FORMULIR BAGAN ALUR CARA KERJA PRAKTIKUM KBB PRODI PROFESI

BIDAN FAKULTAS ILMU KESEHATAN UNIVERSITAS ‘ASYIYAH YOGYAKARTA

NAMA Ery Kurnia
NIM 2310101161
KELAS/KELOMPOK LJ 2 / LB 1
JUDUL PRAKTIKUM Membuat ringkasan penelitian dan
paraphrase

Mencoba meresume
artikel penelitian Link
https://getdigest.com/en => artikel berbahasa Inggris

https://resoomer.com/id/ => artikel berbahasa Indonesia

 ARTICLE :
Nyeri persalinan merupakan pengalaman subjektif tentang sensasi fisik yang terkait dengan
kontraksi uterus, dilatasi dan penipisan serviks, serta penurunan janin selama persalinan. Respon
fisiologis terhadap nyeri meliputi peningkatan tekanan darah, denyut nadi, pernapasan, keringat,
diameter pupil, dan ketegangan otot. Nyeri persalinan ditandai dengan adanya kontraksi rahim,
kontraksi sebenarnya telah terjadi pada minggu ke-30 kehamilan yang disebut kontraksi Braxton
hicks akibat perubahan-perubahan dari hormon estrogen dan progesteron tetapi sifatnya tidak
teratur, tidak nyeri dan kekuatan kontraksinya sebesar 5 mmHg, dan kekuatan kontraksi Braxton
hicks ini akan menjadi kekuatan his dalam persalinan dan sifatnya teratur. Pusat Data Persatuan
Rumah Sakit seluruh Indonesia menjelaskan bahwa 15% ibu di Indonesia mengalami komplikasi
persalinan dan 21% persalinan yang dialami merupakan persalinan yang menyakitkan karena
merasakan nyeri yang sangat hebat, sedangkan 63% tidak memperoleh informasi tentang persiapan
yang dilakukan guna mengurangi nyeri pada persalinan (Yuliasari dan Santriani 2015).
Berdasarkan profil Dinas Kesehatan Provinsi Sumatra Utara tahun 2016 AKI berjumlah 80% yang
disebabkan unersia uteri sebanyak (8%) eklamsi sebanyak (25%). AKB sebanyak 74% yang
disebabkan persalinan dengan partus lama sebanyak (18%) dan inersia uteri sebanyak (11%)
(Dinkes Sumut,2016). Sedangkan Tetania uteri juga merupakan his yang yang terlalu kuat dan
sering, sehingga tidak terdapat kesempatan untuk relaksasi otot rahim, akibatnya yaitu, terjadinya
partus presipitatus atau partus yang berlangsung dalam waktu 3 jam, yang mengakibatkan hal yang
fatal seperti terjadinya persalinan tidak pada tempatnya, terjadi trauma pada janin, trauma jalan
lahir ibu yang luas, dan dapat menyebabkan asfiksia (Manuaba, 2010). Partus lama merupakan
penyumbang kematian ibu terendah, akan tetapi jumlahnya mengalami peningkatan dari tahun
2010 sebesar 1,0%, tahun 2011 sebesar 1,1% dan tahun 2012 sebesar 1,8%. Hasil penelitian lain
menunjukkan primipara mengalami tingkat nyeri persalinan lebih tinggi dibandingkan dengan
multipara yaitu sebesar 2,63 kali (95% CI 0,96-7,20) (Fania Nurul Khoirunnisa dkk, 2017). Hasil
penelitian Magfiroh (2012) menemukuan bahwa intensitas nyeri 3,9 lebih hebat pada paritas ibu
primipara dibandingkan dengan ibu multipara dan ibu yang memiliki usia resiko tinggi merasakan
nyeri 4 kali lebih hebat dibandingkan ibu yang tidak memiliki umur beresiko tinggi. Sedangkan
Penelitian Komariah tahun 2005 (dikutip dari Magfiroh, 2012) bahwa umur ibu yang kurang dari
20 tahun lebih merasakan nyeri hebat dibandingkan dengan umur yang berusia 25- 35 tahun. Bagi
ibu primigravida (ibu pertama kali hamil), kehamilan merupakan pengalaman pertama kali dalam
periode kehidupannya. Situasi tersebut dapat menyebabkan perubahan drastis baik pada fisik ibu
maupun psikologis (Bethsaida dan Pieter, 2013). Hasil studi yang dilakukan oleh Noack and Atai
dengan judul ”Presence of the Husband in The Delivery Room” kepada 650 pasangan ibu bersalin
di Jerman dan hasilnya 90% ibu ditemani oleh suaminya mengatakan lebih nyaman dan persalinan
pun berlangsung lancar (dikutip dari Utami, 2009). Hal ini diperkuat oleh pernyataan Hilmansyah
(2011) bahwa dukungan yang baik akan membantu ibu menurunkan rasa nyeri yang diderita.
Dalam kondisi relaks, tubuh akan memproduksi hormon bahagia yang disebut endorphin yang akan
menekan hormon stressor sehingga rasa nyeri yang dirasakan akan berkurang. Dukungan diberikan
oleh suami akan membuat ibu lebih nyaman dan lebih menikmati setiap perjalanan persalinan,
semakin ibu menikmati proses persalinan maka ibu akan merasa lebih relaks akibatnya ibu tidak
lagi terfokus pada rasa nyeri persalinan, sehingga nyeri persalinan tidak lagi terasa. Upaya untuk
menurunkan nyeri pada persalinan dapat dilakukan baik secara farmakologi maupun non
farmakologi. Manajemen nyeri secara farmakologi lebih efektif dibanding dengan metode non
farmakologi, namun metode farmakologi lebih mahal, dan berpotensi mempunyai efek samping
yang kurang baik. Sedangkan metode non farmakologi lebih murah, simpel, efektif dan tanpa efek
yang merugikan dan dapat meningkatkan kepuasan selama persalinan, karena ibu dapat
menguontrol perasaan dan kekuatannya, (Danuatmaja, 2014). Berdasarkan hasil wawancara
terhadap penolong persalinan di kamar bersalin RSUD dr. M.Thomsen Nias pada bulan desember
terdapat 34 ibu inpartu dan 13 diantaranya mengalami nyeri, disebabkan kurangnya pengetahuan
tentang nyeri dan dukungan keluarga saat melahirkan. Berdasarkan latar belakang diatas, peneliti
tertarik melakukan penelitian tentang “Faktor yang berhubungan dengan intensitas nyeri persalinan
kala I di UPTD RSUD dr.M.Thomsen ”.

RESSUME :
Nyeri persalinan merupakan pengalaman subjektif tentang sensasi fisik yang terkait dengan kontraksi
uterus, dilatasi dan penipisan serviks, serta penurunan janin selama persalinan. Respon fisiologis terhadap nyeri
meliputi peningkatan tekanan darah, denyut nadi, pernapasan, keringat, diameter pupil, dan ketegangan
otot. Nyeri persalinan ditandai dengan adanya kontraksi rahim, kontraksi sebenarnya telah terjadi pada minggu
ke-30 kehamilan yang disebut kontraksi Braxton hicks akibat perubahan-perubahan dari hormon estrogen dan
progesteron tetapi sifatnya tidak teratur, tidak nyeri dan kekuatan kontraksinya sebesar 5 mmHg, dan kekuatan
kontraksi Braxton hicks ini akan menjadi kekuatan his dalam persalinan dan sifatnya teratur. Pusat Data
Persatuan Rumah Sakit seluruh Indonesia menjelaskan bahwa 15% ibu di Indonesia mengalami komplikasi
persalinan dan 21% persalinan yang dialami merupakan persalinan yang menyakitkan karena merasakan nyeri
yang sangat hebat, sedangkan 63% tidak memperoleh informasi tentang persiapan yang dilakukan guna
mengurangi nyeri pada persalinan . Partus lama merupakan penyumbang kematian ibu terendah, akan tetapi
jumlahnya mengalami peningkatan dari tahun 2010 sebesar 1,0%, tahun 2011 sebesar 1,1% dan tahun 2012
sebesar 1,8%. Hasil penelitian lain menunjukkan primipara mengalami tingkat nyeri persalinan lebih tinggi
dibandingkan dengan multipara yaitu sebesar 2,63 kali . Hasil penelitian Magfiroh menemukuan bahwa intensitas
nyeri 3,9 lebih hebat pada paritas ibu primipara dibandingkan dengan ibu multipara dan ibu yang memiliki usia
resiko tinggi merasakan nyeri 4 kali lebih hebat dibandingkan ibu yang tidak memiliki umur beresiko tinggi. Hal
ini diperkuat oleh pernyataan Hilmansyah bahwa dukungan yang baik akan membantu ibu menurunkan rasa nyeri
yang diderita. Dalam kondisi relaks, tubuh akan memproduksi hormon bahagia yang disebut endorphin yang
akan menekan hormon stressor sehingga rasa nyeri yang dirasakan akan berkurang. Dukungan diberikan oleh
suami akan membuat ibu lebih nyaman dan lebih menikmati setiap perjalanan persalinan, semakin ibu menikmati
proses persalinan maka ibu akan merasa lebih relaks akibatnya ibu tidak lagi terfokus pada rasa nyeri
persalinan, sehingga nyeri persalinan tidak lagi terasa. Upaya untuk menurunkan nyeri pada persalinan dapat
 dilakukan baik secara farmakologi maupun non farmakologi.

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BEFORE PHARAFRASE :
Labor pain is a subjective experience of physical sensations associated with uterine contractions,
cervical dilation and effacement, and fetal descent during labor. Physiological responses to pain
include increases in blood pressure, pulse rate, respiration, sweating, pupil diameter, and muscle
tension. Labor pain is characterized by uterine contractions, contractions actually occur in the 30th
week of pregnancy which are called contractionsBraxton hicks due to changes in the hormones
estrogen and progesterone but they are irregular, painless and the strength of the contractions is 5
mmHg, and the strength of Braxton Hicks contractions will be the strength of his during labor and
are regular in nature. The Indonesian Hospital Association Data Center explained that 15% of
mothers in Indonesia experienced birth complications and 21% of the births they experienced were
painful births because they felt very intense pain, while 63% did not receive information about the
preparations made to reduce pain during labor ( Yuliasari and Santriani 2015). Based on the profile
of the North Sumatra Provincial Health Service in 2016, MMR was 80%, caused by uterine unertia
(8%) and eclampsia (25%). IMR is 74%, which is caused by labor with prolonged labor (18%) and
uterine inertia (11%) (North Sumatra Health Department, 2016). Meanwhile, uterine tetania is also
a hyssis that is too strong and frequent, so that there is no opportunity for relaxation of the uterine
muscles, the result is, precipitate labor or parturition which lasts within 3 hours, which results in
fatal things such as inappropriate labor, which occurs. trauma to the fetus, extensive trauma to the
mother's birth canal, and can cause asphyxia (Manuaba, 2010). Prolonged labor is the lowest
contributor to maternal mortality, however the number has increased from 2010 of 1.0%, 2011 of
1.1% and 2012 of 1.8%. The results of other studies show that primiparas experience higher levels
of labor pain compared to multiparas, namely 2.63 times (95% CI 0.96-7.20) (Fania Nurul
Khoirunnisa et al, 2017). The results of Magfiroh's (2012) research found that pain intensity was
3.9 times greater in parity primiparous mothers compared to multiparous mothers and mothers who
were of high risk age felt pain 4 times more intense than mothers who were not of high risk age.
Meanwhile, Komariah's research in 2005 (quoted from Magfiroh, 2012) showed that mothers aged
less than 20 years felt more severe pain than those aged 25-35 years. For primigravida mothers
(first-time pregnant mothers), pregnancy is the first experience in their life. This situation can
cause drastic changes both physically and psychologically in the mother (Bethsaida and Pieter,
2013). The results of a study conducted by Noack and Atai with the title "Presence of theHusband
in The Delivery Room” to 650 couples of mothers giving birth in Germany and the result was that
90% of mothers accompanied by their husbands said they were more comfortable and the birth
went smoothly (quoted from Utami, 2009). This is reinforced by Hilmansyah's (2011) statement
that good support will help mothers reduce the pain they suffer. In a relaxed state, the body will
produce happy hormones called endorphins which will suppress stressor hormones so that the pain
felt will be reduced. The support provided by the husband will make the mother more comfortable
and enjoy each birth journey more. The more the mother enjoys the birth process, the more relaxed
the mother will feel as a result of which the mother is no longer focused on the pain of labor, so
that the labor pain is no longer felt. Efforts to reduce pain during labor can be done both
pharmacologically and non-pharmacologically. Pharmacological pain management is more
effective than non-pharmacological methods, but pharmacological methods are more expensive
and have the potential to have unfavorable side effects. Meanwhile, non-pharmacological methods
are cheaper, simpler, effective and without detrimental effects and can increase satisfaction during
labor, because the mother can control her feelings and strength (Danuatmaja, 2014). Based on the
results of interviews with birth attendants in the delivery room at RSUD dr. M. Thomsen Nias in
December there were 34 mothers in labor and 13 of them experienced pain, due to lack of
knowledge about pain and family support during childbirth. Based on the background above,
researchers are interested in conducting research on "Factors related to the intensity of labor pain in
the first stage at the UPTD Dr.M.Thomsen Regional Hospital".

AFTER PHARAFRASE :
Labor pain is the subjective experience of physical sensations associated with uterine contractions,
dilation and effacement of the cervix, and descent of the fetus during childbirth. Physiological
responses to pain include increases in blood pressure, pulse, respiration, sweating, pupil diameter,
and muscle tension. Labor pain is characterized by contractions of the uterus, the contractions
actually occur at 30 weeks of pregnancy, called contractions. Braxton hicks are caused by
changes in the hormones estrogen and progesterone, but they are irregular, painless, and have a
contraction force of 5 mmHg and strength. Braxton Hicks contractions are her forte during
labor and are regular in nature. The Information Center of the Indonesian Hospital Association
explained that 15% of Indonesian mothers experienced childbirth complications, and 21% of
births were painful because they felt very severe pain, while 63% did not receive information
about preparations to reduce pain. labor force (Yuliasari and Santriani 2015). According to the
North Sumatra County Health Profile, MMR was 80% in 2016, which was caused by uterine
inertia (8%) and eclampsia (25%). The IMR is 74% due to prolonged labor (18%) and uterine
inertia (11%) (North Sumatra Ministry of Health, 2016). At the same time, uterine tetany is also
too strong and frequent hysteria, which makes it impossible for the muscles of the uterus to
relax, resulting in labor or delivery lasting 3 hours, which causes fatal things, such as
inappropriate. from the birth that takes place. trauma to the fetus, extensive trauma to the
mother and birth canal, and can cause suffocation (Manuaba, 2010). Prolonged labor is the least
cause of maternal mortality, but since 2010, that number has increased by 1.0%, 1.1% in 2011,
 and 1.8% in 2012. Results of other studies show that primiparas experience greater labor pain
compared to multiparas, namely 2.63 times (95% CI 0.96-7.20) (Fania Nurul Khoirunnisa et al,
2017). The results of Magfirohand#039;s (2012) study showed that the intensity of pain was 3.9
times higher in mothers with multiple births than in mothers with multiple births, and mothers
of high risk age felt pain 4 times more than mothers who were . not strong risk age Meanwhile, a
study by Komariahand#039;s (cited in Magfiroh, 2012) (2005) found that mothers under 20
experienced more severe pain than those between 25 and 35. For primigravida mothers (mothers
who are pregnant for the first time), pregnancy is the first experience of their life. Such a
situation can cause drastic changes in the mother, both physically and psychologically (Bethsaida
and Pieter, 2013). A study by Noack and Atai titled andquot: Spousal presence in the delivery
room of 650 mothers giving birth in Germany. The result was that 90% of mothers with their
husbands said they felt more comfortable. and the delivery was uneventful (cited in Utami,
2009). This is supported by Hilmansyahand#039;s (2011) claim that good support helps mothers
to reduce their suffering. In a relaxed state, the body produces happy hormones called
endorphins, which suppress stress hormones so that pain decreases. The support of a husband
makes a mother more comfortable and enjoys each birth journey more. The more the mother
enjoys the birthing process, the more relaxed the mother feels, because of this the mother no
longer focuses on the pain of childbirth, so the pain of childbirth no longer feels. Efforts to
reduce labor pain can be made both pharmacologically and non-pharmacologically.
Pharmacological pain management is more effective than non-pharmacological methods, but
pharmacological methods are more expensive and can have negative side effects. At the same
time, non-medical methods are cheaper, easier, effective and without harmful effects and can
increase satisfaction during childbirth, because the mother can control her emotions and strength
(Danuatmaja, 2014). Dr. explained based on the results of the interviews of birth assistants in the
delivery room of RSUD. M. Thomsen In December, 34 women gave birth in Nia, of which 13
experienced pain due to a lack of knowledge about pain and family support during childbirth.
Based on the above background, researchers are interested in conducting a study "Factors
related to the intensity of labor pain in the first stage at UPTD Dr.M.Thomsen Regional Hospital".

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