Conclusion Conclusions and Recommendations

Kemenkes RI, 2012. Pedoman Pencegahan dan Pengendalian Infeksi Tuberkulosis Di Fasilitas Pelayanan Kesehatan. Jakarta. Direktorat Bina Upaya Kesehatan Fitriani, E. 2012. Faktor Resiko yang berhubungan dengan kejadian Tuerkulosis Paru. Semarang. Unnes Journal of Public Health Kemenkes RI. 2014. Pedoman Nasional Penanggulangan Tuberkulosis, Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan, Jakarta: Kemenkes RI. Prabu, Faktor Resiko TBC, Desember 24 2008, http:putraprabu.wordpress.com 20081224faktor-resiko-tbc, diakses tanggal 19 Juni 2014. Rab, T. 1999. Ilmu Penyakit Paru, editor Sandy Qlintang, Jakarta: Hipokrates Tjiptoherijanto, P. Soesetyo, B. 1994. Ekonomi Kesehatan, Rineka Cipta, Jakarta. WHO, 2012. “Global Tuberculosis Report 2012”. World Health Organization 20 Avenue Appia, 1211 –Geneva–27, Switzerland. Tersedia di www. who.int- tuberkulosis. diakses pada tanggal 25 Mei 2014. 855 INFLUENCE OF STUDENTS KNOWLEDGE AND ATTITUDE LEVEL ABOUT HEALTHY LIFE BEHAVIOR TOWARD GARBAGE DISPOSING AT IIK BHAKTI WIYATA KEDIRI Zuyyina Fihayati, Endah Retnani Wismaningsih, Ruli Asharil Institut Ilmu Kesehatan Bhakti Wiyata Kediri Abstract Educational institution is primary target which should be practicing Healthy life behavior such as washing hand with soap, eating healthy food and beverage, healthy latrines, and disposing garbage into garbage can. These behavior where strongly influenced by individuals level of knowledge and attitude. This study aimed to analyze the influence of students knowledge and attitude level about healthy life behavior toward garbage disposing at IIK Bhakti Wiyata Kediri. This research was a cross sectional study, number of sample determined by cluster sampling technique. Data were analyzed by multiple linier regression in order to determined the most influenced variable toward garbage disposing. The result showed that 58,18 respondents has moderate knowledge, and 71,82 respondents has good attitude about healthy life behavior. the multiple linier regression result test showed that the most influenced variable toward garbage disposing was attitude with p value 0,011 0,05 mea nwhil e knowledge has no influence p value 0,944 0,05. From this research, it‟s known that attitude has most influence toward garbage disposing. Keyword : Knowledge, attitudes and garbage disposing. INTRODUCTION Health behavior particularly healthy life behavior PHBS are important factor which influence individual and community health status. Through KEPMENKES RI No.1193MENKESX2004, government has established healthy life behavior vision 2010. Healthy life behavior are a set of behavior which practiced based on awareness as the learning results to enable individual or family to self assist in health area and actively participated in achieving community health Pusat Promosi Kesehatan, Depkes RI 2006. Healthy life behavior is a health behavior that closely related to individual behavior. Wherein the formation of the behavior is strongly influenced by individual knowledge. Knowledge or cognitive is an 865 important basic domain in the formation of individual practice Notoatmodjo, 2007. In the educational institution campus, school, pesantren , seminar, padepokan , etc, primary target have to practice behavior that can created a healthy life behavior‟s instititution, including washing hand with soap, eating healthy food and beverage, healthy latrines, and disposing garbage into garbage can, do not smoke, do not do drugs, alcohol, psychotropic and other addictive substances, do not spit in public area, eradicate mosquito nest, Kementrian Kesehatan RI, 2011. Health educational institution school is a education major with health background which aimed to develop reliable health workers that not only reliable handling their clients but also always practice healthy life behavior in daily life, in order to increase their productivity and also being a role model for their community. To achieve those target, students prospective health workers have to prepared –as early as 2.Specific Purpose a. Describing respondent‟s characteristics based on sex and age. b. Analyzing the influence of students knowledge about healthy life behavior possible- in to being competence toward garbage disposing at IIK Bhakti resources, productive, and have healthy life behavior. Wiyata Kediri. c. Analyzing the influence of students attitude level about healthy life There are 3 faculties at Institut Ilmu behavior toward garbage disposing at Kesehatan IIK Bhakti Wiyata Kediri, that are Public Health Faculty now known as Faculty of Health Science, Faculty of Medical Dentistry, Faculty of Pharmacy. Total students of IIK Bhakti Wiyata are IIK Bhakti Wiyata Kediri. d. Analyzing the influence of students knowledge and attitude level about healthy life behavior toward garbage disposing at IIK Bhakti Wiyata Kediri. 1783 student, which divided into 11 e. Analyzing the most influencing study program. Interview result from fifteen students randomly choose showed that all of them ever disposed garbage at public area not in the trash can. Based on that observation researcher want to analyze about the variable knowledge and attitude toward garbage disposing at IIK Bhakti Wiyata Kediri. BENEFIT OF RESEARCH 1. Benefit for Institution This research can be udes as additional influence of students knowledge and literature available in the development attitude level about healthy life behavior toward garbage disposing at IIK Bhakti Wiyata Kediri. Based on those reason, the problem formulated as : are there influence of students knowledge and attitude level of science particularly about healthy life behavior in the health educational institiution, also can be used as teaching materials and assessment in the community. 2. Scientific Benefit The result of this research can be used as about healthy life behavior toward additional health promotion literature, garbage disposing at IIK Bhakti Wiyata Kediri Research Purpose 1.General Purpose particularly about healthy life behavior in the health educational institiution as the reference for the next research 3. Benefit for Student As the knowledge and motivation for Analyzing influence of students the student to be more active –even as knowledge and attitude level about healthy life behavior toward garbage disposing at IIK Bhakti Wiyata Kediri 866 role model- in practicing healthy life behavior particularly about garbage disposing. Wiyata Kediri from June 1 to 6 2014. RESEARCH METHOD level about healthy life behavior toward Data was conducted at IIK Bhakti garbage disposing. st th Data Analyzing Research Design Data analyzed technique was used a This research was a quantitative approach, using cross sectional study that is a study where observation of risk factor variable and effected variable or independent variable and dependent conducted at the same time Notoatmodjo, 2010. Population Population of this research was all student of IIK Bhakti Wiyata Kediri. Total population were 1783 student. Sample Sample is part of population that will be software application. The variable was statistically tested using Multiple Linier Regression to assest the influence of students knowledge and attitude level about healthy life behavior and which variable has more influence toward garbage disposing at IIK Bhakti Wiyata Kediri. RESULT AND DISCUSSION Characteristic of the Respondent The Characteristic of the respondent is showed in the table below: Table 1. Characteristic of the Respondent researched or half of total characteristics of population Nursalam, 2003. Total No Characteristic Frequ- ency Percen- tage sample in this research was 330 student, which divided into 11 cluster. 1 Sex Male Female 153 149 43,33 56,67 Variable of the Research 2 Age years 20 ≥ 21 181 149 54,85 45,15 Independent variable are variable which was the cause or change dependent variable. Independent variable of this research were knowledge and attitude about healthy life behavior. dependent variable are variable which was the effect or have been changed by independent variable. Dependent variable of this research were garbage disposing. Primary data, 2014 Based on the Table 1, it‟s known that 56,67 respondent were female and 54,85 were 21 years old or older. Variable’s Characteristic Student‟s level of knowledge about healthy life behavior is showed in the table below: Table 2. Student‟ s Knowledg e Level Instrument of the Research This research used questionnaire as the instrument to conduct the data. The questionnaire consist of independent and dependent variables in the educational institution which measured by assessment No 1 2 3 Knowledge Level Low Moderate High Total Frequency - 192 138 330 Percentage - 58,18 41,82 100 of the students knowledge and attitude 867 Primary data, 2014 Based on the Table 2, it‟s known that 58,18 of respondent have moderate knowledge level about healthy life behavior. behavior toward garbage disposing at IIK Bhakti Wiyata Kediri is showed in the below: Table 5. Multiple Linier Regression Test Result Student‟s level of attitude about healthy life behavior is showed in the table below: Table 3. Student‟s Attitude Level No Attitude Level Frequency Persentage Model Unstandari zed Coefficient Standa rized Coeffi cient t Sig. Std. 1 2 Low Moderate - 93 - 28,18 B Erro r Beta 3 High 237 71,82 1 Cons 1.7 .176 10.1 .000 Total 330 100 tant 84 48 Primary data, 2014 Penge .00 .046 -.004 - .944 Based on the Table 3, it‟s known that 71,82 of respondent have high attitude tahu- an 3 .071 level about healthy life behavior, which Sikap .12 .050 .140 2.55 .011 mean that IIK Bhakti Wiyata‟s Student have positive attitude about it. Primary data, 2014 Based on Table 5, it‟s known that there was no i nfl ue nc e of st ude nt s Student‟s practice about healthy life behavior particularty garbage disposing is showed in the table below: knowl e dge l e ve l about healthy life behavior toward garbage disposing at IIK Bhakti Wiyata Kediri Sig = 0,944. There Table 4. Student‟s Practice was an i nfl ue nc e of st ude nt s No Garbage Frequency Percentage a t t it ude le ve l about healthy life disposing behavior toward garbage disposing at IIK 1 2 3 Low Moderate High Total 10 269 51 330 3,03 81,52 15,45 100 Bhakti Wiyata Kediri Sig = 0,011. From the Multiple Linier Regression Test result, it‟s known that garbage disposing were influenced by students knowledge and Primary data, 2014 Based on the Table 4, it‟s known that 81,52 of respondent have moderate practice of garbage disposing, which mean that IIK Bhakti Wiyata‟s have not always attitude level about healthy life behavior Sig = 0,039. Notoatmodjo 2003, although individual has high educational background, it does dispose their garbage into garbage can. not certify that heshe also have knowledge about disease and how to Characteristic of the Influence Between Variables The influence of the students knowledge prevent it, because their knowledge are only at the level of know and not yet at the level of understanding, applying, and attitude level about healthy life 868 analyzing, or evaluating the material related about the possible effect. st ude nt s a t t i t ude l e ve l about healthy life behavior toward garbage From the result and, it can conclude that knowledge level also has influence toward garbage disposing. Festinger 1957, other than knowledge, bad habits and culture also influence individual in practicing a behavior. Culture of a group in the community usually are heritable which also formed attitude and perception toward health. Ratna 2010, cultural practice is an act that must made as habits by learning. So although an individual has a higher education, it‟s not certify that disposing at IIK Bhakti Wiyata Kediri 4. Based on the result, it can be conclude that there was an i nfl ue nc e of st ude nt s knowl e d ge a nd a t t it ude l e ve l about healthy life behavior toward garbage disposing at IIK Bhakti Wiyata Kediri. 5. Based on the result, it can be conclude that student‟s attitude has more effect than student‟s knowledge toward garbage disposing at IIK Bhakti Wiyata Kediri. heshe will have practice health behavior. Suggestion Despite of that, student‟s attitude has 1. IIK and BEM should made rule about more effect than student‟s knowledge garbage disposing and give strict toward garbage disposing at IIK Bhakti Wiyata Kediri. Attitude is the readiness and willingness to act and not the sanction or punishment to students whom violate the rule so the student will be a competence health worker and implementation of particular motive. have a good healthy life behavior. Notoatmodjo 2010, Attitute is not an act but presdipotition of a behavior closed behavior. Sani 2011, Attitude is a readiness to act as the reaction and appreciation toward the object. Basically, the attitude of most IIK Bhakti Wiyata‟s students showed good correlation toward garbage disposing. 2. IIK should adding garbage can and place it at the hall, cafeteria, and parking lot. 3. IIK should place poster which appeal the student to dispose the garbage in to the can. . REFFERENCE Festinger, L. 1957. A theory of cognitive dissonance. California: Stanford Conclusion 1. Based on the result, it can be conclude that most of the respondent were female and 21 years old or older. 2. Based on the result, it can be conclude that there was no i nfl ue nc e of st ude nt s knowl e d ge l e ve l about healthy life behavior toward garbage disposing at IIK Bhakti Wiyata Kediri. 3. Based on the result, it can be conclude that there was an i nfl ue nc e of 869 University Press Kementerian Kesehatan RI, 2011. Profil Kesehatan Indonesia 2010. http:www.depkes.go.iddownloads PROFIL_DATA_KESEHATAN_IND ONESIA_TAHUN_2011. pd f. Diakses 21 Desember 2013 Notoatmodjo, S. 2007. Promosi kesehatan ilmu perilaku. Jakarta: Rineka Cipta. Notoatmodjo, S. 2003. Pendidikan dan Perilaku Kesehatan .Jakarta : Rineka Cipta Nursalam. 2011. Konsep Dan Penerapan Metodologi Penelitian Ilmu Keperawatan Pedoman Skripsi Tesis Dan Instrumen Penelitian Keperwatan . Jakarta : Salemba Medika Proverawati, A. Rahmawati, E. 2012. Perilaku hidup bersih sehat P HBS. Yogyakarta : Nuha Medika. Sina,Seni Susanti dkk. 2010. Sikap Terhadap Perilaku Hidup Bersih Dan Sehat Pada Mahasiswa Stikes Citra Husada Mandiri Kupang Tahun 2010. Jurnal dipublikasikan Stikes Citra Husada Mandiri Kupang. Santoso, Slamet Iman. 2005. Beberapa Segi Pendidikan Pembinaan Wata k Tugas Utama Pendidikan . Jakarta : Penerbit Universitas Indonesia. Sani, Fahrudin Nasrul.2011. Hubungan tingkat pengetahuan sehat - sakit dengan sikap mahasiswa Universitas Muhammadiyah Surakarta tentang perilaku hidup bersih dan sehat. Jurnal dipublikasikan Universitas Muhammadiyah Surakarta 870 THE EFFECT OF CLASSICAL MUSIC THERAPY TO INCREASE GLASGOW COMA SCALE IN MODERATE TO SEVERE TRAUMATIC BRAIN INJURY PATIENTS AT MARDI WALUYO BLITAR HOSPITAL Christina Dewi P, Riesa Yuni Pangestuti Nursing Major Faculty of Health Science Institut Ilmu Kesehatan Bhakti Wiyata Kediri Email: christ_wijaya_nsyahoo.com Abstract Brain injury begins with brain function are accompanied intersitial hemoragic which may cause interruption of the continuity of the patients brain and aggravating circumstances that can reduce the level of consciousness, causing death. Music therapy as a nursing intervention that can be performed by nurses as sensory stimulation can improve the awareness and potential for rehabilitation in patients with brain injury. This study aims to determine the effect of music therapy on the increase in the Glasgow Coma Scale in patients with moderate-severe brain injury. This study uses a pre-experiment design with One-grouph-pre-post test design and the technique accidental sample obtained 10 respondents in the bougainvillea and the ICU in Mardi Waluyo Hospital Blitar. Descriptive analysis with paired simple test illustrates that classical music therapy after an increase in Glasgow coma scale significantly to patients moderate to severe brain injury is Pvalue = 0.000.Conclusions from this study that there is the influence of classical music therapy to increase the Glasgow Coma Scale in patients with moderate to severe brain injury in Mardi Waluyo Hospital Blitar. Based on the research results suggested that the provision of classical music therapy can be applied in hospitals, especially in patients with brain injury. Keywords: Glasgow Coma Scale and classical music therapy INTRODUCTION Brain injury is a traumatic disruption of brain function with or without interstitial bleeding in the brain substance without followed by the dissolution of continuity of the brain 1. According to Iavagnilio 2 , in the United States, the incidence of brain injury each year reached around 500,000 cases. Of these cases, 10 died before arriving at hospital. Who arrived at the hospital, 80 were classified as mild brain injury, and 10 were moderate and the rest of the brain injury is severe traumatic brain injury. Incidence of brain injuries mainly occur in the productive age group between 15-44 years. 872 According to Djohan 3 , music therapy is musical activities to resolve the various problems in the aspect of physical, psychological, cognitive and social needs of individuals with physical disabilities. With the incidence of such and a high mortality rate, the need for therapy assistant in addition to primary therapy to overcome the problem of severe traumatic brain injury, music therapy is one of nursing interventions as stimulation to patients which are expected to have an impact on the recovery and patients healing. Soo et al 4 states, music can also give effect to the improvement of health, reduce stress. Music is effective to reduce anxiety and increase positive feelings in medical-surgical patients. Music influence the mechanism of action of the autonomic nervous system, about 20 minutes and then respondents GCS was observed 10 minutes later. The hormonal, so it can indirectly influence results of Glasgow coma scale but patients who are given music observation score before therapy therapy will feel more relaxed and calm. Some research about the benefits of music therapy for human health above has been developed in various countries, especially in Europe and America. In Indonesia, the research conducted by Asrin et al 5 found that music therapy can be influential to improve the level of consciousness with severe traumatic brain injuries. During the theraphy session each respondents shows positive changes on physical response and psychosocial which the response are the compared to after the classical music therapy. After getting permission from the head of the nursing hospitals Mardi Waluyo Blitar, research conducted in the bougenvill room and the ICU Mardi Waluyo Blitar hospital to conduct preliminary studies, determine the sample, the sample in measuring the value of the Glasgow coma scale early before therapy classical music then conducted music therapy for 20 minutes by using earphones every patient and 10 present of the tears, the movement of the minutes after the music therapy fingers and toes, the movement in the area around the jaw and attempt to open the eyelids. The same thing also stated by Novita 6 in his study where the music can reduce the stimulation of the sympathetic nervous system, where the response is to lower tensions that arise neuromuscular activity, increase the threshold of awareness, decrease the activity of adrenaline. In Mardi Waluyo Blitar hospital, during the past year January 2014 - December 2014, the average number of traumatic brain injury patients each years is 101 patients in the bougenvill room and in the ICU which are consist of light brain measured again the value of the Glasgow coma scale later on the observation sheet compared between Glasgow coma scale score after the therapy with classical music. The population in this study were all patients with moderate to severe brain injury in hospitals Mardi Waluyo Blitar in February - March 2015. Samples taken in this research is 10 respondents, using minimal sample with accidental technique 8 . Inclusion criteria are willing to become a respondent, moderate brain injury patients with GCS ≥9 12, severe traumatic brain injury patients with GCS 3 8, had stable injury 45 patients, moderate brain vital signs with a period of injury 24 patients, severe traumatic brain injury 32 patients. Based on the above writer is interested in conducting research on the influence of classical music therapy to increase patients Glasgow coma scale in moderate to severe brain injury in Mardi Waluyo Blitar hospital. RESEARCH METHOD The study used pre-experimental design hospitalization more than 1 day, aged 12 - 80 years, and patients diagnosed with moderate to severe brain injury either due to traffic accidents, direct trauma or penetrating trauma. This study was conducted in the ICU and bougenvill room of Mardi Waluyo Hospital from 16 February until 16 March 2015. The primary data obtained directly from Glasgow coma scale observations of each patients before and with pre-post test desaign 7 . In this after classical music therapy. The study, Glasgow coma sclae observation secondary data were getting from was done before music therapy. The respondent accept the music therapy for 873 documentation and patients medical records in the ICU and bougenvill room of Mardi Waluyo Blitar Hospital. RESULT AND DISCUSSION Result A. Respondents characteristic The analysis of the respondent characteristics in this study illustrates the distribution of of brain injury, vital signs and initial Glasgow Coma Scale. Results of this analysis also illustrates the mean, confident interval, Glasgow Coma Scale score after classical music therapy. The following results are : respondents by age, sex, cause Tabel 1 : Respondent distribution frequency in the moderate to severe traumatic brain injury at Mardi Waluyo Blitar hospital Characteristic Age : Early adolescence 12 - 16 years Late adolescence 17 - 25 years Early adulthood 26 - 35 years Late adulthood 36 - 45 years Early elderly 46 - 55 years Late elderly 56 - 65 years Elderly 65 years Total Gender : Male Female Total Brain injury causes : Accident Penetrating trauma Direct trauma Total Vital sign Blood pressure Low : n 1 1 3 2 1 1 1 10 9 1 10 7 - 3 10 10 10 30 20 10 10 10 100 90 10 100 70 - 30 100 - Blood pressure : 9060 mmHg - - Normal - Blood pressure : 9060 mmHg-13090 mmHg 5 50 High - Blood pressure : 13090 mmHg 5 50 Total Vital sign temperature Low : 10 100 - Temperature : 36,5 C - - Normal - Temperature : 36,5 C-37,5 C 10 100 874 High - Temperature : 37,5 C - - Total Vital sign Heart rate Low : 10 100 - Heart rate : 60xmenit - - Normal : - Heart rate : 60-100x.menit 8 80 High : - Heart rate : 100xmenit 2 20 Total Vital sign Respiratory rate Low : 10 100 - RR : 12xmenit - - Normal : - RR : 12-20xmenit - - High : - RR : 20xmenit 10 100 Total Early GCS 9-12 Moderate traumatic brain injury 3-8 Severe traumatic brain injury Total 10 4 6 10 100 40 60 100 Resource : primary data from april 2015 respondents 70, and direct trauma Based on Table 1 it can be seen that the age distribution of respondents majority who suffered brain injury moderate - severe in Mardi Waluyo Blitar hospital is in the age group of early adulthood are 3 respondents 30, and minorities are at the age of early adolescence 1 respondents 10 , late adolescence 1 respondent 10, early elderly 1 respondent 10, late elderly 1 are 3 respondents 30. From the data above it can be seen that for the characteristics of the vital signs of the respondents are for blood pressure who are in the category of high blood pressure are 5 respondents 50, and 5 respondents are in the category of normal blood pressure 50. The majority temperature of the respondents are in a safe rate that is 36,5 C - 37,5 C number of 10 respondents 100. For respondent 10, respondent 10. elderly 1 the majority of the heart rate, 8 respondents 80 have normal heart rate and 2 respondents 20 have high Based on gender, the respondent who have sex male are 9 respondents 90 and the female 1 respondent 10. heart rate. All of the respondent was showed high respiratory rate. While the distribution of the Distribusi untuk skala Glasgow characteristics of the causes of brain injury moderate to severe can be Coma Scale responden dapat di kategorikan menjadi 2 yaitu pada classified into accidents by 7 873 skala Glasgow Coma Scale 9-12 COS terdapat 4 responden dengan persentase 40 sedangkan untuk Glasgow Coma Scale 3-8 COB terdapat 6 responden dengan The distribution of the respondents Glasgow Coma Scale can be classified into moderate traumatic brain injury GCS 9-12 there are 4 persentase 60. respondents 40 and severe traumtaic brain injury GCS 3-8 there are 6 respondents 60. B. Main variable Tabel 2 : Respondents Glasgow coma scale frequency before and after interventions in the day 1 until day 3 at Mardi Waluyo Blitar hospital Glasgow Coma Scale GCS post score No Level Day 1 Day 2 Day 3 resp of Sess Sess Sess Sess Sess Sess Level of ond en Pr e GCS conscio usness qualita ion 1 ion 2 ion 1 ion 2 ion 1 ion 2 GCS consciousne ss qualitative tive 01 02 03 04 05 06 07 08 09 10 10 7 10 6 7 7 11 11 4 5 Moderate Severe Moderate Severe Severe Severe Moderate Moderate Severe Severe Stupor Coma Stupor Coma Coma Coma Stupor Stupor Coma Coma 10 7 10 6 7 7 11 11 4 5 10 7 10 6 8 7 11 11 5 5 11 8 10 6 9 7 11 11 5 5 12 9 11 7 9 8 12 12 5 6 12 9 11 8 9 8 12 12 6 7 13 9 11 8 9 9 12 12 7 7 Light Moderate Moderate Severe Moderate Moderate Moderate Moderate Severe Severe Somnolen Stupor Stupor Coma Stupor Stupor Somnolen Somnolen Coma Coma Resource : primary data from april 2015 Tabel 3 : Descriptive test mean, confident interval, Pvalue of the respondents Glasgow Coma Scale before and after intervention from day 1 until day 3 at Mardi Waluyo Blitar hospital Confident Interval N Mean Lower 95 Upper Pvalue GCS pre 10 7,8 5,9903 9,6097 GCS post 10 9,7 8,1528 11,2472 0,000 Resources : primary data from april 2015 873 Based on the table 2 can be interpreted that the Glasgow coma scale before and after therapy were given classical music a significant increase, it can be seen on the Glasgow coma scale in each column of respondents are pre - post for 3 days has increased significantly. The

2. Glasgow coma scale after the

classical music therapy at Mardi Waluyo Blitar hospital From the distribution of the data obtained, the respondents with moderate brain injury that changed the GCS to be a mild brain injury as much as 1 mean increase in scale of the respondents with initial GCS Glasgow coma scale after being given music therapy was 1 - 3 points. Based on table 3 can be seen that from the data collected have been score 10 to 13, 3 respondents with initial GCS score 10-11 to 11-12, of respondents with brain injury weight amounted to 6 with 3 of them have increased GCS to performed the data analysis moderate brain injury, but 3 of processing of the results of this study showed that the mean of the respondents amounted to 10 with pre GCS classical music therapy can be interpreted by 7.8 and for GCS post classical music therapy can be interpreted by 9.7 whereas for the t value with CI = 95 for GCS pre classical music therapy at 5.9903 lower and 9.6097 upper and CI 95 for GCS post classical music them still suffered severe brain injury but still increased GCS points. This is consistent with the Rihiantoro et al 9 which states that a coma patients hemodynamic status is also controlled by the central nervous system, especially in the medulla oblongata, sensory stimulation is an action to raise awareness and potential for rehabilitation in therapy at 8.1528 lower and comatose patients. Stimulation 11.2472 upper. The analysis of the level of significance to the respondent pvalue = 0.000. Discussion activities may include stimulation of the sensory sight, hearing, smell, taste, touch and kinestesia.

3. Analysis of test result paired with

simple test of the effect of

1. Glasgow coma scale before the classical music

therapy to classical music therapy at Mardi increasing Glasgow coma scale Waluyo Blitar hospital for moderate-severe traumatic In this study, respondents were selected in moderate brain injury patients GCS ≥9 12 and severe traumatic brain injury patients GCS 3 8. Respondents in this study there were 4 respondents diagnosed with a brain injury was the range of scores GCS 10-11 and 6 respondents were diagnosed with severe traumatic brain injury and for severe traumatic brain injury with the range of scores GCS 4-7. 872 brain injury at Mardi Waluyo Blitar hospital Analysis of test results paired with a simple test of the influence of classical music therapy to increase patients Glasgow Coma Scale for moderate to severe brain injury in Mardi Waluyo Blitar hospital of test data obtained pvalue = 0.000 with α = 0.05, therapy Classical music is very influential to improve the Glasgow Coma Scale in patients with moderate to severe brain injury. The responses of the physical and psychosocial well showed positive changes in the present of the tears, the movement of the fingers and toes, the movement of the jaw area as well as efforts to open up and move the eyelids, moaning and talking distracts. This is according to research conducted by Asrin et al 5 found that music therapy can be influential in raising awareness of the status of severe head injury patients and achieve the physical and psychosocial responses. Music is organized auditory stimuli consisting of melody, rhythm, harmony, timbre, form and style. Classical music is often a benchmark of music therapy, because it has a wide range of tone and tempo dynamic 10. This shows that when respondents listening to music, waves transmitted through ossicels in the middle ear and cochlear fluid 2. The identification results after classical music therapy is one of the respondents to the initial GCS score 10 COS increased GCS up to 13 COR, 3 respondents with initial GCS score 10 and 11 COS only increased GCS points that have high levels of awareness qualitative stupor into somnolence. While 3 respondents with initial GCS 7 COB increased GCS to 9 COS, but there were 3 respondents severe traumatic brain injury with initial GCS score 4 to 7, initial GCS score 5 to 7 and the value of the initial GCS 6 to 8. 3. There is a very significant difference in Glasgow Coma Scale for brain injury patients with moderate to severe pvalue = 0.000 and α = 0.05. It can be concluded that there is the influence of classical music therapy to increase the Glasgow Coma Scale in patients with running through to the auditory moderate to severe traumatic nerve and stimulates secrete endorphins. Endorphins have a relaxing effect on the body. The effect of music is lowered brain injury at Mardi Waluyo Blitar hospital. REFFERENCE stimulus of the sympathetic nervous system. Response arising from a decrease in the activity is reduce the activity of adrenaline, decreased neuromuscular tensions, increase the threshold of consciousness 11 . CONCLUSION 1. Identification prior to classical music therapy has a range of scores GCS 10-11 to moderate brain injury as much as 4 responders and the range of scores GCS 4-7 for severe traumatic brain injury as much as 6 respondents. 873 1. 2. 3. 4. Muttaqin, Arif. 2011. Buku ajar asuhan keperawatan klien dengan gangguan persyarafan. Jakarta : Salemba medika, Iavagnilio, C.L. 2011. Traumatic brain injury : improving the patient‟s outcome demands timely and accurate diagnosis. Journal of Legal Nurse Consulting, 22 3, 3 – 9. Djohan. 2011. Terapi musik : teori dan aplikasi. Penerbit Galangpress : Yogyakarta, Soo, K.D. et al. 2011. Effect of music therapy on mood in stroke patients. Yonsei Med Journal, Vol 52 6 , 5. Asrin, Mardiyono Saryono. 8. Sugiyono. 2010. Statistika 2007. Pemanfaatan terapi Untuk Penelitian Edisi Revisi . musik untuk meningkatkan Bandung : Alfa Beta, status kesadaran pasien trauma 9. Rihiantoro, Tori., Nurachman, kepala berat, Jurnal E., Hariyati. 2008. Pengaruh Keperawatan Soedirman The Soedirman Jurnal of Nursing2 . No.2. Hlm 102- terapi musik terhadap status heodinamika pada pasien koma di Ruang ICU sebuah rumah 106, sakit di Lampung. Jurnal 6. Novita, Dian. 2011. Pengaruh Terapi Musik Terhadap Post Keperawatan Indonesia 12 No.2, Juli 2008 Hlm 115-120, Operasi Open Reduction Internal 10. Nurrahmani. 2012. Kamus Fixation ORIF di RSUD Dr. H musik. Yogyakarta : Kanisius, Abdul Moeloek Provinsi 11. Sarayar, C., et al. 2013. Lampung. Tesis, Universitas Pengaruh musik klasik terhadap Indonesia, Jakarta diakses 07 September 2013 http:lontar.ui.ac.id-is.html , penurunan tekanan darah pada pasien pra-hemodialisis di ruang Dahlia BLU RSUP. Prof.Dr.R.D 7. Nursalam. 2013. Konsep dan Kandou Manado. E-journal penerapan metodologi penelitian keperawatan. Jakarta : Salemba Medika, 874 keperawatan e-Kp1. No.1. Hlm 1-7. THE CORRELATION OF KNOWLEDGE AND ATTITUDE WITH THE DECISION-MAKING OF BRIDE COUPLE TO CONDUCT PREMARITAL CHECK-UP IN WORK AREA OF KUA DISTRICT OF PARE KEDIRI Ira Haslinda, Tintin Hariyani, Linda Andri Mustofa Advanced Midwifery Study Program STIKES Karya Husada Kediri Email: tintinhariyani1gmail.com ABSTRACT Premarital check up is the preparation efforts pregnancy and early detection of a disease that could endanger the mother and baby. Many people do not know about the purpose, benefits and procedures of premarital check-up. This resulted in a low number of bride and groom couples who do premarital check-up. There are several causal factor, namely the lack of knowledge, because not a lot of counseling and information about premarital check-up. This results in negative attitudes toward premarital check-up. The objective of this research was to know the correlation between knowledge and attitude with the decision-making of bride couple to conduct premarital check-up. Data collection was conducted in KUA Pare Kediri, which was held in July-August 2015. The design used analytic with approach of cross-sectional. The population was all couples bride. The sample amounted to 58 respondents. Samples were taken by technique of simple random sampling. The independent variables in this research were knowledge and attitude. The dependent variable was the decision to conduct premarital check-up. The data collection used questionnaire sheet. The data analysis used statistical test of Chi-Square with significance level of 0.05. The research results of knowledge and attitude with the decision to conduct premarital check-up, from the Chi-Square test results obtained there was a correlation between knowledge and attitude with the decision to conduct premarital check-up. While the closeness correlation were low, with contingency coefficient of 0.35. The increasing number of knowledge that gained about premarital check-up it will have an impact on the mindset, which resulted in a couple brides to be positive. With good knowledge and positive attitude, the bride and groom couples willing to do premarital check-up. Keywords: knowledge, attitude, decision making to conduct Premarital Check Up 879 INTRODUCTION The fundamental requirement in a marriage, one of which is for the function of reproduction and genetics that produce offspring Gardiner and Kosmitzki, 2005. Descendants expected that generation of intelligent and free of disease and disability are not only physically but also spiritually. To mendapatkanya need for early skirining associated with decreased disease, chronic and infectious that can affect reproductive health in this case related to the effort to have offspring. Premarital Check Up is a preventive measure to detect reproductive health and genetics. Premarital Check Up contains a set of laboratory tests to ascertain the health status of both the prospective bride. From the results of the study in China found brides who followed the premarital health examination Premarital Check-up that is equal to 63.4 Heketh, 2003: 277-279. According to the study conducted in Central Java showed that 89 of brides do not do premarital medical examination Premarital Check-up Ulfah, 2008. Decision making the bride and groom to make premarital medical examination Premarital Check-up voluntarily remains low this is due to several factors. Of all the factors that have been investigated it was found that a low knowledge greatly affect the decision making the bride and groom to do premarital check-up. Bride and groom couples ignorance about how the procedures of examination, the type of inspection as well as the main one is related to the benefits of premarital check-up resulted bride and groom couples are reluctant to do pemarital check-up Notoatmodjo, 2007: 140. Attitude is one that supports the bride and groom couples do premarital check-up. Positive or negative attitude of the couple bride bride influence the decision to conduct premarital check-up or not Nojoadmojo, 2007: 124. It is known that from 58 respondents, the majority of respondents were never informed about premarital check-up as many as 33 respondents 57. 880 To increase the number of brides who do premarital check-up, the need for an increase in promotion and health education activities related to the importance of premarital check- up on the prospective bride and groom by health personnel. It aims to improve knowledge and attitudes pair bride and groom, so that there will be an increasing number of brides who do premarital check-up. Premarital check-up is intended as a preparation for the pregnancy and to produce offspring that are free of disease and disability. METHODS Design used is cross sectional analytic approach. The study population is all couples bride and groom in the working area of KUA Pare. Samples were taken by simple random sampling technique. The independent variable in this study is the knowledge and attitudes as well as the dependent variable is the decision making the bride and groom to do premarital check-up. Data collection will be done with the questionnaire sheet. Analysis of data using statistical Chi-Square test with significance level of 0.05. RESULTS General Data Characteristics Based Ever Presence Respondents to Information About Premarital Check Up Characteristics of Respondents Based Sources of Information About Premarital Check Up Characteristics of Respondents by Sex It is known that from 58 respondents, half of the respondents received information about premarital check-up from others as many as 14 respondents 50. It is known that from 58 respondents, half of the respondents were female as many as 29 respondents 50. Characteristics of Respondents by Age It is known that from 58 respondents, nearly half of respondents last high school education as many as 28 respondents 48. Characteristics of Respondents by Income Level Characteristics of Respondents by Education Level It is known that from 58 respondents, the majority of respondents have an income of RP1.339.750 ≤ as many as 41 respondents 70. Specific Data It is known that from 58 respondents, the majority of respondents aged 35 years as many Distribution Knowledge of Respondents by Level of as 32 respondents 55. 881 No Level of Freque Percenta Knowledge ncy ge Nearly half of the respondents have a good knowledge of conduct premarital check-up 1 2 3 Less Enough Good 24 16 18 41 28 31 as much as 16 respondents 27.6. And a small portion of respondents have less knowledge did premarital check-up as much as 14 respondents 24.1. Total 58 100 Of the 58 respondents, nearly half of the respondents have less knowledge as many as 24 respondents 41. Distribution of respondents by attitude Based on the results of statistical tests chi-square correlation value obtained by the decision-making knowledge to do Premarital Check Up, the result x 2 count = 10.9 is greater than x 2 table = 5.991 10.9 5.991 where Ho is rejected. With contingency coefficient value of No 1 2 Attitude Negative Positive Total Frequency 26 32 58 Percentage 45 55 100 0.35. It means that there is a relationship between knowledge of the decision of the bride and groom to conduct premarital check-up in the working area of KUA districts Pare with the relationship low. Relationship Between Attitude With Decision Making Of the 58 respondents, the majority of respondents have a positive attitude as many as 32 respondents 55. Distribution of Respondents by Decision Making N o Attitud e Decision Making Do Do Not Premarital Premarital Check Up Check Up Total Of the 58 respondents, the majority of respondents chose to do Premarital Check Up as many as 38 respondents 66. Relationship Between Knowledge With Decision Making No 1 2 Decision Making Do Premarital Check Up Do not Melakukan Frequen cy 38 20 Percentage 66 34 No. Knowledg Decision Making Total Premarital Check Up e Do Do Not Total 58 100 1 2 Less Enough Premarita l Check Up 10 17,2 12 Premari tal Check Up 14 24,1 4 24 41,4 16 1 2 Negati ve Positiv e Total 12 20,7 26 44,8 38 65,5 14 24,1 6 10,4 20 34,5 26 44,8 32 55,2 58 100 3 Total Good 20,7 16 27,6 38 65,5 6,9 2 3,5 20 34,5 27,6 18 31 58 100 Nearly half of respondents have a positive attitude do premarital check-up as much as 26 respondents 44.8. And a small portion of respondents have a negative attitude not 882 conduct premarital check-up as much as 14 respondents 24.1. Based on test results obtained chi-square value of the correlation attitude with the decision to do Premarital Check Up, the result x 2 count = 7.9 greater than x 2 table = 7.9 3,841 where Ho is rejected. With a contingency coefficient of 0.35. It means that there is a relationship between the attitude of the bride and grooms decision to conduct premarital check-up in the working area of KUA districts of Pare with the relationship low. DISCUSSION Knowledge The survey results revealed that of the 58 respondents, nearly half of the respondents have less knowledge as many as 24 respondents 41. Some studies have noted that certain demographic factors have an effect on the bride and groom to participate in Premarital Check Up. These factors include gender, age, place of residence, education, and income bride. Besides the awareness, knowledge and attitudes towards Premarital examination Check Up Wang, 2013. Knowledge can be obtained by means of traditional and modern. In the knowledge that there are three domains of cognitive, affective and psychomotor. Differences in the ability of a person to receive information depengaruhi by several things, for example the level of education, income, local culture etc. Knowledge of the respondents were less because not many counseling related to premarital check-up. So not many respondents know what the purpose, keutungan and losses premarital check-up and how the examination procedure. So the effect on the decision to do the bride and groom couples premarital check-up. Attitude According to the research that has been conducted shows that of the 58 respondents, the majority of respondents have a positive attitude as many as 32 respondents 55. Attitude is the assessment can be opinion a person to a stimulus or object Nojoadmojo, 2007: 124. A positive attitude can be shown by the respondent he received well and proactively with counseling about premarital check-up. It is also willing to conduct premarital check-up because of his own conscience. 883 Respondents feel the need for premarital checkups and considers it important health himself and partner. Besides the positive attitude of the respondents is likely due to the requirement before the wedding to attach the results of the current marriage registration at KUA. So without knowing much about the benefits and purpose of premarital check-up candidate besikap pengatin positive and agreed to conduct premarital check- up. Decision To Perform Premarital Check Up According to the results of the study showed that of the 58 respondents, the majority of respondents chose to do Premarital Check Up as many as 38 respondents 66. Decision making is the process of choosing an alternative way of acting with an efficient method according to the situation. Decision-making can be seen in relation to the process, namely that a decision is the final state of a process that is more dynamic Salusu, 2005: 87. The bride and groom a good decision that is where the bride is willing to participate actively to conduct premarital check-up. The decision to conduct premarital bride kebanyaakan based because marriage at the KUA requirements that require the bride to attach the results of premarital check-up when performing marriage registration. So many brides decide to conduct premarital check-up. In the process of making ones decision to conduct premarital check-up or not, can be affected by several factors. Relationship Between Knowledge And Attitude With Decision To Perform Premarital Check Up Based on the results of statistical tests chi-square correlation value obtained by the decision-making knowledge to do Premarital Check Up, the result x2 count = 10.9 is greater than x2 table = 10.9 5.591 where Ho is rejected. More information is obtained it will affect knowledge bride and groom couples resulting in the decision to conduct premarital check-up. Based on test results obtained chi-square value of the correlation attitude with the decision to do Premarital Check Up, the result x 2 count = 7.9 greater than x 2 table = 7.9 3,841 where Ho is rejected.