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https://ijhsrd.com/index.php/ijhsrd/about/editorialTeam 4/4 e-ISSN: 2715-4718 DOI: 10.36566/ijhsrd/Vol2.Iss2/X https://ijhsrd.com/index.php/ijhsrd
CONTENTS
Volume 2, Number 2 October 2020
1. Factors Related To The Second Rubella Measles Immunization In Konawe Islands District...... 1 Abdul Syahid, Timbul Supodo, Sunarsih
2. The Effect Of Health Education Audiovisual Based On Health Belief Model Towards Compliance Behavior Of Tb Patients In Prevention Transmission At Nambo Public Health Center Area...... 8 Ari Nofitasari, Nawawi, Mimi Yati, Sarah Sarizan Yunam
3. Factors Associated With Elderly’s Satisfaction In Integrated Health Service Post In Village Tobimeita District Of Nambo City Of Kendari...... 13 Sartini Risky MS, Dewi Sari Pratiwi, Muhammad Ikhsan Akbar
4. Modeling Techniques In Moms And Children On The Success Of Toilet Training Among Toddler Age Children...... 22 Asbath Said, Nurdin
5. Factors Related To Negative Stigma For Hiv/ Aids Patients In Boro-Boro Village, Ranomeeto Sub-District South Konawe Regency...... 26 Firman, Umi Rachmawati, Wa Ode Pipit
6. The Effectiveness Of Providing Raced Chicken Eggs On The Nutrition For Pregnant Women In Chronic Energy Deficiency In Kendari City, Sulawesi, Tenggara...... 34 Sitti Aisa, Sunarsih, Nurmiaty
7. Factors Related To The Event Of Sibling Rivalry In Children 1-5 Years Old In Labibia Sub-District Of Mandonga District In Kendari City...... 43 Islaeli Islaeli, Anisa Purnamasari, Sartina
8. The Effect Of Giving Breastfeeding On Baby’s Nutritional Status: A Comparative Study In North Buton District, Indonesia...... 48 Tasnim Tasnim, Susiatin
9. The Relationship Between Workload And Motivation With Health Worker’s Performance In Communicable Disease Program In Primary Health Centre In East Kolaka District...... 53 Muh.Said, La Ode Saafi, Sunarsih
1
Syahid, A., Supodo, T. & Sunarsih. DOI: 10.36566/ijhsrd/Vol2.Iss2/29 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718
Research Article Open Access
FACTORS RELATED TO THE SECOND RUBELLA MEASLES IMMUNIZATION IN KONAWE ISLANDS DISTRICT
Abdul Syahid1, Timbul Supodo2, Sunarsih3
1,2,3Magister of Public Health Study Program, College of Health Sciences Mandala Waluya Kendari, Southeast Sulawesi, Indonesia
Corresponding Author : Abdul Syahid Email : : [email protected]
Abstract
Background: National coverage of Rubella-Measles immunization in December 2019 was 87.33%. The coverage of Rubella-Measles 2nd immunization in Southeast Sulawesi Province with the lowest achievement was in Konawe Islands Regency. at 26.35%. This study aimed to analyze the factors associated with measles-rubella 2nd immunization in Konawe Islands Regency. Methods: The design of this study is a quantitative study with a comparative study approach, namely a form of research that compares two groups or more of a certain variable. The study population was 1119 children aged 25 to 30 months, while the study sample was 152 children aged 25 to 30 months, and respondents were mothers who had children aged 25 to 30 months who were selected as samples. The sampling technique used simple random sampling. Descriptive data analysis, inferential analysis, and odds ratio with Chi-square statistical tests
were used. Re sult: The results of the study there is a relationship between knowledge (p-value = 0.000; OR = 1.1) with Rubella Measles immunization. Conclusion: There is a knowledge relationship with measles-rubella 2 immunization in Konawe Islands District.
Key words: immunization, Measles Rubella
Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 1
Syahid, A., Supodo, T. & Sunarsih. DOI: 10.36566/ijhsrd/Vol2.Iss2/29 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 INTRODUCTION immunization in 2019 reached 32,287 Measles-Rubella immunization is one (53.3%) of the target of 60,572 under 3 years type of immunization that is included in the old children, still very low when compared national basic immunization program, which to the national target of 95%, with the functions to protect the child's body from highest district or city achieving that is two diseases at once, measles and German Kendari City of 7,365 (83.46%) of the target measles (rubella)(1). Meanwhile, both of 8,824 under 3 years old children and the common measles and rubella or German lowest district coverage was Islands Konawe measles disease cases are still common, Regency of 195 (26.35%) of the target of especially in children (2). German measles 740 under 3 years old children (11). also need extra attention if pregnant women Islands Konawe Regency in 2019, the suffer from the disease. In the first trimester coverage of Rubella Measles 1 immunization pregnant women, rubella can cause as an indicator of accessibility or the amount miscarriage(3). Fetal death in the womb and of service coverage was 731 (99.7%) of the congenital abnormalities in the baby, target of 733 babies, while for Rubella therefore measles-rubella (MR) Measles 2 immunization coverage as an immunization needs to be given to prevent indicator of effectiveness or success of the these two dangerous diseases(4). protection level was 195 (26, 35%) is still Health improvement depends on the very low when compared with the national performance of health workers (5). Likewise, target of 95% (12). Based on preliminary to increase the coverage of measles-rubella studies, knowledge is a factor that causes the 2nd (second) immunization, the role of low coverage of rubella measles 2 health workers is very important, both in immunization, lack of family support, providing direct immunization to targets and especially husbands who are still afraid of in providing education about health problems the illness their children experience after (6). receiving rubella measles immunization and The Ministry of Health integrated the assumption that their children will be measles and rubella vaccines into the healthy without immunization as well as national basic immunization program in community belief factors. Still have doubts 2019, where before being integrated into the about the legal rubella measles vaccine. national basic immunization program, measles-rubella (MR)(7). The campaign was carried out in stages, namely, in 2017 METHOD carrying out a measles-rubella (MR) The research design used a campaign on the island of Java and in 2018 comparative study(1). The research was outside the island of Java(8). In the program, carried out in 7 Primary health cara in the rubella measles 2 immunization with the Konawe Islands Regency area. The study combination vaccine is given 2 times, population was all toddlers aged 25-30 namely measles-rubella 1 at the age of 9-12 months, divided into two groups, namely the months, and measles-rubella 2 at the age of group that did not receive measles rubella 2 18-24 months(9). immunization as many as 934 children under Nationally, the coverage of Measles- five and the group that received 185 measles Rubella immunization in 2019 reached rubella 2 immunization while the study 87.33% of the national target of 95%, while sample was divided into two. The group that the average coverage per province outside did not get measles rubella 2 immunization Java was 72.79%, even the Provinces of was 88 children under five and the group that Aceh, West Sumatra, and Riau were only received measles rubella 2 immunization was 50%(10). In Southeast Sulawesi Province, 64 children under five. The sample size was the coverage of Rubella Measles 2 (two) determined using the Lemeshow formula.
Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 2
Syahid, A., Supodo, T. & Sunarsih. DOI: 10.36566/ijhsrd/Vol2.Iss2/29 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 The sampling technique uses simple random than good knowledge. Family support shows sampling. Data collection using a the results of statistical tests using Chi- questionnaire(2). squared analysis at α = 5% and df = 1, the value of X2 is calculated> X2 table (1,660 <3,841), meaning that there is no RESULT relationship between family support and Table-1 shows that out of 152 measles-rubella 2nd in Islands Konawe respondents, 85 (55.9%) of respondents had Regency. Because there was no relationship less knowledge of rubella measles between family support and rubella measles immunization. Family support. It shows that 2 immunization, the relationship closeness out of 152 respondents, 77 (50.7%) had less test was not continued, and the Odds Ratio family support for MR immunization. (OR) value of family support for measles- Confidence. It shows that out of 152 rubella 2nd at the 95% level (CI), obtained respondents, 17 (11.2) respondents were not an OR of 1.615. This means that less family sure about the legal rubella measles support has a risk of 1.615 times greater than immunization vaccine. good family support. The level of confidence Table-2 shows the results of statistical shows the results of statistical tests using tests using Chi-squared analysis at α = 5% Chi-squared analysis at α = 5% and df = 1, and df = 1, the value of X2 is calculated> X2 obtained the value of X2 count> X2 table table (64,597> 3,841), meaning that there is (1,919 <3,841), meaning that there is no a relationship between knowledge and confidential relationship with measles- rubella measles 2 in Islands Konawe rubella 2nd in Islands Konawe Regency. Regency. The results of the relationship Because there is no relationship between closeness test show the Phi (Φ) coefficient of belief and rubella measles 2 immunization, 0.665, this shows the strength of a strong the relationship closeness test and the relationship between knowledge and confidence Odds Ratio (OR) value for measles-rubella 2nd and the Odds Ratio measles-rubella 2 at the 95% level (CI) were (OR) value of knowledge against measles- not continued, an OR of 2,600 was obtained. rubella 2nd at the 95% level (CI), obtained This means that beliefs with less risk are OR of 25,468. This means that less 2,600 times greater than good beliefs. knowledge has a risk of 25,468 times greater
Table 1. Distribution of respondents based on Knowledge, Family Support and Faith in Islands Konawe Regency Frequency Percentage Variable (n=152) (%) Knowledge Good 67 44.1 Less 85 55.9 Family support Good 75 49.3 Less 77 50.7 Confidence Sure 135 88.8 Unsure 17 11.2 Source: Primary Data 2020
Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 3
Syahid, A., Supodo, T. & Sunarsih. DOI: 10.36566/ijhsrd/Vol2.Iss2/29 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 Table 2 Knowledge Relationship, Family Support and Faith in Konawe Islands District Rubella Measles Immunization 2 The group that The X² Variable OR Phi (Φ) did not receive immunized Count immunizations group n % n % Knowledge Good 14 15.9 53 82.8 64.597 25.468 0.065 Less 74 84.1 11 17.2 Family support Good 39 44.3 36 56.3 1.660 1.615 0.118 Less 49 55.7 28 43.7 Confidence Sure 75 61.4 60 93.7 1.919 2.600 0.134 Not sure 13 38.6 4 6.3 Source: Primary Data 2020
DISCUSSION Then from 85 respondents who had a Relationship of knowledge with rubella- low level of knowledge, there were 74 measles 2nd immunization respondents (84.1%) who did not receive Knowledge is the result of knowing, rubella measles 2 immunization, respondents and this happens after someone senses an who had less knowledge were more likely to object. Knowledge is generally obtained not do measles-rubella 2 immunization, this from experience, it can also be obtained from was probably due to measles immunization. books, mass media, and from electronic rubella is relatively new so not all people media(15). know it. Lack of public knowledge of this The results showed that of the 67 matter made it unaware that at this time well-informed respondents, there were 14 measles-rubella 2 immunization was a respondents (15.9%) who did not receive continuation of the measles-rubella 1 rubella measles 2 immunization, this immunization. The 85 respondents who had indicates that knowledge is not the dominant a low level of knowledge, there were 11 factor in influencing respondents to respondents (17, immunize measles-rubella 2, because even The statistical test results show that though they know the importance of the calculated chi-square value (X² hit) = immunization rubella measles 2 but because 64,597> X² tab = 3,841, which means there they have other activities sometimes forget is a relationship between knowledge and to bring their children to get rubella measles rubella measles 2 immunization in Konawe 2 immunization. Of 67 respondents who Islands District, by closeness test ( = 0.665) have good knowledge, there are 53 shows the strength of a strong relationship respondents (82.8%) who received measles- between knowledge and rubella measles 2, rubella 2 immunization, this shows that the with an Odds ratio OR value of 25,468, better a person's level of knowledge, the which means that less knowledge has a risk more he has the awareness to immunize his of 25.46 times greater than good knowledge. child because he already understands and Another study conducted, the results understands the purpose and benefits for his of the chi-square test found that respondents child's health. who did not receive rubella measles immunization were found in respondents Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 4
Syahid, A., Supodo, T. & Sunarsih. DOI: 10.36566/ijhsrd/Vol2.Iss2/29 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 with poor knowledge, p = 0.006 <0.05, thus 1,660
Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 5
Syahid, A., Supodo, T. & Sunarsih. DOI: 10.36566/ijhsrd/Vol2.Iss2/29 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 allows children to be immunized against CONCLUSION rubella measles. Based on the results of research and The 17 respondents who stated that discussion, there is a relationship between they were not sure about rubella measles 2nd knowledge and measles-rubella (MR) 2 immunization, there were 13 respondents immunization in Islands Konawe Regency (38.6%) who did not receive rubella measles and there is no relationship between family 2 immunization and 4 respondents (6.3%) support and measles-rubella (MR) 2 who received measles-rubella 2nd immunization in Islands Konawe Regency immunization. This is because in a small and there is no relationship between belief number In the community there is still a and measles immunization. rubella (MR) 2 in debate about the legal status of the Islands Konawe Regency, so it can be prohibition of the rubella measles vaccine, concluded that the low coverage of rubella there are still parents of toddlers who refuse measles 2 immunization is influenced by the to give measles-rubella immunization factor of maternal knowledge that is still because parents' awareness of the importance lacking in the Islands Konawe Regency. of immunization for children under five is still low, so with the existence of issues . circulating about the legal status of rubella REFERENCES measles vaccine make it a guideline for them 1. Putri TN. 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Borneo Student in 2019: Universitasy of Islam Negeri Research (BSR). 2020;1(3):1326-34 Alauddin Makassar; 2019 (Indonesia). (Indonesia). 7. Azmi Z. Behaviour of mother who did 16. Prabandari GM, Syamsulhuda B, not get immunization in Toddopuli Kusumawati A. Faktors related to Primary health care, Makassar City: mother's acceptance for rubella Measles University of Islam Negeri Alauddin for primary school children in Gumpang Makassar; 2018 (Indonesia). Village, Kartasura sub-district, 8. Pramitasari DA, Puteri IRP. The Sukoharjo District. Jurnal Kesehatan relationship between mother's Masyarakat (e-Journal). 2018;6(4):573- knowledge and attitude with obedity to 81 (Indonesia). follow Measles-Rubella immunization in 17. Trisnawati RE. The effect of family comprehensice health services in support to Antenatal Care 4 visiting for Nganglik II Primary health care in pragnant mothers in Dintor Primary Sleman District, Yogyakarta. 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DOI: 10.36566/ijhsrd/Vol2.Iss2/31 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 Research Article Open Access THE EFFECT OF HEALTH EDUCATION AUDIOVISUAL BASED ON HEALTH BELIEF MODEL TOWARDS COMPLIANCE BEHAVIOR OF TB PATIENTS IN PREVENTION TRANSMISSION AT NAMBO PUBLIC HEALTH CENTER AREA Ari Nofitasari1, Nawawi2, Mimi Yati3, Sarah Sarizan Yunam4 1,2,3,4 College of Health Sciences Mandala Waluya Kendari, Southeast Sulawesi, Indonesia. Corresponding Author : Ari Nofitasari Email : [email protected] ABSTRACT Background: Health education can improve an adherence and reduce treatment delays in Tubercul osis (TB) patients. Based on results of interviews with TB patients at Nambo Public Health Center in December 2019, the results of interviews that has conducted on 4 patients, it found that the patients was undergoing treatment at the public health center , there were family members who were undergoing same treatment, there had been no routine preventive measures. The 4 patients interviewed said that they did not know clearlyto preventiontransmission because the health worker only gave a sheet of paper which was re commended to be read at home. The General objective of this study was to determine the effect of health education patients in prevention of transmission at the Nambo Public Health Center Area. Methods: The type of study was quasyi experimental method with a pre test and post test design. The population of this study was 75 people, by using proportional random sampling technique with 26 respondents. The method of analysis used paired t test of the statistical analysis. Result: The results of this study, showed that the above table analysis obtained the value of t=10,111>1,706, where t count was greater than the value of t table. It shows that there was asignificant effect of Health Prevention behavior at Nambo Public Health Center. Conclusion: It is hoped that the Nambo Community Health Center will always educationorconselingwhichwillincreasecommunityknowledge on TB prevention in the working area. Key words: Health Belief Model, TB transmission, Prevention Behavior, Nambo Public Healh Center Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 8 Nofitasari, A., et al. DOI: 10.36566/ijhsrd/Vol2.Iss2/31 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 INTRODUCTION (8).Education given using audio-visual Tuberculosis (TB) has existed for media is more effective in changing a thousands of years and remains a major person's behavior, because the information global health problem today and remains one conveyed through the visual sense can be of the top 10 causes of death and the leading absorbed by the brain by 75% - 87% and the cause of single infectious agent in the world rest through other senses (9) . (1). In the working area of the Nambo Based on the results of interviews Community Health Centre, Kendari City, in with TB patients at the Nambo Health Center 2017, there were 90 cases of pulmonary TB. in December 2019, information was obtained In 2018, from January to November there that the patient underwent treatment at the were 93 cases of pulmonary TB. While the Nambo Community Health Centre, there number of TB cases in the last three months were family members who were undergoing in the working area of the Nambo health the same treatment, there had been no routine center has tended to increase, in July 2019 preventive measures. The 4 patients the number of TB cases undergoing interviewed said they did not know how to treatment was 42 people, in August 2019 it clearly prevent transmission because the was 56 people and in September 2019 it was health worker only gave a sheet of paper 75 people. TB cases in Nambo Community which was recommended to be read at Health Centre are in one family suffering home.The results of interviews with TB from TB. Of the 75 cases there were those officers stated that several inhibiting factors who stopped taking their medication (2). that affected the recovery of pulmonary TB Adherence to TB treatment is a were some pulmonary TB patients who major determinant of treatment success (3). dropped out of treatment because they felt Non-adherence to treatment leads to they had recovered, were bored with taking prolonged infection, recurrence, drug medication, and still lacked behavior towards resistance, which can lead to increased preventing transmission. Education has been morbidity and mortality. This can pose a carried out as an effort to improve adherence, very serious risk to society and contribute to but it is done only once and in one direction, the failure to eradicate disease globally (4). does not dig much about patient beliefs, and Several strategies have been the media used have not provided a clear implemented in an effort to support TB picture of TB disease. treatment adherence, including through counseling, education to TB sufferers and METHOD health workers, psychological interventions, This study uses a quasi-experimental reminders, direct assistance in taking type with a pre-test-post-test design method medication, support from peers and (10). This research was conducted from providing incentives. However, non- March to April 2020. The sample in this compliance problems are still found in study were 36 patients with TB in the patients. TB (5). Compliance with TB working area of the Nambo public Health patients in TB disease prevention can be Center in September 2019, spread across 5 improved through health education regarding urban villages. the disease and its treatment and providing information about the location and cost of RESULT care for free (6). Table-1 shows that at the time of the Providing education with audio- pre-test of 26 respondents, there were 6 visual media can facilitate the delivery of respondents (23.1%) who had well TB information (7). In addition, it is also Transmission Prevention Behavior and 20 effective in increasing adherence to respondents (76.9%) who had less TB treatment actions or procedures Transmission Prevention Behavior, while at Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 9 Nofitasari, A., et al. DOI: 10.36566/ijhsrd/Vol2.Iss2/31 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 the post test there were 26 respondents, 24 Transmission Prevention Behavior at Nambo respondents (92.3%) had well TB Public Health Center transmission prevention behavior and 2 respondents (7.7%) who lacked TB Table 1 transmission prevention behavior. Descriptive Transmission Prevention of Table-2 shows that the statistical test TB Behavior at Nambo Public Health results obtained a significant value of 0.000 Center <α 0.05. The results of table analysis also Transmission Pre test Post test obtained the value of t = 10,111> 1,706, Prevention n % n % where t count is greater than the value of t Behavior table. This shows that there is an effect of Well 6 23,1 24 92,3 Health Education Audiovisual Based on the Less 20 76,9 2 7,7 Health Belief Model (HBM) on TB Total 26 100 26 100 Table 2 Audiovisual Health Education Based on t Health Belief Model (HBM) Against TB Transmission Prevention Behavior at Nambo Public Health Center Transmission Prevention Mean SD t count P value Behavior Pre test 45,38 15,807 10,111 0.000 Post test 69,23 13,542 DISCUSSION person's level of knowledge (11), where The results of this study shows that the according to Notoatmodjo (2014) the higher means of behavior of the respondents before the level of education, the better the the intervention was 45.38 and after the knowledge, in this case, of course, intervention (post test) increased to 69.23. It knowledge about TB transmission shows that basically the respondent's prevention behavior (12). behavior is quite well, however health Simonds(1976) in (13) aims to bring education still needs to be done considering about behavioral changes in individuals, that there is some information that is not yet groups and populations that are larger than known by the respondent. If seen the TB prevention behavior, towards behaviors characteristics of the respondents, there are that are conducive to current health and still 7,7% junior high school students and behavior. future.The results of this study are junior high school students, 8%. From the in line with the research of Moonaghi, results of the study, it was found that there Hasanzadeh, Shamsoddini, were still those who lacked preventive Emamimoghadam, & Ebrahimzadeh (2012), behavior, as many as 2 respondents (7.7%) showing that health education using video or this was because there were some who did audiovisual can be as effective as using face- not pay attention to the intervention and to-face methods (8). some did not understand the interventions The provision of health education is given. not easy to see or measure the benefits for Education will affect a person's the community. Health education is a long learning process, the higher the education, term education. where in the short term the easier it is for that person to receive health education will affect changes / information that can and is absorbed clearly increase in public knowledge. Meanwhile, in (9).The level of education usually affects a the medium term health education will affect Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 10 Nofitasari, A., et al. DOI: 10.36566/ijhsrd/Vol2.Iss2/31 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 behavior, then this behavior will affect the promoting adherence to treatment for increase in public health indicators as an tuberculosis ( Review ) Patient education outcome of health education. and counselling for promoting adherence This research was conducted 13 times to treatment for tuberculosis. Cochrane with interventions for 1 month, where the Database of Systematic Reviews, 2012; intervention was given, respondents were 5(2–4). shown videos of TB transmission prevention 5. Alipanah, N., Jarlsberg, L., Miller, C., behaviors, the advantage of this video is that Linh, N. N., Falzon, D., Jaramillo, E., & this video is very interesting because the Nahid, P. Adherence interventions and video is combined with illustrations and outcomes of tuberculosis treatment: A animation about TB transmission, in the systematic review and meta-analysis of video there is the origin of the video. TB, trials and observational studies. PLoS how TB is transmitted, how to prevent TB, Medicine Journal, 2018; 15(7). and TB treatment, so that respondents are 6. Rondags, A., Himawan, A. B. and enthusiastic to ask questions. Metsemakers, J. F. M. ‘Factors The results of (14)showed an increase Influencing Non-Adherence To in attitude and behavior scores in the Tuberculosis Treatment In Jepara , intervention group supported by the presence Central Java , Indonesia. Southeast Asian of video media where the duration of the Journal of Tropical Medicine and Public video in this study was 10 minutes, the Health2014; 45(4), pp. 859–868. duration of the video would influence 7. Marini BL, Funk K, Kraft MD, Fong JM, someone's interest and absorption of Naanos R, Stout SM, et al. The effects of information.Research by (15), Shows that an informational video on patient health education using audiovisual media can knowledge, satisfaction, and compliance improve knowledge and attitudes of sufferers with venous thromboembolism in preventing tuberculosis transmission. prophylaxis: A pilot study. Patient Educ Couns. 2014;96(2):264–7 CONCLUSION 8. Kandler S, Mao D, McNaughton BL, Based on the research results, it can be Bonin V. Encoding of tactile context in concluded that there are: There is an effect of the mouse visual cortex. bioRxiv. 2018; Health Education Audiovisual Based on the 199364. Healt Belief Model (HBM) on TB 9. Notoatmodjo, S. Health Promotian and Transmission Prevention Behavior at Nambo Behavior.Jakarta: Rineka Cipta. 2014. Community Health Centre. 10. Nursalam & Efendi. Education in Nursing. Jakarta: Salemba Medika.2008. . 11. 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DOI: 10.36566/ijhsrd/Vol2.Iss2/31 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 PromotionPractice. Annual Review of Public Health, 2008; (29): 253–272. 14. Nurhatiningsih, Sri. The effect of health education with audiovisual media and booklet media on caregiver behavior in preventing tuberculosis in family members. Health Science and Pharmacy Journal. 2018; (2):3: 97-102 15. Hesti Ummami Y, Abi Muhlisin SK. Effect Of Health Education On The Improvement Of Tuberculosis Patient Knowledge And Attitude About Infection Prevention In Health Simo Tuberculosis (Doctoral dissertation). Surakarta: Universitas Muhammadiyah Surakarta. 2016. Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 12 Risky, S., Pratiwi, D.S. & Akbar, M. I. DOI: 10.36566/ijhsrd/Vol2.Iss2/33 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 Research Article Open Access FACTORS ASSOCIATED WITH ELDERLY’S SATISFACTION IN INTEGRATED HEALTH SERVICE POST IN VILLAGE TOBIMEITA DISTRICT OF NAMBO CITY OF KENDARI Sartini Risky MS1, Dewi Sari Pratiwi2, Muhammad Ikhsan Akbar3 1,2,3College of Health Sciences Mandala Waluya Kendari, Southeast Sulawesi, Indonesia Corresponding Author : Sartini Risky MS Email : [email protected] ABSTRACT Background: Based on the results of interviews with researchers, six out of ten elderly said they were not satisfied with the service because the starting time for integrated post services was sometimes late, the lack of information obtained was related to elderly integrated service post activities. First person said he was satisfied with the service but still complained about the irregular timing of the integrated service post activities. Research is aimed to determine Factors-Factors Associated With Satisfaction Elderly In Integrated Service Post In Village Tobimeita District of Nambo city of Kendari. Methods: This type of research uses research quantitative design with cross-sectional study population of fifty six people. Sampling using purposive sampling with a sample size of fifty six respondents. The data is processed by using a test Fisher's exact test and continued with the test Coefficient Phi. Result: Based on the results of statistical tests there is a strong relationship between service quality and the level of satisfaction of the elderly with p value 0.000 < α 0.05 , there is a moderate relationship between service and the satisfaction level of the elderly with p value 0.000 < α 0.05, and there is a strong relationship between the attitude of officers with elderly satisfaction level p value 0.000 < α 0.05. Conclusion: Researchers suggest that active remind and motivate the elderly to follow integrated service post elderly, other than that in running its role officers also should have to be friendly to the elderly so that the elderly feel happy to follow integrated service post elderly. Key words: Integrated Service, Post, Elderly, Satisfaction Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 13 Risky, S., Pratiwi, D.S. & Akbar, M. I. DOI: 10.36566/ijhsrd/Vol2.Iss2/33 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 INTRODUCTION feelings of disappointment will arise if the One form of health care for the elderly Integrated Healthcare Center officers' in the community is the Integrated attitude in providing health services is not in Healthcare Center for the elderly. Integrated accordance with the patient's expectations. If Healthcare Center is a public health service the attitude of Integrated Healthcare Center facility established in small villages that are officers at a health service facility matches not reached by hospitals or their expectations, patients will always come clinics(1). Someone is said to be elderly to the health service facility for when they are 60 years old or more, because treatment. Patients will always seek health certain factors cannot fulfill their basic needs services in facilities where the performance both physically, spiritually and socially and attitude of the health service Integrated (2). In Indonesia, the population aged 60 Healthcare Center officers can meet years and over or the elderly (elderly) is expectations or not disappoint the patient. (7) estimated to increase from 18 million in Abeli Public Health Center is one of 2012 to 80 million in 2030, or an increase of the health service providers located in 63% to 64%. The number of elderly people Nambo sub-district, Tobimeita Village and in Southeast Sulawesi spread across several has an elderly Integrated Healthcare sub-districts in 2017 amounted to 554,278 Center. Based on the latest data, there were people, for 2018 the number was 560,596 235 Integrated Healthcare Center for elderly people, while for 2019 the number was in 2017, 193 people in 2018 and 35 people in 569,103 people, this happened along with the 2019. Meanwhile, in 2020, there were 56 increase in life expectancy (3) elderly people who actively participated in Satisfaction is a description of the elderly Integrated Healthcare someone's expectations for services or Center. Elderly Integrated Healthcare Center services that match expectations or held by Puskesmas Abeli as a routine not. Elderly Integrated Healthcare Center are program on the 4th of each month (8) visitors who immediately feel how Integrated Based on the results of interviews with Healthcare Center provide services to the researchers, 6 out of 10 elderly people said elderly, in which there is the role of cadres they were not satisfied with the service who try to improve all services and activities because the starting time for Integrated in implementing Integrated Healthcare Healthcare Center services was sometimes Center for the elderly so that the elderly feel late, the lack of information obtained related the expectations that are desired (4). Elderly to elderly Integrated Healthcare Center satisfaction with elderly Integrated activities. 1 person said he was satisfied with Healthcare Center health services will arise if the service but still complained about the the services provided by Integrated irregular timing of the Integrated Healthcare Healthcare Center health workers are in Center activities. Based on the above accordance with the 5 table system. The background, the researchers are interested in service is influenced by several factors such conducting research on " Factors Related to as quality or service quality, the attitude of Elderly Satisfaction in Elderly Integrated Integrated Healthcare Center officers, and Healthcare Center in Tobimeita Village, health services.(5) Nambo District, Kendari City " An accurate level of patient satisfaction is needed in an effort to improve the quality METHOD of health services (6) . Patients will feel This type of research uses a satisfied if the Integrated Healthcare Center quantitative study with a non- officers 'attitude in providing health services experimental design with a Cross Sectional is the same or exceeds their expectations and Study approach . The research was carried vice versa, the patient's dissatisfaction or out in June 2020 at the Elderly Integrated Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 14 Risky, S., Pratiwi, D.S. & Akbar, M. I. DOI: 10.36566/ijhsrd/Vol2.Iss2/33 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 Healthcare Center, Tobimeita Village, RESULT Nambo District, Kendari City. The total a. Respondent characteristics population is 56 people and a sample of 56 Table 1. Characteristics of Respondents at people using non-probability the Elderly Integrated Healthcare Center sampling techniques with purposive in Tobimeita Village, Nambo District, sampling technique. The instrument used Kendari City was a questionnaire. Collecting data using Age N % secondary data, namely by taking data from 45-49 17 30,4% institutions and primary data, namely data 60-75 39 69,6% obtained directly from respondents. Data Total 56 100% analysis used univariate analysis and Gender N % bivariate analysis. Male 15 26,8 Female 41 73,2 Total 56 100% Table 1.Shows that of the 56 respondents, most were 60-75 years old, namely 39 respondents (69.6%) and the rest were 45-59 years old, namely 17 respondents (30.4%) with 15 respondents (26, 8%) were male, while 41 respondents (73.2%) were female. b. The Relationship between Service Quality and Elderly Satisfaction at Integrated Healthcare Center Elderly Tabel 2. Relationship between Service Quality and Elderly Satisfaction in Elderly Integrated Healthcare Center Uji Nilai Satisfaction Level Service Total Fisher’s phi Quality Not satisfied Satisfied Exact n % n % n % Well 3 5,4 29 51,8 32 57,1 0,000 0,707 Less 19 33,9 5 8,9 24 42,9 Total 22 39,3 34 60,7 56 100 Table 2 explains the relationship satisfaction level of the elderly at the elderly between service quality and elderly Integrated Healthcare Center by 29 (51.8%) satisfaction at the Elderly Integrated respondents. Meanwhile, of the 24 (42.9%) Healthcare Center in Tobimeita Village, respondents whose service quality was not Nambo District, Kendari City. It shows that good, it was found that respondents who of the 56 respondents there are 32 (57.1%) received the quality of their services were respondents whose service quality is good, it not satisfied with the satisfaction level of the is found that respondents who get the quality elderly at the elderly Integrated Healthcare of their services are not satisfied with the Center as many as 19 (33.9%) respondents, satisfaction level of the elderly at the elderly and the quality of service was not good. The Integrated Healthcare Center by 3 (5.4%) of quality of the service is satisfied with the respondents, and those whose service quality satisfaction level of the elderly in the elderly is good at find respondents who get the Integrated Healthcare Center for 5 (8.9%) quality of service are satisfied with the respondents. Based on the results of Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 15 Risky, S., Pratiwi, D.S. & Akbar, M. I. DOI: 10.36566/ijhsrd/Vol2.Iss2/33 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 statistical tests using the Fisher's Exact Test, closeness test using the Cramers test it was found that p = 0.000 and which means obtained the value of the phi coefficient of it is smaller than the value of α = 0.05. So 0.707 and entered the coefficient interval Ho is rejected and Ha is accepted means that 0.60-799 with the strong category. This the research hypothesis is accepted (There is shows that there is a strong relationship a strong relationship between the quality of between the quality of service and the level service and the level of satisfaction of the of satisfaction of the elderly at the Elderly elderly at the Elderly Integrated Healthcare Integrated Healthcare Center in Tobimeita Center in the Tobimeita Village, Kendari Village, Nambo District, Kendari City. City). The results of the relationship c. Service Relationship with Elderly Satisfaction at Elderly Integrated Healthcare Center Table 3. Service Relationship with Elderly Satisfaction at Elderly Integrated Healthcare Center in Tobimeita Village, Nambo District, Kendari City.. Uji Nilai Satisfaction Level Total Fisher’s phi Service Not satisfied Satisfied Exact n % n % n % Well 6 10,7 29 51,8 35 62,5 Less 16 28,6 5 8,9 21 37,5 0,000 0,585 Total 22 39,3 34 60,7 56 100 Table-3 shows that of the 56 with the satisfaction level of the elderly in respondents, there were 35 (62.5%) the elderly Integrated Healthcare Center of 5 respondents whose services were good, it (8.9%) respondents. Based on the results of was found that respondents who received statistical tests using the Fisher's Exact Test, their services were not satisfied with the it was found that p = 0.000 and which means satisfaction level of the elderly at the elderly it is smaller than the value of α = 0.05. So Integrated Healthcare Center by 6 (10.7%) Ho is rejected and Ha is accepted means that respondents, and whose services good, it was the research hypothesis is accepted (There is found that respondents who got their services a moderate relationship between the service were satisfied with the satisfaction level of and the satisfaction level of the elderly at the the elderly at the elderly Integrated Elderly Integrated Healthcare Center in the Healthcare Center as many as 29 (51.8%) of Tobimeita Village, Kendari City). The respondents. Meanwhile, of the 21 (37.5%) results of the relationship closeness test respondents whose service was not good, it using the Cramers test obtained the value of was found that respondents who received the phi coefficient of 0.585 and entered the their services were not satisfied with the coefficient interval 0.40-599 in the moderate level of satisfaction of the elderly at the category. This shows that there is a moderate elderly Integrated Healthcare Center by 16 relationship between services and elderly (28.6%) respondents, and those whose satisfaction at the Elderly Integrated services were not good, it was found that Healthcare Center in Tobimeita Village, respondents who got their services Satisfied Nambo District, Kendari City. Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 16 Risky, S., Pratiwi, D.S. & Akbar, M. I. DOI: 10.36566/ijhsrd/Vol2.Iss2/33 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 d. Relationship between Officer Attitudes and Elderly Satisfaction at the Elderly Integrated Healthcare Center Table 4. The Relationship between Officer Attitudes and Elderly Satisfaction at Elderly Integrated Healthcare Center in Tobimeita Village, Nambo District, Kendari City 2020 Uji Nilai Satisfaction Level Total Fisher’s phi Service Not satisfied Satisfied Exact n % n % n % Well 17 30,4 1 1,8 18 57,1 0,000 0,777 Less 5 8,9 33 58,9 38 42,9 Total 22 39,3 34 60,7 56 100 Table 4 shows that of the 56 closeness test using the Cramers test respondents, there were 18 (32.1%) obtained the value of the phi coefficient of respondents who had a good attitude, it was 0.777 and entered the coefficient interval found that respondents who found the 0.60-799 with the strong category. This attitude of the officers were dissatisfied with shows a strong relationship between the the satisfaction level of the elderly at the attitude of the suspect and the satisfaction of elderly Integrated Healthcare Center were 17 the elderly at the Elderly Integrated (30.4%) respondents, and the attitude of the Healthcare Center in Tobimeita Village, officers who well, it was found that Nambo District, Kendari City. respondents who got the attitude of the officers were satisfied with the satisfaction DISCUSSION level of the elderly at the elderly Integrated Relationship between Service Quality and Healthcare Center by 1 (1.8%) of Elderly Satisfaction at Elderly Integrated respondents. Meanwhile, of the 38 Healthcare Center in Tobimeita Village, (67.9%) respondents whose attitude of the Nambo District officers was not good, it was found that Good service quality is an important respondents who got the attitude of the measure that is fundamental to service officers were not satisfied with the quality (9). This is because it provides satisfaction level of the elderly at the elderly information on the success of quality service Integrated Healthcare Center by 5 (8.9%) providers with the values and expectations of respondents, and those whose attitudes were patients who have their own authority to set not good, were found by respondents Those the desired quality service standards. Patient who get the service are satisfied with the satisfaction can be interpreted as a consumer satisfaction level of the elderly in the elderly attitude, namely some degree of liking or Integrated Healthcare Center as many as 33 disliking the perceived service. In addition, (58.9%) respondents. Based on the results of patient satisfaction is a subjective value to statistical tests using the Fisher's Exact Test, the quality of services provided (10). Based it was found that p = 0.000 and which means on the results of statistical tests using it is smaller than the value of α = 0.05. Then the Fisher's Exact Test, it was obtained p = Ho is rejected and Ha is accepted means that 0.000 and which means it is smaller than the the research hypothesis is accepted (There is value α = 0.05. So Ho is rejected and Ha is a strong relationship between the attitude of accepted means that the research hypothesis the officers and the satisfaction level of the is accepted (There is a strong relationship elderly at the Elderly Integrated Healthcare between the quality of service and the level Center in the Tobimeita Village, Kendari of satisfaction of the elderly at the Elderly City). The results of the relationship Integrated Healthcare Center in Tobimeita Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 17 Risky, S., Pratiwi, D.S. & Akbar, M. I. DOI: 10.36566/ijhsrd/Vol2.Iss2/33 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 Village, Kendari City). This is in line with and felt by the elderly. If the quality of research conducted by Sicily, 2018 with the Integrated Healthcare Center services for the title Relationship of Health Service Quality elderly who are received or felt is in with Patient Satisfaction at the Shoulder accordance with expectations, then the Health Center of Manado City, the results of quality of service that is perceived by the statistical tests obtained p value = 0.025 with elderly is good and satisfying (5) OR = 2.97, which means that Ha accepted Ho is rejected, which means There is a Relationship between Service and Elderly relationship between the quality of health Satisfaction in Elderly Integrated services and patient satisfaction at the Healthcare Center in Tobimeita Village, Shoulder Health Center in Manado Nambo District City. However, in this study there were 3 Health services are services that strive respondents (5.4%) who received good to fulfill patient expectations so that patients service quality but were not satisfied at the will feel satisfied and feel indebted and level of satisfaction. This is because there are grateful. These patients will also share with still elderly people who get unclear others about good health services. Patient information about the implementation of the satisfaction outcomes from health services, Integrated Healthcare Center for the that is why patient satisfaction is the goal of elderly. In this case, the Integrated striving to improve health services. Services Healthcare Center cadres for the elderly in the implementation of Integrated should be clearer in providing information Healthcare Center activities for the elderly regarding the timing of implementing the are one of the indicators used to measure the Integrated Healthcare Center for the satisfaction of the elderly. Health services at elderly. For example, information is the Elderly Integrated Healthcare Center delivered 2 or 3 days before the elderly include physical and mental emotional health Integrated Healthcare Center is held so that checks. The results of physical health checks what is a problem for the elderly can be are recorded and monitored with a Health resolved. And 5 respondents (8.9%) who Card (KMS) to find out earlier the disease received poor service quality at the (early detection) or the threat of health Integrated Healthcare Center but experienced problems being faced. Other activities that a level of satisfaction with the elderly can be carried out according to local needs Integrated Healthcare Center. This is because and conditions, such as provision of the elderly think that what officers provide is supplementary food (PMT) by taking into not good in providing services such as a lack account the health and nutrition aspects of of timeliness in providing services. In order the elderly and sports activities such as to overcome this problem, it is hoped that the gymnastics for the elderly, relaxing walks to cadres will be more punctual in serving the improve fitness So to deal with elderly health elderly who visit first so that they do not wait problems, the government has issued several for a long time. policies / programs implemented by the The results of this research are in line puskesmas, namely the elderly service with the research conducted by (Suhamdani program, also known as Integrated 2019), at the Integrated Healthcare Center Healthcare Center for the elderly(11) for elderly in Desa Bagi, the work area of the Based on the results of statistical tests Bagu health center. Yang said that there is a using the Fisher's Exact Test, it was found strong relationship between cadre that p = 0.000 and which means it is smaller performance and the satisfaction level of the than the value of α = 0.05. So Ho is rejected elderly. Service quality can be measured by and Ha is accepted means that the research comparing the perceptions between the hypothesis is accepted (There is a moderate expected service and the services received relationship between the service and the Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 18 Risky, S., Pratiwi, D.S. & Akbar, M. I. DOI: 10.36566/ijhsrd/Vol2.Iss2/33 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 satisfaction level of the elderly at the Elderly greatly affect how the elderly follow the Integrated Healthcare Center in the Integrated Healthcare Center for the Tobimeita Village, Kendari City). This is in elderly. The results of this research are in line with research conducted by Dony line with research conducted by Katuuk EM entitled IHC Relations Services Elderly (12), the work area of the Ranomuut Elderly With Satisfaction Levels In Community Health Center, Paal II District, Puskesmas Sukorambi Jember obtained data Manado City. Yang said that there was a analysis techniques spearmen Rho obtained relationship between elderly Integrated the value of p is 0.000 <α (0.05), so it can be Healthcare Center services and the concluded that there There is a significant satisfaction level of the elderly. The quality relationship between the Integrated of health services will be felt by patients if Healthcare Center service for the elderly and the delivery is felt to exceed the expectations the level of satisfaction of the elderly in of service users. Assessment of service users Krajan Hamlet, the Work Area of the is aimed at service delivery, service quality, Sukorambi Community Health Center, or service delivery method Jember Regency. In this study, there were 6 Muninjaya(13). In the world of service, the respondents (10.7%) who received good level of satisfaction can also prevent the service for the elderly Integrated Healthcare elderly from joining the Integrated Center but received a unsatisfied level of Healthcare Center program in their satisfaction with the elderly Integrated environment. This is because some elderly Healthcare Center. This is due to the low people think that joining the Integrated knowledge of the elderly about the benefits Healthcare Center program does not affect of Integrated Healthcare Center. It is hoped their health status. In order to provide that the solution to the existing problem is information related to the elderly Integrated that the cadres will be more active and Healthcare Center, one of the most effective improve again regarding the importance of ways to explain the elderly Integrated joining the Integrated Healthcare Center for Healthcare Center program is through the elderly so that the elderly can be Integrated Healthcare Center cadres to the motivated to participate in the Integrated elderly. It is hoped that the elderly who have Healthcare Center for the elderly. However, followed the Integrated Healthcare Center the elderly still want to participate in the program well for the elderly can maintain Integrated Healthcare Center for the elderly that the Integrated Healthcare Center because the service is good. And 5 program is in accordance with the procedure. respondents (8.9%) who received poor service quality at the Integrated Healthcare The Relationship between Attitude of Center but experienced a level of satisfaction Officers and Elderly Satisfaction at with the elderly Integrated Healthcare Elderly Integrated Healthcare Center in Center. This is because the elderly think that Tobimeita Village, Nambo District those provided by officers are not good in Attitude is a tendency (tendensy) to providing services such as a lack of approach (approach) or stay away (avoid), or timeliness in providing services. In order to do something, either positively or negatively overcome this problem, it is hoped that the towards an institution, event, idea or cadres will be more punctual in serving the concept (13). Patients will feel satisfied if the elderly who visit first so that they do not wait Integrated Healthcare Center officers for a long time. 'attitude in providing health services is the Respondents with less service tend to same or exceeds their expectations and vice give a level of dissatisfaction with the elderly versa, the patient's dissatisfaction or feelings Integrated Healthcare Center. service to the of disappointment will arise if the Integrated elderly Integrated Healthcare Center will Healthcare Center officers' attitude in Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 19 Risky, S., Pratiwi, D.S. & Akbar, M. I. DOI: 10.36566/ijhsrd/Vol2.Iss2/33 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 providing health services is not in Center, this was due to a lack of information accordance with the patient's expectations. If regarding the activities and objectives carried the attitude of Integrated Healthcare Center out in the elderly Integrated Healthcare officers at a health service facility matches Center implementation program . From these their expectations, patients will always come problems, the cadres can provide solutions to the health service facility such as providing clearer information for treatment. Patients will always look for in conducting activities to be carried out so health services in facilities where the that the elderly can find out their performance and attitude of the health purpose from here to build motivation for the service Integrated Healthcare Center officers elderly to participate in the implementation can meet expectations or not disappoint the of the Integrated Healthcare Center for the patient(14). Based on the results of statistical elderly. The results are consistent with terori tests using the Fisher's Exact Test, it was stating that attitude ( attitude ) is a reaction found that p = 0.000 and which means it is or response which was still closed from a smaller than the value of α = 0.05. So Ho is person to a stimulus or object. According to rejected and Ha is accepted means that the Wawan (16) , attitudes can be positioned as a research hypothesis is accepted (There is result of evaluation of attitude objects that a strong correlation between the attitude of are expressed in cognitive, affective the officers and the satisfaction level of the (emotional) and behavioral processes . From elderly at the Elderly Integrated Healthcare the above definitions, it is shown Center in the Tobimeita Village, Kendari that attitude generally consists of cognitive City). The results of this study are in line components (ideas that are generally related with the results of research conducted by to conversation and learning), behavior Lestari et al in Tamantirto Village, Kasihan (tends to influence appropriate and District, Bantul Regency , Yogyakarta inappropriate responses ) and emotions Province, which states that there is a (causing consistent responses). The attitude relationship between the attitude of the of the officers at the community level is the officers and the level of satisfaction of the Elderly Integrated Healthcare elderly at the elderly Integrated Healthcare Center. The objectives of the establishment Center (15). However, in this study there of the Integrated Healthcare Center for the were 17 respondents (30.4%) who got a good elderly are to improve the health status and attitude towards the elderly Integrated quality of elderly health services in the Healthcare Center but got a dissatisfied level community, to achieve a happy and useful of satisfaction with the elderly Integrated old age for the family and Healthcare Center. increase community participation in health This is due to the lack of friendly staff services and communication between towards the elderly. In this case, the the elderly (17) cadres should pay more attention to and improve hospitality as it should be in CONCLUSION providing health services so that visitors who Based on the results of this study, come or participate in the elderly activity it can be concluded that there is a strong program feel satisfied and besides that it is relationship between service quality also hoped that the cadres will not make the and elderly satisfaction levels at the Elderly elderly wait long to receive health Integrated Healthcare Center in Tobimeita services. In addition, there were 33 Village, Nambo respondents (58.9%) who found the officers District, Kendari City 2020; There is a lacking in the elderly Integrated Healthcare moderate relationship between Service and Center but experienced a level of satisfaction Elderly Satisfaction Levels at with the elderly Integrated Healthcare Elderly Integrated Healthcare Center in Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 20 Risky, S., Pratiwi, D.S. & Akbar, M. I. DOI: 10.36566/ijhsrd/Vol2.Iss2/33 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 Tobimeita Village, Nambo District, Kendari Centers Using Health Workload City 2020; There is a strong relationship Method. Public Health of Indonesia. between the Attitude of Officers and the 2020;6(2):63-9. Level of Satisfaction of the Elderly at the 7. Saraswati PS, Risky S. Correlation of Elderly Integrated Healthcare Center in supervision, opportunities for Tobimeita Village, Nambo advancement and job safety with District, Kendari City 2020. satisfaction of puskesmas employees in Based on the conclusions outlined north konawe district. Indonesian above, the suggestions that can be given for Journal Of Health Sciences Research elderly Integrated Healthcare Center cadres And Development (IJHSRD). are expected to actively remind and motivate 2019;1(1):9-21. the elderly to follow the Integrated 8. Public Health Center Abeli. Data for Healthcare Center for the elderly, besides Elderly Integrated health Post. that, in carrying out their role, cadres should Kendari.2020 (Indonesia). also be friendly to the elderly so that the 9. Akbar MI. Survey of patient elderly feel happy to join the elderly satisfaction in hospital of North Integrated Healthcare Center. It is hoped that Buton District. Jurnal Kesehatan the elderly can actively participate in the Masyarakat Celebes. 2020;1(04):1-8. Integrated Healthcare Center for the elderly 10. Iksan. The relationship between the so that their health status can always be quality of health services and BPJS controlled. patient satisfaction in the working area of the Motui Community Health REFERENCES Center, Konawe Regency north. 2018. 1. Ministry of Health of the Republic of 11. Effendy N. Basics of Public Health Indonesia. Long-term Health Sector Nursing. Jakarta: EGC; 2015. Development Plan 2005-2025. Jakarta: 12. Ketuuk EM. Relationship between Ministry of Health RI; 2015 Posyandu Lanisa Services and Levels (Indonesia). Elderly Satisfaction at the Ranomuut 2. Nugroho. Perawatan Gerontik. Jakarta: Health Center, Paal II District Manado EGC; 2015. City. E- Jounal Nursing (e-Kep). 3. Central Bureau Statistics of Southeast 2018;6(1). Sulawesi. Southeast Sulawesi in 13. Muninjaya AA. Health Management. Figures; 2019. 2, editor. Jakarta: EGC; 2013. 4. Faridah. The Relationship between 14. Poloma, Margaret M. Contemporary Cadre Performance and Elderly Sociology. Jakarta: PT. Raja Grafindo Satisfaction in Optimizing the Elderly Persada,; 2016. Posyandu in the Muara Kumpeh 15. Lestari P. Several Factors Contributing Community Health Center Area in to Activeness Elderly Visit to Pudak Village. Scintia Journal Adi Posyandu Case Study in Tamantirto Wangsa University Jambi. 2018;1(1). Village in Poor Bantul Regency, DIY 5. Suhamdani. Performance Relationship Province. Medical journal 45, (2) of Elderly Posyandu Health Cadres 2011;45(2) (Indonesia). With Elderly Satisfaction Levels at the 16. Wawan. Knowledge, Attitude, and Elderly Posyandu in Bagu Wilaya human behavior. Yogyakarta.: Nuha Village Bagu Health Center Work. Medika.; 2010 (Indonesia). Health Junal Qomarul Huda. 17. Ismawati S, C. Integrated health prost 2019;7(2). and ready village. Yogyakarta: Nuha 6. Akbar MI. Analysis Of The Needs Of Medika; 2010 (Indonesia). General Practitioners In Public Health Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 21 Said, A. & Nurdin. DOI: 10.36566/ijhsrd/Vol2.Iss2/34 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 Research Article Open Access MODELING TECHNIQUES IN MOMS AND CHILDREN ON THE SUCCESS OF TOILET TRAINING AMONG TODDLER AGE CHILDREN Asbath Said1, Nurdin2 1,2College of Health Sciences Mandala Waluya Kendari, Southeast Sulawesi, Indonesia Corresponding Author : Asbath Said Email : [email protected] ABSTRACT Background: The ability of children in activities related to toilets that take care of an inheritance, but something that must always be remembered and taught. To teach skills for this training, it takes the right technique or method so that it is easy to connect with children. One such technique is modeling techniques. The research objective was to determine the effect of modeling techniques on mothers and children on the success of toilet training in Toodler-aged children at PAUD AFI, Konawe Regency. Methods: Using quantitative methods through this type of pre-experimental research with a one-group approach pretest-posttest design with simple random sampling means that the sample is 30 children aged. Result: The results of the Paired T-Test explain the effect of modeling techniques on mothers and children on toilet training for toddlers in PAUD AFI, Konawe Regency (p = 0.000). . Conclusion: The use of modeling techniques in mothers and children must prepare and build from an early age for children where parents can teach children of age-related to the good toilet so that they can toilet training for children toddler. Key words: Modeling techniques, toilet training, toddler Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 22 Said, A. & Nurdin. DOI: 10.36566/ijhsrd/Vol2.Iss2/34 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 INTRODUCTION of children to defecate and not urinate in the Growth and development are two toilet is the use of diapers (5). different terms, but they are inseparable and independent (1). According to Supartini, METHOD children are individuals who still depend on This study used a pre-experimental adults and their environment, meaning they design through a one-group pretest-posttest need an environment that can facilitate the design approach with a total sample of 30 fulfillment of children's needs (2). Nursalam children aged toddler based on inclusion explained that growth is an increase in the criteria. The sample was taken using a simple physical size and structure of a person's body random sampling technique. This research due to an increase in the number and size of was conducted at PAUD AFI Konawe cells quantitatively, such as an increase in Regency using bivariate analysis, namely the body weight, height, and head Paired T-Test. circumference. Development is defined as an increase in the maturity of the functions of each body and is qualitative, such as the RESULT child's ability to lie on his stomach, sit, walk, talk, pick up objects around him, as well as Table 1.Distribution of Respondents by the emotional and emotional maturity of the Gender, Age, Child Toileting Pre-Test and child (3). Post-Test for Children in PAUD AFI, Konawe According to Wong, the Regency development of children consists of the Variable Category f % prenatal period (from conception to 40 weeks Gender Male 14 46,7 Female 16 53,3 of gestation), the infant period (from birth to 12 months of age), the early childhood Age 2 years 9 30,0 period 1 year to 6 years of age), the middle 3 years 18 60,0 4 years 3 10,0 childhood period ( ages 6 to 11-12), and late Child Enough 5 16,7 childhood (ages 11-12 to 18 years). The early Toileting Pre Less 25 83,3 childhood period consists of the toddler, Test namely the age of children 1 to 3 years, and Child Enough 19 63,3 the preschool period, which is between 3 to 6 Toileting Less 11 36,7 years (3). According to Freud regarding the Post Test psychosexual development of children this Total 30 100 age is in the anal phase where the child's pleasure lies in the anal. Children like to hold their feces, even playing with their feces as Table 1 shows that the most they wish. Thus, toilet training is the right respondents based on gender are women as time to do this during this period (4). many as 16 respondents (53.3%), the most Usually, as the child can walk, the two dominant age of the respondents is 3 years sphincters are increasingly able to control the old as many as 18 respondents (60.0%), the urge to urinate and defecation, so this phase behavior of children's toileting before is the right time to teach children toilet treatment is known that toileting is training. To assess the failure of toilet dominated by toileting. less than 25 training can be seen at preschool age, where respondents (83.3%) and the behavior of children should be able to urinate and children's toileting after treatment it was defecate without the help of other people. known that sufficient toileting was 19 One of the factors causing the independence respondents (63.3%). Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 23 Said, A. & Nurdin. DOI: 10.36566/ijhsrd/Vol2.Iss2/34 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 Tabel 2.Effect of modeling techniques on that there is an effect of using modeling mothers and children on the success of techniques on mothers and children on the toileting training in toddler uses at PAUD success of toilet training for toddlers age AFI, Konawe Regency children in PAUD AFI, Konawe Regency. No Toileting Mean t p According to Hidayat, the Test Count Value definition of toilet training is an effort to train children to be able to control their 1 Pre test 4,67 10,830 0,000 urination and defecation. This toilet training 2 Pos test 8,77 can take place in a child's life phase, namely the age of 18 months - 24 months. In the practice of urinating and defecating, children Table 2 shows that the mean value at need preparation both physically, the time of the pre-test was 4.67 and at the psychologically, and intellectually. Through post-test was 8.77, the results of the this preparation, it is hoped that the child will statistical test showed that the p-value <0.05, be able to control the bowel and urination the t value 10.830> the t table value 1.734 independently (6). These toilet training which means that there is the effect of skills include the child's ability to be aware modeling techniques on mothers and of the willingness of BAK and defecating, children on the success of toilet training in the child's ability to communicate it, the toddlers. child's ability to control BAK and defecate correctly in the bathroom (toilet), in the form DISCUSSION of the child can resist the urge to defecate The results of the post-test research until he reaches the toilet and mastery of all a obtained a mean value of 8.77 which means series of behaviors to go to the toilet (going there is an increase in the mean value of the to the bathroom, taking off your pants/skirt mean pre-test, this indicates that there has and panties, sitting on the toilet and been an improvement in children's toileting urinating/defecating, cleaning yourself / to be sufficient where sufficient toileting for wiping until it is clean, standing up from the children is 19 respondents where 18 children toilet, flushing the toilet until it is clean, already understand that BAK and BAB must drying wet body parts with a rag, put on your be in the toilet but there are still 11 underwear and pants/skirt, wash your hands respondents who are still lacking in toileting, and dry them (5,7). especially in the part of drying wet body The success of toilet training depends parts that were rinsed after defecating and on the readiness of the child and the family, washing, only 7 people did it from all such as physical readiness, where the child's respondents, likewise for the act of cleaning ability is physically strong and capable. This themselves / wiping properly only 8 can be shown that the child can sit or stand respondents from the whole Those who do so that it makes it easier for children to be this are due to other factors that cause this, trained to defecate and urinate, as well as such as the age of the child who is still a psychological readiness where the child toddler so that it takes time and the needs a comfortable atmosphere to be able to participation of parents at home to always control and concentrate in stimulating to guide, direct and get their children to do defecate or urinate and knowing some parts toileting independently at home, the of the body and function (8). Toilet training statistical test results obtained a significant is also important in the development of a value of 0.000 <0,05. the results of the child's personality because toilet training is analysis of the table above also obtained the the first moral exercise that a child has value of t count = 10.830> 1.734, where t is received and is very influential in subsequent greater than the value of t table. This shows moral development (9). Widayatun explained Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 24 Said, A. & Nurdin. DOI: 10.36566/ijhsrd/Vol2.Iss2/34 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 that parents' motivation is influenced by 3-5 Years Old Children In Paud In intrinsic factors and extrinsic factors. Pekanbaru City In 2017. Menara Ilmu, Intrinsic factors are the impulses that come 13(1). from within a person, namely in the form of 7. Wantah, Maria J. (2007). PTeaching knowledge, attitudes, mental state, and age Discipline and Moral Formation: maturity, while extrinsic factors are in the Jakarta: Ministry of National form of facilities, infrastructure, and the Education, Directorate General of environment (3). Higher Education. 8. Hidayat, & Aziz, Alimul. (2012). CONCLUSION Introduction to Child Nursing (Vol. 3). The effect of using modeling techniques Jakarta Salemba Medika. on mothers and children on the success of 9. Suherman. (2000). Child Development toilet training in toddler age children in Pocket Book. . Jakarta: EGC. PAUD AFI, Konawe Regency. The use of modeling techniques in mothers and children must consider the early introduction and teach children where parents can teach children about good toileting so that the success of toilet training in toddler age children. . REFERENCES 1. Riyadi, Sujono. (2009). Nursing Care for Children. Yogyakarta: Graha Ilmu. 2. Islaeli, Islaeli, Yati, Mimi, & Fadmi, Fitri Rachmillah. (2020). The effect of play puzzle therapy on anxiety of children on preschoolers in Kendari City Hospital. Enfermería Clínica, 30, 103-105. 3. Ningsih, Sri Fitdiyah. (2012). The relationship between knowledge and behavior of mothers in implementing toilet training with bedwetting habits in preschool children in RW 02 Babakan Urban Village, Tangerang City. 4. Cahyaningsih, Dwi Sulistyo. (2011). Developmental growth of children and adolescents. Jakarta: TIM. 5. Uyun, Khumrotul, Arifah, Siti, Kp, S, Ke, M, & Dian Nur, W. (2016). The Relationship between using diapers and toilet training skills for toddlers in Jrahi Pati village. Muhammadiyah Surakarta university. 6. Warlenda, Sherly Vermita, Maharani, Riri, & Widodo, M Dedi. (2019). Factors Related To The Implementation Of Toilet Training In Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 25 Firman, Rachmawati, U. & Pipit, W.O. DOI: 10.36566/ijhsrd/Vol2.Iss2/35 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 Research Article Open Access FACTORS RELATED TO NEGATIVE STIGMA FOR HIV/ AIDS PATIENTS IN BORO-BORO VILLAGE, RANOMEETO SUB-DISTRICT SOUTH KONAWE REGENCY Firman1, Umi Rachmawati2, Wa Ode Pipit3 1,2, 3College of Health Sciences Mandala Waluya Kendari, Southeast Sulawesi, Indonesia. Corresponding Author : Wa Ode Pipit Email : [email protected] Abstract Background: The high number of people living with HIV / AIDS until 2018 has created a negative stigma for HIV / AIDS patients in Boro-Boro Village, Ranomeeto Sub-District, South Konawe Regency. The purpose of this study was to determine the factors associated with negative stigma for HIV / AIDS patients in Boro-Boro Village, Ranomeeto District, South Konawe Regency Methods: Type of research is quantitative method with a cross-sectional design with a population of 585 people. Sampling technique usedd accidental sampling technique with a sample size of 83 respondents. Analysis data used the chi square test. The independent variable in this study was knowledge about HIV / AIDS, perception, and education, while the dependent variable was negative stigma for people with HIV / AIDS. The instrument of this study is a questionnaire. Result: The results showed that there was still a high negative stigma for people with HIV / AIDS with n = 69 (83.1%). There is a weak relationship between knowledge and negative 2 stigma for people with HIV / AIDS with a value of X count 4.110, 0.255. There is a weak correlation between perceptions and negative stigma for people with HIV / AIDS with a value 2 of X count 7.338, φ 0.331. There is a weak relationship between education and a negative stigma for people with HIV / AIDS with a value of X2count 5.551, φ 0.291. Conclusion: Researchers suggest to Ranomeeto Primary Health Care to conduct more frequent health education about HIV / AIDS and form village cadres by providing accurate knowledge about HIV / AIDS, for further researchers to add and look for variables that are closely related to negative stigma for people with HIV / AIDS in the community. Key words: HIV AIDS, Community Stigma, Patients Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 26 Firman, Rachmawati, U. & Pipit, W.O. DOI: 10.36566/ijhsrd/Vol2.Iss2/35 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 INTRODUCTION anticipating the widespread transmission of this disease (4,5). Data from the World Health Some of the factors that influence the Organization (WHO) notes that globally stigma for HIV / AIDS, namely HIV / AIDS there are 36.9 million people in various is a life-threatening disease, people are afraid countries living with HIV and AIDS in 2017. of being infected with HIV, diseases are Of the total sufferers, 1.8 million of them are associated with stigmatized behaviors in children under 15 years of age. The rest are society, PLWHA are often considered to be adults, some 35.1 million sufferers. responsible if someone is infected, values Recorded the number of deaths was caused morals or religion make people believe that by AIDS as many as 940,000 cases HIV / AIDS is the result of moral violations. worldwide. That figure consists of 830,000 Many of these PLHIV later lost their jobs, deaths in adulthood and the remaining were isolated from their families and 110,000 in children. Most people with HIV / communities, rejected by health services AIDS are found in the East and South Africa knowing their HIV status. Stigma and Region, with a total of 19.6 million sufferers. discrimination against people living with Furthermore, in second place is the West and HIV / AIDS are influenced by several factors Central Africa Region with 6.1 million such as knowledge, perception, education, people living with it (1). gender, age, economic status, exposure to In Indonesia, from 2005 to March information sources about HIV / AIDS, as 2019, the number of reported HIV cases well as interactions with PLHIV also affect a reached 338,363 people, while the number of person's stigma for PLWHA (6). AIDS conditions reported since it was first According to data from the Health discovered in 1987 to March 2019 reached Office, the number of HIV / AIDS cases in 115,601 people. From January to March Southeast Sulawesi from 2015 to the end of 2019, 11,081 HIV transmissions were 2018 continued to increase, in 2015 there reported, while AIDS cases reached 1,536 were 158 people with HIV / AIDS. Then in people (2). 2016 it decreased to 123 people, 2017 as HIV / AIDS is a disease for which no many as 120 people and in 2018 it increased cure has been found. The sufferers are only again to 183 people (7). given drugs to prevent the spread of the virus Based on data from the Health Office, in the body. Most of those infected with HIV from 17 districts / cities in Southeast / AIDS are people whose behavior is morally Sulawesi, the spread of HIV / AIDS in contrary to religious and social norms. Kendari City in 2018 was in the first position Sometimes they get unpleasant treatment with the most cases of 52 people. Following from their family and friends / community, the city of Bau-Bau with 24 people and such as ridicule, insults or even other Wakatobi as many as 16 people South attitudes that show a stigma of disliking HIV Konawe District, especially Ranomeeto / AIDS sufferers (3). District, has a total of 5 people with HIV / AIDS-related stigma is all prejudice, AIDS. The village of Boro-Boro is a village insults and discrimination directed at PLHIV located in Ranomeeto District which has 1 and individuals, groups or communities person, the number of HIV / AIDS sufferers associated with PLWHA. The stigma against because the patient works as a female sex PLWHA hinders the process of socialization worker (FSW), this patient has been and even treatment because it makes them recognized by the community (8). feel isolated and even considered as people The results of the interviews I had with who are insulted by their status as ODHA. 7 people in the community stated that they The stigma that exists in the community had negative thoughts (negative stigma) regarding HIV and AIDS is a problem in towards people with HIV / AIDS, 3 of them Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 27 Firman, Rachmawati, U. & Pipit, W.O. DOI: 10.36566/ijhsrd/Vol2.Iss2/35 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 because of their low knowledge factor, they Boro-Boro Village, Ranomeeto District, said that they did not understand and did not South Konawe Regency who were more than get enough information about HIV / AIDS. 18 years old. The number of respondents was AIDS, 2 of them because of the perception 83 respondents from a population of 585 factor, they said that they had a bad view of people. The sampling technique in this study PLWHA due to a lack of understanding of was carried out using accidental sampling. HIV / AIDS, and 2 of them because of This research is located in Boro-Boro educational factors, they said that their level Village, Ranomeeto District, South Konawe of education was still low so they did not get Regency from June to July 2020 information about HIV / AIDS, this will give a negative stigma to PLWHA due to a lack of knowledge. RESULT The Relationship between Knowledge and Negative Stigma for HIV / AIDS METHOD Patients in Boro-Boro Village, Ranomeeto District, South Konawe Regency in 2020 as This research is a quantitative study shown in the following table with a cross sectional study approach. Respondents in this study were the people of Table 1. The Relationship between Knowledge and Negative Stigma for HIV / AIDS Patients in Boro-Boro Village, Ranomeeto District, South Konawe Regency in 202 Stigma Total Statistic Knowledge Positif Negatif 2 n % n % n % X test= 4,110 Less 43 91.5 4 8,5 47 100 2 Well 26 72,2 10 27,8 36 100 X tab= 3,841 Total 69 83,1 14 16,9 83 100 = 0,255 The results showed that of the 83 were found 10 respondents (12.0%) gave a respondents, there were 47 (56.6%) positive stigma for HIV / AIDS sufferers. respondents who had less knowledge, it was Based on the results of the chi-square found that respondents gave a negative test for the relationship between knowledge stigma for HIV / AIDS sufferers by 43 and stigma for people with HIV / AIDS, it (51.8%) respondents and those with less shows that X2 count (4,110) ≥ X2 table knowledge were found respondents gave a (3,841), the research hypothesis H0 is positive stigma against people with HIV / rejected and Ha is accepted, which means AIDS by 4 (4.8%) respondents, while 36 that there is a negative relationship between (43.4%) respondents with good knowledge knowledge and stigma for HIV / AIDS were found respondents who gave a negative sufferers. in Boro-Boro Village, Ranomeeto stigma for HIV / AIDS sufferers by 26 District, South Konawe Regency. (31.3%) and those with good knowledge Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 28 Firman, Rachmawati, U. & Pipit, W.O. DOI: 10.36566/ijhsrd/Vol2.Iss2/35 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 The results of the analysis showed that Boro-Boro Village, Ranomeeto District, the value of the phi coefficient was 0.255 South Konawe Regency in 2020. and entered the coefficient interval from 0.20 The Relationship between Perceptions to 0.399 in the weak category. This shows and Negative Stigma for HIV / AIDS the relationship between knowledge and Patients in Boro-Boro Village, Ranomeeto negative stigma for HIV / AIDS sufferers in District, South Konawe Regency in 2020 as shown in the table below: Table 2. The Relationship between Perceptions and Negative Stigma for HIV / AIDS Patients in Boro-Boro Village, Ranomeeto District, South Konawe Regency in 2020 Stigma Total Statistic Perception Negatif Positif 2 n % n % n % X hit= 7,338 Negatif 49 92,5 4 7,5 53 100 2 Positif 20 66,7 10 33,3 30 100 X tab= 3,841 = 0,331 Total 69 83,1 14 16,9 83 100 The results showed that of the 83 (3,841), the research hypothesis H0 is respondents, there were 53 (63.9%) rejected and Ha is accepted, which means respondents who had negative perceptions, it that there is a perception relationship with was foaund that the respondents gave a negative stigma for HIV / AIDS sufferers. in negative stigma for HIV / AIDS sufferers by Boro-Boro Village, Ranomeeto District, 49 (59.0%) respondents and those who had South Konawe Regency. negative perceptions were found to give The results of the analysis obtained the positive stigma for people with HIV / AIDS. value of the coefficient phi of 0.331 and HIV / AIDS sufferers were 4 (4.8%) entered the coefficient interval from 0.20 to respondents, while of the 30 (36.1%) 0.399 in the weak category. This shows the respondents who had positive perceptions it relationship between knowledge and was found that 20 (24.1%) respondents gave negative stigma for HIV / AIDS sufferers in a negative stigma to HIV / AIDS sufferers Boro-Boro Village, Ranomeeto District, and those who 10 (12.0%) respondents found South Konawe Regency in 2020 positive perceptions who gave a positive The Relationship between Education stigma to HIV / AIDS sufferers. and Negative Stigma for HIV / AIDS Based on the results of the chi-square Patients in Boro-Boro Village, Ranomeeto test for the relationship between knowledge District, South Konawe Regency in 2020. As and stigma for people with HIV / AIDS, it shown in the table below: shows that X2 count (7,338) ≥ X2 table Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 29 Firman, Rachmawati, U. & Pipit, W.O. DOI: 10.36566/ijhsrd/Vol2.Iss2/35 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 Table 3. The Relationship between Education and Negative Stigma for HIV / AIDS Patients in Boro-Boro Village, Ranomeeto District, South Konawe Regency in 2020 Stigma Total Statistic Education Positif Negatif 2 n % n % n % X test= 5,551 High 46 92,0 4 8,0 50 100 2 X tab = 3,841 Low 23 69.7 10 30,3 33 100 = 0,291 Total 69 83,1 14 16,9 83 100 The results showed that of the 83 respondents there were 50 (60.2%) DISCUSSION respondents with low education, it was found Since it was first discovered, HIV that respondents gave a negative stigma for /AIDS has caused various responses such as HIV / AIDS sufferers by 46 (55.4%) rejection, fear, stigma and discrimination respondents and those with low seeducation which have caused anxiety and prejudice were found respondents gave a positive against people with HIV / AIDS. Stigma is stigma against HIV / AIDS sufferers. / AIDS the act of giving a social label that aims to by 4 (4.8%) respondents, while from 33 separate or discredit a person or group of (39.8%) respondents who had a high people with bad labels or views. In practice, education, it was found that 23 (27.7%) stigma results in acts of discrimination, respondents gave a negative stigma to HIV / namely the act of not recognizing or failing AIDS sufferers and those with high to fulfill the basic rights of individuals or education It was found that 10 respondents groups as should be human beings with gave a positive stigma against HIV / AIDS dignity (4). sufferers (12.0%). Lack of knowledge about HIV / AIDS Based on the results of the chi-square tends to give a negative stigma against test for the relationship between education people with HIV / AIDS. Stigma and and stigma against people with HIV / AIDS, discrimination against HIV / AIDS sufferers it shows that X2count (5,551) ≥ X2 table are influenced by the level of knowledge, (3,841), the research hypothesis H0 is this is in accordance with the results of rejected and Ha is accepted, which means research in Kupang City, NTT Province that there is a negative relationship between which states that respondents who have less education and stigma against HIV / AIDS knowledge give a high stigma of 75% and sufferers. in Boro-Boro Village, Ranomeeto low stigma amounted to 24.7%, while District, South Konawe Regency. The results respondents who have good knowledge give of the analysis showed that the value of the a high stigma of 33.9% and a low stigma of phi coefficient was 0.291 and entered the 66.1% in this study there is a significant coefficient interval from 0.20 to 0.399 in the relationship between knowledge and stigma weak category. This shows the relationship in PLWHA (9). between education and negative stigma According to Febrianti's research against HIV / AIDS sufferers in Boro-Boro (2017) respondents who have less knowledge Village, Ranomeeto District, South Konawe have a heavy stigma of 76.4% and a mild Regency in 2020 stigma of 23.6%, while respondents who Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 30 Firman, Rachmawati, U. & Pipit, W.O. DOI: 10.36566/ijhsrd/Vol2.Iss2/35 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 have good knowledge give a heavy stigma of and sinful. This negative assessment causes 54.7% and a mild stigma of 45.3 % of this sufferers to be embarrassed to go for research found that knowledge is related to treatment so that they tend to hide their cause and effect with stigma against disease, so that it will endanger the wider PLWHA (6) community. This research is also in line with Respondents with negative perceptions research in Dewantara District, North Aceh tend to give negative stigma to people with Regency, which states that there is a HIV / AIDS. The perception of people living relationship between knowledge and with HIV or people with AIDS will greatly discrimination against PLWHA. In this affect how that person will behave and study, the lower the public's knowledge behave towards people with HIV / AIDS. about HIV / AIDS, the higher the This research is in accordance with the nationalism and PLWHA (10). study of concerning Community Stigma Knowledge of HIV / AIDS greatly Against People With HIV / AIDS which influences a person's attitude towards people shows that someone who has negative with HIV / AIDS. The stigma against HIV / perceptions of PLWHA has a twice as large AIDS sufferers appears related to a person's risk of committing stigma than with people ignorance of HIV transmission and negative who have positive perceptions. This stigma attitudes towards being informed by the HIV arises because the public does not know / AIDS epidemic, misunderstanding or lack correct and complete information on HIV, of public knowledge about HIV / AIDS often especially about the mechanism of HIV has an impact on the fear of people living transmission, groups of people at risk of with HIV / AIDS, so that postponement of contracting HIV and ways of prevention, prevention of HIV / AIDS sufferers. including the use of condoms (12). Lack of correct information about HIV This research is also in line with / AIDS and its transmission is caused by research in Kupang City, NTT Province, it talking about matters related to sexual was found that 70% of respondents who had relations which causes obstacles for young a lack of perception gave high stigma to people to protect themselves from behaviors PLWHA. Meanwhile, respondents who had a that are at high risk of carrying out HIV good perception gave a high stigma against transmission. PLWHA, 26.4%. In this study, there is a This knowledge of HIV / AIDS causes significant relationship between knowledge the public to draw conclusions that are and stigma in PLWHA (9). inconsistent with the real knowledge about In social life, stigma also prevents HIV / AIDS. There are several PLWHA from carrying out social activities. misconceptions about HIV / AIDS, such as PLWHA is closed off and tends not to be HIV / AIDS can be transmitted through willing to interact with family, friends and social contact such as shaking hands, eating neighbors. This is because some people think together, breathing air around PLHIV, and that people who are HIV positive are people others. This misconception has led to who have bad behavior such as female sex stigmatization of HIV / AIDS sufferers. workers, drug users, and homosexuals. This Perception is the process of observing group is considered by some people to the outside world which includes attention to influence the HIV / AIDS epidemic and understanding and recognition of objects or make people reject and hate the group. events (11). The strength of the general Education is all efforts that are planned public's view of HIV / AIDS, which is a to influence other people so that they do sexually transmitted disease and has a stigma what is expected by education (13). in Indonesian culture. Those who contract Education is an individual learning process this disease are considered dirty, immoral Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 31 Firman, Rachmawati, U. & Pipit, W.O. DOI: 10.36566/ijhsrd/Vol2.Iss2/35 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 in order to have an understanding and CONCLUSION knowledge of something. Based on the research results it can be The research is in line with research in concluded as follows: Dewantara District, North Aceh Regency, 1. There is a weak relationship between which states that there is a relationship Knowledge and a negative stigma against between education and discrimination people with HIV / AIDS in Boro-Boro against PLHIV. It can be explained that the Village, Ranomeeto District, South lower the level of education, the Konawe District. discrimination against PLHIV will also be 2. There is a weak relationship between higher. In population groups with high Perception and negative stigma against education, it can reduce discrimination HIV / AIDS sufferers in Boro-Boro against PLWHA, with higher education Village, Ranomeeto District, South someone will get enough information about Konawe District. PLWHA so that it affects attitudes towards 3. There is a weak relationship between PLWHA (10). education and a negative stigma against High education also makes it easier for people with HIV / AIDS in Boro-Boro someone to access health information. The Village, Ranomeeto District, South ease with which a person absorbs Konawe District information will influence the formation of new, healthier behaviors, such as health REFERENCES information about HIV / AIDS (10). A person's education greatly affects a 1. UNAIDS, 2017. HIV / AIDS in person's attitude towards people with HIV / Figures: 36.9 Million Sufferers, 25 AIDS. The stigma against people with HIV / Percent Unaware. [on line]. (updated AIDS appears related to a person's ignorance December 1, 2018). Accessedd of the mechanism of HIV transmission due https://amp.kompas.com/lifestyle/read/ to a person's low education, which results in 2018/12/01/124545720/hivaids-dalam- a misunderstanding or a lack of public angka-369-juta-penderita-25-persen- knowledge about HIV / AIDS. tak-menyadarinya 2nd February 2020. Low education causes the community (Indonesia) to have conclusions that are inconsistent with 2. Rahmawati, M., 2019. Combating HIV real knowledge of HIV / AIDS. There are / AIDS in Indonesia under the RKUHP several misconceptions about HIV / AIDS, Threat. South Jakarta: Institute for such as HIV / AIDS can be transmitted Criminal Justice Reform (ICJR). through social contact such as shaking hands, (Indonesia) eating together, breathing air around PLHIV, 3. Hermawati, P., 2011. The Relationship and others. This misconception has led to between Perceptions of PLWHA and stigmatization of HIV / AIDS sufferers. the Stigma of HIV / AIDS in the One of the obstacles in controlling HIV Community and Social Interactions of / AIDS is the existence of stigma and PLWHA. Undergraduate thesis. Faculty discrimination against HIV / AIDS sufferers, of Psychology. Syarif Hidayatullah the provision of information related to HIV / State Islamic University Jakarta, AIDS through health education and Jakarta. (Accessed 30th Januari 2020). socialization is very effective in reducing the (Indonesia) stigma of society towards PLWHA. 4. Firman, 2017. HIV/AIDS Nursing Someone with high education and Care. Kendari: CV. Metro Graphia understanding related to HIV / AIDS is Kendari. (Indonesia) expected to reduce and even eliminate the 5. Tjay Tan Hoan & Rahardja Kirana. stigma in PLWHA. 2008. Important Drugs Efficacy, Use, Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 32 Firman, Rachmawati, U. & Pipit, W.O. DOI: 10.36566/ijhsrd/Vol2.Iss2/35 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 and Side Effects. Jakarta: Pt Elex 13. Maulana, D., J., Heri, 2009. Health Media Komputindo. (Indonesia) Promotion. Jakarta: EGC. (Indonesia) 6. Febrianti, 2017. Factors Related to Stigma for People Living with HIV and AIDS (PLWHA). Journal Endurance, 2 (2), hal. 158-167. (accessed 28th Januari 2020). (Indonesia) 7. Provincial govermnet Southeast Sulawesi, 2019. HIV / AIDS cases in Southeast Sulawesi reached 183 people. [on line]. (updated April 23, 2019). https://www.google.com/amp/s/penasu ltra.com/amp/kasus-hiv-aids-di-sultra- capai-183-orang/ (Accessed 2nd Februari 2020). (Indonesia) 8. Health Profile Provincial govermnet Southeast Sulawesi 2017. Data & Information of Southeast Sulawesi Provincial Health Office. Kendari. (Accessedd at www.dinkes.sultraprov.go.id 2nd Februari 2020). (Indonesia). 9. Konstantinus, H., Zahroh, S., & Antono, S., 2017. Community Sitgma for PLWHA in Kupang City, NTT Province. Jurnal of Health Promotion Indonesia, 1 (12), page 62-77. (Accessed 2nd Februari 2020). (Indonesia). 10. Nurma, Fahmi, I., Syarifuddin, A., & Nelly, M., 2018. The Cause of Discrimination in Dewantara Subdistrict, Aceh Utara District for People with HIV-AIDS. Health Research Journal , 1 (5), page. 1-9. (Accessed 1st Februari 2020). (Indonesia). 11. Sunaryo, 2004. Psychology For Nursing. Jakarta: EGC. (Indonesia) 12. Kasanah, U., & Lintang, K., F., I., 2017. The Relationship between Public Perceptions of HIV and Discriminatory Stigma Incidents in PLWHA (People With HIV / AIDS) in Pati District, 2017. (Journal of Midwifery Science and Health), 2 (9), page. 124-134. (Accessed 27th Januari 2020). (Indonesia). Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 33 Aisa, S., Sunarsih, & Nurmiaty. DOI: 10.36566/ijhsrd/Vol2.Iss2/36 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 Research Article Open Access THE EFFECTIVENESS OF PROVIDING RACED CHICKEN EGGS ON THE NUTRITION FOR PREGNANT WOMEN IN CHRONIC ENERGY DEFICIENCY IN KENDARI CITY, SULAWESI, TENGGARA Sitti Aisa1, Sunarsih2, Nurmiaty3 1,2,3College of Health Sciences Mandala Waluya Kendari, Southeast Sulawesi, Indonesia. Corresponding Author : Sitti Aisa Email : [email protected] ABSTRACT Background: Chronic Energy Deficiency (CED) of energy is a problem that is often encountered in pregnant women, this often occurs due to malnutrition in the long term, especially those related to carbohydrates and fats that are not consumed. Research purposes; For the effect of eating one egg a day on the nutritional status of pregnant women in CED in Kendari City, Southeast Sulawesi Province in 2020. Methods: Using a quasi-experimental design, the total sample was 36 CED pregnant women, in the working area of Primary health care Nambo and Primary health care Abeli. Intervention Egg delivery was carried out for 8 weeks, measured LBW and BW every 2 weeks, measu rements were carried out 5 times, namely before the intervention, after weeks 2, 4, 6 and 8. Data analysis used independent t test, paired test and oneway statistical test. anova. Result: Using the independent t test, the results were there were no differences between the body weight (BW) and Upper Arm Circumference (UAC) interventions and the group before the study. Furthermore, the paired test results obtained differences in weight and LBW before and after offering eggs to the intervention group. There were differences in BW and UAC after offering eggs to The results of the independent t test were obtained. There were differences in weight and UAC after offering eggs in the intervention group and the control group. The results of the analysis with the one-way aova test showed that the effective time of offering boiled eggs to increase body weight and UAC was the eighth week Conclusion: There was no difference in weight and UAC in the intervention group and control group before the study, but there were differences in weight and LBW before and after egg administration in the intervention and control groups Key words: Chicken eggs, nutrition of pregnant women, Chronic energy deficiency Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 34 Aisa, S., Sunarsih, & Nurmiaty. DOI: 10.36566/ijhsrd/Vol2.Iss2/36 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 INTRODUCTION Primary health care Nambo not only Chronic energy deficiency ( CED ) ) is has a high CED but also its condition which a problem that is often found in pregnant is located on the coast which contains a lot of women, this often occurs related to protein from fish species. But the fact is that malnutrition in the long term, especially consuming protein from fish is not enough, those related to carbohydrates and fats that so that pregnant women experience CED. In are not consumed properly(1). Measurement the second trimester, pregnant women need of upper arm circumference ( UAC ) is additional calories of 180 kcal / day and in performed to detect the risk of CED in the second and third trimesters around 300 pregnant women. If a pregnant woman kcal / day. Nutrients that contain calories, experiences a UAC size of less than 23.5, such as carbohydrates, protein and fat. And then the pregnant woman is at risk of dietary components which include vitamins experiencing CED. CED can also be and minerals. It is recommended that foods confirmed by measuring the body mass containing protein be consumed every day to index (BMI). Pregnant women are diagnosed meet the protein needs in the body. Because with CED in the first trimester of pregnancy. protein cannot be stored as a reserve(7). If you have a BMI of less than 18.5, then the Eggs are very good for consumption by mother is at risk of experiencing CED. mothers when they enter the second trimester However, usually women begin to become of pregnancy, because besides containing pregnant in the second or third trimester so protein they also contain calcium and that their pre-pregnancy weight and height vitamin D. Two nutrients that are mandatory can be used as pre-pregnancy BMI (2). for mothers to fulfill because the second The risks that will be experienced by trimester is a period of bone formation and pregnant women in CED are miscarriage, teeth(8). Lack of calcium and vitamin D puerperal bleeding, and maternal death(3). makes its growth imperfect, so that the fetus Meanwhile, fetuses and children include will be susceptible to various bone diseases. impaired fetal growth, risk of low birth The results of Sugita and Supiati's 2016 weight (LBW), risk of babies with congenital research on anemic pregnant women stated abnormalities, and risk of stunting. This that consumption of boiled eggs was incident will be experienced since the baby is effective in increasing Hb levels in pregnant in the womb and will continue into women in the second trimester in the adulthood(4).WHO has experienced CED working area of Klaten Tengah Primary problems in almost all developing countries health care (9). such as Bangladesh, India, Indonesia, Based on the above background, the Myanmar, Sri Lanka and Thailand with a researchers wanted to provide additional CED prevalence of 15-47%. The prevalence food in the form of boiled eggs for CED of CED in pregnant women in Asia is as pregnant women with a dose of one seed per much as 20% (Black et al, 2008). Whereas in day and given at night. Eating boiled eggs Indonesia alone the incidence of CED in has many health benefits, compared to fried pregnant women was 24.2% in 2013 and this eggs. Boiling is one way to get optimal egg risk decreased to 17.3% (5). The prevalence benefits. Because boiled eggs are the result of pregnant women in CED based on profile of cooking that are not contaminated with data from Southeast Sulawesi was 22.5% in other harmful substances. This study aims to 2015 and decreased by 22.38% in 2017. determine the effect of giving one egg a day Kendari City, the number of pregnant on the nutritional status of pregnant women women in CED was 12.3, the highest was in CED at Primary health care Nambo, Primary health care Nambo, namely 91.0% Kendari City, Southeast Sulawesi Province and the lowest is Primary health care Poasia in 2020. as much as 3,6%(6). Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 35 Aisa, S., Sunarsih, & Nurmiaty. DOI: 10.36566/ijhsrd/Vol2.Iss2/36 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 METHOD group. Six weeks after the intervention, the The type of research used is average weight gain in the intervention group experimental research with a quasi- was 3.42 kg, namely the body weight to 54.2 experimental approach(10). In this design, kg. Whereas in the control group the average there are two groups, each of which is body weight gain was 2.46 kg, namely the randomly selected. The first group was given body weight being 50.7 kg. Both groups intervention and the other group was not gained weight, but the intervention group given intervention(11). Intervention Egg gained more weight than the control group. delivery was carried out for 8 weeks, Eight weeks after the intervention, the measuring LBW and BW every 2 weeks, average weight gain in the intervention group measurements were carried out 5 times, was 5.42 kg, body weight was 56.2 kg. namely before the intervention, after weeks Whereas in the control group the average 2, 4, 6 and 8. Kendari City in June to August body weight gain was 3 kg, namely the body 2020. The population in this study were all weight being 51.24 kg. Both groups CED pregnant women in the working area of experienced weight gain, but the weight gain the Primary health care Nambodan Primary in the intervention group was greater than the health care Abeli, Kendari City from January weight gain in the control group. to May 2020. Nambo Primary health care Based on the figure above 42, it can be total 46 people and Abeli Primary health care seen that the average size of the LBW before 28 people so the total population is 70 the intervention in the intervention group people. The sample size is 36 people. Data was 21.5. Whereas in the control group the analysis used statistical test independent t average body weight was 21.27 cm.Two test, paired test and oneway anova. weeks after the intervention, it was seen that the average increase in LBW size was 0.58 RESULT cm in the intervention group, namely 22.08 Nutritional Status cm. Whereas in the control group the average Based on grafic-1 above, it can be seen increase in LBWsize was 0.16, namely 21.42 that the average body weight before the cm. Both groups had an increase in LBW intervention in the intervention group was size, but the intervention group had a greater 50.78 kg. Whereas in the control group the increase than the control group.Four weeks average body weight was 48.24 kg. Two after the intervention it was seen that the weeks after the intervention there was an mean increase in LBW size in the increase in the average body weight of 1.37 intervention group was 0.95, that is, 22.45. kg in the intervention group, namely 52.15 Whereas in the control group the average kg. Whereas in the control group there was increase in LBW size was 0.57, namely an increase in the average body weight of 21.84 cm. Both groups had an increase in the 0.65 kg, namely body weight to 48.89 size of the LBW, but the intervention group kg.Between the intervention group and the had a greater increase than the control group. control group both experienced weight gain, Six weeks after the intervention, it was seen but in the intervention group the weight gain that the average increase in LBW size in the was greater than the weight gain in the intervention group was 1.25, namely 22.75 control group. Four weeks after the cm. Whereas in the control group the average intervention, the average weight gain in the increase in LBW size was 0.73, namely intervention group was 2.39 kg, namely 22.00 cm. Both groups had an increase in 53.17 kg. Whereas in the control group the LBW size, but the intervention group had a average body weight gain was 1.53 kg, greater increase than the control group. Eight namely the body weight to 49.77 kg. Both weeks after the intervention, it was seen that groups gained weight, but the intervention the mean increase in LBW size in the group gained more weight than the control intervention group was 1.62 cm, namely Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 36 Aisa, S., Sunarsih, & Nurmiaty. DOI: 10.36566/ijhsrd/Vol2.Iss2/36 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 23.12 cm. Whereas in the control group the group experienced a greater increase than the average increase in LBW size was 1.22, control group. namely 22.49 cm. Both groups experienced an increase in LBW size, but the intervention Inferential Analysis Based on table 1 below, the results of the analysis with the t test obtained a value of 1.186 Table 1 Analysis of weight differences between the intervention group and the control group before the study Sample n Mean t-test, Group p value Intervensi 18 50.7778 t test. = 1.186 P value = Figure.1 0,0244 Nutritional weight status based on body weight before and after 2 weeks, 4 weeks, 6 weeks and 8 weeks Based on table 2 below, the results of the analysis with the t test obtained a value of 1.229 in LBW between the intervention group and the control group before the study was conducted. Thus, there was no significant difference between the intervention group and the control group in BW and UAC, so this group was homogeneous. Table 2 Analysis of differences in UAC between the intervention group and the control group before the study Sample n Mean t-test Group p value Intervensi 18 21,7389 t test. = 1,229 Figure 2 Mean nutritional status based on body weight P value = before and after 2 weeks, 4 weeks, 6 weeks 0,0244 and 8 weeks of intervention Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 37 Aisa, S., Sunarsih, & Nurmiaty. DOI: 10.36566/ijhsrd/Vol2.Iss2/36 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 Based on table 3 above, the results of 11,171> t table 1,746. This means that Ho is the analysis with the t test show that after 8 rejected, there is an increase in BW in the weeks of intervention, the t value = 9.205> t control group. table 1.746. This means that Ho is rejected, Table 6 there is an increase in body weight before Analysis of weight before and after offering and after being given eggs. eggs to the control group Table 3 Control n Mean t test, p value Analysis of body weight before and after egg Group feeding in the intervention group Before 18 21.2667 t test = -5.127 Intervention n Mean t test Group p value After 18 22.4889 P value = 0,000 Before 18 50.7778 t test. = -9,205 After 18 56.0222 P value = 0,000 Based on table 7 below, the results of the analysis with the t test obtained a count Based on table 4 below, the results of value of 2.064> t table 1.64 so that Ho is the analysis with the t test show that after 8 rejected, meaning that there is a difference in weeks of intervention, the t value = 9.357> t the increase in body weight between the table 1.746. This means that Ho is rejected, intervention group and the control group. there is an increase in BW before and after The average increase in body weight in the being given eggs. intervention group was greater than that of Table4 the control group, where the weight gain of Analysis of body weight before and after giving the intervention group was 56.0222> eggs to the intervention 51.2444. Intervention n Mean t test, Group p value Table 7 Before 18 21.5028 t test. = -9.357 Post-test analysis of BW for the intervention After 18 23.1194 group and the control group P value = 0,00 Intervention n Mean t test, p value Based on table 5 below, the results of and Control the analysis with the t test show that after 8 Before 18 56.0222 t test = 2.064 weeks without intervention, the value of t After 18 51.2444 count = 11,171> t table 1,746. This means P value = 0,047 that Ho is rejected, there is an increase in body weight in the control group. Based on table 8 below, the results of Table 5 the analysis with the t test obtained the t Analysis of body weight before and after egg value of 2.763> t table 1.64 so that Ho was feeding in the control group rejected, that is, there was a difference in the increase in BW between the intervention Control n Mean t test, p value group and the control group. The average Group increase in BW in the intervention group was Before 18 48.2389 t test = -11.171 greater than that of the control group, where After 18 51.2444 the BW mean of the intervention was P value = 0,00 23.7500> 22.4889. Based on table 6 below, the results of the t-test analysis show that after 8 weeks without intervention, the value of t count = Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 38 Aisa, S., Sunarsih, & Nurmiaty. DOI: 10.36566/ijhsrd/Vol2.Iss2/36 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 nutrition. Maternal weight before pregnancy Table 8 and weight gain during pregnancy affect fetal UAC post-test analysis of the intervention growth(12). group and the control group The results of the study can be seen Intervention n Mean t test, p value in graph 1 above, that the average body and Control weight before the intervention, both the Before 18 23.7500 t test = 2.763 intervention group and the control group, has After 18 22.4889 P value = 0,009 increased. However, the intervention group experienced greater weight gain than the Based on table 9 below, with the control group. In the intervention group the oneway ANOVA test it is proven that there average body weight before the intervention is a difference in the increase in body weight. was 50.78 kg and after the intervention During the 8 weeks of being given boiled gradually increased to 52.15 kg at the second eggs, body weight increased and increased week, 53.17 kg at the fourth week, 54.2 kg at significantly at week 8. the sixth week, and 56.02 kg on the eighth week. . Whereas in the control group there was an increase that was less than the weight Table 9 gain in the intervention group. In the control Analysis of the effective time of giving eggs to group the average body weight gain before increase body weight using One way Anova intervention was 48.24 kg, after monitoring without intervention there was an increase to BW Mean F p value 48.89 kg at week two, 49.77 kg at week four, Intervention 56.0222 2.619 0.041 50.7 kg at week six, and 51.24 kg at the eighth week. Control 51.2444 The results showed that giving one boiled egg per day could increase the weight Based on table-10 below, with the of pregnant women in CED. Pregnant oneway ANOVA test it is proven that there women are a group that is prone to is an increase in UAC increase. UAC experiencing nutritional problems. This can increases occurred at week six after being be dangerous not only for the mother but given eggs and increased more significantly also for the child in her womb. A person's at week 8 nutritional condition is affected by their nutritional status during pregnancy(8). The Table 10 nutritional status of pregnant women greatly Analysis of the effective time of offering eggs affects the growth of the fetus in the womb. to increase UAC by one way Anova Maternal nutritional status that is not good both before pregnancy and during pregnancy LBW Mean F p value will cause Low Birth Weight (LBW)(13). Intervention 23.119 7.336 0.000 Increase in UAC after consumption of Control 22.516 boiled eggs UAC measurements are often used to measure the nutritional status of pregnant DISCUSSION women. UAC is a description of the state of Weight gain after consumption of boiled muscle tissue and subcutaneous fat layer. eggs Upper Arm Circumference (UAC) is a type Body weight is a description of the of anthropometric examination used to amount of protein, fat, water and minerals in measure the risk of CED in women of the bones. Body weight is related to fetal childbearing age which includes adolescents, Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 39 Aisa, S., Sunarsih, & Nurmiaty. DOI: 10.36566/ijhsrd/Vol2.Iss2/36 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 pregnant women, nursing mothers and and fetal development. During pregnancy, couples of reproductive age (CRA). While the mother will experience physical and the threshold for UAC in women with the physiological changes. In pregnancy, normal risk of KEK is 23.5 cm and if it is less than changes appear, among others, in the 23.5 cm then the woman has CED(14). increase in body weight (BW) of the mother The results of the study can be seen in in accordance with the growth and graph 2 above, that the average LBW before development of the fetus, additional fat the intervention both the intervention group reserves, and placental development, and the control group experienced an increased body fluids and breast increase. However, the intervention group enlargement. In addition, due to hormonal experienced a greater increase in UAC than changes, pregnant women also experience the control group. In the intervention group psychological, sociological and emotional the average UAC before intervention was changes (17). 21.5 cm and after intervention gradually The results of the study for eight increased to 22.8 cm at week two, 22.45 cm weeks, at the second, fourth and sixth weeks at week four, 22.75 cm at week six, and there was a relationship between offering 23.12 cm at the eighth week. Whereas in the boiled eggs to the nutritional status of control group there was an increase that was pregnant women in CED, both based on less than the increase in UAC in the body weight and UAC, but it was not intervention group. In the control group the significant. In the eighth week there were average increase in UAC before intervention differences in body weight and UAC with was 21.27, after monitoring without before offering boiled eggs. For eight weeks intervention there was an increase to 21.43 between the intervention group and the cm at week two, 21.84 cm at week four, control group with P values (0.01 and 0.04). 22.00 cm kg at week six, and 22. 49 in the The difference in the increase in body weight eighth week. is 5.24 kg, the difference is UAC 1.62 cm. UAC measurements cannot be used to where the greatest increase occurred in the monitor changes in nutritional status in the intervention group and the intervention short term(15). UAC measurement is used group P value (0.05). This means that the because the measurement is very easy and increase in weight and UAC increases fast. There are two possible results of UAC significantly in the eighth week. measurements, which are less than 23.5 cm Thus,consuming boiled eggs, both body and above or equal to 23.5 cm. If the weight and UAC can be said to reach a measurement result is <23.5 cm, it means the significant value at the eighth week. risk of SEZ and ≥ 23.5 cm means there is no Chicken eggs are animal protein risk of SEZ. The results showed that giving foods that are easy to obtain and process. one boiled egg per day could increase the Eggs are processed by boiling healthier weight of pregnant women in CED(16). because there is no added fat during cooking. Eggs are suitable in many methods, used as The effect of giving boiled eggs on the the main or side menu to snacks. Eggs are a nutritional status of pregnant women in nutritious food choice that is not rich in CED animal protein, but also good vitamins and Pregnancy nutrition of pregnant minerals, namely vitamin A, vitamin B women is one of the determining factors that complex, vitamin D, selenium, folic acid, affect the birth of normal and healthy babies. and zinc. Eggs as a food ingredient that has During pregnancy, there is an increased need many advantages, for example, the high for nutrients, such as carbohydrates, protein, nutritional content of eggs, the price is vitamins and minerals to meet the needs relatively cheap when compared to other associated with changes in the mother's body protein sources (18). Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 40 Aisa, S., Sunarsih, & Nurmiaty. DOI: 10.36566/ijhsrd/Vol2.Iss2/36 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 By consuming eggs, the intake of boiled eggs to increase BW and LiLA is the daily energy needs of pregnant women who eighth week. are high can be met. The appetite of pregnant women who often experience changes makes REFERENCES eggs a nutrient-dense food choice because 1. Loya RRP, Nuryanto N. 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Health Ministry of Republic of working area of Primary health care Klaten Indonesia. Basic Health Research in Tengah(20). Likewise, the research 2018. Jakarta: Health Ministry of conducted by Suprapti on offering boiled Republic of Indonesia. 2018 eggs to postpartum mothers proved a (Indonesia). significant difference in changes in the Hb 6. Kendari PDKK. Southeast Sulawesi levels of post-partum mothers who Province Profile in 2017. Kendari; consumed boiled eggs in purebred chickens Department of Health of Southeast with post-partum mothers who did not Sulawesi. 2018 (Indonesia). consume boiled eggs. an increase in Hb 7. Health Ministry of Republic of levels in postpartum mothers Indonesia. Indonesian Health Profile in 2015. Jakarta: Health Ministry of Republic of Indonesia. 2015 CONCLUSION (Indonesia). As above explanation, some of There 8. Noviyanti PH. Obedity from pregnant was no difference in weight and UAC in the women to consume the iron table in intervention group and control group before PMB Surabaya: Surabaya: Merdeka the study, but there were differences in University. 2019 (Indonesia). weight and UAC before and after egg 9. Sugita S, Supiati S. The effect of administration in the intervention and control consuming chicken egg to increasing groups, and The effective time for offering the Hemoglobine in pregnant women in Central Klaten Primary Health Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 41 Aisa, S., Sunarsih, & Nurmiaty. DOI: 10.36566/ijhsrd/Vol2.Iss2/36 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 Centre. Jurnal Ilmu Kesehatan. Tulang Bawang Barat Primary Health 2016;5(2) (Indonesia). Centre. Poltekkes Tanjung Karang; 10. Mackey A, Gass SM. Second language 2019 (Indonesia). research: Methodology and design: 20. Lutfiasari D, Yanuaringsih GP. The Routledge; 2015. effect of chicken egg consumtion on 11. Sugiyono. Statistik Nonparametris Hemoglobine in pregnant mothers. Untuk Penelitian. 2015. Jurnal Bidan Pintar. 2020;1(1):11-20 12. Ilmiani TK. The relationship between (Indonesia). pregnant women's knowledge with increasing body weight in Bandar Lampung Primary Health Centre. 2019 (Indonesia). 13. Sari F, Ernawati E. The relationship between mother's attitude about baby and child feeding with nutritional status in under two years old. Journal of Health (JoH). 2018;5(2):77-80 (Indonesia). 14. Thena ELM. The relationship between husband support and nutritional Status Gizi with Anemia in pregnant mother in Ladja Primary Health Centre in Ngada District of NTT: Airlangga University; 2018 (Indonesia). 15. Aini I. The relationship between Upper Arm Circle with Anemia in pregnant mother in Dukuh Klopo Primary Health Centre in Peterongan Sub District in Jombang District. Jurnal Kebidanan. 2017;7(1) (Indonesia). 16. Arliansyah ARW. The relationship between fat consuming with nutritional Status with hypertension in elderly women in Sanut Kaja Village, South Denpasar Sub District: Poltekkes Denpasar; 2019 (Indonesia). 17. Andriani Z. Overview of pregnant nutritional status based on Upper Arm Circle in Sukamaju Village of Depok City: UIN Syarif Hidayatullah Jakarta: Fakulty of Medicine and Health Sciences. 2015 (Indonesia). 18. Hardiyani AM. The effect of Cassava powder (ipomoea batatas) on egg rendang gredient: University of Negeri Jakarta. 2016 (Indonesia). 19. Rahma Cahyani D. Widwifery of children growth and malnutrition in Daya Asri Village of Daya Murni Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 42 Islaeli,I., Purnamasari, A. & Sartina DOI: 10.36566/ijhsrd/Vol2.Iss2/38 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 Research Article Open Access FACTORS RELATED TO THE EVENT OF SIBLING RIVALRY IN CHILDREN 1-5 YEARS OLD IN LABIBIA SUB-DISTRICT OF MANDONGA DISTRICT IN KENDARI CITY Islaeli Islaeli1, Anisa Purnamasari2, Sartina3 1,2,3College of Health Sciences Mandala Waluya Kendari, Southeast Sulawesi, Indonesia. Corresponding Author : Islaeli Islaeli Email : [email protected] ABSTRACT Background: Child psychological development is an important part of child welfare indicators. The development of child psychology determines the mental readiness of children, one of the problems in children's psychological development is sibling rivalry, which is a sense of competition due to the birth of a younger sibling, causing competition to get attention from their parents. Based on the initial survey, out of 8 mothers with children aged 1-5 years said that since the arrival of their new siblings, their first children often fuss and cry for no reason and want to always be noticed, sometimes even want to hit and injure their younger siblings. This study aims to determine the factors associated with the incidence of sibling rivalry in children aged 1-5 years in Labibia village, Mandonga sub-district, Kendari city. Methods: The type of study was cross sectional design method. The sample in this study were all mothers who had two or more children aged 1-5 years in Labibia Village, Mandonga District, namely 39 mothers. The sampling technique used simple random sampling, the method of analysis used the Chi Square test. Result: The results of this study, showed that there was a moderate relationship between 2 2 knowledge and the incidence of sibling rivalry (X count = 6.955> the value of X table = 2.705) and the value of phi (φ) = 0.422, there was a moderate relationship between parenting 2 2 styles and the incidence of sibling rivalry (X Count = 8,269> the value of X Table = 2.705) and the value of phi (φ) = 0.460 and there is a strong relationship between attitude and the 2 2 incidence of sibling rivalry (X count = 18.373> value of X Table = 2.705) and the value of phi (φ) = 0.686. Conclusion: It is hoped that the parents further increase knowledge and awareness of the behaviors given and understanding of good parenting, with a good attitude will have a positive impact on their children. Key words: Sibling rivalry incident, knowledge, parenting style, attitude, labibia village Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 43 Islaeli,I., Purnamasari, A. & Sartina DOI: 10.36566/ijhsrd/Vol2.Iss2/38 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 INTRODUCTION getting attention, the child can take Childhood is a period of growth and dangerous actions such as pushing his development starting from infants (0-1 younger sibling out of bed. Therefore, some years), playing age or toddlers (1-2.5 years), of the behaviors which can be done are pre-school (2.5-5 years), school age (5-11 giving affection and fair love for children, years). years), to adolescents (11-18 years). preparing older children to welcome the This range differs from one child to another presence of a new sibling, giving punishment given the different backgrounds of children. according to the child's mistakes not because Children in the development process have of a golden child or not, sharing between physical, cognitive, self-concept, coping parents and children, and pay attention to patterns and social behavior. Monitoring the children's protests against parents' mistakes psychological development of children up to (4). Mother's knowledge and parenting style pre-school age is one of the core about sibling rivalry is very important in the competencies of nurses (1). development of a baby's personality. If the Child psychological development mother is unable to prevent it, the determines mental readiness in the next competition that occurs between children phase, namely adolescence and adults. One will remain and be carried over to adulthood. of the problems with children's psychological It is very important that the mother's development is sibling rivalry. Sibling knowledge about sibling rivalry and how to rivalry arises because of the attitudes and prevent and handle it, so that the competition parenting patterns of parents towards their that occurs becomes a positive thing, and children, birth spacing that is too close, birth helps the maturity of the child's social life order in the family, the sex of the main and is able to solve problems in fierce siblings of the same sex, the number of competition (5). siblings and the influence of other people. Based on the results of previous Forms of sibling rivalry include direct research, there is the relationship between reactions and indirect reactions. Immediate mother's knowledge of the incidence of reactions are such as hitting, pinching or sibling rivalry, where the level of knowledge kicking. Meanwhile, indirect behavior is of mothers on sibling rivalry in 31 toddlers such as making mischief, fussing, pretending (48.4%) is very low. (6). Other studies have to be sick, crying without cause, and doing shown a relationship between parenting habits or something that has not been done styles and the incidence of sibling rivalry in for a long time(2). Sibling rivalry usually children aged 1-5 years (7). The attitude of occurs in childhood when the age difference parents in caring for children can also cause between siblings is too close, namely the 3-5 children to experience sibling rivalry, which year age range of preschool age and will is based on research that there is a significant reappear when the ages of 8-12 are school relationship between the attitudes of parents age. Usually sibling rivalry increases in and the occurrence of sibling rivalry in preschool children (3-5 years) because at this children aged 3-5 years. (4). time children tend to experience high Based on the initial survey, beside of 8 jealousy if their parents give a little mothers who had children aged 1-5 years difference in attention to their siblings, at said that since the arrival of a new younger this time children's egocentrism is very high sibling, their first child often fussed and (3). cried for no reason and wanted to always be Sibling rivalry is a natural thing for noticed, sometimes even wanted to hit and families with more than one toddler, so injure their younger siblings, fuss and cry for parents are the key to the emergence of no reason, want to always pay attention and sibling. If parents are negligent and the child those who used to not wet the bed, wet feels that they are not getting injustice or not themselves again. Based on the results of Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 44 Islaeli,I., Purnamasari, A. & Sartina DOI: 10.36566/ijhsrd/Vol2.Iss2/38 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 observations made by researchers, there are were also 8 respondents (47.1%) with still many mothers who still compare their sufficient knowledge level with sibling children, let their children do a fight and rivalry occurring. . Then there were 22 there are still many mothers who respondents who had less knowledge, then unknowingly put one child as the one who there were 3 respondents (13.6%) who had a was defeated to break up a fight between lack of knowledge with no sibling rivalry siblings. This shows the lack of knowledge and 19 respondents (86.4%) had a lack of and the role of parents about sibling rivalry. knowledge with sibling rivalry. This study aims to determine the factors Table-2 shows that the 39 respondents, associated with the incidence of sibling there were 16 respondents with good rivalry in children aged 1-5 years in Labibia parenting, including 9 respondents (56.2%) village, Mandonga sub-district, Kendari city. good parenting with no sibling rivalry and 7 respondents (43.8%) good parenting with no METHOD sibling rivalry. Then there were 23 This study uses a cross sectional design respondents with less parenting styles, method. This research was conducted from including 3 respondents (13.6%) less May to June 2018. The sample in this study parenting with no sibling rivalry and 20 was 39 mothers in Labibia Village, respondents (87.0%) less parenting with Mandonga District, Kendari City. The sibling rivalry. sampling technique in this study used simple Table-3 shows that the 39 respondents, random sampling with the inclusion criteria there were 16 respondents with positive of mothers who have two or more children attitudes including 11 respondents (68.8%) aged 1-5 years. To see the relationship positive attitudes with no sibling rivalry and between variables, a Chi-Square test was there were 5 respondents (31.2%) positive performed. attitudes with no sibling rivalry. Then there were 23 respondents with negative attitudes, RESULT including 1 respondent (4.3%) negative Table-1 shows that the 39 respondents, attitudes with no sibling rivalry and 22 there were 17 respondents who had a respondents (95.7%) negative attitudes with sufficient level of knowledge, of which 9 sibling rivalry occurring. respondents (52.9%) had sufficient knowledge with no sibling rivalry and there Table 1 The Relationship between Mother's Level of Knowledge and Sibling Rivalry inLabibiaSubdistrict, Mandonga District, Kendari City Sibling Rivalry Incident Chi Square Level of 2 Not sibling Sibling Total X Count> Mother's 2 rivalry rivalry X Table Knowledge n % n % n % Well 9 52,9 8 47,1 17 100 6,955 > Less 3 13,6 19 86,4 22 100 2,705 Total 12 30,8 27 69,2 39 100 φ = 0,422 Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 45 Islaeli,I., Purnamasari, A. & Sartina DOI: 10.36566/ijhsrd/Vol2.Iss2/38 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 Table 2 The Relationship between Parenting Pattern and Sibling Rivalry inLabibiaSubdistrict, Mandonga District, Kendari City Sibling Rivalry Incident Chi Square Parenting Not sibling Sibling Total X2 Count > Pattern rivalry rivalry X2 Table n % n % n % Well 9 56,2 7 43,8 16 100 8,269 > Less 3 13,6 20 87,0 23 100 2,705 Total 12 30,8 27 69,2 39 100 φ = 0,460 Table 3 The Relationship between Mother's Attitude and Sibling Rivalry inLabibiaSubdistrict, Mandonga District, Kendari City Sibling Rivalry Incident Chi Square Mother's Not sibling Sibling Total X2 Count > Attitude rivalry rivalry X2 Table n % n % n % Positive 11 68,8 5 31,2 16 100 18,373 > Negative 1 4,3 22 95,7 23 100 2,705 Total 12 30,8 27 69,2 39 100 φ = 0,686 DISCUSSION Parenting patterns are patterns of Knowledge is a very important domain parental behavior that are applied to children for the formation of one's actions (ovent that are relative and consistent over time. behavior). From experience and research, it This pattern of behavior can be felt by turns out that behavior based on knowledge children in negative and positive terms. will be more sustainable than behavior that is Good parenting style will result in good not based on knowledge (5). Based on the children's behavior and also shape children's research results, it shows that respondents psychological development (8). Based on the who have a sufficient level of knowledge results of the study, it shows that respondents experience sibling rivalry. This is because who have good parenting styles but the mother only knows about sibling rivalry, experience sibling rivalry because children but she doesn't apply it to her children. often get influences from the outside Furthermore, respondents who have a low environment such as television shows that level of knowledge but do not experience contain elements of violence. Furthermore, sibling rivalry are due to the child's love and respondents who have less parenting style affection for their siblings. The results of this but do not experience sibling because the study are consistent with previous research child feels that siblings are friends to play which suggests that competition with and learn. This research is supported by siblings is a feeling of jealousy and hatred previous research which states that applying that a child usually experiences with the authoritative parenting, parents with this type presence of his sibling. This feeling arises of parenting tend to be fairer to their not because of hatred towards his new children.(9). Parents better prepare their sibling, but rather from a change in situation siblings to accept the presence of a new or condition (6). sibling, teach their children to share with each other, and teach children not to criticize Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 46 Islaeli,I., Purnamasari, A. & Sartina DOI: 10.36566/ijhsrd/Vol2.Iss2/38 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 or mock their friends. This shows that 2. McNerney, Usner, J. Sibling Rivalry in authoritative type parents tend to be more Degree and Dimensions Across the positive in caring for their children. Giving Lifespan. J Sci Wcp Muohio Edu authority to children to express opinions so [Internet]. 2001; Available from: that children feel more valued(10). [email protected] Attitude is the most important concept 3. Woolfson R. Sibling Competition: in social psychology that discusses elements Encouraging Children to Be Friends. of attitude both as individuals and groups Jkt Erlangga. 2004;(Translation of (10). Based on the results of the study, it Fransiscus Rudianjo). shows that respondents who have a positive 4. Maghfuroh. The relationship between attitude but experience sibling rivalry, this is parents’ attitudes and the incidence of because children often get influences from sibling rivalry in children aged 3-5 their siblings who have negative attitudes years in Brengkok-Brondong- such as wanting to be noticed and spoiled, Lamongan Village. Sci J Health Sci. causing the child to feel jealous. 2012;X (1) hal 9-13. Furthermore, respondents who have a 5. Wawan. A, Dwi M. Knowledge, negative attitude but do not experience Attitudes and Human Behavior. sibling rivalry are caused by children who Yogyakarta : Nuha medika; 2011. really accept and love their siblings so they 6. Purnamasari D, Bakara, Derision don't experience sibling rivalry. The results Marsinova, Sutriyanti Y. Relationship of previous research suggest that the attitude between Mother’s Knowledge Level of parents in caring for children can cause and Sibling Rivalry Incidence at children to experience sibling rivalry, so this Toddler Age. Health J. 2014;V(2), Hal theory can be proven by research. (9). The 182-188. attitude of parents is very positive in caring 7. Rofi’ah S. Parenting Patterns for for children, the incidence of sibling rivalry parents with the incidence of sibling decreases, while the more negative attitudes rivalry in children aged 1-5 years. J of parents in caring for children, the Midwifery Sci. 2013;(1 (3)):152–9. incidence of sibling rivalry increases, and 8. Rebar D, Bailey NW, Jarrett BJM, learning with peers is an effective strategy to Kilner RM. An evolutionary switch solve problems in children (10). from sibling rivalry to sibling cooperation, caused by a sustained loss CONCLUSION of parental care. Proc Natl Acad Sci. Based on the research results, it can be 2020 Feb 4;117(5):2544–50. concluded that there are there is a moderate 9. Smith AL, Atwater DZ, Callaway RM. relationship between knowledge, parenting Early Sibling Conflict May Ultimately styles and the incidence of sibling, and also Benefit the Family. Am Nat. 2019 there is a strong relationship between Oct;194(4):482–7. attitudes and the incident of sibling rivalry in 10. Nofitasari A, Islaeli, Pratiwi DS, Said Labibia Village, Mandonga District, Kendari A, Risky S, Lestari SA. Knowledge City. and Attitude of Primary School Teacher on the Practice of Selected REFERENCES Food Students Containing Additional 1. Ministry of Health Republic of Hazardous Foodstuffs in Sdn 01 Poasia Indonesia. Health Data and Kota Kendari. Indian J Public Health Information Window Bulletin. Jakarta : Res Dev. 2018;9(6):399. Ministry of Health Republic of Indonesia; 2011. Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 47 Tasnim, T. & Susiatin. DOI: 10.36566/ijhsrd/Vol2.Iss2/39 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 Research Article Open Access THE EFFECT OF GIVING BREASTFEEDING ON BABY’S NUTRITIONAL STATUS: A COMPARATIVE STUDY IN NORTH BUTON DISTRICT, INDONESIA Tasnim Tasnim1, Susiatin2 1,2College of Health Sciences Mandala Waluya Kendari, Southeast Sulawesi, Indonesia. Corresponding Author : Tasnim Tasnim Email : [email protected] ABSTRACT Background: Mother who giving exclusive breast feeding in North Buton District was less than others in Nourt Buton District. This study investigated the risk factors of giving exclusive breastfeeding and non-exclusive breastfeeding for 0-6 month old babies’ nutritional status in Kulisusu primary health care in North Buton District. Methods: This study was quantitative study which used a Case Control study design. Data analysis used independen t-test. This study recruited 82 mothers who had under 6 months old babies. This study was conducted in Kulisusu Primary Health Care area, in North Buton, Southeast Sulawesi province, Indonesia. Result: The resuld found that there was significant differences of nutritional status between babies who gave exclusive breastfeeding and non-exclusive breastfeeding for 0-6 months old babies (p value =0,001 < 0,05). Conclusio n: This study suggested for health workers and community health volunteers to give motivate for mothers in order to give exclusive breastfeeding for their babies aged under 6 months. The primary health care must promote about benefits of exclusive breastfeeding for babies’ health and their growth. Key words: Exclusive, Breastfeeding, Baby, Nutrition, Status Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 48 Tasnim, T. & Susiatin. DOI: 10.36566/ijhsrd/Vol2.Iss2/39 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 INTRODUCTION sectional study design. This study was taken The presentage of giving breastfeeding in Kulisusu Primary Health Care area in tends to decreasing in Southeeast Sulawesi. Kulisusu sub-district of North Buton district, In 2016, the precentage of mothers who gave Southeast Sulawesi in Indonesia. This study breastfeeding was about 53,37%, compared was conducted in May to August 2018. The to 47.43% in 2017 (1). North Buton was one study recruited 82 babies aged less than 6 of districts which had less numbers of months old and their mothers. The samples mothers who gave breastfeeding for the were obtained with simple random sampling babies compared to other district such as technique. Data anlysis used independent Konawe (66,67%), Kolaka (61,10%), South samples t-test of statistical test. The Konawe (61,87%), Bombana (66,39%), and significant effect used 0.05. North Kolaka district (67,62%). Some of sub-district in North Buton District still had low percentage of babies who were RESULT breastfeed by their mothers such as in Bone There were 82 babies who were sub-district, namely about 40.58%. investigated for four months. The Compared to other sub-districts in North distribution of age of the respondents is Buton, such as Kulisusu sub-district which shown in this table. had high percentage of mothers who gave breastmilk (2). Table 1. Distribution of baby’s age in As we know breast milk is one of good Kulisusu Primary Health Care Area, North food for a baby. Adequate breastmilk for Buton District in 2018 babies will help the baby’s growth. Breast Age of Baby Number Percentage milk also can protect the baby from (Month) (n) (%) infectious disease because of increasing 1 9 11.0 baby’s immunity (3). Giving breastfeeding 2 10 12.2 for the baby also can increase mother’s 3 health condotion. The mothers can prevent 8 9.8 from breast cancer or Carcinoma mamae (4, 4 25 30.5 5). However, there are still mothers who do 5 18 22.0 not give exclusive breast milk for less than 6 12 14.6 six months old baby. There are many factors Total 82 100 for that condition. One of the factor is social class and culture (5). Other factor is family support, and mothers’ knowledge and The higher proportion of baby aged 4 attitude. Another factor is the brand of months (30.5%), while the lower propostion formula milk (5). Because of breastfeeding is of baby aged 3 months (9.8%). They very important for baby’ nutrition and health comprised of male (42.7%) and female status, so this study investigates the effect of babies (57.3%) (Table 2). breast milk compared to formula milk for baby’s nutritional status. This study was Table 2. Distribution of sex of babies in The taken in North Buton. Study in 2018 METHOD Number Percentage The pupose of study is to understand Sex (n) (%) Male the differences of babies’ nutritional status 35 42,7 between babies who were given breast milk Female 47 57,3 compared to babies who were given formula Total 82 100 milk. This quantitative study used cross Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 49 Tasnim, T. & Susiatin. DOI: 10.36566/ijhsrd/Vol2.Iss2/39 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 Based on the mother’s age, the high Table 4. Distribution of mother’s educaational proportion of age was mothers aged between level in this study in 2018 26-30 years old, namely 39% (32 mothers). Mother’s Number Percentage The lowers proportion of mother’s age was education (n) (%) 36-40 years old, namely 14 mothers (17.1% Bacheloor 18 22,0 Senior high Table 3. Distribution of mother’s age in this school 52 63,4 study in 2018 Yunior high school 12 14,6 Mother’s Number Percentage Total 82 100 age (n) (%) 20-25 16 19,5 Some of the mother also did not have 26-30 32 39,0 job (61%). They were wives and do domestic 31-35 20 24,4 chores. Howeve, there wer around 18 36-40 14 17,1 mothers who worked as civil serven (22%) Total and taders (17.1) (table 5). 82 100 Based on the investigation, there was Some of mothers passed from Senior significant difference of babies’ nutritional high school, namely 52 mothers (63.4%). status between babies who were given breast The lower proportion of mothers had Yunior milk and formula milk (p value = 0.001 < high school of their educational level, 0.05. namely 12 mothers (14.6%) (see table 4). Table 5. Distribution of Mother’s Job in This Study in Kulisusu Subdistrict of North Buton District in 2018 Mother’s Job Number (n) Percentage (%) No job 50 61,0 Civil Serven 18 22,0 Trader 14 17,1 Total 82 100 Table 6. Comparation of Babies’ Nutritional Status between Babies who were Given Breast Milk and Formula Milk in Kulisusu Sub-Distribusi in 2018 Nutritional Formula Milk Breast Milk Total Status n % n % n % Good 25 60,98 41 100 66 80,49 Worse 16 39,02 0 0 16 19,51 Total 41 100 41 100 82 100 Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 50 Tasnim, T. & Susiatin. DOI: 10.36566/ijhsrd/Vol2.Iss2/39 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 Table 7. Independent t test of differences of babies’ nutritional Status between babies who were given Breast milk and Formula Milk in Kulisusu Sub-District in 2018 Paired Differences Mean t df Sig. (2-tailed)* Nutritional Status – Breast feeding -0.305 -3.536 81 0.001 Note: *Independent sample t-test DISCUSSION parturition. Also, breastfeeding can prevent The finding explains that breast milk breast cancer and delay pragnancy (8). gave significant effect for under 6 months By increasing mother’s health status, old babies’ nutritional status rather than babies will get good rearing from their formula milk. The babies who were given health mother. Thus, the babies will growth breast milk had good growth compared to and become new health and strong those who were given formula milk. This generation. The next generation will have finding shows that breast milk is one of good high productivity which affect to their food for under 6 months old babies. The income and wellbeing. By increasing the composision of nutrition in breast milk is family income, the national income also will still adequate for under 6 months old babies increase which affect to high quality of although they are not fed additional food. As public services. This means, community we know that breast milk contains about 7% health and wellbeing will be secure. As we of carbohidrate, 0.9% of protein and 3.8% of know that income is one of determinants of fat (4). Compared to the formula milk nutritional status in children, especially in compresses only 4.8% of carbohidrate, 3,4 % under five years old (9, 10). Therefore, of protein and 3.7% of fat. Therefore, under breastfeeding is very important aspect, 6 months old babies do not need additional especially for under six months old babies. food. The breast milk is still enough for Moreover, as we understand from this under-6 months old babies’ nutrition needs finding that about 61% mothers in this study (3). Some of others studies stated that under did not have job. This means the mothers had 6 months old bibies who were breastfed enough time to nurture their babies. The exclusively about 1.62 times bigger than mothers could be able to prepare breast milk those who were not given exclusive anytime. Compared to working mothers, the breastfeeding (6). mothers did not have enough time to give Adequate nutrition in under six months breast milk, except there are a breastfeeding old babies is very important because the or nursery room in their office. growth in this period will affect to whole individual health. Therefore, this period is CONCLUSION called with the golden age (7). Moreover, As above explanation, some of breastfeeding has some benefits, including strategies should be done to motivate mother’s psychology and family income. mothers in order to give breast milk rather Interms of mother’s psychology, than formula milk. First of all, health breastfeeding can prevent or obstruct post promotor in Kulisusu Primary Health Care Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 51 Tasnim, T. & Susiatin. 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DOI: 10.36566/ijhsrd/Vol2.Iss2/41 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 Research Article Open Access THE RELATIONSHIP BETWEEN WORKLOAD AND MOTIVATION WITH HEALTH WORKER’S PERFORMANCE IN COMMUNICABLE DISEASE PROGRAM IN PRIMARY HEALTH CENTRE IN EAST KOLAKA DISTRICT Muh.Said1, La Ode Saafi2, Sunarsih3 1,2,3Magister of Public Health Study Program, College of Health Sciences Mandala Waluya Kendari, Southeast Sulawesi, Indonesia Corresponding Author : Muh.Said Email : [email protected] Abstract Background: The incidence of infectious diseases in the world, Indonesia and provinces is still relatively high. Based on WHO data (2017), the top ten diseases that cause death are under 5 years of age, including HIV / AIDS 4%, diarrhea 18%, measles 1%, malaria 8%, pneumonia 16%, premature 12%, birth asphyxia 9%. , neonatal sepsis 6%, congenital abnormalities 4%, and accident 3%. In Indonesia, the incidence of infectious diseases is still high and some have experienced an increase in cases from the previous year. The data from the East Kolaka Health Service Profile shows that Accute Respiratory Infection (ARI) has increased by 55%, the number of sufferers is 84, while diarrheal disease has increased by 24%, the number of sufferers is 839, and TB disease has increased by 65% The number of patients 129. Methods: This type of research is a cross sectional study. The population of this study were all programmers in the working area of the East Kolaka Health Service as many as 48 programmers. The sampling technique was carried out by simple random sampling using the Lemeshow formula. Data were collected through a questionnaire and then analyzed using the Chi Square test. Result: The results showed that chi square of motivation = 5.773 and workload = 8,644. They chi squar etable is 3,841 at α = 5% and df = 1. It means that chi square value> chi square table. Conclusion: There was a relationship between motivation, and workload with performance of officers in East Kolaka Regency. Key words: Performance, workload, motivation, health worker. Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 53 Said, M., Saafi, L.O & Sunarsih. DOI: 10.36566/ijhsrd/Vol2.Iss2/41 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 INTRODUCTION From the data from the profile of the Infectious disease is a disease that is East Kolaka Health Office, ARI disease has transmitted from a person, animal, or source increased by 55%, the number of patients is of inanimate objects to another person either 84, while diarrhea has increased by 24%, the directly, with the help of vectors or by other number of sufferers is 839, and TB disease means(1). Several types of infectious has increased by 65% for the number of 129 diseases such as pulmonary tuberculosis, sufferers. it requires the performance of all dengue fever, and diarrhea have several health personnel in the primary health centre, similarities in physical environmental factors especially those specifically in the infectious (altitude and rainfall), socio-economic disease control program unit (P2M) in an environment (family category, population effort to reduce the incidence of ARI, density, and occupant density), and hosts diarrhea and TB in the working area of the (age, sex, and behavior)(2). East Kolaka Health Office. ARI and TB are The study of World Health always included in the list of the top ten Organization (WHO) in 1995 reported that largest diseases in the working area of the pulmonary diseases or Tuberculosis (TB) East Kolaka Health Office, from these data it was endemic with an estimated 9 million is necessary to increase the performance or cases / year(3). Currently in Asia, including role of officers(9). India, China, Indonesia, Bangladesh, Philippines and Pakistan. There are 4.5 METHOD million cases means more than half of This type of research is a quantitative Tuberculosis (TB) cases in the world. In study using cross sectional study design(10). 1993 WHO designated pulmonary TB as The The population of this study was all Global Emergency because in most countries programmers in the working area of the East in the world, TB disease was out of Kolaka Health Service as many as 48 control(4). programmers. While a sample of 33 The incidence of infectious diseases in respondents. The samples in this study the world, Indonesia, and provinces is still conducted by random sampling.The high(5). The results of a study by Saomi sampling technique carried out by simple et.al, 2015 in the Ex Residency of Pati random sampling using the Lemeshow regarding the factors that influence the case formula(11). Data were collected through a finding of pulmonary tuberculosis have an questionnaire and then analyzed using the interest in becoming a TB officer. Officers Chi Square test(12). feel that their duties and responsibilities as implementing TB program officers have high RESULT risks and heavy burdens(6). Table 1 shows that out of 16 health Diarrheal disease is an endemic disease workers who have low motivation, there are in Indonesia and is also a potential outbreak 87.5% whose performance does not meet and that often results in death, Southeast 16% of workers whose performance meets. Sulawesi is no exception(7). Based on the Meanwhile, of the 17 respondents who had results of the 2015 Riskesdas, the prevalence high motivation, there were 41.2% whose of diarrhea in Southeast Sulawesi was 7.3% performance did not meet and 58.8% of the with the incidence of diarrhea in children officers whose performance was satisfactory. under five around 5%. The number of Based on the results of statistical tests using diarrhea cases handled in 2018 was 39,913 the chi-square test obtained X2 count> X2 cases or 53.72% of the estimated cases, table (5.773> 3.841) atα 0.05 df = 1. This higher than in 2017 of 35,864 cases (46.77% means that there is a relationship between of the estimated cases)(8). compensation and performance of officers in East Kolaka Regency. The results of the Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 54 Said, M., Saafi, L.O & Sunarsih. DOI: 10.36566/ijhsrd/Vol2.Iss2/41 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 relationship closeness test show the Phi (Φ) performance of officers in East Kolaka coefficient of 0.481, this shows the strength Regency in the medium relationship of the relationship between motivation and category. Table 1 Relationship between Motivation and Officer Performance Officer Performance Total Statistic test Motivation Does not meet the Fulfill f % f % f % X2hit = 5.773 Low 14 87.5 2 12.5 16 100 X2tab = 3,841 High 7 41.2 10 58.8 17 100 p value = 0.016 Total 21 63.6 12 36.4 33 100 phi = 0.481 Table 2 shows that of the 18 health test obtained X2 count> X2 table (8,644> workers who have a light workload, there are 3,841) at α 0.05 df = 1. This means that there 88.9% whose performance does not meet and is a relationship between workload and the 11.1% of workers whose performance is performance of officers in East Kolaka satisfactory. Meanwhile, of the 15 Regency. The results of the relationship respondents who had a heavy workload, closeness test show the Pi coefficient (Φ) of there were 33.3% whose performance did not 0.481, this shows the strength of the meet and 66.7% of the officers whose relationship between compensation and performance was satisfactory. Based on the performance of officers in East Kolaka results of statistical tests using the chi-square Regency, in the strong relationship category. Table 2 Relationship between Workload and Officer Performance Officer Performance Total Statistic test Workload Does not meet the Fulfill f % f % f % X2hit = 8,644 Light 16 88.9 2 11.1 18 100 X2tab = 3,841 Weight 5 33.3 10 66.7 15 100 p value = 0.003 Total 21 63.6 12 36.4 33 100 phi = 0.575 DISCUSSION officers. The strength of this relationship is Relationship between Motivation and in the medium category. These results can be Infectious Disease Staff’s Performance explained that, employees who have high Motivation is a series of attitudes and motivation will have a high responsibility to values that influence individuals to achieve work enthusiastically and as well as possible, specific things in accordance with individual mobilizing all abilities and skills in order to goals(13). These attitudes and values are an achieve optimal performance. Good invisible impetus that provides the strength employee performance will be achieved if to encourage the individual to behave in employees have high motivation to work. achieving goals(14). The results of this study are in line with Based on research that has been done research by Sulastriningsih (2016) which on 33 Infectious disease officers in East shows that there is a positive effect of Kolaka Regency regarding work motivation, motivation of health workers on the it is known that there is a relationship performance of health workers in between motivation and the performance of implementing IMCI(15). In addition, from Indonesian Journal Of Health Sciences Research and Development Vol. 2, No. 2, October 2020 55 Said, M., Saafi, L.O & Sunarsih. DOI: 10.36566/ijhsrd/Vol2.Iss2/41 https://ijhsrd.com/index.php/ijhsrd e- ISSN: 2715-4718 the results of Octavariny's (2018) research, it of course affects the productivity of the is concluded that there is a close relationship hospital itself(20). between both intrinsic and extrinsic work motivation obtained by KIA officers and the CONCLUSION resulting performance in carrying out their The conclusions in this study that there duties as MCH officers(16). is a correlation between motivation with performance of officers in East Kolaka Relationship between Workload and Regency. The results of the closeness test Communicable Disease Staff’s show the strength of the relationship between Performance motivation and performance of officers in Workload is a group or a number of East Kolaka Regency in the medium activities that must be completed by an relationship category. Apart from motivation, organizational unit or an office holder within workload also has a relationship with the a certain period of time(17). Workload is the performance of officers in East Kolaka main parameter that companies must pay Regency. The closeness test results show the attention to in an effort to improve employee strength of the relationship between performance. The workload of the workload and the performance of officers in appropriate employee will provide a high East Kolaka Regency in the strong performance output(18). relationship category. Based on research that has been done on 33 Infectious disease officers in East . Kolaka Regency regarding workload, it is REFERENCES known that there is a relationship between 1. Setiyabudi R. Systematic review : workload and officer's performance. The Factors related to malaria as strength of this relationship is categorized as communcable diseases in Indonesia. strong. 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