HUBUNGAN KONSELING DALAM ANTENATAL CARE (ANC) DENGAN KOPING PADA IBU HAMIL PRIMIGRAVIDA SAAT MENGHADAPI PERSALINAN DI KOTA PALU

ELVARIA MANTAO, Dr. Dra. Sumarni, M.Si ; Drs. Abdul Wahab M.PH

2018 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Sebagian besar wanita hamil pertama mengalami kesulitan mengatasi masalah gangguan fisik dan emosional bahkan kehilangan kontrol menjelang persalinannya. Koping yang maladaptif memiliki pengaruh terhadap kejadian kelahiran prematur, serta penyulit kehamilan yang diakibatkan karena pengaruh psikologis ibu ketika menjelang persalinan. Ibu hamil yang melakukan pemeriksaan kehamilan secara teratur dan mendapat konseling selama antenatal maka calon ibu mendapatkan informasi mengenai janin, mendeteksi komplikasi, berperilaku sehat, dan akan mempengaruhi koping ibu. Tujuan: Untuk mengetahui hubungan konseling dalam Antenatal Care (ANC) dengan koping pada ibu hamil primigravida saat menghadapi persalinan di Kota Palu. Metode: Penelitian observasional menggunakan rancangan cross sectional. Variabel bebas konseling dalam antenatal care (ANC), variabel terikat koping pada ibu hamil. Populasi adalah semua ibu hamil primigravida di Kota Palu. Sampel penelitian adalah ibu hamil primigravida yang telah memasuki trimester III kehamilan yang melakukan ANC di rumah sakit pemerintah dan Puskesmas di Kota Palu sebanyak 90 responden. Pengumpulan data dengan menggunakan kuesioner. Analisis bivariat menggunakan chi-square dan analisis multivariat dengan menggunakan logistic regression untuk mengetahui hubungan konseling dalam antenatal care (ANC) dengan koping pada tingkat kepercayaan 95% dan p-value <0,05. Hasil : Ibu primigravida yang memiliki koping adaptif sebesar 45,5% dan ibu primigravida yang mendapat konseling dalam ANC memiliki koping yang adaptif sebesar 54,4%. Terdapat hubungan yang signifikan (p<0,05) antara konseling dalam ANC dengan koping pada ibu hamil primigravida (OR=6,0; CI95% 2,03-17,9). Terdapat hubungan yang signifikan pada umur (OR=4,3; CI95%1,33-14,3), pendidikan (OR=3,5; CI95% 1,25-9,99), dan dukungan suami (OR=3,7; CI95% 1,48-9,46) dengan koping pada ibu hamil primigravida (p<0,05), sedangkan pekerjaan dan status ekonomi dengan koping pada ibu primigravida tidak terdapat hubungan yang signifikan. Kesimpulan : Konseling dalam ANC dapat meningkatkan koping yang adaptif pada ibu hamil primigravida saat menghadapi persalinan.

Research Background: During their first pregnancy, most women find it difficult to manage their both physical and emotional disorders. Even, they usually also lose their control by the time they are delivering their babies. Maladaptive coping are one factor influencing the phenomena of premature birth and pregnancy complication due to the mothers psychological condition just before delivering their babies. Pregnant women who do regular pregnancy checkup and gain counseling during her antenatal period can get able to earn information related to their fetus, detect their complications earlier, perform a healthy life style, and will affect the mother's coping. Research objective: This research aims to investigate the counseling relationship between Antenatal Care (ANC) and coping on primigravida pregnant women during delivering their babies in Palu. Research methods: This research is an observation research applying the cross sectional design. The independent variable is the counseling during antenatal care (ANC); while the dependent variable is the coping on pregnant women. Moreover, the population of this research involved all primigravida pregnant women in Palu. The research sample consisted of ninety primigravida pregnant women that had entered theirthird trisemester of pregnancy and conducted ANC in either hospitals or community health centers in Palu. The data were collected by using questionnaires. The bivariate analysis was done by employing chi-square; where as the multivariate analysis was performed by hiring logistic regression, aiming to figure out the relationship between counselling during antenatal care (ANC) and coping with the confidence level of 95% and (p-value <0.05). Research findings: Primigravida women with adaptive coping come with the percentage of 45.5%. Primigravida women having counseling during their ANC have adaptive coping as much as 54.4%. There is a significant relationship (p<0.05) between counseling during ANC and coping on prigrimavida pregnant women (OR = 6.0; CI95% 2.03-17.9). There is a significant relationship between age (OR = 4.3; CI95% 1.33-14.3), education (OR = 3.5; CI95% 1.25-9.99), their husbands supports (OR = 3.7, CI95% 1.48-9.46), and coping on prigrimavida pregnant women (p<0.05). Where as employment and economic status with coping in primigravida mother did not have a significant relationship. Conclusion: Counseling during ANC improves adapting coping on primigravida pregnant women while giving birth.

Kata Kunci : koping, konseling, antenatal care, primigravida.