93 Analysis of the Relationship of the Characteristics, Knowledge And Attitude of the Midwife With Completion of Partograph Filling in Normal Delivery

Info 2022 Partograph used for early detection of problems and complications in childbirth. Results of preliminary study through interviews obtained 80% of midwives who apply partograf,midwives who apply 30% for claiming the cost of labor by social asurance filling properly, 20% apply partograf by in complete filling, 30% apply partograf but filling is wrong, and 20% is not filling the partograf. The population is all midwives in health centers totaled 84 Padangmatinggi midwife, sampling technique was total population. The data was collected by using a validated questionnaire, secondary data from public health center, partograf sheet documenting data of health centers of Padangmatinggi. Analysis of the data through univariate analysis and a bivariate analysis using Chi-square test and logistic regression. There is correlation between work period (p=0.008;RP=1,504), employee status (p=0.013;RP=1,487), knowledge (p = 0.000; RP = 5.667), attitude (p = 0.000; RP = 7.222) with a completeness filling of partograf in normal delivery care. Attitude (p=0.001;RP=67.019) was the variable most strongly


INTRODUCTION
The partograph should be used in all deliveries in the active phase of the first stage carried out anywhere [1] but in fact the latest data 2017 obtained from WHO on the use of partographs were studied in three countries namely Ecuador, Jamaica and Rwanda stated that only 57.7% of health workers (doctors, midwives and nurses) performed delivery assistance by filling out partographs, and from this figure the midwife received a proportion of 34.1%. Research conducted in Nigeria 2018 by Fowole stated that only 32.3% of midwives used partographs during delivery assistance.
Results of preliminary studies through interviews that have been conducted of 10 midwives at the Padangmatinggi Public Health Center on March 13 , 2022, it was found that 80% of midwives applied partographs in normal delivery care, of midwives who applied partographs 30% of midwives applied partographs for claiming labor costs (BPJS) the filling was correct, 20% of midwives applied partographs by filling which is incomplete, 30% of midwives apply the partograph but it is filled out incorrectly, and 20% of the midwives do not apply the partograph at all on the grounds that they have forgotten how to fill in the partograph and feel that they do not need to apply the partograph. The number of normal deliveries assisted at the Padangmatinggi Public Health Center was 65 deliveries from August 2021 to February 2022, from the number of deliveries assisted by 60 deliveries of BPJS patients (Social Security Administering Body), 5 deliveries of general patients, with complete partograph documentation, 35 BPJS patients filled partographs correctly, 25 BPJS patients filled partographs incompletely and general patients (5 patients) did not fill in partographs.

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Based on background in above, the author is interested to conduct research on the analysis of the relationship between characteristics, knowledge and attitudes midwives with completeness of filling out partographs in normal delivery care at Padangsidimpuan Padangsidimpuan Public Health Center in 2022. Formulation of the problem Less than optimal completion of partograph filling in normal delivery care by midwives at Padangsidimpuan P Padangmatinggi Public Health Center. Research purposes to analyze the relationship between the characteristics, knowledge and attitudes of midwives with the completeness of filling out partographs in normal delivery care at the Padangmatinggi Public Health Center. Benefits of research : For midwives at the Padangmatinggi Public Health Center as input in the application of the use of partographs in care delivery to improve the quality of midwifery services Padangsidimpuan Health Office, it is hoped that it can be an input to further improve health service programs in the work area of the Health Office Padangsidimpuan especially in the application or use of partographs in every Normal Delivery Care by birth attendants, especially midwives at the Padangmatinggi Public Health Center. For further researchers as a source of information in conducting research related to the application of partographs in normal delivery care.

METHOD
The type of research used is an analytic survey using a cross sectional approach . Study this carried out at the Padangmatinggi Public Health Center on March 29 2022. Population in study this is All midwives at the Padangmatinggi Health Center totaled 84 midwives, with technique taking sample is the total population . Data collection is carried out with use questionnaire that has been validated , secondary data from documentation sheet partograph Public health center Padangmatinggi . Data analysis is analysis univariate t, analysis bivariate with Chisquare test and multivariate analysis with logistic regression.

Characteristics of Midwives (Age, Term of Service, Employee Status, and Training) at the Padangmatinggi Public Health Center
The results showed that the majority of midwives were at the age of 20-35 years, namely 50 respondents (59.5%), working years >5 years 49 respondents (58.3%), and non-civil servant status, namely 46 respondents (54.8%). and never had training for 78 respondents (7.1%).

Midwives' knowledge of partographs at the Padangmatinggi Public Health Center
The results showed that 54 respondents (64.3%) had poor knowledge of midwives and 30 respondents (35.7%) had good knowledge.

Midwives' Attitudes about Partographs at Padangmatinggi Public Health Center
The results showed that 54 respondents (64.3%) had a negative attitude and 30 respondents (35.7%) had a positive attitude.

Partograph Filling Equipment
The results showed that 56 respondents (66.7%) filled out the incomplete partograph, and 28 respondents (33.3%) filled out the partograph completely. The results of the analysis showed that there were 37 ( 74.0 %) of 50 midwives aged 20-35 years who filled out incomplete partographs and 19 (55.9 %) of 34 midwives aged >35 years filled out incomplete partographs. Bivariate statistics show that there is no significant relationship between the age of the midwife and the completeness of filling out the partograph in normal delivery care with p value = 0.084. The work demands of midwives in fulfilling their professional functions and responsibilities are not determined by the age factor but rather based on their professional competence. Monitoring labor through the application of partographs in labor is the fourth competency of midwives [6]. Midwife competencies are abilities and characteristics that are based on knowledge, skills and behavioral attitudes that a midwife must possess in carrying out midwifery practice in various health settings, safely and responsibly in accordance with standards [4].

Connection hope work b idan with k completeness artograph p filling in nature care normal delivery
The results of the analysis showed that there were 29 ( 82.9 %) of 35 midwives with 1-5 years of service filling out incomplete partographs and 27 (55.1 %) of 49 midwives with >5 years of service filling incomplete partographs. The results of the bivariate statistical test showed that there was a significant relationship between the period of service of the midwife and the completeness of filling out the partograph in normal delivery care with p value = 0.008 and the results of the multivariate analysis showed that there was no relationship between the period of service and the completeness of filling out the partograph with a value of p> 0.05.
The working period of midwives shows that there are still midwives who have not worked for a long time, namely non-PNS midwives (village midwives and honorary midwives) so that it will be difficult to solve the problems they are facing, experience can be used as an effort to gain knowledge by repeating the experiences that have been obtained in solving problems faced in the past. According to Azwar (2018), experience can be directly related to increasing knowledge, the more experiences one encounters in life, the more direct influence one's knowledge will have on one's knowledge. servant status filled out incomplete partographs. From the results of statistical tests, it is known that there is a significant relationship between the status of midwife employees and the completeness of filling out partographs in normal delivery care with p value = 0.013 and the results of multivariate analysis obtained that there is no relationship between employee status and completeness of filling out partographs with p>0.05.
Based on the above, it shows that the midwife's employment status is one of the factors that motivates a person to take certain actions or actions which in doing his job Civil servant midwives are obligated fulfill working hours at the puskesmas while the village midwife only comes to the puskesmas once a month and when there is an official schedule in the delivery room. Midwifery employment status is the state/position of the midwife in relation to the environment/workplace [4].

Training relationship b idan with k completeness artograph p filling _ in nature a suhan normal delivery _
The results showed that there were 52 (66.7 %) of 78 midwives who had never been trained to fill out incomplete partographs and there were 4 ( 66.7 %) of 6 midwives who had training in filling out complete partographs. From the results of statistical tests, it is known that there is no relationship between midwife training and the completeness of filling out partographs in normal delivery care with p value = 1.00 and the results of multivariate analysis there is no relationship between training and completeness of partograph filling with p value> 0.05. This is probably because most of the midwives have never attended training so their knowledge does not increase which causes perceptions to remain unchanged. With training midwife could add knowledge and knowledge specifically in Partograph filling can be effective as a monitoring tool in the labor process.
Training is every effort for repair performance worker on something profession certain that are Becomes not quite enough answer , or one existing job relation with work , goals training is that the employees could dominate knowledge , skills and emphasizing behavior in training programs and for applied in activity everyday [16] .

Connection knowledge of midwife with completeness artograph p filling in nature care normal delivery
The results showed that there were 51 (91.1%) of the 54 midwives who had poor knowledge of filling out incomplete partographs and 5 (8.9%) of 30 midwives who had good knowledge of filling incomplete partographs . From the results of statistical tests, it is known that there is a significant relationship between the knowledge of the midwife and the completeness of partograph filling in normal delivery care and the results of multivariate analysis show that there is a relationship between knowledge and the completeness of partograph filling with p = 0.012 and RP = 13.046 (95%CI; 1.755)-96.999) means that midwives with less knowledge have a 13.046 times greater chance of filling out incomplete partographs than midwives with good knowledge.
This illustrates that most midwives have less knowledge about the completeness of filling partographs in normal delivery care, this is probably due to lack of understanding in filling partographs because they have forgotten how to fill in partograph components. Knowledge has an important role in the application of the partograph, because a midwife must carry out the competence of a midwife, one of which is in the fourth competency of a midwife, namely monitoring labor through application in childbirth (Setiawan, 2018). Knowledge or cognitive domain is a very important domain in the formation of one's actions [10]. 3.2.6. Midwife attitude relationship with k completeness artograph p filling in nature care normal delivery The results showed that there were 52 (96.3%) of the 54 midwives who had a negative attitude in filling out the incomplete partograph and 4 (13.3%) of the 30 midwives had a positive attitude in filling out the incomplete partograph. From the results of statistical tests, it is known that there is a significant relationship between the attitude of the midwife and the completeness of filling out the partograph in normal delivery care and the results of the multivariate analysis the value of the attitude RP is 67,019 with a p value <0.05, meaning that midwives with a negative attitude are 67.019 times more likely to fill out the partograph incomplete compared to midwives who are positive This illustrates that most of the midwives have a negative attitude with incomplete filling of partographs because midwives feel there is no need to apply partographs and there are reasons for forgetting how to fill out partographs and are influenced by the perception of midwives who say "monitoring the progress of labor does not use partograph sheets which are important to be safe" . This is because most of the midwives have never attended training, knowledge of partographs is only obtained when attending DIII midwifery education so that their knowledge does not increase and perceptions do not change. Factors that influence the achievement of attitudes include ability factors and motivational factors. Attitude or attitude is related to its effect and role in character building and the system of relations between groups as well as choices that are determined based on the environment and its influence on change [22].

Exp Interpretation (B)
The results of the multivariate analysis in table 4.13 show the attitude RP value is 67,019 with a p value <0.05, meaning that midwives with a negative attitude have a 67,019 times greater chance of filling out incomplete partographs compared to midwives who have a positive attitude, the knowledge RP value is 13,046 with a p <0 value. .05, which means that midwives with less knowledge have a 13.046 times greater chance of filling out incomplete partographs compared to midwives with good knowledge. Meanwhile, tenure and employee status did not give significant results (p>0.05) in the multivariate test. The attitude variable is the independent variable that has the strongest relationship with the completeness of filling out the partograph compared to other independent variables.

CONCLUSION
The age of the midwife was not related to the completeness of filling out the partograph in normal delivery care. The working period of the midwife is not related to the completeness of filling out the partograph in normal delivery care. Employee status is not related to the completeness of filling out partographs in normal delivery care. Training is not related to the completeness of filling out partographs in normal delivery care. Knowledge of midwives is related to the completeness of filling out partographs in normal delivery care where midwives who are knowledgeable are 13,046 times the estimated risk of filling out partographs are incomplete compared to midwives who have good knowledge. The attitude of the midwife is related to the completeness of filling out the partograph in normal delivery care where the midwife who has a negative attitude is 67,019 times the estimated risk of filling out the partograph is incomplete compared to the midwife who has a positive attitude. Attitude is the most powerful factor relate with completeness charging partograph in care normal delivery