�Syntax Literate : Jurnal Ilmiah Indonesia
p�ISSN: 2541-0849
��e-ISSN : 2548-1398
Vol.
7, Special Issue No. 1, Januari 2022
�
THE EFFECTIVENESS OF THE
KANGAROO METHOD CARE (KMC) ON BODY TEMPERATURE STABILITY IN LOW BIRTH WEIGHT
(LBW) BABIES IN THE PERINATOLOGY ROOM OF THE REGIONAL PUBLIC HOSPITAL DR ACHMAD
DIPONEGORO PUTUSSIBAU
Lestari Makmuriana, Dewi Ultari Srimentari, Tri Wahyuni, Lilis Lestari�������������
STIK Muhammadiyah Pontianak, Indonesia
Email: [email protected], [email protected], [email protected],
[email protected]
Abstract
Low birth weight is a baby born
with birth weight of less than 2500 grams. Babies with low birth weight have a
great potential to experience various health problems as a result of incomplete
and mature organs and body functions. One of the problems than often occurs is
the imperfect regulation of body temperature. To maintain the stability of body
temperature, a methoded is used, namely the Kangaroo
Method Care (KMC). The purpose of this study was to determine the effectiveness
of the Kangaroo Method Care (KMC) on the stability of body temperature in Low
Birth Weight (LBW) infants in the Perinatology Room of The Regional Public
Hospital dr Achmad Diponegoro Putussibau. This
research is a quantitative research. This study uses a
quasy-experimental without a control group with the
design used is a pretest post test one group design.
This research test using Paired T-Test. This research was conducted in the
Perinatology Room of the Regional Public Hospital dr Achmad Diponegoro Putussibau which was carried out on April 12th � June 24th
2021 with a total of 25 LBW respondents. The results of statistical tests based
on the t-test, the count value was -11,126 with a
p-value 0f 0,000. It is known that the p-value is� 0,000 < α (0,05), this
indicates that there is an effect of the Kangaroo Method Care (KMC) on the
stability of body temperature in Low Birth Weight (LBW)� infants in the Perinatology Room of The
Regional Public Hospital dr Achmad
Diponegoro Putussibau.
Keywords: Kangaroo Method Care, Body
temperature, LBW
Introduction
One indicator to determine the degree of public health is the
infant mortality rate (IMR). The infant mortality rate in Indonesia is still
very high, the most common cause of infant mortality is the birth of low birth weight babies (LBW). IMR is the number of infant
deaths in the first 28 days of life per 1000 live births. The infant mortality
rate in Indonesia is still higher than other ASEAN countries, which is 27 per
1000 live births (Anindya et al., 2020).
Reports of the incidence of LBW in 2015 in the world contained 15.5% low birth
weight, which means that around 20.6 million babies are born each year, 96.5%
of them in developing countries. The rate of LBW in developing countries
(16.5%) is more than double the rate in developing regions (7%). Low birth
weight (LBW) is one of the main problems in developing countries. India is one
of the countries with the highest incidence of LBW. About 27% of babies born in
India are LBW. South Asia has the highest incidence, with 28% of infants with
LBW, while East Asia/Pacific has the lowest rate, at 6% (World Health Organization (WHO), 2015).
�In West Kalimantan, the trend of the
percentage of LBW cases since 2014 in West Kalimantan Province has increased.
The trend of the percentage of LBW cases in West Kalimantan Province in the
last 5 years in 2014 was 2.60%, in 2015 it was 2.62%, in 2016 it was 3.20%, in
2017 it was 3.62% and in 2018 it increased by 3 ,66 % (Dinas Kesehatan Provinsi Kalimantan Barat, 2019).
The work report of the Kapuas Hulu district health office is an accumulation of
data reported from health care facilities with LBW Infant Coverage in 2018 as
many as 343 LBW babies from a total of 4,222 live births, all of which were
handled. Meanwhile, from the 2018 death rate report, of the 65 babies who died
there were 5 babies with LBW cases, this LBW case is the number five
contributor to infant mortality in Kapuas Hulu Regency (Kapuas, 2018).
Based on data from the Perinatology Room of RSUD dr. Achmad
Diponegoro Putussibau in
2019, the incidence of low birth weight (LBW) babies in the January to June
2019 range fell with a total of 106 LBW babies. From July to December 2019, it
increased with a total of 138 LBW babies, there was an increase in the LBW
birth rate with a difference of 30 babies per 6 months in 2019 (Kapuas, 2018). Low birth weight
babies have a great potential to experience various health problems as a result
of incomplete and mature organs and body functions. Health problems that need
attention from the health care team when caring for LBW babies are problems
that occur as a result of imperfect regulation of body temperature, respiratory
function, nervous function, cardiovascular function, bleeding system, digestive
system, and immune system (Hughes & Simpson, 1995).
In Indonesia, there are still many people who do not know the benefits of
Kangaroo Method Care (KMC). In general, hospitals or clinics that have complete
incubator facilities are still limited in number. In addition, the use of
incubators to care for LBW babies requires high costs. Due to the limitations
of incubator facilities, it is not uncommon for one incubator to be occupied by
more than one baby and can increase the occurrence of nosocomial infections in
hospitals (Acharya, Singh, Bhatta, & Poudel, 2014).� The Effect of Kangaroo Treatment Method on
Increasing Body Temperature of Low Birth Weight Infants in Nicu
Grandmed Lubuk Pakam Hospital showed that the results of the study showed
that there was an effect of Kangaroo Treatment Method on increasing body
temperature of low birth weight infants (Acharya et al., 2014).
The results of this study were supported by the results of another study . Shows that health education is effective in
improving the practice of kangaroo care methods. The gap that occurred in the
RSUD dr. Achmad Diponegoro Putussibau, precisely in the Perinatology room, was limited
in the special sling used for the kangaroo method care (KMC) care for babies
with low birth weight. This special sling only amounts to 1 piece, while babies
with low birth weight sometimes can have more than 1 on the same day of care,
as a result the health workers on duty have to replace them with long cloths.
Another gap found is that there are no nurses/midwives on duty in the
perinatology room who have attended special training on kangaroo care methods.
Based on the above phenomenon, researchers are interested in conducting research
on the effectiveness of the kangaroo method of care for the stability of body
temperature in infants with low birth weight (LBW) in the perinatology room of
RSUD Dr. Achmad Diponegoro Putussibau. The purpose of this study was to determine the
effectiveness of Kangaroo Treatment Method on Body Temperature Stability in Low Birth Weight Babies (LBW) in the Perinatology Room of
Dr. Achmad Diponegoro Putussibau Hospital.
Method
This
research is a quantitative research. This study uses a quasi-experimental without
a control group with the design used is a pretest post test one group design.
The research test used Paired T-Test. In this study, the sampling technique
used by the author is to use a non-probability technique, namely a saturated
sample or often called total sampling.
The
population of this study were infants with low birth weight (LBW) at the
Regional General Hospital Dr. Achmad Diponegoro Putussibau who was treated in
the Perinatology room from April 12th - June 24th 2021 were conducted in the
perinatology room of RSUD Dr. Achmad Diponegoro Putussibau. With a total of 25
LBW respondents. This instrument
was developed by the researcher after conducting a literature review on
journals and books on kangaroo care methods. The data collection tools used were
observation sheets, thermometers, pulse oximetry, informed consent and baby
scales.
Intervention
in the study began in April to June 2021. If at that time there were LBW babies
who met the inclusion criteria, the researchers immediately took the baby as a
sample of one baby, the kangaroo method was treated for at least 2 hours, then
temperature measurements were taken before and after kangaroo care.
This
research data collection used observation sheets, thermometers, pulse oximetry,
informed consent and baby scales. After the patient agreed, the researcher
asked the mother of the LBW baby to sign the informed consent form, after which
the researcher conducted the study. This research has passed the ethical test
from STIK Muhammadiyah Pontianak with registration number
99/II.I.AU/KET.ETIK/IV/2021. Univariate analysis was conducted to describe the
characteristics of age, gender and birth weight. Bivariate analysis was carried
out on two variables to determine the relationship or correlation, differences.
The qualitative independent variables in this study have two categories.
Therefore, the test was carried out using the method of using the average
difference test for two paired samples (paired sample t-test).
Results and Discussion
Results
1.
Univariate analysis test
Before treatment with the Kangaroo Method on the stability of body
temperature in Low Birth Weight Babies (LBW) the mean value (average) was
36.5740 and after the mean value (average value) increased to 37.1988. Before
the Kangaroo Method Treatment was carried out on the stability of body
temperature in Low Birth Weight Babies (LBW) the median value (middle value)
was 36.550 and after the median value (middle value) increased to 37.1. Before
the Kangaroo Method Treatment on the stability of body temperature in Low Birth
Weight (LBW) infants the minimum value (lowest value) was 36.5 and after the
minimum value (lowest value) was increased to 36.95. Before the Kangaroo Method
Treatment for the stability of body temperature in Low Birth Weight Babies
(LBW) the maximum value (highest value) was 36.90 and after the maximum value
(highest value) was increased to 37.95.
Mean, Median, Minimum and Maximum Effectiveness of Kangaroo Method
Treatment on Body Temperature Stability in Low Birth Weight (LBW) Babies in the
Perinatology Room of Dr Achmad Diponegoro Putussibau Hospital.
Table 1
|
Body body temperature |
Score |
|||
|
Mean |
Median |
Minimum |
Maximum |
|
|
Pre Test |
36,5740 |
36,550 |
36,35 |
36,95 |
|
Post Test |
37,1988 |
37,10 |
36,90 |
37,95 |
2. Bivariate analysis test (Paired
Sample T-Test)
Based
on table 2, it can be seen that before the Kangaroo Method treatment was given
to the stability of body temperature in Low Birth Weight
Babies (LBW) the mean value (average) was 36.5740 and after the mean value
(average value) increased to 37, 1988. Based on the t-test, the t-count value
was -11.126 with a p-value of 0.000. It is known that the p-value is 0.000 <
(0.05), this indicates that there is an effect of Kangaroo Method treatment on
the stability of body temperature in Low Birth Weight
Babies (LBW) in the Perinatology Room of Dr. Achmad Diponegoro Putussibau Hospital.
The
Effectiveness of Kangaroo Method Treatment on Body Temperature Stability in Low
Birth Weight (LBW) Babies in the Perinatology Room of Dr Achmad
Diponegoro Putussibau Hospital.
Table 2
|
Variable |
Treatment |
N |
Mean |
SD |
T |
p-value |
|
body temperature |
Pre test |
25 |
36,5740 |
0,13317 |
-11,126 |
0,000 |
|
Post test |
25 |
37,1988 |
0,21104 |
.
Discussion
The Effectiveness of the Kangaroo Care Method on the Stability of Body
Temperature in Babies with Low Birth Weight (LBW) in the Perinatology Room of
RSUD Dr. Achmad Diponegoro Putussibau
The results of research conducted on 25 respondents with low birth weight babies in the Perinatology room of RSUD dr.
Achmad Diponegoro Putussibau showed that the average body temperature of
babies with low birth weight (LBW) before the Kangaroo Treatment Method was 36.
50C and after Kangaroo Care Method was carried out at 37.10C. After the Paired
T-Test test was carried out, the t-count value was -11.126 with a p-value of
0.000. It is known that the p-value is 0.000 < (0.05), this indicates that
there is an effect of the Kangaroo Care Method on the stability of body
temperature in Low Birth Weight Babies (LBW) in the
Perinatology Room of Dr. Achmad Diponegoro
Putussibau Hospital.
The ambient temperature of the baby while in the womb is 36�C-37�C and
immediately after birth the baby is exposed to a generally lower environmental
temperature. This causes the baby to lose heat in the baby's body or what is
called hypothermia. Hypothermia in infants occurs due to the inability to
maintain heat production in the baby's body and shivering, insufficient
subcutaneous fat (brown fat), and an immature nervous system regulating body
temperature (IBU, 2017).
In addition, the baby's surface area will decrease thereby accelerating heat
loss. LBW babies have little adipose tissue and decreased flexibility, so they
need a warmer environmental temperature to reach a normal temperature (Nur�aisyah, 2020).
The findings in this study showed that all LBW infants who were
respondents experienced an increase in body temperature, and an increase in the
frequency of oxygen saturation after the Kangaroo Method Treatment. In other
words, Kangaroo Treatment Method can normalize the baby's body physiology. The
KMC method can also provide a stimulus to the hypothalamus which can release
corticotropin-releasing factor (CRF) and also endorphins so as to produce a
sense of comfort and calm in the baby (Yusuf et al., 2017).
In this study, according to the data obtained regarding the baby's
weight before being given the kangaroo method, it was closely related to the
incidence of mothers who gave birth before term. This is in accordance with the
data obtained in this study, there were 5 infants with low birth weight who
were not yet full term. Mothers who have a pregnancy of less than 37 weeks will
be at risk of giving birth to babies with LBW. This can happen because the
intrauterine growth of the fetus is not optimal. Where the development and
growth of the fetus in intrauterine takes � 38 weeks for the baby to be ready
to be born and adjust to the environment outside the womb .
In this study also found mothers who gave birth to twins where there
were 7 LBW babies who were twins. This can be influenced by the occurrence of
LBW because the baby has to share nutrition with the two fetuses and also the
space for the baby to grow and develop is getting smaller because there are two
fetuses in one uterus. Given the unique physiological demands placed on the
body during multiple pregnancies, it is imperative that healthcare providers
advise women on the importance of adequate caloric intake and provide guidance
on macronutrient and micronutrient intake for optimal pregnancy outcomes.
The benefits of the kangaroo method of care include a stable baby's
heart rate, more regular breathing, so that the distribution of oxygen
throughout the body is better. Babies can sleep soundly and for a long time,
are calmer, cry less and gain weight faster, make breastfeeding easier,
strengthen the bond between mother and child, and shorten the care period
between mother and child.
In this study, the cloth used for the treatment of the kangaroo method
was an ordinary long cloth, namely using a jarik
cloth. Jarik cloth will be tied or tied behind the
mother's shoulder to support so that the baby does not fall. The implementation
of this kangaroo method uses a simple method. In hospitals with complete
facilities, they usually use special cloths for kangaroo treatment, but in this
study, researchers only used regular long cloths made of cotton. At the time of
the implementation of the kangaroo method of care, there was no standard
temperature application in the room, this was related to inadequate hospital
facilities. The implementation of the kangaroo method was carried out in grade
2, there were 3 babies with LBW, and 22 babies with other LBW carried out in a
class 3 room, all without any standard application of temperature.
Kangaroo mother care improves growth and reduces problems with low birth weight babies such as hypothermia, hypoglycemia,
and length of hospital stay. Therefore, it should be recommended in the care of
all these high-risk neonates.
Conclusion
Based on the results of research and discussion, it can be concluded
that the average body temperature before Kangaroo Method Care (KMC) is 36.50C.
The average body temperature after Kangaroo Method Care (KMC) is 37.10C. The
effect of Kangaroo Method Care (KMC) on increasing body temperature in LBW in
the perinatology room of Dr. RSUP. Achmad Diponegoro Putussibau in 2021
with a p-value of 0.000.
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Copyright holder: Lestari Makmuriana, Dewi Ultari Srimentari,
Tri Wahyuni, Lilis
Lestar (2022) |
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First publication right: Syntax Literate: Jurnal Ilmiah
Indonesia |
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