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Journal of Drug Delivery and Therapeutics

Open Access to Pharmaceutical and Medical Research

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Open Access   Full Text Article                                                                                                                                                                   Research Article 

Baby Massage Video to Increase Knowledge, Motivation and Behavior of Postpartum Mothers

Rasumawati¹*, Erlin Puspita², Nina Herlina³, Erik Ekowati⁴

^1,2Department of Midwifery, Health Polytechnic of Jakarta I, Indonesia

^3,4Department of Midwifery, Gunadarma University, Indonesia

INTRODUCTION

Baby is a very special period known as the golden age, as a golden period and a critical period of development for a person at the age of 0-12 months. Babies are called the golden age because it lasts very short and cannot be repeated. It is said to be a critical period because at this time babies are very sensitive to the environment therefore babies need to adapt to their surrounding environment by providing nutritional intake and good touch stimulation.^1–3

Stimulation in the form of touch will support the achievement of optimal growth and development. Failure to provide a stimulus will reduce their nutritional status which results in impaired growth and development. Good nutrition can be seen from the increase in body weight, which is one indicator of infant health that can be used as a benchmark for infant growth. The nutritional status of children under five is measured based on age, body weight and body length.^4–7

Indicators of weight/height describe nutritional status that are acute in nature as a result of conditions that last for a short time, such as decreased appetite due to illness or suffering from diarrhea. In such circumstances the child's weight will quickly drop so that it is no longer proportional to his height and the child becomes thin. Based on national prevalence data on nutritional status (weight-for-age) in children aged 0-23 months, very thin is 4.1% and underweight is 11.9%. The national prevalence of nutritional status (length/height-for-age) in children aged 0-23 months is very short 13.4% and 17.7% short. Data from DKI Jakarta on the incidence of nutritional status (weight-for-age) in children aged 0-23 months who are very thin is 3.4% and thin is 15.6%. Meanwhile, the prevalence of nutritional status (length/height-for-age) of DKI Jakarta in children aged 0-23 months is very short 10.4% and short 12.6%. The prevalence in East Jakarta of nutritional status (weight-for-age) in children aged 0-23 months in the thin category 20.9% and very thin 8.8%, for nutritional status (length/height-for-age) in children aged 0 – 23 very short months is 8.5% and short is 23.8%.^8–10

Until now, there is still poor nutritional status which is a concern for the government and health workers to deal with the problem of underweight babies and prevent increasing cases of malnutrition or undernutrition. One of the things that can be done in dealing with weight problems is to adjust the diet or provide nutritious nutrition. Weight problems in children are caused by a child's decreased appetite. This can be overcome by giving supplements or vitamins to children and stimulation. One form of providing stimulation to stimulate more optimal child growth and development can be done by giving baby massage regularly and with the right technique.^11–13

Massage is one of the easiest and most natural ways to build an inner connection with gentle touch and eye contact, thereby increasing bonding and accelerating interaction between mother and baby thereby establishing a very affectionate relationship that will stimulate the production of oxytocin. The hormone oxytocin is useful for facilitating breast milk. Research shows 80% of oxytocin hormone production is influenced by the mother's psychological condition. In addition, massage will make the baby hungry quickly so that the more breast milk the baby gets, the more breast milk production increases.^14,15 According to research conducted by Farida et al. there is an effect of baby massage on the frequency and duration of breastfeeding.¹⁶

Baby massage can relieve tension and fussiness. A gentle massage will help relax his muscles so he can calm down and fall asleep. Supported by research conducted by experts on mothers who have healthy babies aged 15 days, massage for 4 months is carried out on sleep duration, infant growth and development, and maternal anxiety levels. The results showed that infants experienced longer sleep duration.¹⁷

There are many benefits of proper baby massage, but traditional baby massage performed by traditional birth attendants is still common in many areas. Parents or other family members take their babies to a massage therapist and they believe that baby massage is an alternative therapy to cure diseases. This is due to a lack of knowledge about the benefits of baby massage, and they do baby massage based on experience and not accompanied by a scientific explanation of the correct way of baby massage.^18,19

Baby massage can’t be done carelessly, there are ways that must be considered, the right time to do massage and has been trained to do massage. The negative impact on babies, if baby massage is done in the wrong way and not in accordance with medical provisions, can cause swelling, bruising, shifting of veins, pain in the baby so that the baby becomes fussy and has difficulty sleeping. The risk of baby massage is usually caused by the practitioner's negligence in massaging and wrong massage.²⁰

In an effort to reduce the adverse effects of improper baby massage, it is better if the baby massage is carried out by the mother herself from an early age after the baby is born or the postpartum mother who is near the baby at all times. However, most mothers have not been able to provide care for their newborns because postpartum mothers have a fear of holding, bathing and massaging babies. Proper baby massage requires sufficient knowledge. Health education is an effort to assist postpartum mothers in increasing knowledge, motivation, and skills to achieve optimal health. The use of the right method in an educational process is very important.²¹

Due to limited access to health services due to the Covid-19 pandemic, the provision of appropriate media can be used by postpartum mothers in meeting needs related to caring for babies and making information easier to receive so that they can support postpartum mothers' interest in doing baby massage independently. Video media provides a more real picture and improves the ability to digest and remember the message conveyed. In addition, videos have an attractive appearance, such as sound and moving images, dramatization effects and easy timing of viewing.^22,23

Health promotion using video media is a suitable method to increase knowledge, motivation, and skills because it is practical, easy to understand and applied according to the level of knowledge. Supported by research conducted by Yanuarini et al. audiovisual media can increase mother's knowledge in massaging her baby with statistically significant results p=0.00 (α<0.05). The results of research conducted by Sitorus, using Leaflet Media and Audio Media before and after being given counseling there was a significant increase in baby massage using Audio Visual Media which was more effective than Leaflet Media. Therefore, researchers are interested in conducting a study entitled video media intervention on knowledge, motivation of postpartum mothers in doing baby massage.^24,25

MATERIALS AND METHODS

The design of this study was a pretest-posttest control group design, namely after the first observation (pre-test) was carried out which allowed researchers to examine the changes that occurred after the treatment (post-test) in the intervention and control groups.²⁶ The intervention group was given a baby massage video once a week, while the control group was given a baby massage intervention which is usually done by a midwife. The population is 200 postpartum mothers who visit and give birth at the Anny Rahardjo clinic from June to August 2021. The sampling technique uses purposive sampling, with a sample of 60 respondents. Analysis of the data used is bivariate analysis to analyze the variables of knowledge, motivation and behavior of postpartum mothers about infant massage, using the Mann Whitney test. Multivariate analysis to determine the quantitative relationship between the independent variable and the dependent variable after controlling for other variables using the Wilcoxon test.

RESULT

Table 1: Distribution of Respondent Characteristics by Age, Education and Parity in Intervention Groups and Control Groups

Table 1 shows that the characteristics of the respondents in the baby massage video media treatment group in the baby massage video media treatment group according to age, it was found that the majority of respondents were mothers aged 20-34 years as many as 20 people (66.7%). Characteristics of respondents in the control group according to age, it was found that the majority of respondents were mothers aged 20-34 years as many as 20 people (66.7%).

Table 2: Differences knowledge of postpartum mothers before and after getting baby massage video media in the intervention group and control group

Table 2 shows that the average knowledge of the intervention group respondents before giving the baby massage video (pretest) was 31.90. The average knowledge of the control group respondents (pretest) was 29.10. The results of the statistical test obtained a p-value of 0.521, so it can be concluded that there is no difference in the average knowledge of the two groups in the pretest. In the intervention group after giving baby massage video (posttest) 41.00. The average knowledge of the control group respondents (posttest) was 20.00. The results of the statistical test obtained a p-value of 0.000, so it can be concluded that after the treatment group received an intervention in the form of giving baby massage videos, there was a difference in the average posttest in the treatment group and the control group on the knowledge variable.

Table 3: Differences motivation of postpartum mothers before and after getting baby massage video media in the intervention group and control group

Table 3 shows that the average motivation of the intervention group respondents before giving the baby massage video (pretest) was 32.90. The average motivation of the control group respondents (pretest) was 28.10. The results of statistical tests obtained p value of 0.282, so it can be concluded that there is no difference in the average motivation of the two pretest groups. For the average motivation of respondents in the intervention group after giving a baby massage video (posttest) 40.47. The average motivation of the control group respondents (posttest) was 20.53. The results of the statistical test obtained a p value of 0.000, so it can be concluded that after the treatment group received an intervention in the form of giving baby massage videos, there was an average difference (posttest) in the treatment group and the control group on the motivation variable.

Table 4: Differences behavior of postpartum mothers before and after getting baby massage video media in the intervention group and control group

Table 4 shows that the average behavior of the intervention group respondents before giving the baby massage video (pretest) was 34.10. The average motivation of respondents in the control group (pretest) was 26.90. The results of the statistical test obtained a p-value of 0.107, so it can be concluded that there is no difference in the average behavior of the two groups at the time of the pretest. For the average behavior of respondents in the intervention group after giving a baby massage video (posttest) 39.05. The average behavior of the control group respondents (posttest) was 21.95. The statistical test results obtained a p value of 0.000, so it can be concluded that after the treatment group received an intervention in the form of giving a baby massage video, there was a difference in the average (posttest) in the treatment and control groups on behavioral variables.

Table 5. Differences knowledge, motivation, behavior  of postpartum mothers before and after getting baby massage video media in the intervention group and control group

Table 5 shows that the results of the Wilcoxon test in the treatment and control groups can be concluded that the intervention of giving baby massage videos has a positive effect on increasing mother's knowledge, motivation and behavior. This can be seen from the results of the analysis showing an increase in the average score of knowledge and motivation of postpartum mothers (100%) and behavior (93.33%), and there is no decrease in the scores of the three variables in the treatment group. In the control group, the Wilcoxon test results showed a decrease in scores on knowledge (6.67%), motivation and behavior by 3.33% respectively.

DISCUSION

The factors that caused the intervention group giving baby massage videos a positive effect on increasing knowledge based on the results of the analysis of increasing the average knowledge score of 100%, that the majority of postpartum mothers aged 20-34 years were 20 people (66.7%) and the minority of respondents aged < 20 years is 4 (13,3%). This is a factor that affects mother's knowledge, where age affects one's memory/capture and mindset. Memory is influenced by age, as you get older, your way of thinking will develop, so that when you are given knowledge about baby massage through counseling about baby massage, it is easier to understand it.²² This is in line with the results of Safrina & Rosmawar's research which states that there is a relationship between maternal age and mother's knowledge of infant massage. In accordance with the research by Nurseha & Komalasari that maternal age was significantly related (p=0.038) with an increase in mother's knowledge about infant massage. In this study, the age of the mother was 20-34 years.^27,28

At a certain age or towards old age the ability to accept or remember a knowledge will decrease. To sharpen and facilitate one's grasping power related to age, the provision of information about one's education must be appropriate and innovative. Information conveyed through video media affects the increase in knowledge because the message is conveyed through audiovisual where the senses that play a more role are sight and hearing so that the message is easy to understand and convey well.^29,30

Likewise, there was a change in motivation for the better in the intervention group giving baby massage videos a positive effect on increasing mother's motivation, based on the results of the analysis showing motivation (100%). This is inseparable from the process of increasing knowledge. The results showed that the intervention group respondents who had higher education were 19 (63.3%), with the criteria for higher education in this study being Diploma/bachelor graduates.

Education affects the learning process, the higher a person's education, the easier it is to receive information. With higher education, someone will tend to easily get information, both from other people and using the media to deliver information, and the more information that comes in, the more knowledge will be gained. Highly educated people will respond more rationally to the information obtained and think about the benefits. Through proper health education in conveying information, the message will be easily conveyed, encouraging someone to think and understand something and ultimately be motivated to take action on knowledge. Motivation is a series of efforts to provide certain conditions so that someone wants and will do something, for example about baby massage.^31–33

Mother's understanding of baby massage obtained through health education can increase mother's knowledge about baby massage so that it becomes a source of consideration for motivation to do baby massage independently. This is in line with research conducted by Ningsih et al. stated that the level of education was related to the respondent's ability to receive information about baby massage. Supported by Pangesti et al statement (2021) that there is an effect of health education on the motivation of mothers to massage their babies independently with a p value of 0.000 (p <0.05).^34,35

Providing information can accelerate a person to acquire new knowledge leading to positive behavior. Providing information will increase people's knowledge, then knowledge will raise awareness so that they will be motivated, and in the people behave accordingly because it is based on their own circumstances and not thoughts.²² Information is a form of stimulus that can encourage or stimulate mothers to do something like baby massage independently, this is supported by the current era of technology, access to information can be obtained quickly and easily. Through the provision of baby massage video information, it is easier for someone to access and adopt it, thereby increasing motivation in a positive direction.

Based on the results of the study, it was known that the intervention group giving baby massage videos had a positive effect on increasing mother's behavior, based on the results of the analysis it showed 93.33% behavior. An increase in skills is the impact of treatment as a learning process for the baby's mother. This is supported by the results of research on the characteristics of respondents based on the number of children, the majority of respondents have more than one child as many as 19 people (63.3%).

In terms of experience parity is shaping the mother's experience in doing baby massage. Experience is a source of knowledge or a way to obtain truth and knowledge. Experience is one factor in increasing one's knowledge. People who have experience caring for many children will have better knowledge when compared to people who have experience caring for one child. If the mother often does baby massage on her first child, then the mother will be adept at baby massage on her second child. This is supported by the results of research conducted by Nurseha & Komalasari that there is a significant relationship between parity (p = 0.000), with knowledge and behavior about infant massage where most parity mothers have children more than 2-4.²⁸

Behavior is an action of an organism that can be observed and even studied in passive and active forms, the passive form is a response that occurs in humans and is not directly visible to others in the form of knowledge, attitudes, motivations and perceptions. The active form is a form of implementation that is carried out in the form of actions such as baby massage. The problem that occurs today, most mothers who have given birth do not massage their babies. The reasons are because they don't know how to do baby massage, don't know the benefits of baby massage, and are also afraid that problems will occur with their baby if they massage the wrong one.³⁶ A person's skills can be determined by the knowledge, attitudes, motivation, and availability of facilities and the behavior of health workers as health facilitators in providing health education through counseling, demonstrations, using media such as leaflets and learning videos.

In accordance with the advancement of science, Technology, Information and Communication (ICT) in developing health education, as health workers do innovations and new things about baby massage through updated science training so that they can make their own baby massage video learning media which can later be given and taught to mothers who have a newborn.

CONCLUSION

The provision of video media intervention to postpartum mothers doing baby massage as many as 60 respondents resulted in no difference between the two control groups and the treatment group at the beginning of the study (pretest) on average knowledge, motivation and behavior. After the treatment group received an intervention in the form of giving baby massage videos, there was an average difference (posttest) in the treatment and control groups on the knowledge, motivation and behavior variables with p-value = 0.000. 

Multivariate analysis of the intervention carried out by giving baby massage videos had a positive effect on increasing mother's knowledge, motivation and behavior compared to the control group who only did baby massage without video.

ACKNOWLEDGEMENTS

The authors thank to Poltekkes Kemenkes Jakarta I for funding this research, all participants and research assistants.

CONFLICT OF INTEREST

The author declared that don’t have conflict of interest

ETHICAL CLEARANCE

The study was conducted after obtaining approval from Health research ethics committee Respati Indonesia University No.126/SK.KEPK/UNR/VI/2021.

REFERENCES

1. Anjani AD, Aulia DLN, Wibisono C. Information giving effect to knowledge mothers with babies of infant massage. Int J Inf Res Rev. 2018; 5(7):5590-6.

2. Carpenter H. Secret gardens: a study of the golden age of children's literature. Faber & Faber; 2012.

3. Andriana D. Tumbuh kembang & terapi bermain pada anak. 2013;

4. Altimier L, Phillips R. The neonatal integrative developmental care model: advanced clinical applications of the seven core measures for neuroprotective family-centered developmental care. Newborn Infant Nurs Rev. 2016; 16(4):230-44. https://doi.org/10.1053/j.nainr.2016.09.030

5. Lin Z, Green RS, Chen S, Wu H, Liu T, Li J, et al. Quantification of EUGR as a measure of the quality of nutritional care of premature infants. PLoS One. 2015; 10(7):e0132584. https://doi.org/10.1371/journal.pone.0132584

6. Ernawati F, Rosamalina Y, Permanasari Y. Pengaruh Asupan Protein Ibu Hamil Dan Panjang Badan Bayi Lahir Terhadap Kejadian Stunting Pada Anak Usia 12 Bulan Di Kabupaten Bogor (Effect of the Pregnant Women's Protein Intake and Their Baby Length at Birth to the Incidence of Stunting Among Children. Nutr Food Res. 2013; 36(1):1-11.

7. Prabandari Y, Hanim D, AR RC, Indarto D. Hubungan kurang energi kronik dan anemia pada ibu hamil dengan status gizi bayi usia 6-12 bulan di kabupaten boyolali (correlation chronic energy deficiency and anemia during pregnancy with nutritional status of infant 6-12 months in Boyolali regency). Nutr Food Res. 2016; 39(1):1-8. https://doi.org/10.22435/pgm.v39i1.5964.1-8

8. Reber E, Gomes F, Vasiloglou MF, Schuetz P, Stanga Z. Nutritional risk screening and assessment. J Clin Med. 2019; 8(7):1065. https://doi.org/10.3390/jcm8071065

9. Kousky C. Impacts of natural disasters on children. Futur Child. 2016; 73-92. https://doi.org/10.1353/foc.2016.0004

10. Kemenkes RI. Hasil utama riskesdas 2018. Jakarta.

11. Shobah A. Hubungan Pemberian MP-ASI Dengan Status Gizi Bayi 6-24 Bulan. Indonesia J Heal Dev. 2021; 3(1):201-8. https://doi.org/10.52021/ijhd.v3i1.76

12. Perdani ZP, Hasan R, Nurhasanah N. Hubungan praktik pemberian makan dengan status gizi anak usia 3-5 tahun di Pos Gizi Desa Tegal Kunir Lor Mauk. J Jkft. 2017; 1(2):9-17. https://doi.org/10.31000/jkft.v2i2.59

13. Rokayah Y, Nurlatifah L. Efektifitas Pijat Bayi Terhadap Pertumbuhan Dan Perkembangan Pada Bayi Usia 5-6 Bulan Di Desa Rangkasbitung Barat Tahun 2017. J Med (Media Inf Kesehatan). 2018; 5(2):156-67. https://doi.org/10.36743/medikes.v5i2.56

14. Moore ER, Anderson GC. Randomized controlled trial of very early mother-infant skin-to-skin contact and breastfeeding status. J Midwifery Womens Health. 2007; 52(2):116-25. https://doi.org/10.1016/j.jmwh.2006.12.002

15. Juwita S, Jayanti ND. Pijat Bayi. Penerbit CV. Sarnu Untung; 2019.

16. Farida F, Mardianti M, Komalasari K. Pengaruh Pijat bayi terhadap peningkatan frekuensi dan durasi menyusu pada bayi usia 1-3 bulan. J Kebidanan. 2018; 7(1):61. https://doi.org/10.26714/jk.7.1.2018.61-68

17. Yılmaz HB, Conk Z. The effect of massage by mothers on growth in healthy full term infants. J Hum Sci. 2009; 6(1):969-77.

18. Roesli U. Pedoman Pijat Bayi Prematur dan Bayi usia 0- 3 bulan. Jakarta: Trubus Agriwiya; 2013.

19. Sari AN, Pangestika VP. Hubungan Pengetahuan dan Sikap Ibu Tentang Pijat Bayi (Di Posyandu Seruni dan Kamboja Desa Klangon Kecamatan Saradan Kabupaten Madiun). J Kebidanan. 2018; 7(1):44-53. https://doi.org/10.35890/jkdh.v7i1.24

20. Suririnah. Buku Pintar Merawat Bayi 0-12 Bulan. Jakarta: Gramedia Pustaka; 2014.

21. Suliha U, Resnayati Y. Pendidikan kesehatan dalam keperawatan. EGC; 2019.

22. Notoatmodjo S. Ilmu perilaku kesehatan. Jakarta: rineka cipta. 2010; 200:26-35.

23. Sadiman AS. Media Pendidikan pengertian, pengembangan dan pemanfaatannya. 2006;

24. Yanuarini TA, Yani ER, Farida AY. Pengaruh Pendidikan Kesehatan Pijat Bayi terhadap Kemampuan Psikomotor Ibu Melakukan Pijat Bayi 1-3 Bulan. J Wiyata Penelit Sains dan Kesehat. 2020; 7(1):62-8. https://doi.org/10.33366/jc.v7i2.1035

25. Sitorus S. Efektivitas Promosi Media Leafleat Dengan Media Audio Visual Tentang Pijat Bayi Terhadap Pengetahuan Ibu Di Wilayah Kerja Puskesmas Pembantu Amplas Tahun 2017. 2020;

26. Notoatmodjo S. Metodologi penelitian kesehatan. Jakarta: rineka cipta; 2010.

27. Safrina N, Rosmawar C. Faktor-Faktor Yang Mempengaruhi Pengetahuan Ibu Tentang Pijat Bayi Di Bps Jauniwati Indrapuri Kabupaten Aceh Besar Tahun 2016. 2016.

28. Nurseha N, Komalasari D. Hubungan Karakteristik Ibu Yang Memiliki Bayi Usia 0-24 Bulan Dengan Pengetahuan Tentang Pijat Bayi. Faletehan Heal J. 2020; 7(1):42-7. https://doi.org/10.33746/fhj.v7i1.77

29. Sumartini NP, Purnamawati D, Sumiati NK. Pengetahuan pasien yang menggunakan terapi komplementer obat tradisional tentang perawatan hipertensi di Puskesmas Pejeruk tahun 2019. Bima Nurs J. 2020; 1(2):103-12. https://doi.org/10.32807/bnj.v1i2.516

30. Alini A, Indrawati I. Efektifitas Promosi Kesehatan Melalui Audio Visual Dan Leaflet Tentang SADARI (Pemeriksaan Payudara Sendiri) Terhadap Peningkatan Pengetahuan Remaja Putri Tentang Sadari Di SMAN 1 Kampar Tahun 2018. J ners. 2018; 2(2). https://doi.org/10.48186/bidkes.v2i08.120

31. Kholisotin K, Prasetyo AD, Agustin YD. Pengaruh penyuluhan berbasis video whatsapp tentang persalinan terhadap pengetahuan dan sikap ibu hamil trimester III di Puskesmas Klabang Kabupaten Bondowoso. Indones J Heal Sci. 2019; 11(2):182-94. https://doi.org/10.32528/ijhs.v11i2.2962

32. Aticeh A, Maryanah M, Sukamti S. Pengetahuan kader meningkatkan motivasi dalam melakukan deteksi dini tumbuh kembang balita. J ilmu dan Teknol Kesehat. 2015; 2(2):71-6.

33. Kusnasetia S, Rini R. Pengaruh Konseling terhadap Motivasi Ibu Melakukan Perawatan Metode Kangguru pada Bayi Berat Badan Lahir Rendah. KEMAS J Kesehat Masy. 2016; 11(2):270-5. https://doi.org/10.15294/kemas.v11i2.4028

34. Ningsih AW, Darmawan MTS, Kuntari T. Perbandingan peningkatan pengetahuan ibu tentang pijat bayi setelah mendapat penyuluhan dan pemutaran VCD di Kelurahan Widodomartani, Ngemplak, Sleman, Yogyakarta. JKKI J Kedokt dan Kesehat Indones. 2011; 13-9.

35. Pangesti CB, Nurjanah S, Astuti HP, Agussafutri WD. Pengaruh pendidikan kesehatan dengan metode demonstrasi terhadap motivasi ibu dalam memijat bayi secara mandiri di PMB Elisabeth Banyuanyar Surakarta. J Kebidanan Indones. 2021; 12(1). https://doi.org/10.36419/jki.v12i1.436

36. Andriyani R, Sari RB. Hubungan Sikap Ibu Tentang Pijat Bayi dengan Perilaku Ibu dalam Memijat Bayi di Posyandu Wilayah Kerja Puskesmas Sidomulyo Pekanbaru. J Kesehat Komunitas. 2015; 2(6):270-3. https://doi.org/10.25311/keskom.Vol2.Iss6.87