ISGH 3 | Vol 3. No. 1 | Oktober 2019 | ISSN: 2715-1948
RELATIONSHIP BETWEEN BABY SPA FREQUENCY AND SLEEP PATTERN AMONG INFANTS AGED 3-6 MONTHS AT PRIVATE PRACTICE MIDWIFE ONENG
MAJALENGKA DISTRICT IN 2019
Suyanti*1, Ade Tedi Irawan² [email protected]
1Midwifery DIII Study Program of STIKes YPIB Majalengka, Indonesia
² Nursing Bachelor Study Program of STIKes YPIB Majalengka, Indonesia ABSTRACT
Baby spa is a series of activities given to babies with the aim of providing relaxation for the baby in a system of treatment using water media or hydrotherapy through a series of scrubs, massage, and all activities that can make the body more relaxed. This was a pre-experimental study with a static group comparison design. Samples in this study were 30 infants who were assigned to control group of 15 infants who received Baby Spa treatment and experimental group of 15 infants who did not receive Baby Spa treatment. This study was conducted in February-April 2019. Data analysis used univariate analysis with frequency distribution of central tendency and bivariate analysis with Mann Whitney test. The results of the analysis obtained a mean sleep pattern among infants of 0.60 with a standard deviation of 0.498, the lowest sleep pattern was 0 and the highest sleep pattern was 1. Based on the interval estimation result it can be concluded that it was 95% believed that the mean sleep pattern among infants was 0.41 to 0.79. The results showed that the mean baby who had baby spa treatment was 19.00. Meanwhile, the mean baby who did not have baby spa was 12.00. Statistical test results obtained
value of 0.012 <0.05, then Ho was rejected. It meant that there was a relationship between baby spa and sleep pattern among infants aged 3-6 months at Private Practice Midwife Oneng Majalengka in 2019. Baby Spa can be used as an intervention for clients and clients can visit the Baby Spa clinic. For this reason, healthcare providers, especially midwives, need to get education and training regarding Baby Spa technique so that they are able to apply it to their clients appropriately.Keywords: Baby Spa, sleep pattern, infants aged 3-6 months
INTRODUCTION
Improvement in the quality of human life is influenced by the quality of humans since the pregnancy period until the age of five, which is a critical period for the life of human growth and development. Infancy is an anxiety period as well as a critical period of one's development. It is said to be a critical period because at this time infants are very sensitive to the environment and it is said to be an anxiety period because infancy is very short and cannot be repeated (Ministry of Health of the Republic of Indonesia, 2013).
Most babies who have Baby Spa are babies aged 3-6 months, because this age range is a good time for babies to get to know the swimming pool since at this age babies are very happy with water and do not cry when swimming. This is due to the aquatic reflex has not disappeared (the ability to breathe before the baby touches the water). The baby also has an instinct to float and dive that prevents him from swallowing water while in the water. Baby swimming is done using a special float
and is carried out around 10-15 minutes, twice a week. Baby Spa will be more effective if the frequency is in accordance with the recommendation. In this study most of the respondents did as suggested by 2x15 minutes each week (Sundari, 2015).
It was recorded that the global number of baby spa was 5,980,951. (World Data, 2015) In Indonesia the total number of infants was 4,880,951 (Indonesian Statistical Data, 2016) and the number of infants who got Baby Spa was 4,665,025 (Basic Health Research, 2016). In West Java, there were 981,906 infants (West Java Provincial Health Office Profile Data, 2016) and the number of infants who got Baby Spa was 545,025 (Basic Health Research, 2016). In Majalengka District, the total number of infants was 103,000 (Majalengka District Health Office Profile Data, 2016) and the number of infants who got Baby Spa was 959 (Majalengka District Health Office Profile Data, 2017). At Private Practice Midwife Oneng it was recorded the number of Baby Spa of 150 (Oneng Midwife data, 2018) and
the number of Baby Spa was 150 visits (in December, 2017).
The results of the study conducted by Siti Rohmah Cimahi in 2016 stated that there was a relationship between the frequency of baby spa and sleep pattern among infants 3-6 months. Parents should know that Baby spa was very effective to improve the quality of baby sleep, especially on the length of sleep so that it is expected to be able to improve the intelligence abilities among infants.
Based on the problems mentioned above, the authors are interested in conducting a study entitled
"Relationship Between Baby Spa Frequency and Sleep Patterns among Infants Aged 3-6 Months at Private Practice Midwife Oneng Majalengka District in 2019".
STUDY OBJECTIVES
In general this study aims to determine the relationship between baby spa frequency and sleep pattern among infants aged 3-6 months at Private Practice Midwife Oneng, Jatiwangi Subdistrict, Majalengka District in 2019. The specific objectives are:
1. To determine the Frequency Distribution of Sleep Pattern among Infants Aged 3-6 Months at Private Practice Midwife Oneng, Jatiwangi Subdistrict, Majalengka District in 2019.
2. To determine the Relationship Between Baby Spa Frequency and Sleep Pattern among Infants Aged 3-6 Months at Private Practice Midwife Oneng, Jatiwangi Subdistrict, Majalengka District in 2019
METHODS
This was a pre-experimental study with a static group comparison design. In this design the experimental group received treatment/intervention followed by observation. The observation results were compared to the control group that did not receive treatment/intervention (Notoatmodjo, 2010). The population in this study were all infants aged 3-6 months. The number of samples used was 30 people. The respondents were assigned into two groups: the experimental group and the control group, each group consisted of 15 infants aged 3-6 months who came to Private Practice Midwife Oneng. The study sampling used Non Probability Sampling technique namely purposive sampling.
This study was conducted in February-April 2019.
Data analysis was carried out using SPSS software version 20.0. Data analysis included univariate analysis and bivariate analysis.
RESULTS
Table 1 Frequency Distribution Based on Visits among Infants Aged 3-6 Months at Private Practice
Midwife Oneng Midwife Majalengka in 2019 Variable Mean SD
Minimum - Maximum
95% CI
Baby sleep
pattern 0.60 0.498 0 -1 0.41 –
0.79
Based on analysis results in table 1 a mean sleep pattern among infants was 0.60 with a standard deviation of 0.498, the lowest sleep pattern was 0 and the highest sleep pattern was 1. Based on the interval estimation result it can be concluded that it was 95% believed that the mean sleep pattern among infants was 0.41 to 0.79.
Table 2. Distribution of Normality Test on the Effect of Baby Spa on the Sleeping Pattern Among Infants Aged 3-6 Months at Private Practice Midwife Oneng
Midwife Majalengka in 2019 Mean Median SD Df ρ value
0.60 1.00 0.498 30 0.389
Based on table 2 it was known that the normality test result on the sleep pattern among infants obtained a mean of 0.60, a median of 1.00 with a standard deviation of 0.498. According to the statistical test results, it was obtained a ρ value of 0.389. The result of data normality test was declared normal if the significance was > 0.05. From the above data it was known that a significant value was 0.389. The significance for both variables was higher than 0.05, thus it can be concluded that the data were normally distributed. Since the study data were not normally distributed, the analysis used a parametric statistical test, namely the Mann- Whithey-test, which is a statistical technique used to determine the differences between two medians from two distributions.
Table 3. Distribution of the samples proportion based on Mann-Whitney test regarding the relationship between Baby Spa and Sleep Pattern among Infants Aged 3-6 Months at Private Practice
Midwife Oneng Midwife Majalengka in 2019 Baby Spa Mean U
value W value
Z
value value No Baby Spa 12.00
60 180 -2.513 0.012 Baby Spa 19.00
Based on table 3 it was obtained that the mean baby who had baby spa treatment was 19.00, while, the mean baby who did not have baby spa was 12.00. Statistical test results obtained value of
0.012 <0.05, then Ho was rejected. It meant that there was a relationship between baby spa and sleep pattern among infants aged 3-6 months at Private Practice Midwife Oneng Majalengka in 2019.
DISCUSSION
The results of the analysis obtained a mean sleep pattern among infants of 0.60 with a standard deviation of 0.498, the lowest sleep pattern was 0 and the highest sleep pattern was 1. Based on the interval estimation result it can be concluded that it was 95% believed that the mean sleep pattern among infants was 0.41 to 0.79. This was due to all respondents in this study did Baby Spa so that their sleep patterns were good. The mean sleep pattern both in the control and experimental groups ranged from 0.41 to 0.79.
The results of this study are in line with the results of a study conducted by Siti Rohmah, Cimahi in 2016 which stated that there was a relationship between the frequency of baby spa and sleep pattern among infants 3-6 months. Relaxation mjust be done because when the babies are born they have to adapt to changes in the environment.
Age 3-6 months is a good time for babies to get to know the swimming pool since at this age babies are very happy with water and do not cry when swimming. This is due to the aquatic reflex has not disappeared (the ability to breathe before the baby touches the water). The baby also has an instinct to float and dive that prevents him from swallowing water while in the water. Baby swimming is done using a special float and is carried out around 10-15 minutes, twice a week. The water used for swimming should be quite warm, with a minimum temperature of 34 - 35°C so that the baby does not get cold and can be relaxed (Riksani, 2014 in Qoriesa, 2014).
The frequency of the Baby Spa will be more effective if the frequency is in accordance with the recommendation. In this study most of the respondents did as suggested by 2x15 minutes every week (Sundari, 2015). Sleep patterns vary greatly at this time. Generally, active babies sleep less than quiescent babies. Generally at the age of 3-6 months babies have developed their sleep patterns at night for at least 9-11 hours (Maryunani, 2013).
Stage I of sleep occurs when the baby feels sleepy and starts to fall asleep, if he hears a sound of something he wakes up immediately, actually sleep lasts 30 seconds to the first 5 minutes of the sleep cycle. In the stage II of sleep, throughout the body is like being in a deeper stage I of sleep and is still easily awakened, even though it is actually in a state of sleep which lasts from 10 to 40 minutes, the
baby can be awakened due to sudden jolt of limbs.
In the Stage III of sleep the baby has a sound sleep, very relaxed, and the muscle tone disappears. Stage IV of sleep is the most restful sleep, without dreams and the baby is difficult to wake (Rizema, 2014).
According to Sundari (2015), after doing the Baby Spa, the baby was sound, the baby slept ≥ 9 hours and the baby was not fussy when he woke up in the morning. A sound and regular sleep process is very good for the baby because during this time the baby has a development process. Indeed, we can not provide a benchmark time for babies to sleep uniformly on each baby, because every baby has their own uniqueness. However, there are certain amounts that are common in baby sleep patterns.
The results of this study are expected to provide motivation to healthcare providers, especially midwives to provide intervention of Baby Spa technique for infants to promote regular sleep pattern. It is expected that after intervention is given to the client, the client can visit Baby Spa clinic. Therefore, healthcare providers, especially midwives need to get education and training regarding Baby Spa technique so that they are able to apply it to their clients appropriately.
It was known that the normality test result on the sleep pattern among infants obtained a mean of 0.60, a median of 1.00 with a standard deviation of 0.498. According to the statistical test results, it was obtained a ρ value of 0.389. The result of data normality test was declared normal if the significance was > 0.05. From the above data it was known that a significant value was 0.389. The significance for both variables was higher than 0.05, thus it can be concluded that the data were normally distributed. Since the study data were not normally distributed, the analysis used a parametric statistical test, namely the Mann-Whithey-test, which is a statistical technique used to determine the differences between two medians from two distributions.
The results of the study conducted by Siti Rohmah Cimahi in 2016 stated that there was a relationship between the frequency of baby spa and sleep pattern among infants 3-6 months. Parents should know that Baby spa was very effective to improve the quality of baby sleep, especially on the length of sleep so that it is expected to be able to improve the intelligence abilities among infants.
Likewise with the results of a study conducted by Siti Fatimah in Ambarawa Subdistrict, Semarang District in 2015, which stated that only 7 infants (29.2%) who had routine baby spa while as many as 15 infants (62.5%) had regular baby Spa. The statistical test results obtained ρ value of (0.084 >
0.05), this indicated that the baby sleep pattern was not influenced by baby spa visit. This study is expected to be able to add information for mothers who have babies aged 3-6 months to do baby spa.
Furthermore, the results of a study conducted by Layyinatus Ahofa at Bonang Subdistrict, Demak District in 2014 stated that the Wilcoxon test results obtained ρ value of 0.000 and there was a relationship between the frequency of baby spa and sleep pattern among infants aged 3-6 months.
The results of this study are in line with the theory that the sleep quality is assessed from the sleep phase of the baby, namely active sleep (Rapid eye movement or REM) and quiescent sleep (non- REM). Infants aged 3-6 months need to sleep about 14 hours/day (Rizema, 2014). Sleep pattern can change according to stages, namely from the first stage of non-REM to the third or fourth stage. The baby may return to the first stage, then turn back.
Stage I of sleep occurs when the baby feels sleepy and starts to fall asleep, if he hears a sound of something he wakes up immediately, actually sleep lasts 30 seconds to the first 5 minutes of the sleep cycle. In the stage II of sleep, throughout the body is like being in a deeper stage I of sleep and is still easily awakened, even though it is actually in a state of sleep which lasts from 10 to 40 minutes, the baby can be awakened due to sudden jolt of limbs. In the Stage III of sleep the baby has a sound sleep, very relaxed, and the muscle tone disappears. Stage IV of sleep is the most restful sleep, without dreams and the baby is difficult to wake (Rizema, 2014).
According to Sundari (2015), after doing the Baby Spa, the baby was sound, the baby slept ≥ 9 hours and the baby was not fussy when he woke up in the morning. A sound and regular sleep process is very good for the baby because during this time the baby has a development process. Indeed, we can not provide a benchmark time for babies to sleep uniformly on each baby, because every baby has their own uniqueness. However, there are certain amounts that are common in baby sleep patterns.
Based on the results of this study it is expected that mothers monitor the sleep pattern of infants aged 3-6 months and bring their babies to get baby spa treatment at Private Practice Midwife Oneng.
Baby spa was very effective to improve the quality of baby sleep, especially on the length of sleep so that it is expected to be able to improve the intelligence abilities among infants. It is also in accordance with the study results which proved that baby spa was very useful for sleep pattern among infants aged 3-6 months.
Based on table 4.3 it was obtained that the mean baby who had baby spa treatment was 19.00,
while, the mean baby who did not have baby spa was 12.00. Statistical test results obtained value of 0.012 <0.05, then Ho was rejected. It meant that there was a relationship between baby spa and sleep pattern among infants aged 3-6 months at Private Practice Midwife Oneng Majalengka in 2019. The results of this study are in line with the results of a study conducted by Siti Rohmah, Cimahi in 2016, there was a relationship between the frequency of baby spa and sleep pattern among infants aged 3-6 months. Parents should know that Baby spa was very effective to improve the quality of baby sleep, especially on the length of sleep so that it is expected to be able to improve the intelligence abilities among infants.
Likewise with the results of a study conducted by Siti Fatimah in Ambarawa Subdistrict, Semarang District in 2015, which stated that only 7 infants (29.2%) who had routine baby spa while as many as 15 infants (62.5%) had regular baby Spa. The statistical test results obtained ρ value of (0.084 >
0.05), this indicated that the baby sleep pattern was not influenced by baby spa visit. This study is expected to be able to add information for mothers who have babies aged 3-6 months to do baby spa.
Furthermore, the results of a study conducted by Layyinatus Ahofa at Bonang Subdistrict, Demak District in 2014 stated that the Wilcoxon test results obtained ρ value of 0.000 and there was a relationship between the frequency of baby spa and sleep pattern among infants aged 3-6 months.
The results of this study are in line with the theory that a baby spa is a series of activities given to babies with the aim of providing relaxation for the baby in a system of treatment using water media or hydrotherapy through a series of scrubs, massage, and all activities that can make the body more relaxed (Sundari, 2015).
The frequency of the Baby Spa implemented to the baby will be more effective if the frequency is in accordance with the recommendation. In this study most of the respondents did as suggested by 2x15 minutes each week (Sundari, 2015). Sleep patterns vary greatly at this time. Generally, active babies sleep less than quiescent babies. Generally at the age of 3-6 months babies have developed their sleep patterns at night for at least 9-11 hours (Maryunani, 2013).
Sleep quality is assessed from the sleep phase of the baby, namely active sleep (Rapid eye movement or REM) and quiescent sleep (non- REM). Infants aged 3-6 months need to sleep about 14 hours/day (Rizema, 2014). Sleep pattern can change according to stages, namely from the first stage of non-REM to the third or fourth stage. The
baby may return to the first stage, then turn back.
Stage I of sleep occurs when the baby feels sleepy and starts to fall asleep, if he hears a sound of something he wakes up immediately, actually sleep lasts 30 seconds to the first 5 minutes of the sleep cycle. In the stage II of sleep, throughout the body is like being in a deeper stage I of sleep and is still easily awakened, even though it is actually in a state of sleep which lasts from 10 to 40 minutes, the baby can be awakened due to sudden jolt of limbs. In the Stage III of sleep the baby has a sound sleep, very relaxed, and the muscle tone disappears. Stage IV of sleep is the most restful sleep, without dreams and the baby is difficult to wake (Rizema, 2014).
Baby's sleep cycle is consistent with his character, active babies will sleep actively too.
Usually babies play and do activities that make them comfortable such as crying, sucking their fingers, wiggling and shaking their head, moving around and falling asleep again (Rizema, 2014). The time for sleep is approximately 18 hours per day and the remaining time is to play and do activities that make babies comfortable, for example chatting with mothers and family members. However, the problems experienced by mothers are problems for babies who find it very difficult to sleep at night and if not treated seriously there will be disorders in behaviors, growth and development and brain (Widodo A, 2013).
A sound and regular sleep process is very good for the baby because during this time the baby has a development process. Indeed, we can not provide a benchmark time for babies to sleep uniformly on each baby, because every baby has their own uniqueness. However, there are certain amounts that are common in baby sleep patterns. The results of this study are expected to provide motivation to healthcare providers, especially midwives to provide intervention of Baby Spa technique for infants to promote regular sleep pattern. Based on the study results, there was a relationship between baby spa and sleep pattern among infants aged 3-6 months. Thus, this study can be continued to further prove such relationship. It is expected that after intervention is given to the client, the client can visit the Oneng Midwife PMB (Baby Spa clinic).
Therefore, healthcare providers, especially midwives need to get education and training regarding Baby Spa technique so that they are able to apply it to their clients appropriately.
CONCLUSIONS
1. The results of the analysis obtained a mean sleep pattern among infants of 0.60 with a standard deviation of 0.498, the lowest sleep pattern was
0 and the highest sleep pattern was 1. Based on the interval estimation result it can be concluded that it was 95% believed that the mean sleep pattern among infants was 0.41 to 0.79.
2. Based on table 4.2 it was known that the normality test result on the sleep pattern among infants obtained a mean of 0.60, a median of 1.00 with a standard deviation of 0.498. According to the statistical test results, it was obtained a ρ value of 0.389. The result of data normality test was declared normal if the significance was >
0.05. From the above data it was known that a significant value was 0.389. The significance for both variables was higher than 0.05, thus it can be concluded that the data were normally distributed. Since the study data were not normally distributed, the analysis used a parametric statistical test, namely the Mann- Whithey-test, which is a statistical technique used to determine the differences between two medians from two distributions.
3. Based on the study results, it was obtained that the mean baby who had baby spa treatment was 19.00, while, the mean baby who did not have baby spa was 12.00. Statistical test results obtained value of 0.012 <0.05, then Ho was rejected. It meant that there was a relationship between baby spa and sleep pattern among infants aged 3-6 months at Private Practice Midwife Oneng Majalengka in 2019.
RECOMMENDATIONS 1. For the Community
It is recommended to the public to understand the benefits of baby spa, so as to encourage the community to support and become a support group for mothers to stimulate growth and development of their babies by performing stimulation through baby spasm. It is also recommended, especially for baby parents to perform baby spa and meet the needs of the baby sleep pattern. Based on the results of this study it is expected that mothers monitor the sleep pattern of infants aged 3-6 months and bring their babies to get baby spa treatment at Private Practice Midwife Oneng.
Baby spa was very effective to improve the quality of baby sleep, especially on the length of sleep so that it is expected to be able to improve the intelligence abilities among infants. It is also in accordance with the study results which proved that baby spa was very useful for sleep pattern among infants aged 3- 6 months.
2. For the Clinic
It is recommended that healthcare porviders at Private Practice Midwife to review the implementation of the role of midwives in providing education and services to the community regarding the benefits of baby spa for sleep pattern among infants aged 3-6 months. The results of this study are also expected to be able to provide motivation to healthcare providers, especially midwives to provide interventions for the Baby Spa technique to the baby to promote regular sleep pattern. It is expected that after being given an intervention to the client, the client can visit Private Practice Midwife Oneng. Therefore, healthcare providers, especially midwives, need to get education and training regarding Baby Spa technique so that they are able to apply it to their clients appropriately.
3. For Researchers
The results of this study can be used as a basis and consideration for similar studies in the future.
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