COMPARISON OF NEW BORN MORBIDITY BETWEEN PERVAGINAM BREECH LABOR AND SECTIO CAESAREA WITH GLUTEAL PRESENTATION
Morbidity Comparison Between The Newborn And Sectio Breech Deliveries Pervagina Caesarea Breech
Linda Andri Mustofa
Prodi D IV Bidan Pendidik STIKES Karya Husada Kediri E-mail:
fardenmuktigmail.com
ABSTRACT
Labor with breech is a challenge in the management of obstetric and is associated with perinatal morbidity and mortality . This study aims to determine differences in maternal and perinatal
morbidity between delivery and sectio caesarea pervagina with breech .The study design was observational comparative approach . The variable in this study is in labor pervagina infant
morbidity and section caesarea breech . The research was conducted on August 8 to August 23, 2014 at Amelia Pare Hospital . 30 population breech babies born vaginally and 53 babies were
born with a breech presentation section caesarea 2010 to 2014, with a total sample techniques .
Data were analyzed using T test Test with a confidence level of 95 α = 0.05 . Results of the analysis showed that the vaginal delivery , 1 infant 3.3 had severe asphyxia , 12 infants
40 moderate and 17 infants 56.7 severe asphyxia . Conversely babies born with Sectio Caesarea , none suffered severe asphyxia , 10 infants 18.9 mild asphyxia and 43
infants 81.1 mild asphyxia . T test with a confidence level of 95 was obtained count value is smaller than alfa 0:02 , which means that there are differences in morbidity among
infants born vaginally and sectiocaesarea breech . Labor with breech presentation at risk for both mother and baby , with the greatest risk to the fetus is hypoxia , caused by pinching the
cord between the head and pelvis when the head enters the pelvic cavity .
Keywords : neonatal morbidity , vaginal breech deliveries , sectiocaesarea .
INTRODUCTION
A breech deliveries WITH AN hearts management challenges associated
WITH obstetrics and perinatal morbidity and mortality . There was a breech
presentation Approximately 3 Up to 4 of all deliveries .Optimal method for having
a baby with breech presentation into a very controversial issue and a major question in
the field of midwifery . Breech delivery at term vaginal cause of perinatal mortality
and morbidity rates between 1 and 2 . Perinatal morbidity and mortality in breech
delivery reached nine times higher than spontaneous vertex delivery . Incidence of
trauma and hypoxia damage is particularly high in small premature infants under 1.5
kg and the large baby over 3.5 kg Paul MF, Cawford, 2005: 184:312-3.
The study acknowledges that there is a slightly greater risk of neonatal with
997
labor pervagina types of delivery options to be considered and chosen before birth , and
should consider the health condition of the mother and the fetus and medical
requirements that apply. Most of the pregnant women at the antenatal check the
midwife , so the midwife should be able to help the mother to help pregnant women to
plan and make choices labor. To be able to assist pregnant women with breech birth
plan and choose the type of delivery , midwives should know the advantages and
disadvantages and the fulfillment of requirements to deliver pervagina or SC to
consider the risk of morbidity and maternal and perinatal mortality .
LITERATURE REVIEW Breech presentation Diagnosis
Breech is a longitudinal layout with the head of the fetus in the uterine fundus .
The incidence is 3 to 4 , but had fetal morbidity and mortality rates are high.
Diagnosi breech is generally not difficult . Titegakkan diagnosis by anamnesis,
palpation, examination, X-ray examination, scanning and Ultra Sono Tomographic
USG .
Etiology Breech Presentation
Location of the fetus in the uterus depends on the process of adaptation of the
indoor fetus in the uterus . In pregnancy until approximately 32 weeks , the amount
of water relative needs more , allowing the fetus to move freely . Thus the fetus can
put yourself in a cephalic presentation , breech or transverse layout . In pregnancy
the last quarter of the fetus is growing rapidly and the amount of water needs
relatively reduced because the buttocks with both legs folded bigger than the head
of the buttocks are forced to occupy a greater space in the fundus , while the head
is in a smaller space in the lower uterine segment.
In the months of pregnancy is not enough breech higher frequency while at
term pregnancy the fetus is mostly found in the presentation of the head. Other factors
that play a role in the breech of which is multparitas , twin pregnancy , hidramnion,
hidrosepalus, plasenta previa and a narrow pelvis . Sometimes breech caused by
abnormalities of the uterus and uterine deformities . Placenta is located in the
cornu fundus can also cause breech because the placenta reduce the size of the rooms in
the area of the fundus .
Labor mechanism with Breech Presentation
Buttocks into the pelvic cavity with a line transverse or oblique groin . After
touching the pelvic floor occurs in the rotary axis so that at the bottom of the
the second leg . After the pivot swivel breech birth occurs outside the fetal
abdomen was in posterior shoulder through the door that allows the pelvis to the largest
line of shoulder transverse or oblique . Axis rotation occurs in the shoulder , so
that the shoulders are under simpisis front and rear shoulder passes perineum .
At the time of the head into the pelvis with transverse or oblique sagittal
suture . Occur in the pelvic cavity in the head rotation axis , so that the face
memutas to posterior and occiput towards simpisis. By suboksiput as hipomoklion the
chin , mouth , nose and the entire head was born in succession pass through the
perineum . There is a real difference between the birth of the fetus in cephalic
presentation and the fetus was born breech.
At the presentation were born head first is part of the largest fetus so that the
head has been born birth weight is not a member of difficulty. In contrast to the
breech respectively - were born part of the increasingly great starts from the birth of
the buttocks, shoulders, and then the head .
Labor with Breech Presentation
Case for section caesarea planned in breech presentation has been reviewed
on a large scale by Brke and direkomondasikan on American college of
Obstetricians and Gynecologists. TBT using designs randomissed control trial to
compare the safety section caesarea breech deliveries pure planned pervagina .
Two thousand women were recruited from 121 centers in 26 countries .
The study concluded siding premature in 1999. Combined autcame peinatal and
neonatal mortality and serious neonatal morbidity with exclude neonatal disorders
were significantly lower in the planned sectiocaesarea than vaginal delivery group
1.6 versus 5.0 , mrelative risk [ RR ] 0.33 and statistically no difference in
maternal mortality and serious morbidity
pelvis line occupies thigh pelvic
significantly between the two groups. Kind anteroposterior diameter and front
trochanter is under simpisis. Then came the lateral flexion of the body of the fetus , so
the trochanter back past the perineum and was born around the buttocks , followed by
998
of labor with breech presentation is one of the big questions in obstetrics that have
been broken by the international community obstetric through randomized
controlled trials to answer questions about
what kind of delivery is best for fetuses with breech presentation
Research shows that a planned cesarean delivery safer for labor with
breech . Even based on the data monitoring committee , the results of this research for a
while is because the final results of the study were able to answer questions that
have been posed. But then the results are considered to be convincing has been
controversial .
Criticism of researchers to continue again . Some researchers even referred to
has attracted rekomondasi . In an article written by Charlotte L Deans and Zoe Penn
in The Obstetricians and Gynaecologist journal publish more data about labor rviw
pervagina the breech . Large studies conducted by PREMODA study group was
Trial , assessment of the fetal heart rate 100 in PREMODA and 33.4 on TBT
and duration of the second stage more than 60 minutes 0 , 2 on PREMODA and
5.0 on TBT . They do not realize that these things affect the risk of neonatal
slightly larger in vaginal deliveries .
Other researchers have also published research showing ourcame
comparable results in a smaller population . Irion and colleagues compared 385 with a
vaginal delivery of breech presentation at birth section 320 caesarea planned and have
fewer maternal complications in childbirth pervagina group and no neonatal morbidity
corrected.
Dublin alarab and colleagues published data on 641 deliveries . Caesarea
planned delivery section 343 and 298 published in 2007.
The study was deliveries pervaginal trial in which 146
conducted at a maternity unit at 800 women in France and Belgium with desaian
prospective study , comparing breech deliveries pervagina with secsio caesarea
planned.
Researchers said the study conducted in France in 2001 until 2002.
The vaginal delivery of breech presentation made in accordance with the standards and
are routinely offered to women in accordance with rigorous criteria based on
the guidelines set by the Collège National des Gynécologues et Obstétriciens Français
CNGOF include the size of a normal pelvis , no hyperextension of the fetal head
as determined by ultrasound , the estimated fetal weight between 2500 to 3800 grams ,
perfect breech presentation , examination electrically continuous fetal heart rate
monitoring fetal wellbeing during labor informed consent pada ibu. Pada kelompok
ibu yang direncanakan persalinan pervaginam 71 sukses dan skor apgar
kurang dari 4, tidak ada perbedaan outcame yang berbeda diantara dua kelompok dan
hanya satu neonatal yang meninggal, itupun pada kelompok section caesarea.
Researchers commented on the difference between the critical management
of their population with a study population Term Breech Trial TBT . For example
the use of pelvimetry 82.4 in PREMODA and 9.8 in the Term Breech
999
successfully. Reusable stringent selection criteria that allow for a vaginal delivery .
They reported only two neonates born vaginally with Apgar score of 7 to 5
minutes .
Both have normal neurology at 6 weeks and no deaths perinata and no trauma
or neurological disorder significantly in both groups. Deans CL, Penn Z. The case
for and against vaginal breech delivery. The Obstetrician Gynaecologist
2008;10:139
–144.
Prognosis delivery with breech delivery
The infant mortality rate in the high lebith breech deliveries when
dibandiangkan with the location of the head . Naidoo Hospital in Semarang , Medan
Priyadi general Hospital and the Hospital Hasan Sadikin obtained perinatal mortality
rate respectively 38.5 , 29.4 and 16.8 . Eastman Reporting perinatal mortality
rates between 12 to 14 . The most important cause of perinatal mortality is
prematurity and handling sempuarna with less labor due to hypoxia or bleeding inside
the skull . While hypoxia caused by pinching the cord between the head and
pelvis when the head enters the pelvic cavity and due to retraction of the uterus
that can cause the release of the placenta before birth head .
Birth head Janian longer than 8 minutes after birth umbilicus will cause
fetal life . In addition bilajanin nose and mouth breathing before birth can be
dangerous because inhaled mucus can clog the airways . The danger of fetal asphyxia
caused by cord menumbung , it is often 4
5 6
7 8
Amount
1 1
10 13
4
30
3.3 3.3
33.3 43.3
13.3
100
found in breech perfect legs or buttocks legs are not perfect teeapi rare for breech
presentation . Injury to the fetal head occurs because the head must pass through the
pelvis in a shorter time than the delivery head presentation , sihingga no time for
kepaa to adjust to the shape and size of the pelvis.
The above table shows that the breech vaginal delivery , Apgar score of
babies born have low Apgar score Apgar score of 3 and higher only 8. Most babies
born in vaginal deliveries had Apgar score of 6 number of 10 infants 33.3 7
number 13 infants 43.3 .
Compression and decompression head happen quickly intervening , so Easily
cause injury to the head and bleeding in the 2.
Frequency Distribution Apgar scores at five minutes breech vaginal delivery
. skull . When Obtained disproportion
cepalopelvic , Although light in a breech delivery is very dangerous. Compression
and decompression head intervention occurs quickly , so easily cause head injury
and bleeding in the skull. When Getting a disproportion cepalopelvic , Though light in
a breech delivery is very dangerous. APGAR
Skor
5 6
7 8
9
Amount Amount
2 9
11 8
30 Percentage
6.6 30.0
36.7 26.7
100
Multiparity with good obstetric history does not always guarantee delivery in breech
would be smooth because the fetus is large can cause pelvic disproportion despite
normal size .
METHOD Research Design
Research design is comparatif study with observasional approach.
In contrast to babies born with vaginal delivery , breech babies are born
with caesarea section has a first -minute Apgar score better , ie low Apgar score 5
higher than the lowest Apgar score of babies born vaginally . Apgar scores are
also higher at highest 9 .
Samples that meet the inclusion criteria were 30 infants with breech presentation
who are born vaginally and 53 infants with breech presentation who are born with
3. Frequency Distribution APGAR Score
First Minute on Labor Sectio Caesarea With Presentation Buttocks .
section caesarea in Amelia Pare Hospital in 2010 until 2014 .
APGAR Skor
5
Amount
2
Percentage
3.8
RESULTS AND DISCUSSION 1. Frequency Distribution First Minute
APGAR scores at vaginal delivery Buttocks With Presentation
6 8 15.1 7 20 37.7
8 23 43.4
Amount 53 100
In the fifth minute Apgar score
APGAR Skor
3
Amount
1
Percentage
3.3 increased with the presentation breech
babies born vaginally . Proven in Table 4.3 can be seen that in the fifth minute Apgar
score is a minimum of five and the number
1000
of babies who have Apgar score of 7 increased to 20 infants 37.7 and
Apgar score of 8 to 23 infants 43.4 . contrast to babies born by section caesarea
has Apgar scores 8 number of 11 infants 36.7 and Apgar score of 9 number 8
infants 26.7 .
4. Frequency Distribution minute Apgar
score five on Labor Sectio Caesarea With Gluteal Presentation.
The highest Apgar score was also higher APGAR scores are 9 while the
highest babies born vaginally is 8. Most breech babies born vaginally had Apgar
APGAR Skor
5 6
7
Amount
2 9
Percentage
30.0 score 7 some 13 babies 43.3 in
contrast to babies born by section caesarea has Apgar scores 8 number of 11 infants
36.7 and Apgar score of 9 number 8 infants 26.7
8 9
Jumlah
11 8
30
36.7 26.7
100
6. Comparison of Five Minute APGAR
Scores In Vaginal Delivery And Sectio Caesarea With Gluteal Presentation.
In the fifth minute Apgar score
Vaginal delivery Childbirth Sectio
increased infant born with breech presentation dengna section caesarea .
AS ∑
∑ Caesarea
Sig 2-
Proven in Table 4.4 can be seen that in the tailed
fifth minute Apgar score maximum 9 number 8 infants 26.7
5 6
2 8.7
0.00 5.
Comparison Minute APGAR Score 7
9 30.0
3 5.7
Fist In Vaginal Delivery And Sectio Caesarea With Gluteal Presentation
Vaginal delivery Childbirth Sectio Caesarea
8 9
11 8
30
36.7 26.7
100
16 34
53
30.2 64.2
100 AS
∑ ∑
Sig 2- tailed
DISCUSSION
3 4
5 6
7 8
9 1
1 1
10 13
4
30
3.3 3.3
3.3 33.3
43.3 13.3
100
2 9
11 8
53
30.0 36.7
26.7
100
0.02 Based on statistical test obtained by
value calculated on the difference in scores Apgar in the first minute 0:02 and in the
fifth minute 0:00 smaller with alpha 0.005 , which means there are significant
differences between the scores APGAR in babies born vaginally and sectiocaesarea
and also means there are differences in morbidity where the vaginal delivery ,
morbidity is higher .
From the results of statistical tests In contrast to babies born with
vaginal delivery , breech babies are born with caesarea section has a first -minute
Apgar score better , ie low Apgar score 5 higher than the lowest Apgar score of
babies born vaginally who have low Apgar scores 3 .
The highest Apgar score was also higher APGAR scores are 9 while the
highest babies born vaginally is 8. Most breech babies born vaginally had Apgar
score 7 some 13 babies 43.3 in
1001
proved that breech babies born vaginally had a higher mrbiditas compared with
breech babies are born with section caesarea. Birth attendants entirely obstetrics
and gynecology specialist doctors so aid delivery has been done well, as evidenced
by vaginal delivery output, only 1 infant 3.3 who were born vaginally suffered
severe asphyxia in the first minute of his birth, and none of the infants who died.
However, there are still 12 infants 40
had moderate asphyxia and 17 babies have 56.67 and no one baby was born
without asphyxia or normal. Lack of good labor output can be caused by many things
one of which refers delay, delay decisions and may be due to predictions of
proportionate size and fetal pelvis performed with simple measurements
without using pelvimetry.
The results showed similar results to the study conducted by the Term Breech
Trial TBT is a large multicenter study International randomized controlled trial to
determine whether the planned labor SC safer than childbirth pervagina planned in
fetuses with breech. The study involved 2,088 women from 121 centers in 26
pervagina and costs epidural higher and the cost of neonatal intermediate and intensive
care for mothers and infants in group deliveries pervagina planned Henderson J
, Stavros P , 2010: 174 8 : 1118 to 1119 .
In contrast to the results of research , in some countries abroad , based on the
results of the study showed no difference in morbidity or asphyxia among infants born
vaginally or sectiocaesarea . The success of breech vaginal delivery due to meticulous
screening by using sophisticated equipment and careful preparation for labor , one of
them with the readiness funds to support the smooth delivery is the delivery process .
Studies on the population of Europe countries. Participants were randomly
also concluded advantage for neonates in selected, both the SC labor groups planned
or in groups pervagina planned deliveries. Data were obtained from 2083 women. Of
the 1041 women included in the group SC planned, 941 90.4 correctly - it gave
birth to the SC and from 1042 women were included in the group of labor pervagina,
591 56.7 gave birth pervagina Palencia R, Gafni A, Hannah ME, Ross S, Willan
AR, Et all 2010: 38: 490-8.
Study Term Breech Trial TBT which was published in 2000 reported that
there is a combination autcame perinatal mortality or neonatal morbidity and
neonatal serious to exclude abnormalities konginetal was significantly lower in the
group SC planned than in the group of labor pervagina planned 17 1039 [1.6] v.
521039 [5.0], relative risk [RR] 0.33, 95 confidence interval [CI] 0:19 to 0:56,
and statistically there was no significant difference in maternal morbidity and
mortality are serious between SC group planned and labor groups pervagina
planned 411041 [3.9] v. 331042 [3.2], relative risk [RR] 1:24, 95
confidence interval [CI] 0.79-1.95 Iddekinge BV 2007: 9: 171-6
TBT also provide economic evaluation showing that lower costs at
planned SC group than in the group pervagina planned deliveries 7,165
versus 8,042 [ Canadian ] . These costs are primarily related to the cost of
hospital and doctors fees for childbirth
1002
breech deliveries with SC . Selection of the population in the breech presentation has
been done with great care to examine the results of the planned delivery pervagina
compared to SC planned. A large study published in 2006 with a prospective study
of 8000 women in the maternity unit in France and Belgium , comparing labor
pervagina and SC , said that during the study period of 2001 to 2002 in France ,
labor pervagina with breech implemented in standard and offered routinely in women
according to rigorous selection criteria in accordance with the guidelines required by
the Collège National des Gynécologues et Obstétriciens Français CNGOF .
In women with childbirth pervagina planned , 71 success not only of the
Apgar score in the first 5 minutes of less than 4 , there was no difference in
individual autcome different in both groups. Only one non malformations and neonatal
death occurs in the SC group . The author commented on the criticism of Management
of the different between their population with a population of at BTM , as an
example of the use pelvimetry 82.4 versus 9.8 in the Term Breech Trial ,
fetal heart rate monitoring 100 versus 33.4 and the period at 60 minutes of the
second 0.2 versus 5.0 .
The study acknowledges that there is a slightly greater risk of neonatal
pervagina with labor , but not as it was concluded by the authors of TBT . At
willing in France conducted a rigorous selection and management guidelines to
minimize the risk . The author also published a study comparing autcome the
smaller population . Irion and friends - friends in Switzerland compare pervagina
planned 385 deliveries with the planned 320 SC maternal complications were
smaller at birth pervagina smaller and there was no difference in neonatal morbidity .
Iddekinge BV , 200 : 171-6 .
In Dublin , Alaran and friends - friends publish data from 641 deliveries ,
deliveries SC 343 planned and 298 deliveries pervagina planned , where 146 of
pervagina successful delivery . Conducted a rigorous selection on research pervagina
delivery . Reported only two neonates born pervagina have 7 Apgar score at 5 minutes
and no anomalies perinatal deaths or cases of trauma and neurological dysfunction
significantly in both groups . In this study nulliparous women were significantly less
in group deliveries pervagina than multiparous women Deans CL , Penn ,
2008: 139-44
Autcome data available from long- term neonates born with birth pervagina is
encouraging and BTM comes from the author , who has published a subgroup
analysis in 2004. This suggests that the prevalence of death or abnormal
neurodevelopment in two years did not differ between the groups and labor
pervagina Caesarean section is supported by the publication of data from a population
smaller than the more dominant BTM came from developing countries , where the ante-
natal screening and counseling be applied CL Deans , Penn , 2008 : 139-44 .
Another implication of the implementation of planning policy SC for
all deliveries with breech , will have a negative impact , namely the reduction in
the number of practitioners with the skills and experience to help pervagina with
breech deliveries . Although he has made a policy , but undiagnosed breech will happen
. Some of these women will choose breech deliveries pervagina and some women
might bring them to the doctors due date to give birth to the SC.
1003
Drycott and friends - colleagues show that emergency obstetric training can
reduce perinatal autcame on delivery to the location of the head. So training breech
deliveries may be required as the ancient art . Improved SC in the future and vaginal
birth after caesarea VBAC that can not be predicted , can be made a policy for the
selection of antenatal safe to predict whether a pregnant woman can give birth to
breech pervagina Deans CL , Penn , 2008: 139-44
Education and preparation for childbirth including potential complications
and treatment is . anatenatal important part of the service . handling is HCWs should be
professional to the patients choice to give birth pervagina or SC . The officer must
explain the importance of the effect of birth SC planned against maternal and neonatal
autcome , subsequent pregnancy outcomes and patient acceptance of choice SC. When
counseling about labor SC, we must remember that childbirth SC at risk . Based
on studies comparing SC repeats VBAC labor , we must anticipate the ultimate
choice of women for childbirth SC which is planned to heighten the incidence of
maternal morbidity , including bleeding , infection and venous thromboembolism .
Maternal mortality which occurred in the State - developed countries ,
2 to 3 times higher in SC planned labor than labor pervagina although no large
studies of the risk of maternal mortality in childbirth SC planned. Lawrence M ,
Leeman MD . Plante LA 2006 : 265-8 , Murphy DJ , Pope C , Frost J , Liebling RE
, 2003 : 1-5 .With ultrasound , the estimated fetal weight between 2500 to
3800 grams , perfect breech presentation , examination electrically continuous fetal
heart rate monitoring fetal wellbeing during labor informed consent of the mother . In
the group of women who planned vaginal delivery and a 71 success Apgar score of
less than 4 , there is no difference outcame different between the two groups and only
one neonatal death , and even then the group section caesarea .
In Indonesia the problems that often arise in the selection of the type of
delivery is the lack of readiness in planning
delivery. Failing to detect abnormalities Jakarta:
Badan Pusat
Statistik; layout , ketidaktauan the public about the
risks of labor with breech presentation , and economic problems causing people prefer
to choose a vaginal delivery without considering the risks to mother and baby .
Midwives should improve the ability to perform prenatal care and early
referral of pregnant women planning on adengan abnormalities breech . Midwives
should not be attending births with breech presentation , but the midwife as those
closest to the public should be able to help mothers and their families to understand the
condition of the mother and planning deliveries with communication ,
information and education .
SUGGESTION
The midwife must assist pregnant women to plan labor in accordance with the
2008. BKKBN. Indonesia. Buku panduan praktis
pelayanan kontrasepsi. Edisi ke-2. Jakarta BKKBN; 2006
Chapman V, Ester M. Asuhan kebidanan persalinan dan kelahiran. Jakarta:
EGC; 2006. Departemen kesehatan. Indonesia. Menuju
persalinan yang aman dan selamat agar ibu sehat bayi sehat. Jakarta:
Departemen kesehatan Indonesia; 2009.
Departemen kesehatan. Indonesia. Pedoman program perencanaan persalinan
dan pencegahan komplikasi dengan stiker. Jakarta: Departemen
kesehatan Indonesia; 2009.
Henderson J, Stavros P. The economic case for planned cesarean section for
conditions of the mother and the risk factors breech presentation
at term. so that labor can run smoothly and
complications can be prevented with good planning . With a breech pregnancy is a
pregnancy with a very high risk and should give birth in hospital There are 2 types of
labor with breech that can be chosen by the mother , which pervagina labor and breech
deliveries . Choice of type of delivery should be considered and chosen before
birth , and should consider the health National perinatal epidemiology.
[serial online]. 2006. [diunduh tanggal 19 Juli 2010];1748:1118-
1119. Tersedia dari URL: http:www.cmaj.cacgireprint174
81118 Deans CL, Penn Z. Review the case for and
against vaginal breech delivery. Obstetgynaecol. [serial online].
2008. [diunduh tanggal 19 Juli condition of the mother and the fetus and
2010];10:139-44. Tersedia dari
medical requirements that apply Vaginal delivery with a breech
presentation is done according to standard and routinely offered to women who fit the
criteria are strictly based on the guidelines set by the Collège National des
Gynécologues et Obstétriciens Français CNGOF includes the size of a normal
pelvis , no hyperextension of the head of the fetus is determined by ultrasound , fetal
weight estimates between 2500 to 3800 grams , perfect breech presentation ,
examination electrically continuous fetal heart rate monitoring fetal wellbeing during
labor informed consent of the mother . URL:
http:onlinetog.orgcgireprint103 139
Iddekinge BV. Risk management planned vaginal breech delivery :should this
be the mode of choice?. Obstetgynaecol. [serial online].
2007. [diunduh tanggal 19 Juli 2010];9:171-6. Tersedia dari URL
http:onlinetog.orgcgireprint93
171 Lawrence M, Leeman MD. Plante LA.
Patient-choice vaginal delivery?. Obstetginaecol. [serial online].
2006. [diunduh tanggal 19 Juli 2010];43:265-8.
Tersedia dari
REFERENCES Badan Pusat Statistik. Indonesia. Survai
demografi dan kesehatan Indonesia.
1004
URL: http:www.annfammed.orgcgirep
rint43265
Liu DTY, Ayu NMS. Manual persalinan. Edisi ke-3. Jakarta: EGC; 2008.
Murphy DJ, Pope C, Frost J, Liebling RE. Women‟s views on the impact of
operative delivery in the second stage of labour: qualitative
interview study. Obstetginaecol. 2003. [serial online];327:1-5.
Tersedia daru URL: http:www.bmj.comcgireprint32
774241132 Nursalam. 2003. Konsep dan Penerapan
Piane GM. Evidence practices to reduce maternal mortality: a systematic
reviw. Public health. [serial online]. 2008 [diunduh tanggal 25 Juni
2010];311:26-31. Tersedia dari URL:
http:jpubhealth.oxfordjournals.org
Saifuddin AB, Wiknjosastro GH, Affandi B, Waspodo D. Buku Panduan
praktis pelayanan kesehatan maternal dan neonatal. Edisi ke-2.
Jakarta: Yayasan bina pustaka
Metodologi Penelitian Ilmu
Sarwono prawirohardjo; 2006. Keperawatan. Jakarta : Salemba
Medika Martaadisoebrata D, Sastrawinata RS,
Saifuddin AB. Bunga rampai obstetri dan ginekologi sosial:
Perkembangan obstetri dan ginekologi sosial. Jakarta: yayasan
bina pustaka Sarwono Prawirohardjo; 2005. h. 20.
Mc Donald. Obstetri Williams. Jakarta: EGC. 1997.
Manuaba. Pengantar Kuliah Obstetri. Jakarta: EGC. 2007
Paul MF, Cawford. Use of external abdominal ice to complete external
cephalic version in term breech pregnancy. Obstetgynecol. [serial
online]. 2005. [diunduh tanggal 19 Juli 2010]:184:312-3. Tersedia
dari URL: http:www.jabfm.orgcgireprint18
4312 Palencia R, Gafni A, Hannah ME, Ross S,
Willan AR. Et all. The costs of planned cesarean versus planned
vaginal birth in the term breech trial. [serial online]. 2006. [diunduh
tanggal 19 Juli 2010];1748.[11 scrib]. Tersedia dari URL:
http:www.cmaj.cacgireprint174
81109 Pasupathy D, Wood AM, Pell JP, Fleming
M, Smith GCS. Time trend in the risk of delivery related perinatal
and neonatal death associated with breech presentation at term.
Epidemiology. [serial online]. 2008. [diunduh tanggal 19 Juli
2010];38:490-8.
Tersedia dari URL: http:ije.oxfordjournals.org
1005
ABSTRACT RISK SCREENING OF PRE-ECLAMPSIA AND ECLAMPSIA IN PREGNANT
WOMEN IN PUSKESMAS PLOSO KLATEN REGENCY KEDIRI Siti Asiyah
Advance Midwifery Study Program STIKES Karya Husada Kediri Email:
aninkamilagmail.com Pre-eclampsia in Indonesia was the second leading cause of maternal mortality, while in East
Java was the first cause of death. From year to year pre-eclampsia cases continue to rise, these conditions require preventive measures in order to reduce morbidity and mortality due to
pre-eclampsia. The research objective was to screen potential risk pregnant women to pre-eclampsia. This type of research descriptive with operational research approach, the entire
population was pregnant women in Puskesmas Ploso Klaten number of 170 pregnant women, total sampling technique sampling which met the inclusion criteria a number of 117
respondents. Data collection tools such as interview guides, tension meter, measuring weight and height. The experiment was conducted in June and July 2015. The data analysis of
frequency distribution percentages. From interviews obtained 45 pregnant women 38.46 there was a risk factor to develop pre-eclampsia, and 52.63 are factors that primigravida
pregnancy status. From the results of the examination showed 57 48.7 positive 1, 20 17.1 positive 2 and 6 5.1 positive 3. Allegedly immunologic factors contribute to
the onset of hypertension in pregnancy was proven by the fact primigravida have a greater risk of hypertension in pregnancy when compared multigravida. Whereas, of the value ROT,
MAP and IMB means that 48.7 has the potential for pre-eclampsia occurs less than 50. 17.1 has the potential to occur pre-eclampsia by 50 and 6 5.1 had the potential to
occur 75 of pre-eclampsia.
Keywords: Screening, pregnant women, the risk of pre-eclampsia
PRELIMINARY The cause of death of women
giving birth in Indonesia is divided into two, namely the direct cause of
death and cause of death indirectly. The first death is the largest cause of
highest. Diagnosis Preeclampsia is set at least
two symptoms of the triad of preeclampsia preeclampsia is the
increase in overweight marked edema,
bleeding 34, both preeclampsia and proteuria,
high blood pressure, eclampsia was 18, an indirect cause
of 18, 11 other direct causes, embolism 1, 10 abortion, sepsis
8. Sulistiono A, 2013. While the maternal mortality rate in East Java
pre-eclampsia and eclampsia 34.88, bleeding 25.09, 26.98 other causes,
heart 8.08, 4.98 infesi Maternal Mortality Report IFI and the District
se Municipality of East Java in 2012. Based on these data we can conclude
the maternal mortality rate due to pre eclampsia and eclampsia are still very
high in Indonesia, especially in East Java causes of maternal mortality are
1011
because it is pregnant supervision is very important because the cause of
death is quite high, especially in developing countries Manuaba, I;
2003. Based on observations of researchers has been applied in the
field is limited to detecting the case, then in case of pre-eclampsia is done
handling. Cases of preeclampsia may actually be predicted from the
beginning before pregnant women develop preeclampsia and can
diperkirakanan there is likely to occur with preeclampsia along with the
amount of risk, namely with
Mananyakan previous history and risk factors of pregnant women as well as
perform a physical examination that sederhanan such as blood pressure and
weight measurements. With predicted time of the research was not in
place, or have been diagnosed with pre-eclampsia. In this study,
the sampling techniques used in a way without random
non-random
from the beginning about the risk of
sampling.
Retrieval technique pre-eclampsia can be carried out
preventive measures so as not to place pre-eclampsia. The positive impact
kedepanya could lower the maternal mortality rate due to a case of
pre-eclampsia. METHODS
This type of research is descriptive or explanatory research
ecplanatory research
with the approach of
operational research,
being used is
total sampling.
Ie the sampling is done by taking the
overall research subject who met the inclusion criteria.Sadangkan
sample in this research were 117 pregnant women. Manual data
collection tools such as interviews to multiply medical history and
risk factors, as well as the tension meter airaksa to check blood
pressure, weight scales that have
because this research is to been re-calibrated
and height implement the process of antenatal
care in screening the risk of pre-eclampsia, to do an interview
and blood pressure check and counting IMB pregnant women,
resulting uotput pregnant women have a risk of pre-eclampsia
terdeksi Hidayat A, 2010. The variable in this study is a single
gauges. Data were collected in two ways interview and
examination of blood pressure, weight and height.
RESULTS Results interview Risk factors for
pre-eclampsia Table 1 Distribution Frequency
Pre-eclampsia risk
variable, as it only aims to find the big picture case, without
No. Risk factors preeclampsia
for Frequency
performing analytical tests. The variables in this study are the risk
factors and clinical symptoms of pre-eclampsia risk. The population
1. 2.
No risk There are R isk
amount 72
45 117
61.53 38.46
100
in this study were all pregnant women who are in the working
area of Puskesmas Plosoklaten totaling 170 people from four
villages namely distance 66, Village Klanderan 16 Kawedusan
Village 43, Village Gondang 45 people. Inclusion criteria were
common characteristics of research subjects in the target
population and the population to be studied affordable. Nurasalam,
2010 criteria for inclusion in this study were pregnant women who
were in the area, Willing respondents, more than 20 weeks
gestational age. The exclusion criteria is to eliminate or exclude
subjects who meet the inclusion criteria for various reasons.
Nursalam 2010 The exclusion criteria in this study were At the
1012
From the table above shows the respondents obtained 45 of 117
pregnant women 38.46 there is a risk factor to develop pre-eclampsia.
Table 2 Distribution of Frequency of types of risk Pre eclampsia
No. Risk factors for Frequenc preeclampsia y
1. Primigravida 30 2. Age risky 14
3 A history of pre eclampsia 1 4 Illness 7
History of 4 hypertension 1
Diabetes Tooth ache
amount 57 From the table above types of risk actors
are 52.63 of the factors, namely pregnancy status or nulliparous pregnant
the first time. P rosentase
52.63 24.56
1.75 12.3
7.01 1.75
100
3
shows that of the 117 respondents almost
Factor F
F 1
No 34
29.1 symptoms
2 Positive
56 47.9
1 0.9
1 P3 rosentase
Positive 20
17.1 2
4 Positive
6 5.1
3 Amount
116 99.1
1 0.9
Based on the contingency table above shows that of the 117 respondents almost
half of the respondents, 56 respondents 47.9 showed positive clinical
symptoms 1 the case of preeclampsia in pregnant women in the family there is a
history of preeclampsia.
Frequency Table 9 Effect of pregnancy status nulliparous with clinical symptoms of
pre-eclampsia risk. 20No. Clinical 17.1 Primigravida
Total symptoms
amount 117
100 Based on the above table shows that of the
117 respondents surveyed nearly half of the respondents, there were 83 respondents
70.9 positive for risk, and almost half, or 20 respondents positive 2.
Table 7 Effect of maternal age with clinical symptoms of pre-eclampsia risk
No. Clinical symptoms Age of mother
Total No Factor
There Factor
Physical examination F
F Table 3 Distribution assessment ROT
Roll
1 No symptoms
29 24.8
5
Over Test
2 Positive 1
50 42.7
7 No. Value ROT
Frequency P rosentase Positive 2
18 15.4
2 1.
Positive 76
65 4 Positive 3
6 5.1
2. Negative
41 35 Amount
103 88.0
1 Based on the contingency table above
amount 117
100 Based on the above table shows that of the
117 respondents surveyed most of the respondents, there were 76 respondents
65 had a positive ROT value. Table 4 Distribution of ratings MAP
Mean Arterial Pressure
half of the respondents, 50 respondents 42.7 showed positive clinical
symptoms 1 occurs at the age of preeclampsia that there is no risk factors
for preeclampsia. Table 8 Effect of families with a history of
No. Value MAP Frequency P rosentase
pre-eclampsia with clinical 1.
2. Positive
Negative 28
89 23.9
76.1 symptoms of pre-eclampsia
risk No Clinical
Families with a history of Pre Total amount
117 100
. symptoms Eclampsia
Based on the above table shows that of the 117 respondents surveyed almost all
respondents, there were 28 respondents 23.9 had a positive MAP value.
Table 5 Distribution of ratings BMI Body mass index
No. Value IMB Frequency 1. Positive 12 10.3
2. Negative 105 89.7 amount 117 100
Based on the above table shows that of the 117 respondents surveyed almost all
respondents, there were 12 respondents 10.3, body mass index is not a risk of
pre-eclampsia. Table 6 Distribution scoring of clinical
symptoms of pre-eclampsia risk of Value ROT, MAP and IMB
No. The risk of pre-eclampsia P rosentase 1. No symptoms 34
29.1 2. Positive 1 57 48.7
3. Positive 2 4. Positive 3 6 5.1
1 No symptoms 24 20.6 10 8.5 34 29.1 2 Positive 1 46 39.3 11 9.4 57 48.7
3 Positive 2 13 11.1 7 6.0 20 17.1 4 Positive 3 4 3.4 2 1.7 6 5.1
amount 84 74.4 30 25.6 117 100
The relationship of risk factors with clinical symptoms
1013
No Factor There
No Factor There Factor F F F
Based on the contingency table above shows that of the 117 respondents almost
half of the respondents, 46 respondents 39.3 showed positive clinical
symptoms 1 the case of preeclampsia in pregnant women whose pregnancy status
F 34 29.1
57 48.7 20 17.1
6 5.1 117100
is not at risk of preeclampsia. DISCUSSION
From interviews obtained 45 pregnant women 38.46 there is a risk factor to
develop pre-eclampsia, and 52.63 were of factors, namely pregnancy status
primigravid or pregnant the first time. Many risk factors for pre-eclampsia occurs
one of which is primigravida first pregnancy this can be explained on the
theory of immunologic intolenransi mother and fetus. Allegedly immunologic
factors contribute to the onset of hypertension in pregnancy is proven by
the fact primigravid have a greater risk of hypertension in pregnancy when compared
multigravida Angsar D, 2010. Normal maternal immune response does not reject
the products of conception which is foreign. This is because the
human leukocyte antigen protein
G HLA-G, which plays a role in modulating the
immune response, so she did not reject the products of conception placenta. HLA-G
in the placenta protects the fetus from lysis by trafoblas Natural killer cells NK
mother. Boutiler PL, Mallet V, 1977.
HLA â € G facilitate trafoblas invasion into the maternal decidua tissue. In the
placenta of hypertension in pregnancy HLA-G downhill and easy inflammatory
reaction Yie Shang-mian, et al, 2004 At the beginning of the second trimester of
pregnancy women have a tendency to occur with preeclampsia, turns out to have
the proportion of helper cells is lower than the tension of normal Dikman A, John
CM, 2010. From the results of who develop preeclampsia 26 will
develop preeclampsia daughter, son-in-law while 8 had preeclampsia Riedman C,
Walker I.1992 From the results of the examination of
symptoms clinics, 76 respondents 65 had a positive ROT value. ROT value is
the measurement by comparing two measurements of First Instance in the
supine position and then second on his side if the difference between the two is
more or equal to 9 mm Hg then tested positive for risk of pre-eclampsia
Sulistiono A, 2014. ROT value but less accurate if used as a measure of the risk of
pre-eclampsia compared to the value of MAP Gumilar E, 2013. MAP calculation
of 28 respondents 23.9 had a positive MAP value. 12 respondents 10.3, body
mass index, a risk of pre-eclampsia. Of the value ROT, MAP and IMB are combined
and create a score for risk of pre-eclampsia. Ie if positive 2 the mother is potentially
the case of pre-eclampsia 50, and if positive 3 potential of 75 will occur
pre-eclampsia Gumilar E, 2013 From the results, the results of 57 48.7 positive
1 , 20 17.1 positive 2 and 6 5.1 Positive 3. This means that 48.7 has
the potential for pre-eclampsia occurs less than 50, while the positive 2 a 17.1
has the potential to occur pre-eclampsia by 50 and 6 5.1 had the potential to
occur pre eclampsia 75. If the positive results obtained 2 and positive 3 then
the mother must be referred to a doctor for preventive drug therapy of hypertension so
as not to occur pre-eclampsia Sulistiono
cross-tabulations contingency tables
A, 2014. Such screening is very easy and between primigravida with clinical
symptoms obtained 20 positive pregnant women at risk of pre-eclampsia consists of
11 9.4 positive 1, 7 6.0 positive 2 and 2 1.7 positive 3. Bardasar
this data it is very important to pay attention to possible cases of
inexpensive. Easy as can be done by medical personnel as well as the primary
medical provider midwives spearhead pelanyanan antenatal care at the level of
basic services such as health centers or villages.Membutukan cheap because only
simple equipment. But although simply
pre-eclampsia in pregnant women
remains to be done with the correct primigravida. Besides other risk factors
such as maternal age and a history of pre-eclampsia, hypertension history in
keluanga also need to be aware of. The existence of heredity with a single gene.
methods and with standard tools. From the study results mutkhir mentioned variations
between operators large enough that could affect the diagnosis of high blood pressure
in pregnancy Duggan, and Mileen 1998;
More maternal genes in determining Brown and Simpson,
1992, Derry; hypertension when compared with
genotype janin.Telah proven that women
1014
Wilkinson et al, 1991. For this reason it is suggested that the mother lying in the
same position every blood pressure checks. Checks should be made guidelines for
blood pressure in pregnancy are strictly Shoop. DIV Midwives Stikes Karya
Husada. Kediri December 21 2014 defined, checks the blood pressure of
Yie Shang-play, Liang-hong Li, Yue
pregnant women with a sitting or lying Li-mei, Librach C. HLA-G
protein position with the back left ditingikan with
pillows, sebaikya the left arm IBI Center, 2006.
concentration in placental tissue
preeclamsia, Am J maternal serum and
are Decreased in Obstet Gynecal, 2004;
191: 525-9 BIBLIOGRAPHY
Angsar D, Mose JC, Hypertension In Pregnancy, Obstetrics Sarwono
Prawiroharjo.BP-SP. Jakarta.2010, 534-35 Boutiller PL, V. Mallet HLA-G
in Pragnancy, Review of Reproduction, 1997;
2: 7-13 Brown MA, Jm Simpson, 1992, Diversity
of Blood pressure recording during Pregnancy: implications for the
hypotensive disorders.Med March 2 J Aust 1992; 156 5: 306-308
Duggan, and Mileen 1998. Blood Pressure Measurements in Pregnancy: The US in a
survey of methods used in theaching hospitals in south Australia. Aus NZ J
Obstet Gynaecol 1998.
Deeker GD.Risk Factor for preeclamsia. Clinical Obstrtris and Gynecology.
1999.42: 422-35 Gumilar ED, Akbar A I.2013.Deteksi
Early preeclampsia. Division Feto maternal Dpt SMF Obstretri
Gynekology.RS Dr.Soetomo. Airlangga University School of Medicine. Surabaya.
IBI Indonesian Midwives Association. Services 2006.Standar
kebidanan.IBI.Jakarta
Maternal Mortality report Sekabupaten and City in East Java, 2012
Manuaba I BG, Manuaba C AI, Manuaba F IBG.2007. Introductory Lectures Obstretri,
Chapter 6 Komplokasi In Pregnancy, Hypertension in Pregnancy. EGC. Jakarta
Riedman C, Walker I. preeclamsia The Fact.Oxford University Press, New York,
1992: 130-3
Sulistiono A.Deteksi early preeclampsia and management of pre-referral. Work
1015
CONTINGENCY TRAINING ROLE OF EARLY IN THE COMMUNITY TO IMPROVE PREPAREDNESS OF TSUNAMI HAZARD ON SIDEM BEACH
TULUNGAGUNG 2015
Siti Nurhasanah
STIKes Hutama Abdi Husada Tulungagung
stikeshahtayahoo.co.id Abstract
Indonesia is a country which in Ring of Fire region, its makes Indonesia have some kind of the potensial disaster, one of them is Tsunami. Preparedness is very important to the community, so
we need training early contingencies. In this study Pre-experimental design was used to form one group pretest and post test, as a pretest given questionnaires and as treatment given lectures
and leaflets ended with giving the same questionnaire again with a pre-test questionnaire, the number of respondents are 20 people. The results based on the statistical test with Wilcoxon
Signed Rank test obtained significant value of 0.000 which is smaller than the value of α 0.05. This suggests that the hypothesis is accepted which means that there are differences in the
tsunami hazard preparedness in Sidem Beach Tulungagung before and after the training is conducted. So counseling or training is essential once performed on people who are not
equipped to improve preparedness against tsunami hazard.
Keywords: contingencies, preparedness and tsunami
PRELIMINARY
Disaster had often heard all the good people in the media such as television,
RESEARCH METHODS
The design in this research is using the pre-experimental easily done even if
newspapers, radio and other media. there is a weakness in terms of internal
Catastrophic events is something bad happens to a person or group of people,
such as tsunami, floods, earthquakes, volcanoes and therefore make peoples lost
property, objects and even lives. Tsunami is a terrible disaster. Our country is prone to
disasters, both natural and man-made.
Early contingency training to improve the preparedness of the
community is very important to do by everyone, especially those located
around the coast. Training is planned any attempt to influence, increase
knowledge and change the behavior of other individuals, groups or
communities that contingency training early heading towards the positive must
be implemented by all the people, especially the early contingency training
on the handling of the tsunami disaster.
1060 validity and external validity.
The population in this study are all coastal communities that fit the criteria in
Sidem who do not get early counseling about training of contingentcy, there are 20
people.
The sample in this study is equal to the total sample or study population.
The sampling technique used by researchers is total sampling, which means the
determination of the sample by selecting all of the samples that match the criteria.
Independent variables: contingency early training. Variable dependent : tsunami
hazard preparedness.
RESEARCH RESULT
respondents. Recapitulation of research respondents
If it compared the greatest frequency before based on results of a questionnaire
and after training there is an increase, from distributed before and after training on an
early contingent on the community to improve preparedness against tsunami
hazard on the Sidem beach Tulungagung can be presented in frequency distribution
table as follows: enough category to good category.
Nevertheless, it should be further analyzed whether there are statistically significant
increase.
DISCUSSION
Respondents from Sidem beach 1. Against Tsunami Hazard Preparedness
Before Training Descriptive analysis of tsunami hazard
preparedness against the respondent before the training given.
Tulungagung selected as many as 20 people and were given a questionnaire before
training. The result was 14 70.0 of respondents have sufficient preparedness in
the category preparedness against tsunami hazard, 4 20.0 of respondents have
preparedness in the poor category in the
The frequency distribution of
tsunami hazard preparedness and only 2
respondents by Tsunami Hazard
10.0 of respondents have preparedness
Preparedness Against Before Training. in the category lacking in preparedness
Preparedness Less
Enough Good
Total
Total 4
14 2
20 20,0
70,0 10,0
100,0
against tsunami hazard. Some respondents don‟t understand
about knowing the causes of tsunamis and how to save themselves if tsunami occur.
Results of the questionnaire showed that respondents only know that when there is a
Based on the data in the table was preparedness respondent before given
training, the most are in the category enough, as many as 14 70.0 of
respondents.
2. Against Tsunami Hazard Preparedness Training After Descriptive analysis of
tsunami hazard preparedness respondents were given after the
training.
The frequency distribution of respondents by Tsunami Hazard
Preparedness Against After Training
Preparedness Total
danger sign should immediately save themselves. They don‟t know how to save
themselves from tsunami correctly. After training, respondents given and
the result is no respondents who have less preparedness against tsunami, 2 10.0 of
respondents have sufficient preparedness in the category in tsunami hazard
preparedness and almost all respondents have preparedness in both categories in
preparedness against the dangers of tsunamis, which is 18 90 of
respondents.
Results of statistical test to Wilcoxon Signed Rank test obtained significant value
of 0.000 which is smaller than the value of α 0.05. This suggests that the hypothesis
Less Enough
Good Total
2 18
20 0,0
10,0 90,0
100,0
is accepted which means that there are differences in the tsunami hazard
preparedness Sidem Beach Tulungagung before and after training.
Changes in tsunami hazard Based on the table above, it turns
preparedness is evident in the age group out after the
responder preparedness 30 years - 60 years with significant value
training given, that most are in the category of good, as many as 18 90.0 of
1061 0.005. These results indicate that young age
is easier to understand the contingency
training than those aged 60 years. While based education is a significant value of
0.031 with higher education more easily to understand the contingency training than
respondents with elementary school. Based on the work of no significance to the
changing understanding of contingency training, where the results of a statistical
test 0.05, which is 0.773 which means that education has no effect in changing
understanding of contingency training. While at work as fishermen have a good
improvement, because fishermen will better know signs of a tsunami than the other jobs
of the respondents. Carter. 1998.
Konsep Resiko Analisa Bencana
Direktorat Jendral Bina Kesehatan. 2006.
Pedoman Penanganan Bencana Secara Umum
. Departemen Kesehatan RI.
Notoatmodjo, Soekidjo. 2002.
Metodologi Penelitian Kesehatan.
Jakarta : Rineka Cipta.
Nursalam dan Pariani, Siti. 2001.
Pendekatan Praktis Metodologi Riset Keperawatan
. Jakarta : CV Sagung Seto.
Panduan pembuatan tesis, Universitas Airlangga Surabaya, 2014
Prof.Dr.M.Zainudin, 2011 .Metodologi Penelitian
Farmasi dan
CONCLUSION
Before training contingent, there Kesehatan,Airlangga university
press. were 14 70.0 of respondents have
Riwidikdo, Handoko. 2012.
Statistik
sufficient preparedness in the category, 4 20.0 of respondents have preparedness
Kesehatan : Belajar Mudah Teknik Analisis Data dalam
in the poor category and only 2 10.0 of
Penelitian Kesehatan.
Cetakan respondents have preparedness in the poor
category. Keempat. Yogyakarta : Mitra
Cendikia Press. After training
contingency no
Sukardi. E Maramis WF.1986.
Evaluasi
respondents who have preparedness in the
PelatihanPembelajaran
: poor category, 2 10.0 of respondents
have sufficient preparedness in the category Penilaian Keberhasilan
Pembelajaran. Applied and
nearly all respondents
have Approoach.
preparedness in either category, namely 18 90 of respondents.
BIBLIOGRAPHY
Anderson. 1998.
Konsep Bencana
Bakornas. 2005.
Pengantar Perencanaan Kontijensi : Manajeman Kedaruratan dan
Perencanaan Kontijensi
. Painan. INEE. 2012.
Standar Minimum untuk Pendidikan : Kesiapsiagaan, Respons,
Pemulihan.
Jakarta : INEE World Conference on Disaster
Reduction, 18-22 January 2005, Kobe,
Hyogo, Japan, International Strategy for Disaster
Reduction WHO. 2005.
Hyogo Framework for ; Action 2005-2015 : Buliding the
BNPB. 2011.
Panduan Perencanaan Resilience of Nations and
Kontijensi Menghadapi Bencana.
Edisi Kedua. Jakarta : BNPB. BNPB. 2008.
Peraturan Kepala Badan Nasional Penanggulangan
Bencana Nomor ; 4 Tahun 2008 tentang Pedoman Penyusunan
Rencana Penanggulangan Bencana.
Jakarta : BNPB. Budiarjo L Irawati.P.Prasasti T. 1994.
Mengajar Di Perguruan Tinggi :
Direktorat Jendral Pendidikan Tinggi
1062
Communities to Disasters.
Kobe : WHO
1063
STUDY OF KNOWLEDGE IN CHILDREN OF DISEASES DIPHTHERIA POSYANDU 8 BAGO VILLAGES IN DISTRICT TULUNGAGUNG
2015 Yeni Setyo Prastiwi
1
Azmi Bagus Prayogo
2
STIKes Hutama Abdi Husada Tulungagung
Email: mecino06.mail.com
Abstract Diphtheria is a disease caused by Corynebacterium diphtheria. The purpose of this study
was to identify the knowledge of mothers about diphtheria. Design used in this research is descriptive using the techniques in making Total Sampling with a population of 35 people
and a sample of 35 respondents.Data dikumpulks using a questionnaire measuring instrument. with the data collection technique the researchers came to the Posyandu then
perform the informed concent then gave questionnaires to respondents.The data obtained and dioalah through the steps: Editing, Coding, Sorting, Scoring, Tabulating, then
presented in tabular form of distribution, frequency and narrative and presented to be analyzed descriptively using the formula: P= SpSm x 100. From the research, it was
found that knowledge of mothers of diphtheria in IHC 8 Village Bago Tulungagung gained 6 respondents 17.1 were included in either category, 22 respondents 62.9
in the category of pretty, 7 respondents 20 fall into the category of less. Results showed an average of all 35 respondents found the knowledge level of 66.8 and are
included in the category enough.So the need for additional insight on diphtheria that better knowledge of the respondent.
Keyword: Knowledge, mother, children under five, diphtheria.
PRELIMINARY
Diphtheria is an acute infectious disease that is highly contagious that
occur locally on mucosal respiratory tract or skin, produced by bacillus gram-
positive Corynebacterium diphtheria, is characterized by the formation of
exudate shaped membrane at the site of infection, followed by general
symptoms caused by an exotoxin produced by this bacillus. SudoyoAru,
especially in East Java, in 2011 occurred 665 cases, in 2012 there were 954 cases
and in 2013 then occurs 333. http:dinkes.jatimprov.go.id, whereas
in Tulungagung itself occurred 9 cases in 2011 and then in 2012 increased to 16
cases and in 2013 the Department of Health Tulungagung noted there were
22 cases of diphtheria with most events in the village of Bago with 4 cases, one
incident is in RT 02 RW 03 who entered the village Bago IHC 8. Previous
et al 2009.
environment in the village of Bago Number of diphtheria cases and
deaths continue to increase, if no action never occurred case diphtheria
especially the last 3 years there were no is more intensive expected to be
cases of diphtheria there.
increased drastically. http:www.smallcrab.com.
In Indonesia in 2011 occurred 806 cases, in 2012 there were 1,192 cases in
2013 and 778 cases last occurred. Has been an outbreak of diphtheria cases,
1067 http:www.dinkes.tulungagung.go.id
According Notoatmojo 2007, human behavior is the result of
knowledge, if knowledge is less then the urge to behave lakupun less. Mothers
who lack knowledge about the disease
diphtheria, an effect on behavior,
percentage of sentences that are namely the lack of maternal sensitivity
to the signs and symptoms of diphtheria. In addition to mothers lack of
knowledge about the disease diphtheria are also due to the lack of information
from the health service. Notoatmojo 2007
Lack of knowledge of mothers of diphtheria at risk of increased
transmission of the disease, because the signs and symptoms of diphtheria is
almost the same as influenza, so many mothers who thought that the boy was
only suffering from the flu, but in fact are experiencing the early phase of the
disease diphtheria.
Diphtheria disease itself is a disease common in the throat, and common
problems that occur on the sufferer is pain that cause children to swallow hard
to eat, and when this happens continuously will result in nutritional
deficiencies children. SudoyoAru, et al 2009.
To anticipate the spread of diphtheria required a knowledge that will form a
behavior and consciousness. To increase knowledge about the disease diphtheria
mother needed an education about the disease and how to prevent diphtheria
the start of which provide immunity in children by: DPT immunization for
Toddlers.
Immunizations given 3 times that at the age of 2 months, 3 months and 4
months, avoid direct contact with patients. Maintaining personal hygiene,
qualitative Arikunto, 2006. The population in this study are all mothers
in the village of Bago IHC 8 Tulungagung. Total population in this
study as many as 35 people. The sample in this study are all mothers in IHC 8
Village Bago Tulungagung numbering as many as 35 people. In this study,
using total sampling technique in which the entire population is used as a
research subject. The variable in this study is a single variable, namely Mrs.
Knowledge Village Toddlers in Posyandu 8 Bago Tulungagung 2015.
After the questionnaires distributed, data collection, after the data obtained
do data processing Editing, Coding,
Sorting, Scoring, Tabulating,
then the data were analyzed result is a percentage
using the formula P = Sp Sm x 100. Description:
P is the percentage obtained, Sp is the score obtained, SM is the highest score
is expected. The processing of the data is interpreted in the sentence qualitative
criteria: good = 76-100, quite = 56- 75, and less = 56 Nursalam,
2013.
RESEARCH RESULT Mother Knowledge About Disease
Diphtheria Toddlers Table 1 : Distribution of frequency of
knowledge of mothers of diphtheria in IHC 8 Village
Bago Tulungagung 2015.
to maintain stamina by eating nutritious foods and exercising wash hands before
eating, perform regular health checks. From the description above, the
authors are interested to investigate
N o
1 2
3 Knowledg
e Good
Just Less than
Frequenc y
6 22
7 Percen
t 17,1
62,9 20
further the knowledge of mothers of diphtheria in Posyandu 8 Village Bago
Tulungagung
RESEARCH METHODS
In this research using descriptive research design, ie when the fixed data
collected, summed compared with the
amount 35 100 Average Just 66,3
Source: Questionnaire Research 2015 Based on Table 1 above shows that the
majority of mothers knowledge of diphtheria in IHC 8 village Bago, from
expected number and percentage obtained. From then interpreted by the
1068 35 respondents
there were 22
respondents 62.9
with enough
found in educated respondents College knowledge.
DISCUSSION
Based on Table 1 above shows that most of the mothers knowledge of
diphtheria in IHC 8 Village Bago in 2015 from 35 respondents obtained 22
respondents 62.9 knowledgeable enough, with the average of the whole is
as much as 66.3.
According to the theory of as many as 6 people 17 which is
considered as a high level of education, so it feels natural that mothers
knowledge of diphtheria in the category enough.
CONCLUSIONS AND SUGGESTIONS
A. CONCLUSION Knowledge mothers of diphtheria in
IHC 8 Village Bago Tulungagung using Notoadmodjo 2003
knowledge is a questionnaire sheet obtained results
influenced by two factors: internal and external factors, wherein the internal
from 35 respondents obtained an average of the whole is as much as
factors include age,
intelligence, 66.3 are in the category enough.
attitude, personality,
whereas the
external factors include
the
A. ADVICE
environment, education, employment, resources, religion, socio-economic, and
cultural. From the results it can be seen that
there is conformity between facts and theories, where the work can affect a
persons knowledge, where most respondents worked as IRT as many as
15 people 43. Based on the theory Notoadmodjo 2003, someone who is
busy with the day-to-day work or activities will have a little free time in
obtaining the information. But even so the results of the study showed that
knowledge of mothers of diphtheria in fair category. It is also due precisely to
the preoccupations of respondents often interact with others, so it is more often
gets information, therefore it is considered reasonable if the knowledge
of mothers of diphtheria in the category enough.
In addition to occupation, age may also affect the level of knowledge.
Where most of the respondents aged 31- 40 years as many as 14 people 40.
At this age of the respondents have a lot of experience so it can easily receive
information.
Education is also very influential in the level of knowledge, which the
majority of respondents had high school as many as 15 people 43 to say the
category of education level is quite high, but the good knowledge are mostly
1069 1. Theoretical Suggestions
Theoretically, the results of this study are expected to be an addition to the
information and can add knowledge to the mothers of diphtheria.
2. Practical Advice a. For the Respondents
Society in particular mothers should increase knowledge about diphtheria,
for example by seeking the necessary information from the print or
electronic media, and following the extension of health.
b. For Researchers Places As input information and knowledge,
as well as education media about diphtheria.
c. For Educational Institutions Expected educational institutions can
use the results of this study as additional material information for
learning in the educational process, so that the student and the student
can contribute for example, counseling and motivation directly to
the public.
d. For Further Research
Results of this study can be used as a reference for research on what
factors are likely to influence the level of knowledge of mothers about
diphtheria.
ACKNOWLEDGEMENT REFERENCE
Arikunto, S. 2006. Research Procedure A Practice Approach. Jakarta: PT.
Rineka Reserved. Alimul, Aziz. 2007. Nursing Research
and Scientific Writing Techniques. Jakarta: Salemba
Medika.
Hidayat, Aziz Alimul, 2008. Methods Data Analysis Techniques.
Jakarta: Salemba Medika. Gunarso, S, 2010. Concepts and Health
Education, Jakarta: PT. Gramedia Pustaka Utama.
Koencoroningrat, 2013. Book Introduction to Anthropology.
Mubarak, Iqbal, Zahid, 2007. Book Health Promotion. Jakarta: Graha
Science Notoadmojo S. 2007. Health Education
and Behavior. Jakarta: Rineka Reserved.
Nursalam. 2013. Practical Approach Nursing Research Methodology.
Jakarta: Salemba Medika.
Nurul, Effendy. 2011. Science Communication Theory and
Practice. Bandung: PT. Teens Rosdakarya.
Sudoyo Aru, et al. 2009. Textbook of Medicine. Jakarta: Salemba
Medika. Setiadi. 2007. The concept and writing
of Nursing Research. Surabaya: Cipta Graha.
http:www.smallcrab.com Accessed October 27 2014 Time: 16:54 pm
Jakarta: Salemba Medika. http:dinkes.jatimprov.go.id Accessed
Muaris, H, 2006. Textbook of Pediatrics, Volume 2. Jakarta: PT.
Gramedia Pustaka Utama
1070 October 27, 2014 Time: 17:03 pm
1071
The Effect of Health Education About Circumcision Against Anxiety in Children who will do Circumcision Actions
in Campurdarat, Tulungagung Hadi Santoso
STIKes Hutama Abdi Husada Tulungagung
Email:
Hadisantoso.stikesgmail Abstract
Anxiety is a condition in which individuals or groups to experience feelings that are difficult or scared and nervous activity decreased in responding to the threat of non-
specific uncertainty. Anxiety often appear in children who will be taken circumcision. Most of them feel anxious because of a lack of knowledge. One way to
improve knowledge in these children is to provide health education among them is the provision of leaflets. Of the problem researchers aimed to determine the effect of the
provision of leaflets about the circumcision procedure on the level of anxiety in children that will be taken circumcision. The study design used was quasi experiment with
methods of pre-test post test.Using incidental sampling technique with the subjects children will be taken circumcision in the district Campurdarat Tulungagung by the
number of 20 respondents fit the inclusion criteria. Data collection techniques used quisioner HARS scale to determine the anxiety level of each respondent according to the
criteria. so that unknown percentage of respondents according to their level. Furthermore, the data tekumpul processed using SPSS statistical test Statistical Product and Service
Solution windows version 13 by the Wilcoxon Signed Rank test analysis with the results of Test p 0.05, where H0 is rejected, which means no influence. From the results
obtained Wilcoxon statistical test where p = 0.002 p 0.05, so H0 is rejected and H1 accepted which means there is a leaflet giving the effect of circumcision procedure on the
level of anxiety in children that will be taken circumcision. Thus needs to be given leaflets about the circumcision procedure to the child that will be taken circumcision to
reduce anxiety.
Keywords: Emergency, Grant Leaflet, and Circumsicion INTRODUCTION
procedures and anasthesia. One form of One of the circumsicion‟s respon
is anxiety. Anxiety is a condition in which individual or groups feel difficult
or scared and nervous activity decreased in responding to the threat of non-
specific uncertainty Carpenito, 1995, 132. Surgery is difficult experience for
more patients. Many bad things can happen too, and it will danger for
patients. So patients and families often show their attitude which unusually with
their anxiety that they feel. Usually, treatment efforts that can be done to
minimize or reduce anxiety in children is through health education. Health
education is all the effort planned to influence other people, groups, or
communities so that they do what would be expected by educational actors. Prof.
Dr. Soekidjo, Notoatmodjo. 1996.
As a media of helath education, namely leaflets. Leaflet is a form of
information delivery or health education through the sheets are folded. The
their anxiety correlates with all
information content can be in the form procedures which must doing by patients
and also threaten safety life for the impact of many surgical operation
1074 of words or images or a combination.
Prof.Dr.Soekidjo, Notoatmodjo. 1996
From the children who lack In this study, there is only the
primary health education
about treatment group were given a leaflet
circumcision, it can cause anxiety. From some incidents of phenomena in society,
when it will circumcision done, almost of the children feel anxious at times.
Beside that, researcher also had same experience, it was high anxiety when it
about the treatment of anxiety in children to be performed circumcision.
Observations carried out before and after treatment was given to the respondent.
Population in this study are the children to be performed circumcision in
will be taken circumcision
Campurdarat, Tulungagung. circumcision.
From the results of the The sample of this research is the
children known to be doing circumcision preliminary study that researchers do in
in Campurdarat and include in
the Campurdarat, October 2011, 9
Tulungagung in respondents who
inclusion criteria. In this study, sampling technique
interviewed, 8 of them said anxious at a that means incidental
sampling time will be taken circumcision, one of
them said no problem. The impacts of anxiety can make them fear, tense and
restless when it will be taken circumcision. They also have difficulty
sleeping as well as diseases such as headaches, increased blood and so on.
All of it due to the mental technique sampling is done by chance
encountered by researchers Latipun, 2008, while independent variable in this
study is the provision of leaflets about the circumcision procedure. In this
study, researchers collected data by observing the childs anxiety level will
be taken circumcision using HARS
pressure will be taken when the
before being given treatment for the circumcision. Of the impact of these
concerns, it need support systems such as family or the closest person who will
provision of leaflets about the circumcision procedure. Then the child
is treated by administration of leaflets listen and
give advice. Emotional
about the circumcision procedure, after support will be very useful for someone
who is getting anxiety. The role of health workers is needed to provide
health education about circumcision procedures in the implementation of
measures that circumcision can decrease anxiety in children and the children feel
calm and ready to do circumcision.
Based from description above, the researchers interested in conducting
research with title The Effect of health education about circumcision to anxiety
in children to be performed circumcision in Campurdarat Tulungagung..
the treatment is given to children who will be circumcision researchers
observed another childs anxiety levels to be performed the circumcision. After
the data collected from the observation level of anxiety children to be performed
circumcision before and after treatment of the data will be processed by the
editing, coding, sorting, tabulating and scoring. Then the data were analyzed
using Wilcoxon Signed Rank test that will show the influence of whether or
not the provision of leaflets anxiety about the procedure of circumcision
against children will be taken
RESEARCH METHODOLOGY
sircumcision. Wilcoxon signed rank test This
study uses Quasi was used to test the hypothesis of
experiments with pre test - post test. This design does not use a control
group. This draft seeks to strengthen the causal relationship to the group by
comparing the results of the pretest and significance comparatif two samples are
correlated when the data in ordinal tiered .To determine whether the effect
of health education about circumcision procedure with leaflets against the
post-test but without making a
childs anxiety will circumcision in comparison with the influence imposed
on other groups. Nursalam, 2001.
1075 Campurdarat, Tulungagung, using a
computer with a technique SPSS
Statistical Product and Service Solution Version 13 of Windows. To determine
Wilcoxon Signed Rank Test p value = 0.02, with p 0,05 so that H0 rejected
the level of significance between
and H1 accepted which means that there variables in a meaningful measurement
of the effect of the level of significance was p 0.05 that means H0 rejected H1
accepted, there is influence between the is significant influence between the
provision of leaflets about the circumcision procedure against the
childs anxiety level that will act
variables measured. circumcision.
Health education administration leaflet is the
RESEARCH RESULT
From 20 respondents before being educational activities undertaken by
spreading the message, instill confidence given health
education about so that people are not only conscious,
circumcision, most of as many as 11 respondents experiencing moderate
anxiety level with the percentage of 55 and then after a given health education
about circumcision most of which were 9 respondents experiencing mild anxiety
level with a percentage of 45. While, Wilcoxon Signed Rank Test that
know, and understand, but is also willing and able to carry out the
suggestion that has to do with health. Anwar, 1993. Information will be an
impact on a persons knowledge. Wied Hary A. 1998 Accurate information can
help eliminate fear and reduce anxiety Depkes RI, 1998. Referring to theory
researchers do p value = 0.02, with p above and
associated with cross 0,05 so that H0 rejected and H1
accepted, that means there is significant influence between the provision of
tabulation shows that anxiety most happen at children aged 11-15 years
with previous secondary school leaflets
about the circumcision education is as much as 6 children with
procedure against the childs anxiety the percentage of 46.15 with anxiety
level that will act circumcision.
being, then after the treatment given to as many as 5 percent of children with 38
DISCUSSION
Based on the results of the study showed changes in levels of anxiety
before and after health education leaflets about circumcision is found that before
being given health education leaflets about circumcision of 20 respondents
will be taken circumcision as many as 11 respondents experienced anxiety
level was the percentage of 55, while 6 respondents experienced anxiety level
light with a percentage of 30, and 3 respondents experienced a degree of
severe anxiety with a percentage of 15 and after given health education leaflets
about circumcision of 20 respondents will be taken circumcision most of as
many as nine respondents experienced anxiety level light with a percentage of
45, while 6 respondents had moderate anxiety level with the percentage of
30, 4 respondents no worries with the percentage of 20, and 1 respondent
suffered severe anxiety level with the percentage of 5. As well as the
1076 , 46 to mild anxiety, it shows the
effect of the provision of health education leaflets about circumcision.
Anxiety levels of children will be taken before the circumcision is given
health education leaflets and after given health education leaflets showed a
decrease in anxiety levels. This proves that the information obtained through
health education leaflets accompanied by counseling about circumcision can
reduce the level of anxiety children.
Information obtained through the provision of health education leaflets are
quite clear and easy to read so it‟s easy to understand and be understood by
children. How the good extension anyway so the majority of respondents
who experienced high levels of anxiety with numbers later after being given
health education leaflets and counseling about circumcision can reduce the level
of anxiety. That means, giving health education leaflets showed an influence
on the childs level of anxiety.
Hidayat, A. 2003.
Riset Keperawatan dan Teknik Penulisan Ilmiah
. Jakarta: Salemba Medika.
CONCLUSIONS AND SUGGESTIONS
Mansjoer, A. 2000.
Kapita Selekta
CONCLUSION
From Wilcoxon Signed Rank test that researchers do p value = 0.02, with
Kedokteran
.
Aesculapius Jakarta: Media
p 0,05 so that H0 rejected and H1 accepted that means there is significant
influence between the provision of leaflets about the circumcision
procedure against the childs anxiety Nursalam. 2003.
Konsep dan penerapan Metodologi Penelitian Ilmu
Keperawatan
. Jakarta: Salemba Media.
level that will take circumcision.
Nursalam. 2005..
Asuhan Keperawatan Bayi dan Anak
. Jakarta: Salemba
SUGGESTION
Expected to health workers are associated with these results, nurses can
use leaflet to minimize the childs Medika.
Pusat pendidikan Tenaga Kesehatan Departemen Kesehatan RI,
anxiety which will be taken
2009..
Asuhan Keperawatan
circumcision and should have to apply the knowledge and application of
knowledge learned during the lecture by providing health education using a
variety of media that exist today.
The results could be used as a reference future studies, mainly related
to anxiety levels of children will be taken circumcision and further research
to look for a more complete supporting
Dalam Kontek Keluarga.
Jakarta Setiadi. 2007.
Konsep dan Penelitian Riset Keperawatan
.Surabaya: Graha Ilmu
Wrana, P. 1939. Historical review: Circumcision.
Archives of Pediatrics
56: 385 392. as
quoted in: Zoske, Joseph data about the respondents among
Winter 1998. Male
others, additional data on the information obtained.
Circumcision: A Gender
BIBLIOGRAPHY
Perspective.
Journal of Studies
62: 189 –208.
Men‟s
Arikunto, S. 2006.
Prosedur Penelitian Suatu Pendekatan Praktek
. Jakarta: Rinek Cipta
Yupi, S. 2004.
Buku Ajar: Konsep Dasar Keperawatan anak
. Jakarta: EGC
Asih,Y. 1999.
Dasar-Dasar Riset
Keperawatan
. Jakarta: EGC Danim,
S. 2003.
Riset Keperawatan Sejarah Metodologi
. Jakarta: EGC
Gollaher, D. February 2000.
Circumcision: a history
of the world‟s most
controversial surgery
. New York, NY: Basic Books. hlm. 53
–72.
1077
THE CORELATION OF BODY MASS INDEX BMI WITH CARDIORESPIRATORY RESISTANCE ON NURSING PROGRAM STUDENTS
Oka Ludianita
1,
Ita Novita Dewi
2
STIKes Hutama Abdi Husada Tulungagung Email: zahyardia_odiayahoo.com
Abstract
Someone who has full of weight body, will suffer Cardiovaskuler. So it assumed that someone who has big body having cardiorespiratory endurance lower than normal people. The goal of the research
is to know the correlation between BMI and cardiorespiratory endurance.This research design used correlation design by using sectional cross approaching. The populations of the research are the
students of sarjana degree of grade III. The samples of the research are 52 people by using sampling total technique. BMI data is taken by using Antropometri measurement and using Balke test for
cardiorespiratory endurance.The result of the research had been found that 52 student have normal BMI and having cardiorespiratory endurance. There were 16 people 47 from the statistic test of
Spearman Rho is gotten
score ρ= 0,002 α= 0,05 so H rejected and H
1
accepted. There is a correlation between BMI and Cardiorespiratory endurance on the students of nurse program on grade
III at STIKes Hutama Abdi Husada Tulungagung.From the result above showed that good cardiorespiratory immune system existing by having routine exercires and enough nutrient, so BMI
will be normal from that reason. The researcher hopes that the student must pay attention to BMI and cardiorespiratory endurance in order incrate the health of body and reaching healthy life.
Keyword : Body Mess Index, Cardiorepiratory Endurance, Student
INTRODUCTION
Lifestyle of the people who tend to not have as much physical activity is something to
watch out, because these habits can affect ones health. Various kinds of organ function
decline in this community can be prevented through exercise Samihardja J., 2005.
Sport is any systematic physical activity to encourage, foster and develop the
potential of physical, spiritual, and social. Sports activities that can be done in everyday
life sometimes requires great body energy, due perhaps in the sport activity there are
movements that are quite complex or complicated. Because any movement in the
sport activity definitely requires energy from the body. Activities regular exercise can help
maintain physical fitness infallible, 2007.
One form of capital is human resource development of healthy, that is healthy
physically, mentally and socially. Teenagers who are healthy and have good endurance to
be able to excel in learning and work so that productivity is increased. According to the
WHO, adolescent is an individual both women and men who are in a period or age between
children and adults. Limitation of teenagers in this case is the age of 10-24 years. Someone
1081 who has a prime cardiorespiratory endurance
can perform daily activities with optimal and not get tired, and still have the energy reserves
to do other activities Bastian, 2009. Cardiorespiratory endurance is the ability to
receive, convey and to extract oxygen for physical work. It is the ability to survive in the
physical work at a certain intensity. Cardiorespiratory endurance will improve with
regular participation in aerobic activity, such as brisk walking, jogging, cycling, and
swimming. Term aerobic means with oxygen, but when applied to exercise, refers
to activities in which the oxygen requirement can be given continuously during the
performance Anspaugh, 2006.
Cardiorespiratory endurance is determined by the strength of Maximum
Oxygen Volume VO2max, which is defined as the highest average oxygen that can be
generated during exercise and is shown in the number of milliliters of oxygen consumed per
kilogram of body weight per minute Nieman, 2008.
According to Lloyd, et. al 2004 stated that the results of research on
cardiorespiratory endurance conducted at the Nursing Academy student Serang Banten