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Background: Surgical Patient Safety is essential to be carried out in operating theatre to prevent mortality and surgical complication. Patient safety is the basic principal in medical care and a major component of medical care management in hospital (WHO, 2009). Objective: To investigate association between SSC implementation among surgical team, surgical site infection and duration of hospital stay. Method : This is an analytical cross sectional study. Population of this study was women who underwent cesarean section with live birth in Barru general hospital during 1 December 2016-30 April 2017. This study was carried out in Barru general hospital, 137 samples met inclusion and exclusion criteria. Data was obtained from medical records. Maternal outcome were duration of hospital stay, surgical site infection, and maternal mortality. Besides, this study also assesed knowledge and compliance of surgical team in implementation of SSC. The result of this study was analysed with computer statisctics analysis program. Result adn Discussion : One-hundred thirty seven patients met study criteria. Compliance of surgery team in SSC was 64%,. SSC was not implemented precisely in 36% patients (49 patients). There is no significant association between surgical team compliance with surgical site infection in cesarean section patients ( p=0.078 ). A significant association was found between surgical team compliance with duration of hospital stay ( p=0.006 ). Conclusion: The surgical team compliance in implementation of SSC was not yet optimal. An intensive socialization is needed to improve compliance of team in order that SSC implementation run promptly. This was part of efforts to reduce post operative complication and shorten hospital stay. Keywords : SSC, cesarean section, compliance, infection, duration of hospital stay

Umar Dhani 1 , Ova Emilia 2 , Risanto Siswosudarmo 3 ABSTRACT Background: Abortion is still the most common complication of pregnancy. Inadequate secretion of progesterone in early pregnancy has been associated with one of the cause of miscarriage. Progesterone supplementation has been used to prevent abortion but it is still debatable. Objective : To compare the success rate of vaginal progesterone vs oral allylestrenol in the treatment of threatened abortion and duration of maintaining pregnancy. Method: Randomized Clinical Trial. The study was conducted at four affiliated hospitals of Sardjito hospital Yogyakarta from November 2013 to May 2014. Subjects with the diagnosis threatened abortion meeting the following criteria were included: 8-16 weeks gestational age, hemoglobin content eH 10 g/dL, and live fetus. The following patients were excluded: there was a history of induced abortion, hormonal treatment, associated with IUD use, uterine anomaly and gynecology tumor. A total of 60 patients were recruited to obtain 0.6 times proportion difference and 80% power of study. Eligible subjects consisting of 30 and 29 were randomly allocated into vaginal progesterone and oral allylestrenol groups. Ability to maintain, duration of pregnancy and side effects were outcomes of interest. Chi - square, t-test, Fisher exact test and survival analysis were used for statistical analysis. Result & Discussion: Abortion rate in vaginal progesterone was 23.3% compared 37.9% with oral allylestrenol group (RR=0.61; 95% CI 0.27-1.36). Duration of maintaining pregnancy was 16.57 days vs 9.82 days in vaginal progesterone and oral allylestrenol respectively (mean difference 6.75 days; 95% CI 2.30-11.20). There was no difference in term of gestational age on the abortion rate ( p >0.05). One case undergoing nausea was found in oral allylestrenol group. Conclusion: There was no difference between vaginal progesterone and oral allylestrenol in term of abortion rate. Vaginal progesterone could maintain pregnancy longer than oral allylestrenol. Keywords: Threatened abortion, Vaginal progesterone, Oral allylestrenol, Abortion rate, Side effect. ABSTRAK Latar Belakang: Abortus masih merupakan komplikasi kehamilan yang sering terjadi. Sekresi progesteron yang tidak memadai pada awal kehamilan telah dikaitkan dengan salah satu penyebab abortus. Suplementasi progesteron digunakan untuk mencegah keguguran spontan walaupun masih diperdebatkan. Tujuan: Membandingkan keberhasilan terapi progesteron vaginal vs. allylestrenol oral dalam hal kejadian abortus dan lama terjadinya abortus pada kasus abortus iminens . Metode: Randomized Clinical Trial. Penelitian dilakukan dibagian Obstetrika dan Ginekologi di RS Kabupaten yang merupakan afiliasi RS Sardjito dari bulan November 2013 sampai dengan Mei 2014. Subyek yang memenuhi kriteria berikut ini: hamil 8-16 minggu, terdiagnosis abortus iminens, kadar hemoglobin > 10 g/dL, dan janin hidup. Pasien berikut ini tidak dimasukkan dalam penelitian: riwayat abortus provokatus, riwayat penggunaan terapi hormonal, abortus imminens karena kegagalan IUD, anomali uterus dan tumor ginekologis. Sebanyak 60 pasien diikutsertakan dalam penelitian ini untuk mendapatkan beda proporsi kejadian abortus sebesar 0,6 kali dengan kekuatan penelitian sebesar 80%. Subjek dibagi menjadi dua kelompok secara random yaitu kelompok yang mendapat progesteron vaginal dan allylestrenol oral masing-masing sebanyak 30 dan 29. Keberhasilan mempertahankan kehamilan, lama hari bertahan dan efek samping adalah hasil yang dinilai. Uji Chi-square , t- test, uji Fisher dan analisis s urvival adalah uji statistik yang dipakai. Hasil & Pembahasan: Kejadian abortus pada kelompok progesteron vaginal adalah 23,3% dibanding, 37,9% pada kelompok allylestrenol oral (RR=0,61; 95% CI 0,27-1,36). Lama bertahan pada kelompok progesteron vaginal rata-rata 16,57 hari dibanding rata-rata 9,82 hari pada kelompok allylestrenol oral (beda rata-rata 6,75 hari; 95% CI 2,30-11,20). Tidak ada perbedaan bermakna pengaruh umur kehamilan terhadap kejadian abortus pada kedua kelompok ( p >0,05). Efek samping berupa perasaan mual hanya dijumpai pada kelompok allylestrenol oral. Kesimpulan: Tidak terdapat perbedaan kejadian abortus pada kedua kelompok meskipun kemampuan bertahan lebih lama pada kelompok progesteron vaginal. Kata Kunci: Abortus iminens, progesteron vaginal, allylestrenol oral, angka abortus, efek samping. 1,2,3 Bagian Obstetri dan Ginekologi Fakultas Kedokteran Universitas Gadjah Mada/RS SardjitoYogyakarta

Background The philosophy of midwifery education is based on the ‘Women-centred care’ model, which provides holistic care to women. Continuity of care (CoC) is integral to the concept of holistic women-centred care and fundamental to midwifery practice. The objective of this study was to determine any differences in students’ understanding of midwifery care philosophy between students who underwent the CoC learning model and those who underwent the fragmented care learning model. Method We used a quasi-experiment design. This study was conducted by all final year midwifery students at two schools of midwifery in Indonesia. Fifty four students from one school attended 6 months of clinical training using the CoC learning model. The control group was comprised of 52 students from the other school. These students used the conventional clinical training model (the fragmented care learning model). The independent T-test using SPSS was used to analyse the differences between the two groups of students in terms of understanding midwifey care philosophy in five aspects (personalized, holistic, partnership, collaborative, and evidence-based care). Results There were no significant differences between the groups before interventon. There were significant differences between the two groups after clinical training (p

Family planning for unmet needs among childbearing aged couples in an urban community in Yogyakarta Purpose This study aimed to determine the relationship of provider bias with unmet needs for family planning in couples of childbearing age in the Kraton area of the city of Yogyakarta. Method This cross-sectional study involved 121 respondents of childbearing age couples in Kraton sub-district of Yogyakarta city. Data retrieval technique used multistage random sampling. Data analysis used univariable, and bivariable analysis with chi square tests with significance level (p

PENDIDIKAN/PEKERJAAN MATERNAL DAN FAKTOR RISIKO PREEKLAMPSIA: STUDI EPIDEMIOLOGI DI KOTA TERNATE Lilie Fransiska 1 , Edi Patmini 2 , Abdul Wahab 3 , Ova Emilia 4 ABSTRACT Background : Preeclampsia is one of leading cause of maternals and infants morbidity and mortality that can be prevented by an early detection in pregnant woman who have risk factors to preeclampsia. Early detection and management have a significant role in decreasing maternal and infant mortality rate. Objective: To determine the proportion of pregnancy with risk to preeclampsia and related risk factors. Method : This research is an observational study with cross sectional design. The independent variables are level of maternal education, and occupation. The dependent variable is increased risk of preeclampsia during pregnancy. Data collected by direct interview, physical examination and laboratory examination. Data analysis was done with SPSS programme. Results and Discussion : The result showed that there was no significant difference in maternal educational level with the risk of preeclampsia (p= 0,919), and there is no significant difference between maternal working status with risk of preeclampsia (p= 0,435). Conclusions : This research showed that maternal level of education and working status didn’t have a significant influence to the risk of preeclampsia (p> 0,05). Keywords : maternal occupation, level of maternal education, risk of preeclampsia ABSTRAK Latar Belakang : Preeklampsia merupakan salah satu penyebab morbiditas dan mortalitas pada ibu dan bayi yang dapat dicegah dengan melakukan deteksi dini pada ibu hamil yang memiliki risiko terhadap terjadinya preeklampsia. Tujuan: Penelitian ini bertujuan untuk menentukan proporsi ibu hamil dengan risiko preeklampsia di Kota Ternate dan faktor-faktor risiko yang terkait. Hasil penelitian ini diharapkan supaya dapat digunakan untuk meningkatkan kesehatan ibu dan anak di Kota Ternate. Metode : Penelitian ini merupakan penelitian observasional dengan menggunakan desain studi potong lintang. Variabel bebas adalah tingkat pendidikan dan jenis pekerjaan ibu. Variabel terikat adalah peningkatan risiko terjadinya preeklampsia selama kehamilan. Data dikumpulkan dengan melakukan wawancara langsung, pemeriksaan fisik, dan pemeriksaan laboratorium. Selanjutnya analisis deskriptif pada data penelitian dilakukan dengan menggunakan program SPSS. Hasil dan Pembahasan : Hasil analisis menunjukkan bahwa tidak ada perbedaan bermakna antara kelompok berpendidikan tinggi dan kelompok berpendidikan rendah (p= 0,919), serta antara kelompok bekerja dan tidak bekerja (p= 0,435). Kesimpulan : Faktor pendidikan dan pekerjaan maternal tidak memiliki pengaruh yang bermakna terhadap risiko terjadinya preeklampsia (p> 0,05). Kata kunci : pekerjaan ibu, pendidikan ibu, risiko preeklampsia 1 Mahasiswa S1 Fakultas Kedokteran UGM, Yogyakarta 2 Bagian Obstetri dan Ginekologi Fakultas Kedokteran UGM 3 Bagian Ilmu Kesehatan Masyarakat UGM, Yogyakarta 4 Bagian Obstetri dan Ginekologi Fakultas Kedokteran UGM

The influence of antenatal class implementation toward exclusive breastfeeding in Gunung Kidul Purpose This study aimed to determine the effect of the implementation of the antenatal class toward exclusive breastfeeding. Methods The research was a case-control study with a quantitative approach. This research was also supported by a qualitative approach which aimed to complement and reinforce the results obtained from the quantitative data. Sample cases were 135 exclusive breastfeeding infants aged 6-12 months, and the control sample were 135 not exclusive breastfeeding infants aged 6-12 month. Data analysis used the McNemar and conditional logistic regression tests with significance level of p =

The use of intra uterine device (IUD) and sexual activity patterns in women in Kupang Purpose The purpose of this study was to know the influence of intra uterine device type contraceptive use to the pattern of sexual activity. Methods This research was an observational study with a cross-sectional design using questionnaires to collect data. The samples were 190 women of fertile age in the city of Kupang. The correlation of intra uterine device usage and sexual activities pattern was analyzed by using chi square tests, and continued with multivariate analysis using logistic regression tests, using confidence interval (CI) of 95% and a level of significance of p

Low birth weight (LBW) is a significant public health problem in the world. It was estimated globally by the World Health Organization (WHO) that prevalence of LBW was 15% of all births. In Murung Raya district LBW cases remain high. This paper aimed to identify and discuss the relationship between environmental risk factors with LBW in Murung Raya.A spatial analysis was conducted with 150 women as the total participantswho were recruited through the incidence data in 2013-2014. The questionnaires, medical records, and geographic data were measured by Stata software, ArcGis, SatScan, and Geoda. The study results indicated there was significant correlation between health behavior and environmental variables with the strength of external neighborhood effect across LBW risk factors. More intense clustering of high values (hot spots) was found through the spatial analysis showing that most of the cases were located near the defined buffer zone. This research demonstrates that the spatial pattern analysis provided greater statistical power to detect an effect that was not apparent in the previous epidemiology studies.

Prior to admission, medical students were subject to psychological tests to measure their logical thinking skills and personality, hence predicting their ability to complete their studies. The results showed 56,45% of medical students obtained recommendation category 4 (doubtful) and 5 (not recommended), two categories which are considered to be at-risk group with avery small probability of completing their studies. These results predicted that students in the mentioned groups will have difficulties in achieving the clinical competence level required by the Indonesian Doctors’ Competency Standard (IDCS). The aim of the study was to investigate clinical competency achievement by at-risk medical students in the third year, after following interpersonal skills development training program on July 2011. This research used qualitative study design through psychological examination, written self-reflection and in-depth interview after the training. Interpersonal skills development training for at-risk medical students gave positive effects to theircharacter development for the helping profession. It was concluded that interpersonal skills training could help improve medical student’s achievement of clinical competence especially for at-risk group in their clinical rotations stage.Keywords: medical students, at-risk group, interpersonal skills, clinical competenceAbstrakPada mahasiswa kedokteran yang baru masuk dilakukan pemeriksaan psikologis untuk memperoleh gambaran penalaran dan kepribadian untuk memprediksi kemampuan mahasiswa dalam menyelesaikan pendidikan. Berdasarkan pemeriksaan tersebut diperoleh 56,45% mahasiswa dengan hasil uji psikometrik kategori rekomendasi 4 (diragukan) dan 5 (tidak disarankan) yang disebut sebagai kelompok at-risk. Kelompok at risk memiliki peluang keberhasilan rendah untuk menyelesaikan pendidikan dan akan mengalami kesulitan mencapai kompetensi klinik sesuai Standar Kompetensi Dokter Indonesia. Tujuan penelitian ini adalah menggali pengalaman pencapaian kompetensi klinik mahasiswa kelompok at-risk pada tahun ketiga, setelah mengikuti pelatihan pengembangan keterampilan interpersonal yang dilaksanakan pada bulan Juli 2011. Penelitian ini menggunakan rancangan studi kualitatif dengan wawancara mendalam setelah dilakukan pelatihan. Pengembangan keterampilan interpersonal pada mahasiswa kedokteran kelompok at-risk memberikan dampak positif terhadap pembentukan kepribadian sebagai helping profession. Disimpulkan bahwa pengembangan keterampilan interpersonal yang diberikan dalam bentuk pelatihan dapat digunakan untuk membantu meningkatkan pencapaian kompetensi mahasiswa khususnya kelompok at-risk di tahap klinik.Kata Kunci: mahasiswa kedokteran, kelompok at-risk, keterampilan interpersonal, kompetensi klinik.

PENGARUH PEMBERIAN ASI EKSKLUSIF TERHADAP KEMBALINYA MENSTRUASI PADA IBU MENYUSUI DI RS ST. CAROLUS JAKARTA Popy Irawati 1 , Mohammad Hakimi 2 , Ova Emilia 3 ABSTRACT Background: Exclusive breastfeeding has benefit for both the baby and mother. The breastfeeding patterns have a close relation with return of menses. Breastfeeding practice in Indonesia is rare (27-40%) and 37,4% babies received a weaned food, and only 10% babies received six months exclusive breastfeeding. In Jakarta, most mothers realized benefit of breastfeeding for their babies and family themselves. This research is located at St. Carolus Hospital because St. Carolus is a centre of lactation in Jakarta Objective: To identify the impact of exclusive breastfeeding on median time of return of menses on breastfeeding mother in St. Carolus hospital. Method: An observational study with retrospective cohort study design. Samples are a year breastfeeding’s mother in St. Carolus Hospital. The total samples are 129 respondents. The samples are available with consecutive sampling. The data were analyzed using univariable, bivariable and multivariable methods. Bivariable statistic tests were chi square, log rank and Kaplan Meier’s survival analyzed methods. The multivariable statistic test was cox regression Hazard model. Result and Discussion: Median time of the return of menses on exclusive breastfeeding group was 20 weeks, and an unexclusive breastfeeding is 12 weeks. The breastfeeding pattern and the return of menses on breastfeeding mother are significant related (HR=2,4; CI 95%=1,65-3,55 ;P

PERILAKU BIDAN DALAM PELAKSANAAN INISIASI MENYUSU DINI DI WILAYAH KERJA PUSKESMAS II TAMBAK, PUSKESMAS BANYUMAS DAN PUSKESMAS I KEMRANJEN Sumiyati 1 , Ova Emilia 2 , Djaswadi Dasuki 3 ABSTRACT Background: Early Initiation of Breastfeeding (EIB) is important because it can increase the success of exclusive breastfeeding and infant survival. However, the implementation of the EIB is still not optimal in Banyumas. One of the factors that support the success of EIB is the support of health workers, especially midwives. Central Bureau of Statistics of Banyumas regency in 2012 said that most of deliveries in Banyumas 78.52% in 2011 attended by midwives. Objective: To determine the behavior of midwives in the implementation of Early Initiation of Breastfeeding at Work Area of Tambak Public Health Center Banyumas. Public Health Center and Kemranjen Public Center. Methods: The study was cross sectional complemented with qualitative data. The experiment was conducted at the Working Area of Tambak II, Banyumas and Kemranjen I public healh centers with 38 midwives as subjects. In-depth interviews conducted to 6 midwives and 4 postpartum mothers. Results and Discussion: There were a significant association between knowledge and attitudes of midwives to practice implementation of EIB, knowledgeable midwife tent to practice E.I.B 1.79 times higher than less knowledgeable midwife. Good attitude midwives 1.62 times more likely to support EIB practice. Conclusion: The behavior of midwife in the implementation of the EIB practices is influenced by a good knowledge and attitudes that support the EIB. Factors that inhibit the EIB, included flat nipples exhaustment of postpartum mothers and lack of rest among health professionals when encountered prolong labor. Keywords: knowledge, attitude, practice, midwife, early initiation of breastfeeding ABSTRAK Latar Belakang: Inisiasi Menyusu Dini (IMD) penting karena dapat meningkatkan keberhasilan ASI eksklusif dan kelangsungan hidup bayi. Namun pelaksanaan IMD masih belum optimal di Kabupaten Banyumas. Salah satu faktor yang mendukung keberhasilan IMD adalah dukungan tenaga kesehatan terutama bidan. Badan Pusat Statistik Daerah Kabupaten Banyumas tahun 2012 menyatakan sebagian besar penduduk Kabupaten Banyumas sekitar 78,52% pada tahun 2011 menggunakan tenaga kesehatan bidan untuk menolong persalinan. Tujuan: Untuk mengetahui perilaku bidan dalam pelaksanaan Inisiasi Menyusu Dini di Wilayah Kerja Puskesmas II Tambak, Puskesmas Banyumas dan Puskesmas I Kemranjen. Metode: Penelitian observasional dengan rancangan cross sectional. Penelitian ini secara kuantitatif dan kualitatif. Penelitian dilaksanakan di Wilayah Kerja Puskesmas II Tambak, Puskesmas Banyumas dan Puskesmas I Kemranjen dengan subjek penelitian 38 bidan dan wawancara mendalam dengan 6 bidan serta 4 ibu postpartum . Hasil dan Pembahasan: Hasil analisis bivariabel terdapat hubungan yang bermakna antara pengetahuan dan sikap bidan dengan pelaksanaan praktik IMD, bidan yang berpengetahuan baik 1,79 kali lebih besar untuk melakukan praktik IMD dengan baik dibandingkan dengan bidan yang berpengetahuan kurang. Sikap bidan yang mendukung IMD 1,62 kali lebih besar untuk melakukan praktik IMD dengan baik dibandingkan dengan sikap bidan yang tidak mendukung IMD. Kesimpulan: Perilaku bidan dalam pelaksanaan praktik IMD dipengaruhi oleh pengetahuan yang baik dan sikap yang mendukung terhadap IMD. Faktor yang menghambat IMD antara lain bentuk puting yang mendatar sehingga bayi kesulitan untuk menghisap, ibu postpartum merasa capai dan lelah karena kurang istirahat serta faktor tenaga kesehatan, apabila menolong persalinan dengan kala II lama sehingga pelaksanaan IMD kurang dari satu jam. Kata kunci: pengetahuan, sikap, praktik, bidan, inisiasi menyusu dini 1 Poltekkes Kemenkes Semarang 2,3 Bagian Obstetri dan Ginekologi, Fakultas Kedokteran UGM

PEMANFAATAN POJOK LAKTASI DI PUSKESMAS I CILONGOK KABUPATEN BANYUMAS Khusnul Khotimah, Ova Emilia,Mohammad Hakimi ABSTRACT Background : Based on survey Indonesian demographic and health in 2007 that exclusive breastfeeding 38 % decrease from 39,5% in 2002-2003, child under 6 months who gets milk incease from 16,7% until 27,9% in 2007. American Academy of Pediatrics (1)get recomendation baby must get exclusive breastfeeding in 6 month until 2 years old. Banyumas regency are have a program to increase scope of exclusive breastfeeding by regulation of regent number 52 in 2012 about increase exclusive breastfeeding in Banyumas Regency. One of the material in socialization is about lactation room and standardization, right of women worker to breastfed in office, public facility. Objective : to determine factors can effected utilization of lactation room in Puskesmas I Cilongok. Methods : this study was an observational study with a cross sectional design and qualitative study or called mix method. Location of study in Puskesmas I Cilongok. Sample of this study is employed mother who breastfeed and visitors of Puskesmas I Cilongok in Banyumas Regency. Sampling method used sampling convinience get 41 women until this study done. independent variable are attitude of breastfeed mother about lactation room and behavior of breastfeed mother. Dependent variable is utilization of lactation room. Data analysis consisted of univariable analysis, bivariable analysis using chi-square test and multivariable analysis using logistic regression test and also qualitative analysis. Results and Discussion : there is no effect attitude of breastfeed mother about lactation room with utilization of lactation room, can we see from p = 0,247 (RP1,58; 95% CI 0,70-3,55), the similar result from dialogue that mother have good attittude but not utilized, they say not get socialization from health worker. The good Behavior breastfeed mother have relation with utilization, can we see p = 0,028, RP2,35 (95% CI 1,05-5,23). Results from dialogue mother who get bad behavior not utilized. Utilization in lactation room only just breastfeeding, never used to pamp and saving breastmilk. People not respond that room lactation is a necessary, because without policy about room lactation, they are can breastfed in any where. Conclusion : Good attitude of breastfeed mother about lactation room can not get effect utilization of lactation roomand good behavior breastfeedmother can get effect with utilization lactation room in Puskesmas I Cilongok. Keyword : attitude breastfeed mother, behavior breastfeed mother and utilization lactation room ABSTRAK Latar Belakang :Berdasarkan data Survey Demografi dan Kesehatan Indonesia (SDKI) tahun 2007 tercatat bahwa cakupan ASI eksklusif sebesar 38% menurun dari 39,5%di tahun 2002-2003, sementara jumlah bayi dibawah 6 bulan yang diberi susu formula meningkat dari 16,7% menjadi 27,9% ditahun 2007. American Academy of Pediatrics (1)merekomendasikan bahwa durasi minimal ASI eksklusif menjadi 6 bulan tetapi optimal harus terus selamaminimal 2 tahun.Kabupaten Banyumas sedangmemiliki program gunameningkatkan cakupan ASI eksklusif yang dituangkan lewat Peraturan Bupati Banyumas nomor 52 tahun 2012 tentang peningkatan pemberian ASI di Kabupaten Banyumas. Salah satu materi sosialisasi tersebut berisi tentang anjuran pengadaan pojok laktasi beserta standarisasinya, hak ibu bekerja yang menyusui di kantor pemerintahan, sarana pra sarana umum juga. Tujuan :Untuk mengetahui faktor-faktor yang mempengaruhi pemanfaatan pojok laktasi di Puskesmas I Cilongok. Metode:Penelitian ini menggunakan jenis observasional dengan desaincross sectionaldan kualitatif. Tempat penelitian Puskesmas I Cilongok. Sampel penelitian ibu bekerja menyusui dan pengunjung puskesmas memiliki bayi umur 0 bulan sampai dengan 2 tahun berada di Puskesmas I Cilongok. Pengambilan sampel menggunakan sampling conviniencediperoleh 41 orang selama penelitian dilakukan.Variabelindependen adalah sikap ibu menyusui terhadap pojok laktasi, perilaku ibu menyusui. Variabel dependen ialah pemanfaatan pojok laktasi. Analisa data meliputi analisis univariabel, bivariabeldengan menggunakan chi square sedangkan multivariabel menggunakan uji regresi logistik serta analisis kualitatif. Hasil dan Pembahasan :Sikap ibu menyusui terhadap ketersediaan pojok laktasi tidakmempengaruhi pemanfaatan pojok laktasi dilihat dari nilai p = 0,247 (RP1,58; 95% CI 0,70-3,55), hasil ini didukung hasil wawancara bahwa sikap baik tetapi tidak memanfaatkan pojok laktasi dengan alasan sosialisasi yang kurang dari petugas kesehatan. Perilaku ibu menyusui yang baik berhubungan dengan pemanfaatan pojok laktasi dilihat dari nilai p = 0,028, RP2,35 (95% CI 1,05-5,23). Hasil wawancara ibu yang berperilaku tidak baik cenderung tidak memanfaatkan pojok laktasi. Pemanfaatan pojok laktasi hanya untuk menyusui saja, tidak digunakan untuk memeras dan penyimpanan ASI. Rendahnya pemanfaatan pojok laktasi dikarenakan faktor kebutuhan. Masyarakat desa tidak menganggap bahwa pojok laktasi merupakan kebutuhan, karena tanpa adanya kebijakan pengadaan pojok laktasi mereka dapat menyusui dimanapun. Kesimpulan :sikap ibu menyusui terhadap ketersediaan pojok laktasi yang baik tidak mempengaruhi pemanfaatan pojok laktasi dan perilaku ibu menyusui yang baik dapat mempengaruhi pemanfaatan pojok laktasi di Puskesmas I Cilongok Kabupaten Banyumas. Kata kunci : sikap ibu, perilaku ibu, pemanfaatan pojok laktasi

PERSEPSI REMAJA TERHADAP FAKTOR PENGHAMBAT PEMANFAATAN PELAYANAN KESEHATAN REPRODUKSI DI PUSKESMAS GAMBOK KABUPATEN SIJUNJUNG Vella Dwi Yani, Ova Emilia, Hari Kusnanto ABSTRACT Background : Reproductive health service is an important component that has to be improved globally because teenagers often lack basic information about reproductive health. Despite the need for reproductive health service only a few teenagers utilize the service due to several constraints in having reproductive and sexual health service as a result of limited access to the service and negative perception about center of reproductive health service. Data of Sijunjung District Health Office Sumatera Barat show that only 20% of teenagers utilize reproductive health service available. Whereas cases in teenagers indicate that 9.2% of teenagers have had premarital sexual intercourse and 40% are married at teenage period (

PAJANAN ASAP DALAM RUMAH TERHADAP KEJADIAN ISPA NONPNEUMONIA PADA ANAK BALITA DI KABUPATEN KAPUAS Mayae Hugo, Ova Emilia,Mei Neni Sitaresmi ABSTRACT Background : Acute respiratory infections (ARI) is one of themain causes of disease burden in developing countries, and 40-60% patients visits at the health center. Riskesdes analysis report the under–five children who suffer from upper respiratory tract infection prevalence 42.8%. ARI occurrence is affected by many factors, including environmental factors. Little attention has been given to indoor air pollution particularly for people in rural areas, although the known particles of smoke in the room known as the most influential factors on the health of children where children spend most of their time indoors Objective : To know whether smoke exposure inside the house is a risk factor toward non pneumonia ARI among under-five children. Method : This was a study using a case control study design. Subjects were under-five children aged 12-59 months old in Kapuas District taken by non probability sampling method. Sample size was 106, divided into two groups namely case (n=53) and control (n=53). Data analysis used univariate analysis, bivariate analysis, and multivariate analysis with logistic regression. Result : Non pneumonia ARI had a 2.7 time greater risk of contracting under-five children exposed by smoke inside their house (95%CI=1.16-6.60). Multivariate analysis proportion of house condition which was not really hygienic, member of family who contracted ARI, bad nutritional status had a significant relationship to non pneumonia ARI among under-five children. Conclusion : Non pneumonia ARI among under-five children had a significant relationship to smoke exposure inside the house. Keywords : non pneumonia ARI, smoke exposure inside the house, under-five children ABSTRAK Latar Belakang : Infeksi saluran pernapasan akut (ISPA) merupakan salah satu penyebab utama beban penyakit di negara berkembang. Terdapat 40-60% kunjungan pasien di pusat layanan kesehatan. Analisis Riskesdesmelaporkan prevalensi anak-anak balita yang menderita infeksi saluran pernapasan atas 42,8%. Kejadian ISPA dipengaruhi oleh banyak faktor, termasuk faktor lingkungan. Sedikitnya perhatian yang diberikan terhadap polusi udara dalam ruangan terutama bagimasyarakat di daerah pedesaan,meskipun partikel yang berasal dari asap di dalam ruangan dikenal sebagai faktor yang paling berpengaruh pada kesehatan anak di mana anak-anak menghabiskan sebagian besar waktu mereka di dalam ruangan. Tujuan : Untuk mengetahui apakah paparan asap di dalam rumah merupakan faktor risiko terhadap non pneumonia ISPA pada balita. Metode : Penelitian ini merupakan penelitian dengan menggunakan disain penelitian kasus kontrol. Subyek penelitian adalah balita berusia 12-59 bulan di Kabupaten Kapuas diambil dengan metode non probability sampling. Jumlah sampel adalah 106, dibagi menjadi dua kelompok yaitu kelompok kasus (n=53) dan kelompok kontrol (n=53). Analisis data yang digunakan analisis univariat, analisis bivariat, dan analisis multivariat dengan regresi logistik. Hasil dan Pembahasan : ISPA non pneumonia memiliki risiko 2,7 kali lebih besar menjangkiti anak yang terpapar asap di dalam rumah mereka (95% CI=1,16-6,60). Proporsi analisis multivariabel kondisi rumah yang tidak benarbenar higienis, anggota keluarga yang terjangkit ISPA, status gizi buruk memiliki hubungan yang signifikan terhadap ISPA non pneumonia pada balita. Kesimpulan : ISPA non pneumonia pada balita memiliki hubungan yang signifikan terhadap paparan asap di dalam rumah. Kata kunci: ISPA non pneumonia, paparan asap di dalam rumah, balita

Background: The number of caesarean section (CS) operations in the world has increased sharply within the last 20 years. Increase of the need for CS operations also increases the problem related to surgical process. Infection happens about 2% to 16% after CS operation. The incidence of post CS is associated with some factors such as supplementation of prophylaxis antibiotics, duration of childbirth, width of membrane wound, duration of surgical nursing monitoring and number of CS. CS infection associated with antibiotic use occurs before or after CS operation. The incidence increases 3 times in patients that do not use antibiotics before CS operation. Use of prophylaxis antibiotics in CS operation significantly minimizes the incidence of infection.Objective: To identify antibiotic use according to standard operational procedure to the incidence of infection in CS mothers.Method: The study was analytical with cross sectional design, undertaken at Abepura Local Hospital. Population were all mothers who gave birth through CS at the hospital. Samples were taken using systematic random sampling technique as many as 44 samples. Data were obtained through questionnaire, interview and document studies and analyzed using chi square and logistic regression test, risk prevalence at confidence interval (CI) 95% and significance p

Background: A large number graduates of midwife even now accompanied with low competency isues in associated with quality of clinical learning . Now implementation of clinical learning with caseload model has problems. Clinical learning model in clinical practice that student, teacher and clinical midwife experienced provide greater insight to develop an effective clinical teaching strategy in midwifery education. The main objective of this study was to investigate student midwife, teacher and clinical midwife’ insight about an ideal clinical learning model in midwifery education. Method: A qualitative study by Focus Group Discussion (FGDs). By selected randomly, this study was conducted 32 from 76 final year midwifery students at Estu Utomo Boyolali Midwifery Academy, 14 lecturer and 13 clinical midwife who involve in Estu Utomo Boyolali Midwifery Academy clinical practice program at 2013-2014. There are 4 groups of student midwife, 2 groups of lecturer and 2 groups of clinical midwife. FGDs were arranged in 3 session differently between students, lecturer and clinical midwife. FGDs were facilitated by researcher and 3 research assistant. Data were analyzed using Atlas.Ti 6.1 software to support the coding process and identifying the main categories from verbatim transcripts. Results: Six themes emerged from the focus group data, “student caseload”, “duration of clinical practice”, “clinical placement”, “clinical mentorship”, “documentation”, and “clinical assessment”. From the sixth themes, demonstrated that an ideal clinical learning model in midwifery education to design preparation clinical learning should consider about that components. An ideal clinical learning model in midwifery education should give priority to quality than quantity especially to suggest decreasing student caseload. Conclusion: This study showed that midwife student, teacher and clinical midwife suggest that clinical learning model should give priority to quality than quantity to gain midwifery care competence. Clinical learning model therefore applied with student case loading that each student have different need. They are suggest that midwifery clinical learning should be consistent with the midwifery care philosophy “women center care” that provide midwifery continuity of care.

Intervention on midwife behavior about early initiation of breastfeeding practice using short message servicePurposeThis research examined the effects of an intervention by delivering short message service towards midwife behavior.MethodsThis research was a quasi-experimental study with pre and post test design using control group. A total of 64 midwives in Palembang participated until data extraction. About 18 themes of short messages were delivered through participants’ mobile phone. Data were analyzed by univariate, bivariate, and linear regression tests.ResultsResults showed that the intervention improved early breastfeeding perceptions by about 7.3% (p= 0.0308). Participants’ knowledge was increased after intervention although there was no significant mean difference between groups. Almost all participants (over 80%) practiced imperfect early breastfeeding, especially in giving information since antenatal care, short-duration, and directing baby for sucking mother’s nipple.ConclusionNot all of participants facilitated early breastfeeding in every birth because of other factors such as unsupported mother and infant’s condition. Early initiation of breastfeeding is not easily implemented by health staff. It is better that midwives could motivate mothers to breastfeed within 1 hour since antenatal care. The important keys are having high commitment and confidence which contribute to midwives’ belief for practicing every step in every birth. We concluded that this research should be continued for long-term-analysis to give more significant results., Latar belakang: Angka kematian bayi dan angka kematian ibu dapat ditekan dengan memfasilitasi bayi baru lahir untuk menyusu sendiri 1 jam setelah persalinan, yang dikenal dengan istilah inisiasi menyusu dini. Namun, persentase menyusu dalam 1 jam di Provinsi Sumatera Selatan hanya mencapai 29,2% pada tahun 2010. Beberapa penelitian menemukan faktor penghambat meliputi kurangnya pemahaman dan persepsi tenaga penolong persalinan. Penelitian ini bertujuan melihat pengaruh pemberian pesan singkat terhadap perilaku inisiasi menyusu dini pada bidan.Metode: Jenis penelitian ini adalah quasi-experimental melalui before and after design dengan kelompok kontrol. Subjek penelitian berjumlah 64 bidan di Kota Palembang. Perlakuan yang diberikan berupa 18 topik pesan edukasi dalam bentuk pesan singkat melalui handphone. Data dianalisis melalui uji univariat, bivariat, dan regresi linear.Hasil: Pemberian perlakuan meningkatkan persepsi sebesar 7.3% (p value = 0.0308). Pengetahuan kelompok intervensi meningkat setelah perlakuan, walaupun perubahan rerata tidak bermakna dibandingkan dengan kelompok kontrol. Sebagian besar subjek kurang tepat dalam menjalankan tahapan inisiasi menyusu dini, antara lain tentang pemberian informasi saat layanan antenatal, durasi yang singkat, dan bayi masih diarahkan saat inisiasi menyusu dini.Kesimpulan: Pelaksanaan inisiasi menyusu dinibelum dijalankan secara maksimal oleh bidan. Tidak semua persalinan difasilitasi inisiasi menyusu dini karena keadaan ibu dan bayi yang tidak mendukung. Bidan sebaiknya dapat memberikan motivasi ibu bersalin, dimulai saat pemeriksaan kehamilan. Komitmen dan kepercayaan diri merupakan kunci dari keyakinan bidan untuk senantiasa memfasilitasi inisiasi menyusu dini pada setiap persalinan. Selain itu, hasil penelitian ini perlu dianalisis jangka panjang untuk dampak yang lebih signifikan.

The correlation of reproductive health information exposure from media on premarital sexual behaviour: an Indonesia demographic health survey 2012 analysis Purpose This study aimed to determine the correlation of type and intensity of exposure of reproductive health information through media to the sexual behavior of adolescents and young adults in Indonesia. Methods This study used a cross-sectional design. The data used was the Indonesian sub-survey of adolescent reproductive health, Indonesia demographic and health survey. Results The results showed that adolescents and young adults who receive the health information type of adolescent reproductive health category have a smaller prevalence in sexual intercourse before marriage than information of contraceptive methods category or both. The intensity of exposure to reproductive health information which was low or no exposure, have higher prevalence of premarital sexual behavior. Age, gender, level of education, level of wealth, smoking, drinking alcohol, drug consumption and dating intimacy are significantly associated with premarital sexual behavior of adolescents and young adults. Conclusion Type and intensity of reproductive health information are significantly associated with premarital sexual behavior of adolescents and young adults. The high intensity of exposure and type of adolescent reproductive Health category have a smaller prevalence in sexual intercourse before marriage.

Effects of peer education and interactive group discussion on cognitive ability in dealing with unwanted pregnancy PurposeThis study aimed to determine the effectiveness of peer education methods and interactive discussions through audiovisual media on cognitive ability change in solving the problem of unwanted pregnancy.MethodsThis quasi-experimental study used a randomized control trial design involving 99 students. The instrument used was a questionnaire, with the module method of peer education and interactive discussions through audiovisual media, agency and facilitator.ResultsAdolescent reproductive health education after considering living with family consistently had a significant effect on increasing the average value of cognitive ability to solve the problem of unwanted pregnancy. Living with family can predict the cognitive ability of teenagers in solving the problem of unwanted pregnancy by 15%.ConclusionInteractive discussions through audiovisual media and peer education modules enhance adolescents’ cognitive ability to solve unwanted pregnancy problems, and are significantly influenced by family factors.

Background: The traditional medical Oath of ‘first do no harm’ is something that is very rarely breached either intentionally by a doctor, nurse or other health practitioner. Resident is health workers who perform services directly to patients that’s why their knowledge and attitudes towards patient safety are very useful Objective: To determine the relationship of the level of knowledge with the attitudes about patient safety in obstetrics and gynecology resident while services in delivery room at Dr DR Sardjito hospital. Method: Descriptive methods with cross sectional approach, accompanied by a qualitative research The study involved 90 residents of Obstetrics and Gynecology at Sardjito Hospital Yogyakarta , by filling out a questionnaire. Knowledge assessed based on the number of correct answers and categorized into good and bad. Attitudes toward patient safety was assessed using a Safety Attitude Questionnaire (SAQ) labor and delivery version. Reliability was measured using Cronbach’s alpha. The qualitative data collection (interviews) conducted to support the descriptive data. Result and Discussion: Cronbach’s Alpha value for SAQ= 0.862, and the question of knowledge = 0.702. Between 77 responden who had good level of knowlage, only 53,2% had a good level of attitudes, and between 13 who has bad level of knowlage, there were 10 responden with good level of attitudes (76,9%) (RP 0,69;95%CI 0,44-1,04; p= 0,11). Elements of stress recognition on the attitude were getting the lowest average value (3.50 ± 0.56). From the qualitative data were known that the resident had desire for a reduction in working hours as well as improved communication and collaboration between teams. Althogh most of resident had a good level of knowledge and attitudes about patient safety, there were no meaning because of p value was >0,05 (OR 2,69;95%CI 0,66-10,9; p= 0,17). Conclusion: Clinically, a good level of knowledge about patien safety improving a good level of attitude towards patient safety. Keywords: Knowledge- attitude- patient safety- resident obstetrics

Background : Clinical education requires competent supervisor to guide student. Supervisory competency should be trained and closely monitored to ensure quality learning process taking place. The aim of this study is to evaluate the effect of micro-skill supervisory model to improve the supervision quality among nursing student. Method: The research used quantitative approach with quasi experimental design. Subject consisted 91 students of the third year Nursing students at Magelang Health Polytechnic. Students were divided into two groups: intervention group (44 students) and control group (47 students) using purposive sampling. Research questionnaire consisted of 21 items which were derived from 5 micro skill domains was used. Intervention was supervision using micro-skill model during 2 weeks in a rotation of clinical practice. Results: There was no difference of quality clinical supervision was used in the control group while in experiment group the pre and post test score was significantly different. The experiment group had higher quality of supervision. The study showed that only 9 items showed significant improvement of supervision and 12 items did not show any improvement. Conclusion: Clinical teaching using micro skill model is more effective in improving the quality of nursing student clinical supervision compare to the conventional method.

Background: Stigma of people living with HIV/AIDS is an aspect which disrupts the program of HIV/AIDS infection prevention. Some studies show that the widespread of stigma of people living with HIV/AIDS is related to knowledge about methods of HIV/AIDS infection. One most effective method to improve knowledge about HIV/ AIDS is education at schools. This study is carried out at Surakarta Municipality whereby knowledge about HIV/ AIDS and the presence of stigma of people living with AIDS among school age teenagers have never beenobserved.Objective: To identify the relationship between knowledge about HIV/AIDS and stigma of people living with HIV/ AIDS among senior high school students at Surakarta Municipality.Method: The study was qualitative observational with cross sectional design to get deeper explanation and offer input for policy making in introducing relevant intervention. Subject of the study were as many as 558 students of 4 junior high schools of Surakarta Municipality. Quantitative data analysis used univariable, bivariable with chi square test and multivariable with logistic regression and stratification.Result: The result of test on knowledge about HIV/AIDS showed that mean was 15.40 from maximum score of 20, whereas the result of test on stigma of people living HIV/AIDS showed that mean was 15.70 from maximum score of 21. The result of qualitative study showed that there was misunderstanding about methods of HIV/AIDS infection and the presence of stigma of people living with HIV/AIDS, either among the students or teachers. The result of bivariable analysis showed that the stigma was 3.37 times stronger among students with limited knowledge about HIV/AIDS than among those with good knowledge about HIV/AIDS.Conclusion: Students with limited knowledge about HIV/AIDS had higher risk for stigma of people living with HIV/AIDS that those with good knowledge.Keywords: stigma, HIV/AIDS

Background: Based on disorder mapping due to Iodine deficiency in 1998 and 2003, elimination of Iodine deficiency in household by consuming minimally 90 percent Iodine salt and giving Iodine oil capsule to fertile women in endemic Iodine deficiency, medium to severe, had been carried out. Evaluation of Iodine in urine appeared related to hyperthyroid cases, and a number of people were in critical Iodine status. Hyperthyroid especially for fertile women may cause fatigue and led to low working activity.Objective: To find out correlation between thyroid and working activity of fertile women in endemic Iodine deficiency.Method: The study was a cross-sectional design using two samples in Magelang District. The samples were 100 fertile women who were divided into two groups, namely hyperthyroid (50 persons) and norm thyroid group (50 persons) taken by using systematic sampling.Result: Bivariate analysis showed significant relationship between hyperthyroid and working activity (RP=4.10; 95%Cl; 2.32 - 7.24). Using stratification analysis it was found that hyperthyroid were higher among women with hormonal contraceptive (RP=6.45; 95%Cl; 2.55 - 16.34) and consumed Iodine capsule (RP=4.73; 95%Cl; 2.37 - 9.43).Conclusion: There was a significant correlation between hyperthyroid and working activity of fertile women. Hyperthyroid women tend to have lower working activity (four times lower) than norm thyroid women. The modified effects were hormonal contraceptive and Iodine capsule factors. The factors not affecting the correlation between hyperthyroid and working activity of fertile women were age, Body Mass Index (BMI) and Iodine salt consumption.Keywords: Iodine deficiency, hyperthyroid, working activity

Background: Emotional changes and physical disorders at premenstrual period are common among reproductive- age females. The problem might lead to decrease inworking productivity and ininterpersonal problems. Obese females (BMI> 30) are at higher risk of experiencing premenstrual syndromes. A preliminary study at Midwifery Academy in Kudus District had revealed the overweight and obesity prevalence of 13.72% and 11.87%. The figures were higher than the predicted obesity prevalence of 4.7% in the year 2000.Aim: The study was conducted to identify the relationship between body mass index and premenstrual syndrome.Methods: Cross sectional research was conducted to collect data from 371 students from Midwifery Academy in Kudus District. Univariate analysis was used to describe the frequency distribution. Bivariate analysis using chi-square for trend and chi square tests, as well as multivariate analysis with applied logistic regression model were used to assess the association between risk factors and premenstrual syndrome.Result: The chi-square for trend test showed odds ratios for premenstrual syndrome of 1.72 (95%CI=0.84-3.57), 3.96 (95%CI=1.62-9.80), and 9.78 (95%CI=3.53-27.94) among normal, overweight and obese students, respectively. There were odds ratios of 1.08 (95%CI=0,63-1,86) and 2.66 (95% CI=1,24-5,76) in middle adult women and older adult women, respectively. Contraceptive usage and stress level were also identified as significant factors of premenstrual syndrome. Logistic model using age, contraceptive usage and stress levelmade the best model in showing significant relationships between BMI and stress level and premenstrualsyndrome.Conclusion: There was a significant relationship between body mass index and premenstrual syndrome, and obesity is a risk factor of premenstrual syndrome.Keywords: obesity, body mass index, premenstrual syndrome

Background: Increased coverage of deliveries by health personnel in Indonesia (82.3%) does not synergize with decreased MMR (228/100.000 live births). The low quality of care at the primary level becomes the main causal factor for the slow achievement of the MDGs. Midwives as providers in the primary care level become the front liners in delivery assistance. Public perception of the low quality of DIII midwifery graduates becomes a concern to the occurrence of medical errors by DIII midwifery graduates. Competence of delivery care is one of midwives’ competences at risk of medical error. In Bantul District, the number of maternal deaths in 2010 was 18 cases with a majority of deaths occurring during childbirth.Objective: To describe compliance to normal delivery care and medical errors that occurred in the delivery care conducted by DIII midwifery graduates.Methods: A quantitative study with a cross-sectional design to the occurrence of medical errors in delivery care by DIII midwifery graduates in Bantul District. Data were collected by questionnaire (self reported) and analyzed by univariate, bivariate and multivariate.Results: The results of the analysis suggested that 41.51% medical error occurred in the delivery care and 24.53% of delivery care by D III midwifery graduates were categorized as not good (n = 53). Self reported about medical errors in the four aspects being studied showed that 14 respondents (26.42%) said that medical error ever occurred in the action aspect of delivery assistance, 10 respondents (18.87%) said that medical errors occurred in the prevention of infection, 8 respondents (15.09%) stated that medical error occurred during the administration of drugs and only 3 respondents (5.66%) said that medical errors occurred at the time of diagnosis establishment. Not good delivery care was significant to the occurrence of medical errors (p = 0.000), and 3.8 times causing a medical error after being controlled by extraneous variables (facilities & SOP) with R² value of 0.16.Conclusion: Delivery care by DIII midwifery graduates in Bantul District 75,5% was categorized good, and 41.51% medical error occurred in the delivery care. The prevalence of not good delivery care increased the incidence of medical errors than that of good delivery care. Medical errors in delivery care expressed through self-reported in this study showed that they were also influenced by the completeness of equipment and standard operating procedures in obstetric care facility.Keywords: medical error, DIII Midwifery Graduates, delivery care

Tujuan: Penelitian ini membuktikkan korelasi stres dengan premenstrual syndrome pada mahasiswi yang tinggal di pondok pesantren.Metode: Survei kepada 143 mahasiswi dengan kuesioner. Hasil: 34,9% mahasiswi mengalami stres dan 32,8% premenstrual syndrome. Stres berkorelasi dengan premenstrual syndrome. Faktor eksternal yang berhubungan adalah usia menarche. Tiga gejala terparah meliputi 22,3% fisik, 21,6% lelah, dan 18,1% penurunan aktivitas. Kesimpulan: Mahasiswi yang stres lebih berpotensi mengalami premenstrual syndrome daripada mahasiswi yang tidak stres., Stress and premenstrual syndrome events in female college students in boarding schoolsPurposeThis study aimed to determine the correlation between stress and premenstrual syndrome events in female college students who live in Islamic boarding schools.MethodThis study used a cross-sectional design. Respondents were female college students who live in boarding schools and met inclusion criteria as a respondent. Data collection technique was simple random sampling.ResultsThere were correlations between stress and premenstrual syndrome, and the external variable which was related with premenstrual syndrome was age of menarche. Prevalence of female college students who experienced stress was 34.9% and prevalence of premenstrual syndrome was 32.8%. Severe symptoms experienced by respondents were physical symptoms (22.3%) such as breast tenderness, headache, joint or muscle pain, bloating, weight gain, fatigue or weakness (21.6%), and decreased interest of doing activities at home/dorm (18.1%).ConclusionFemale college students who experienced stress have more potential to experience premenstrual syndrome than female college students who did not experience stress.

Abortus menjadi masalah yang penting dalam kesehatan masyarakat karena berpengaruh terhadap morbiditas dan mortalitas maternal. Di Indonesia, belum ada data yang komprehensif tentang kejadian abortus, berbagai data yang ada sebelumnya berdasarkan survei dengan cakupan yang relatif terbatas. Abortus yang tidak aman bertanggung jawab terhadap 11% kematian ibu di Indonesia. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan kejadian abortus di Indonesia. Penelitian ini dilaksanakan dengan metode observasional menggunakan disain studi cross sectional. Data penelitian diperoleh dari data Survei Demografi dan Kesehatan Indonesia 2002-2003. Analisis data dilakukan secara bertahap yaitu: analisis univariat, analisis bivariat dan analisis multivariat dengan regresi logistik. Hasil menunjukkan bahwa risiko abortus meningkat seiring dengan peningkatan usia ibu. Wanita dengan paritas 0-2 berisiko lebih tinggi untuk mengalami abortus dibandingkan wanita dengan paritas 3 atau lebih (OR=5,2, IK 95%=3,49-7,89). Wanita yang bekerja berisiko 2,7 kali lebih tinggi untuk mengalami aborsi daripada wanita yang tidak bekerja (OR= 2,7 , IK 95%= 2,10-3,58). Selain itu, risiko abortus meningkat pada wanita yang menikah pada usia 30 tahun atau lebih (OR=1,8, IK95%= 1,30-2,48). Risiko abortus tidak berhubungan bermakna dengan riwayat abortus sebelumnya, tingkat pendidikan dan tingkat sosial ekonomi.Kata kunci : Abortus, tren abortus, determinan abortus, IndonesiaAbstractAbortion has become a main problem in public health because of its impact on maternal morbidity and mortality. There is no comprehensive data on abortion in Indonesia. So far, data were based on survey with limited coverage. Unsafe abortion is responsible to 11 percent of maternal mortality in Indonesia. This research objective is to determine factors related to abortion in Indonesia. The study was an observational method with cross sectional design. Thesedata are gathered from Indonesian Demography and Health Survey 2002–2003. Data analysis used univariate, bivariate and multivariate analysis with logistic regression. The risk of an abortion increased in line with the increasing of maternal age. Women with 0-2 parity have higher risk than multiparity (OR=5.2, IK95%=3.49-7.89). Employed women have higher risk than unemployed (OR=2.7, IK95%=2.10-3.58). The risk of abortion increased among women married at 30 years old or over (OR=1.8, IK95%=1.30-2.48). There is no significant association between history of abortion, education, socioeconomic and risk of abortion.Key words : Abortion, trend of abortion, abortion’s determinant, Indonesia

Summary. This paper reports on a study of approaches to learning of undergraduate medical students in the University of Gadjah Mada, Indonesia. The Lancaster Approaches to Studying Inventory was translated into Indonesian and the translated form pilot tested. The instrument was then completed by 90 students, 30 each in first, second and fifth year in the Faculty of Medicine. It was found that Indonesian students generally gave higher rates than previous studies have reported. Factor analysis of their responses showed strong resemblances to other groups in the factors of meaning and reproducing orientation. Differences found in Indonesian students' responses were in strategic and non-academic orientations. There were differences between the response patterns of first-, third- and fifth-year students. It is concluded that the instrument is valid for use in Indonesia.

Background Many studies have explored approaches to learning in medical school, mostly in the classroom setting. In the clinical setting, students face different conditions that may affect their learning. Understanding students’ approaches to learning is important to improve learning in the clinical setting. The aim of this study was to evaluate the Study Process Questionnaire (SPQ) as an instrument for measuring clinical learning in medical education and also to show whether learning approaches vary between rotations. Methods All students involved in this survey were undergraduates in their clinical phase. The SPQ was adapted to the clinical setting and was distributed in the last week of the clerkship rotation. A longitudinal study was also conducted to explore changes in learning approaches. Results Two hundred and nine students participated in this study (response rate 82.0%). The SPQ findings supported a two-factor solution involving deep and surface approaches. These two factors accounted for 45.1% and 22.5%, respectively, of the variance. The relationships between the two scales and their subscales showed the internal consistency and factorial validity of the SPQ to be comparable with previous studies. The clinical students in this study had higher scores for deep learning. The small longitudinal study showed small changes of approaches to learning with different rotation placement but not statistically significant. Conclusions The SPQ was found to be a valid instrument for measuring approaches to learning among clinical students. More students used a deep approach than a surface approach. Changes of approach not clearly occurred with different clinical rotations.

Background: The clinical supervisor's roles influence the quality of clinical education as a teacher and their interaction with students. Underlined the importance of refreshment on clinical teaching skills for clinical supervisors, the 3rd Webinar series of IAMHPE has inspired the recommendations on essential elements in the clinical education of medical and health profession education.Gaps: Recent studies have highlighted the complexity of facilitating clinical education and the socio-cultural influence on clinical supervisor-student relations. As a gap, Indonesia has a hierarchical and collectivist culture and thus the potential to hinder improving students' learning development during clinical education.Recommendation: An understanding of the Gaps between literature and Indonesia's socio-cultural influence on clinical education, we develop several recommendations, including 1) Building Clinical Supervisor-Student Relations that support students' development; 2) Making role modeling explicit and integrating into teaching and learning;3) Facilitating the gradual development of students' clinical abilities, and 4) Re-conceptualization of feedback in clinical education as a “dialogue”.