CONTOH KUESIONER PERAWATAN BAYI 1

KUESIONER PENELITIAN SEKOLAH TINGGI ILMU KESEHATANSTIKES NANI HASANUDDIN

“TINGKAT PENGETAHUAN IBU TENTANG PERAWATAN BAYI”MAKASSAR 2010/2011

A.     IDENTITAS WILAYAH1.      Nomor Responden : 2.      Propinsi : 3.      Kabupaten/Kota : 4.      Kecamatan : 5.      Kelurahan/Desa : 6.      Lingkungan : 7.      RW/RW :

B.      IDENTITAS UMUM RESPONDENa.      ORANG TUA (IBU)1. Nama :2. Alamat :3. Umur :4. Agama :5. Status Perkawinan :6. Pendidikan Terakhir :7. Status Pekerjaan :8. Pengalaman Kerja : a. b. c.9. Suku Bangsa :

C.      IDENTITAS BAYI1. Nama : 3. Jenis Kelamin : 5. Anak ke :6. Umur :7. Berat Badan :8. Panjang Bayi :

D.     PERTANYAAN          Pilihan Ganda1. Bagaimana Tingkat pengetahuan Ibu tentang perawatan bayi?a. Sangat tahu c. Kurang tahu

b. Tahu d. Tidak tahue. Lainnya .............................................................................................................. ................................................................................................................................ 2. Ketika anak ibu lahir, Apakah ASI ibu sudah bisa langsung keluar?a. Sangat Banyak c. cukup banyakb. Banyak d. Kurange. lainnya ............................................................................................................... ................................................................................................................................ 3. Apakah Ibu Tahu cara untuk memandikan bayi?a. Sangat tahu c. kurang tahub. Tahu d. tidak tahue. Lainnya .............................................................................................................. ................................................................................................................................ 4. Berapa Kali dalam sehari Ibu memandikan bayi?a. 2 kali sehari c. setiap bayi ganti popokb. 1 kali sehari d. tidak pernah dimandikane. lainnya ............................................................................................................... ................................................................................................................................ 5. Apakah ibu tahu cara membersihkan pusar bayi?a. sangat tahu c. kurang tahub. tahu d. tidak tahue. Lainnya ............................................................................................................. .......................................................................................................................... 6. apakah ibu rutin membersihkan pusar bayi?a. sangat rutin c. sekali dalam setahunb. sekali 6 bulan d. Jika pada saat kotore. Lainnya,............................................................................................................. ............................................................................................................................... 7. sejak umur berapa Ibu memberikan susu formula pada bayi ibu?a. 6 bulan c. sejak lahirb. 7 bulan d. 1 tahune. Lainnya .............................................................................................................. ..... .......................................................................................................................... 8. Apakah ibu tahu cara membersikan telinga bayi anda?a. sangat tahu c. Kurang tahub. tahu d. tidak tahue. Lainnya .............................................................................................................. ................................................................................................................................ 9. Apakah ibu tahu cara memberikan ASI yang benar pada bayi?a. sangat tahu c. kurang tahub. tahu d. tidak tahue. lainnya ............................................................................................................... ................................................................................................................................ 10. Apakah ibu tahu cara menggendong bayi?

a. sangat tahu c. kurang tahub. tahu d. tidak tahue. lainnya ............................................................................................................... ................................................................................................................................ 11. Apakah ibu tahu cara menidurkan bayi?a. sangat tahu c. kurang tahub. tahu d. tidak tahue. lainnya ............................................................................................................... ................................................................................................................................ 12. Apakah ibu rutin memeriksakan bayi ke posyandu?a. Sangat Rutin c. Rutinb. Kadang-kadang d. Tidak pernahe. Lainnya .............................................................................................................. ...................................................................................................................................... 13. Apakah pijitan-pijitan kecil sebelum atau sesudah bayi mandi itu penting?a. Sangat Penting c. Kurang pentingb. Peting d. Tidak pentinge. lainnya ............................................................................................................... ................................................................................................................................ 14. Apakah Imunisasi itu penting menurut ibu?a. sangat Penting c. kurang pentingb. Penting d. tidak pentinge. Lainnya ............................................................................................................. ................................................................................................................................ 15. Apakah ibu rutin membawa bayi ke posyandu?a. sangat Rutin c. Kadang-kadangb. Rutin d. tidak pernahe. lainnya ............................................................................................................... ................................................................................................................................ 16. Apakah Imunisasi itu penting menurut ibu?a. sangat Penting c. kurang pentingb. Penting d. tidak pentinge. Lainnya.............................................................................................................. ................................................................................................................................                      ESSAI1. menurut Ibu, apakah bayi boleh di urut?a. Ya, ...................................................................................................................... ................................................................................................................................ b. Tidak, ................................................................................................................. ................................................................................................................................ 2. apakah ibu melakukan tindakan untuk menghindarkan bayi ibu dari kuman?a. Ya,....................................................................................................................... ................................................................................................................................. b. Tiadak, .............................................................................................................

................................................................................................................................. 3.      apakah ibu memperhatikan tumbuh kembang bayi?a. ya, ...................................................................................................................... ................................................................................................................................ b. Tidak, ................................................................................................................. ................................................................................................................................ 4.      apakah ibu memperhatikan imunisasi yang harus di berikan pada bayi?a. Ya, ...................................................................................................................... ................................................................................................................................ b. Tidak, ................................................................................................................. ................................................................................................................................ 5.      apakah ibu mengetahui standar kebutuhan makanan bayi?a. Ya, ...................................................................................................................... ................................................................................................................................ b. Tidak, ................................................................................................................. ................................................................................................................................ 6. Apakah Ibu melahirkan secara Normal (tanpa sesar)?a. Ya, ...................................................................................................................... ................................................................................................................................ b. Tidak, ................................................................................................................ ................................................................................................................................ 7. Ibu melahirkan di rumah sakit (rumah bersalin)?a. ya, Sebutkan nama rumah sakitnya, .................................................................. ................................................................................................................................. b. Tidak, .................................................................................................................. ................................................................................................................................. 8. Apakah bayi Ibu mecapai berat badan normal?a. Ya, ...................................................................................................................... ................................................................................................................................ b. Tidak, ................................................................................................................. ................................................................................................................................ 9. Apakah Ibu setuju kalau perawatan bayi seharusnya dilakukan di rumah sakit dan bukan di rumah?a. Ya setuju karena:................................................................................................ ................................................................................................................................ b. Tidak setuju,....................................................................................................... ................................................................................................................................ 10. Apakah Ibu memberikan Asi eksklusif yaitu dari umur 0-6 bulan pada bayi ibu?a. Ya, ...................................................................................................................... ................................................................................................................................ b. Tidak, ................................................................................................................. ................................................................................................................................ 11. Apakah ASI untuk si bayi itu penting?a. Ya, .......................................................................................................................

................................................................................................................................. b. Tidak, .................................................................................................................. ................................................................................................................................. 12. Apakah bayi ibu sudah bisa minum ASI secara langsung?..... a. Ya, ....................................................................................................................... ................................................................................................................................ ..... b. Tidak, .................................................................................................................. ................................................................................................................................ 13. Adakah Selain ASI yang ibu berikan kepada bayi anda?..... a. Ya, Ada, .............................................................................................................. ................................................................................................................................ ..... b. Tidak Ada, ........................................................................................................... ..... .......................................................................................................................... 14. Apakah anda mengkomsusi susu ibu menyusui atau vitamin untuk menambah ASI?a. Ya, ...................................................................................................................... ................................................................................................................................ b. Tidak, ................................................................................................................. ..... .......................................................................................................................... 15. Setelah memberi ASI kepada bayi, Apakah bayi sering muntah.?a. Ya, ...................................................................................................................... ................................................................................................................................ b. Tidak, ................................................................................................................. ................................................................................................................................ 16. Apakah bayi anda rewel ketika di beri ASI?a. Ya, ...................................................................................................................... ................................................................................................................................ b. Tidak, ................................................................................................................. ................................................................................................................................ 17. Apakah ibu memberi jadwal makan atau ASI kepada bayi anda?a. Ya, ...................................................................................................................... ................................................................................................................................ b. Tidak, ................................................................................................................. ................................................................................................................................ 18. Ketika anak anda sudah bisa mengkomsumsi selain ASI, apakah ibu memberikan makanan khusus bayi?a. Ya, ...................................................................................................................... ................................................................................................................................ b. Tidak, ................................................................................................................. ................................................................................................................................ 19. Apakah anda tahu standar kebutuhan gizi untuk bayi.?a. Ya, ...................................................................................................................... ................................................................................................................................ b. Tidak,, ................................................................................................................ ................................................................................................................................

20. Adakah mitos atau kebiasaan lain sebelum atau memberikan ASI kepada bayi anda?a. Ya, ...................................................................................................................... ................................................................................................................................ b. Tidak, ................................................................................................................. ................................................................................................................................ 21. Apakah anda bisa memandikan bayi?a. Ya, ...................................................................................................................... ................................................................................................................................ b. Tidak .................................................................................................................. ................................................................................................................................ 22. Apakah ibu memandikan bayi secara rutin?a. Ya, ...................................................................................................................... ................................................................................................................................ b. Tidak, ................................................................................................................. ................................................................................................................................ 23. Apakah ada losien atau minyak oil yang diberikan ke air dan tubuh bayi?a. Ya, ...................................................................................................................... ................................................................................................................................ b. Tidak, ................................................................................................................. ................................................................................................................................ 24. Apakah ibu memberikan shampoo pada bayi tiap kali mandi?a. Ya, ...................................................................................................................... ................................................................................................................................ b. Tidak, ................................................................................................................. ................................................................................................................................ 25. Apakah pijitan-pijitan kecil sebelum atau sesudah bayi mandi itu penting?a. Ya, ...................................................................................................................... ................................................................................................................................ b. Tidak, ................................................................................................................. ................................................................................................................................ 26. Apakah anda merawat bayi anda sendiri (tanpa babysister)?a. Ya, ...................................................................................................................... ................................................................................................................................ b. Tidak, ................................................................................................................. ................................................................................................................................ 27. Apakah ibu, tahu cara menghilangkan biang keringat bayi?a. Ya, ..................................................................................................................... ................................................................................................................................ b. Tidak, ................................................................................................................ ................................................................................................................................ 28. Ketika anak anda sudah bisa mengkomsumsi selain ASI, apakah ibu memberikan makanan khusus bayi?a. Ya, ...................................................................................................................... ................................................................................................................................

b. Tidak, ................................................................................................................. ................................................................................................................................ 29. apakah kamar bayi terpisah dengan kamar ibu?a. Ya, ...................................................................................................................... ................................................................................................................................ b. Tidak .................................................................................................................. ................................................................................................................................ 30. apakah ibu tahu penyebab dari biang keringat pada bayi?a. Ya, ....................................................................................................................... ................................................................................................................................. b. Tidak, .................................................................................................................. ................................................................................................................................. 31. Apakah ada kebiasaan yang aneh, atau ganjil ketika bayi sedang tidur?a. Ya, ....................................................................................................................... ................................................................................................................................. b. Tidak, .................................................................................................................. ................................................................................................................................. 32. Menurut Ibu Apakah boleh bayi pada usia 1-2 bulan sudah bisa tidur secara tengkurap?a. Ya, ....................................................................................................................... ................................................................................................................................. b. Tidak, .................................................................................................................. ................................................................................................................................. 33. Apakah suami anda ikut berperanserta dalam Merawat si kecil?a. Ya, ...................................................................................................................... ................................................................................................................................ b. Tidak, ................................................................................................................. ......................