Faktor-Faktor yang Berhubungan dengan Penggunaan Partograf oleh Bidan dalam Pertolongan Persalinan di Kabupaten Klaten

Abstract

Universitas Diponegoro Program Pascasarjana Program Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi dan Kebijakan Kesehatan Minat Manajemen Kesehatan Ibu dan Anak 2011 ABSTRAK Bekti Sayekti Faktor-Faktor yang Berhubungan dengan Penggunaan Partograf oleh Bidan dalam Pertolongan Persalinan di Kabupaten Klaten x + 96 halaman + 24 tabel + 3 gambar + 6 lampiran Partograf merupakan panduan pengelolaan dan observasi persalinan normal yang akan memudahkan penolong persalinan dalam mendeteksi kasus kegawatdaruratan pada ibu dan janin. Partograf memegang peranan penting dalam menentukan diagnosa persalinan. Jenis penelitian yang digunakan adalah penelitian observasional rancangan cross sectional. Data diperoleh dari sumbernya menggunakan lembar observasi dan kuesioner. Lokasi penelitian ini adalah di lingkungan Dinas Kesehatan Kabupaten Klaten. Subyek penelitian adalah seluruh Bidan Praktek Swasta yang memberikan pelayanan pertolongan persalinan dan sudah dilatih APN, jumlah sampel 78 bidan berdasarkan kriteria inklusi. Analisis hasil penelitian dengan menggunakan uji Chi square dan Regresi Logistic Multiple. Hasil penelitian menunjukkan penggunaan partograf baik (61,5%), sarana bidan praktek swasta baik (70,5%), pengetahuan bidan baik (66,7%), sikap bidan baik (57,7%), motivasi bidan baik (52,6%), persepsi supervisi baik (44,9%). Adanya hubungan antara motivasi dengan penggunaan pertograf (p-value=0,014), adanya hubungan sikap bidan dengan penggunaan partograf (p- value=0,006) dan tidak adanya hubungan antara pengetahuan, sarana, persepsi supervisi dengan penggunaan partograf. Hasil dari uji regresi menunjukkan adanya pengaruh motivasi dengan penggunaan partograf ( p- value= 0,022, exp ß 3,257), adanya pengaruh sikap dengan penggunaan partograf ( p- value =0,009 , exp ß 3,790). Rekomendasi dari penelitian ini bagi semua bidan praktek swasta, wajib menggunakan partoraf dalam setiap pertolongan persalinan. Bagi Dinas Kesehatan Kabupaten Klaten memberikan refreshing, reward dan sanksi. Bagi puskesmas memonitor laporan persalinan BPS, bekerjasama dengan IBI memberikan bimbingan. Bagi Ikatan Bidan Indonesia membuat komitmen dengan bidan praktik swasta, bekerja sama dengan Dinas Kesehatan dan puskesmas. Bagi teman-teman bidan wajib menggunakan partograf. Kata kunci : Praktik, bidan praktik swasta, partograf, pertolongan persalinan. 47 Diponegoro University Postgraduate Program Master’s Program in Public Health Majoring in Health Policy Administration Sub Majoring in Maternal and Child Health Management 2011 ABSTRACT Bekti Sayekti Factors Related to the Usage of Partograph by Midwives in Assisting Birth Deliveries in Klaten District x + 96 pages + 24 tables + 3 figures + 6 enclosures Partograph was a normal birth delivery management and observation guide. It would simplify birth delivery assistant in detecting an emergency situation on mother and the fetus. Partograph had important roles in determining birth delivery diagnosis. This was an observational study with cross sectional approach. Data was collected from resourced using observation paper and questionnaire. Study location was in the Klaten district health office coverage area. Study subjects were all private practice midwives who gave delivery assistance and had been given normal delivery care training. Total number of study samples was 78 midwives based on inclusion and exclusion criteria. Chi square test and multiple logistic regressions were applied in analyzing research data. Results of this study showed good usage of partograph (61.5%), good facilities for private practice midwives (70.5%). Midwives were sufficiently knowledgeable (66.7%), midwives had good attitudes (57.7%), midwives had good motivation (52.6%) and good supervision perception (44.9%). There were associations between motivation and partograph usage (p: 0.014), association between midwives attitude and partograph usage (p: 0.006) and no association between partograph usage and knowledge, facility, supervision perception. Regression test indicated that there was an influence of motivation towards partograph usage (p value: 0.022, expB: 3.257), there was an influence of attitude towards partograph usage (p value: 0.009, exp B: 3.790) Recommendations were given for all private practice midwives, Klaten district health office, puskesmas and Indonesian midwifery association (IBI). All private practice midwives should use partograph in assisting every delivery. Klaten district health office should provide refreshing, rewards and sanctions. Puskesmas should monitor delivery reports done by private practice midwives and give guidance in collaboration with IBI. IBI should make commitment with private practice midwives and build collaboration with district health office and puskesmas. Key words : Practice, private practice midwives, partograph, delivery assistance