Analysis Of The Need For Perinatal Health Services

Lastri Mei Winarni* -  STIKes Yatsi Tangerang, Indonesia
Koestika Safitri -  STIKes Yatsi Tangerang, Indonesia
Nuryanti Nuryanti -  STIKes Yatsi Tangerang, Indonesia
DOI : 10.33024/jkm.v8i2.5509

Latar belakang : kesehatan mental perinatal ibu belum diskrining secara rutin, banyak ibu yang memiliki faktor resiko namun belum teridentifikasi bahwa mereka memiliki kesejahteraan menengah hingga yang buruk dari determinan kesehatan mental. Kesempatan untuk mendeteksi kecemasan, rasa takut, khawatir, stress sering terlewatkan oleh tenaga kesehatan yang melakukan pemeriksaan

Tujuan : menganalisis kebutuhan pelayanan kesehatan mental perinatal di Kota Tangerang

Metode : Desain penelitian yang akan digunakan pada penelitian ini adalah observasional dengan pendekatan mixed method dengan jenis eksploratori sekuensial. Lokasi penelitian di lima Puskesmas di Kota Tangerang. Penelitian dilakukan antara Januari -September 2021. Melibatkan partisipan untuk wawancara mendalam sebanyak 8 orang dan responden untuk mengisi kuesioner sebanyak 102 ibu. Analisis data kualitatif menggunakan analisis tematik, sedangkan analisis univariat digunakan untuk data kuantitatif.

Hasil : ditemukan lima tema yang berkaitan dengan kebutuhan pelayanan kesehatan mental perinatal, yaitu (1) peningkatkan kesiapan sumber daya manusia, (2) tahapan pelayanan kesehatan mental perinatal, (3) dukungan sarana dan prasarana, (4) kebijakan dan peraturan kesehatan ibu, (5) kolaborasi interprofessional untuk pelayanan kesehatan mental. Dalam survei yang dilakukan 46,1% ibu membutuhkan pelayanan kesehatan mental perinatal; 77,5% ibu membutuhkan dukungan psikologis dari tenaga kesehatan; 32,4% ibu membutuhkan pelayanan konseling psikologis, dan 63,7% ibu memahami pentingnya Kesehatan psikologis selama hamil, bersalin dan nifas namun tidak mengetahui penangannya.

Kesimpulan : Pelayanan kesehatan mental untuk ibu perlu dipertimbangkan dan diupayakan menjadi salah satu program pelayanan kesehatan ibu pada masa kehamilan, persalinan, maupun masa nifas. Upaya tersebut dapat berupa upaya promotif, preventif, kuratif dan rehabilitatif.

Saran : Perlu integrasi pelayanan kesehatan mental dalam pelayanan kesehatan ibu saat ini. Dukungan dari pemangku kebijakan mengenai peraturan yang jelas, penyiapan sumber daya manusia, kelengkapan sarana dan prasarana serta alur rujukan yang tepat perlu dikembangkan untuk menangani ibu hamil, ibu bersalin maupun ibu nifas yang mengalami gangguan psikologis pada fase reproduksinya.

 

Kata kunci : Ibu hamil, Ibu nifas, Kesehatan mental, Kesehatan mental perinatal, Kondisi psikologis

 

ABSTRACT

 

Background : Maternal perinatal mental health has not been screened routinely, many mothers have risk factors but have not identified that they have moderate to poor well-being as a determinant of mental health. The opportunity to detect anxiety, fear, worry, stress is often missed by health workers who carry out examinations

Purpose : analyzing the need for perinatal mental health services in Tangerang

Methods : The research design that will be used in this study is observational with a mixed method approach with a sequential exploratory type. The research location is in five Puskesmas in Tangerang City. The study was conducted between January -September 2021. It involved 8 participants for in-depth interviews and 102 respondents to fill out a questionnaire. Qualitative data analysis used thematic analysis, while univariate analysis was used for quantitative data.

Result : found five themes related to the need for perinatal mental health services, namely (1) increasing the readiness of human resources, (2) stages of perinatal mental health services, (3) supporting facilities and infrastructure, (4) maternal health policies and regulations, (5 ) interprofessional collaboration for mental health services. In the survey, 46.1% of mothers needed perinatal mental health services; 77.5% of mothers need psychological support from health workers; 32.4% of mothers need psychological counseling services, and 63.7% of mothers understand the importance of psychological health during pregnancy, childbirth and postpartum but do not know how to handle it

Conclusion : Mental health services for mothers need to be considered and strived to be one of the maternal health service programs during pregnancy, childbirth, and the postpartum period. These efforts can be in the form of promotive, preventive, curative and rehabilitative efforts

Suggestion : It is necessary to integrate mental health services into current maternal health services. Support from policy makers regarding clear regulations, preparation of human resources, completeness of facilities and infrastructure as well as appropriate referral lines need to be developed to deal with pregnant women, mothers in labor and postpartum women who experience psychological disorders in their reproductive phase

 

Keywords : Mental health, Perinatal mental health, Postpartum mothers, Pregnant mothers, Psychological health

 

 

Keywords : kesehatan mental perinatal, ibu hamil, ibu nifas, kesehatan mental, kondisi psikologis

  1. Abdollahi, F., Zarghami, M., Do, T. K. L., Nguyen, T. T. H., & Huong, T. T. (2018). Effect of postpartum depression on women’s mental and physical health four years after childbirth. Eastern Mediterranean Health Journal, 24(10), 1002–1009. https://doi.org/10.26719/2018.24.10.1002
  2. Afiyanti, Y., & Rachmawati, I. N. (2014). Metodologi Penelitian Kualitatif Dalam Riset Keperawatan.
  3. Baron, E. C., Hanlon, C., Mall, S., Honikman, S., Breuer, E., Kathree, T., Luitel, N. P., Nakku, J., Lund, C., Medhin, G., Patel, V., Petersen, I., Shrivastava, S., & Tomlinson, M. (2016). Maternal mental health in primary care in five low- and middle-income countries: A situational analysis. BMC Health Services Research. https://doi.org/10.1186/s12913-016-1291-z
  4. Braun, V., & Clarke, V. (2019). Reflecting on reflexive thematic analysis. Qualitative Research in Sport, Exercise and Health, 11(4), 589–597. https://doi.org/10.1080/2159676X.2019.1628806
  5. Chou, F. H., Avant, K. C., Kuo, S. H., & Fetzer, S. J. (2008). Relationships between nausea and vomiting, perceived stress, social support, pregnancy planning, and psychosocial adaptation in a sample of mothers: A questionnaire survey. International Journal of Nursing Studies. https://doi.org/10.1016/j.ijnurstu.2007.08.004
  6. Department of Mental Health and Substance. World Health Organization. (2016). Improving Maternal Mental Health. In World Health Organization. https://www.who.int/mental_health/prevention/suicide/Perinatal_depression_mmh_final.pdf?ua=1
  7. Fisher, J., Cabral de Mello, M., Patel, V., Rahman, A., Tran, T., Holton, S., & Holmes, W. (2012). Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: a systematic review. Bulletin of the World Health Organization, 90(2), 139G-149G. https://doi.org/10.2471/BLT.11.091850
  8. Galderisi, S., Heinz, A., Kastrup, M., Beezhold, J., & Sartorius, N. (2015). Toward a new definition of mental health. World Psychiatry : Official Journal of the World Psychiatric Association (WPA), 14(2), 231–233. https://doi.org/10.1002/wps.20231
  9. Goebel, A., Stuhrmann, L. Y., Harder, S., & ... (2018). The association between maternal-fetal bonding and prenatal anxiety: An explanatory analysis and systematic review. Journal of Affective …. https://www.sciencedirect.com/science/article/pii/S0165032717325016
  10. Han, Q., Guo, M., Ren, F., Duan, D., & Xu, X. (2020). Role of midwife‑supported psychotherapy on antenatal depression, anxiety and maternal health: A meta‑analysis and literature review. Exp Ther Med, 20(3), 2599–2610. https://doi.org/10.3892/etm.2020.9011
  11. Hidayat, M. M., Rachmawati, I. N., & Gayatri, D. (2019). Prenatal distress and increased psychosocial risks in the postpartum period among Indonesian women. Enfermeria Clinica, 29, 476–481. https://doi.org/10.1016/j.enfcli.2019.04.071
  12. JCPMH. (2012). Guidance for commissioners of perinatal mental health services 1 Guidance for commissioners of perinatal mental health services Joint Commissioning Panel for Mental Health Joint Commissioning Panel for Mental Health www.jcpmh.info 2 Practical Mental Healt. www.jcpmh.info
  13. Nagle, U., & Farrelly, M. (2018). Women’s views and experiences of having their mental health needs considered in the perinatal period. Midwifery, 66, 79–87. https://doi.org/10.1016/j.midw.2018.07.015
  14. O’Hara, M. W., & Wisner, K. L. (2014). Perinatal mental illness: Definition, description and aetiology. Best Practice & Research Clinical Obstetrics & Gynaecology, 28(1), 3–12. https://doi.org/https://doi.org/10.1016/j.bpobgyn.2013.09.002
  15. Park, S., Kim, J., Oh, J., & Ahn, S. (2020). Effects of psychoeducation on the mental health and relationships of pregnant couples: A systemic review and meta-analysis. International Journal of Nursing Studies, 104, 103439. https://doi.org/https://doi.org/10.1016/j.ijnurstu.2019.103439
  16. Rait, G. (2003). Mental health in primary care: a new approach. Family Practice, 20(3), 354–355. https://doi.org/10.1093/oxfordjournals.fampra.a001513
  17. Report Of The Who-Unfpa Meeting Held In Geneva, S. (2008). Maternal mental health and child health and development in low and middle income countries. World Health, February.
  18. Rinata, E., & Andayani, G. A. (2018). Karakteristik ibu (usia, paritas, pendidikan) dan dukungan keluarga dengan kecemasan ibu hamil trimester III. MEDISAINS. https://doi.org/10.30595/medisains.v16i1.2063
  19. Royal College of Psychiatrists. (2015). Perinatal mental health services: Recommendations for the provision of services for childbearing women. http://www.rcpsych.ac.uk/publications/
  20. Siallagan, D., & Lestari, D. (2018). TINGKAT KECEMASAN MENGHADAPI PERSALINAN BERDASARKAN STATUS KESEHATAN, GRAVIDITAS DAN USIA DI WILAYAH KERJA PUSKESMAS JOMBANG. Indonesian Journal of Midwifery (IJM). https://doi.org/10.35473/ijm.v1i2.101
  21. Steen, M., & Francisco, A. A. (2019). Maternal Mental Health and Wellbeing. Acta Paulista de Enfermagem, 32, III–IVI. http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-21002019000400001&nrm=iso
  22. Stewart, D. E., Robertson, E., Phil, M., Dennis, C., Grace, S. L., & Wallington, T. (2003). Postpartum Depression: Literature review of risk factors and interventions. WHO Publication, October, 289. http://www.who.int/mental_health/prevention/suicide/lit_review_postpartum_depression.pdf
  23. Sumedang, J. K. (2010). Hubungan Antara Tingkat Kecemasan Dengan Kualitas Tidur Pada Ibu Hamil Trimester Iii Di Puskesmas Jatinangor Kabupaten Sumedang. Jurnal Psikologi. https://doi.org/10.1089/ees.2013.0409
  24. Surjaningrum, E. R., Minas, H., Jorm, A. F., & Kakuma, R. (2018). The feasibility of a role for community health workers in integrated mental health care for perinatal depression: A qualitative study from Surabaya, Indonesia. International Journal of Mental Health Systems, 12(1), 1–16. https://doi.org/10.1186/s13033-018-0208-0
  25. Tachibana, Y., Koizumi, N., Akanuma, C., Tarui, H., Ishii, E., Hoshina, T., Suzuki, A., Asano, A., Sekino, S., & Ito, H. (2019). Integrated mental health care in a multidisciplinary maternal and child health service in the community: The findings from the Suzaka trial. BMC Pregnancy and Childbirth, 19(1), 1–11. https://doi.org/10.1186/s12884-019-2179-9
  26. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. (2017). Mental Health Care in the Perinatal Period. In Australian Clinical Practice Guideline (Issue October). https://cope.org.au/wp-content/uploads/2017/10/Final-COPE-Perinatal-Mental-Health-Guideline.pdf
  27. UNFPA. (2019). Perinatal Mental Health : A Resouce Guidebook in Perinatal Mental Health for Maternity Care Providers. https://doi.org/10.4135/9781473917774.n7
  28. Utami, A., & Lestari, W. (2011). Perbedaan tingkat kecemasan primigravida dengan muligravida dalam menghadapi kehamilan. Jurnal Ners Indonesia.
  29. Vianna, P., Bauer, M. E., Dornfeld, D., & Chies, J. A. B. (2011). Distress conditions during pregnancy may lead to pre-eclampsia by increasing cortisol levels and altering lymphocyte sensitivity to glucocorticoids. Medical Hypotheses, 77(2), 188–191. https://doi.org/https://doi.org/10.1016/j.mehy.2011.04.007
  30. Winarni, L. M. (2018). PENGARUH DUKUNGAN SUAMI DAN BOUNDING ATTACHMENT DENGAN KONDISI PSIKOLOGI IBU POSTPARTUM. Jurnal Ilmiah Bidan, 3(2), 1–11.
  31. Winarni, L. M., Ikhlasia, M., & Sartika, R. (2020). Dampak Latihan Yoga Terhadap Kualitas Hidup Dan Psikologi Ibu Nifas. Jurnal Kebidanan Malahayati, 6(1), 8–16. https://doi.org/10.33024/jkm.v6i1.2126
  32. World Health Organization. (2015). Thinking healthy: A manual for psychosocial management of perinatal depression. World Health Organization, 1, 180.
  33. World Health Organization. (2018). Mental health: strengthening our response. https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response
  34. Yu, Y., Zhang, S., Wang, G., Hong, X., Mallow, E. B., Walker, S. O., Pearson, C., Heffner, L., Zuckerman, B., & Wang, X. (2013). The combined association of psychosocial stress and chronic hypertension with preeclampsia. American Journal of Obstetrics and Gynecology, 209(5), 438.e1-438.e12. https://doi.org/10.1016/j.ajog.2013.07.003

Open Access Copyright (c) 2022 Jurnal Kebidanan Malahayati

Policies

Submissions

Other

Focus and Scope
Section Policies
Peer Review Process
Publication Frequency
Open Access Policy		Online Submissions
Author Guidelines
Copyright Notice
Privacy Statement
Author Fees		Journal Sponsorship
Journal History
Site Map
About this Publishing System
JKM (Jurnal Kebidanan Malahayati)