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CONTOH KUESIONER PERAWATAN BAYI 1

KUESIONER PENELITIAN SEKOLAH TINGGI ILMU KESEHATAN


STIKES NANI HASANUDDIN
TINGKAT PENGETAHUAN IBU TENTANG PERAWATAN BAYI
MAKASSAR 2010/2011

A.
1.
2.
3.
4.
5.
6.
7.

IDENTITAS WILAYAH
Nomor Responden
:
Propinsi
:
Kabupaten/Kota
:
Kecamatan
:
Kelurahan/Desa
:
Lingkungan
:
RW/RW
:

B. IDENTITAS UMUM RESPONDEN


a. ORANG TUA (IBU)
1. Nama
:
2. Alamat
:
3. Umur
:
4. Agama
:
5. Status Perkawinan
:
6. Pendidikan Terakhir :
7. Status Pekerjaan
:
8. Pengalaman Kerja
:
a.
b.
c.
9. Suku Bangsa
:
C.
1.
3.
5.
6.
7.
8.

IDENTITAS BAYI
Nama
Jenis Kelamin
Anak ke
Umur
Berat Badan
Panjang Bayi

:
:
:
:
:
:

D. PERTANYAAN
Pilihan Ganda
1. Bagaimana Tingkat pengetahuan Ibu tentang perawatan bayi?
a. Sangat tahu
c. Kurang tahu

b. Tahu
d. Tidak tahu
e. Lainnya ..............................................................................................................
................................................................................................................................
2. Ketika anak ibu lahir, Apakah ASI ibu sudah bisa langsung keluar?
a. Sangat Banyak
c. cukup banyak
b. Banyak
d. Kurang
e. lainnya ...............................................................................................................
................................................................................................................................
3. Apakah Ibu Tahu cara untuk memandikan bayi?
a. Sangat tahu
c. kurang tahu
b. Tahu
d. tidak tahu
e. Lainnya ..............................................................................................................
................................................................................................................................
4. Berapa Kali dalam sehari Ibu memandikan bayi?
a. 2 kali sehari
c. setiap bayi ganti popok
b. 1 kali sehari
d. tidak pernah dimandikan
e. lainnya ...............................................................................................................
................................................................................................................................
5. Apakah ibu tahu cara membersihkan pusar bayi?
a. sangat tahu
c. kurang tahu
b. tahu
d. tidak tahu
e. Lainnya .............................................................................................................
..........................................................................................................................
6. apakah ibu rutin membersihkan pusar bayi?
a. sangat rutin
c. sekali dalam setahun
b. sekali 6 bulan
d. Jika pada saat kotor
e. Lainnya,.............................................................................................................
...............................................................................................................................
7. sejak umur berapa Ibu memberikan susu formula pada bayi ibu?
a. 6 bulan
c. sejak lahir
b. 7 bulan
d. 1 tahun
e. Lainnya ..............................................................................................................
..... ..........................................................................................................................
8. Apakah ibu tahu cara membersikan telinga bayi anda?
a. sangat tahu
c. Kurang tahu
b. tahu
d. tidak tahu
e. Lainnya ..............................................................................................................
................................................................................................................................
9. Apakah ibu tahu cara memberikan ASI yang benar pada bayi?
a. sangat tahu
c. kurang tahu
b. tahu
d. tidak tahu
e. lainnya ...............................................................................................................
................................................................................................................................
10. Apakah ibu tahu cara menggendong bayi?

a. sangat tahu
c. kurang tahu
b. tahu
d. tidak tahu
e. lainnya ...............................................................................................................
................................................................................................................................
11. Apakah ibu tahu cara menidurkan bayi?
a. sangat tahu
c. kurang tahu
b. tahu
d. tidak tahu
e. lainnya ...............................................................................................................
................................................................................................................................
12. Apakah ibu rutin memeriksakan bayi ke posyandu?
a. Sangat Rutin
c. Rutin
b. Kadang-kadang
d. Tidak pernah
e. Lainnya ..............................................................................................................
......................................................................................................................................
13. Apakah pijitan-pijitan kecil sebelum atau sesudah bayi mandi itu penting?
a. Sangat Penting
c. Kurang penting
b. Peting
d. Tidak penting
e. lainnya ...............................................................................................................
................................................................................................................................
14. Apakah Imunisasi itu penting menurut ibu?
a. sangat Penting
c. kurang penting
b. Penting
d. tidak penting
e. Lainnya .............................................................................................................
................................................................................................................................
15. Apakah ibu rutin membawa bayi ke posyandu?
a. sangat Rutin
c. Kadang-kadang
b. Rutin
d. tidak pernah
e. lainnya ...............................................................................................................
................................................................................................................................
16. Apakah Imunisasi itu penting menurut ibu?
a. sangat Penting
c. kurang penting
b. Penting
d. tidak penting
e. Lainnya..............................................................................................................
................................................................................................................................

ESSAI
1. menurut Ibu, apakah bayi boleh di urut?
a. Ya, ......................................................................................................................
................................................................................................................................
b. Tidak, .................................................................................................................
................................................................................................................................
2. apakah ibu melakukan tindakan untuk menghindarkan bayi ibu dari kuman?
a. Ya,.......................................................................................................................
.................................................................................................................................
b. Tiadak, .............................................................................................................

.................................................................................................................................
3. apakah ibu memperhatikan tumbuh kembang bayi?
a. ya, ......................................................................................................................
................................................................................................................................
b. Tidak, .................................................................................................................
................................................................................................................................
4. apakah ibu memperhatikan imunisasi yang harus di berikan pada bayi?
a. Ya, ......................................................................................................................
................................................................................................................................
b. Tidak, .................................................................................................................
................................................................................................................................
5. apakah ibu mengetahui standar kebutuhan makanan bayi?
a. Ya, ......................................................................................................................
................................................................................................................................
b. Tidak, .................................................................................................................
................................................................................................................................
6. Apakah Ibu melahirkan secara Normal (tanpa sesar)?
a. Ya, ......................................................................................................................
................................................................................................................................
b. Tidak, ................................................................................................................
................................................................................................................................
7. Ibu melahirkan di rumah sakit (rumah bersalin)?
a. ya, Sebutkan nama rumah sakitnya, ..................................................................
.................................................................................................................................
b. Tidak, ..................................................................................................................
.................................................................................................................................
8. Apakah bayi Ibu mecapai berat badan normal?
a. Ya, ......................................................................................................................
................................................................................................................................
b. Tidak, .................................................................................................................
................................................................................................................................
9. Apakah Ibu setuju kalau perawatan bayi seharusnya dilakukan di rumah sakit dan bukan di
rumah?
a. Ya setuju karena:................................................................................................
................................................................................................................................
b. Tidak setuju,.......................................................................................................
................................................................................................................................
10. Apakah Ibu memberikan Asi eksklusif yaitu dari umur 0-6 bulan pada bayi ibu?
a. Ya, ......................................................................................................................
................................................................................................................................
b. Tidak, .................................................................................................................
................................................................................................................................
11. Apakah ASI untuk si bayi itu penting?
a. Ya, .......................................................................................................................

.................................................................................................................................
b. Tidak, ..................................................................................................................
.................................................................................................................................
12. Apakah bayi ibu sudah bisa minum ASI secara langsung?
..... a. Ya, .......................................................................................................................
................................................................................................................................
..... b. Tidak, ..................................................................................................................
................................................................................................................................
13. Adakah Selain ASI yang ibu berikan kepada bayi anda?
..... a. Ya, Ada, ..............................................................................................................
................................................................................................................................
..... b. Tidak Ada, ...........................................................................................................
..... ..........................................................................................................................
14. Apakah anda mengkomsusi susu ibu menyusui atau vitamin untuk menambah ASI?
a. Ya, ......................................................................................................................
................................................................................................................................
b. Tidak, .................................................................................................................
..... ..........................................................................................................................
15. Setelah memberi ASI kepada bayi, Apakah bayi sering muntah.?
a. Ya, ......................................................................................................................
................................................................................................................................
b. Tidak, .................................................................................................................
................................................................................................................................
16. Apakah bayi anda rewel ketika di beri ASI?
a. Ya, ......................................................................................................................
................................................................................................................................
b. Tidak, .................................................................................................................
................................................................................................................................
17. Apakah ibu memberi jadwal makan atau ASI kepada bayi anda?
a. Ya, ......................................................................................................................
................................................................................................................................
b. Tidak, .................................................................................................................
................................................................................................................................
18. Ketika anak anda sudah bisa mengkomsumsi selain ASI, apakah ibu memberikan makanan
khusus bayi?
a. Ya, ......................................................................................................................
................................................................................................................................
b. Tidak, .................................................................................................................
................................................................................................................................
19. Apakah anda tahu standar kebutuhan gizi untuk bayi.?
a. Ya, ......................................................................................................................
................................................................................................................................
b. Tidak,, ................................................................................................................
................................................................................................................................

20. Adakah mitos atau kebiasaan lain sebelum atau memberikan ASI kepada bayi anda?
a. Ya, ......................................................................................................................
................................................................................................................................
b. Tidak, .................................................................................................................
................................................................................................................................
21. Apakah anda bisa memandikan bayi?
a. Ya, ......................................................................................................................
................................................................................................................................
b. Tidak ..................................................................................................................
................................................................................................................................
22. Apakah ibu memandikan bayi secara rutin?
a. Ya, ......................................................................................................................
................................................................................................................................
b. Tidak, .................................................................................................................
................................................................................................................................
23. Apakah ada losien atau minyak oil yang diberikan ke air dan tubuh bayi?
a. Ya, ......................................................................................................................
................................................................................................................................
b. Tidak, .................................................................................................................
................................................................................................................................
24. Apakah ibu memberikan shampoo pada bayi tiap kali mandi?
a. Ya, ......................................................................................................................
................................................................................................................................
b. Tidak, .................................................................................................................
................................................................................................................................
25. Apakah pijitan-pijitan kecil sebelum atau sesudah bayi mandi itu penting?
a. Ya, ......................................................................................................................
................................................................................................................................
b. Tidak, .................................................................................................................
................................................................................................................................
26. Apakah anda merawat bayi anda sendiri (tanpa babysister)?
a. Ya, ......................................................................................................................
................................................................................................................................
b. Tidak, .................................................................................................................
................................................................................................................................
27. Apakah ibu, tahu cara menghilangkan biang keringat bayi?
a. Ya, .....................................................................................................................
................................................................................................................................
b. Tidak, ................................................................................................................
................................................................................................................................
28. Ketika anak anda sudah bisa mengkomsumsi selain ASI, apakah ibu memberikan makanan
khusus bayi?
a. Ya, ......................................................................................................................
................................................................................................................................

b. Tidak, .................................................................................................................
................................................................................................................................
29. apakah kamar bayi terpisah dengan kamar ibu?
a. Ya, ......................................................................................................................
................................................................................................................................
b. Tidak ..................................................................................................................
................................................................................................................................
30. apakah ibu tahu penyebab dari biang keringat pada bayi?
a. Ya, .......................................................................................................................
.................................................................................................................................
b. Tidak, ..................................................................................................................
.................................................................................................................................
31. Apakah ada kebiasaan yang aneh, atau ganjil ketika bayi sedang tidur?
a. Ya, .......................................................................................................................
.................................................................................................................................
b. Tidak, ..................................................................................................................
.................................................................................................................................
32. Menurut Ibu Apakah boleh bayi pada usia 1-2 bulan sudah bisa tidur secara tengkurap?
a. Ya, .......................................................................................................................
.................................................................................................................................
b. Tidak, ..................................................................................................................
.................................................................................................................................
33. Apakah suami anda ikut berperanserta dalam Merawat si kecil?
a. Ya, ......................................................................................................................
................................................................................................................................
b. Tidak, .................................................................................................................
......................