Surakarta Hospital Research Articles

The Compability Level of Tuberculin Skin Test and T-SPOT.TB, Sensitivity and Spesifisity of T-SPOT.TB in Detecting Latent Tuberculosis in Hemodialysis Patients

Background: Controling Latent Tuberculosis Infection (LTBI) is important for the End TB Strategy program. The prevalence of LTBI and reactivation to active tuberculosis are increased in immunodeficiency conditions, such on hemodialialysis patients. Laten tuberculosis can be diagnosted by Tuberculin Skin Test (TST) and immunoglobulin release assay (IGRA). This diagnostic study aimed to determine the agreement level of TST and T-SPOT.TB, accurancy of T-SPOT.TB, and the correlation between T cluster of differentiation 4 (CD4+) cell counts with TST and T-SPOT.TB. Methods: This is a cross sectional study design was performed in hemodialysis patients of Dr. Moewardi Surakarta Hospital in May 2018. The study subject had TST and T-SPOT.TB examinations by using 2 Tuberkulin Unit (TU) of intradermal purified protein derivate (PPD) RT 23 (Biofarma, Bandung) and venous blood ELISPOT analysis, respectively. Statistical analysis used windows SPSS 21. Results: There were 30 study subjects. The prevalence of LTBI was 23.3%. The agreement level of TST and T-SPOT.TB was substantial (K=0.667;P<0.001). The sensitivity and specificity of T-SPOT.TB were 66.7% and 95.8%, respectively. There were no significant correlation of CD4+ T cell counts with TST (R=0,253;P=0,177), T-SPOT.TB ESAT-6SFUs (R=-0.169;P=0.317), T-SPOT.TB CFP-10 SFUs (R=0.006;P=0.975), and the highest value of T-SPOT.TB ESAT-6/CFP-10 SFUs, (R=-0.070;P=0.741). Conclusion: The prevalence of LTBI is high in hemodialysis patients, thus early detection is necessary. TST examination is recommended for LTBI diagnostic tool in hemodialysis patients because of its practical use, inexpensive, and does not require skilled personnel.

The Effect of Administration of Lycopene on Interleukin 8 Levels and Hospitalization Time of Patients with Chronic Obstructive Pulmonary Disease Exacerbations

Background: Exacerbated chronic obstructive pulmonary disease is an acute condition, characterized by persistent air flow limitations, related to the excessive chronic inflammatory response in the airways and lung parenchyma caused by exposure to harmful gases or particles. Increased airway inflammation during exacerbations leads to increased levels of IL-8 and the risk of hospitalization. Lycopene is a carotenoid which has a positive effect on the respiratory system. The purpose of this study was to determine the effect of administration lycopene to IL-8 levels and hospitalization time of patients with COPD disease exacerbations.Methods: The experimental test with pretest and posttest design for 30 patients with COPD exacerbations in Dr. Moewardi Surakarta Hospital and Dr. Soehadi Prijonegoro Sragen Hospital was conducted from February to March 2018. Samples were taken by consecutive sampling divided into two groups including the treatment group receiving standard therapy and lycopene 1x10 mg / day during treatment and the control group only receiving standard therapy. IL-8 levels and hospitalization time of patients with COPD disease exacerbations were measured.Results: There were significant differences between the treatment group compared to the control group for a decrease in IL-8 (p = 0.029) and a decrease in hospitalization time (p = 0,000).Conclusion: The administration of lycopene 1x10 mg / day significantly reduce IL-8 levels and hospitalization time of patient with COPD exacerbations.

PERAN MEDI ASI MODAL PSI KOLOGI S: HUBUNGAN ANTARA KEPEMI MPI NAN AUTENTI K DAN KOMI TMEN ORGANI SASI ONAL STUDI PADA RUMAH SAKI T JI WA DAERAH SURAKARTA DAN RUMAH SAKI T PKU MUHAMMADI YAH SURAKARTA

This study aims to examine the mediating role of pshychological capital in the rlationship between authentic leadership and organizational commitment. Organizational commitment is an important factor in improving hospital performance. Commitment as a type of pshchological bond that reflects the dedication and responbility of employees to the work targets and goals of the hospital so that when organizational commitment is built the hospital will lead to various beneficial results. Data was obtained through distributing questionnaires to employees who worked at Surakarta Regional Mental Hospital and PKU Muhammadiyah Surakarta Hospital. The research sample used amounted to 159. The sampling technique used in this study was the Cluster Sampling technique. Hypothesis testing is done using regression analysis with mediating variables. The results in this study indicate that authentic leadership has a positive and significant effect on organizational commitment, authentic leadership has a positive and significant effect on psychological capital, psychological capital has a positive and significant effect on organizational commitment. This means psychological capital mediates the relationship between authentic leadership and psychological capital

The effect of administration of lycopene on interleukin 8 levels and hospitalization time of patients with chronic obstructive pulmonary disease exacerbations

Abstrak. Latar Belakang: Eksaserbasi pada penyakit paru obstruktif kronik merupakan kondisi akut yang ditandai dengan hambatan aliran udara yang persisten dari respon inflamasi kronik yang berlebihan pada saluran napas dan parenkim paru yang disebabkan oleh paparan gas atau partikel berbahaya. Peningkatan peradangan saluran napas selama eksaserbasi menyebabkan peningkatan kadar IL-8 dan risiko rawat inap. Likopen merupakan karotenoid yang memiliki efek positif pada sistem pernapasan. Tujuan penelitian ini adalah untuk mengetahui pengaruh pemberian likopen terhadap kadar IL-8 dan lama rawat inap pasien PPOK eksaserbasi akut.Metode: Uji eksperimental dengan desain pretest dan posttest pada 30 pasien PPOK eksaserbasi di RSUD Dr. Moewardi, Surakarta dan RSUD Dr. Soehadi Prijonegoro, Sragen dilakukan pada bulan Februari-Maret 2018. Pengambilan sampel secara consecutive sampling dibagi menjadi dua kelompok yaitu kelompok perlakuan yang mendapat terapi standar dan likopen 1x10 mg/hari selama pengobatan dan kelompok kontrol hanya mendapat terapi standar. Dilakukan pengukuran kadar IL-8 dan waktu rawat inap pasien dengan PPOK eksaserbasi.Hasil: Terdapat perbedaan yang bermakna antara kelompok perlakuan dibandingkan dengan kelompok kontrol untuk penurunan IL-8 (p = 0,029) dan penurunan waktu rawat inap (p = 0,000).Kesimpulan: Pemberian likopen 1x10 mg / hari secara signifikan menurunkan kadar IL-8 dan lama rawat inap pasien eksaserbasi PPOK.Kata kunci: eksaserbasi akut, kadar IL-8, lama rawat inap, likopen, PPOK.Abstract. Background: Exacerbated chronic obstructive pulmonary disease is an acute condition, characterized by persistent air flow limitations, related to the excessive chronic inflammatory response in the airways and lung parenchyma caused by exposure to harmful gases or particles. Increased airway inflammation during exacerbations leads to increased levels of IL-8 and the risk of hospitalization. Lycopene is a carotenoid which has a positive effect on the respiratory system. The purpose of this study was to determine the effect of administration lycopene to IL-8 levels and hospitalization time of patients with COPD disease exacerbations.Methods: The experimental test with pretest and posttest design for 30 patients with COPD exacerbations in Dr. Moewardi Surakarta Hospital and Dr. Soehadi Prijonegoro Sragen Hospital was conducted from February to March 2018. Samples were taken by consecutive sampling divided into two groups including the treatment group receiving standard therapy and lycopene 1x10 mg / day during treatment and the control group only receiving standard therapy. IL-8 levels and hospitalization time of patients with COPD disease exacerbations were measured.Results: There were significant differences between the treatment group compared to the control group for a decrease in IL-8 (p = 0.029) and a decrease in hospitalization time (p = 0,000).Conclusion: The administration of lycopene 1x10 mg / day significantly reduce IL-8 levels and hospitalization time of patient with COPD exacerbations.Keywords: lycopene, COPD, acute exacerbation, IL-8 level, hospitalization time

Biopsychosocial Factors Affecting Quality of Life in Post-stroke Patients: A Path Analysis Evidence from Surakarta Hospital, Central Java

Biopsychosocial Factors Affecting Quality of Life in Post-stroke Patients: A Path Analysis Evidence from Surakarta Hospital, Central Java

Biopsychosocial Factors Affecting Quality of Life in Post-stroke Patients: A Path Analysis Evidence from Surakarta Hospital, Central Java

Background : Basic health research shows that the prevalence of non-communicable diseases has in­creased, including cancer, stroke, chronic kidney disease, diabetes mellitus, and hypertension. The impact of these changes can cause one of them to decrease the quality of life of patients. Stroke in individuals can cause several changes including physical, social and psychological changes that will affect the quality of life. This study aimed to analyze the determinants of the quality of life of pa­tients post stroke. Subjects an d Met h od: This study was a cross sectional study conducted at Surakarta City Hos­pital, from September to October 2019. The sample used was 200 patients post stroke. The sam­pling technique used purposive sampling. The dependent variable was the quality of life of patients post stroke. The independent variables were age, gender, employment status, patient income, fa­mi­ly income, attack status, post-stroke comorbidity, duration of illness, marital status, family sup­port, level of functional disorders, and depression status. The data were collected by questionnaire. The data were analyzed by path analysis with the Stata 13 program. Result : The quality of life of post-stroke patients increased directly in patients with married status (b=1.79; 95% CI=0.24 to 3.35; p=0.024), have a job (b=1.93; 95% CI=0.13 to 3.72; p=0.035), good fa­mily support (b=2.17; 95% CI=0.46 to 3.88; p=0.013), and mild functional disorders (b=1.68; 95% CI=0.11 to 3.25; p=0.036). Quality of life decreased directly in patients aged ≥60 years old (b=-1.99; 95% CI=-3.80 to -0.17; p=0.032), female gender (b=-1.74; 95% CI=-3.28 to -0.19; p= 0.027), stro­­kes more than 1 time (b=-1.87; 95% CI=-3.59 to -0.15; p=0.033), sick ≥6 months (b=-2.12 ; 95% CI=-3.87 to -0.36; p=0.018), have comorbidities (b=-1.96; 95% CI=-3.67 to -0.24; p= 0.025), and de­pression (b=-1.40; 95% CI=-2.97 to 0.16; p=0.078). Quality of life was indirectly affected by age, ill­ness, marital status, family support, family income, and employment status. Conclusions: The quality of life of post-stroke patients increased directly affected by marital sta­tus, employment status, family support, and functional disorders. Quality of life was directly affec­ted by age, gender, attack status, duration of illness, comorbidity and depression. Keywords : stroke, quality of life, path analysis. Cor r espondence: Maki Zamzam. Master Program of Public Health Sciences, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta, Central Java. Email: makizz477@gmail.com. Mobile: +6281251543935. Journal of Epidemiology and Public Health (2020), 5(1): 1-14 https://doi.org/10.26911/jepublichealth.2020.05.01.01.

Community’s Social Construction on Covid-19 Patients with Supervision in Surakarta Indonesia

Negative stigma labelled against Covid-19 patients and health workers can worsen Covid-19 management situation. Therefore, this research aimed to analyze Surakarta people’s interpretation on Covid-19 patient and their social construction process on Covid-19 patient in Surakarta Indonesia. This qualitative research with phenomenological research employed purposive sampling technique. Research informants consisted of Surakarta people, Pulmonologists and Nurses in Dr. Moewardi Surakarta Hospital, Chief Executive of Covid-19 Management Acceleration Task force of Surakarta City, etc. Online observation, in-depth interview, and documentation with internet media were used to collect primary and secondary data. Method and data source triangulations were used to validate data. Interactive model of analysis was conducted using Berger’s Social Construction theory. Surakarta People’s social construction on Covid-19 positive patients passed through some process:Externalization processindicated with Surakarta people’s early perception on Covid-19 as a new disease known poorly, thereby generating fear and ignorance among them;Objectification processshowing people with varying perspectives on Covid-19 positive patients; andInternalization processfinding the subjective reality of Surakarta People on Covid-19 patients affected by objectification stage, later creating interpretation on individual or group having ever interacted with this virus patient.

The improvement of Self Immunity, Mental and Psychosocial Health to Prevent Covid-19 Infection in Elders in Surakarta Indonesia

Elder group is the one with the risk of being infected with Coronavirus Disease 19 (Covid-19). It is very important to prevent Covid-19 transmission with any attempt, particularly in elders. This research aimed to help explain the importance of maintaining immunity and preventing Covid-19 transmission to elders in order to be alerted to Covid-19 in Surakarta Indonesia. This qualitative research with explorative approach employed purposive sampling technique. Unit of analysis consisted of elders in many areas in Surakarta, Chief Executive of Covid-19 Management Acceleration Task force of Surakarta City, pulmonologist and nurses in Dr. Moewardi Surakarta Hospital, Chairperson of Surakarta City’s Health Office (DKK), Head of Disease Control and Environmental Health Division of Surakarta Health Office, and Chairperson of Surakarta City’s Social Office. Data collection was conducted through observation, in-depth interview, and documentation, and then method and data source triangulations. Data analysis was conducted using an interactive model of analysis with Parsons’ system theory. The result of research showed that the Covid-19 prevention in elders in Surakarta was conducted through improving their physical immunity, nursing care for elders, nursing care for family, and preventing physical, and mental and psychosocial health problems in elders.

Perbedaan Kecepatan Pengembangan Paru Sebelum dan Sesudah Latihan Pernapasan Diafragma dalam Upaya Mempercepat Pelepasan Water Seal Drainage (WSD)

An Pleural effusion is an excessive accumulation of fluid, blood or water in thepleural cavity which will cause the increase of shortness of breath because of thedecreasing space for lung expansion. One of the efforts to reduce the complaintsof shortness of breath is by insertion of water seal drainage. Water Seal Drainage(WSD) is a medical action performed to remove air or fluid from the pleuralcavity. The patient's ability to breathe effectively is an indicator to release WSD.This study generally aims to determine the effectiveness of diaphragmaticbreathing exercises on the speed of lung expansion in patients with water sealdrainage insertion.The research design was pre experiment with pre test - post test group design.The population in this study were patients with insertion of WSD who wereadmitted to Dr. Muwardi Surakarta Hospital. The sampling technique waspurposive sampling. The number of samples were 16 respondents. To measurelung expansion, the indicator used Peak Expiratory Flow Rate as measured bypeak flow meter. Data analysis used dependent t-test.The results show that there are differences in the speed of lung expansion inpatients with WSD insertion before and after diaphragmatic breathing exerciseswith p-value of 0.0001.Suggestion for nurses to be able to train diaphragmatic breathing exercise inpatients with WSD insertion increase lung expansion so that WSD can bereleased and the risk of infection can be reduced

Hubungan Antara Lama Menderita Diabetes Dengan Nilai Ankle Brachial Index

Duration of suffering diabetes melitus type 2 causes glucose increase in blood results in blood vessels damage, creates a risk of complications which will usually appear in 5-10 years. Further examination is needed is to measure Ankle brachial index (ABI), which is the ratio of blood pressure in the ankle and arm. The purpose of this research was to investigate the relationship between duration of diabetes melitus and an ankle brachial index in patients with type 2 diabetes melitus in Hospital Dr. Moewardi Surakarta. This research is a descriptive correlative with cross sectional approach. The sample used in this study 30 patients with type 2 diabetes melitus who were hospitalized in Dr. Moewardi Surakarta Hospital. Sampling technique used is consecutive sampling. The instrument used to record data are questionnaires, sphygmomanometer and stethoscope. Analysis of the data used is the chi square test. Bivariat results found that respondents who had normal ABI values with the duration of diabetes 0.05), which means that Ho is accepted. The conclusions of this study indicate that there is no relationship between duration of diabetes melitus with an ankle brachial index in patients with diabetes melitus type 2 whichmeans that the duration of diabetes melitus does noteffect the value abnormality ABI.

Determinan Kinerja Staf Akuntansi di RS PKU Muhammadiyah Surakarta

The purpose of this study is to examine the influence of professionalism, organizational commitment, and job satisfaction to job performance. The sample of this study are 44 accounting staff in PKU Muhammadiyah Surakarta Hospital. With multiple regression analysis, the result of the research shows that professionalism and organizational commitment has significant effect to job performance. While job satisfication has no significant effect to job performance. Keywords: Professionalism, Organizational Commitment, Job Satisfaction, and Job Performance JEL Classification code: C21, C83, J28, J81

PERSONAL PROTECTIVE EQUIPMENT UTILIZATION IN CENTRAL STERILE SUPPLY DEPARTEMENT PKU MUHAMMADIYAH HOSPITAL SURAKARTA

Personal Protective Equipment (PPE) utilization are very effective in minimizing injuries and accident for healthcare workers. Due to high availability of potential hazard in Central Sterile Supply Departement (CSSD) PKU Muhammadiyah Surakarta hospital management decided PPE utilization as an obligation for all healthcare workers This study aim to analyze risk and hazard factor, PPE function and availability, and healthcare workers PPE utilization in CSSD unit based on goverment regulations. This study used observational method and describe PPE utilization and implementation in CSSD unit as a result. The result of this study is the biggest risk factor, which is biological hazard. CSSD unit already prepared PPE that suit the goverment regulations. PPE utilization still not yet fully implemented regarding to CSSD regulations. Conclusion from this study, in general, PPE utilization and implementation in CSSD unit is according to goverment regulation UU No.1 Tahun 1970 and Per 08/MEN/VII/2010 from Kemnakertrans. Keyword : PPE implementation, PPE utilization

Perbedaan Kecepatan Pengembangan Paru Sebelum dan Sesudah Latihan Pernapasan Diafragma dalam Upaya Mempercepat Pelepasan Water Seal Drainage (WSD)

An Pleural effusion is an excessive accumulation of fluid, blood or water in the pleural cavity which will cause the increase of shortness of breath because of the decreasing space for lung expansion. One of the efforts to reduce the complaints of shortness of breath is by insertion of water seal drainage. Water Seal Drainage (WSD) is a medical action performed to remove air or fluid from the pleural cavity. The patient's ability to breathe effectively is an indicator to release WSD. This study generally aims to determine the effectiveness of diaphragmatic breathing exercises on the speed of lung expansion in patients with water seal drainage insertion. The research design was pre experiment with pre test - post test group design. The population in this study were patients with insertion of WSD who were admitted to Dr. Muwardi Surakarta Hospital. The sampling technique was purposive sampling. The number of samples were 16 respondents. To measure lung expansion, the indicator used Peak Expiratory Flow Rate as measured by peak flow meter. Data analysis used dependent t-test. The results show that there are differences in the speed of lung expansion in patients with WSD insertion before and after diaphragmatic breathing exercises with p-value of 0.0001. Suggestion for nurses to be able to train diaphragmatic breathing exercise in patients with WSD insertion increase lung expansion so that WSD can be released and the risk of infection can be reduced.

Correlation between Nutritional Status of Pregnant Mothers and Low Birth Weight in the Surakarta Hospital

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Path Analysis on the Determinants of Severe Preeclampsia in Surakarta, Central Java

Background: Preeclampsia is a major cause of maternal morbidity and mortality that occurs at gestational age >20 weeks. It is characterized by hypertension and proteinuria. Shortly, severe preeclampsia may develop into eclampsia accompanied by seizures or coma. This study aimed to examine the determinants of severe preeclampsia in Surakarta, Central Java. Subjects and Method: This was a case-control study conducted in Gajahan health center, Dr. Moewardi hospital, and Surakarta hospital, Surakarta, Central Java, from October 2018 to December 2018. A sample of 200 pregnant women was selected by fixed disease sampling. The dependent variable was severe preeclampsia. The independent variables were age, education, stress, parity, history of hypertension, history of diabetes mellitus (DM), ANC visit, and family history of hypertension. Data on preeclampsia were obtained from medical record. The other data were collected by questionnaire. The data were analyzed by path analysis. Results: Severe preeclampsia was directly and positively associated with age <20 or ≥35 years (b= 1.23; 95% CI= 0.31 to 2.14; p= 0.008), history of hypertension (b= 1.54; 95% CI= 0.58 to 2.51; p= 0.002), history of DM (b= 1.12; 95% CI= 0.21 to 2.03; p= 0.016), and stress (b= 1.58; 95% CI = 0.60 to 2.56; p = 0.002). It was negatively associated with parity (b= -0.96; 95% CI= -1.90 to - 0.01; p = 0.046) and ANC visit (b= - 1.98; 95% CI= -2.91 to - 1.05; p<0.001). Severe preeclampsia was indirectly associated with education, ANC visit, and family history of hypertension. Conclusion: Severe preeclampsia is directly and positively associated with age, history of hypertension, history of DM, and stress. It is negatively associated with parity and ANC visit. Severe preeclampsia is indirectly associated with education, ANC visit, and family history of hypertension. Keywords: severe preeclampsia, determinants, path analysis Correspondence: Prafista Wulan Sari. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami No. 36 A, Surakarta, Central Java. Email: prafistaw@yahoo.com. Mobile: +6285740772699. Journal of Maternal and Child Health (2019), 4(2): 126-135 https://doi.org/10.26911/thejmch.2019.04.02.08

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN TINGKAT DEPRESI PADA PASIEN KANKER YANG MENJALANI KEMOTERAPI DI RUMAH SAKIT Dr. OEN SURAKARTA

Background: Suffering from cancer is a prominent stimulus for patients, so it can clearly bring great mental stress and suffering to the patient. Cancer patients undergoing chemotherapy usually experience various symptoms as a result of the disease or from chemotherapy itself. These symptoms affect the patient both physically and emotionally and furthermore negatively affect the treatment. Depression is a common symptom in cancer patients that are difficult to detect. This condition can negatively affect the quality of life of patients. Patient response to cancer can be affected by past life experiences with the disease. Each client uses different coping strategies. Support provided, will provide great benefits for subsequent therapy, prognosis and improvement of patient's quality of life. Objective: To know the factors related to depression level in cancer patients who underwent chemotherapy at Dr. OEN SURAKARTA Hospital. Research subjects: Cancer patients undergoing chemotherapy. Keywords: Frequency of chemotherapy, stage of cancer, coping mechanism, family support, depression level

PENGUKURAN LAJU PAPARAN RADIASI PADA RUANG PEMERIKSAAN MSCT 64 SLICE

Background:Radiation exposure rate measurements have been done on the MSCT 64 Slices examination room radiology section Dr. Moewardi Surakarta Hospital due to lack of repeat measurement after replacement of examination door. This study aims to determine the rate of radiation exposure and radiation safety in the examination room for workers and public refers to the NCRP report no. 147 about stuctural shielding design for medical x-ray imaging facilities.&#x0D; Methods: This type of research is quantitative research with survey approach. This research was conducted in March 2018. Data collection was done by observation, documentation, and measure the radiation exposure in measurement points some places, which are controlled and uncontrolled areas. Data analysis was done descriptively by comparing data with NCRP report no.147.&#x0D; Results:The measurement results of the rate of radiation exposure, point A and B shows the leakage of radiation exposure. While the point of C, D, E no leakage of radiation.&#x0D; Conclusions: The value of background radiation exposure in the MSCT 64 Slices examination room radiology section Dr. Moewardi Surakarta Hospital exceeds the dose rate base on the height of the location according to UNSCEAR. Leakage of radiation exposure occuring at point A is woorkes door and point B front door MSCT 64 Slices examination room not safe for workes and public because it exceeds the limit of radiation exposure rate value which allowed

Hubungan Kausalitas Workplace Spirituality Dan Kinerja Karyawan: Perspektif Mediasi Etika Kerja Islam

Human resource is a very important element in achieving organizational goals. If the organization has a good quality of resources, the organization will be more effective. While the effectiveness of the organization is reflected from the employee performance. The purpose of this study is to examine the effect of workplace spirituality on Islamic work ethic, Islamic work ethic on employee performance, workplace spirituality on employee performance, and the influence of Islamic work ethic as an intervening variable on the relation between workplace spirituality and employee performance, with samples from PKU Muhammadiyah Surakarta Hospital, and IPHI Pedan Hospital, Klaten. The result of the research shows that workplace spirituality has significant effect on Islamic work ethic with, Islamic work ethic has no significant effect to employee performance, workplace spirituality has no significant effect to employee performance, and Islamic work ethic as mediation variable on relation between workplace spirituality (STK) to employee performance has no significant influence.

Analysis of Positioning at Kasih Ibu Hospital Surakarta

Kasih Ibu Hospital is one of the private B type hospitals in Surakarta residency which is facing a tight competition in maintaining its quality in proportion to its income. Kasih Ibu Hospital competes with other type B hospitals, namely X Surakarta Hospital and Y Hospital Surakarta. This research used a descriptive method. The population was the service users of Kasih Ibu Hospital, X Hospital Surakarta and Y Hospital Surakarta. A sample of 50 people was taken by accidental sampling. Data collection was by questionnaire. Data analysis was performed by Multidimensional Scaling (MDS) and biplot perception maps. X Hospital Surakarta is the closest competitor of Kasih Ibu Hospital Surakarta, with a Euclidean distance of 2.8127. X Surakarta Hospital, more prominent intangibles, and empathy dimensions. Kasih Ibu Hospital Surakarta is more prominent in the dimensions of responsiveness, and at a lower level is the reliability and assurance dimension. Y Hospital Surakarta does not specifically stand out on the dimension of service quality based on patient perception. The dimensions which although not too prominent but the closest are empathy. X Surakarta Hospital is the closest competitor of Kasih Ibu Hospital Surakarta. X Hospital Surakarta, more prominent intangibles and empathy dimensions. Kasih Ibu Hospital Surakarta is more prominent in the dimensions of responsiveness, and at a lower level is the reliability and assurance dimension.

Psychosocial Factors Associated with Anxiety and Delivery Pain

Background: Anxiety and pain are physiologic symptoms experienced by mothers during birth delivery. However, if these symptoms are not well-managed they can cause low birth weight, prematurity, prolonged labor, and postpartum depression. This study aimed to analyze the psychosocial factors associated with anxiety and delivery pain. Subjects and Method: This was an analytical observational study with cross sectional design. The study was conducted at Gajahan community health center, Surakarta Hospital, and Muhammadiyah Hospital, Delanggu, Central Java, from December 2017 to January 2018. A total sample of 166 delivery mothers were selected for this study by purposive sampling. The dependent variables were anxiety and delivery pain. The independent variables were parity, psychological stress, coping mechanism, family income, and family support. The data were collected by questionnaire. Anxiety was measured by modified Preg­nancy Related Anxiety Questionaire (PRAQ_R). The data were analyzed by path analysis. Results: Delivery pain increased with higher anxiety (b= 0.30, SE= 0.02, p<0.001). Anxiety decreased with higher delivery pain (b = -1.19, SE= 0.02, p<0.001) and increased with higher stress (b = 0.92, SE= 0.09, p<0.001). Anxiety decreased with coping mechanism (b = -0.31, SE = 0.08, p<0.001) and parity (b= -0.86, SE= 0.37, p<0.001). Stress decreased with better coping mechanism (b= -0.48, SE= 0.08, p<0.001), higher family income (b = -0.16, SE = 0.04, p<0.001), parity (b= -2.13, SE= 0.36, p<0.001), and stronger family support (b = -0.22, SE = 0.06, p=0.007). Coping mechanism increased with parity (b = 1.39, SE = 0.33, p<0.001) and strong family support (b= 0.46, SE= 0.06, p<0.001). Conclusion: Delivery pain increases with higher anxiety. Anxiety associated with delivery pain, stress, and coping mechanism. Keywords: delivery pain, anxiety, psychosocial, family income, parity, coping mechanism, stress Correspondence: Shofia Maharani Khoirun Nisa. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: shofiamkn@gmail.com. Mobile: +6285736382926 Journal of Maternal and Child Health (2018), 3(1): 44-58 https://doi.org/10.26911/thejmch.2018.03.01.05