Student ’ s knowledge of covid-19 positive postpartum mother ’ s c are

The COVID-19 virus initially occurred in China, and there have been nine reported cases of pregnant women and ten babies born exposed to the COVID-19 virus at the Zhongnam Hospital, Wuhan University (Liang & Acharya, 2020). The Indonesian government has designated this nonnatural disaster as a national disaster through the Presidential Decree of the Republic of Indonesia Number 12 of 2020 concerning the determination of the Non-Natural Disaster for the Disease Virus Spread 2019 (COVID -19) as a national disaster so that maternal and neonatal health services are among the affected services. The impact of access and quality led to increased morbidity and mortality of mothers and newborns, so a referral hospital was formed to treat COVID-19 patients with positive OTG, ODP, PDP, or COVID-19 status (Nursalam et al., 2020; Pradana & Casman, 2020; Soedarsono, 2020). Almost all levels of society experience pneumonia-like symptoms, including children, adults, the elderly, pregnant women, newborns, and childbirth3. In Obstetrics and Gynecology patients who confirmed COVID-19 at Fatmawati Hospital, 14% of the 36 who had selfadministered-57 % were waiting for the results. The results of research regarding the picture of anxiety of positive postpartum mothers with COVID-19 using the Postpartum Specific Anxiety Scale (PSAS questionnaire showed that most mothers experienced a high level of anxiety related to the care of their babies. Strict protocols and spiritual biopsychosocial aspects are needed in carrying out treatment management on pregnant women and childbirth (Rochmawati et al., 2020; Setiati & Azwar, 2020; Setiawati et al., 2021). Nursing services as part of health services lead to more professional and quality development (Sharma & Dhar, 2016). Nursing requires continuous education, has a branch of knowledge of skills, abilities, and norms, provides specific services, has authority in decisionmaking and practice, and has a code of ethics as a professional nurse; in this case, students are expected to know about Covid-19 postpartum maternal care so that continuous care can be provided (Crisp et al., 2020). ARTICLE INFORMATION ABSTRACT


Methods
This cross-sectional study applied a consecutive sampling technique to select 57 students in East Jakarta. The descriptive research sample is in a population with a slight prevalence of <20%. This study was conducted from August to December 2020. The sample criteria covered students in semesters 3 and 5 nursing academy whose ages ranged from 18-25. The location of this research is at the Hermina Manggala Husada nursing academy, East Jakarta, which has received Director's permit No.021 / HMH / AKP / VIII / 2020. This research was conducted from August to December 2020. The ethical principles applied in this research have been agreed upon and confirmed as passed the test of ethics by the Health Research Ethic Committee of Poltekkes Jakarta 2 No LB.02.01 / I / KE / 00 / 524/2020.
A knowledge questionnaire about postpartum COVID was developed by researchers with reference (Eisler & Potter, 2014), (Zhou et al., 2020) (Silalahi et al., 2013) and consists of questions and answers related to COVID-19 for pregnancy, childbirth, and breastfeeding. The questionnaire consisted of 15 items with multiple-choice questions. Correct answers are given a score of 1, and incorrectly given a score of 0. Measurement of knowledge with a set of tests/questionnaires about objects to be searched was according to (Putra et al., 2016), who states the level of knowledge categorization as follows, sound: 76 -100%, enough: 50-75%, less: <50%. Constructive validity and reliability were carried out for 36 students in different classes of the nursing academy. This questionnaire has been validated, and the reliability found used Pearson Product Moment; the result of the validity test used r table (α = 5%) and stated that among 16 questions correlation coefficient (r) of 15 items was in a range r count> r table (r table = 0.271). There was only one Rvalue that was not valid because r XY <r table about where you found out about information postpartum COVID-19 positive maternal care. The reliability test showed that Cronbach's alpha score was 0.820, which was more significant than 0.6 and was reliable. Limitations: 1) Items on invalid knowledge instruments are removed; there is no substitute for the same substance; 2 experts do not carry out) instrument development, and content validity is not carried out. 3) the number of samples for construct validity is limited.

Results and Discussion
The respondents' characteristic distribution was listed based on age, gender, semester, school origin, specialization in maternity subjects, and having heard of postpartum maternal care for COVID--19 in the media. Information can be seen in Table 1     The selection of characteristic variables asked of respondents is adjusted from previous research, which attaches characteristic data based on age, gender, college/school origin, and year of study/level of education, intrinsic factors. In contrast, extrinsic factors are information from social media (Mudatsir et al., 2020;Silalahi et al., 2013).
The results showed that most students were at most 19-20 years old with good knowledge, 66.7%. Ages 19-20 years old are the productive age in receiving knowledge. Students are dominated by women with good knowledge, 5.6%, from vocational schools with good knowledge, 7.1%. Based on data from the Indonesian Internet Service Providers Association (APJI) in 2017, of about 143.26 million internet users, 49.52% are dominated by millennials, ranging in age from 19 to 34 years (Syakurah & Moudy, 2020). So, this is in line with the majority of research respondents, namely 20 years old dominated millennials.
Student knowledge is lacking about providing positive education for COVID-19 mothers who breastfeed, 94.74% how to breastfeed as much as 80.7% infected with COVID-19 from mother to baby 77.9%, The findings of this study indicate that knowledge is less than optimal about the care of positive postpartum mothers for COVID-19. The results of Hutahaean's research about the knowledge of nurse students on preventing COVID-19infection showed that nurses have good knowledge, 54.9%, and less knowledge, 45.1% (Hutahaean et al., 2020). This indicates that students need to know about positive maternal care for COVID-19 so they can carry out nursing care well in the hospital.
According to (Silalahi et al., 2013), breastfeeding is a joint decision between health workers, mothers, and families. There are three options for breastfeeding babies born to mothers with suspected and confirmed COVID-19 (depending on the clinical condition of the mother). The first choice is in the clinical condition of the mother being severe so that the mother does not allow expressing breast milk and there are adequate health facilities. The literature study conducted by Yang et al. through a review of 14 studies found that Health students only had an average score on breastfeeding attitudes and had limited knowledge, especially regarding breastfeeding assessment and management (Hutahaean et al., 2020). Families and health workers choose to prevent the risk of transmission by temporarily separating the mother and baby. The nutrient of choice is donor breast milk or formula. The mother can keep pumping to maintain milk production but discard it until the mother is declared cured. The second option is where the clinical condition of the mother is mild/moderate. Families and health workers choose to reduce the risk of transmission and maintain the closeness of mother and baby. The choice of nutrition is expressed in breast milk. The mother wears a mask while expressing herself. Mothers wash their hands with soap and water for at least 20 seconds before expressing themselves (discipline in maintaining hand hygiene). The mother must clean the pump and all equipment that comes in contact with breast milk and the container after every occasion (according to factory manufacturing). Dairy milk is given by health workers or families who do not suffer from COVID-19. Pumps and bottles of breast milk are not shared. Breastfeeding bottles are stored separately from non-COVID-19patients. In the third option, in clinical conditions where the mother is asymptomatic/mild and/or facilities -limited infrastructure or does not allow separate care (Pereira et al., 2020) mother must clean the pump and all equipment that comes in contact with breast milk and the container after every occasion (according to factory manufacturing). Dairy milk is given by health workers or families who do not suffer from -COVID-19. Pumps and bottles of breast milk are not shared. Breastfeeding bottles are stored separately from non-COVID-19 patients. In the third option, families and health workers accept the risk of contracting and reject the temporary separation of mother and baby. Women generally have a better awareness of seeking formal and informal information. The amount of information obtained affects the level of knowledge. Women are psychologically more motivated and diligent in learning and working than men. This is what makes the academic achievement of women better than men. Research conducted at the University of Hertfordshire, England, showed that the concentration level of women was better than that of men (Fitriyanti, 2017). A better concentration level will make the information obtained by a person easier for someone to remember and understand. This causes the level of knowledge in women to be better than in men.
Students are actively studying or learning about positive COVID-19postpartum care from several information and official government websites (Zhong et al., 2020); respondents who had tertiary education/academy in this study were only 52.6%, the rest were high school or equivalent at 46.4%, and 1.1% had less education. The cognitive process uses a procedure to solve problems (Soekidjo, 2010). Knowledge is influenced by a person's experience and the environment, which can then be expressed and believed to give rise to motivation. Occupation and educational/occupational background were found to be associated with the level of knowledge of positive COVID-19 postpartum maternal care. Individuals with an excellent educational background will try to increase their knowledge by accessing information about the COVID-19infection through social media, which is the news source most accessed by nearly 80% of respondents COVID-19, such as WhatsApp, Line, Instagram, and Facebook. According to (Riskesdas, 2018), social media is the main reason for the millennial generation accessing the internet, which is 83.23%, while getting information/news is 68.01%, and for entertainment, it is 46.81% (Budiati et al., 2018). This causes COVID-19 to become a worldwide phenomenon because social media access occurs every second, spreading easily and quickly. Assessment of the second active component is an effort to avoid COVID-19; this supports the adaptation theory, which states that a good level of knowledge can encourage someone to take suitable action, too (Silalahi et al., 2013).
The gender variable statistical test results with good knowledge show that women are better than men. Women are psychologically more motivated and diligent in studying and working than men, which makes the academic achievement of women better than men.
The result of the variable statistical test in semester 5 had better knowledge than in semester 3, which is associated with good knowledge. Semester 5 or longer gets more material than semester three because it affects knowledge, insight, and understanding of information obtained based on experience. Someone's experience will affect the mindset of an action to be taken. The results showed that many students with a high level of knowledge would easily understand that there is a relationship to knowledge, which is in line with the research, that there is a significant relationship between the level of knowledge about postpartum mothers with COVID-19.
The results of the statistical test of variables from schools at most vocational schools, with specialization in maternity nursing, and obtaining information through social media are associated with good knowledge; this is related to the results of research by (Peng et al., 2020) showing Chinese students' knowledge related to COVID-19 with knowledge results was good. The knowledge data of students in Pakistan related to knowledge in preventing COVID-19was good knowledge (Budiati et al., 2018). This is similar to the knowledge data of medical students in India who have poor knowledge regarding COVID-19. In contrast to the results of research on students in the Philippines, knowledge related to the prevention of COVID-19 was obtained with good knowledge results. Knowledge related to COVID-19 was obtained by students from social media, the internet, television, the Ministry of Health, WHO, and friend information (Mas' udi & Winanti, 2020). This article was written by the Indonesian government and the Ministry of Health to take