DIFFERENCES IN THE LEVEL OF KNOWLEDGE, ATTITUDE AND BEHAVIOR

AND HEALTHY LIVING (PHBs) MOTHER WITH THE OCCURRENCE OF

DIARRHEA IN CHILDREN
WORKING IN THE HEALTH Seyegan, SLEMAN

Hastomo *, Sri Muryani **, *** Haryono

* Alumni D4 JKL polytechnic MOH Yogyakarta, Jl.Tatabumi 3, Banyuraden, Limestone, DIY 55 293,
email: hastm_inc@ymail.com
** JKL Polytechnic MOH Yogyakarta
*** JKL polytechnic MOH Yogyakarta, email: haryono.kl@gmail.com

Abstract

As an environmental-based disease, diarrhea frequently attacks un-der infant

and five children. The total diarrhea incidences troughout 2008 in Seyegan
Community Health Center were more than 800 cases. The study was to under-
Stood the correlation between mothers' level of knowledge, attitude and Prac-
Tice on healthy and clean Behaviors (PHBs) with diarrhea incidence of
Reviews their underfive children. The study was an observational one with
case control de-sign. The case group consisted of 46 children who were
Diagnosed of diarrhea in the last two months, meanwhile the control group
comprised 46 undiagnosed with other children. A valid and reliable piloted
questionnaire and check-lists were used to measure the predictor factors. The
study Showed that in the con-trol group, the level of knowledge,

Keywords : PHBs,
diarrheaPRELIMINARY
Environmentally based disease is
still the biggest health problem for the
people of Indonesia. It is pitch-reflection
of the high level of all the means
invented and visits to health service
commitment At ABC-nan. Which belong
to the group of these diseases are: in-
feksi acute respiratory tract, lung
tuberku-losis, diarrhea, malaria, dengue
fever, air-blood, intestinal worms and
gang-guan health / food poisoning a-tau
as chemicals and pesticides1),
The high incidence of diseases
Berba-sis environment caused by the
poor condition of basic sanitation,
especially clean water and latrines,
increasing pollution, less hiegienisnya
way of managing food, low peri-salable
clean and healthy life (PHBs), and poor
management of chemical pesticides in
household , In masha-rakat, health
problems based ling-
kungan can cause extraordinary event 2),
Based on this, the pitch-facing
environmental health problem there
need to be done step-white antisi and
also measures to reduce the intensity of
the scene, by looking at the indicators to
obtain its required support system-Lans
good survey.
Through good surveillance system
which includes the collection, analysis,
data presentation and dissemination of
in-formation, then the rapid response
actions which are supported by the
source da-ya and adequate logistics can
be done as an effective response 3),
Diarrheal diseases as one of the
environment-linked diseases, often me-
attacking babies and toddlers. If it is not
solved, the incidence of diarrhea that
persists will cause dehydration that can
me-nyebabkan death. The incidence of
in-are children in the world reached 1 mi-
Wild of cases each year, with the victim-
ninggal me about 5 million people, 3.2
million in late-peerless in developing
countries 4),
Based on the data in 2003, the
frequency of outbreaks of diarrhea was
recorded throughout many 92 cases with
3865 people infected and 113 deaths
with case fatality rate (CFR) of 2.92%.
Se-added, data from the health profile of
In-donesia in 2005, diarrheal diseases
nempati me-fifth of the 10 major
diseases in outpatients and first order in
hospitalized patients in the hospital.
As for the location of the study,
namely Puskesmas Seyegan, Sle-man,
according to the report week-an
outbreak of (W2), in 2008 ter-record 293
cases of diarrhea in the age group of
less than 5 years and 516 cases for the
age group more than 5 years. Total
cases increased when compared with
the data in 2007. This is an indicator that
he-re surveillance activities in the area
needs to be improved.
There are several risk factors for the
environment based on the incidence of
diarrhea-well wila Seyegan health
center, the pe-rilaku society, conditions
kua-litas water and sanitation facilities in
the community. Percentage of sanitation
facilities in the area eligible are: Clean
Water Facility 96.55%, 36.99% Jam-tire
and Wastewater Disposal Facility
26.85%. It is seen that the two means of
the latter, prosenta-Senya still very low5),
The incidence of diarrhea in infants
is very e-rat relation to the healthy
behaviors of their mothers, so the study
of healthy behaviors of the mother on the
health of children under five should be
done to give benchmarks prevention
mechanism.
Based on the results of activities
PHBs in Puskesmas Seyegan, from four
sample villages in mid-year, data
showed that 75% of residents have
behaved. Although the by-increasingly,
behavior that's responsible Activity is
measured in the extremely complex and
be-lum guarantees the possibility as fak-
tor-specific risks for disease diarrheal
diseases.
According Suhartini 6), Preferably
measured behavior is behavior that
specifically affects the incidence of
diarrheal disease according distribu-si
and etiology.
From the above background, the
authors assume that the educator's and
the mother's knowledge very shortly
PHBS support in applying and
subsequently will determine the status of
all health is a toddler. This is because
mothers are the caretakers, protectors
and educators are always air-exist close
to their children.
In this case, the mother's behavior
as a function of air-defense or self-
defense mechanism. In other words, the
fairy conduct a clean and healthy mother
can protect her child from harm inco-kit,
especially diarrhea are also common ka-
rena bad food intake which was
administered by the mother that caused
it-right of the child to low immunity7),
METHODS
This study uses a method
observational study with case control
design 8), Data collected by me-toda
interviews with respondents yes-that
mothers-ins by using questionnaires and
observations trumen gyro-sung against
kondiri sanitation by using a check-list.
Data collection was conducted
terha-dap case and con-trol group. As a
group of patients with diarrhea cases
were aged under 5 ta-hun who went to
Puskes-mas Seyegan in the last two
months and diagnosed by the local
medical or paramedical personnel
suffering from diarrhea.
While the control group were
children who live close to the case,
which in the period that sa-ma does not
suffer from diarrhea. One kri-Teria used
to select the con-trol is they do not use
clean water and latrines the same one
used by toddlers cases.
 Knowledge, attitudes and behavior kan R of 0.9785, 0.6714, 0.9824, and
of the mother observed is related to: the 0.9705.
habit of washing hands after defecation, These numbers are all larger than
handwashing before meals and drink, as 0.632 R table, so it can be stated that all
well as bowel habits. Instru-men is reliable and can be
Before use, the instrument pe- magnified use in research.
ngumpulan data is tested beforehand Respondents Knowledge of
vali-ditasnya. Construct validity was PHBs
tested by statistical test product moment,
and validi-bag contents through the table 1,
The frequency distribution
approval of the supervising this the level of knowledge about PHBs
research, by referring to existing
theories. Category The case group The control group
In addition, the test is also level
knowledge f % f %
conducted reliabi-litas to know whether
Instru-men have a high consistency of Less 27 58.7 2 4.3
response, namely by using Cronbach Enough 13 28.3 23 50.0
Alpha test
Well 6 13.0 21 45.7
To test the validity of the second,
involved 10 mothers who had children total 46 100 46 100
aged under five whose characteristics
are approximately equal to the mothers From the table above, it appears
res-Ponden research. They come from that pa-da group of cases, the number of
Hamlet Danen RT 03 RW 29, Sumberadi respondents whose level of knowledge is
Mlati, Sleman. Yogyakarta. less a-dalah the most, namely 27 a-tau
Data were analyzed using Chi Squa- 58.7%. Whereas in the control group, the
re with SPSS and also ana-lysis Odds most is me concoct with enough
Ratio (OR) of each risk factor using the knowledge level, that is 23 people or
software EpiInfo, each using α0.05. In 50.0%.
addition, 95% Confidence Interval Furthermore, the statistical test me-
calculated to present a range of values is nunjukkan p-value <0.001, which can be
believed to exist in the study population. interpreted that the knowl-knowledge
level of respondents in both groups was
RESULTS significantly different.
Advanced epidemiological analysis
Validity test obtained by comparing his ha between
By using the SPSS lu-nak, the less and better knowledge, acquired OR
correlation coefficient of 47.25 (95% CI: 7.35 to 400.38).
(R) each of the questions on the
questionnaire and check list is greater Respondents attitude of PHBs
than R table (0.632). Thus Instru-men
who used valid and usable concluded. table 2,
The frequency distribution
respondents' attitudes about PHBs
test Reliability
The statistical test to measure the The case group The control group
Category
level questionnaire reliabili-bag of attitude
f % f %
knowledge, attitudes and behavior, as
well as check- list of environmental Less 18 39.1 10 21.7
conditions; each menghasil- Enough 26 56.5 14 30.5
 Well 2 4.4
total 46 100
Table 2 above shows the flood-wa in
the cases, the number of response-den
whose attitude toward PHBs cu-coup is
the highest, with 26 o-rang or 56.5%.
While the group together all the control,
the largest number are mothers whose
attitude good category, that is 22 people
or 47.8%.
Statistical test results further
magnified by p-value <0.001, which can
diinter-pretasikan that respondents'
attitudes toward PHBs in ter-me-mang
both groups was statistically significant
different. In this regard, ana-lysis
advanced epidemiological obtained by
comparing only an-tara respondents are
less and good attitude, obtained by OR
of 19.80 (95% CI: 3.34 to 152.99).
22 47.8 batch of cases and controls was air-
difference and statistically significant.
46 100
Advanced epidemiological analysis
obtained by comparing anta-ra less
behavior and fine, obtained by OR of
69.00 (95% CI: 8.34 to 831.56).
Respondents Environmental
Conditions
From Table 4 it is seen that for
group of cases, the number of
respondents with environmental
conditions included in the ka-tegori less,
is the highest amount that is 22 people.
In contrast, for the control group, the
number of response-den the greatest
number are mothers that the
environmental conditions are good, that
is 20 people or 43.5%.
table 4,
The frequency distribution
environmental conditions of respondents

Respondents behavior of PHBs Category The case group The control group
condition
table 3, environment f % f %
The frequency distribution
respondent behavior of PHBs Less 22 47.8 8 17.4

Enough 19 41.3 18 39.1

The case group The control group
Category
behavior Well 5 10.9 20 43.5
f % f %
total 46 100 46 100
Less 18 39.2 2 4.4

Enough 25 54.3 21 45.6 Furthermore, statistical Chi square

Well 3 6.5 23
total 46 100 46
Table 3 shows that in the cases, the
number of respondents whose behavior
towards PHBs enough there was the one
that most, ie 25 people or 54.3%. While
on the con-trol group, the largest amount
is me concoct whose behavior including
da-lam into either category, that is 23
people or 50.0%.
Furthermore, the results of statistical
tests in-obtained p-value <0.001; which
can be interpreted that the response
behavior-den in between to-do PHBS
50.0 test results showed that p-value <0.001,
100
which can be interpreted that the con-
dition of respondents environment
between the two study groups was
different air-meaning.
Advanced epidemiological analysis
obtained by comparing his ha between
less and better environmental conditions,
obtained by OR of 11.00 (95% CI: 2.66
to 49.21).
Respondents Education Level The
level of education can be
predictors of the tendency of the lawyer-
aruh the level of mothers' knowledge of
PHBs.
In this study, a mother-gorikan
dikate have this level of education is
good if at least graduated from high
school; level
education enough if at least graduated derung to follow posyandu and obtain
from high school, and the education information about kesehat's.
level of less if only graduated from In this regard, Cha-dijah, cited by
primary or below. Warman 10)Air-opinion that the education
From the table below, it can be seen of parents, especially mothers, is one
that in both groups, no good education. kun-ci socio-cultural changes. Relatively
For groups of cases, those who are less high educated mother will have a health
educated are more numerous banned- maintenance measures, Khu-susnya to
ding sufficient, whereas the opposite infants, the better.
situation encountered in the con-trol Knowledge about health is the basis
group. for peri-behavior change. However, there
Statistical test results further must remain conscious of his possibility
magnified by p-value <0.006, which can that someone be-lum necessarily act on
diinter-pretasikan that the educational the basis of knowledge knowl-owned.
level res-Ponden both groups was air- Similarly, a person may not necessarily
statistically significant difference. act on the basis of knowledge, and so
did someone not necessarily act in
table 5,
The frequency distribution accordance with the rules of the air-I.
The education level of respondents This is caused by the sis-em personality
of each individual formed by education
Category The case group The control group and experience11),
condition
environment f % f %
Respondents attitude of PHBs
Less 25 54.3 13 28.3 The results also showed him to the
Enough 21 45.7 33 71.7 effect that the attitude of PHBs among
Well 0 0.0 0 0.0
respondents of different case and control
groups were statistically significant. The
total 46 100 46 100 mother of a toddler control groups have
a tendency to have a healthier attitude
DISCUSSION which leads to the elusion of their
toddlers from diarrhea.
Respondents Knowledge Skepis indication on the health
PHBs paradigm by case group tended le-bih
The results of analysis infor-viding large, so that the viewpoint of the health
that group of cases over the cen-derung paradigm in most response-den in the
to have knowledge of diarrhea were less case group tended to be taken as a
compared to the control group. matter of course, without feeling the
Knowledge gained from the need to take some action ter-course.
mother's yes-health information in their According to Blum in Notoatmojo 7),
village environment, such as when they Attitude factor has a great influence on
visited Posyandu toddler a-tau PKK the health status masyara-kat. Mother's
activities. If connected de-ngan results of attitude in the field of health determine
the study therefore indicates that clicking the level of health of family members,
mothers in clogs-pok case, the intensity including a toddler. This is because
of clicking follow the activities mentioned usually the Peng
above, tend to be low.
This is in accordance with what is
encountered by Adisasmito 9) in his
research, namely that mothers whose
children do not suffer from diarrhea for
more CENTER
foster care for infants is mother so le-ih
many interactions that occur.
Respondents behavior of PHBs As the
two factors before-
it is statistically research-unjukkan me
that the respondent's behavior-ara into
two groups in relation to PHBs are
different.
This implies that mothers tend to be
the cases do not apply its attitude in the
form of behavior or action, so it gives ri-
siko for the occurrence of diarrhea in
their children.
Their attitude that considers the
health paradigm is a matter of course
causes a small man-cenderungannya to
peri-behavior / positive action health
paradigm.
Maternal motivation to perform tin-
dakan supporting the positive reaction in
the case group tended to be small
anyway, so by looking at these things
need to be given a boost or innovations
to them so able to produce such a
positive reaction. Push-an or innovation
can be in the Ben-tuk activities such as
competitions all environmental clearance
or other programs that are empowering
for goodness-rakat.
According Notoatmojo 7), Behavioral
me-rupakan one form of action in the
active form, the individual response
tehadap stimulus appears in the form of
real action. Meanwhile, according
Suhartini6), Human action is a major
behavioral factors that influence in
determining health status.
Warman 10), In a study done in
Pekan Arba Tembilahan Indragiri Hilir
District of Riau province, about the
relationship between the level of
knowledge of mothers with diarrhea in
terms of the social aspects of eco-nomi,
concluded that there was a significant
association between maternal behavior
with the incidence of diarrhea in children.
Da-
lam it Notoatmojo 7) also berpen-can that
behavior is a factor predisposing
influence on an air-pe-nyakit incident.
Respondents Environmental
Conditions Environmental
conditions can greatly
act as enabling factors, ie factors that
make it easier for the occurrence of
diarrhea. The results showed bah-wa
environmental conditions between the
two groups differed statistically, that in
the group of cases the condition was
worse than in the con-trol group.
Indication-coup Run to the
environmental conditions of use
environmental health infrastructure. In
this in-all know that there are more than
50% of all cases the batch of waste
water treatment facilities are not yet
qualified. Quality indicators that are often
overlooked by the public, among others
are: ter-lid means pengleolaan
wastewater and fulfillment within 10
meters of su-mur dug nearby.
Waste management is also still ha-
rus note, because most respondents still
throw trash on vacant land such as
bushes around the house. As for the
disposal of household lim-bah still
carried out on open ground that is
generally directly below the house. To
these two things would be a good
medium for germs per-tread.
To break the chain of transmission
of communicable diseases such as
diarrhea this, magnified Lukan efforts of
various parties, especially health care
workers and peme-'s instructions in the
District Seyegan, such as u-paya
increase outreach to the community so
that the Bertam-bahnya information
obtained diha-rapkan with Inevitably,
they will improve the environmental
conditions.
In addition, it is also necessary-daan
Oversight of public infrastructures un-tuk
improve hygiene Lingkung's, such as
latrines, where penampung-
an interim garbage, where knowl-lolaan
waste, and so forth.
Respondents Education Level A
person's education level, da-
lam this case mothers as respondents,
will provide different levels of pe-
ngetahuan about health paradigm. In
other words, the higher the level of
education will also have a greater
knowledge diban-dingkan with lower
educational levels.
In this study showed that statistically
there are differences in education levels
between groups ka-sus and control. This
is consistent with previous findings that,
in the case group was also lower
knowledge level compared to the control
group.
The tendency of the bu-kan se
mean in the health paradigm-and should
apply as of the above conditions. In the
health paradigm, knowledge of a person
with a low level of education can be
improved through health information
service and moti-vasi in any event
conducted in the village, in the form of
pe-propagation leaflets, counseling kom-
prehensif, as well as the award to the
mother.
Linear relationship Factors Linear
relationship with reviewing
Additional factors that may affect the
incidence of diarrhea by using statistical
test of cross-factor, the value of T
greater, namely 5.627 in the aggregate
relation to the environmental conditions
kate-gori tngkat less and less maternal
education. Based on this it can be
concluded that the level of knowledge,
attitudes and behaviors since late
mother can get stronger as the mother's
education level and the condition of the
environment is at ka-tegori less.
This is in accordance with penda-pat
Chadijah, in Warman 10), That the
education of the parents, especially the
mother, is one of the key changes
socio-cultural. A relatively high education
will have a better practice terjadap health
care environment and the family,
especially children under five.
CONCLUSION
From the results of the study it can
be concluded that there are differences
in the level of knowl-knowledge, attitudes
and behaviors among mothers about
their PHBs her toddler son had suffered
from diarrhea and no.
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