DIFFERENCES QUALITY OF LIFE POSTPARTUM WITH OPERATION CAESAREAN AND VAGINAL DELIVERY IN THE HOSPITAL
RSUD SURAKARTA
MANUSCRIPT
Submitted as a Partial Fulfillment of the Requirements For Getting Bachelor Degree of Nursing
By : Rosanee Pawae
J210.112.009
HEALTH SCIENCE FACULTY
RESEARCH
DIFFERENCES QUALITY OF LIFE POSTPARTUM WITH OPERATION CAESAREAN AND VAGINAL DELIVERY IN HOSPITAL
RSUD SURAKARTA
Abstraction
The postpartum period significantly affects physical and mental health of the mother and may affect the quality of life usually with life changes such as sleep deprivation, irregular food intake, and dehydration. Delivery methods have differences between operation cesarean and vaginal delivery. Differences physical, psychological and economic the impact on quality of life for postpartum. The purpose of this study was to analyze whether there are differences in quality of life between postpartum with operation cesarean and vaginal delivery in hospital Surakarta. This study is a comparative study with cross sectional design. Sample were 40 maternal postpartum in hospital Surakarta comprising 20 postpartum operastion cesarean and 20 postpartum vaginal delivery. Data processing technique using the technique of Mann Whitney Test. Based on the results of research and discussion, the conclusions of this study are: (1) quality of life of postpartum operation cesarean mostly well (100%), (2) quality of life for postpartum with vagina delivery are mostly good (70%) and excellent (30%), and (3) there are differences in the quality of life postpartum with opertion cesarean and vagina delivery (p-value 0.038), where mothers with vaginal delivery have a better quality of life than postpartum operation (75, 25> 70.55).
DIFFERENCES QUALITY OF LIFE OF OPERATIONS WITH POSTPARTUM critical transition for women, which significantly affect the physical and mental health of women after
childbirth and psychological
problems postpartum may interfere with the mother's ability to care for her baby and may affect the quality of life usually with various life changes such as lack of sleep, food
intake is not regularly, and
dehydration. This period ranging from 6 hours to 42 days postpartum (Aktas, Demet & Terzioglu, Fusun, 2013).
Results of data from Riskesdas (2013), the number of women giving birth to normal (Vigina delivery) in Daerahi in urban areas it was 19.9 % higher than in Java Tengh 10.1 %
(health profile, 2013). Figures
maternity / childbirth in Indonesia amounted to 4,492,618 persons, 525 527 people in Central Java.
Results of preliminary studies in Surakarta Hospital (2014), gave birth to normal incidence (Vigina delivery) in Surakarta hospitals by 59 %, while the cesarean operation by 41 %. For postpartum patients with cesarean surgery and birth vaginally need for sleep problems is very important for not only the recovery of the patient's body but to maximize patient care and in the care of baby at the hospital.
Mothers who give birth vaginally usually gives a certain satisfaction
from the psychological than
cesarean delivery operations. In terms of the economy as a vaginal delivery is more economical than delivery by surgery or cesarean
sektio because it sektio cesarean delivery tools that require more complicated (Zohreh, et al., 2013).
Surgical delivery by cesarean mothers because there are factors that affect maternal and fetal factors,
fetal abnormalities, abnormal
location of the baby is too big, umbilical cord abnormalities and twins. Maternal factors consist of pelvic circumstances, age, abnormal
uterine contractions, premature
rupture of membranes and
preeclamsia (Hutabalian, 2011). Cesarean operation will cause pain. The pain experienced by the mother postpartum wounds are derived from abdominal surgery. Complained of pain due to scar fault. This complaint is actually reasonable because the body wound healing and poses no perfect (Christina, 2012). Vaginal birth would cause pain such as cesarean operation but
will sumbuhnya quickly from
cesarean surgery. Birth canal
laceration or injury usually mild edge sometimes there is also a wide wound so as to causing any bleeding that can be life memebahyakan mother (Kritcharoen, et al., 2010). The pain is caused Activity of Daily Living disturbed, bonding attachment (bonds of affection) and Early Initiation of Breastfeeding is not fulfilled due to an increase in pain intensity if the mother moves (Fabris, 2011).
Women in this period needs help and emotional support social support is important to the health of women, especially satelah childbirth, and their role as mothers create stout teatangan for the mother and can greatly affect their ability to
enjoy the baby care
partner as a parent. This period is characterized by an intensive period and demands for caring for the baby and breastfeeding. problems often
arise for postpartum maternal
including pain, discomfort in the breast, constipation, regulate the activity of homework, coping with emotional distress, sibling jealousy and kelelah. (Sadat, et al., 2010).
Results of observation of
researchers to 5 postpartum patients with cesarean surgery in primiparous third day after birth, showing all the patients have not been able to perform with maximum care in infants, this condition is caused patients still experience pain in the
surgical incision. Baby care
performed by family members of patients perawata ata. Interviews researchers to 5 patients were obtained keterngan that 3 people had not dared to do baby care because of fear to wound conditions dialakukan some movement, for example, feeding the baby while sleeping mindless and was told by her parents and had seen other family members ever do so.
Furthermore, the observation of the researchers of the 5 patients with vaginal birth postpartum primiparous third day after birth, showed that most patients had activity baby care. 4 patients had been feeding her mothers receive enough stitches bannyak and cause pain.
This study aims to determine
differences in quality of life between postpartum mothers with cesarean surgery and vaginal birth.
The Methods of Research
Design of Research
This type of research is
descriptive comparative research to find a comparison of two samples or two tests on the object of study. To determine differences in quality of life between postpartum mothers with vaginal births and cesarean surgery (Suyanto & Salama, 2009). Using a cross sectional study design
is research conducted
measurements at the same time /
moment. This research is
quantitative research. Quantitative research is demanding the use of
numbers, ranging from data
collection, interpretation of these data, as well as the appearance of the results (Hidayat, 2007).
Populasi dan Sampel
The study population was
patients were primiparous cesarean operation 20 people and vaginal births are primiparity 20 people in hospitals Surakarta.
The sample in this study was 40 people who were divided into 2 groups: 20 people as a group of
mothers giving birth to
operasisesariadan 20 people as a group of mothers giving birth vaginally with the determination of sample accidental sampling.
The Measurement
DIFFERENCES QUALITY OF LIFE OF OPERATIONS WITH POSTPARTUM MOTHER AND BIRTH VAGINAL SESARIA IN HOSPITAL RSUD SURAKARTA (ROSANEE PAWAE)
5
The data analysis
Analysis of the data in this study is univariate and bivariate.
THE RESULT AND
DISCUSSIONS
Univariate analysis
Distribution frequency of quality life
Table 1 Distribusi Frekuensi Kualitas Hidup
Quality of life Sesaria Pervaginam
F % F %
Table 2. Mann Whitney Test
Means of quality life score
p-value
partum cesarean surgery and
vaginal births significance value (p - value) 0.038 less than 0.05 (0.038 < 0.05) so that H0 is rejected and concluded there is a difference in the quality of life of patients with postpartum by operation cesarean and vaginal birth.
Furthermore, based on the average score of the quality of life shows that the average score of the quality of life of patients postpartum
pervagiman birth higher than
cesarean surgery postpartum
patients (75.25 > 70.55). Based on the average value of quality of life scores is concluded that vaginal birth postpartum patients have a better
quality of life than patients
postpartum cesarean surgery
Discussions
A. Quality of life postpartum mother
1. Quality of life postpartum mother with sesaria
The results showed that of the 20 respondents, the quality of life of postpartum maternal surgery cesarean all have good quality of life 100 % because the mother was in the hospital for health workers in the phase of taking hold is kesepatan good to provide various
counseling and health
education are required
postpartum mothers. postpartum vaginal birth as much as 14 respondents (70 %) and 6 respondents (30 %) is very good because one of the factors that cause the quality of life of respondents postpartum maternal vaginal birth, namely the support of the family.
Quality of life is a picture of the condition of
postpartum maternal
mother and child, as well as
vaginal and cesarean
respondents showed most have a good quality of life. One of the factors that lead to postpartum quality of life of respondents in this study is the support of the family. In the process of maternity care in hospitals Surakarta, birth mother after childbirth wards can directly occupy space and can interact directly with other family members. Family interaction with post partum mothers have an impact on the help of family members in care of postpartum mothers
and babies. Assistance
obtained from the family will improve the quality of life of both the mother post partum cesarean or vaginal.
Bahadoran (2007) revealed that one of the factors associated with postpartum mother's quality of life is family and husband. The family and the husband is the most effective factor to take
exercise during after
kehamillan. Because the
husband and family support to decision making physical exercise, mental, social as different aspects of quality of life for postpartum mothers.
It is as stated in the research Hastuti (2014) about the relationship with the family support maternal quality of life. This study suggests that
family support related quality of life of maternal, where the higher the family support, the better the quality of life of mothers giving birth because
family support is very
important for mothers giving birth to aid activities that are
not biased mom feel
someone accompany not
alone.
B. Differences in Quality of Life Among Mothers With Postpartum Birth vaginal and cesarean surgery
Mann Whitney Test
results of the analysis of
differences in the quality of life of patients with postpartum by cesarean surgery and vaginal births significance value (p - value) 0.038 less than 0.05 (0.038 < 0.05) that concluded there is a difference in the quality of life of patients with postpartum by cesarean surgery and vaginal births.
Furthermore, based on the average score of the quality of life shows that the average score of the quality of life of patients postpartum pervagiman
birth higher than cesarean
surgery postpartum patients
(75.25 > 70.55). Based on the average value of quality of life scores is concluded that vaginal birth postpartum patients have a better quality of life than patients postpartum cesarean surgery.
This study shows that there are differences in the quality of life of patients with post
partum vaginal birth and
DIFFERENCES QUALITY OF LIFE OF OPERATIONS WITH POSTPARTUM the incidence of postpartum blues in postpartum mothers with normal deliveries and caesarean operation. The study concluded that postpartum mothers with cesarean surgery have a higher incidence of postpartum blues as
compared with postpartum
mothers with normal deliveries
because of some medical
technology (the use of tools such as opersai obstetric cesarean, episiotomy) in aid delivery could
trigger postpartum blues.
Delivery by cesarean surgery is a medical intervention that may cause emotional reactions are not expected.
difference between maternal
postpartum by cesarean and vaginal. While the psychological domain showed no significant difference.
Mothers who give birth by cesarean surgery has limitations physically higher than vaginal birth mother. Because they care cuts due to cesarean surgery requires a recovery time, so that the physical ability of mothers giving birth by cesarean to be blocked for some time. The big difference in the physical ability to have an impact on the differences in the treatment of children, physical functioning, and psychological functioning (Majzoobi, 2014).
Comparison between
maternal postpartum physical abilities by cesarean and vaginal
in this study have an impact on the difference in quality of life for child care domain. But the results of this study are not supported by previous studies, the research Zahra (2015), which examines the quality of life between maternal postpartum by cesarean method, vaginal, and gave birth in the water (water birth). This study concluded that
there were no significant
differences in physical abilities
postpartum mothers with
cesarean method, vaginal, and water birth. This study suggests
the development of better
treatment process, causing the healing process faster cesarean postpartum mothers, so the physical limitations of the lower cesarean postpartum mothers and do not disturb the physical ability of the mother in the care of babies.
This study showed
differences in the quality of life of physical health domain between
cesarean and vaginal
postpartum mothers, where the physical health of the mother postpartum vaginal better than
cesarean. The results are
consistent with the results of Benhaz (2009) which states that the results of a study of 100 respondents by cesarean and
vaginal delivery (normal)
acquired 75 % did not
to the cesarean so long healing process.
Other appropriate
research by Ramona (2006), which examines differences in
quality of life of mothers
postpartum cesarean and
vaginal. This study shows that there are differences in the quality of life postpartum mothers with cesarean and vaginal. This
study shows that cesarean
delivery are at risk of physical disruption higher than vaginal delivery. As it gets the possibility of a surgical wound infections, limited movement of his body because of the surgical wound so that the wound healing process and discharge Atua dirty blood clot from the womb affected.
This study showed no difference in the quality of life domain of psychology between postpartum maternal cesarean and vaginal. Results of this study showed postpartum mothers are not impaired by psikoligis among others feel happy with his presence, no regrets after giving birth to a child, the joy of being a
postpartum normal and
caesarean. This study concludes that the quality of life of maternal psychological decline, with the onset of the baby blues and maternal depression in child care. The study was conducted with the observation period of 2 months, 4 months, 6 months and 12 months.
The big difference in the results is due to researchers with previous research on this study,
researchers conducted
observation or testing the quality of life of mothers postpartum day 3 after birth, where the mother is still in hospital and get help maternal and infant care from nurses. The existence of such aid cause the mother has not experienced any problems or interruptions in the nursing child, so that the mother has not been feeling troublesome or child care problems if the mother alone to care for her child.
Conclussions and Suggestions
Conclussions
1. Quality of life postpartum mothers with cesarean surgery are mostly well (100 %).
2. Quality of life postpartum mothers
with vaginal births are
pervagiman (p-value 0.038),
where mothers with vaginal
delivery have a better quality of life than mothers with postpartum
Suggestions
1. For Mother Postpartum
Postpartum mothers should
increase their understanding of the condition after postpartum. By understanding these conditions, postpartum mothers are able to
manage their lives after
postpartum condition both
physically and mentally, so the quality of life of postpartum mothers can occur well.
DIFFERENCES QUALITY OF LIFE OF OPERATIONS WITH POSTPARTUM
responsibility for the baby's
development. Support from family
and society to postpartum
mothers is needed, so that the health of mothers and infants postpartum better.
3. For further Researcher
Researchers can further improve the subject of research by increasing the number of samples of research or study area, as well as adding other variables are variables related to the quality of life of post partum mothers, in order to know the factors that
DAFTAR PUSTAKA
AKTAŞ1& Füsun TERZİOĞLU.
2013. Occurrence of
depression during the
postpartum period and risk factors. Turkish Journal of Medical Sciences, 843-850. Andrew. U.M. 2014. Perbandingan
Kejadian Postpartum Blues
Pada Ibu Postpartum
Dengan Persalinan Normal Dan Operasi Sesaria. Jurnal Penelitian. Riau: Program
Studi Ilmu Keperawatan
Universitas Riau.
B. Torkan, S. P. 2007. Comparative Analysis of Life Quality in
Mothers after Cesarean
Section and Normal Vaginal Delivery.
Bahadoran, P. 2007. Evaluating the effect of exercise on the postpartum quality. Iranian of
Nursing and Midwifery
Research.
Christina, S., & Kristanti, E. E. 2012.
Early Mobilization in
Connection with Improved
konsep,proses,& praktik 7th ed, Jakerta: EGC.
Hastuti, P. 2014. Dukungan
Keluarga terjadap Kemajuan
Persalinan. Jurnal
Keperawatan. Volume V,
Nomor 1, April 2014.
Hidayat, A. Aziz Alimul. 2007. Metode Penelitian Kebidanan & Teknik Analisis Data. Edisi 1. Jakarta : Salemba Medika. Hutabalian,D. 2011. Pengaruh Umur
Terhadap Persalianan
Sektio.
Kongsuriyanavin, W.,
Kunrattanaporn, B., &
Techatraisak, K. (88-99).
2010. Factors Affecting
Postpartum Women’s Mental
Health. Thai Journal of
Nursing Council.
Kritcharoen, S., Chuntharapat, S.-p., Phol-In, K., & Pongpaiboon, P. 2010. Knowledge and
expected services about
natural childbirth of midwives. Songkla Med J, 169-178. Riset Kesehatan Dasar (Riskesdas).
(2013). Badan Penelitian dan
Pengembangan Kesehatan
Suyanto.& Salamah, Ummi. 2009. Riset Kebidanan Metodologi & Aplikasi. Yogjakarta: Mitra Cendikia Press.
Sadat, Z., Taebi, M., Saberi, F., & Kalarhoudi, M. A. 2013. The relationship between mode of
delivery and postpartum
physical and mental health related quality of life. PMCID: PMC, 499-504.
after Vaginal Delivery and
Cesarean Section.
J.Midwifery Reprod Health.
2(4): 207 – 214. Iran:
Hamadan University of
Medical Science.
Zahra K. 2014. A Comparison of
Mother’s Quality of Life after
Normal Vaginal, Cesarean, and Water Birth Deliveries. Journal of Medical Science. Vol 3, No 2. Iran: Shiraz
University of Medical
Sciences.
*Rosanee Pawae: Mahasiswa S1 Keperawatan FIK UMS. Jln A Yani Tromol Post 1 Kartasura
**Siti Arifah, S.Kep., M.Kes: Dosen Kepera-watan FIK UMS. Jln A Yani Tromol Post 1 Kartasura.
