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"ABSTRAKIt is well known that iron and zinc deficiencies have negative consequences on growth and development; therefore combined iron and zinc supplementation has been proposed to be applied at community level. However, studies on zinc supplementation and infant's growth have shown inconsistent results. While physiological factors may partly explain the variation in findings, contribution of care specifically psychosocial care to the outcomes has been less discussed. This study aims to investigate whether effect of micronutrient (zinc, iron, vitamin A) supplementation in improving infants' growth and developmental outcomes is modified by levels of psychosocial care. The main hypothesis of the study is that zinc and iron supplementation improves growth and developmental outcomes of the infants and that the effect is improved with more favorable psychosocial care. The study involved 800 infants aged 3-6 months living in the rural area of East Lombok, West Nusa Tenggara. The main study was a double-blind community intervention study where syrup -consisting of zinc alone, Z (10 mg/d), zinc+iron, ZF (10 mg of each/day), zinc+ iron+ vitamin-A, ZFA (10 mg/d for each zinc and iron, 1,000 IU for vitamin-A), or placebo-- were given in daily dose for six months. The measured outcomes were growth, index on mental (MDI) and psychomotor (PDI) development using Bayley Scale of Infant Development II (BSID II), and micronutrient status (hemoglobin, serum zinc, ferritin, and retinol). Psychosocial care was assessed using Home Observation for Measurement of the Environment (HOME) Inventory scale. Other data included morbidity, food intake, childcare practices, resources for care, and socio-economic condition. Significant effect on serum zinc was observed in Z, ZF and ZFA groups and on serum retinol in ZFA group (p<0.05). Prevalence of anemia and low iron storage (ferritin <10 µg/L) remained the same in ZF and ZFA groups while increased (p<0.01 for hemoglobin, p<0.05 for ferritin) in Z and placebo groups. In general there was no significant effect of the supplementation on growth (HAZ, WHZ, WAZ). However, positive response on linear growth (HAZ) was observed among initially stunted infants, especially stunted boys who receive both zinc and iron (ZF and ZFA groups, p<0.05). There was an improvement of mental development in all groups, but only significantly in ZF group (p<0.05). In addition, subjects whose anemia remained uncorrected had significantly lower mental scores than those who were not/ no longer anemic (p<0.05). Better psychosocial care was associated with better growth, and the difference in growth among upper and lower levels of psychosocial care is minimal in the infants who received iron-zinc supplementation, suggesting that both supplementation and psychosocial care had an effect on growth. However, during the six-month supplementation, combination of both supplementation and better psychosocial care was not more significant than interaction of iron-zinc supplement and male sex (for HAZ) or levels of psychosocial care alone (for WAZ). Growth is determined not only by micronutrient intake and status but also by the contributing role of psychosocial care. Psychosocial care affected growth indirectly through better nutrient intake and health practices, and possibly through direct mechanism, which was not yet identified. The effect of zinc+ iron supplementation on mental development was stronger when combined with better psychosocial care and higher hemoglobin level. Accelerated mental performance was also observed in placebo, suggesting that factor(s) other than nutritional factor(s) may influence mental performance. On the other hand, psychomotor outcome was more predicted by nutritional status (WAZ), age, nutrient intake and illness. Results from this study concluded that mental development was determined both by micronutrient status and psychosocial care. Psychosocial care affected mental development partly through better initial mental performance, but mainly direct suggesting that environmental factor(s) had a stronger role than initial status in determining mental performance. Six months after the supplement was no longer given, growth (HAZ, WAZ, WHZ) remained better in infants having better psychosocial care. The association between growth (HAZ, WAZ) and HOME score at six months after the end of supplementation became stronger than during the intervention period, whereas positive benefit of the supplementation on -HAZ among boys -as observed by the end of the 6-month supplementation- was no longer maintained at this point of time. During the six-month supplementation, the subsequent six months, and over the total 12-month period, nutrient intake together with illness and psychosocial care were significant determinants of nutritional status (HAZ and WAZ). Results of this study suggest that incorporating care elements including encouragement of psychosocial care in supplementation/nutritional programs should improve its effectiveness and sustainability. The study also recommends further study to investigate more optimal iron: zinc ratio (probably more than 1:1) when given to anemic, iron deficient subjects and to investigate the mechanism connecting psychosocial care and nutrition/ health outcomes. "

"Nyeri merupakan stimulus yang dapat merusak perkembangan otak bayi prematur. Tujuan penelitian mengetahui pengaruh developmental care terhadap respon nyeri akut pada bayi prematur yang dilakukan prosedur invasif. Penelitian ini menggunakan rancangan quasi experimental non equivalent control group, before and after design, dengan jumlah sampel 42 bayi prematur terdiri dari 21 responden sebagai kelompok kontrol dan 21 sebagai kelompok intervensi. Hasil penelitian ada perbedaan yang signifikan dari respon nyeri akut sebelum dan sesudah dilakukan developmental care (p value=0,000). Rekomendasi penelitian developmental care perlu diterapkan dalam memberikan asuhan keperawatan pada bayi prematur dan diharapkan ada penelitian lanjutan tentang pengaruh developmental care terhadap perkembangan bayi prematur di kemudian hari baik dari aspek kognitif, bahasa maupun motorik.

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Pain is a stimulus that can damage the developing brains of premature babies. The objectives of this research was to determine the effects of developmental care on acute pain response in premature babies who had been performed invasive procedures. This study used quasiexperiment research design non equivalen control group, before and after design, involving 42 sample consisted of 21 premature babies in both control and intervention group.

This study found that there was a significant difference on acute pain responses before and after developmental care been implemented (p value=0,000). Recommendation from this research are developmental care needs to be applied in nursing care for premature babies and it also important to investigate the long term influence of developmental care on development of premature babies either from the aspect of cognitive, languange and motor skills."

"Nyeri merupakan stimulus yang dapat merusak perkembangan otak bayi prematur. Developmental care merupakan salah satu strategi untuk mengurangi respon nyeri akibat prosedur invasif. Penelitian ini bertujuan untuk mengetahui pengaruh developmental care terhadap respons nyeri akut pada bayi prematur yang dilakukan prosedur invasif. Penelitian menggunakan rancangan quasi experimental non equivalent control group, before and after design, dengan jumlah sampel 42 bayi prematur terdiri dari 21 responden sebagai kelompok kontrol dan 21 sebagai kelompok intervensi yang dipilih dengan teknik sampling accidental sampling. Pada penelitian ini didapatkan hasil ada perbedaan selisih skor respons nyeri akut antara kelompok yang diberikan developmental care dan kelompok kontrol (p= 0,000; α= 0,05), developmental care menurunkan skor nyeri sebesar 2,05 poin. Developmental care perlu diterapkan dalam memberikan asuhan keperawatan pada bayi prematur. Penelitian lanjutan tentang pengaruh developmental care terhadap perkembangan bayi prematur pada dari aspek kognitif, bahasa, dan motorik perlu dilakukan.

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Pain is a stimulus that can damage the developing brains of premature babies. Developmental care is one strategy in reduce pain caused by invasive procedure. The objective of this research was to determine the effects of developmental care on acute pain response in premature babies who had been performed invasive procedure. This study used quasiexperiment research design non equivalen control group, before and after design, involving 42 sample consisted of 21 premature babies in both control and intervention groups, technical sampling used accidental sampling. This study founded that there was a significant difference in change score of acute pain response between on intervention and control groups (p= 0.000; α= 0.05), developmental care decreased 2,05 point of pain scores). Developmental care was recommended to be applied in nursing care for premature babies. Further research on effect developmental care on development of premature babies influence cognitive, languanges, and motor skills aspects need to be designed."

"ABSTRACTPemberian ASI eksklusif dapat mencegah gangguan pertumbuhan dan perkembanganpada bayi serta risiko berbagai masalah kesehatan di masa depan. Penelitian inidilakukan untuk mengetahui faktor dominan yang berhubungan dengan lamapemberian ASI eksklusif. Penelitian ini menggunakan desain studi cross-sectionalpada 151 ibu menyusui di wilayah kerja Puskesmas Cipayung, Depok. Penelitian inimenggunakan data sekunder dari penelitian ldquo;Intervensi Peningkatan ASI dan MPASIDalam Rangka Penerapan Program 1000 Hari Pertama Kehidupan rdquo;. Hasil penelitianmenunjukkan bahwa terdapat 70,2 ibu memberikan ASI eksklusif selama 6 bulan.Analisis bivariat menunjukkan adanya hubungan bermakna antara status bekerja ibu,pengetahuan ibu, suplementasi susu, asupan energi, dan asupan karbohidrat selamamenyusui dengan pemberian lama pemberian ASI eksklusif. Analisis multivariatmenunjukkan suplementasi susu pada ibu menyusui sebagai faktor dominan yangberhubungan dengan lama pemberian ASI eksklusif OR= 4,096 . Terlihat bahwasuplementasi susu pada ibu menyusui dapat meningkatkan pemberian ASI eksklusifhingga 6 bulan.

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ABSTRACTExclusive breastfeeding could prevent child rsquo s growth and development disorders andalso prevent the risk of health problems occurring later in life. The purpose of this studywas to determine the dominant factor that related to exclusive breastfeeding duration.A cross sectional design study was used with 151 breastfeed mothers at working areaof Puskesmas Cipayung, Depok as participants. This study used secondary data from ldquo Intervensi Peningkatan ASI dan MPASI Dalam Rangka Penerapan Program 1000Hari Pertama Kehidupan rdquo research. In this study, 70,2 mothers were found to give 6months exclusive breastfeeding. Bivariate analysis found that mother rsquo s working status,mother rsquo s knowledge, milk supplementation, energy intake and carbohydrate intakeduring breastfeeding were significantly related to exclusive breastfeeding duration.Multivariate analysis resulted that milk supplementation was the dominant factor thatrelated to exclusive breastfeeding duration OR 4,096 . Milk supplementation forbreastfeed mothers was found to increase the duration of exclusive breastfeeding up to6 months."

"Nyeri merupakan salat satu ketidaknyamanan yang sering dialami bayi yang dirawat di rumah sakit. Tujuan dari studi kasus ini adalah untuk mendapatkan gambaran tentang pemenuhan rasa nyaman neoantus dengan Non-nutritive Sucking (NNS) dan pijat ekstremitas berdasarkan penerapan Model Konservasi Levine. Model ini mempertimbangkan konservasi bayi saat prosedur ketidaknyamanan, peningkatan adaptasi bayi untuk mencapai keutuhan. Lima bayi dengan berbagai kondisi yang mengalami masalah nyeri akut diberikan asuhan keperawatan dengan pendekatan model konservasi Levine. Masalah keperawatan lain yang ditemukan adalah ketidakefektifan pola nafas, ketidakefektifan termoregulasi, ikterik neonatus, risiko cidera, risiko pertumbuhan tidak proporsional, ketidakcukupan ASI, dan risiko keterlambatan perkembangan. Masalah-masalah tersebut berisiko meningkatkan ketidaknyamanan dan menghambat proses adaptasi neonatus dalam mencapai keutuhan.

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Pain is a discomfort sensational that felt by hospitalized neonates. The purpose of this case study is to get description about the fulfill comfort of neoantus with Non Nutritive Sucking (NNS) and extremities massage based Levine Conservation Model application. This model considers the conservation of the baby during discomfort procedures, increased infant adaptation to achieve the wholeness. Five infants with various conditions experienced acute pain problems given nursing care with levine conservation model approach. Another nursing problems found were ineffective breathing patterns, neonatal jaundice, ineffective thermoregulation, risk of injury, risk of disproportionate growth, insufficient breastfeeding and risk of developmental delay. Such problems are at increased risk of discomfort and inhibit the neonatal adaptation process in achieving neonatal wholeness."

"ABSTRAKASI menjadi nutrisi utama yang bermanfaat bagi pertumbuhan bayi. Pada satu tahun pertama pertumbuhan terdapat masa bayi mengalami peningkatan frekuensi menyusu yang disebut juga dengan masa growth spurts. Penelitian ini bertujuan untuk mengidentifikasi gambaran grafik pertumbuhan 0-6 bulan pada bayi yang mendapat ASI eksklusif di Kota Depok. Jenis penelitian yang digunakan adalah penelitian deskriptif dengan studi cross sectional retrospektif. Sampel yang dibutuhkan sebanyak 106 responden ibu yang memiliki bayi usia 6-12 bulan yang telah mendapat ASI eksklusif. Pengambilan sampel dilakukan dengan metode consecutive sampling. Penelitian ini menggunakan analisis univariat dengan hasil yang menunjukkan terjadi peningkatan yang tinggi pada rata-rata kenaikan berat badan bayi di usia 0 ke 1 bulan sebesar 1006 gram. Hasil penelitian ini diharapkan dapat bermanfaat bagi perkembangan ilmu terkait masa growth spurts yang terjadi pada bayi. Penelitian selanjutnya diharapkan menggunakan studi penelitian yang berkelanjutan agar dapat memantau secara langsung fenomena growth spurts pada bayi.

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ABSTRACTBreastfeeding provides the beneficial main nutrition for baby growth. During the first year of growth, a baby experiences an increase in breastfeeding frequency, which is called as growth spurts. This research aims to identify the growth graph of 0 6 months age exclusively breastfed infants in Depok. The method used is descriptive research with retrospective cross sectional study. The sample requires 106 respondents mothers of 6 12 months age exclusively breastfed infant. The sampling is done by the consecutive sampling method. This research uses univariate analysis with the results indicating the high increase of average baby weight at the age of 0 to 1 month of 1006 grams. The results of this study are expected to be useful for the development of science related to the growth spurts in infants. Further research is expected to use continuous research study in order to monitor the growth spurts in infants directly."

"Disertasi ini bertujuan untuk mengetahui faktor-faktor yang berpengaruh terhadap terjadinya deviasi positif pertumbuhan sampai usia lima bulan dan mengali perilaku penyimpang positif pada keluarga dengan status ekonomi rendah. Jenis penelitian adalah perpaduan penelitian kuantitatif (kohort prospektif) dengan penelitian kualitatif (Rapid Assesment Procedure). Besar sampel adalah 61 bayi BBLR (2000-2499 gram) yang lahir cukup bulan. Sampel diperoleh dari 5 rumah sakit 7 klinik bidan di Kota Pekanbaru. Hasil menunjukkan bahwa pada usia lima bulan terjadi deviasi positif pertumbuhan sebesar 65,6%. Faktor yang berpengaruh adalah pemberian ASI, kesehatan bayi dan lingkungan pengasuhan. Perilaku positif deviants adalah frekuensi pemberian ASI dalam 24 jam lebih dari 12 kali, memeriksa kesehatan bayi setelah satu minggu dilahirkan, ibu menjaga kebersihan rumah, ayah turut mengasuh bayi, keputusan bersama ibu dan nenek dalam pemberian makanan pada bayi.

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This dissertation aims to determine the factors that influence the occurrence of a positive deviation of growth until the age of five months and experience the positive deviant behavior in families with low economic status. The research type is a combination of quantitative research (prospective cohort) with qualitative research (Rapid Assessment Procedure). The sample size was 61 infants of low birth weight (2000-2499 g) were born at term. Samples were obtained from 5 hospitals 7 midwife clinics in the city of Pekanbaru. The results showed that at the age of five months of positive growth deviation of 65.6%. Factors that influence breastfeeding, infant health and caring environment. Positive Deviants behavior is the frequency of breastfeeding within 24 hours more than 12 times, check the health of babies born after one week, mother to keep the house, father helped care for infants, a decision with his mother and grandmother in infant feeding."