Abstract

Background and Purpose: The performance of nurses in providing care to patients is an important component for patient satisfaction and healing. Nurse's performance is determined by many factors. This study aims to determine the association between nurse performance in providing nursing care with education, nurse perceptions of financial rewards, career development opportunities, and supervision of the ward head.

Method: A cross-sectional survey was conducted on all nurses (164 people) at inpatient wards of Tabanan General Hospital. Data collection was carried out using a self-administered questionnaire in April 2018. Bivariate analysis was performed using chi-square test, and multivariate analysis was conducted using multiple logistic regression to determine the adjusted odds ratios.

Results: The results showed that the mean score of nursing care performance was 70.17 from a maximum score of 80. All independent variables were found to be associated with nurse performance, namely perceptions of career development opportunities (AOR=1.6; 95% CI = 1.03-1.3; p = 0.011), financial rewards (AOR = 1.1; 95% CI = 1.01-1.2; p = 0.029) and supervision of the ward chief (AOR = 1.1; 95% CI = 1.01-1.2; p = 0.022).

Conclusion: Nurses' perceptions of financial rewards, career development opportunities, and supervision of the ward chief are associated with nursing care performance. Provision of rewards, career development and supervision need to be considered in the efforts to improve nurse performance.

Abstract

Background and Purpose: The performance of nurses in providing care to patients is an important component for patient satisfaction and healing. Nurse's performance is determined by many factors. This study aims to determine the association between nurse performance in providing nursing care with education, nurse perceptions of financial rewards, career development opportunities, and supervision of the ward head.

Method: A cross-sectional survey was conducted on all nurses (164 people) at inpatient wards of Tabanan General Hospital. Data collection was carried out using a self-administered questionnaire in April 2018. Bivariate analysis was performed using chi-square test, and multivariate analysis was conducted using multiple logistic regression to determine the adjusted odds ratios.

Results: The results showed that the mean score of nursing care performance was 70.17 from a maximum score of 80. All independent variables were found to be associated with nurse performance, namely perceptions of career development opportunities (AOR=1.6; 95% CI = 1.03-1.3; p = 0.011), financial rewards (AOR = 1.1; 95% CI = 1.01-1.2; p = 0.029) and supervision of the ward chief (AOR = 1.1; 95% CI = 1.01-1.2; p = 0.022).

Conclusion: Nurses' perceptions of financial rewards, career development opportunities, and supervision of the ward chief are associated with nursing care performance. Provision of rewards, career development and supervision need to be considered in the efforts to improve nurse performance.

Background and purpose: Stunting in children is a chronic nutritional concern that has short-term and long-term health effects. Several studies have shown inconsistent results related to the association between stunting and anemia and increased maternal weight during pregnancy. This study aims to determine anemia during pregnancy, increased body weight and weight gain during pregnancy based on body mass index (BMI) before pregnancy stunting with.

Method: A case control study was carried out using the baseline data of an intervention studyconducted from April to September to prevent stunting in children aged 6-23 months in nine villages in Bangli District, Bali Province. Baseline data collection was conducted from December 2017–February 2018 by interviews with 330 mothers of the children and observation of their ANC records. The number of samples for the case control study was 156 children aged 6-23 months consisting of 78 cases and 78 controls (1:1). Cases were selected by systematic random sampling from 82 children with stunting and controls were selected in the same way from 248 children without stunting. Data analyzed were maternal age at pregnancy, education, employment, number of children, family income, height, hemoglobin level and maternal body weight during pregnancy. Multivariate analysis with logistic regression was conducted to determine the adjusted odds ratio (AOR) of each risk factor.

Results: The increase in maternal weight during pregnancy which is not in accordance with maternal BMI before pregnancy and an increase in maternal weight of <10 or >12.5 kilograms are significantly associated with stunting with AOR=3.53 (95%CI: 1,55-8.07) and AOR=3.31 (95%CI: 1.24-8.85). Hemoglobin <11gr/dL during pregnancy was not found to be significantly associated with stunting (AOR=5.02; 95%CI: 0.80–31.71).

Conclusion: The increase of maternal weight during pregnancy which is not suitable with BMI before pregnancy and an increase in maternal weight of <10 or >12.5 kilograms are risk factors for stunting in children aged 6-23 months. In addition to monitoring the increase of maternal weight during pregnancy, it is important to consider the mother's BMI before pregnancy in order to reduce the risk of stunting.

Background and purpose: Stunting in children is a chronic nutritional concern that has short-term and long-term health effects. Several studies have shown inconsistent results related to the association between stunting and anemia and increased maternal weight during pregnancy. This study aims to determine anemia during pregnancy, increased body weight and weight gain during pregnancy based on body mass index (BMI) before pregnancy stunting with.

Method: A case control study was carried out using the baseline data of an intervention studyconducted from April to September to prevent stunting in children aged 6-23 months in nine villages in Bangli District, Bali Province. Baseline data collection was conducted from December 2017–February 2018 by interviews with 330 mothers of the children and observation of their ANC records. The number of samples for the case control study was 156 children aged 6-23 months consisting of 78 cases and 78 controls (1:1). Cases were selected by systematic random sampling from 82 children with stunting and controls were selected in the same way from 248 children without stunting. Data analyzed were maternal age at pregnancy, education, employment, number of children, family income, height, hemoglobin level and maternal body weight during pregnancy. Multivariate analysis with logistic regression was conducted to determine the adjusted odds ratio (AOR) of each risk factor.

Results: The increase in maternal weight during pregnancy which is not in accordance with maternal BMI before pregnancy and an increase in maternal weight of <10 or >12.5 kilograms are significantly associated with stunting with AOR=3.53 (95%CI: 1,55-8.07) and AOR=3.31 (95%CI: 1.24-8.85). Hemoglobin <11gr/dL during pregnancy was not found to be significantly associated with stunting (AOR=5.02; 95%CI: 0.80–31.71).

Conclusion: The increase of maternal weight during pregnancy which is not suitable with BMI before pregnancy and an increase in maternal weight of <10 or >12.5 kilograms are risk factors for stunting in children aged 6-23 months. In addition to monitoring the increase of maternal weight during pregnancy, it is important to consider the mother's BMI before pregnancy in order to reduce the risk of stunting.

Background and purpose: Level of anxiety among women approaching menopause is often high. This is influenced by knowledge, education, culture and customs, body image perception and self-efficacy. This study aims to determine the relationship between knowledge, perception of body image and self-efficacy with anxiety in perimenopausal women.

Methods: This study employed a cross sectional design with 87 perimenopausal women aged 45-55 years in Dauh Puri Klod Village, Denpasar City, Bali Province. Respondents were selected with systematic random sampling from 1,039 women aged 45-55 years recorded in Dauh Puri Klod Village. Interviews were conducted at each respondent's house in August 2018. Data collected included sociodemographic characteristics, knowledge, perception of body image, self-efficacy and anxiety levels among women approaching menopause. Bivariate analysis with chi square test and multivariate analysis with logistic regression were conducted to identify the association between variables.

Results: The results of bivariate analysis showed that variables associated with anxiety were knowledge (p=0.001), perception of body image (p=0.012) and self-efficacy (p=0.001). The results of multivariate analysis with the backward method showed that the variables associated with anxiety were knowledge (AOR=10.83; 95%CI: 3.31-35.37) and self-efficacy (AOR=3.48; 95%CI: 1.09-11.14).

Conclusion: Anxiety in women approaching menopause is associated with knowledge and self-efficacy, but is not associated with perceptions of body image. Knowledge plays the most dominant role in reducing anxiety. Education needs to be improved to reduce anxiety in women approaching menopause.

Background and purpose: Level of anxiety among women approaching menopause is often high. This is influenced by knowledge, education, culture and customs, body image perception and self-efficacy. This study aims to determine the relationship between knowledge, perception of body image and self-efficacy with anxiety in perimenopausal women.

Methods: This study employed a cross sectional design with 87 perimenopausal women aged 45-55 years in Dauh Puri Klod Village, Denpasar City, Bali Province. Respondents were selected with systematic random sampling from 1,039 women aged 45-55 years recorded in Dauh Puri Klod Village. Interviews were conducted at each respondent's house in August 2018. Data collected included sociodemographic characteristics, knowledge, perception of body image, self-efficacy and anxiety levels among women approaching menopause. Bivariate analysis with chi square test and multivariate analysis with logistic regression were conducted to identify the association between variables.

Results: The results of bivariate analysis showed that variables associated with anxiety were knowledge (p=0.001), perception of body image (p=0.012) and self-efficacy (p=0.001). The results of multivariate analysis with the backward method showed that the variables associated with anxiety were knowledge (AOR=10.83; 95%CI: 3.31-35.37) and self-efficacy (AOR=3.48; 95%CI: 1.09-11.14).

Conclusion: Anxiety in women approaching menopause is associated with knowledge and self-efficacy, but is not associated with perceptions of body image. Knowledge plays the most dominant role in reducing anxiety. Education needs to be improved to reduce anxiety in women approaching menopause.

Background and purpose: The quality of life of people living with HIV is influenced by many factors, one of which is social support. Social support consists of four elements, namely information, instrumental, emotional and appraisal supports. Publication on the association between the quality of life of people living with HIV and the four elements of social support shows inconsistent results. The purpose of this study is to determine the association between the four elements of social support and the quality of life of people living with HIV.

Methods: A cross-sectional survey was carried out at the WM Medika Clinic, Kerti Praja Foundation, Denpasar, Bali. Samples were people living with HIV who came to the clinic between July-August 2018 to take antiretroviral (ARV) drugs. The total number of samples was 92 patients selected through the convenience sampling. Data was collected by conducting individual interviews and consisted of respondent characteristics, quality of life, information, instrumental, emotional and appraisal supports. Data were analyzed using logistic regression to determine the association between social support and quality of life of people living with HIV.

Results: Emotional support was the only element of social support found to be significantly associated with quality of life of people living with HIV with AOR=4.918 (95%CI: 1.268-19.082). Whereas the other three elements were not found to be related to the quality of life of people living with HIV, these were instrumental support (AOR=0.865; 95%CI: 0.228-3.278); information support (AOR=0.949; 95%CI: 0.248-3.637); and appraisal support (AOR=0.317; 95%CI: 0.095-1.057).

Background and purpose: The quality of life of people living with HIV is influenced by many factors, one of which is social support. Social support consists of four elements, namely information, instrumental, emotional and appraisal supports. Publication on the association between the quality of life of people living with HIV and the four elements of social support shows inconsistent results. The purpose of this study is to determine the association between the four elements of social support and the quality of life of people living with HIV.

Methods: A cross-sectional survey was carried out at the WM Medika Clinic, Kerti Praja Foundation, Denpasar, Bali. Samples were people living with HIV who came to the clinic between July-August 2018 to take antiretroviral (ARV) drugs. The total number of samples was 92 patients selected through the convenience sampling. Data was collected by conducting individual interviews and consisted of respondent characteristics, quality of life, information, instrumental, emotional and appraisal supports. Data were analyzed using logistic regression to determine the association between social support and quality of life of people living with HIV.

Results: Emotional support was the only element of social support found to be significantly associated with quality of life of people living with HIV with AOR=4.918 (95%CI: 1.268-19.082). Whereas the other three elements were not found to be related to the quality of life of people living with HIV, these were instrumental support (AOR=0.865; 95%CI: 0.228-3.278); information support (AOR=0.949; 95%CI: 0.248-3.637); and appraisal support (AOR=0.317; 95%CI: 0.095-1.057).

Background and purpose: Low birth weight (LBW) is a major causal factor for neonatal and perinatal mortality. The aim of this study is to determine the risk of LBW incidence in pregnant women with weight gain not in accordance with the Institute of Medicine (IOM) standards.

Methods: This study used a retrospective cohort design with data obtained from three Public Health Centres (PHCs) in Gianyar District over the period of January-December 2017. Samples in this study were 186 pregnant women with the following criteria: complete data on the mother’s medical record, had an antenatal care visit in the first trimester and at the end of the third trimester, at term delivery, not giving birth to twins and no complications during pregnancy. The sample size was determined with 95% confidence level, 80% power, the proportion of LBW in the group of inadequate weight gain of 26%, the proportion of LBW in the group of adequate weight gain of 9% and a relative risk (RR) estimate of 3.0. Data extracted from medical record consisted of weight gain, pre-pregnancy weight, height, upper arm circumference, hemoglobin level, employment, age, parity and birth weight. The cumulative incidence of LBW was calculated to determine the RR. Multivariate analysis with binary logistic regression was conducted to determine the adjusted RR (ARR).

Results: The incidence of LBW in the group whose weight gain during pregnancy not in accordance with IOM standards was 59%, while those in accordance with the standards were 8.2% with RR=7.22 (95%CI: 3.96–13.19). The ARR for those with weight gain during pregnancy not in accordance with IOM standards was 15.33 (95%CI: 5.82-40.38). The incidence of LBW in the anemia group was 49% and not anemia group was 10%. The RR and ARR values for LBW in the anemia group were 4.72 (95%CI: 2.66-8.36) and 6.66 (95%CI: 2.53-17.53) respectively.

Background and purpose: Low birth weight (LBW) is a major causal factor for neonatal and perinatal mortality. The aim of this study is to determine the risk of LBW incidence in pregnant women with weight gain not in accordance with the Institute of Medicine (IOM) standards.

Methods: This study used a retrospective cohort design with data obtained from three Public Health Centres (PHCs) in Gianyar District over the period of January-December 2017. Samples in this study were 186 pregnant women with the following criteria: complete data on the mother’s medical record, had an antenatal care visit in the first trimester and at the end of the third trimester, at term delivery, not giving birth to twins and no complications during pregnancy. The sample size was determined with 95% confidence level, 80% power, the proportion of LBW in the group of inadequate weight gain of 26%, the proportion of LBW in the group of adequate weight gain of 9% and a relative risk (RR) estimate of 3.0. Data extracted from medical record consisted of weight gain, pre-pregnancy weight, height, upper arm circumference, hemoglobin level, employment, age, parity and birth weight. The cumulative incidence of LBW was calculated to determine the RR. Multivariate analysis with binary logistic regression was conducted to determine the adjusted RR (ARR).

Results: The incidence of LBW in the group whose weight gain during pregnancy not in accordance with IOM standards was 59%, while those in accordance with the standards were 8.2% with RR=7.22 (95%CI: 3.96–13.19). The ARR for those with weight gain during pregnancy not in accordance with IOM standards was 15.33 (95%CI: 5.82-40.38). The incidence of LBW in the anemia group was 49% and not anemia group was 10%. The RR and ARR values for LBW in the anemia group were 4.72 (95%CI: 2.66-8.36) and 6.66 (95%CI: 2.53-17.53) respectively.

Background and purpose: Number of people in Indonesia who have access to smartphones is quite high, but their use for health education media specifically for the detection of pneumonia is still limited. This study aims to determine the effectiveness of use of video information through the WhatsApp (WA) application compared to leaflets in order to increase maternal knowledge about early detection of pneumonia among under-five children.

Methods: A pretest-posttest randomized control trial was conducted in three of the six sub-villages (called banjar) in the Gelgel Village, Klungkung District. Banjar was selected purposively by considering the distance between banjar. As many as 30 mothers were selected as samples from around 45-50 mothers of children under five in each banjar. The intervention was conducted randomly where one banjar was given intervention with videos through WA, one banjar with leaflets and one banjar as a control group. The intervention was carried out for three weeks (August-September 2018). Data were collected before and after the intervention through face-to-face interviews with the mothers in their homes which included social demographics, mother's knowledge about pneumonia detection and educational media preferences. Bivariate data analysis was conducted with paired t-test and multivariate analysis with General Linear Model.

Results: Characteristics of respondents in all three groups were similar in terms of age, education, employment and parity. The results of interviews on educational media choices showed that most respondents (64%) preferred WA media. The increase in mean knowledge score after the intervention was significantly higher in the WA group which was 6.93 (95%CI: 6.38-7.49) and leaflet 5.90 (95%CI: 5.49-6.44) compared to the control group 1.87 (95%CI: 1.26-2.47). There was no significant difference between the WA and the leaflet group. The results of multivariate analysis showed that educational media (F=110.99; p<0.001) and education (F=16.69: p<0.001) were significantly associated with the increase in knowledge after adjustments were made based on age, employment and parity.

Background and purpose: Number of people in Indonesia who have access to smartphones is quite high, but their use for health education media specifically for the detection of pneumonia is still limited. This study aims to determine the effectiveness of use of video information through the WhatsApp (WA) application compared to leaflets in order to increase maternal knowledge about early detection of pneumonia among under-five children.

Methods: A pretest-posttest randomized control trial was conducted in three of the six sub-villages (called banjar) in the Gelgel Village, Klungkung District. Banjar was selected purposively by considering the distance between banjar. As many as 30 mothers were selected as samples from around 45-50 mothers of children under five in each banjar. The intervention was conducted randomly where one banjar was given intervention with videos through WA, one banjar with leaflets and one banjar as a control group. The intervention was carried out for three weeks (August-September 2018). Data were collected before and after the intervention through face-to-face interviews with the mothers in their homes which included social demographics, mother's knowledge about pneumonia detection and educational media preferences. Bivariate data analysis was conducted with paired t-test and multivariate analysis with General Linear Model.

Results: Characteristics of respondents in all three groups were similar in terms of age, education, employment and parity. The results of interviews on educational media choices showed that most respondents (64%) preferred WA media. The increase in mean knowledge score after the intervention was significantly higher in the WA group which was 6.93 (95%CI: 6.38-7.49) and leaflet 5.90 (95%CI: 5.49-6.44) compared to the control group 1.87 (95%CI: 1.26-2.47). There was no significant difference between the WA and the leaflet group. The results of multivariate analysis showed that educational media (F=110.99; p<0.001) and education (F=16.69: p<0.001) were significantly associated with the increase in knowledge after adjustments were made based on age, employment and parity.