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The Effectiveness of the FASA method to
Minimize Abstinence Behavior of Pregnant
Women
1st Ana Zumrotun Nisak
S1 Keperawatan
Universitas Muhammadiyah Kudus
Kudus, Indonesia
anazumrotun@umkudus.ac.id
2nd Lailiyani Khoirunnisa’
S1 Keperawatan
Universitas Muhammadiyah Kudus
Kudus, Indonesia
lailiyani@umkudus.ac.id
Abstract—Health behavior is any form of experience
and interaction of individuals with their environment,
especially those relating to knowledge and attitudes about
health that create individual actions towards health. This
behavior was also carried out by several pregnant women
who were still abstaining from eating during pregnancy.
This abstinence behavior they do because of the influence of
the environment of pregnant women themselves, especially
from the family. The purpose of this study was to determine
the effectiveness of the family psychology approach method
(FASA) to minimize abstinence behavior of pregnant
women. This study used a quasi-experimental design with
one group pre-post test design. The study population was
all pregnant women who abstained from eating. The sample
was 54 respondents, using total sampling. Pre and post-test
analysis using Wilcoxon. This study was conducted for 1
month for the application of the FASA method by
providing knowledge of pregnant women and families
about abstinence behavior. The results obtained after the
method of family psychology approach, there are 49
pregnant women and families have increased knowledge
and understanding of abstinence for pregnant women and
leave abstinence during pregnancy. Statistical test results
obtained significance value 0,001 (p <0.05). It can be
concluded that the FASA method is effective to minimize
the abstinence behavior of pregnant women.
Keywords—FASA, abstinence behavior, pregnant women
I. INTRODUCTION
Culture is a work that includes knowledge, beliefs,
art, morals, law, customs, abilities, habits that are
obtained by humans as family members [1]. One form of
culture carried out by society is behavior. Behavior is an
action taken by humans to fulfill needs based on
knowledge, beliefs, values and norms with the person
concerned. One of human behavior is starting from
behavior related to health. Health behavior is any form of
experience and interaction of individuals with their
environment, especially those relating to knowledge and
attitudes about the health that shape individual actions
towards health [2]. One health behavior One part of these
things that must be fulfilled is balanced nutrition related
to food selection. When viewed from a nutritional point
of view, health from food does not only concern all
healthy foods, but also must consist of four components,
namely carbohydrates, proteins, fats, and vitamins. It
also must be supplemented with milk for calcium needs
or also called nutritional balance [3].
Pregnant women are one group of people who are
vulnerable to health, especially nutritional problems [5].
Foods consumed by pregnant women should not only
follow their appetite, but also need to look at the food
needs needed for the health of pregnant women [4]. In
addition to adequate nutrition, food choices are also
influenced by the beliefs, knowledge and attitudes of
pregnant women in choosing food, because the choice of
food in pregnant women will be shaped by social
perceptions and myths from their environment in the
form of prohibitions or suggestions, mainly carried out
by husbands and families pregnant women [6].
The influence of customs which is still strongly
entrenched in society, sometimes is not in accordance
with health regulations, such as the prohibition of
mothers not to eat too much, because it will impact the
difficulty of giving birth, and this is a negative myth that
needs attention [7]. Abstinence culture in pregnant
women will actually harm the health of the mother and
the fetus it contains. For example, pregnant women are
prohibited from eating eggs and meat, even though eggs
and meat are very necessary to meet the nutritional needs
of pregnant women and fetuses. Various restrictions can
cause pregnant women to experience anemia, which has
the effect of making bleeding during childbirth which
can continue to be the death of the mother and the baby
can experience LBW [8].
The existence of pregnant women who abstain from
certain foods can be influenced by several factors
including the role of family, age, education, knowledge,
experience, social culture and health workers. In
addition, belief in the prohibitions of old people, and
cannot be separated from the influence of people around
pregnant women, such as biological mothers, mother-in-
law, grandmother, relatives or neighbors also influence
[9].
Impaired nutritional intake of pregnancy can cause
premature birth, low birth weight (LBW), intra uterine
growth retardation (IUGR), infant death, miscarriage and
abnormalities in the central nervous system. There are
Advances in Health Sciences Research, volume 27
Proceedings of the 1st International Conference on Science, Health, Economics,
Education and Technology (ICoSHEET 2019)
Copyright © 2020 The Authors. Published by Atlantis Press B.V.
This is an open access article distributed under the CC BY-NC 4.0 license -http://creativecommons.org/licenses/by-nc/4.0/. 131
four factors that influence pregnancy success including
genetic, maternal environment, immunobiology and
nutritional status. The nutritional status of pregnant
women is a factor that can be modified [10]. The need
for balanced nutrition, both quality and quantity is very
important for pregnant women. But what often happens
in the community is the strong socio-cultural influence
on daily habits. Customs and traditions are the basis of
this behavior. This phenomenon is still affecting the
habits of the community in terms of trusting the
existence of dietary restrictions [11].
Knowledge or cognitive is an important factor in the
formation of behavior, if pregnant women have
knowledge about disorders and complications of
pregnancy, it is possible to behave to maintain, prevent,
avoid or overcome the risk of complications. Disparities
in socioeconomic status and low levels of education
cause limited awareness and understanding of mothers to
care for and maintain their pregnancy [12].
The development of health promotion media in
disease prevention management has been carried out.
However, providing specific information to pregnant
women and families is still little done. The emphasis on
health promotion lies in the efforts of health education
through the media of newspapers, radio, television,
leaflets, magazines, posters, brochures, and others [13].
But this media is still limited in its use. Increasing the
knowledge capacity of mothers through health education
both directly and indirectly is important. Although the
support of health workers has provided counseling
services for pregnant women during Antenatal care
(ANC) examinations, it did not reach groups of pregnant
women to maintain health during pregnancy [14].
The family is the environment the first time someone
gets education, experience and interact. The individual in
the family is a reflection of the family. Although not all
individual behavior is what is taught in the rules set in
the family, but the positive or negative attitude of the
individual will affect the whole family. Likewise, if the
family's views on good nutrition of pregnant women
must abstain from certain foods, this will also be
followed by family members. The method of family
psychology approach (FASA) is an approach method by
providing intervention to pregnant women and families.
The FASA method provides interventions in the form of
health education and an understanding of the nutrition of
pregnant women and the consequences of abstinence
during pregnancy.
II. METHOD
This research was conducted in Dawe sub-district,
Kudus Regency, using a quasi-experimental method with
one group prepost-test design. The study population was
all pregnant women who abstained from eating. The
number of samples was 54 respondents, using total
sampling.
Included in the inclusion criteria are pregnant women
who abstain from eating while pregnant, pregnant
women with healthy conditions. Exclusion criteria were
pregnant women with complications and referrals. Data
collection in this study used interview techniques and
questionnaire distribution. Questionnaire and interview
questions given to respondents are knowledge of
pregnant women about nutrition of pregnant women
which includes nutrition of pregnant women trimester I,
II and III, food to help the growth of the fetus and due to
malnutrition in pregnant women. An understanding of
the nutrition of pregnant women and the consequences of
abstinence during pregnancy is given using the family
psychology approach (FASA). Analysis of pre and post-
test using Wilcoxon test. This research was conducted
for 1 month, in July - August 2019.
III. FINDING
A. Univariate Analysis
1) Characteristics of pregnant women
The characteristics of the respondents
examined in this study were the characteristics of
pregnant women which included age, parity and
education.
TABLE 1. FREQUENCY DISTRIBUTION OF CHARACTERISTICS
OF PREGNANT WOMEN IN KUDUS REGENCY
Characteristics
Frequency
Percentage
(%)
Age
<20 years
20-35 years
>35 years
Parity
Primiparitas
Multiparitas
Grandemultiparitas
Education
Elementary school
Junior high
High school
College
0
47
7
31
23
0
3
15
26
10
0
87
13
57,4
42,6
0
5,6
27,8
48,1
18,5
Most of the age of pregnant women are at the
age of 20-35 years by 47 people (87%), these results
reach the conclusion that the majority of pregnant
women in Kudus enter reproductive age and a small
portion enter into high risk gestational age ie age> 35
years. Parity of pregnant women mostly have ≤ 1 child
of 31 people (57.4%) and the average graduated from
high school is 26 (48.1%).
2) Family abstinence traditions
Pregnant women who abstain from eating are a
tradition and advice from the families of pregnant
women themselves.
TABLE 2. FREQUENCY DISTRIBUTION OF ABSTINENCE
TRADITIONS IN PREGNANT WOMEN
Abstinence tradition
Frequency
Percentage
(%)
Mother and Father
Mother and Father-in-law
Husband
Another family
20
24
3
7
37
44,4
5,6
13
Abstinence to eat by pregnant women is largely a
tradition of mothers and fathers-in-law of 24 people
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132
(44.4%), mothers and biological fathers 20 people
(37%), husbands by 3 people (5.6%) and influenced by
other families by 7 people (13%).
B. Bivariate Analysis
Knowledge will influence someone in behaving.
Before being given the knowledge by the FASA method,
pregnant women maintain their womb by not consuming
foods that they deem endanger their womb. After being
given knowledge with the FASA method, pregnant
women know the benefits of foods that have been
avoided.
TABLE 3. STATISTICAL TEST RESULTS FOR DIFFERENCES
IN KNOWLEDGE BEFORE AND AFTER THE FASA METHOD
IS GIVEN
n
Medium
Rerata
±s.b
p
(minimum-
maksimum)
Prior
knowledge
given the
FASA method
Knowledge
after being
given the
FASA method
54
54
2,00
2,29
2,14
2,75
0,001
Statistical test results using the Wilcoxon test
obtained a significance value of 0.001 (p <0.05), thus
conclusions can be drawn related to the knowledge
collected between before giving the FASA method and
supplementing the FASA method.
TABLE 4 STATISTICAL TEST RESULTS OF DIFFERENCES IN
BEHAVIOR BEFORE AND AFTER THE FASA METHOD IS
GIVEN
N
p
Abstinence behavior
before and after given
the FASA method
54
0,001
Based on the results of statistical tests there are
changes in abstinence behavior before and after the
FASA method, with a significance value of 0.001 (p
<0.05), thus there are significant behavioral differences
between before giving the FASA method and after
giving the FASA method.
IV. DISCUSSION
At the age of 20-35 years is a reproductive age,
where a woman with that age is said to be ready to
experience pregnancy. Age can be associated with
personal experience, whatever and is being experienced
by someone will help shape and influence one's social
stimulation. On average, pregnant women experience
pregnancy for the first time (primiparity), so the
experience of pregnancy has not been widely obtained.
This causes respondents to still follow the parents
'recommendations and do the parents' recommendations
to believe in myths. And they cannot fight for fear that
something unexpected will happen in her pregnancy.
Abstinence to eat by pregnant women is largely a
tradition of mothers and father-in-law of 24 people
(44.4%). They believe that pregnant women who abstain
from certain foods while pregnant will provide health
and safety for both mother and baby. The tradition of
abstinence influences one's perception of pregnancy.
Basically, people worry about pregnancy and childbirth.
In the tradition of people who believe in abstinence from
eating during pregnancy, the person will give birth safely
and healthily. However, this assumption can actually
affect the nutritional intake of pregnant women resulting
in pregnant women experiencing malnutrition.
In line with Mohammad research (2016) [15] which
states that cultural influences are still present in our
society in terms of attitudes during pregnancy. Especially
the attitude of pregnant women who still live with
parents, in-laws or relatives who have Javanese traditions
and belief in myths that are still thick, in Javanese
culture there are some restrictions that must be obeyed
by their own husbands or pregnant women, including
husbands or pregnant women are prohibited from
persecuting or killing animals and should not tease
people with disabilities so that when the baby is born not
disabled and perfectly healthy.
Health education in this case is to provide knowledge
to pregnant women and families about the nutrition of
pregnant women which includes nutrition for pregnant
women trimester I, II and III, food to help the growth of
the fetus and due to malnutrition in pregnant women.
This counseling is not only given to pregnant women,
but also to families who are in the same house with
pregnant women.
By providing health education to pregnant women and
families, they not only know, but they understand good
nutrition for pregnant women. This FASA method also
changes family perceptions of abstinence from pregnant
women.
The family is where the individual first gets
education and experience. The family also provides
psychological benefits in the family that provides
benefits regarding the mindset and benefits of positive
thinking of each family member, understanding the
character of each family member, facilitating deeper
interaction, providing the strongest support and
motivation compared to any existing figure and forming
norms behavior in life.
The FASA method puts forward a psychological
approach to pregnant women and families. This
intervention provides knowledge and understanding to
pregnant women and families who abstain from eating,
to better know and understand the nutrition of pregnant
women. The nutritional needs of pregnant women can be
met through nutrition that meets all elements of
nutrients. With the fulfillment of maternal nutrition
during pregnancy, will optimize the process of healthy
fetal development. Besides functioning to help the
process of fetal development, good nutrition also
prevents anemia in pregnant women, premature birth,
LBW, IUGR, infant death, miscarriage and abnormalities
in the central nervous system. From the results of the
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133
FASA method, it is known that knowledge of pregnant
women and families about nutrition of pregnant women
has increased, seen from the knowledge before being
given an intervention and after being given an
intervention. After the intervention of pregnant women
and the family is given a better understanding of the
nutrition of pregnant women, and this can be seen from
changes in behavior of pregnant women who leave
abstinence to maintain the health of the fetus and mother.
V. CONCLUSIONS
From the results of the study it can be concluded that
pregnant women in Kudus Regency are still practicing
abstinence because of family advice. Pregnant women do
not consume or avoid certain foods because they are
recommended or have become a tradition in the family.
The FASA method is very effective to minimize the
abstinence behavior in pregnant women.
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