PERBEDAAN EFEKTIVITAS SENAM NIFAS DAN MOBILISASI DINI TERHADAP INVOLUSI UTERUS : Studi di Wilayah Puskesmas Bojonegoro, Kabupaten Bojonegoro, Jawa Timur tahun 2013

Abstract

Latar Belakang : Salah satu komplikasi nifas adalah proses involusi yang tidak berjalan dengan baik (subinvolusi) yang dapat menyebabkan perdarahan dan kematian ibu. Kecepatan involusi uterus dipengaruhi oleh usia ibu, jumlah anak yang dilahirkan (paritas), menyusui eksklusif, mobilisasi dini, senam nifas, dan menyusui dini Tujuan : Untuk membedakan efektivitas senam nifas dan mobilisasi dini terhadap involusi uterus. Metode Penelitian : Jenis penelitian adalah quasy experimental. Subyek penelitian adalah ibu nifas primipara dengan kelahiran spontan usia 20 – 35 tahun di wilayah Puskesmas Bojonegoro. Subyek dibagi menjadi dua kelompok yaitu kelompok I (n=18) dengan intervensi senam nifas dan II (n=18) dengan intervensi mobilisasi dini. Analisis yang digunakan uji chi square dan regresi logistik. Hasil Penelitian : Hasil uji chi square didapat kelompok senam nifas dengan involusi uterus normal =14 orang (77,8%) dan kelompok mobilisasi dini dengan involusi uterus normal = 6 orang (33,3%), nilai p value = 0,019, RO (CI 95%) = 2,3 (1,2-4,7). Hasil uji regresi logistik secara bersama – sama variabel kelompok intervensi dan ASI Eksklusif berpengaruh terhadap involusi uterus dengan nilai p value < 0,001, besar pengaruh 42,0% dan ketepatan 72,2%. Hasil uji secara terpisah didapatkan bahwa variabel kelompok intervensi dengan nilai p value = 0,019 RR (CI 95%) = 8,6 (1,4 – 51,9) dan variabel ASI Eksklusif dengan nilai p value = 0,009 RR (CI 95%) = 10,9 (1,8 – 65,1) Kesimpulan : Senam nifas lebih efektiv terhadap proses involusi uterus normal dibandingkan mobilisasi dini, sehingga senam nifas dapat dijadikan program wajib dalam asuhan nifas. Kata Kunci : involusi uterus, senam nifas,mobilisasi dini, perbedaan efektivitas Background: One of the complications of parturition is an involution process that is not running properly (sub-involution) which can cause bleeding and death effect of mother. Uterine involution velocity depends on the mother age, number of children born (parity), exclusive breastfeeding, early mobilization, parturition gymnastics, and early lactation Objective: To distinguish the effectiveness of parturition gymnastics and early mobilization toward uterine involution. Methods: The study was Queasy experimental. Subjects were primiparous parturition women with spontaneous birth 20-35 years old in the Regional Health Center of Bojonegoro. Subjects were divided into two groups: group I (n = 18) with parturition gymnastics intervention and II (n = 18) with early mobilization intervention. The analyses used in this study were the chi square test and logistic regression. Results: Results of chi square test obtained parturition gymnastics group with normal uterine involution = 14 (77.8%) and early mobilization group with normal uterine involution = 6 (33.3%), p value = 0.019, RO (95% CI) = 2.3 (1,2-4,7). The results of logistic regression simultaneously the same variables and exclusive breastfeeding intervention group effect on uterine involution with p value <0.001, effect of 42.0% and 72.2% accuracy. The test results separately showed that the variables of intervention group with p value = 0.019 RR (95% CI) = 8.6 (1.4 to 51.9) and exclusive breastfeeding variables with p value = 0.009 RR (95% CI) = 10.8 (1.8 to 65.1) Conclusion: Parturition gymnastics are more effective toward normal uterine involution process than early mobilization, so it can be used as a mandatory parturition gymnastics program in parturition care. Keywords: uterine involution, parturition gymnastics, early mobilization, differences in effectiveness