PENGARUH EDUKASI HOLISTIK PERSIAPAN PERSALINAN PADA IBU HAMIL TRIMESTER III TERHADAP EFIKASI IBU DALAM MENGHADAPI PERSALINAN

FARIDA KARTINI, Prof. dr. Ova Emilia, Sp.OG (K)., M.Med. Ed., Ph.D..; Prof. dr. Djaswadi Dasuki, MPH., Ph.D., Sp.OG(K).; Prof. R.A. Dra. Yayi Suryo Prabandari, M.Si., Ph.D.

2019 | Disertasi | DOKTOR ILMU KEDOKTERAN DAN KESEHATAN

Latar belakang: Perubahan-perubahan pada kehamilan trimester III yang keterkaitan dengan aspek biologis, psikologis, sosial dan spiritual pada kehamilan dan proses persalinan perlu diketahui ibu. Hal ini penting untuk meningkatkan efikasi ibu dalam menghadapi persalinan, sehingga diharapkan ibu dapat bersalin dengan aman, nyaman dan luaran yang sehat. Tujuan penelitian: Mengetahui pengaruh edukasi holistik persiapan persalinan pada ibu hamil trimester III terhadap efikasi ibu dalam menghadapi persalinan. Mendapatkan gambaran tentang materi edukasi holistik berdasarkan pendapat ibu hamil trimester III. Metode penelitian: Desain penelitian adalah multi method. Populasi penelitian adalah ibu hamil trimester III, dengan jumlah sampel 80 ibu hamil yang terbagi dalam kelompok perlakuan dan kontrol. Teknik sampling consecutive sampling. Analisis data menggunakan analisis univariat, bivariat dan multivariat. Hasil: Terdapat perbedaaan skor pengetahuan sebelum dan sesudah edukasi DELTA 6,25 CI = 4,553-7,947 pada kelompok perlakukan dan DELTA 5,175 CI = 2,977-7,373 pada kelompok kontrol. Terdapat perbedaaan skor outcome expectancy sebelum dan sesudah edukasi DELTA 17,15 CI = 10,82-23,48 pada kelompok perlakukan dan DELTA 7,625 CI = - 0,04-15,29 pada kelompok kontrol. Terdapat perbedaaan skor efficacy expectancy sebelum dan sesudah edukasi sebesar DELTA 15,75 CI = 8,965-22,535 pada kelompok perlakukan dan DELTA 8,7 CI = 2,474-14,926 pada kelompok kontrol. Secara statistik tidak ada perbedaan pengaruh edukasi holistik dan edukasi standar dalam meningkatkan pengetahuan t = 0,783, P = 0,436, CI = -1,658-3,808, outcome expectancy t = 1,938, p = 0,056, CI = -0,259-19-309 dan efficacy expectancy t = 1,549, p = 0,126, CI = -2,014-16,114. Usia, lama pendidikan, status pekerjaan, jumlah kehamilan, paritas, jarak anak, ketakutan dan ketidaknyamanan bukan merupakan variabel konfonding terhadap pengetahuan, outcome expectancy dan efficacy expectancy. Dari perhitungan besar efek, secara klinis, edukasi holistik dapat meningkatkan pengetahuan dalam kategori lemah, dan meningkatkan outcome expectancy dan efficacy expectancy dalam kategori sedang. Hasil wawancara pada ibu mendapatkan hasil bahwa materi edukasi holistik lebih lengkap dan jelas sehingga ibu menjadi yakin dapat bersalin dengan lancar. Kesimpulan: Secara statistik tidak terdapat perbedaan antara edukasi holistik dan edukasi standar dalam meningkatkan pengetahuan, outcome expectancy dan efficacy expectancy, namun, secara klinis ada peningkatan. Materi edukasi holistik menjadikan ibu lebih percaya diri untuk dapat melahirkan dengan lancar.

Background: Changes in trimester III pregnancy period which are related to biological, psychological, social, and spiritual in pregnancy and giving birth process must be understood by women. This is very essential in order to improve womens efficacy in in dealing with giving birth process. Thus, the giving birth process can be held comfortably, safely, and the outcome expectancy is healthy. Objective: The study is to investigate the effect of holistic education during labor preparation in trimester III pregnant women on womens efficacy in dealing with labor and gain the description of holistic education material based on trimester III pregnant womens opinions. Method: The design of the study was multi method. The population of the study was trimester III pregnant women with 80 pregnant women as the samples which was divided into 2 groups; intervention and control group. The sampling technique was consecutive sampling. The data were analyzed using univariat, bivariate, and multivariate analysis. Result: There was a difference of knowledge after being given education in intervention group DELTA 6.25 Cl = 4.553 - 7.947 in intervention group and DELTA 5.175 Cl = 2.977 -7.373 in control group. There was a difference score of efficacy expectancy before and after education with DELTA 17.15 Cl = 10.82 - 23.48 in intervention group and DELTA 7.625 Cl = 0.04 - 15.29 in control group. Statistically, there was no effect difference of holistic and standard education in improving knowledge t = 0.783, P = 0.436, Cl = - 1.658 - 3.808, outcome expectancy t = 1.549, p = 0.126, Cl = 2.014 - 16.114. Age, education length, working status, total pregnancy number, parity, birth spacing, fear, and inconvenience were not confounding variables on knowledge, outcome expectancy, and efficacy expectancy. Based on the effect scale counting, clinically, holistic education can improve knowledge in low category and improve outcome expectancy and efficacy expectancy in moderate category. According to the interview result to the samples, it was found that holistic education is more complete and clearer so that women feel ensured that the giving birth process runs well. Conclusion: Statistically, there is no difference between holistic education and standard education in improving knowledge, outcome expectancy and efficacy expectancy. However, clinically, there is an improvement. Holistic education material makes women become more confident to give birth.

Kata Kunci : Edukasi, holistik, ibu hamil, efikasi, trimester, Education, holistic, pregnant women, efficacy, trimester