The effectiveness of simulation health education to mother breastfeeding skill between two groups in rural area of Riau, Indonesia
Agrina
, Febriana Sabrian, Reni Zulfitri, Arneliwati, Herlina, Ari Pristiana Dewi
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Community Health Nursing Division, Faculty of Nursing, Riau University, Indonesia
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The benefits of breastfeeding to infant health as well as the society in general are well documented. Breast milk contains nutrients, at specific percentages, needed for the growth and development of infants. Consequently, breastfeeding is the main source of nutrition for babies.<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">1,2</span></a> In the same vein, breastfeeding has been associated with lower rates of gastrointestinal, respiratory, and urinary tract infection and less atopic illness during the first year. Moreover, supplying the complementary food before 6 months of baby age is correlated to child undernutrition.<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">3,4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The World Health Organization (WHO) recommends Exclusive Breastfeeding (EBF) for the first six months of a baby's life and continuation of the breastfeeding for up to two years.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">5</span></a> Despite the fact that the importance of breastfeeding is well known throughout the world, many mothers from both developing and developed countries stop breastfeeding before the WHO recommended. It was recorded by UNICEF that only 38% of all infants born in developing world got exclusive breastfeeding in the first six months of their life and that majority of the mothers provide alternative food supplements for their babies under six months.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">6</span></a> Indonesia, as a developing country, is not excluded from these problems. A study carried out on Pekanbaru, one of the urban areas in Indonesia, shows that majority of nursing mothers in the area gave some form of complementary food to their babies under 6 months because they feel that giving them only breast milk is not enough.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">7</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">In the past two decades, the role of maternal self-efficacy in the initiation and during the process of breastfeeding has been increasingly shown to be of great importance. A high maternal self-efficacy results in longer duration of breastfeeding by mothers because of the confidence they have in its continuity. This is confirmed by different studies that have shown that there is a positive correlation between maternal self-efficacy and the duration of breastfeeding.<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">8,9</span></a> There is possible extension of this duration when mothers receive appropriate nursing interventions, continuing support and evaluation which can be in form of educational programs that are introduced in order to promote breastfeeding. According to a study by Pugin et al.,<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">10</span></a> providing breastfeeding skill-based education to expectant mothers before birth increases breastfeeding rate. It emphasises that early introduction of appropriate and effective interventions will also help mothers achieve the recommended six months exclusive breastfeeding.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The findings of the research show that mothers that received prenatal education experience an increase in the duration of breastfeeding as well as the skills and knowledge involved in the process. However, it was reported that despite the efforts of Indonesia government in promoting breastfeeding, the EBF rate is still lower than expected.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">11</span></a> A study carried out in Riau, a rural area of Indonesia, shows that the prevalence of exclusive breastfeeding was only 30.8% in the area and the major reason cited by mothers is that they feel that breast milk only cannot satisfy infants in their first six months.<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">12</span></a> Moreover, the study also reveals that most of the mothers engage in wrong breastfeeding techniques.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The study carried out in Indonesia show that breastfeeding skill is one of the most important factors needed in achieving a successful EBF practice. This study is aimed at evaluating the effect of using simulation technique of health education to improve breastfeeding skills for mothers in rural area of Riau.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Method</span><p id="par0030" class="elsevierStylePara elsevierViewall">This study made use of a quasi-experimental posttest-only control design. The research was conducted between July and September 2018. Purposive sampling was used to select 26 mothers who have had breastfeeding experience in Posyandu (child and mother's health post) in Perambahan village as rural area in Riau, Indonesia. Thirteen of the selected respondents were used as intervention group while the remaining thirteen respondents were used as the control group for the research. The observation sheet used in the research contained 8 breastfeeding techniques which served as a guide in assessing the breastfeeding skills of these mothers. After the simulation technique had been implemented in the intervention group for two weeks, the observation sheet was used to assess the breastfeeding skills of the mother. Independent <span class="elsevierStyleItalic">T</span>-test was applied in this study to compare the difference between the mean of the 2 groups.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="par0035" class="elsevierStylePara elsevierViewall">The result of the research showed that 53.8% of the 26 respondents were in the reproductive age of 20–35 years old with senior high school (42.3%) as their highest level of education. It was also discovered that majority of the respondents were housewives (96.2%) and that 80.8% of their family income were below the city minimum income for a month. Majority of the mothers, represented by 88.5% were reported to be living in a nuclear family circumstances as shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows that the number of mothers that performed good breastfeeding skills were lower in control group, 5 respondents, compared to the 8 respondents recorded in the intervention group after the intervention procedures.</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">Furthermore, <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> shows that the mean for breastfeeding skill for mothers in intervention group was 7.00 (SD 0.913) while a mean of 4.54 (SD 1.330) was observed for the control group after the simulation technique was used in educating them. A mean difference with <span class="elsevierStyleItalic">p</span> value of 0.000 was discovered between the 2 groups after the intervention.</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Discussion</span><p id="par0050" class="elsevierStylePara elsevierViewall">The result of this research shows that the use of simulation technique of health education is an appropriate method of intervention that can be use in increasing breastfeeding skill of mothers. This is supported by the higher percentage of 30.8% recorded by the use of the method for the intervention group compared to the 19.2% recorded by the control group. A difference was also observed in the skill category of the mothers in the two groups after the intervention procedure.</p><p id="par0055" class="elsevierStylePara elsevierViewall">Many factors have been discovered to be the cause for the inability of mothers to carry out exclusive breastfeeding successfully for 6 months and breastfeeding skill has been observed to be one of them. Previous studies have revealed that despite the advantages offered by breast milk to infants, EBF is not popular among mothers. Mothers have been found to be feeding their babies with other foods thinking that breast milk may not be sufficient for them.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">7</span></a> This thought and reasoning have been associated with the lack of knowledge about breast milk by mothers. Another study also revealed that poor feeding techniques could be the reason why mothers failed to engage in EBF.<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">12</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Failure of adequate breastfeeding has been observed to be caused by latch on mistakes as well as wrong positioning of babies during the process. This results in decreased production of milk by the breast and, consequently, leads to early termination of exclusive breastfeeding. This can be rectified through appropriate interventions such as the simulation technique employed in this research. This has been established by the results of this research which show that the intervention has a significant effect on the breastfeeding skills of mothers with a <span class="elsevierStyleItalic">p</span> value <.01.</p><p id="par0065" class="elsevierStylePara elsevierViewall">The research shows that simulation technique makes it possible for participants to get a real understanding of an education activity through the use of visual demonstration. This is supported by a research conducted by Wardani.<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">13</span></a> This study result showed that majority of the mothers only as housewife and they have low level of education, the demonstration method was very influential in increasing their rate of absorption and interest in learning. It can be deduced that using counseling kit in health education can optimize the learning quality of participants.</p><p id="par0070" class="elsevierStylePara elsevierViewall">Lack of breastfeeding knowledge and skill make mother is easy to supply the complementary feeding for their babies.<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">14</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Conclusion</span><p id="par0075" class="elsevierStylePara elsevierViewall">The use of simulation technique is appropriate in increasing the breastfeeding skills of nursing mothers. This is important because the use of good breastfeeding skill contributes to improvement in the rate of EBF in Indonesia.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:9 [ 0 => array:3 [ "identificador" => "xres1173531" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1097568" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 3 => array:2 [ "identificador" => "sec0010" "titulo" => "Method" ] 4 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 5 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 6 => array:2 [ "identificador" => "sec0025" "titulo" => "Conclusion" ] 7 => array:2 [ "identificador" => "xack401122" "titulo" => "Acknowledgement" ] 8 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2018-10-04" "fechaAceptado" => "2018-11-14" "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1097568" "palabras" => array:3 [ 0 => "Simulation health education" 1 => "Breastfeeding skill" 2 => "Rural mothers" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To evaluate the effect of health education by simulation for improving breastfeeding mother's skill in rural area in Riau.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">This study was quasi experimental posttest-only control design. Purposive sampling was used to recruit 26 mothers who have breastfeeding experience in Posyandu (child and mothers health post) in Perambahan village as rural area in Riau, Indonesia. Thirteen respondents as intervention group and 13 respondents as control group in this study. Two weeks after implementing the breastfeeding educational through simulation technique in the intervention group, observed checklist to assess mother skill was completed by researcher.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Fifty-three point eight percent of respondents were 20–35 years old, 80.8% mothers education level were low education in junior and senior high school level and 96.2% of them did not have any formal job outside at the home. There was a significant of mean difference in the breastfeeding mother's skill between intervention and control groups, 7.0 and 4.5 respectively (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.01).</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Health education technique was important thing to increase the breastfeeding mother's skill. The simulation is appropriate as one of the methods in health education for mothers.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Peer-review of abstracts of the articles is under the responsibility of the Scientific Committee of Riau International Nursing Conference 2018. Full-text and the content of it is under responsibility of authors of the article.</p>" ] ] "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Characteristics \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Frequency \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Percentage (%) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Age</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>25–35 y.o. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">53.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>>35 y.o. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">46.2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Education</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Elementary \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Junior high \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">38.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Senior high \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">42.3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>University \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Working</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>House wife \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">96.2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Teacher \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Family</span><span class="elsevierStyleItalic">income</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">80.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>≥IDR 2.516.000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">19.2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Living with</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Nuclear family \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">88.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Extended family \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2002979.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Based on city minimum income a month.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Socio-demographic characteristics of mothers.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Mother skill \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Control group</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Intervention group</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Total</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">N</span> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">% \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">N</span> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">% \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">N</span> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">% \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Not good \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">30.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">19.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100.0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Good \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">19.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">30.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100.0 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2002978.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Mother breastfeeding skill between intervention and control group after intervention.</p>" ] ] 2 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Respondent group \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">N</span> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Mean \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">SD \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Min \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Max \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span> value \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Intervention \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.00 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.913 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Control \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.54 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.330 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2002977.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The difference mean of mother's breastfeeding skill between intervention and control group after simulation health education.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:14 [ 0 => array:3 [ "identificador" => "bib0075" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Breastfeeding and the risk of hospitalization for respiratory disease in infancy: a meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "V.R. 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Yesi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:2 [ "tituloSerie" => "Int Health Environ Technol Caring Sci Conf" "fecha" => "2018" ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0135" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pengaruh Metode Demonstrasi Terhadap Prestasi Belajar Mata Kuliah ASKEB II Persalinan (Standart Asuhan Persalinan Normal) Ditinjau dari Motivasi Belajar pada Mahasiswa Prodi Kebidanan STIKES Dian Husada Mojokerto" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R.A. Wardani" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:1 [ "fecha" => "2011" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0140" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pusat Promosi Kesehatan" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Ministry Health of Indonesia" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2005" "editorial" => "Pengembangan Media Promosi Kesehatan" "editorialLocalizacion" => "Jakarta" ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack401122" "titulo" => "Acknowledgement" "texto" => "<p id="par0080" class="elsevierStylePara elsevierViewall">Our appreciation goes to all mothers that participated in this study and also to the nursing faculty of Riau University for the grant they awarded us for this research. Our deepest appreciation also goes to all health workers in Public Health Center for their support.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/11308621/00000029000000S1/v2_201904020624/S1130862119300038/v2_201904020624/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/11308621/00000029000000S1/v2_201904020624/S1130862119300038/v2_201904020624/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130862119300038?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 10 | 4 | 14 |
| 2024 October | 17 | 20 | 37 |
| 2024 September | 36 | 11 | 47 |
| 2024 August | 40 | 2 | 42 |
| 2024 July | 30 | 11 | 41 |
| 2024 June | 18 | 7 | 25 |
| 2024 May | 38 | 9 | 47 |
| 2024 April | 28 | 14 | 42 |
| 2024 March | 42 | 8 | 50 |
| 2024 February | 55 | 9 | 64 |
| 2024 January | 54 | 6 | 60 |
| 2023 December | 123 | 8 | 131 |
| 2023 November | 128 | 17 | 145 |
| 2023 October | 103 | 7 | 110 |
| 2023 September | 82 | 10 | 92 |
| 2023 August | 100 | 6 | 106 |
| 2023 July | 129 | 9 | 138 |
| 2023 June | 109 | 1 | 110 |
| 2023 May | 151 | 5 | 156 |
| 2023 April | 135 | 8 | 143 |
| 2023 March | 168 | 9 | 177 |
| 2023 February | 161 | 13 | 174 |
| 2023 January | 148 | 12 | 160 |
| 2022 December | 204 | 8 | 212 |
| 2022 November | 214 | 21 | 235 |
| 2022 October | 126 | 12 | 138 |
| 2022 September | 111 | 28 | 139 |
| 2022 August | 46 | 13 | 59 |
| 2022 July | 45 | 11 | 56 |
| 2022 June | 29 | 6 | 35 |
| 2022 May | 14 | 10 | 24 |
| 2022 April | 29 | 6 | 35 |
| 2022 March | 23 | 13 | 36 |
| 2022 February | 32 | 4 | 36 |
| 2022 January | 45 | 12 | 57 |
| 2021 December | 19 | 4 | 23 |
| 2021 November | 35 | 10 | 45 |
| 2021 October | 17 | 18 | 35 |
| 2021 September | 13 | 11 | 24 |
| 2021 August | 30 | 9 | 39 |
| 2021 July | 18 | 11 | 29 |
| 2021 June | 13 | 8 | 21 |
| 2021 May | 21 | 9 | 30 |
| 2021 April | 55 | 24 | 79 |
| 2021 March | 35 | 10 | 45 |
| 2021 February | 18 | 10 | 28 |
| 2021 January | 32 | 28 | 60 |
| 2020 December | 16 | 12 | 28 |
| 2020 November | 17 | 4 | 21 |
| 2020 October | 12 | 11 | 23 |
| 2020 September | 80 | 23 | 103 |
| 2020 August | 25 | 26 | 51 |
| 2020 July | 33 | 12 | 45 |
| 2020 June | 25 | 7 | 32 |
| 2020 May | 28 | 16 | 44 |
| 2020 April | 21 | 9 | 30 |
| 2020 March | 24 | 6 | 30 |
| 2020 February | 22 | 16 | 38 |
| 2020 January | 27 | 15 | 42 |
| 2019 December | 15 | 13 | 28 |
| 2019 November | 19 | 14 | 33 |
| 2019 October | 16 | 10 | 26 |
| 2019 September | 13 | 7 | 20 |
| 2019 August | 14 | 2 | 16 |
| 2019 July | 12 | 12 | 24 |
| 2019 June | 17 | 6 | 23 |
| 2019 May | 47 | 16 | 63 |
| 2019 April | 15 | 19 | 34 |
| 2019 March | 6 | 6 | 12 |
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