize their goal to behave healthily, so patients in the experimental group that the higher the goal, the higher the increased. self-efficacy of that person (Tobergte & Self-efficacy will affect someone in Curtis, 2013). According to Iswari dkk., thinking, feeling, motivating themselves, (2017) said that respondents who have acting and making decisions. A person high self-efficacy about a disease who has high self-efficacy in him will experienced will be more easily adhere to make him better in maintaining his health advice and advice from health workers as (Salam, 2017). well as possible so that hypertension is not Based on research conducted by continued or cause other complications. Novitasari, Murhayati, & Nurhayati 2. Control group (2016) which states that the provision of Based on the results of statistical health education is very influential in tests in the control group, there was no improving one's self-efficacy. Based on effect before (pre test) and after (post test) the theory, this is because there are several without being given individual health factors that influence a person's self- education using flipbook media to obtain efficacy, namely mastery experience self-efficacy of hypertensive patients in (mastery of experience), vicarious controlling diet with p value 0.840> α (0 experiences (experiences of others), social 05) which can be concluded that there is persuation (social persuasion), and no increase in self-efficacy. physiological and emotional states The absence of an increase in self- (physiological conditions and emotional). efficacy of hypertensive patients in the According to Kamtono, Nurhayati, control group in controlling the diet so & Wulandari (2016) so that the goal of that respondents were hampered to obtain providing health education is achieved, it information properly from this individual must pay attention to various things, one health education activity, even though of which is the media and methods. The they only received health education after method used by researchers in this study post test self-efficacy and previously also is individual health education. Health possible health workers had given education conducted individually can information about hypertension diet. make respondents focus more on paying C. Ratio of self-efficacy of attention to the information conveyed so hypertensive patients after being that the acceptance of respondents will be given individual education in the better (Kurnianingtyas, 2017). experimental group and the control According to Induniasih & Ratna group without being given health (2017) said that the information conveyed education in conducting counseling can be Based on the results of statistical influenced by the methods and media tests obtained the mean post test self- used, where the methods and media for efficacy in the experimental group was delivering information can have a 46.82 and 42.00 in the control group. The significant effect on health education. The results of the analysis obtained p value media used in health education can help (0,000) self-efficacy <α (0,05), it can be respondents understand the material concluded that there is a significant presented by researchers. In this study, the 125 Poster Presentation Riau International Nursing Conference 2018 RINC2018 media used by researchers in providing from various parties in the completion of health education using flipbook media. this research. where the media can facilitate researchers 1Nurpa Tri Ramadhani: Student of in clarifying the contents of the message Nursing Faculty of Riau University, to be conveyed, but also presented in Indonesia. stages to provide time for respondents to 2Ns. Gamya Tri Utami, M.Kep: understand the content of the material. Functional groups lecturers in Medical This can be seen from the results of the Nursing Surgery at the Nursing Faculty of analysis above which showed an increase Riau University, Indonesia. in self-efficacy of hypertensive patients in 3Juniar Ernawaty, S.Kp., M.Kep., the experimental group after being given M.Ng: Functional groups lecturer in individual health education using flipbook Medical Nursing Surgery at the Nursing media. Faculty of Riau University, Indonesia. Conclusion References Results showed that half of the Arisandi. (2016). Pengaruh senam jantung respondents were in the age range 60-74 sehat terhadap tekanan darah pada years 50%, the majority of the last lansia dengan hipertensi. Skripsi (tidak education was high school 38.2%, the dipublikasikan). Pekanbaru: majority of respondents were male 52.9%, Universitas Riau. the majority of respondents' work was IRT Hendiarto, Y., & Hamidah. (2014). or not working 41.2% , and most Hubungan antara self-efficacy dengan respondents suffered from hypertension perilaku sehat pada penderita jantung more than 5 years 64.7%.. koroner. Jurnal Psikologi Klinis dan The results of the statistical test Kesehatan Mental, 3(2). Diakses pada measurement of the mean pre-test self- 22 Februari 2018 dari: efficacy in the experimental group was http://journal.unair.ac.id/download- 43.65 after being given individual health fullpapers-jpkk51cd6bdad2full.pdf. education using flipbook media Induniasih, & Ratna, W. (2017). Promosi experienced a significant increase in post- kesehatan pendidikan kesehatan dalam test self-efficacy to 46.82. While the mean keperawatan (Cetakan I). Yogyakarta: pre test in the control group was 42.12 and Pustaka Baru Press the post test of the control group was Iswari, D. N., Windyastuti, E., & 42.00. Priambodo, G. (2017). Hubungan self- Based on the results of statistical efficacy dengan kepatuhan diit tests in the experimental group found a hipertensi di RSUD Pandan Arang significant difference between mean self- Boyolali. Digital Library, 1–12. efficacy before and after being given Diakses pada 19 Februari 2018 dari: health education using flipbook media. In http://digilib.stikeskusumahusada.ac.id this study it can be concluded that Kamtono, S., Nurhayati, Y., & Wulandari, I. individual health education using flipbook S. (2016). Pengaruh pendidikan media on self-efficacy of hypertensive kesehatan tentang penanganan kejang patients in controlling the diet effectively demam pada balita terhadap self increases the self-efficacy of hypertensive efficacy ibu di Desa Tempur Sari patients with p value self-efficacy (0,000) Tambak Boyo Mantingan Ngawi. <α (0,05). Digital Library. Diakses pada 08 Juli Acknowledgements 2018 dari: Researchers express the highest http://digilib.stikeskusumahusada.ac.id gratitude for the guidance and assistance Kemenkes, RI. (2012). Masalah hipertensi di Indonesia. Dikases pada 04 Januari 126 Poster Presentation Riau International Nursing Conference 2018 RINC2018 2018 dari: Tobergte, D. R., & Curtis, S. (2013). Self http://www.depkes.go.id/article/view efficacy in changing societies. Journal /1909/masalah-hipertensi-di- of Chemical Information and Modeling indonesia.html. (Vol. 53). Diakses pada 25 Januari Kemenkes RI. (2013). Riset kesehatan 2018 dari: dasar. Diakses pada 03 Januari 2018 https://doi.org/10.1017/CBO97811074 dari: 15324.004. http://www.depkes.go.id/resources/dow Whelton, P. K., Carey, R. M., Aronow, nload/general/Hasil Riskesdas W. S., Casey, D. E., Collins, K. J., 2013.pdf. Himmelfarb, C. D., … Muntner, P. Kemenkes RI. (2017). Sebagian besar (2017). Guideline for the prevention, penderita hipertensi tidak detection, evaluation, and menyadarinya. Ministry Of Health management of high blood pressure Republic Of Indonesia. Diakses pada in adults. Journal of the American tanggal 15 Juli 2018 dari: College of Cardiology. http://www.depkes.go.id/article/print/1 https://doi.org/10.1016/j.jacc.2017.1 7051800002/sebagian-besar-penderita- 1.006. hipertensi-tidak-menyadarinya.html. World Health Organization. (2017). Kurniadi, H., & Nurrahmi, U. (2015). Stop! Cardiovascular diseases (CVDs). Gejala penyakit jantung koroner, Diakses pada 10 Januari 2018 dari: kolesterol tinggi, diabetes melitus, http://www.who.int/mediacentre/Factsh hipertensi. Yogyakarta: Istana Media eets/FS317/en. Notoatmodjo, S. (2012). Promosi kesehatan Wulandari, N. (2009). Solusi sehat dan perilaku kesehatan. Jakarta: mengatasi hipertensi Cet.1. Jakarta: Rineka Cipta Agromedia Pustaka Novitasari, V., Murhayati, A., & Nurhayati, Yogiantoro, M. (2015). Pendekatan klinis Y. (2016). Pengaruh pendidikan hipertensi. Dalam buku ajar ilmu kesehatan tentang penanganan tersedak penyakit dalam (p. 2261). Jakarta: benda asing pada balita terhadap self InternaPublishing efficacy ibu di Posyandu Desa Pelem Karangrejo Magetan. Digital Library. Diakses pada 20 Juni 2018 dari: http://digilib.stikeskusumahusada.ac.id/ files/disk1/33/01-gdl-veranovita-1637- 1-artikel-a.pdf. Pramestutie, H. R., & Silviana, N. (2016). The knowledge level of hypertension patients for drug therapy in the primary health care of Malang. Indonesian Journal of Clinical Pharmacy, 5(1), 26–34. Diakses pada 18 Juni 2018 dari: https://doi.org/10.15416/ijcp.2016.5.1.2 6 Salam, A. Y. (2017). Efek self efficacy training terhadap self efficacy dan kepatuhan diet diabetesi. Institutional Repository. Diakses pada 19 Februari 2018 dari: http://eprints.undip.ac.id/55465/ 127 Poster Presentation Riau International Nursing Conference 2018 RINC2018 9. THE COMPARISON OF WARM WATER FEET-SOAKING HYDROTHERAPY AND ACUPRESSURE MASSAGE ON THE BLOOD PRESSURE OF PRIMARY HYPERTENSION PATIENTS Nur Sella1, Erwin2, Riri Novayelinda3 1Student of School of Nursing, Universitas Riau 2School of Nursing, Universitas Riau 3School of Nursing, Universitas Riau Email: [email protected] Abstract Objective: Hypertension is a condition when the blood pressure rises chronically above 140/90 mmHg. If it isn't treated in the long-term basis, hypertension can cause stroke and coronary heart disease. Nonpharmacological therapy that can be used to lower the blood pressure is warm water feet-soaking hydrotherapy and acupressure massage. The purpose of this study was to compare warm water feet-soaking hydrotherapy and acupressure massage on the blood pressure in primary hypertension. Method: This research used quasi experimental design with time series design approach. The research was conducted at Panti Sosial Tresna Werda (PSTW) Khusnul Khotimah Pekanbaru with 32 samples with the criteria for inclusion of the elderly of 60 years, in the pra hypertension and hypertension stage 1 and 2, divided into 16 intervention group I and 16 intervention group II with purposive sampling technique. The intervention group I was given warm water feet- soaking hydrotherapy for 15 minutes and the intervention group II was given an acupressure massage for 30 seconds. The measuring instrument is a digital sphygmomanometer and observation sheet. The analysis used was univariate analysis to see the frequency and percentage, and bivariate analysis with Wilcoxon Sign test and Mann Whitney test. Results: The results showed the average lowering of systole and diastole blood pressure on intervention group I of 13.45 mmHg and 7.72 mmHg and the intervention group II of 6.5 mmHg and 2.49 mmHg. Statistical test results for intervals I and II showed mean difference of blood pressure systole with p value (0,033) < (0,05) and diastole with p value (0,038) < (0,05). Conclusions: That warm water feet-soaking hydrotherapy was more effective than acupressure massage to lower the blood pressure on primary hypertension patients. Keywords: Primary hypertension, warm water feet-soaking hydrotherapy, acupressure massage, blood pressure Introduction nearly 9.4 million people every year. The High blood pressure (hypertension) prevalence of hypertension in the is a condition when the pressure in the Southeast Asia region was 36%. In blood vessels increases chronically that is Indonesia the prevalence of population above 140/90 mmHg. Hypertension that is with hypertension nationally is 30.9% often found is primary hypertension with (Ministry of Health, 2017). 95% of cases and the cause has not been Hypertension also increases with identified (Kozier, 2010). According to age (Riskesdas, 2013). Increasing age the World Health Organization (WHO) in results in susceptibility to hypertension 2013, hypertension is one of the causes of because physiological function has premature death worldwide that kills decreased due to aging process. 128 Poster Presentation Riau International Nursing Conference 2018 RINC2018 Hypertension if left untreated for the long Systole and diastolic blood pressure term will lead to stroke and coronary heart used is the result of blood pressure disease. Therapy for reducing measurements listed in the digital hypertension could be pharmacological sphygmomanometer. Data analysis used therapy (drugs) and non-pharmacological was univariate analysis using frequency therapy (Hartono & Gunardi, 2013). Non- and bivariate analysis using Wilcoxon pharmacological therapy is used to reduce Sign test and Mann Whitney test to see the blood pressure without drug dependence effect of foot soaking hydrotherapy with and side effects such as foot soaking warm water and acupressure massage on hydrotherapy with warm water and blood pressure and see which acupressure massage. interventions are more effective. Foot soaking hydrotherapy with Results warm water is given for 15 minutes, with Table 1 the aim to improve blood circulation in N Mean SD p Variabel the legs that will spread to the body (mmHg) value (Syaifuddin, 2011). Hydrotherapy Systolic: 16 147,08 9,76 Acupressure massage is performed 0,000 at the GV 20 Baihui point which is located Pre test 16 133,63 8,47 Post test 1.5 cun behind the top of the head. To Diastolic: reduce hypertension, press on the top of Pre test 16 88,98 5,16 0,001 the head 30 times, performed in one cycle. Post test 16 81,26 5,15 The trick is to take a straight line parallel Acupressure to the nose and the meeting between the Systolic: 16 144,96 8,79 0,000 Pre test 16 138,46 7,99 left and right ears. Massage is done by Post test pressing using the thumb (Hartono, 2012). Diastolic: In the circulatory system, acupressure Pre test 16 87,38 6,05 0,008 massage can improve blood flow and Post test 16 84,89 5,53 cause a decrease in heart rate which can Systolic: reduce blood pressure. Hydrotherapy 16 133,63 8,47 0,033 Method Acupressure 16 138,46 7,99 This study uses quasy experiment with time series design, observations Diastolic: carried out more than once, involving two Hydrotherapy 16 81,26 5,15 0,038 Acupressure 16 84,89 5,53 groups namely hydrotherapy group and acupressure group. The study was conducted in PSTW Khusnul Khotimah Table 1 shows the results of the test Pekanbaru with a total sample of 32 Man-Whitney showed that the average respondents. systolic blood pressure after intervention Sampling using purposive sampling in the hydrotherapy group was 133.63 with inclusion criteria, namely elderly mmHg while the average systolic blood aged ± 60 years, in prahipertensive pressure after intervention in the conditions, stage 1 hypertension and stage acupressure group was 138.46 mmHg. 2 hypertension, can communicate well and There was a difference in the average are willing to become respondents, do not distribution of systolic blood pressure in have other diseases such as kidney the hydrotherapy group and the disease, stroke, brain injury and does not acupressure group with a difference of suffer from skin disease or skin and foot 4.83 points. Statistical test results obtained and head injuries, history of epilepsy, p value (0.033) <α (0.05). fever and water phobia. 129 Poster Presentation Riau International Nursing Conference 2018 RINC2018 The average diastolic blood pressure parasympathetic stimulus that secretes after intervention in the hydrotherapy acetylcholine which causes dilatation of group was 81.26 mmHg while the average blood vessels (Muttaqin, 2009). diastolic blood pressure after intervention Vascular vasodilation causes the in the acupressure group was 84.89 heart rate and contents of the joints to mmHg. There was a difference in the decrease and cardiac output and total average distribution of diastolic blood peripheral resistance also decrease, pressure in the hydrotherapy group and causing blood flow to increase through the the acupressure group with a difference of blood vessels and blood pressure to fall to 3.63 points. Statistical test results obtained normal (Lambeck, 2014). p value (0.038) <α (0.05). In the intervention group II an Discussion acupressure massage was given. Hypertension often occurs in the Acupressure massage is a complementary elderly because blood pressure tends to therapy that is useful for balancing the increase with age. These changes are still nervous system and endocrine system. In physiological, but make the elderly more this study, acupressure massage was given vulnerable to disease. The peripheral pulse at point GV 20 or DU-20 Baihui which of the elderly will be weaker in the lower was located 1.5 cun behind the top of the extremity, which makes the elderly often head. Emphasis is made using the thumb complain of cold feet (Potter & Perry, for 30 times in one cycle, given 3 times a 2010). week. The trigger factor that causes The benefits of acupressure massage hypertension is stress. Stress felt comes at this point are to overcome headaches. from the environment, where the elderly Headache occurs because the blood feel unnoticed by the family (lack of supply to the brain is reduced or family support) because they live in the inadequate which causes anaerobic social institution. This causes an increase metabolism (not using oxygen for in emotions experienced by the elderly, metabolism). making the sympathetic nervous system Acupressure massage given at the become more active (Kozier, 2010). GV 20 Baihui point can improve and In the intervention group I was improve blood circulation which causes given foot soaking hydrotherapy with the oxygenation process to become warm water over the ankles for 15 smooth so that headaches become reduced minutes starting at 07.00 to 12.00 WIB, and can also reduce blood pressure. carried out 3 times in 1 week. The Emphasis on acupressure points will temperature of warm water used is 36o- affect the physiological changes of the 37oC or slightly above body temperature. body and can affect a person's mental and When given foot soaking hydrotherapy emotional state (Hartono, 2012). with warm water, initially a warm feeling The results of statistical tests using arises, then the feeling of warmth is not Mann Whitney, there were differences in felt anymore and when it comes out of the systolic blood pressure after being given water, a sense of warmth will return. This foot soaking hydrotherapy with warm is because the body is fully adapted to the water and acupressure massage of 4.83 new skin temperature (Syaifuddin, 2011). points with p value (0.033) <α (0.05) The warm conditions given in the while the difference in diastolic blood feet-soaking create a relaxation effect that pressure was 3, 63 points with p value stimulates the release of endorphins, (0.038) <α (0.05). thereby reducing the stimulus of the This means that there are significant sympathetic nerves and increasing the differences between the mean blood 130 Poster Presentation Riau International Nursing Conference 2018 RINC2018 pressure of systole and diastol in the 2Erwin, S.Kp, M.Pep: Lecturer from the hydrotherapy group and the acupressure Department of Medical Nursing, Faculty group so that it can be concluded that foot of Nursing, University of Riau, Indonesia soaking hydrotherapy with warm water is 3Riri Novayelinda, M.Ng: Lecturer at the more effective than acupressure massage Department of Nursing, Faculty of on blood pressure reduction in patients Nursing, University of Riau, Indonesia with primary hypertension. References Conclusion Hartono, A., & Gunardi, S. (2013). Based on the results of the test Synopsis of the Cardiovascular Wilcoxon in the group given foot soaking Organ System. South Tangerang: hydrotherapy with warm water, the Karisma Publishing Group. average systolic blood pressure decreased Hartono, RIW (2012). Acupressure for by 13.45 mmHg with p value (0.000) <α various diseases. Yogyakarta: Rapha (0.05), and the average diastolic blood Publishing. pressure decreased as much as 7.72 Kozier, B. (2010). Nursing Fundamental mmHg with p value (0.001) <α (0.05). Textbook: Concepts, Processes and In the acupressure massage group, Practices. (7th ed.). Jakarta: EGC. the average systolic blood pressure Health, K. (2017). Indonesian Health decreased by 6.5 mmHg with p value Profile. Jakarta: Ministry of Health of (0.000) <α (0.05), and the average the Republic of Indonesia. Obtained diastolic blood pressure decreased by 2.49 on January 12, 2018 from mmHg with p value ( 0.008) <α (0.05). http://www.depkes.go.id From these results it can be concluded that Kesehatan, M. (2014). Regulation of the foot soaking hydrotherapy with warm Minister of Health of the Republic of water and acupressure massage can reduce Indonesia No. 8 of 2014 concerning blood pressure. SPA Health Services. Obtained on Test results in the Mann Whitney May 30, 2018 from has difference in mean systolic blood http://www.hukor.depkes.go.id/uploa pressure of 4.83 points with p value ds/produk_hukum/PMK%2520No.% (0.033) <α (0.05), the difference in the 25208%2520tt%2520Pelayanan%252 average diastolic blood pressure is 3.63 0Kesehatan%2520SPA.pdf points with p value (0.038) <α (0.05). This Lambeck, J. (2014). Hydrotherapy in means that there is a significant difference Adult Neurology. Research Gate. from the average blood pressure between Obtained on March 15 2018 from the hydrotherapy group and the https://www.researchgate.net/publicat acupressure group, and it can be ion/255591602 concluded that Ha1 is accepted, namely Muttaqin, A. (2009). Nursing Textbook for foot soaking hydrotherapy with warm Clients with Cardiovascular and water is more effective in lowering blood Hematological Disorders. Jakarta: pressure than acupressure massage in Salemba Medika. patients with primary hypertension. Potter, PA, & Perry, AG (2010). Acknowledgments Fundamentals of Nursing (7th ed.). Unlimited thanks for the assistance Jakarta: Salemba Medika. and guidance from various parties in the Riskesdas. (2013). Basic Health Research. completion of this thesis. Obtained on 12 January 2018 from 1Nur Sella: Nursing Faculty Student, http://www.depkes.go.id/resources/do University of Riau, Indonesia wnload/general/Hasil Riskesdas 2013.pdf 131 Poster Presentation Riau International Nursing Conference 2018 RINC2018 Syaifuddin. (2011). Human Body Physiology for Nursing Students (2nd ed.). Jakarta: Salemba Medika World Health Organization. (2013). A 2013 Global Health Day Global Health Day Hypertension. Obtained on January 23, 2018 from http://www.who.int 132