Low dosage iron supplementation: the impact of hemoglobin levels and the side effect of non-anemic pregnant women in Denpasar city, Bali, Indonesia, 2016

Background: Nearly 95% of anemia in pregnancy is caused by iron deficiency. Iron tablet is recommended in pregnant women, but only 18% who consume iron tablet. One of the factors that influence compliance is the side effects such as constipation, nausea and vomiting. Pregnant women need additional iron supplementation of 30 mg / day, along with folic acid and vitamin C. Based on the above it is necessary to create Iron tablet formulations with low doses but can be optimally absorbed by the body.Methods: Randomized pre and posttest control group design. The inclusion criteria pregnant women 20-35 years, a distance of children ≥2 years, live in Denpasar city and the number of single fetus. Simple random sampling technique to determine the treatment group and the control group. The statistical test used in analyzing is the normality test, homogeneity, Chi-Square test and test the T-group.Results: During research of 44 respondents obtained the results of 44 (100%) are in a healthy reproductive age and no respondents were vegetarian. The analysis data with statistical test T-test, obtained no difference between low-dose iron supplementation and conventional doses of the hemoglobin of non-anemic pregnant women. Also showed that the low-dose iron supplementation can significantly lower incidence of side effects of iron supplementation in non-anemic pregnant women.Conclusions: The proper used of iron in the appropriate dose, will affect the effectiveness of absorption in the body and helps in reducing the side effects that arise from taking iron tablets during pregnancy

The implementation of prevention of mother-to-children HIV transmission program by private midwife practice at Denpasar city

Background: HIV infection is one of the top health concerns and contagious diseases which could lead to the death of mother and child. Based on the Health Department of Bali Province data (2014), the number of pregnant women who willingly did PMTCT test is 5,029 (42.91%) out of 11,719 pregnant women. This shows that the achievement is still below the national target which is 78% of HIV-tested pregnant women. This research sought to find out the factor which affects the implementation of PMTCT care by BPM at Denpasar city in 2018.Methods: This research was an analytical research using cross-sectional approach. The selection of sample used total sampling technique in which 73 BPM fulfilled the inclusion criteria. Data analysis utilized univariate analysis, bivariate analysis with chi-square test correlation test which was followed by multivariate analysis with logistic regression.Results: This study showed there was a significant relation (with p value 5 years).Conclusions: Supervision from policy makers from Health Department and Public Health Center (Puskesmas) was essential in conducting a review regarding on PMTCT regularly to increase the scope of PMTCT at BPM

PENGARUH RELAKSASI DEEP BREATHING DENGAN TEKNIK SELF INTRODUCTION TRAINING (SIT) DALAM BENTUK AUDIO VISUAL TERHADAP KECEMASAN PADA IBU HAMIL

Anxiety during pregnancy is related to a state of worry in the form of fear or feelings of uncertainty or helplessness and if not treated it can pose a risk to pregnancy. A non-pharmacological approach that can be given to pregnant women is relaxation therapy. Deep breathing relaxation therapy is a relaxation technique that is easiest to apply without having to use an instructor. This technique can be combined with the self-instruction technique, which is a self-verbalization technique by replacing negative thoughts with positive thoughts. The aim of this research is to analyze the comparison of the effectiveness of deep breathing relaxation using the Self Instruction Training technique via audio-visual with the effectiveness of deep breathing relaxation using audio only. The research method used was quasi experimental with the Pretest-Posttest Control Group design technique. The anxiety measuring tool is determined using the State – Trait Anxiety (STAI) tool which is presented in the form of a questionnaire form. The population in this study were pregnant women in the TPMB working area of East Denpasar Community Health Center I. The sampling technique used is accidental sampling. The sample in this study was 30 pregnant women at TPMB Bdn. Ketut Nuriasih, S.ST and TPMB Ni Made Serioni, A.Md. Keb. Based on data analysis using Mann Whitney, a p value of 0.003 was obtained, where the p value was <0.005, which means there was a significant difference in the effectiveness of the final anxiety level in pregnant women who were given deep breathing relaxation audio and pregnant women who were given deep breathing relaxation video using the SIT (Self) method. Instruction Training). For pregnant women, it is hoped that this research will provide benefits as additional knowledge regarding the use of deep breathing relaxation in audio-visual form to relieve discomfort during pregnancy.Kecemasan pada masa hamil berkaitan dengan keadaan khawatir berupa rasa takut atau perasaan yang tidak pasti maupun tidak berdaya dan bila tidak ditangani dapat berisiko pada kehamilan. Pendekatan non-farmakologi yang dapat diberikan kepada ibu hamil yaitu salah satunya dengan terapi relaksasi. Terapi relaksasi deep breathing (nafas dalam) merupakan teknik relaksasi yang paling mudah diterapkan tanpa harus menggunakan instruktur.Teknik ini dapat dikombinasikan dengan teknik self-instruction merupakan teknik verbalisasi diri dengan mengganti pikiran negatif menjadi pikiran positif. Tujuan penelitan ini adalah menganalisa perbandingan efektifitas relaksasi deep breathing dengan teknik Self Instruction Training (SIT) melalui audio visual dengan efektifitas relaksasi deep breathing menggunakan audio saja. Metode penelitian yang digunakan adalah quasy experimental dengan teknik Pretest-Posttest Control Group design. Alat ukur kecemasan ditentukan dengan menggunakan alat (instrument) State – Trait Anxiety (STAI) yang disajikan dalam bentuk Form kuesioner. Populasi pada penelitian ini adalah ibu hamil di TPMB Wilayah kerja Puskesmas I Denpasar Timur. Teknik sampling yang digunakan adalah accidental sampling. Sampel dalam penelitian ini sejumlah 30 ibu hamil di TPMB Bdn.Ketut Nuriasih,S.ST dan TPMB Ni Made Serioni,A.Md.Keb. Berdasarkan analisa data dengan menggunakan mann whitney diperoleh p vaule 0,003 dimana p value < 0,005 yang berarti terdapat perbedaan yang signifikan pada efektifitas tingkat kecemasan akhir pada ibu hamil yang diberi Audio relaksasi deep breathing dan ibu hamil yang diberi Video relaksasi deep breathing dengan metode SIT (Self Instruction Training). Bagi ibu hamil, penelitian ini diharapkan dapat memberikan manfaat sebagai tambahan pengetahuan terkait pemanfaatan relaksasi deep breathing dalam bentuk audio visual dalam meredakan ketidaknyamanan dalam kehamilan

Factors associated with zidovudine substitution in HIV/AIDS patients attending Badung Hospital, Bali, Indonesia between 2006-2014

Background: Zidovudine (AZT) is the most commonly used drug in first line antiretroviral therapy (ART) in Indonesia; however, substitution due to its side effect is common. The majority of HIV positive patients in Badung Hospital Bali are treated with AZT yet no longitudinal studies in Bali have investigated the number of substitutions or the factors associated with it.Methods: A retrospective cohort study of HIV positive persons aged >15 years, receiving AZT between 1st January 2006 – 31st August 2014 was conducted. Persons were included from their date of starting AZT. Cox proportional hazard models were applied to estimate the risk and time to substitution. Substitution was defined as single drug change due to side effects and initiating another drug of the same class.Results: During our study 260 patients started AZT, of which 77 (29.6%) experienced substitution. The risk of substitution was 19 per 100 person years. Of those 77, the median time to AZT substitution was 69 days (IQR 25-178). Factors significantly associated with an increased risk of AZT substitution included women (HR 1.79; 95% CI 1.09-2.94), having low hemoglobin levels <10g% (HR 2.72; 95% CI 1.02-7.21), clinical stage III and IV (HR 3.53; 95% CI 1.26-6.19) at the time of starting AZT, and starting ART after 2012 (HR 3.83; 95% CI 2.19-6.70).Conclusions: Present study identified individuals that may be at a high risk of AZT substitution who should be monitored more closely or consideration given to initiating them on another treatment regimen

Factors influencing the use of personal protective equipment (ppe) in midwifery services, in midwife independent practice (pmb) during the covid-19 pandemic: Faktor-faktor yang mempengaruhi penggunaan alat pelindung diri (apd) dalam pelayanan kebidanan di praktek mandiri bidan (pmb) pada masa pandemi covid-19

Bidan adalah bagian dari petugas kesehatan garda terdepan yang kontak langsung dengan klien dan memiliki risiko untuk terpapar Covid-19. Untuk melindungi diri saat kontak langsung dengan klien wajib mematuhi praktik pencegahan dan pengendalian infeksi, yang mencakup pengendalian administratif, lingkungan dan engineering serta penggunaan Alat Pelindung Diri (APD) yang tepat. Tujuan dari penelitian ini adalah menganalisa faktor – faktor yang mempengaruhi perilaku bidan dalam penggunaan APD yang sesuai dalam pelayanan kebidanan pada masa pandemi Covid-19 dan adaptasi kebiasaan baru. Desain penelitian ini adalah cross-sectional analitik. Subjek penelitian adalah Bidan Delima di Kota Denpasar yang memiliki Praktek Mandiri Bidan yang tetap memberikan pelayanan pada masa pandemi Covid-19 dengan jumlah sample 63 orang sesuai dengan kriteria inklusi. Hasil penelitian didapatkan hasil variabel terdapat hubungan yang signifikan antara usia (p=0,012), pengalaman kerja (p= 0,011), sikap (p= 0,01) dan pengetahuan (p= 0,014) dengan perilaku dalam penggunaan Alat pelindung Diri (APD) yang sesuai level dalam memberikan pelayanan kebidanan pada masa pandemi Covid-19. Sehingga untuk tetap menjaga mutu pelayanan yang baik,  bidan dalam memberikan pelayanan tetap menerapkan protokol kesehatan, menjaga kualitas pelayanan dengan mempertahakan pengetahuan, dan penggunaan level yang sesuai dalam pelayanan kebidanan.Midwives are part of the frontline health workers who are in direct contact with clients and have a risk of being exposed to Covid-19. To protect oneself during direct contact with clients, it is mandatory to adhere to infection prevention and control practices, which include administrative, environmental and engineering controls as well as proper use of Personal Protective Equipment (PPE). The purpose of this study was to analyze the factors that influence the behavior of midwives in the use of appropriate PPE in midwifery services during the Covid-19 pandemic and the adaptation of new habits. The design of this study was cross-sectional analytic. The subject of the study was the Pomegranate Midwife in Denpasar City who had an Independent Midwife Practice who continued to provide services during the Covid-19 pandemic with a sample of 63 people according to the inclusion criteria. The results showed that there was a significant relationship between age (p=0.012), work experience (p= 0.011), attitude (p= 0.01) and knowledge (p= 0.014) with behavior in the use of Personal Protective Equipment (PPE). appropriate level in providing midwifery services during the Covid-19 pandemic. So that to maintain good service quality, midwives in providing services continue to apply health protocols, maintain service quality by maintaining knowledge, and use appropriate levels in midwifery services

Low dosage iron supplementation: the impact of hemoglobin levels and the side effect of non-anemic pregnant women in Denpasar city, Bali, Indonesia, 2016

Background: Nearly 95% of anemia in pregnancy is caused by iron deficiency. Iron tablet is recommended in pregnant women, but only 18% who consume iron tablet. One of the factors that influence compliance is the side effects such as constipation, nausea and vomiting. Pregnant women need additional iron supplementation of 30 mg / day, along with folic acid and vitamin C. Based on the above it is necessary to create Iron tablet formulations with low doses but can be optimally absorbed by the body.Methods: Randomized pre and posttest control group design. The inclusion criteria pregnant women 20-35 years, a distance of children ≥2 years, live in Denpasar city and the number of single fetus. Simple random sampling technique to determine the treatment group and the control group. The statistical test used in analyzing is the normality test, homogeneity, Chi-Square test and test the T-group.Results: During research of 44 respondents obtained the results of 44 (100%) are in a healthy reproductive age and no respondents were vegetarian. The analysis data with statistical test T-test, obtained no difference between low-dose iron supplementation and conventional doses of the hemoglobin of non-anemic pregnant women. Also showed that the low-dose iron supplementation can significantly lower incidence of side effects of iron supplementation in non-anemic pregnant women.Conclusions: The proper used of iron in the appropriate dose, will affect the effectiveness of absorption in the body and helps in reducing the side effects that arise from taking iron tablets during pregnancy

Studi Literatur: Penerapan Kompres Daun Kubis untuk Mengurangi Pembengkakan Payudara pada Ibu Post Partum

Latar Belakang: Pada masa nifas tubuh ibu mengalami pemulihan atau adaptasi sistem reproduksi ke kondisi sebelum hamil. Salah satu perubahan fisik dalam masa nifas adalah laktasi, terhambatnya pengeluaran ASI dipengaruhi salah satunya oleh karena pengeluaran hormon oksitosin yang tidak lancar. Hal ini memicu terjadinya pembengkakan payudara (breast engorgement) yang berakibat pada rasa tidak nyaman yang dialami ibu pada masa nifas Ada berbagai cara dalam mengatasi pembengkakan pada payudara, salah satunya adalah kompres daun kubis. Kompres daun kubis merupakan intervensi non farmakologis yang aman dan mudah dilakukan oleh ibu nifas. Tujuan : Mengidentifikasi penerapan kompres daun kubis terhadap penurunan kejadian pembengkakan payudara pada ibu nifas. Metode: Penelitian ini merupakan studi literatur dari 10 artikel ilmiah yang diperoleh melalui database google Scholar, dipublikasikan antara tahun 2012 hingga 2022. Hasil: Berdasarkan kriteria inklusi dan eksklusi, terdapat 10 jurnal/artikel ilmiah yang memenuhi syarat. semua penelitian menyatakan bahwa kompres kubis efektif terhadap penurunan kejadian pembengkakan payudara pada ibu nifas. Kesimpulan: Kompres kubis merupakan saah satu intervensi non farmakologis yang bisa dipertimbangkan sebagai tindakan alternatif secara mandiri oleh ibu nifas dalam menurunkan pembengkakan pada payudara

EFEKTIITAS PRENATAL YOGA TERHADAP KETIDAKNYAMANAN IBU HAMIL TRIMESTER III DI YAYASAN BUMI SEHAT, UBUD-BALI, INDONESIA

This study aims to determine the effectiveness of prenatal yoga in reducing the discomfort of third-semester pregnant women. Method: This type of research is the analytic and cross-sectional design. The number of samples is 50 pregnant women who meet the inclusion criteria by using a purposive sampling technique. The instrument data collection using a questionnaire that has been tested for validity and reliability. Bivariate analysis using chi-square correlation test and multivariate analysis using multiple logistic regression. Result: The result of the data shows that prenatal yoga is effective in reducing the discomfort of third-trimester pregnant women routinely by &gt; 6 times. Chi-square test results show a significant effect of p-value &lt;0.05. The multivariate result shows the most effective factor in reducing discomfort pregnant women was cramping with OR by 118.58 (95% CI: 6.01-2340.20), so it can be interpreted that prenatal yoga&gt; 6 times effective in reducing cramps in pregnant women. Conclusion: From the result of research conducted, prenatal yoga is effective in reducing discomfort in third-semester pregnant women if done routinely or&gt; 6 times.Penelitian ini bertujuan untuk mengetahui &nbsp;efektifitas Prenatal Yoga dalam mengurangi ketidaknyamanan ibu hamil pada trimester tiga. Metode: Jenis penelitian analitik dan desain cross-sectional. Jumlah sampel sebanyak 50 ibu hamil yang memenuhi kriteria inklusi dengan menggunakan teknik purposive sampling. Pengumpulan data instrumen menggunakan angket yang telah diuji validitas dan reliabilitasnya. Analisis bivariat menggunakan uji korelasi chi-square dan analisis multivariat menggunakan regresi logistik ganda. Hasil: Hasil data menunjukkan bahwa prenatal yoga efektif mengurangi ketidaknyamanan ibu hamil trimester III secara rutin sebanyak&gt; 6 kali lipat. Hasil uji chi-square menunjukkan pengaruh signifikan dari p-value &lt;0,05. Hasil multivariat menunjukkan faktor yang paling efektif dalam mengurangi ketidaknyamanan ibu hamil adalah kram dengan OR sebesar 118.58 (95% CI: 6.01-2340.20), sehingga dapat diartikan bahwa prenatal yoga&gt; 6 kali efektif dalam mengurangi kram pada ibu hamil. Kesimpulan: Dari hasil penelitian yang dilakukan, yoga prenatal efektif dalam mengurangi ketidaknyamanan pada ibu hamil semester III jika dilakukan secara rutin atau&gt; 6 kali

Studi Literatur : Pengaruh Birth Ball Exercises Terhadap Nyeri Persalinan pada Kelahiran Spontan

Latar Belakang: Kehamilan merupakan sebuah peristiwa fisiologis yang menimbulkan banyak perubahan pada berbagai organ dan sistem tubuh ibu hamil.&nbsp; Nyeri pada persalinan merupakan suatu proses proteksi fisiologis dari tubuh ibu bersalin untuk memberitahukan adanya tanda bahaya. Nyeri pada persalinan dapat menganggu kontraksi pada rahim sehingga dapat menyebabkan persalinan lama, penurunan kepala janin sangat lama, janin kekurangan hingga menyebabkan gawat janin. Salah satu metode nonfarmakologi yang dapat digunakan untuk mengurangi nyeri persalinan adalah terapi birth ball. Tujuan Penelitian: Menganalisis pengaruh latihan birth ball terhadap nyeri persalinan spontan berdasarkan studi empiris 10 tahun terakhir. &nbsp;Metedologi: Penelitian ini menggunakan metode deskriptif. Sampel penelitian ini sebanyak 254 orang dengan teknik pengambilan sampel menggunakan total sampling. Data dianalisis menggunakan analisis univariat. &nbsp;Hasil: Penelitian ini merupakan studi pustaka dengan mencari jurnal/artikel ilmiah melalui database google Scholar, dipublikasikan antara tahun 2011 hingga 2021. Kriteria inklusi dan eksklusi yang digunakan untuk mencari jurnal/artikel ilmiah. Hasil: Berdasarkan kriteria inklusi dan eksklusi, terdapat 10 jurnal/artikel ilmiah yang memenuhi syarat. semua penelitian menyatakan bahwa ada pengaruh latihan bola bersalin terhadap nyeri persalinan pada persalinan spontan. Kesimpulan: Ada pengaruh latihan bola kelahiran terhadap nyeri persalinan pada kelahiran spontan