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Abstrak :
Angka kematian ibu merupakan salah satu indikator untuk melihat keberhasilan upaya kesehatan, kecemasan dalam kehamilan merupakan penyebab kematian pada ibu secara tidak langsung. Tahun 2021 di Jawa Barat terdapat 36,2% ibu hamil yang mengalami kecemasan dalam menghadapi persalinan. Hasil skrining Self-Reporting Questionnaire di Puskesmas Cibaregbeg terdapat 12 (37%) ibu hamil yang mengalami kecemasan. Tujuan penelitian ini adalah untuk mengetahui gambaran kecemasan ibu hamil trimester III dalam menghadapi persalinan dengan pendekatan teori trait-state anxiety dari Spielberger (1972)yang meliputi cognitive appraisal, internal stimuli, stressor, a-trait, a-state, defense mechanism dan Coping behavior. Penelitian kualitatif ini menggunakan pendekatan studi kasus di Puskesmas Cibaregbeg dengan 4 ibu hamil yang terindikasi mengalami kecemasan dan 8 informan pendukung. Hasil wawancara mendalam mayoritas informan mengalami kecemasan dalam kehamilannya penilaian kognitif informan mengalami kecemasan yang disebabkan oleh perasaan takut, perasaan kurang stabilnya emosi, perubahan fisik, informan khawatir dengan kesehatan diri dan perkembangan janin yang dikandungnya, perasaan takut menghadapi proses persalinan dan cemas apakah anak terlahir dengan kondisi fisik normal atau tidak, faktor ekonomi dan kurangnya dukungan keluarga. Mekanisme pertahanan digunakan informan untuk melindungi diri dari perasaan cemas, mayoritas informan melakukan upaya Emotional focused coping yaitu dengan berdoa, jalan-jalan dan mendengakan musik, yang bertujuan untuk mengontrol respon emosional terhadap situasi stres yang dialami informan. Penelitian ini merekomendasikan pentingnya pemerintah membuat program skrining kecemasan khusus ibu hamil untuk mendeteksi dan mengatasi kecemasan pada ibu hamil di setiap fasilitas kesehatan tingkat pertama, karena kecemasan ibu hamil dalam merupakan penyebab kematian ibu tidak langsung. ......Maternal mortality is one indicator to see the success of health efforts, anxiety in pregnancy is an indirect cause of maternal death. In 2021 in West Java, there are 36.2% of pregnant women who experience anxiety in facing childbirth. The results of the Self-Reporting Questionnaire screening at the Cibaregbeg Public Health Center showed that 12 (37%) pregnant women experienced anxiety. The purpose of this study was to determine the description of the anxiety of pregnant women in the third trimester in facing childbirth with the trait-state anxiety theory approach from Spielberger (1972) which includes cognitive appraisal, internal stimuli, stressors, a-trait, a-state, defense mechanism and coping behavior. This qualitative research uses a case study approach at the Cibaregbeg Public Health Center with 4 pregnant women who are indicated to experience anxiety and 8 support informants. The results of in interviews that the majority of informants experience anxiety in their pregnancy cognitive assessment of informant experience anxiety caused by feelings of fear, feelings of emotional instability, physical changes, informants are worried about their own health and the development of the fetus they contain, feeling afraid of facing the birth process and worrying whether the child is born with normal physical condition or not, economic factors and lack of family support. The defense mechanism used by informants to protect themselves from feelings of anxiety, the majority of informants made Emotional focused coping that is, by praying, traveling, and listening music, efforts aimed at controlling emotional responses to stressful situations experienced by informants. This study recommends the importance of the government making a special anxiety screening program for pregnant women to detect and overcome anxiety in pregnant women in every first-level health facility, because anxiety in pregnant women is an indirect cause of maternal death.

Abstrak :
Kurang aktivitas fisik menjadi salah satu faktor terjadinya penyakit kronis yang dapat menyebabkan kematian. Proporsi kurang aktivitas fisik di DKI Jakarta terutama pada pegawai perkantoran menghabiskan waktu lebih dari 8 jam di kantor dan 2-4 jam di perjalanan menuju kantor ataupun pulang ke rumah, membuat kurangnya waktu untuk melakukan aktivitas fisik. Penelitian ini dilakukan untuk mengetahui determinan yang berhubungan dengan perilaku aktivitas fisik pegawai di lingkungan Direktorat Jenderal Kesehatan Masyarakat Kementerian Kesehatan RI tahun 2019. Penelitian kuantitatif, desain cross sectional dengan jumlah sampel 125 PNS yang diambil secara systematic random sampling di 6 (enam) unit kerja di Direktorat Jenderal Kesehatan Masyarakat. Pengumpulan data menggunakan self administered questionnaire meliputi variabel dependen yaitu perilaku aktivitas fisik dan variabel independen dari penelitian ini yaitu pengetahuan pegawai tentang aktivitas fisik, karakteristik individu (umur, jenis kelamin, status pernikahan, pendidikan, pendapatan dan riwayat penyakit), pemanfataan media sosial, fasilitas penunjang aktivitas fisik serta dukungan sosial (dukungan keluarga dan dukungan teman). Hasil penelitian menunjukkan pegawai yang mendapatkan dukungan keluarga memiliki peluang hampir 3 kali (OR 2,632; 95% CI: 1,239-5,596) untuk berperilaku aktivitas fisik aktif dibandingkan dengan pegawai yang tidak mendapatkan dukungan keluarga. Perlunya menyusun dan mengembangkan strategi komunikasi perilaku aktivitas fisik dengan pendekatan di tingkat keluarga dengan mengumpulkan dan melibatkan pegawai dan anggota keluarga dengan minat kegiatan aktivitas fisik yang sama seperti penggiat olahraga permainan (seperti: sepak bola, futsal, voli), latihan fisik (seperti: senam, yoga, lari) ataupun penggiat sepeda yang menjadikan sepeda sebagai alternatif transportasi, dan memfasilitasi sekelompok keluarga tersebut untuk mengkampanyekan ke rekan-rekan keluarga lainnya secara berkesinambungan juga dapat menjadi salah satu model intervensi aktivitas fisik.

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Insufficient physical activity is one of the factor in the occurrence of chronic diseases that can cause death. The proportion of less physical activity in DKI Jakarta, especially in office employees spend more than 8 hours in the office and 2-4 hours on the way to work or go home, making a lack of time for physical activity. This research was conducted to determine the determinants relating to the behavior of physical activity of employees in the Directorate General of Public Health Ministry of Health of RI in 2019. Quantitative research, cross sectional design with a sample of 125 civil servants taken by systematic random sampling in 6 (six) units in Directorate General of Public Health. Data collection using a self-administered questionnaire included the dependent variable physical activity behavior and the independent variables of this study, employee knowledge of physical activity, individual characteristics (age, sex, marital status, education, income and disease history), utilization of social media, facilities supporting physical activity and social support (family support and friend support). The results showed that employees who received family support had an opportunity almost 3 times (OR 2,632; 95% CI: 1,239-5,596) to behave actively in physical activity compared to employees who did not get family support. Need to develop behavioral communication strategies for physical activity with approaches at the family level by collecting and involving employees and family members with an interest in physical activity activities similar to sports activists (such as soccer, futsal, volleyball), physical exercise (such as: gymnastics, yoga, running) or bicycle activists who make bicycles as an alternative transportation, and facilitate a group of families to campaign to other family colleagues on an ongoing basis can also be one model of physical activity intervention.

Abstrak :
[ABSTRAK
Pola sirkadian tekanan darah (TD) adalah gambaran TD 24 jam berupa kurva TD yang meningkat pada pagi hari, menurun pada siang / sore hari dan terendah pada malam hari / waktu tidur. 24 hours Ambulatory Blood Pressure Monitoring (24 hrs ABPM) merupakan alat pengukur TD yang lebih akurat dan dapat memperlihatkan pola sirkadian TD 24 jam. Turunnya TD 10 - 20% pada malam hari disebut dipper, jika turun < 10% disebut nondipper. Meningkatnya TD 24 jam dan nondipper merupakan faktor risiko morbiditas dan mortalitas kardiovaskular. Prevalensi hipertensi dan nondipper pada Penyakit Ginjal Kronik Stadium 5 dalam Terapi Dialisis (PGK 5D) masih sangat tinggi. Faktor utama penyebab hipertensi pada PGK 5D adalah menurunnya Laju Filtrasi Glomerulus (LFG) dan meningkatnya cairan ekstraselular. Transplantasi ginjal akan memperbaiki TD dan nondipper dengan membaiknya LFG, meningkatnya produksi urin dan menurunnya cairan ekstraseluler. Namun demikian satu bulan Pasca Transplantasi Ginjal kebutuhan dosis obat imunosupresan masih cukup tinggi yang dapat mengakibatkan hambatan penurunan TD. Tujuan : Mengetahui perbedaan pola sirkadian TD, data dipper / nondipper dan rerata TD 24 jam pada pasien PGK Pra dan satu bulan Pasca Transplantasi Ginjal. Metode Penelitian : Studi Pre experimental dengan before and after design. Subjek penelitian pasien PGK 5D / Pra Transplantasi Ginjal berusia 18 ? 60 tahun, dilakukan di RSCM pada bulan Oktober sampai dengan Desember 2014. Jumlah subjek sebanyak 15 orang. Dilakukan pengumpulan urin 24 jam, pemeriksaan LFG, pengukuran TD 24 jam dengan 24 hrs ABPM, Pra dan satu bulan Pasca Transplantasi Ginjal. Analisis statistik dengan uji McNemar dan uji t dependen. Hasil : Terdapat 12 subjek nondipper dan 3 subjek dipper pada pasien PGK Pra Transplantasi Ginjal. Satu bulan Pasca Transplantasi Ginjal seluruh subjek (15 orang) memperlihatkan keadaan nondipper. Uji McNemar tidak dapat dilakukan karena seluruh subjek PGK satu bulan Pasca Transplantasi Ginjal nondipper (homogen). Terdapat penurunan rerata TD sistolik 24 jam pasien PGK satu bulan Pasca Transplantasi Ginjal yang tidak signifikan (p > 0,05) dan penurunan rerata TD diastolik 24 jam yang signifikan (p < 0,05). Simpulan : Belum terdapat perbaikan nondipper pada pasien satu bulan Pasca Transplantasi Ginjal. Terdapat penurunan rerata TD sistolik 24 jam yang tidak signifikan dan penurunan rerata TD diastolik 24 jam yang signifikan pada pasien satu bulan Pasca Transplantasi Ginjal.

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ABSTRACT
The circadian pattern of blood pressure (BP) is a 24 hours blood pressure (24hrs BP) curve which increases in the morning, decreases in the afternoon/evening and the lowest state is at night/bedtime. 24 hrs Ambulatory Blood Pressure Monitoring (ABPM) is a BP measuring device that is accurate and can exhibit a circadian pattern of 24 hrs BP. The fall of BP 10-􀀃20% at night is called as a dipper, while less than 10% is called as a nondipper. The increasing of 24 hrs BP and nondipper are the risk factor for cardiovascular morbidity and mortality. The prevalence of hypertension and nondipper in Chronic Kidney Disease stage 5 on Dialysis (CKD 5D) are still very high. The main factors causing hypertension in CKD 5D are decreased Glomerular Filtration Rate (GFR) and increased extracellular fluid. Kidney transplantation will improve BP and nondipper by GFR improvement, increases urine production and decreases extracellular fluid. However, one month after kidney transplantation, the dose of immunosuppressant drugs is relatively high, which is an obstacle to decrease BP. Aim: To determine differences in the circadian pattern of BP, the data of dipper and nondipper, and the mean of 24 hrs BP in CKD before, and one month after kidney transplantation. Methods: Design of the study is before and after design. Subjects of the study were patients with CKD 5D before kidney transplantation, aged 18-60 years, were conducted in Cipto Mangunkusumo Hospital during October to December 2014. 15 subjects were included in the study. 24 hrs urine collection, GFR, 24 hrs BP measurement with 24 hrs ABPM were recorded in all subjects, before and one month after kidney transplantation. McNemar test and t dependent test were used in statistical analysis. Results: Before kidney transplantation, 12 of 15 subjects were nondippers while the others 3 subjects were dippers. After kidney transplantation, all subjects (15 patients) were nondippers. McNemar test can not be used because all subjects one month after kidney transplantation were nondippers (homogeneous). The decreasing of the mean of 24 hrs systolic BP was found in all CKD one month after kidney transplantation, but statistically not significant (p>0.05), while decreasing of the mean of 24 hrs diastolic BP was statistically significant (p<0.05). Conclusion: There were still no improvement in nondipper patients one month after kidney transplantation. There were a decrease in the mean of 24 hrs systolic BP but statistically not significant and a decrease in the mean of 24 hrs diastolic BP which is statistically significant in patients one month after kidney􀀃transplantation.;Background: The circadian pattern of blood pressure (BP) is a 24 hours blood pressure (24hrs BP) curve which increases in the morning, decreases in the afternoon/evening and the lowest state is at night/bedtime. 24 hrs Ambulatory Blood Pressure Monitoring (ABPM) is a BP measuring device that is accurate and can exhibit a circadian pattern of 24 hrs BP. The fall of BP 10-􀀃20% at night is called as a dipper, while less than 10% is called as a nondipper. The increasing of 24 hrs BP and nondipper are the risk factor for cardiovascular morbidity and mortality. The prevalence of hypertension and nondipper in Chronic Kidney Disease stage 5 on Dialysis (CKD 5D) are still very high. The main factors causing hypertension in CKD 5D are decreased Glomerular Filtration Rate (GFR) and increased extracellular fluid. Kidney transplantation will improve BP and nondipper by GFR improvement, increases urine production and decreases extracellular fluid. However, one month after kidney transplantation, the dose of immunosuppressant drugs is relatively high, which is an obstacle to decrease BP. Aim: To determine differences in the circadian pattern of BP, the data of dipper and nondipper, and the mean of 24 hrs BP in CKD before, and one month after kidney transplantation. Methods: Design of the study is before and after design. Subjects of the study were patients with CKD 5D before kidney transplantation, aged 18-60 years, were conducted in Cipto Mangunkusumo Hospital during October to December 2014. 15 subjects were included in the study. 24 hrs urine collection, GFR, 24 hrs BP measurement with 24 hrs ABPM were recorded in all subjects, before and one month after kidney transplantation. McNemar test and t dependent test were used in statistical analysis. Results: Before kidney transplantation, 12 of 15 subjects were nondippers while the others 3 subjects were dippers. After kidney transplantation, all subjects (15 patients) were nondippers. McNemar test can not be used because all subjects one month after kidney transplantation were nondippers (homogeneous). The decreasing of the mean of 24 hrs systolic BP was found in all CKD one month after kidney transplantation, but statistically not significant (p>0.05), while decreasing of the mean of 24 hrs diastolic BP was statistically significant (p<0.05). Conclusion: There were still no improvement in nondipper patients one month after kidney transplantation. There were a decrease in the mean of 24 hrs systolic BP but statistically not significant and a decrease in the mean of 24 hrs diastolic BP which is statistically significant in patients one month after kidney􀀃transplantation.;Background: The circadian pattern of blood pressure (BP) is a 24 hours blood pressure (24hrs BP) curve which increases in the morning, decreases in the afternoon/evening and the lowest state is at night/bedtime. 24 hrs Ambulatory Blood Pressure Monitoring (ABPM) is a BP measuring device that is accurate and can exhibit a circadian pattern of 24 hrs BP. The fall of BP 10-􀀃20% at night is called as a dipper, while less than 10% is called as a nondipper. The increasing of 24 hrs BP and nondipper are the risk factor for cardiovascular morbidity and mortality. The prevalence of hypertension and nondipper in Chronic Kidney Disease stage 5 on Dialysis (CKD 5D) are still very high. The main factors causing hypertension in CKD 5D are decreased Glomerular Filtration Rate (GFR) and increased extracellular fluid. Kidney transplantation will improve BP and nondipper by GFR improvement, increases urine production and decreases extracellular fluid. However, one month after kidney transplantation, the dose of immunosuppressant drugs is relatively high, which is an obstacle to decrease BP. Aim: To determine differences in the circadian pattern of BP, the data of dipper and nondipper, and the mean of 24 hrs BP in CKD before, and one month after kidney transplantation. Methods: Design of the study is before and after design. Subjects of the study were patients with CKD 5D before kidney transplantation, aged 18-60 years, were conducted in Cipto Mangunkusumo Hospital during October to December 2014. 15 subjects were included in the study. 24 hrs urine collection, GFR, 24 hrs BP measurement with 24 hrs ABPM were recorded in all subjects, before and one month after kidney transplantation. McNemar test and t dependent test were used in statistical analysis. Results: Before kidney transplantation, 12 of 15 subjects were nondippers while the others 3 subjects were dippers. After kidney transplantation, all subjects (15 patients) were nondippers. McNemar test can not be used because all subjects one month after kidney transplantation were nondippers (homogeneous). The decreasing of the mean of 24 hrs systolic BP was found in all CKD one month after kidney transplantation, but statistically not significant (p>0.05), while decreasing of the mean of 24 hrs diastolic BP was statistically significant (p<0.05). Conclusion: There were still no improvement in nondipper patients one month after kidney transplantation. There were a decrease in the mean of 24 hrs systolic BP but statistically not significant and a decrease in the mean of 24 hrs diastolic BP which is statistically significant in patients one month after kidney􀀃transplantation.;Background: The circadian pattern of blood pressure (BP) is a 24 hours blood pressure (24hrs BP) curve which increases in the morning, decreases in the afternoon/evening and the lowest state is at night/bedtime. 24 hrs Ambulatory Blood Pressure Monitoring (ABPM) is a BP measuring device that is accurate and can exhibit a circadian pattern of 24 hrs BP. The fall of BP 10-􀀃20% at night is called as a dipper, while less than 10% is called as a nondipper. The increasing of 24 hrs BP and nondipper are the risk factor for cardiovascular morbidity and mortality. The prevalence of hypertension and nondipper in Chronic Kidney Disease stage 5 on Dialysis (CKD 5D) are still very high. The main factors causing hypertension in CKD 5D are decreased Glomerular Filtration Rate (GFR) and increased extracellular fluid. Kidney transplantation will improve BP and nondipper by GFR improvement, increases urine production and decreases extracellular fluid. However, one month after kidney transplantation, the dose of immunosuppressant drugs is relatively high, which is an obstacle to decrease BP. Aim: To determine differences in the circadian pattern of BP, the data of dipper and nondipper, and the mean of 24 hrs BP in CKD before, and one month after kidney transplantation. Methods: Design of the study is before and after design. Subjects of the study were patients with CKD 5D before kidney transplantation, aged 18-60 years, were conducted in Cipto Mangunkusumo Hospital during October to December 2014. 15 subjects were included in the study. 24 hrs urine collection, GFR, 24 hrs BP measurement with 24 hrs ABPM were recorded in all subjects, before and one month after kidney transplantation. McNemar test and t dependent test were used in statistical analysis. Results: Before kidney transplantation, 12 of 15 subjects were nondippers while the others 3 subjects were dippers. After kidney transplantation, all subjects (15 patients) were nondippers. McNemar test can not be used because all subjects one month after kidney transplantation were nondippers (homogeneous). The decreasing of the mean of 24 hrs systolic BP was found in all CKD one month after kidney transplantation, but statistically not significant (p>0.05), while decreasing of the mean of 24 hrs diastolic BP was statistically significant (p<0.05). Conclusion: There were still no improvement in nondipper patients one month after kidney transplantation. There were a decrease in the mean of 24 hrs systolic BP but statistically not significant and a decrease in the mean of 24 hrs diastolic BP which is statistically significant in patients one month after kidney􀀃transplantation.;Background: The circadian pattern of blood pressure (BP) is a 24 hours blood pressure (24hrs BP) curve which increases in the morning, decreases in the afternoon/evening and the lowest state is at night/bedtime. 24 hrs Ambulatory Blood Pressure Monitoring (ABPM) is a BP measuring device that is accurate and can exhibit a circadian pattern of 24 hrs BP. The fall of BP 10-􀀃20% at night is called as a dipper, while less than 10% is called as a nondipper. The increasing of 24 hrs BP and nondipper are the risk factor for cardiovascular morbidity and mortality. The prevalence of hypertension and nondipper in Chronic Kidney Disease stage 5 on Dialysis (CKD 5D) are still very high. The main factors causing hypertension in CKD 5D are decreased Glomerular Filtration Rate (GFR) and increased extracellular fluid. Kidney transplantation will improve BP and nondipper by GFR improvement, increases urine production and decreases extracellular fluid. However, one month after kidney transplantation, the dose of immunosuppressant drugs is relatively high, which is an obstacle to decrease BP. Aim: To determine differences in the circadian pattern of BP, the data of dipper and nondipper, and the mean of 24 hrs BP in CKD before, and one month after kidney transplantation. Methods: Design of the study is before and after design. Subjects of the study were patients with CKD 5D before kidney transplantation, aged 18-60 years, were conducted in Cipto Mangunkusumo Hospital during October to December 2014. 15 subjects were included in the study. 24 hrs urine collection, GFR, 24 hrs BP measurement with 24 hrs ABPM were recorded in all subjects, before and one month after kidney transplantation. McNemar test and t dependent test were used in statistical analysis. Results: Before kidney transplantation, 12 of 15 subjects were nondippers while the others 3 subjects were dippers. After kidney transplantation, all subjects (15 patients) were nondippers. McNemar test can not be used because all subjects one month after kidney transplantation were nondippers (homogeneous). The decreasing of the mean of 24 hrs systolic BP was found in all CKD one month after kidney transplantation, but statistically not significant (p>0.05), while decreasing of the mean of 24 hrs diastolic BP was statistically significant (p<0.05). Conclusion: There were still no improvement in nondipper patients one month after kidney transplantation. There were a decrease in the mean of 24 hrs systolic BP but statistically not significant and a decrease in the mean of 24 hrs diastolic BP which is statistically significant in patients one month after kidney􀀃transplantation., Background: The circadian pattern of blood pressure (BP) is a 24 hours blood pressure (24hrs BP) curve which increases in the morning, decreases in the afternoon/evening and the lowest state is at night/bedtime. 24 hrs Ambulatory Blood Pressure Monitoring (ABPM) is a BP measuring device that is accurate and can exhibit a circadian pattern of 24 hrs BP. The fall of BP 10-􀀃20% at night is called as a dipper, while less than 10% is called as a nondipper. The increasing of 24 hrs BP and nondipper are the risk factor for cardiovascular morbidity and mortality. The prevalence of hypertension and nondipper in Chronic Kidney Disease stage 5 on Dialysis (CKD 5D) are still very high. The main factors causing hypertension in CKD 5D are decreased Glomerular Filtration Rate (GFR) and increased extracellular fluid. Kidney transplantation will improve BP and nondipper by GFR improvement, increases urine production and decreases extracellular fluid. However, one month after kidney transplantation, the dose of immunosuppressant drugs is relatively high, which is an obstacle to decrease BP. Aim: To determine differences in the circadian pattern of BP, the data of dipper and nondipper, and the mean of 24 hrs BP in CKD before, and one month after kidney transplantation. Methods: Design of the study is before and after design. Subjects of the study were patients with CKD 5D before kidney transplantation, aged 18-60 years, were conducted in Cipto Mangunkusumo Hospital during October to December 2014. 15 subjects were included in the study. 24 hrs urine collection, GFR, 24 hrs BP measurement with 24 hrs ABPM were recorded in all subjects, before and one month after kidney transplantation. McNemar test and t dependent test were used in statistical analysis. Results: Before kidney transplantation, 12 of 15 subjects were nondippers while the others 3 subjects were dippers. After kidney transplantation, all subjects (15 patients) were nondippers. McNemar test can not be used because all subjects one month after kidney transplantation were nondippers (homogeneous). The decreasing of the mean of 24 hrs systolic BP was found in all CKD one month after kidney transplantation, but statistically not significant (p>0.05), while decreasing of the mean of 24 hrs diastolic BP was statistically significant (p<0.05). Conclusion: There were still no improvement in nondipper patients one month after kidney transplantation. There were a decrease in the mean of 24 hrs systolic BP but statistically not significant and a decrease in the mean of 24 hrs diastolic BP which is statistically significant in patients one month after kidney􀀃transplantation.]