FAKTOR RISIKO RETENSI URIN PASCA-PERSALINAN PERVAGINAM: CASE-CONTROL STUDY

NURUL HIDAYATI, Widyawati, S.Kp., M.Kes., Ph.D., Elsi Dwi Hapsari, S.Kp., M.S., D.S

2020 | Tesis | MAGISTER KEPERAWATAN

Latar Belakang: Proses persalinan pervaginam berdampak terhadap kejadian retensi urin pascapersalinan. Identifikasi faktor risiko kejadian retensi urin pascapersalinan sangat bermanfaat untuk intervensi pencegahan. Tujuan: Mengetahui faktor risiko, faktor dominan, besarnya risiko dan insiden retensi urin pascapersalinan pervaginam di RSUD Banyumas. Metode: Pengambilan data penelitian dengan studi case-control dilakukan pada November 2019 sampai Januari 2020 menggunakan instrument berupa ceklist skrining dan data faktor resiko sejumlah 12 item pertanyaan dengan jawaban dikotomi. Besar sampel sebanyak 168 terdiri dari 42 sampel kasus dan 126 sampel control dengan tekhnik pengambilan sampel purposive sampling. Analisis statistic menggunakan uji Chi Square, Fisher Exact's dan Regresi Logistic. Hasil: Dari 168 sampel penelitian 42 orang diantaranya mengalami retensi urin (40, 48% dengan retensi urin overt dan 59, 52% dengan retensi urin covert). Hasil analisis didapatkan 3 variabel faktor resiko yang berpengaruh terhadap retensi urin pascapersalinan yaitu paritas (p-value 0,003; OR 6,881), durasi kala II (p-value 0,000; OR 174,018) dan episiotomi (p-value 0,015; OR 0,211). Variabel paling dominan adalah durasi kala II dan besarnya resiko kejadian diperoleh nilai R�² 0,394. Kesimpulan: Rumah Sakit berperan penting dalam pemantauan implementasi dan evaluasi terhadap prosedur pencegahan retensi urin pascapersalinan. Perlu pembaruan kompetensi klinis pencegahan retensi urin pascapersalinan melalui pendidikan dan pelatihan. Penerapan upaya promotif dan preventif perlu dilakukan sejak fase antenatal sampai postnatal kepada semua ibu hamil dan bersalin dengan menganggap bahwa semua ibu pascapersalinan pervaginam berisiko terjadi retensi urin. Pentingnya meningkatkan kemampuan skrining mandiri ibu postpartum terhadap faktor risiko retensi urin

Background: The vaginal delivery process has an impact on the incidence of postpartum urinary retention. Identification of risk factors for postpartum urinary retention is very useful for preventive interventions. Purpose: To determine the risk factors, dominant factors, the magnitude of the risk, and the incidence of urinary retention after vaginal delivery in Banyumas Regional Hospital. Methods: Research data collection with a case-control study was conducted from November 2019 to January 2020 using an instrument in the form of a screening checklist and risk factor data with a total of 12 question items with dichotomous answers. The sample size of 168 consisted of 42 case samples and 126 control samples with a purposive sampling technique. Statistical analysis used Chi-squared test, Fisher Exact test, and Logistic Regression. Results: Of 168 study samples, 42 of them experienced urinary retention including 40.48% with overt urinary retention and 59.52% with covert urinary retention. The results of the analysis obtained three risk factor variables that affect postpartum urinary retention, namely parity (p-value 0.003; OR 6.881), prolonged labor in stage II (p-value 0.000; OR 174.018) and episiotomy (p-value 0.015; OR 0.211). The most dominant variable is prolonged labor in stage II and the magnitude of the risk of events obtained R�² value of 0.394. Conclusion: The hospital plays an important role in monitoring the implementation and evaluation of postpartum urinary retention prevention procedures. It is necessary to update clinical competence in preventing postpartum urinary retention through education and training. The implementation of promotive and preventive measures needs to be done from the antenatal to postnatal phases for all pregnant and childbirth women by assuming that all postpartum vaginal mothers are at risk of urinary retention. The importance of increasing the ability of postpartum mothers to self-screen for risk factors for urinary retention.

Kata Kunci : Retensi Urin, Persalinan Pervaginam, Insidensi, Faktor Risiko, Upaya Preventif/ Urinary Retention, Vaginal Delivery, Incidence, Risk Factors, Preventive Measures