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Stress, anxiety, and depression among junior high school students in Purwokerto, Indonesia Agustina, Sindy; Elsanti, Devita
Malahayati International Journal of Nursing and Health Science Vol. 7 No. 11 (2025): Volume 7 Number 11
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/minh.v7i11.599

Abstract

Background: Adolescence is a critical phase characterized by rapid physical, psychological, and intellectual development. Adolescents often exhibit a high level of curiosity, boldness, and impulsive behavior, which, if not properly directed, can lead to physical and mental health problems. The impact of mental health disorders in adolescence is far-reaching, affecting not only the current quality of life but also the future potential of individuals and society. Purpose: To determine the level stress, anxiety, and depression among junior high school students in Purwokerto, Indonesia, Method: Quantitative research with descriptive survey type to explore the mental health condition of adolescents with a focus on stress, anxiety, and depression levels. This study was conducted at Telkom Junior High School, Purwokerto. The sampling technique used was purposive sampling and a sample of 114 respondents was obtained according to the inclusion criteria that had been set, namely adolescents aged 11-13 years and in grade 7. Data collection was carried out using an online questionnaire adapted from a validated psychological scale, namely the Depression Anxiety Stress Scales (DASS) and the Kessler Psychological Distress Scale (K-10). Results: The majority of respondents' age data is 12 years old, as many as 83 respondents (72.8%) with an average value and standard deviation of 12.219 ± 0.475, in the age range of 11-13 years. Most respondents are male, as many as 70 respondents (61.4%). Most respondents experience moderate stress, as many as 52 respondents (45.6%), moderate anxiety, as many as 43 respondents (37.7%), and the normal category at the level of depression, as many as 83 respondents (72.8%). Conclusion: Emotional disorders, such as stress, anxiety, and depression are common among students. Sociodemographic factors, including age and gender significantly influence students' mental health. Male students are more susceptible to stress and anxiety, while female students are more susceptible to major depression due to more complex biological and psychological factors. Suggestion: Emotional disorders, such as stress, anxiety, and depression that occur in adolescents do need to be considered by various parties, especially parents who have more time with their children. In addition, schools must create a comfortable school environment and implement school-based mental health programs.
Effect of insulin adherence educational application on adherence and glycemic control in diabetes mellitus patients Prasaja, Sehat Dwi; Elsanti, Devita
Journal of Midwifery and Nursing Vol. 7 No. 2 (2025): May: Law Science and Field
Publisher : Institute Of Computer Science (IOCS)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35335/jmn.v7i2.6121

Abstract

Diabetes mellitus is a chronic disease that requires lifelong management. Patient adherence to insulin use and glycemic control are crucial factors in diabetes mellitus management. However, low adherence and limited knowledge about insulin usage remain common issues. This study aims to evaluate the effect of the Insulin Adherence Educational Application on insulin adherence and glycemic control in patients with type 2 diabetes mellitus. This study employed a pre-experimental design with a pre-test and post-test without a control group. A total of 18 patients with type 2 diabetes mellitus at Prof. Dr. Margono Soekarjo Hospital were selected using purposive sampling. Data collection was conducted through questionnaires and glycemic level examinations. Paired t-test and Wilcoxon test were used for data analysis. The results showed a significant increase in family support, insulin adherence, and glycemic control after the intervention using the educational application (p < 0.05). The Insulin Adherence Educational Application effectively enhances family support, insulin adherence, and glycemic control in patients with type 2 diabetes mellitus. This research provides education, an Android application (aksi patas) to patients suffering from diabetes mellitus, which includes interesting features, especially about diabetes mellitus.
Pelatihan Peningkatan Koping Mekanisme Remaja: Upaya Mencegah Remaja dari Perilaku Self-Harm dan Resiko Bunuh Diri Estria, Suci Ratna; Herdian, Herdian; Fitriana, Nurul Fatwati; Elsanti, Devita; Supriyatno, Supriyatno; Wikantadi, Latief
Jurnal Peduli Masyarakat Vol 7 No 3 (2025): Jurnal Peduli Masyarakat: Mei 2025
Publisher : Global Health Science Group

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/jpm.v7i3.6049

Abstract

Pengabdian ini bertujuan untuk meningkatkan kesehatan mental remaja melalui pelatihan peningkatan koping sebagai upaya untuk mencegah perilaku self-harm dan resiko bunuh diri. Berdasarkan temuan dari diskusi dengan remaja dan guru ditemukan adanya siswa yang berperilaku self-harm, kurangnya pengetahuan remaja terkait kesehatan mental remaja, bahaya ketika masalah mental dibiarkan saja, mekanisme koping adaptif dan maladaptive serta kurangnya ketrampilan dalam melakukan self terapi saat muncul stressor. Kegiatan ini perlu dilakukan untuk memberikan edukasi terkait self-harm, serta mekanisme koping untuk mengatasi stressor remaja, sehingga remaja dapat mengetahui dan memahami tentang masalah mental yang dirasakan dan cara mengatasinya dengan adaptif, sehingga remaja bisa terhindar dari perilaku self-harm. Untuk mengatasi masalah tersebut, tim pengabdian akan melakukan pengabdian dengan pendekatan ceramah, FGD, serta praktik metode hug therapy, terapi 1-5, mindfulness, relaksasi nafas dalam dan relaksasi otot progresif. Evaluasi dan monitoring akan dilakukan untuk memastikan efektivitas program ini. Peserta dalam kegiatan ini sebanyak 62 siswa. Diharapkan pengabdian ini dapat berkontribusi pada peningkatan kesehatan mental remaja dan membantu mereka mengatasi stressor yang sering muncul karena adanya perubahan dan perkembangan saat remaja. Hasil kegiatan didapatkan pengetahuan siswa terkait masalah mental emosional dan koping mekanisme siswa mengalami peningkatan. Simpulan dari pengabdian ini, bahwa edukasi konsep kesehatan mental dan ketrampilan koping mekanisme dapat meningkatkan pengetahuan dan ketrampilan siswa.
Hubungan Pengetahuan Dan Persepsi Body Image Dengan Kesiapan Siswi Menghadapi Menarche Dini Azizah, Syabila Nurul; Elsanti, Devita; Sumarmi, Sumarmi
Jurnal Keperawatan Muhammadiyah Vol 10 No 2 (2025): JURNAL KEPERAWATAN MUHAMMADIYAH
Publisher : UNIVERSITAS MUHAMMADIYAH SURABAYA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30651/jkm.v10i2.26939

Abstract

Objective: : To determine the relationship between the level of knowledge and perception of body image with readiness to face early menarche in Ledug State Elementary School students. Methods: This type of quantitative research with a descriptive analytical design, using a cross-sectional approach, cluster random sampling technique, a population of 128 female students and a sample of 56 female students. The instruments are a questionnaire on the level of knowledge about menstruation, a questionnaire on body image perception, and a questionnaire on readiness to face menarche. Univariate and bivariate data analysis using the chi square test. Results: The level of knowledge has a significant relationship with readiness to face early menarche with a p value of 0.004 (<0.05). Perceived body image has a significant relationship with readiness to face early menarche with a p value of 0.016 (<0.05). Conclusion: The level of knowledge has a significant relationship with readiness to face early menarche with a p value of 0.004 (<0.05). Perceived body image has a significant relationship with readiness to face early menarche with a p value of 0.016 (<0.05).
Pengaruh Buku Pemilkek (Pengetahuan Kehamilan KEK) Terhadap Pengetahuan Dan Sikap Mengenai Kekurangan Energi Kronis Pada Ibu Hamil Di Wilayah Puskesmas Cilongok II Zenipia Artha, Gendis; Aniarti, Reni Purwo; Aprilina, Happy Dwi; Elsanti, Devita
Jurnal Ilmiah Keperawatan STIKES Hang Tuah Surabaya Vol 20 No 1 (2025): March Edition
Publisher : Sekolah Tinggi Ilmu Kesehatan Hang Tuah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30643/jiksht.v20i1.412

Abstract

Latar Belakang: Kehamilan sebagai suatu proses bertemunya sel telur dan spermatozoa di dalam rahim seorang wanita. Kehamilan sebagai sesuatu yang terjadi secara fisiologis dan alami. Salah satu masalah dalam kehamilan yaitu KEK. KEK merupakan kondisi indeks masa tubuh (IMT) pada orang dewasa berada dibawah angka normal <17,00 yang disebabkan karena kekurangan gizi dalam jangka waktu yang lama. Tingginya KEK dipengaruhi oleh beberapa faktor, faktor yang berhubungan erat dengan terjadinya KEK pada ibu hamil adalah pengetahuan gizi. Dimana pengetahuan juga mempengaruhi perilaku dan sikap ibu hamil. Salah satu usaha untuk meningkatkan pengetahuan yaitu dengan edukasi menggunakan buku Pemilkek (Pengetahuan Kehamilan KEK). Tujuan: Untuk mengetahui pengaruh buku pengetahuan kehamilan KEK terhadap pengetahuan dan sikap pada ibu hamil mengenai KEK di wilayah Puskesmas Cilongok II. Metode: Penelitian ini menggunakan pendekatan Pre Experimental dengan desain rancangan one group pre-post tes design. Sampel penelitian ini adalah 88 ibu hamil di wilayah puskesmas cilongok II yang diambil menggunakan teknik simple random sampling. Analisis yang digunakan adalah Uji Wilcoxon Signed Rank Test. Hasil: Terdapat pengaruh yang signifikan terhadap pengetahuan ibu hamil sebelum dan sesudah diberikan intervensi edukasi dengan media buku dengan p value = 0,000 (p<0,05). Terdapat pengaruh yang signifikan terhadap sikap ibu hamil sebelum dan sesudah diberikan intervensi edukasi dengan media buku dengan p value = 0,000 (p <0,05). Kesimpulan: Terdapat pengaruh yang signifikan intervensi edukasi dengan media buku terhadap pengetahuan dan sikap ibu hamil 
Pola Menyusui dan Permulaan Laktasi dengan Kejadian Hiperbilirubinemia Wardani, Eva Cahya; Aprilina, Happy Dwi; Elsanti, Devita; Ekawati, Endah
Jurnal Persatuan Perawat Nasional Indonesia (JPPNI) Vol 10, No 2 (2025)
Publisher : Persatuan Perawat Nasional Indonesia (JPPNI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32419/jppni.v10i2.679

Abstract

ABSTRAKHiperbilirubinemia merupakan masalah kesehatan yang sering terjadi pada bayi baru lahir dan berisiko menimbulkan komplikasi neurologis. Faktor yang berkontribusi terhadap kejadian hiperbilirubinemia ialah pola menyusui dan permulaan laktasi. Tujuan: Penelitian ini bertujuan untuk menganalisis hubungan pola menyusui dan permulaan laktasi dengan kejadian hiperbilirubinemia pada bayi baru lahir di RSUD Prof. Dr. Margono Soekarjo. Metode: Penelitian ini menggunakan desain kuantitatif dengan metode cross-sectional. Sampel terdiri dari 54 ibu postpartum yang dipilih menggunakan teknik purposive sampling. Data dikumpulkan melalui kuesioner pola menyusui, lembar observasi, dan pengukuran kadar bilirubin menggunakan alat transcutaneus bilirubin (TcB). Analisis data dilakukan menggunakan uji Fisher exact. Hasil: Hasil penelitian menunjukkan bahwa sebagian besar responden (74,1%) memiliki pola menyusui yang kurang baik, dan 87% mengalami permulaan laktasi pada hari kedua. Angka kejadian hiperbilirubinemia pada bayi baru lahir mencapai 50%. Uji statistik menunjukkan hubungan signifikan antara pola menyusui dan kejadian hiperbilirubinemia (p = 0,028) serta antara permulaan laktasi dan kejadian hiperbilirubinemia (p = 0,010). Diskusi: Temuan ini menunjukkan bahwa keterlambatan dalam pemberian ASI dan pola menyusui yang tidak optimal dapat memperlambat proses eliminasi bilirubin pada bayi sehingga meningkatkan risiko hiperbilirubinemia. Hal ini menegaskan pentingnya inisiasi menyusui dini dan pendampingan menyusui yang efektif sejak awal kelahiran. Kesimpulan: Pola menyusui yang kurang baik dan permulaan laktasi yang terlambat meningkatkan risiko hiperbilirubinemia pada bayi baru lahir. Oleh karena itu, edukasi laktasi bagi ibu postpartum perlu ditingkatkan untuk mencegah kejadian hiperbilirubinemia. Kata Kunci: ASI eksklusif,  bayi baru lahir, hiperbilirubinemia, permulaan laktasi, pola menyusui Breastfeeding Patterns and Initiation of Lactation in Relation to the Incidence of Hyperbilirubinemia ABSTRACTHyperbilirubinemia is a common health issue in newborns and poses a risk of neurological complications. Two contributing factors to the incidence of hyperbilirubinemia are breastfeeding patterns and the timing of lactation initiation. Objective: This research aims to analyze the correlation between breastfeeding patterns and the initiation of lactation with the incidence of hyperbilirubinemia in newborns at Prof. Dr. Margono Soekarjo Regional General Hospital. Methods: This research employed a quantitative design with a cross-sectional method. The sample consisted of 54 postpartum mothers selected through purposive sampling. Data were collected using a breastfeeding pattern questionnaire, observation sheets, and measurement of bilirubin levels using a Transcutaneous Bilirubinometer (TcB). Data analysis was conducted using the Fisher’s Exact Test. Results: The findings revealed that the majority of respondents (74.1%) exhibited poor breastfeeding patterns, and 87% initiated lactation on the second day postpartum. The incidence of hyperbilirubinemia in newborns reached 50%. Statistical analysis showed a significant correlation between breastfeeding patterns and the incidence of hyperbilirubinemia (p = 0.028), as well as between the timing of lactation initiation and hyperbilirubinemia (p = 0.010). Discussion: These results suggest that delayed breastfeeding initiation and suboptimal breastfeeding patterns may hinder the elimination of bilirubin in newborns, thereby increasing the risk of hyperbilirubinemia. This underscores the importance of early initiation of breastfeeding and effective lactation support from the beginning of birth. Conclusion: Inadequate breastfeeding patterns and delayed initiation of lactation elevate the risk of hyperbilirubinemia in newborns. Therefore, enhanced lactation education for postpartum mothers is essential to prevent the occurrence of hyperbilirubinemia.Keywords: exclusive breastfeeding, newborn, hyperbilirubinemia, initiation of lactation, breastfeeding pattern
Mekanisme koping sebagai kunci resiliensi pada perempuan dewasa muda dengan kanker ginekologi Syahda, Tiara Maulina; Aniarti, Reni Purwo; Yektiningtyastuti, Yektiningtyastuti; Elsanti, Devita
Holistik Jurnal Kesehatan Vol. 19 No. 7 (2025): Volume 19 Nomor 7
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i7.1509

Abstract

Background: The reproductive health of young adult women is vulnerable to disorders, one of which is gynecological cancer, which is the leading cause of death of women in the world and Indonesia. Early detection of cancer, such as through IVA, is still low, including in Central Java. Gynecologic cancer causes physical and psychological distress, so that coping mechanisms and resilience are very important to support patient adaptation. Purpose: To knowing the relationship between coping mechanisms and resilience in young adult women who experience gynecological cancer. Method: This quantitative study used a cross-sectional approach. The sample consisted of 94 respondents aged 20-40 years, using a consecutive sampling method. Data were collected using a questionnaire and analyzed using statistical tests. Data analysis used the chi-square test. Results: The chi square test analysis show that there is a relationship between coping mechanisms and resilience in young adult women who experience gynecological cancer with a p-value of 0.001. Conclusion: There is a relationship between coping mechanisms and resilience in young adult women who experience gynecological cancer.   Keywords: Coping Mechanism; Gynecological Cancer; Resilience.   Pendahuluan: Kesehatan reproduksi wanita dewasa muda rentan terhadap gangguan, salah satunya kanker ginekologi, yang menjadi penyebab utama kematian wanita di dunia dan Indonesia. Deteksi dini kanker, seperti melalui IVA, masih rendah, termasuk di Jawa Tengah. Kanker ginekologi menimbulkan tekanan fisik dan psikologis, sehingga mekanisme koping dan resiliensi sangat penting untuk mendukung adaptasi. Tujuan: Untuk mengetahui hubungan mekanisme koping dengan resiliensi pada wanita usia dewasa muda yang mengalami kanker ginekologi. Metode: Kuantitatif dengan pendekatan cross sectional. Sampel terdiri dari 94 responden yang berusia 20-40 tahun dengan menggunakan metode consecutive sampling. Data dikumpulkan menggunakan kuesioner dan dianalisis menggunakan uji statistik. Analisis data menggunakan uji chi-square. Hasil: Analisis uji chi square menunjukan bahwa terdapat hubungan antara mekanisme koping dengan resiliensi pada wanita usia dewasa muda yang mengalami kanker ginekologi dengan hasil p-value 0,001. Simpulan: Terdapat hubungan antara mekanisme koping dengan resiliensi pada wanita usia dewasa muda yang mengalami kanker ginekologi.   Kata Kunci: Kanker Ginekologi; Mekanisme Koping; Resiliensi.
Kualitas Hidup Terkait Kesehatan Pada Ibu Hamil Pasca Operasi Caesar: Studi Longitudinal Nuryana, Riska; Elsanti, Devita; Sumarmi, Sumarmi
Jurnal Keperawatan Muhammadiyah Vol 9 No 4 (2024): JURNAL KEPERAWATAN MUHAMMADIYAH
Publisher : UNIVERSITAS MUHAMMADIYAH SURABAYA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30651/jkm.v9i4.24937

Abstract

Background: Research focusing on the quality of life after Caesarean Section (CS) and during subsequent pregnancies is still minimal. In addition, research on the quality of life after multiple CSs is still lacking. Several studies focus on the assessment of the quality of life of pregnant women after giving birth by comparing the type of birth: CS versus vaginal delivery (normal delivery). Objective: This study aims to compare the assessment of health-related quality of life in pregnant women who have a history of CS in the first, second and multiple CSs depending on the number of CSs in the pregnant woman's health history. Methods: A short longitudinal study will be conducted on pregnant women with a history of CS on the day before the planned caesarean section (CS)-T1, and on the third day after CS-T2. Pregnant women with a history of CS are divided into three groups. Group 1: never CS; Group 2: ever CS 1 time; Group 3: ever CS two or more times. Pregnant women will fill out a questionnaire regarding respondent characteristics, obstetric history, surgical or anesthesia history and the health-Related Quality of Life (HRQoL) Questionnaire. General linear model for repeated measurement is used by analyzing correlated and non-independent data that are measured repeatedly. Results: The results of this study showed that GLM with repeated measures was conducted to examine the effect of time (time I, time II and time III) on the quality of life variable. The analysis revealed a significant main effect of time, F (2.39) = 4750.43, p-value = 0.000, indicating that quality of life changed significantly at three time points. Conclusion: An individual approach is needed in planning pregnancy after cesarean, especially to prevent long-term health risks. Education and counseling to help mothers understand the recovery process and manage stress or anxiety. This study provides important insights for health professionals to improve post-cesarean services, both in terms of medical interventions and psychosocial support. Keywords : Sectio Caesarea (CS); quality of life; pregnant women, surgery
Dampak Climate Change Dan Ketahanan Pangan Selama Kehamilan Pada Ibu Hamil Di Pedesaan Indonesia: Studi Kualitatif Dampak Badai El Nino Ernawati; Wijaya, Yosi Maria; Elsanti, Devita; Sumarmi, Sumarmi; Rahayu, Mesra
Jurnal Keperawatan Muhammadiyah Vol 9 No 4 (2024): JURNAL KEPERAWATAN MUHAMMADIYAH
Publisher : UNIVERSITAS MUHAMMADIYAH SURABAYA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30651/jkm.v9i4.25026

Abstract

Background: Agriculture and food are negatively impacted by climate change, especially the long dry season caused by El Niño in Indonesia, especially in rural areas. High dependence on rainfall, land, and lack of representation in decision-making groups result in increased challenges and limited adaptive capacity of pregnant women in climate change including its impact on food security. Objectives: This study aims to characterize: 1) sensitivity to decreased food security related to El Niño for pregnant women; 2) pregnant women's perceptions of the impact of El Niño on food security during pregnancy; and 3) changes in food security and maternal and infant health over time, as observed by pregnant women in rural Indonesia. Methods: This study design is a qualitative design. This study was conducted in one district in South Sulawesi and Central Java Provinces. A semi-structured interview guide was used. Data analysis using qualitative thematic analysis methods of data using the constant comparative method. Transcripts were uploaded to NVivo© 12 to facilitate manual coding. with the constant comparative method and thematic analysis. Results: All informants did not know or did not understand the term El Niño. The most felt impacts due to the long dry season are drought and strong winds that make it difficult to obtain food. The way to overcome food insecurity is to utilize food that is still available to be processed into food that can be consumed and shared or shared with family to survive. Conclusion: Climate change has a significant impact on food security, especially in rural areas, which results in the risk of malnutrition in pregnant women.
PERAN ORANG TUA TERHADAP PERTUMB Anak Toddler Ghina, Alviani Fatihatul; Elsanti, Devita
Borobudur Nursing Review Vol 2 No 2 (2022): Borobudur Nursing Review Vol 2 No 2 (July-December 2022)
Publisher : Universitas Muhammadiyah Magelang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31603/bnur.7860

Abstract

Abstract Background: Children are unique individuals and are not miniature of adults. So, they cannot be treated like adults. Moreover, they need special attention to optimize their growth and development. The role of parents as caregivers is very significant for the development of children. In principle, parenting is how parents control, guide, and accompany their children to carry out their developmental tasks towards maturity. Objective: This study aimed to determine the role of parents on toddlers growth and motor development. Methods: This was a descriptive study with a correlation design. The population was 236 parents who have children aged 1-3 years (Toddler) in the area of Puskesmas (Public Health Care Center) Langkaplancar, Ciamis. Then, the samples were 70 of them who were selected using random sampling technique. Afterwards, the chi square statistical test was carried out to determine the relationship between the independent variable and the dependent variable. Results: The result showed that parents played a role in toddlers growth and development. Conclusion: Parents had significant role on the toddlers growth and development in the area of Puskesmas I Langkaplancar Ciamis, Jawa Barat Province indicated by a p-value of 0.000-0.005. Keywords: Growth, Development, Motor, Toddler Abstrak Latar Belakang : Anak adalah individu yang unik dan bukanlah miniatur orang dewasa sehingga tidak dapat diperlakukan seperti orang dewasa, selain itu anak memerlukan perhatian khusus untuk optimalisasi tumbuh kembang. Peran orangtua sebagai pengasuh sangat besar terhadap perkembangan anak. Pada prinsipnya, pola asuh yakni bagaimana orangtua mengontrol, membimbing dan mendampingi anak-anaknya untuk melaksanakan tugas perkembangannya menuju kedewasaan. Tujuan : Untuk mengetahui Peran orang tua terhadap pertumbuhan dan perkembangan motorik pada anak usia Toddler. Metode : penelitian ini termasuk penelitian deskriptif dengan menggunakan rancangan korelasi dengan populasi orang tua yang mempunyai anak usia 1-3 tahun (Toddler) di wilayah Puskesmas Langkaplancar Ciamis sebanyak 236 orang. Tekhnik penentuan sampel dalam penelitian ini menggunakan teknik random sampling sebanyak 70 orang. Untuk menentukan hubungan antara variabel independen dengan variabel dependen dilakukan dengan uji statistik chi square. Hasil : Penelitian ini menunjukkan bahwa orang tua berperan terhadap pertumbuhan dan perkembangan anak usia Toddler. Kesimpulan : Ada peran orang tua terhadap pertumbuhan dan perkembangan anak usia Toddler di Wilayah Puskesmas I Langkaplancar Ciamis Jawa Barat dengan p-value 0,000 < 0,005. Kata Kunci : Pertumbuhan, Perkembangan, Motorik, Toddler