THE EFFECT OF HEALTH EDUCATION ON BEHAVIOR CHANGE IN THE PREVENTION OF PATHOLOGICAL FLUOR ALBUS TO JAKARTA MIDWIFERY STUDENTS
Fauziah Yulfitria Midwifery Major at Jakarta III Health Polytechnic Email:
[email protected]
ABSTRACT Introduction: Fluor Albus is a common problem experienced by women in various ages. As many as 75 % of women in the world must have experience Fluor Albus and 90 % of women in Indonesia has the potential to experience Fluor Albus. From some research, the data obtained are still many teenagers who have not good behavior on the prevention and treatment of Fluor Albus, this can cause pathological Fluor Albus. The provision of health education to adolescents is one of the efforts to improve knowledge and attitudes and good behavior regarding prevention of pathological Fluor Albus. Objective: to determine the effect of health education on behavior change in prevention of pathological Fluor Albus in Jakarta midwifery students. Method: quasi-experimental research design of pre-test and post-test group design, the sample consisted of 150 people, divided into three groups based on class, namely the intervention group health education through media leaflets, health education through media slide power point and the control group. Each group consisted of 50 students. The data used are primary data by giving questionnaires to respondents. The statistic test use independent t-test and ANOVA. Result: Health education through media leaflets and media power point slides can influence behavior change in prevention of pathological Fluor Albus in Jakarta midwifery students. Keywords: Effect, health education, behavioral change, prevention of pathological Fluor Albus
INTRODUCTION Fluor Albus is liquids other than blood out unusual from vagina, smelling or not followed by itchy in area. Fluor Albus can occur physiologically and pathologically. Physiological cause of Fluor Albus is due to hormonal factors such as before or after menstruation, when the increased sexual desire and during pregnancy. While the pathological Fluor Albus caused by genital infections, foreign objects or other diseases of the reproductive organs (Nurul et al, 2010). Prevention of Fluor Albus should have been done before adolescence. In adolescence, experiencing growth of the reproductive organs and reproductive organs more sensitive adolescents, so that the necessary healthy lifestyle behaviors to prevent pathological Fluor Albus. Fluor Albus pathologic cause an uncomfortable feeling, and in the long term will lead to several serious diseases including pelvic infections and infertility. Not only can result in infertility, Fluor Albus can also cause ectopic pregnancy and also an early symptom of cervical cancer. There are several inhibiting factors for healthy behavior in the prevention of pathological Fluor Albus, including a lack of knowledge of the individual or adolescents on the prevention of Fluor Albus, improper attitude which weakens the motivation for someone to behave in a healthy lifestyle in the prevention of pathological Fluor Albus. Behavioural prevention of pathological Fluor Albus, greatly influenced by knowledge of adolescents. According to Susanto (in Dian Eka Purnama) said that the information obtained is very possible someone adopt the values and knowledge that can affect thinking and action. One source of information a person is through health education.
Health education that may affect a person's knowledge can be obtained from a wide variety of ways from printed media such as posters, leaflets, brochures, magazines, newspapers, stickers and pamphlets, as well as electronic media such as TV, radio, cassette and slide. Leaflets and LCD powerpoint slide media is the most commonly used by health workers in providing health education.The aim of this study to determine the effect of health education on behavior change in prevention of pathological Fluor Albus in Jakarta midwifery students. METHOD This research method is a quasi-experimental research design using pre-post-test group design. This study used three groups of subjects. First performed the measurement by distributing a questionnaire, then one group was not given treatment and the two groups were given treatment that the provision of health education materials, one group using the medium of leaflets and one group using media powerpoint slides, one month later questionnaire was distributed back to the group of respondents the same one. Samples were entire Prodi DIII Midwifery Student Poltekkes Jakarta III TA as much as 150 people. The samples were divided into three groups, each group consisted of 50 people. Data collection tools in this study using a questionnaire, which consisted of questions about behavior. The form of the question is a closed question. The statistic test use independent t-test and ANOVA RESULT The characteristic of respondent are 78 % aged ≥ 18 years and the majority experienced menarche at age ≥ 13 years, which is about 51%. 100% of respondent had experienced physiological Fluor Albus and 83% had experienced pathological Fluor Albus. The respondent experience Fluor Albus just before menstruation (86%), at the time after menstruation (36%), while wearing tight clothing (3%) and at the time of fatigue (35%) and have experienced pathological Fluor Albus with signs of itching (82%), smell (45%), colored (23%) and heat (2%). Table 1. The Score of Respondent Behavior Before and After Giving Leaflet on the Prevention of Pathological Fluor Albus in Jakarta Midwifery Students (n=50) Variabel Behavior Before After
Mean
SD
SE
P-Value
31.96 32.68
3.13 3.52
0.44 0.50
0.05
Average ratings of conduct before giving leaflets was 31.96 with a standard deviation of 3.13. In the assessment after giving leaflets obtained an average of 32.68 with a standard deviation of 3.52. Statistical test results obtained value of 0.05 it can be concluded there is a difference between the behavior before and after the leaflet.
Table 2. The Score of Respondent Behavior Before and After Giving Media Extension with Power Point slides on the Prevention of Pathological Fluor Albus in Jakarta Midwifery Students (n=50) Variabel Behavior Before After
Mean
SD
SE
P-Value
29.94 33.48
4.07 3.16
0.58 0.45
0.000
The average assessment before granting counseling with media power point and slides was 29.94 with a standard deviation of 4.17. Guidance on the assessment after giving the media
power point slides obtained an average of 33.48 with a standard deviation of 3.16. Statistical test results obtained value of 0,000 it can be concluded there is a difference between the behavior before and after the extension services provided by media power point slide. Table 3. The Score of Respondent Behavior Control Group for the Prevention of Pathological Fluor Albus in Jakarta Midwifery Students (n=50) Variabel Behavior Phase I Phase II
Mean
SD
SE
P-Value
32.20 32.12
3.11 3.07
0.44 0.43
0.832
Average Conduct Phase I assessment was 32.20 with a standard deviation of 3.11. In the assessment phase II gained an average of 32.12 with a standard deviation of 3.07. Statistical test results obtained value of 0.832, it can be concluded there is no difference between the behavior of phase I and phase II. Table 4. Effect of Health Education To Change Behavior in Discharge Prevention Pathological Fluor Albus In Jakarta Midwifery Students Health Education After Media Leaflet After Media Slide Power Point Without Both
Mean 32.68 33.48 32.12
F
p-value
6.125
0.000
The table 4. shows the value of F = 6.125 and p-value=0.000, so it can be concluded there is a significant difference in health education using leaflets media with media power point slides to behavioral change. Media power point slides more effective because the mean is greater than the media leaflet (33.48> 32.68). DISCUSSION Effect of Health Education by Using Media Leaflets to Prevention against Fluor Albus behavior Notoatmodjo (2012) says that behavior is a response to the actions or deeds of an organism that can be observed and even studied were distinguished in the form of passive and active, passive form that response that occurs in humans and is not directly visible to others in the form of knowledge, attitudes and perception. The average value of pretest behavior by using media leaflet at 31.96 posttest average value rose to 32.68, resulting in an average rise of 0.72. This is because many respondents after being given health education have better behavior on the prevention of fluor Albus. The results of this study strengthen the research Sugiarsi (2011) showed there are differences in the behavior of early detection of cervical cancer before and after were given health education. This study is in line with research Yustisa and friends (2014) which states that there is a change in the behavior of elementary school students about PHBs before and after health promotion by using media leaflet. Leaflet according to its manufacture and its use including the props are simple, which is characterized, among others, are easy to make, the ingredients can be obtained from local materials, reflecting the customs, life, and local beliefs, written (drawn) with a simple, wear local language and easily understood by the public, and meet the needs of health workers and the public. In this study, leaflets proved to be able to change the attitude of midwifery students on the prevention of fluor Albus, this is because the leaflet has advantages include: durable, includes many people, the cost is not high, do not need electricity, it can be taken anywhere, can bring a sense of beauty, facilitate understanding and enhance the learning passion (Notoatmodjo, 2012)
Effect of Health Education by Using Media Slides Power Point On Prevention Fluor Albus The average value of pretest behavior by using media power point slides at 29.94 posttest average value rose to 33.48, resulting in an average rise of 3.54. This is because many respondents after being given health education have better behavior on the prevention of fluor Albus. The results of this study strengthen the research Sugiarsi (2011) that showed there are differences in the behavior of early detection of cervical cancer before and after were given health education. The results of this study are supported by research Yustisa et al (2014) which states that there is a change in the behavior of elementary school students about PHBs before and after health promotion by using media power point slide. Power Point is one of the programs in Microsoft Office Power Point Office. Microsoft Office Power Point is an application program that is designed specifically for displaying multimedia program. This is as stated Riyana (2008) as follows: The Microsoft Office Power Point is one of the software that is specifically designed to be capable of displaying multimedia programs with attractive, easy to manufacture, easy to use and relatively inexpensive because it does not require raw materials in addition to tools for saving data. Media slides belonging to the group of still images, but it includes the media point of view heard, slide the media has the ability to: (1) Allows the impression emphasis on new facts or to develop a sense of abstraction; (2) to stimulate learners to investigate further ingredients; (3) By adapting and make appropriate, the slides can help to create an understanding and a strong memory, the content of the material; (4) The pictures are simple lines, for example, the chart image, often making effective in conveying information than in the images; (5) Color images can help to make the appeal in the emphasis on an issue that is being discussed; (6) Help verbal or other syimbol as a tool in a still image, it can help to induce clarity (Daryanto, 2011). Effectiveness Health Education Against Behavior Change About Prevention Fluor Albus The result show there is a significant difference in health education using leaflets media with media power point slides to behavioral change (0.000 <0.05). Media power point slides more effective because the mean is greater than the media leaflet (33.48> 32.68). Effectiveness of health education can be seen from the changes in the average value of which at posttest using leaflets media at 32.68, while the use of media power point slides at 33.48, so there is a difference of 0.8. Use of leaflets and power point slides as media promotion of good health is used so as to attract and enable them to grow healthy behavior. Rahmawati (2007) says that the media can influence behavioral change towards a positive respondents, because it is based on the knowledge and experience of the respondents live. Behavior based on knowledge will be more durable than the behavior that is not based on knowledge. Factors that influence the behavior according Notoatmodjo (2012) is a factor of the covering knowledge, perception, emotion, motivation and so on, while the external factors include the surrounding environment that is human, socio-economic, cultural, and so forth.
CONCLUSION AND RECOMMENDATION Leaflet media can influence behavior change towards prevention of pathological Fluor Albus; Media Power Point Slides can influence behavior change towards prevention of pathological Fluor Albus; Media Power Point slides more effectively to changes in behavior regarding prevention of pathological Fluor Albus compared using media leaflet The suggestion for Jakarta Midwifery Students to be involved and active in various activities to improve the knowledge, especially regarding prevention behaviors pathological Fluor Albus. For relevant agencies in order to make improvements counseling activities on reproductive health, especially prevention of pathological Fluor Albus.
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Bionote Fauziah Yulfitria is a lecturer since 2010 and graduated for midwifery specialist in Medical Faculty in Padjadjaran University. Almost all of her reseachs was focus on heatlh women reproduction. The paper about “Reletionship characteristics and sexual behavior with incidence of HIV AIDS in women fertility age” have publicated on Jurnal Madya, Vol 13, No.2, Desember 2012. The Paper about “Family Support in the Prevention of Fluor Albus In Jakarta Midwifery Student” have publicated on Jurnal Kebidanan Pustaka Akademika, Volume 7, No. 1, April 2016.
