THE DESCRIPTION OF ANXIETY LEVEL IN PATIENT WITH PRE

OPERATIONS SECTIO CAESAREA IN THE MAWAR ROOM

DR. M. YUNUS HOSPITAL BENGKULU

By:

Eva Kurnia Sari, Yuniwati, Dian Reflisiani

Department of DIII Midwifery STIKES Tri Mandiri Sakti Bengkulu
Email: evakurniasari17@gmail.com

One cause for sectio caesarea action in pregnancy if the mother had problems in
pregnancy such as pre-eclampsia. Pre-eclampsia is a disease with signs of
hypertension, edema and proteinuria arising from pregnancy. This disease
generally occurs in the 3rd quarter of pregnancy, but may occur earlier, for
example in the molar pregnancy. This study aims to Learn description of anxiety
levels in pre operation sectio caesarea patient in the Mawar Room dr. M. Yunus
Hospital Bengkulu. The population in this study were all pregnant women into
sectio caesarea labor in dr. M. Yunus Hospital Bengkulu as many as 32 people.
Sampling technique using Accidental Sampling where pre sectio caesarea mother
who incidentally discovered during the study. Collecting data in this study using
primary data obtained from interviews to giving birth mother in dr. M. Yunus
Hospital Bengkulu. Data Analysis technique using univariate analysis was
conducted to determine the description of frequency distribution of anxiety levels
in sectio caesarea pre-operative patient in Mawar Room dr. M. Yunus Hospital
Bengkulu. Result of this study found: 19 people (59.4%) women experience light
anxiety. Expected in health workers, especially midwives in Mawar Room dr. M.
Yunus Hospital Bengkulu in order to provide information through education and
health promotion at the maternity about pre sectio caesarea birth process when
patients and families visiting Mawar Room causing anxiety and provide
opportunities for families to spend time with the patient before surgery.

Keywords: Anxiety Level of Pre Sectio Caesarea Patients

A. Introduction
The maternal mortality rate (MMR) is one indicator in determining the
degree of public health. According to WHO (World Health Organization) in 2014,
as many as 536,000 women die from childbirth. As many as 99% of maternal
deaths due to labor problems or births occur in developing countries (WHO,
2014).
According to Indonesian Ministry of Health (2014), the maternal mortality
ratio in developing countries is the highest with 450 maternal deaths per 100.000
live births compared to the ratio of maternal deaths in 9 developed countries and
51 Commonwealth countries and around the world every minute a woman dies
due to complications related to pregnancy, childbirth, and postpartum. In other
words, 1,400 women die every day or more than 500,000 women die each year
due to pregnancy, childbirth and postpartum.
 According to Ahmad (2010), that in Indonesia in 2013 the prevalence of
anxiety risk in pregnancy by 10% - 25% which is more common in women aged
20-44 years. The incidence of depression or anxiety complicate the delivery
process approximately 10% - 15%, while the anxiety that occurs in patients with
cesarean approximately 15% - 25%.
The delivery process is a complex process to save both mother and baby
using a variety of methods such as vaginal deliveries, delivery by using the tools
and operative delivery through Sectio caesarea (SC). The methods are carried out
with special indications with a goal of saving both mother and infant (Manuaba,
2010).
One cause for sectio caesarea in pregnancy if the mother had problems in
pregnancy such as pre-eclampsia. Pre-eclampsia is a disease with signs of
hypertension, edema and proteinuria arising from pregnancy. This disease
generally occurs in the 3rd quarter of pregnancy, but may occur earlier, for
example in molahidatidosa (Wiknjosastro, 2010).
Anxiety is an unclear fear and is not supported by the situation. Anxiety
disorders is a group of conditions that provide an important overview about
excessive anxiety accompanied by a behavioral response, emotional and
physiological individuals who experience anxiety disorder (Vedebeck, 2010).
Based on the initial survey results conducted by researchers, sectio caesarea
in dr. M. Yunus Hospital Bengkulu in 2012 as many as 830 out of 2645 deliveries,
in 2013 as many as 892 out of 2524 deliveries and in 2014 as many as 544 out of
2191 deliveries. From these data indicate that there is a decrease of sectio caesarea
in dr. M. Yunus Hospital Bengkulu because of BPJS regulations require dr. M.
Yunus Hospital as a references provincial level so dr. M. Yunus Hospital only
accept referrals from district and City Hospital.
The problems of this study how the description of anxiety level in
preoperative sectio caesarea patient in the mawar Room dr. M. Yunus Hospital
Bengkulu?.

B. Research Method
This research was conducted in dr. M. Yunus Hospital Bengkulu and
research was conducted on 19 to 25 August 2015. This study used a descriptive
design. The population in this study were all pregnant women in Sectio Caesarea
in dr. M. Yunus Hospital Bengkulu as many as 32 people. The research method
sample using Accidental sampling that all pregnant women in Sectio Caesarea in
dr. M. Yunus Hospital Bengkulu. Collecting data using interview and
questionnaire to obtain data. The data were analyzed using univariate. Univariate
analysis was conducted to determine the description in frequency distribution of
the anxiety levels in preoperative sectio caesarea patient in Mawar Room dr. M.
Yunus Hospital Bengkulu.
C. Research Result
1. Univariate Analysis
Univariate analysis performed to get the description of the anxiety levels in
preoperative sectio caesarea patient based on the characteristics of maternal in the
Mawar Room dr. M. Yunus Hospital Bengkulu.
Table 1.
Frequency distribution of Anxiety Levels in Patients with Pre Operation
Sectio Caesarea in the Mawar Room dr. M. Yunus Hospital Bengkulu

Anxiety Frequency Percentage

Severe 0 0
Moderate 9 28,1
Mild 19 59,4
Not Anxiety 4 12,5
Total 32 100,0

Based on Table 1 above, from 32 maternal with pre sectio caesarea (59.4%)
experienced Mild Anxiety, (28.1%) had moderate anxiety and (12.5%) not having
anxiety.

D. Discussion
Research Results (59.4%) had light anxiety. From the Observations before,
the symptoms show by maternal include Quiet Confidence, Alert, attention at a lot
of things, patience and little uneasy.
Research Results (28.1%) had moderate anxiety. From the observation,
maternal had experience symptoms of anxiety include impatience, irritability,
moderate muscle tension, increased vital signs, start sweating, frequent urination
and headaches.
From research conducted (12.7%) did not experience anxiety. From the
observation, maternal did not experience the symptoms of anxiety, just feel shaky
and frequent urge to urinate. From observations, mother had two or more sectio
caesarea surgery so it tends to be quiet and not having anxiety.
The results are consistent with research conducted by Leoni (2012), about
the image of the anxiety levels from 33 mothers aged 20-35 years, the majority of
mothers (63.6%) experienced mild anxiety and from 6 mother aged <20 or > 35
years old most of them (75%) experienced severe anxiety.
According to Vedebeck (2010), that the anxiety is an unclear fear that is not
supported by the situation. Anxiety disorders is a group of conditions that provide
an important overview of excessive anxiety accompanied by a behavioral
response, emotional and physiological individuals who experience anxiety
disorder.
The cause of the anxiety can be viewed from two factors: internal factors
which include knowledge, education, experience, information and age external
factors consist of the social environment, socio-economic and cultural, threat,
Conflict, fear, unfilled need (Vedebeck, 2010).
According to Struard (2010), anxiety arises from the fear of the disapproval
and interpersonal rejection. Anxiety is also associated with the development of
trauma, such as separation and loss, which raises a specific vulnerability.
Individuals with low self esteem especially susceptible to severe anxiety.
According to Bucklew Vedebeck (2010), that anxiety can affect a person in
many different forms. Some people show concern psychological, emotional, and
physiological. Anxious psychologically and emotionally manifested in psychiatric
symptoms such as tension, confusion, anxiety, difficulty contracting, a feeling of
uncertainty and so on. While physiologically manifested in physical symptoms,
especially in the nervous system for example, can not sleep, heart palpitations,
trembling, stomach nausea, vomiting, diarrhea, shortness of breath accompanied
by tremors in the muscles.
Struard (2010), explains that anxiety has two aspects of healthy and harmful
aspects, depending on the level of anxiety, the anxiety experienced long, and how
well individuals perform coping with anxiety. Anxiety can be seen in the range of
mild, moderate, severe to panic. Each level causes changes in individual
physiological and emotional.

E. Conclusion
1. From 32 pre sectio caesarea maternal there were 19 people (59.4%)
experienced mild anxiety.

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