The Ratu's Model: A prevention model of postpartum depression
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"apellidos" => "Manlapaz" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130862119300221?idApp=UINPBA00004N" "url" => "/11308621/00000029000000S1/v2_201904020624/S1130862119300221/v2_201904020624/en/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "titulo" => "The Ratu's Model: A prevention model of postpartum depression" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "70" "paginaFinal" => "73" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Ratu Kusuma, Budi Anna Keliat, Yati Afiyanti, Evi Martha" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Ratu" "apellidos" => "Kusuma" "email" => array:1 [ 0 => "ratukusuma1975@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Budi Anna" "apellidos" => "Keliat" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Yati" "apellidos" => "Afiyanti" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Evi" "apellidos" => "Martha" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Departement of Nursing, Baiturrahim School of Health, Indonesia" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Faculty of Nursing, Universitas Indonesia, Indonesia" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1253 "Ancho" => 2167 "Tamanyo" => 215350 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The Ratu's Model.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Postpartum depression is a psychological disorder that might occur after few days of postpartum, it usually occurs in the week 2 or 3 and it may last for 1–2 years. The symptom consists sadness, easily offended, crying, sleep disorder, decreased libido, easily exhausted, hard to concerntrate, guilty feeling, feeling unworthy, suspicious, lack interest to the baby, feeling unable being a mother, and even potentially harm the baby.<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">1,2</span></a> The number is estimated to reach 20% in Indonesia, 15–20% in the Riau Province, postpartum depression must to be pressed to 1%.<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">3–7</span></a> The exact cause of postpartum depression has not yet been identified, some theorized that it is affected by biological, psychological, and demographic factors. The biologic factor means physiological changes occurred during pregnancy, labor, and postnatal, nutritional deficiencies, metabolic disorder, anemia, hormonal changes, fatty acid changes, and obstetric-related complications suffered by the pregnant women.<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">2,4,7,8</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Some of psychosocial factors are past failure in marriage, husband's minimum support or any other significant others, domestic violence, history of depression in past pregnancy, history of depression in the family, and mood disorder during period of menstruation.<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">4,9,10</span></a> Demographic factor consists of the age of the pregnant women, educational degree, working status, the number of children, and the norm and cultural perspectives in the society. The other factors are socioeconomic factor and unhealthy lifestyle, such as smoking, consuming alcohol and drugs for recreational purpose.<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">4,11</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Previous studies conducted be the researcher shows that the education provided in the in healthcare services has not yet prioritized integrated prenatal care based on Roy Adaptation Model contextualized among pregnant women, including but not limited to the prioritization of nutrition preventing postpartum depression. Henceforth, a brand new Ratu's Model needs to be established.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">This study is a quasi experimental pre–posttest with the control group. The study was undergone by implementing the model through providing education toward the pregnant women and their husbands and identifying the impact of the Ratu's Model to prevent postpartum depression. The samples in this study were the pregnant women in the second trimester (week 20–27). The intervention and the control group were then divided into 54 participants. The instrument used Edinburgh Postpartum Depression Scale (EPDS). This research was done in 4 health center in Kabupaten Kampar of Riau Province.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">The Ratu's Model</span><p id="par0025" class="elsevierStylePara elsevierViewall">The model involved four main components which were developed based on Roy Adaptation Model.<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">12</span></a> which were education to enhance stimulus of pregnant women, education to enhance coping mechanism, education to enhance adaptive behavioral response, and education to enhance social support of the husband. The more detailed of Ratu's Model is presented in <a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">Education is provided toward the pregnant women and the husbands. Of the intervention group for 3 times for 27 days, each of the sessions was held in 9 days and every session was given 50–60<span class="elsevierStyleHsp" style=""></span>min period of time. After all the intervention ended, the visit would then be executed three times as monitoring system toward the result of education. Multivariat analysis was done by using general linear model-repeated measure (GLM-RM).</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Result</span><p id="par0035" class="elsevierStylePara elsevierViewall">The effectiveness of the Ratu's Model toward the lowered incidience and score of pregnant women is presented in <a class="elsevierStyleCrossRefs" href="#tbl0005">Tables 1 and 2</a>.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> described the incidence of depression in both groups prior and subsequent to the intervention which reaches the number of 17 (15.74%). After being intervened, depression lowers to 60% in intervention group.</p><p id="par0045" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> described that the average score of the postpartum depression in the intervention group is found better than those in the control group with the distinction of 2103 (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.001).</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Discussion</span><p id="par0050" class="elsevierStylePara elsevierViewall">Result of the study indicates that the Ratu's Model is effective in lowering the postpartum depression. The women in the intervention group have 60% of lowered chance of experiencing postpartum depression. The control group, however, do not have the same development. The psychoeducation and the counseling during the period of pregnancy may reduce the incidence of depression during and after the pregnancy.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">4</span></a> The psychoe and educational support group is effective in lowering the incidence of postpartum depression in the period of perinatal.<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">13</span></a> Happiness: “Mom and Baby” package given to the women with postpartum depression, husband or the parents may lower the phenomenon of depression.<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">14</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">The lowered incidence of the postpartum depression in the intervention group may also be caused by the nutrition consumed by the pregnant women, especially the nutrients that may even prevent postpartum depression. Based on the 12 weeks nutritional intake obtained from the respondents, it is known that pregnant women fulfill the intake of carbs, proteins, minerals, and the antioxidants. That 99% of pregnant women consuming B6, B9, vitamin E, vitamin D, omega-3 indicates lower symptoms of postpartum depression.<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">15</span></a> Consumption of selenium in the 6 or 8 weeks old of postpartum phase in the intervention group lower the indication of postpartum depression.<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">16</span></a></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Conclusions</span><p id="par0060" class="elsevierStylePara elsevierViewall">The Ratu's Model is effective to lowering the incidence of postpartum depression. Its is recommended that the Ratu's Model may be utilized as more focus in maternity nursing service to prevent of postpartum depression in any healthcare services.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres1173525" "titulo" => "Abstract" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Objectives" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Method" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Result" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1097562" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 3 => array:2 [ "identificador" => "sec0010" "titulo" => "Methods" ] 4 => array:2 [ "identificador" => "sec0015" "titulo" => "The Ratu's Model" ] 5 => array:2 [ "identificador" => "sec0020" "titulo" => "Result" ] 6 => array:2 [ "identificador" => "sec0025" "titulo" => "Discussion" ] 7 => array:2 [ "identificador" => "sec0030" "titulo" => "Conclusions" ] 8 => array:2 [ "identificador" => "xack401118" "titulo" => "Acknowledgements" ] 9 => 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" => "xpalclavsec1097562" "palabras" => array:3 [ 0 => "Ratu's model" 1 => "Postpartum depression" 2 => "Depression prevention" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The Ratu's Model is a nursing model to prevent postpartum depression, is a product of Ratu's dissertation. Depression is one of the common psychological problem experienced by postpartum women. The number is estimated to reach 20% in Indonesia, 15–20% in the Riau Province, and must to be pressed to 1%.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objectives</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">This study aims to identify the effectiveness of Ratu's Model to prevent postpartum depression.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Method</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Quasi-experiment research alongside with pre–post test analysis of the control group, number of the respondents was undergone among 54 women pregnant and the spouses in each intervention and control group. Educational intervention was given toward intervention group for 3 times, with 3 times monitoring, and 3 times measurement.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Result</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A significant correlation between Ratu's Model with lowered postpartum depression incidence.</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusion</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The Ratu's Model is effective lowering the incidence of postpartum depression.</p></span>" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Objectives" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Method" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Result" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusion" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">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:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1253 "Ancho" => 2167 "Tamanyo" => 215350 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The Ratu's Model.</p>" ] ] 1 => 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: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">Depression incidence \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">Intervention (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>54)</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Control (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>54)</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Total (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>108)</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">Pretest \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">18.52 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12.96 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15.74 \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">Posttest \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">7.41 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12.96 \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">10.19 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2002959.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The changed frequence of depression before and after being intervened by the Ratu's Model (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>108).</p>" ] ] 2 => 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">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">B \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col"><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 and control \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.103 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2002958.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The effectiveness of the Ratu's Model toward the lowered score of postpartum depression (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>108).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:16 [ 0 => array:3 [ "identificador" => "bib0090" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Maternity nursing family, newborn and women's health care" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S.J. 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Ghayour-Mobarhan" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Matern Fetal Neonatal Med" "fecha" => "2011" "volumen" => "24" "paginaInicial" => "104" "paginaFinal" => "108" ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack401118" "titulo" => "Acknowledgements" "texto" => "<p id="par0070" class="elsevierStylePara elsevierViewall">Thanks to all of pregnant women and the husbands, the Chairman of Public Health Office of Riau Province and the Chairman of Kabupaten Kampar, the chairman of community health center, promotor, co-promotor, experts and the others who helping this research.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/11308621/00000029000000S1/v2_201904020624/S1130862119300233/v2_201904020624/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/11308621/00000029000000S1/v2_201904020624/S1130862119300233/v2_201904020624/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130862119300233?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 12 | 0 | 12 |
| 2024 October | 79 | 15 | 94 |
| 2024 September | 102 | 7 | 109 |
| 2024 August | 45 | 7 | 52 |
| 2024 July | 58 | 10 | 68 |
| 2024 June | 59 | 7 | 66 |
| 2024 May | 75 | 4 | 79 |
| 2024 April | 68 | 17 | 85 |
| 2024 March | 39 | 6 | 45 |
| 2024 February | 83 | 9 | 92 |
| 2024 January | 139 | 14 | 153 |
| 2023 December | 136 | 11 | 147 |
| 2023 November | 144 | 28 | 172 |
| 2023 October | 157 | 28 | 185 |
| 2023 September | 107 | 24 | 131 |
| 2023 August | 74 | 7 | 81 |
| 2023 July | 48 | 3 | 51 |
| 2023 June | 73 | 5 | 78 |
| 2023 May | 83 | 15 | 98 |
| 2023 April | 87 | 9 | 96 |
| 2023 March | 85 | 14 | 99 |
| 2023 February | 75 | 6 | 81 |
| 2023 January | 96 | 18 | 114 |
| 2022 December | 72 | 19 | 91 |
| 2022 November | 73 | 7 | 80 |
| 2022 October | 48 | 11 | 59 |
| 2022 September | 45 | 31 | 76 |
| 2022 August | 49 | 13 | 62 |
| 2022 July | 27 | 8 | 35 |
| 2022 June | 34 | 5 | 39 |
| 2022 May | 55 | 15 | 70 |
| 2022 April | 55 | 13 | 68 |
| 2022 March | 63 | 14 | 77 |
| 2022 February | 50 | 8 | 58 |
| 2022 January | 113 | 10 | 123 |
| 2021 December | 49 | 12 | 61 |
| 2021 November | 47 | 13 | 60 |
| 2021 October | 47 | 28 | 75 |
| 2021 September | 57 | 29 | 86 |
| 2021 August | 83 | 20 | 103 |
| 2021 July | 31 | 14 | 45 |
| 2021 June | 53 | 9 | 62 |
| 2021 May | 81 | 18 | 99 |
| 2021 April | 124 | 30 | 154 |
| 2021 March | 74 | 41 | 115 |
| 2021 February | 38 | 16 | 54 |
| 2021 January | 41 | 28 | 69 |
| 2020 December | 30 | 30 | 60 |
| 2020 November | 32 | 18 | 50 |
| 2020 October | 20 | 16 | 36 |
| 2020 September | 42 | 21 | 63 |
| 2020 August | 36 | 21 | 57 |
| 2020 July | 30 | 12 | 42 |
| 2020 June | 28 | 7 | 35 |
| 2020 May | 38 | 15 | 53 |
| 2020 April | 50 | 12 | 62 |
| 2020 March | 49 | 37 | 86 |
| 2020 February | 55 | 21 | 76 |
| 2020 January | 51 | 16 | 67 |
| 2019 December | 53 | 12 | 65 |
| 2019 November | 44 | 16 | 60 |
| 2019 October | 46 | 16 | 62 |
| 2019 September | 76 | 18 | 94 |
| 2019 August | 40 | 25 | 65 |
| 2019 July | 66 | 20 | 86 |
| 2019 June | 73 | 48 | 121 |
| 2019 May | 145 | 72 | 217 |
| 2019 April | 83 | 10 | 93 |
| 2019 March | 7 | 4 | 11 |
| 2019 February | 0 | 2 | 2 |
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