Paediatrica Indonesiana

VOLUME 44 March - April • 2004 NUMBER 3-4

Original Article

Knowledge, attitude, and practice of underfive children
stimulation of working and nonworking mothers
Trie Hariweni, MD; Muhammad Ali, MD; Sri Sofyani, MD; Iskandar Z Lubis, MD

ABSTRACT organized stimulation will improve faster than those
Objective To assess and compare knowledge, attitude, and prac- who are less stimulated. 2 Some previous studies
tice of underfive children stimulation of working and nonworking supported this issue. Field 3 Stated that tactile/
mothers and to determine the correlation between knowledge, at-
titude, practice of stimulation and mothers’ ages, educational level, kinesthetic stimulation might become a cost effective
number of children, and number of underfive children. way to facilitate growth and behavioral development
Methods A cross-sectional study was performed in PT. Indofood even in very small preterm neonates. while Kuperus4
Sukses Makmur, Tanjung Morawa, Medan from October 2002 un-
til November 2002. Respondents were female workers having supported that children with high biological risk were
underfive children assigned as working mothers and wives of male able to catch up their cognitive delay in a highly
workers (with similar inclusion criteria) assigned as nonworking stimulating home envir-onment.
mothers. Selected respondents were interviewed using a struc-
tured questionnaire. Sample size for each group was 58. Knowl- It is necessary to give an optimal understanding
edge, attitude, and practice of stimulation were classified as good, to mothers concerning the importance of stimulation
less, and poor.
in the growth and development, especially at the criti-
Results There were 131 mothers interviewed. There were no sig-
nificant differences in the ages, educational level, number of chil- cal period, under 5 years of age.5 The economic crisis
dren, and number of underfive children. Good knowledge of stimu- had caused mothers to give more time and attention
lation of the working and nonworking mothers were 64.6% and to outside jobs. Data from National Social Economic
97%, respectively; good attitude toward stimulation were 95.4%
and 27.3%, respectively, while good practice of stimulation were Survey 1999 found that 49.2% of workers were fe-
58.5% and 22.7%, respectively. These differences were statisti- male, 85.8% in formal sector and 14.2% in informal
cally significant.
sector. 6 It was worried that this situation could influ-
Conclusion There were significant differences in knowledge, atti-
tude, and practice of underfive children stimulation between work- ence mothers’ knowledge, attitude, and practice of
ing and nonworking mothers. The knowledge of stimulation of the the aspects of health including the stimulation of un-
working mothers was worse than that of the nonworking mothers der-five children.
and the attitude and practice of the working mothers were better
than those of the nonworking mothers [Paediatr Indones The purposes of this study were to assess and
2004;44:51-54]. compare the knowledge, attitude, and practice of
stimulation between working and nonworking moth-
Keywords: working mother, nonworking mother,
stimulation of children, underfive children

S
From the Department of Child Health, Medical School, University of
trong and productive human resources can Sumatera Utara, Medan, Indonesia.
only be reached through optimizing child
Reprint requests to: Trie Hariweni, MD, Department of VChild Health,
growth and development to his potency.1 Medical School, University of Sumatera Utara, Jalan Bunga lU, Medan,
Children with sufficient structured and North Sumatera, Indonesia.

Paediatrica Indonesiana, Vol. 44 No. 3-4 • March - April 2004 • 51

and number of educational level of the majority of the mothers was under-five children on it. number The practice of stimulation of the mothers is of under-five children) and dependent variables (knowledge. and poor. educational level. The practice 1 47 49 2 17 17 of stimulation was classified into good if correct an.200 df = 1 p = 0. November 2002 at Indofood Sukses Makmur Co. Children rect answers were more than 5 out of 6. The nonworking mothers had better The study was done from October 2002 until knowledge than the working mothers did.0001 52 • Paediatrica Indonesiana.4%). Total 65 100 66 100 131 100 Table 1 shows the characteristics of samples. number of children. high school (47. attitude.April 2004 . less Number of under-five if correct answers were 3-4 out of 6. A cross sectional study was performed by interviewing There was a significant difference in the knowledge working mothers and nonworking mothers who had of stimulation between the working and the nonwork- under-five children. 12-35 mo 28 22 >35 mo 19 18 tions. 3-4 • March . and poor if cor. age. >35 11 9 Differences between qualitative data were as. The working mothers had bet- independent variables (the working status of mothers. educational level. Medan. Paediatrica Indonesiana ers and to determine the influence of mothers’ age. 44 No. High School 35 27 Data were analyzed using SPSS program version 10.3%) and most of the mothers had 3 children or more (38. Variables evaluated were nonworking mothers. and practice of stimulation Characteristics Working status were classified as good. and Number of Children poor if correct answers were more than 5 out of 10. we interviewed 131 Less/poor 23 35 2 3 25 19 respondents. ter attitude than the nonworking mothers did. The number of sample ence in the attitude of the working compared to the based on the formula was 58. 1 17 20 The attitude toward stimulation was classified into 2 26 17 ≥3 22 29 good if correct answers were less than 2 out of 6. CHARACTERISTICS OF SUBJECTS The knowledge. less if correct answers were 3-5 out of 10. using a structured questionnaire. educational level. Table 3 shows that there was a significant differ- Tanjung Morawa. number of children. KNOWLEDGE OF STIMULATION more than 5 out of 6. Knowledge Working status Total Working Nonworking mother mother Results n % n % n % Good 42 65 64 97 106 81 During the study period. and practice of stimulation). ≥3 1 0 swers were less than 2 out of 6. and poor if correct answers were TABLE 2. TABLE 1. less. Level of education Primary School 5 9 sessed by means of chi-square test with p value of less Junior High School 20 22 than 0. Working Nonworking Simple random sampling was done on all female mothers mothers employees who had under-five children (the working n n mother group) and all wives of male employees who Age(years) <20 0 3 had under-five children and had no job outside home 20-35 54 54 (the nonworking mother group). Methods and number of under-five children between the groups. the mothers aged between 20-35 years (82. ing mothers. Most of X2 = 22. attitude. There were no significant differences in age. Table 2 shows level of knowledge of stimulation. 65 working and 66 nonworking mothers. less if correct answers were 3-4 out of 6. Vol.0 Academy/University 5 8 Age of under-five Children Knowledge of stimulation was classified into good <12 mo 18 26 if correct answers were less than 2 out of 10 ques.05 was considered as statistically significant. number of children.9%).

attitude. for the development of children and it is trusted un- nificant correlation with the practice of stimulation.6 Good 38 59 15 23 53 41 The level of education has an important role in Less 27 41 48 73 75 57 Poor 0 0. data of the study showed that This study found that in the working mother 80. attitude. 1. the knowledge of educational level and the knowledge or practice of stimulation of the nonworking mothers was better stimulation. the respondents agreed that stimulation is important while.3% were at the low level of education. 44 No.4% of the working mothers and 3% of relations between educational level and the knowl. 60.855 df = 2 p = 0. in the nonworking mother group. n % n % n % From educational aspect. both in the working (94. Referring to the 2000 TABLE 4. and 30. 64. attitude.8%.3% had high mother group and the nonworking mother group.0001 through the improvement of education. It was different from the Number of children and number of under-five study of Marpaung 8 in the poor urban area of children of the mothers had no correlation with knowl.0 3 4 3 2 the establishment of human resource. there were significant correlations between opment of children. but not with attitude toward stimulation. ing mothers. or practice of stimulation.902 df = 1 p = 0. but not with knowledge and attitude of the mothers..3% were at X2 = 63. and high level of educa- Less/poor 3 5 48 73 51 39 tion. Consequently. The working mothers had better practice than The study showed that there were significant the nonworking mothers did. the nonworking mothers who did not have good edge.7%. Trie Hariweni et al: Under-five child stimulation by working and nonworking mothers TABLE 3.1% of Attitude Working status Total them had 1-2 children. Additionally.4% at the middle level and 64.8%) were at the high level of education. It means that they were in the sonable answer to the fact that the working mothers Paediatrica Indonesiana.7 ers. we could conclude that the condi- n % n % n % tion was improved. than that of the working mothers i. this group was iden- Good 62 95 18 27 80 61 tified as having low. where most of the respondents edge. education of their children. the middle level was 12. This condition shows that the birth control mother mother program needs improvement among this group. awareness of stimulation. der the parents’ care. ers. Looking at the family size. It was only 35.0001 the middle level. women are trusted to provide the beginning of ence between the working and the nonworking moth. The differences between Discussion these two studies were caused by the different char- acteristics of samples and questionnaire used. 49. Most of the respondents in this study (82. The develop- Total 65 100 66 100 131 100 ment of science and technology can only be reached X2 = 18. ATTITUDE TOWARD STIMULATION reproductive age. and high mother mother level was 2.9% of the respondents Total 65 100 66 100 131 100 were at the low level of education. 3-4 • March . knowledge of stimulation of the development of chil- dren. stimulation between the working and the nonwork- cant correlation with the knowledge of stimulation.9% of mothers had good knowledge of the devel- group.e.6%. In the nonworking mother group.6%) were nonworking mothers. 34. it was found that most of but not with the attitude and practice of stimulation.6%. As moth- described in Table 4.9% had more than 3 Working Nonworking children.4%) aged On the other hand. we could not find the rea- between 20-35 years. The development of a country depends prima- rily on the level of education of the people. The data stated that 42. age had signifi. Actually. There was a significant differ. Pulogadung Jakarta. differences in knowledge. and practice of In the working mother group. while the rest (6.April 2004 • 53 . and practice. PRACTICE OF STIMULATION Statistik Kesejahteraan Rakyat which stated that the Practice Working status Total proportion of woman at the low level of education Working Nonworking was 52. 97% vs. Vol. there were no cor. mid. age had sig.

though practice based on adequate tumbuh kembang anak dalam upaya optimalisasi knowledge was maintained longer. Bauer CR. attitude. Uji skrining perkembangan dengan some issues from the previous study which stated that metode Denver II. Jakarta: 1996. 44 No. Gunardi the practice did not depend on the attitude and H. 1997. Effects of biological and social factors on the cognitive Age of the working mothers had significant development of very low birth weight children.11 8. 11. ers but no correlation with the attitude of stimulation. 3-4 • March . Manoeroeng SM. Profil nificant correlation between mother age and the kesehatan Indonesia 2000. Lubis ing and nonworking mothers. 1999. Lubis M. there was a sig. Schanberg SM. American academy of pediatrics. 9. Jakarta: Depkes RI. Smrkovsky M. Care of adolescent par- tice of working mothers were better than those of ents and their children (RE0020). 3. 54 • Paediatrica Indonesiana. Soetjiningsih. This was in line with some p. PKB IKA XXXVII FK The results of statistical test showed that there was UI. Indikator sosial wanita Indone- cant effect on her knowledge of children develop. Badan Pusat Statistik. 10. attitude toward stimulation. 7. the attitude and prac. sia. Field TM. et al. Indonesia. Prinsip-prinsip dasar ilmu kesehatan ferences in the knowledge.92:658-65. 2001. [thesis]. Jakarta: Rineka Cipta. ment and care. sikap dan perilaku orangtua tentang edge of working mothers was worse than that of imunisasi. AAP 1986. 1998. Paediatrica Indonesiana had lack knowledge of stimulation compared with References the nonworking mothers who had appropriate atti- tude and behavior of stimulation. Tumbuh kembang anak. practice of stimulation. of under-five children stimulation between work. and practice masyarakat.77:654-8. 1-94. The correlation with the level of knowledge of stimula. CP. 1999. Garcia R. Tactile/kinesthetic stimulation found that there was a significant correlation between effects on preterm neonates. Majalah Kedokteran Nusantara 1990. Vol. daerah kumuh kelurahan Pulogadung Jakarta. tude. Baerts W. and practice of the mothers of stimulation. Deteksi dan intervensi dini penyimpangan knowledge.107: nonworking mothers. We concluded that there were significant dif. In: Sularyo TS. Pengetahuan. American Academy of Pediatrics 1993. 95-133. Sularyo TS. Jakarta: BP FK UI. in fact. Scafidi F. tion but not with the attitude and practice. Weisglas-Kuperus N. atti. Lubis IZ. There had been 1.1:1-11 the nonworking ones. 9 kualitas sumber daya manusia. editors. Musa DA. 11. Marpaung U. Notoatmodjo S. Hubungan pengetahuan dan perilaku ibu The study did not concern with the aspect of tentang stimulasi dengan perkembangan bayinya di child development according to knowledge. Although the knowl. a significant correlation between the level of education 2. Loebis MS. Sudjarwo SR. 1993 Feb 8. Pemantauan Tumbuh Kembang Balita. One was different from the study of Lubis 10 that found day Seminar dan Training on Pencatatan a significant correlation between the knowledge. and practice of immunization and mother’s Jakarta. In the nonworking mothers. Jakarta: Badan Pusat Statistik. 6. Pentingnya stimulasi mental dini. Departemen Kesehatan Republik Indonesia. Sauer PJ. Vega- This was not in line with the study of Marpaung8 which Lahr N. This 5. p. Pediatrics 2001. Jakarta: EGC. attitude.April 2004 . p. the level of education of the mothers with the level of 4. study which stated that mother’s age gave signifi. 429-34. age. and the knowledge of stimulation of the working moth.

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