THE RELATIONSHIP OF ANXIETY LEVEL AND HUSBAND'S

SUPPORT WITH THE CHOICE OF IUD (INTRA UTERINE DEVICE)

CONTRACEPTION AT THE MIDWIFERY CLINIC ADE FIRMAN,
M.KES

PROPOSAL

Arranged by:

Syafira Azlyn
23.15201.0069

BACHELOR'S DEPARTMENT OF MIDWIFERY

FACULTY OF HEALTH SCIENCES
MUHAMMADIYAH UNIVERSITY TANGERANG
[2023/2024]
 FOREWORD

Bismillahir rahmanir Rahim

Assalamu'alaikum Warahmatullahi Wabarakathu

Thank God, the author prays for the presence of Allah SWT because of His blessings and mercy
so that the author can complete the proposal entitled " The RELATIONSHIP OF THE
LEVEL OF ANXIETY AND SUPPORT OF THE HUSBAND WITH THE CHOICE OF
IUD (INTRA UTERINE DEVICE) CONTRACEPTION AT THE ADE FIRMAN, M.KES
MIDWIFERY CLINIC ". The preparation of this proposal was made as one of the
requirements for completing studies and obtaining a Bachelor's degree in Midwifery, Faculty of
Health Sciences at Muhammadiyah University, Tangerang.
The purpose of writing this research proposal is to study how to write a thesis at Muhamadiyah
University, Tangerang.
On this occasion, the author would like to express his thanks to all parties who have provided
moral and material support so that this research proposal can be completed. The author's thanks
go to:
1. My parents have provided prayers, encouragement and enthusiasm during the preparation of
this proposal
2. Mrs. Atnesia Ajeng, S.ST., M.Kes as a lecturer who has educated and provided guidance
during the lecture period
3. I myself have been able to survive from the initial stages to the final stages of studying to
obtain a Bachelor's Degree in Midwifery.
4. As well as proposal research friends who have struggled together with the author in
completing this research proposal

Even though he has tried to complete this research proposal as best as possible, the author
realizes that this research proposal still has shortcomings. Therefore, the author expects
constructive criticism and suggestions from readers in order to improve any deficiencies in the
preparation of this research proposal.

Finally, the author hopes that this research proposal will be useful for readers and other
interested parties.

Tangerang, 09 January 2024

Writer

ii
 LIST OF CONTENTS

COVER
FOREWORD .....................................................................................................................ii
TABLE OF CONTENTS .................................................................................................iii
CHAPTER I INTRODUCTION .......................................................................................1
A. Background .............................................................................................................1
B. Problem Identification ...........................................................................................2
C. Problem Limitation ................................................................................................2
D. Problem Formulation ............................................................................................3
E. Research Objective ................................................................................................3
F. Benefits of Research ...............................................................................................3

CHAPTER II LITERATURE REVIEW .........................................................................4

A. Theoretical Foundation .........................................................................................4
B. Related Research ....................................................................................................7
C. Theoretical Framework .......................................................................................12
D. Conceptual Framework .......................................................................................13

CHAPTER III RESEARCH METHODS ......................................................................14

A. Types and Design of Research ............................................................................14
B. Place and Time of Research ................................................................................14
C. Population and Sample ........................................................................................14
D. Operational Definition .........................................................................................14
E. Research Instrument ............................................................................................14
F. Testing Research Instruments ............................................................................14
G. Data Collection Techniques .................................................................................15
H. Research Hypothesis ............................................................................................15
I. Research Ethics ....................................................................................................16
J. Work Plans and Research Schedules .................................................................16
BIBLIOGRAPHY ............................................................................................................17

iii
 CHAPTER I
INTRODUCTION
A. Background of the problem
Indonesia is one of the most populous countries in the world. The population
explosion is caused by a high population growth rate. This situation clearly gives rise to
two different aspects. On the one hand, this situation may be a great strength for
Indonesia. However, on the one hand, this situation makes the state's burden even heavier
(Welianto, 2020).
In order to achieve balanced population growth and high quality families, efforts
have been made to control the birth rate and reduce the death rate. One plan to reduce
population density is to participate in the Family Planning (KB) program (BKKBN,
2018).
The family planning program is an integrated ( integral ) part of national
development and aims to create economic, spiritual and socio-cultural prosperity for the
Indonesian population so that a good balance can be achieved with national production
capacity. The aim of the family planning program is to create happy and prosperous small
families while the target family planning program, namely couples of childbearing age
(direct targets) and implementers and managers of family planning programs (indirect
targets). (Handayani, 2016).
According to the World Health Organization (WHO), family planning is an action
that helps individuals or married couples to get the birth they want, avoid unwanted
births, regulate the interval between pregnancies, and determine the number of children in
the family. One of the family planning programs is the use of contraception.
contraception. In 2015, contraceptive use in the world was around 64% among married
women of reproductive age, while contraceptive use in Africa was around 33%, Oceania
around 59%, North America around 75%, China 84%, Indonesia 65%, and Asia 57%. 7
The prevalence of contraceptive method use varies throughout the world, IUD
contraception 19%, MOW 14%, pills 9%, condoms 5%, and injections 6%. The use of
short-term methods such as pills, injections and condoms is most widely used in Africa,
Europe, America and Oceania, while long-term methods such as MOW, implants, IUDs
are more widely used in Asia and North America (Suherman, 2017).
To reduce the maternal mortality rate (MMR) and infant mortality rate (IMR), the
government is holding a family planning (KB) program as well as to produce and form
quality families so that it can have a good impact on religion and the country. Ratna, et al
(2023).
The family planning program is an effort to regulate the birth of children, the ideal
birth distance and age , regulate pregnancy through promotion, protection and assistance
in accordance with reproductive rights.
Contraceptive services are a series of activities that include providing IEC,
counseling, medical eligibility checks, contraceptive management, installation or
removal, and management of side effects or complications to prevent pregnancy.
Postpartum Family Planning (PPP) is an effort to prevent pregnancy by using
contraceptive methods/devices/drugs immediately after giving birth up to 42 days/6
weeks after giving birth. Indonesian Ministry of Health (2022).

iv
 Family planning (KB) is one of the most basic and primary preventive health
services for women. Improving and expanding family planning services is one of the
efforts to reduce the very high rates of maternal morbidity and mortality due to pregnancy
experienced by women. Dyah Permatasari (2016).
The IUD contraceptive is a contraceptive method that is carried out by inserting a
special device made of plastic, accompanied by barium sulfate, metal, copper and
progestorone into the uterus. The IUD type of contraception is a long-term contraceptive
method and can be used for up to 5 – 10 years and is effective in reducing pregnancy
rates by 0.6 – 0.8 pregnancies/100 women. The IUD, which is a foreign object, causes a
feeling of anxiety when it is installed. Syurutut Taufiqoh (2020).
Anxiety is influenced by several factors, namely age, education, occupation and
number of children. The factor of young age is that it is easier to experience stress than
old age. The more mature a person's level of thinking increases , the better they will be
able to overcome the problems they face, including anticipating anxiety. Sundeen, S. D.
(2015).
The husband is a motivator, educator and facilitator in selecting family planning
methods. The choice of contraception and satisfaction with its use is greatly influenced
by the husband, the support provided will strengthen the wife's use of contraceptives.
Husband's support in choosing a contraceptive device includes efforts to obtain
information, choose, take them to a service location and pay for the installation of the
contraceptive device. Seeing the large role of husband's support in choosing a
contraceptive method, the researchers wanted to see more about the influence of
husband's support on choosing an IUD method. Syurutut Taufiqoh (2020).
The lack of husband's support often means that the wife does not have the right to
decide when making decisions. Husband's support is the husband's involvement in
providing support to women in carrying out their reproductive duties, for example the
willingness to postpone pregnancy by using an agreed contraceptive method. Ita
Arbaiyah, Nurelila Sari Siregar, Rini Amalia Batubara (2020).

B. Identification of problems
1. The level of IUD use is still very low
2. Anxiety and husband's support are the factors causing the low interest in IUD birth
control

C. Restricting the problem

1. This research only focuses on family planning users at the Ade Firman Midwife
Clinic, M.Kes
2. There are two variables that will be studied, namely the relationship between the level
of anxiety and husband's support and the choice of IUD contraception
3. In taking a sample of 30 family planning users in the fertile age couple (PUS) category
at the Midwife Clinic Ade Firman, M.Kes
4. The research time is approximately 1 month

v
D. Formulation of the problem
Birth control users' anxiety regarding the choice of IUD birth control is influenced
by a lack of knowledge and acceptance of wrong information from the public. Husband's
support is the main trigger for WUS's inactivity to be more open to accepting IUD
contraceptives. In depth, this research answers, how can health workers provide PUS
understanding about the side effects of IUD birth control and educate about IUD birth
control for the health and quality of reproductive organs?

E. Research purposes
To find out the relationship between the level of anxiety and husband's support
with the choice of intrauterine device (IUD) contraception at the midwife clinic, Ade
Firman, M.Kes.

F. Benefits of research
1. Theoretical Benefits
The results of this case study can be used as input to add insight into the case taken.
2. Practical Benefits
a. Student
The results of this case study can be used as input for the midwife profession in its
efforts to provide optimal health services to the community and of course can
provide additional knowledge to the world of midwifery.
b. Educational Institutions
As a theoretical and applicable contribution in comprehensive midwifery care
c. Clients and Society
So that people get health services, especially comprehensive midwifery care

vi
 CHAPTER II
LITERATURE REVIEW

A. Theoretical basis
According to WHO (World Health Organization), family planning is an action
that helps individuals or married couples to achieve certain objectives, to avoid unwanted
births, to get births that are truly desired, to regulate the interval between pregnancies, to
control the time of birth in relation to The age of husband and wife determines the
number of children in the family (Hartanto, 2004).
Family Planning (KB) and reproductive health programs are implemented to
fulfill reproductive rights, so that families can arrange the time, number and spacing of
children ideally according to their wishes or without any element of coercion from any
party. The direct impact of fulfilling reproductive rights is the creation of small, healthy
and prosperous families, so that quality families can be created in accordance with the
vision of the National Family Planning Coordinating Board (BKKBN), namely " Quality
Families 2015".
Contraception is to avoid or prevent pregnancy as a result of the meeting
between mature egg cells and sperm cells. Contraception is an effort to prevent
pregnancy.
Family planning acceptors' knowledge about the use of contraceptives plays an
important role in determining attitudes in choosing contraception. Family planning
acceptors must know and understand the meaning, types of contraception, benefits, how
to use them, side effects and contraindications in using contraceptives. Knowledge and
attitudes are important domains for the formation of actions or behavior. Behavior that is
based on knowledge and a positive attitude will last a long time. ( Tuhu Perwitasari,
2020) .
Contraceptives are one of the tools used to regulate birth spacing and the number
of children. However, contraceptives also have side effects, including bleeding, no
menstruation, spotting and injury to the birth canal when using an IUD, weight gain,
discomfort when having intercourse with a partner and so on. ( Laela Dwi Nur'aini, 2022).
Intrauterine Devices (IUD) is a small object made of flexible plastic, has a
copper coil or also contains hormones and is inserted into the uterus through the vagina
and has threads (Handayani, 2010).
IUD is a contraceptive device that is inserted into the uterus and comes in
various shapes, consisting of plastic (polythyline), some are wrapped in copper (Cu),
some are not, but some are wrapped in copper mixed with silver (Ag). Apart from that,
there are also those whose stems contain the hormone progesterone. (Kusmarjati, 2011).
According to Arum (2011). The types of Intra Uterine Device (IUD) are as
follows:
1. CuT-380 A IUD
It has a small, flexible plastic frame, shaped like the letter T, covered by fine wire
made of copper (Cu).
2. Another IUD circulating in Indonesia is NOVA T (Schering)

vii
 The IUD that is widely used in Indonesia today is the Lippes Loop type and the
medicated type is Cu-T 380 A, Multiload 375 and Nova-T.
a. Lippes Loop IUD Lippes Loop is made of polyethylene, has a spiral shape, the
body contains barium sulfate which makes it radio opaque on X-ray examination.
According to Proverawati (2010), the Lippes Loop IUD is shaped like a spiral or a
continuous letter S. To make it easier to control, a thread is attached to the tail.
Lippes Loop consists of 4 types with different upper length sizes. Lippes Loops
type UD has a low failure rate. Another advantage of this type is that if perforation
occurs it rarely causes injury or intestinal blockage, because it is made of plastic
(Proverawati, 2010).
b. Cu T 380 A IUD Cu – T 380 A is made from T-shaped polyethylene with the
addition of Barium Sulfate. The upright parts of the body are covered with 176 mg
of copper and the middle parts each contain 68.7 mg of copper, with a surface area
of 380 ± 23m2. The size of the vertical section is 36 mm and the transverse section
is 32 mm, with a diameter of 3 mm. At the lower end, a polyethylene monofilament
thread is attached as a control and for removing the IUD.
c. The Multiload 375 (ML 375) IUD is made of polypropylene and has a surface area
of 250 mm2 or a length of 375 mm2 of fine copper wire that wraps around the
vertical stem to increase effectiveness. There are three types of multi load sizes,
namely standard, small and mini. The arm is designed in such a way that it is more
flexible and minimizes expulsion.
d. Nova – T The Nova-T IUD has 200 mm2 fine copper wire with a flexible sleeve
and blunt tip so that it does not cause injury to local tissue when installed. e. The
Cooper-7 IUD is shaped like the number 7 to make installation easier. This type has
a vertical rod diameter of 32 mm and is added with a coil of copper wire (Cu)
which has a surface area of 200 mm2 whose function is the same as the fine copper
coil in the Copper-T type (Proverawati, 2010).
e. The postpartum IUD type of contraception is safe using the Cu T (copper T) IUD,
while the non-copper type requires a delay of up to 6 weeks so it is not suitable for
postpartum (BkkbN, 2018)

The implementation of family programs is included in the medium-term

development plan, namely by carrying out efforts that can increase the use of long-term
contraception. Long-term birth control methods such as IUDs, implants and sterilization.
An intrauterine contraceptive device (IUD) is a contraceptive device that is installed in
the uterus to prevent sperm from entering the fallopian tubes (Anggarini, 2021).
The choice of IUD contraceptive device is influenced by maternal anxiety, long-
term birth control methods such as IUDs, implants and sterilization. An intrauterine
device (IUD) is a contraceptive device that is installed in the uterus to prevent sperm
from entering the fallopian tubes (Dalimawaty, 2021).
Anxiety is a specific condition (situational anxiety) faced in uncertain and
unpredictable situations in connection with the ability to resist trials in the form of
unpleasant feelings experienced by a person, not anxiety as an inherent characteristic of
his personality. (Dias, 2020).
Anxiety can arise influenced by several factors, namely environmental factors,
suppressed emotions, physical causes as interactions between the mind and body, and

viii
hereditary factors. Anxiety has physical symptoms, psychological symptoms, when using
IUD contraception, the symptoms of anxiety often appear as general aggravation, such as
nervousness, annoyance, tension and panic, in addition to feeling sudden headaches,
trembling, sweating, flushed face, dry mouth. indigestion (diarrhea) and frequent
urination. Diana Apriani Putri, Widaryati (2014) .
Husband's support is one source of social support that comes from the family
environment. The husband's role is very much needed by the wife, the involvement and
support given by the husband to the wife will strengthen the relationship between the
couple. The support received by the wife will make her calm and comfortable in making
a decision that has been taken (Asrinah, 2010).
The husband's understanding is an emotional source, information or companion
to deal with every problem and crisis that occurs every day in life, the husband's
understanding has a relationship in making decisions about using contraception. This is
influenced by several factors, for example the husband's lack of knowledge about
contraceptives and the importance of providing support in choosing contraceptives, the
husband's busyness in realizing his role as head of the family in earning a living to meet
the family's needs. (Figure, 2015).
Factors that influence a husband's understanding of contraceptives are level of
knowledge, educational factors, spiritual factors, family practices, socio-economic level
and cultural background factors. According to the researcher's assumption, the husband's
understanding of his wife is because the husband understands his wife's condition and
understands what his wife wants. However, there are also husbands who do not support
their wives' wishes for family planning because they are influenced by environmental
factors, knowledge and religion, where the husband's lack of knowledge is in knowing
the benefits of contraception. (Destyowati, 2012).
Lack of knowledge among potential acceptors greatly influences the use of
MKJP contraception. Several factual findings provide program implications, namely that
when women's knowledge is lacking, the use of contraception, especially MKJP, also
decreases. Proverawati, A. (2016). Guide to Choosing Contraception . Nuha Medica. If
only the target women are always given information, while husbands lack guidance and
approach, husbands sometimes forbid their wives because of ignorance and no
communication to provide knowledge to each other (Fitriyana, 2017).
Mother's anxiety level: Most of the respondents' level of anxiety regarding the
side effects of IUD birth control can be caused by respondents not knowing the side
effects of IUD birth control in the form of vaginal discharge, changes in the menstrual
cycle (generally in the first 3 months and will decrease after 3 months), longer
menstruation and a lot, bleeding (spotting) between menstruation, and when menstruation
is more painful, the increase in respondents who do not know the side effects of IUD
contraception can have unfavorable prejudices against IUD contraception. ( Ratna, et al.
2023).

ix
B. Related research

No Researcher Research Research Results

and Year Title methods
1 Vera Setya The Relationship Quantitative The results of the
Purnaning between the correlation univariate analysis
Anggara (2015) Level of research method showed that the level
Acceptor Anxiety using cross of anxiety with the
and the Choice of sectional data highest presentation
IUD (Intra collection was respondents with
Uterine Device) a severe level of
Contraception at anxiety, namely 19
PKD Kamongan respondents (50%)
Srumbung and it was found that
Magelang the choice of IUD
contraception with
the highest
presentation was
respondents who did
not choose IUD
contraception,
namely 32
respondents
(84.2%) . So it can be
concluded that the
relationship is strong.
2 Dian Selina, The Relationship This type of Bivariate research
Amlah, Reffi between Anxiety research is results of the
Dhamayanti, Level, Education analytical relationship between
Desmansyah and Occupation research with a anxiety level,
(2023) and the Choice of cross-sectional education and
IUD design employment with the
Contraceptive choice of IUD
Devices in contraceptive device
Gunung Meraksa based on the chi
Village square statistical test
of anxiety level p-
value 0.000<0.05 ,
education p-value
0.000<0.05, and
employment p-value
0.000<0, 05 it can be

x
 concluded that there
is a relationship
between the level of
anxiety about
education and work
and the choice of
IUD contraception in
Gunung Meraksa
Village, Lubuk
Batang OKU District
in 2023. There is a
relationship between
the level of anxiety
and the choice of
IUD contraception.
3 Ratna, Irma Relationship This research The results of the
Jayatmi, Ageng between sources method uses a research describe the
Septa Rini of information, descriptive source of
(2023) husband's support analytical design information: more
and level of using quantitative than half of the
anxiety regarding methods with a information source is
the participation cross-sectional from online as much
of IUD birth research design as 20% (44.4),
control acceptors approach husbands do not
support as much as
19 (52.8%), feel
anxious as much as
24 (66.7%) and IUD
family planning
participation is not as
much as 23 (63.9%)
PMB R. The
conclusion of this
research is that there
is a relationship
between information
sources and the
participation of
family planning
acceptors with
(p=0.005 p < a or
0.005 <0.05). There
is a relationship
between husband's
support for the
participation of IUD

xi
 family planning
acceptors with
(p=0.014 p < a or
0.014 < 0.05). there
is a relationship
between the level of
anxiety and the
participation of IUD
family planning
acceptors with
(p=0.010 p < a or
0.010 < 0.05)
4 Dyah Differences in The type of It can be seen that of
Permatasari Anxiety Levels research is the 8 respondents
(2016) of IUD observational who accepted IUD
Contraceptive analytic. The contraception, the
Acceptors With a design used is majority experienced
3-Month cross-sectional severe anxiety, 5
Injection in respondents (62.5%)
Facing Side and of the 66
Effects of respondents who
Contraceptives accepted the 3-month
contraceptive
injection, the
majority experienced
moderate anxiety, 22
respondents (33.3%).
This shows that the
anxiety of IUD
acceptors is greater
than that of 3-month
injectable
contraceptive
acceptors.
5 Fifin Maulidatul The Relationship The research It was found that of
Azizah, Diah between Anxiety method is an the 30 respondents,
Mega Nanda and the Selection analytical most of the levels of
(2019) of Intrauterine correlation design anxiety experienced
Contraceptive with a cross- by respondents
Devices (IUD) in sectional regarding IUD
Injectable Birth approach selection were severe
Control and very severe,
Acceptors in the namely 30% each.
Independent And a small portion
Practice of experienced
Midwife moderate anxiety,

xii
 Suliswinarsih,
SST Probolinggo
District 2019
6 Diana Apriani Factors Analytical survey The p-value of the
Putri, Widaryati Influencing the research uses a relationship between
(2014) Selection of IUD cross-sectional
Contraceptives at time approach
the Jetis Health
Center,
Yogyakarta City
in 2014
7 Nur Faizah, The Relationship This
namely 16.7% or 5
respondents, and it
was found that of the
30 respondents, the
majority preferred
other contraceptives,
namely 83.3% or 25
respondents.
anxiety and the
choice of IUD
contraception is
0.005 < 0.05, so the
statistical test is
significant. The result
of the p-value of
knowledge is 0.109 >
a 0.05 , so the
statistical test is not
significant, the result
of the significant
level of p-value of
husband's support is
0.001 < a 0.05, the
result of the
statistical test is
significant, the result
of the p-value of
confidence is 0.575 >
a 0, 05 then the
statistical test results
are not significant. It
can be concluded that
there is a relationship
between anxiety and
husband's support
with the choice of
IUD contraception
and there is no
relationship between
knowledge and
confidence and the
choice of
contraception.
research The research results

xiii
 Tutik Ekasari, Between Anxiety method uses showed that almost
Mutmainnah Levels and IUD correlation half of the
Zakiyyah (2023) Family Planning analysis with a respondents with
Choices in cross-sectional moderate anxiety, 12
Banyuputih Lor approach people (48%) did not
Village, choose to use IUD
Randuangung contraception. The
District, results of the analysis
Lumajang using SPSS were
Regency obtained with p value
= 0.012 < a = 0.05 .
There is a
relationship between
the level of anxiety
and the choice of
IUD contraception in
Banyuputih Lor
Village,
Randuangung
District, Lumajang
District
8 Syuhrotut Counseling on The method used The mother's anxiety
Taufiqoh, Nur How to Reduce is participatory by is due to fear of
Hidayatul A, Hj. Anxiety Before approaching local experiencing pain
Farida Hajri et al IUD Insertion at community when the IUD is
(2020) PMB Hj. Farida leaders to obtain installed. One of the
Hajri, S.ST., Bd permission and factors in choosing
Surabaya support in an IUD contraceptive
mobilizing related to choosing
women who are an IUD contraceptive
in the postpartum is the fear of side
period. effects. From the
results of the main
complaint,
counseling was given
regarding IUD
installation and then
the mother's anxiety
level was observed
when carrying out
IUD contraception.
9 Maria. TE Koba. Relationship The research used Based on the research
Frans G Mado, between the level an analytical results, respondents
Yoseph Kenjam of knowledge of survey design with more negative
(2019) family planning with a cross- attitudes than
acceptors and the sectional positive attitudes

xiv
 role of health approach mean that
workers with respondents are less
interest in using active towards
long-term MKJP. From the
contraceptive interview results,
methods (MKJP) respondents had a
negative attitude due
to several reasons,
namely fear of
imagining pain and
discomfort after
installing an IUD,
another factor was
anxiety and worry
about their husband
not agreeing to the
use of MKJP.
10 Indra Iswari, Ida Determinants of Data from this All variables in the
Samidah, Maternal Anxiety research will be study were related to
Berlian Knado in Having analyzed using a maternal anxiety with
Sianipar (2022) Contraceptives cross-sectional a p value <0.001.
study as
parametric
research to
determine the
determinants of a
mother's anxiety

C. Theoretical framework
Things that influence the
choice of contraceptions:
1. Knowledge factor
2. Economic factors
3. Education factors
4. Sosio-cultural factors
5. Husband’s support
factor

Selection of IUD
contraseption
Things that influence
husband’s support
1. Intimacy
2. Self-esteem
Choose KB Didn’t choose KB
3. Social skills
xv
4. Income
5. Education level
 : the variable being studied

: variables that are not studied

Source (Notoatmodjo, 2007): (Vita and Fitriana, 2017)

D. Conceptual framework

Independent Variable Dependent Variable

Anxiety level

Selection of IUD
contraseption

Husband’s support

xvi
 CHAPTER III
RESEARCH METHODS

A. Research Types and Designs

This research is an analytical study using a cross-sectional design . The data used
is primary data. Primary data was obtained from filling out questionnaires by respondents
at the Ade Firman, M.Kes Midwife Clinic.

B. Place and time of research

This research was conducted at the Ade Firman, M.Kes Midwife Clinic and the
sample collection time was January 2024

C. Population and Sample

The population in the study were all acceptors of contraceptive pills, injections,
implants and IUDs at the Midwife Clinic Ade Firman, M.Kes. The research sample is
part of the population that meets the criteria for couples of childbearing age (PUS). The
number of samples required is 30 people. Sampling was carried out using the accidental
sampling method , namely sampling by using residents who met the criteria for couples
of childbearing age (PUS) as respondents.

D. Operational definition
Operational definition is defining variables operationally based on observed
characteristics, allowing researchers to make careful observations or measurements of an
object or phenomenon. Hidayat AAA . ( 2019).

E. Research Instrument
The instrument used in this research is a questionnaire which consists of two
parts:
1. Part A: Contains respondent characteristics which include mother's age, husband's
age, mother's education, husband's education, mother's occupation and husband's
occupation.
2. Part B: Contains a husband's support questionnaire. A questionnaire consisting of
20 statements with yes and no options. The husband's support questionnaire
consists of favorable and unfavorable statements. A favorable statement if the
answer is yes, the score is 1 and if the score is 0. The unfavorable statement if the
answer is yes, the score is 0 and if the answer is no, the score is 1.

xvii
F. Testing Research Instruments
Instrument trials were carried out to test whether the measuring instruments used
were valid and reliable. Because by using valid and reliable instruments in data
collection, it is hoped that the research results will be valid and reliable. Therefore, in this
research, a questionnaire trial needs to be carried out to determine the validity and
rehabilitation of the contents of the questionnaire. Apart from that, testing is also
intended to find out whether there are question items that contain answers that are less
objective, less clear or confusing. The instrument trial was carried out by taking 30
respondents taken randomly from the sample .

G. Data collection technique

1. Data processing. Cicik Ratnawati (2019)
The data processing process in this research uses the Statistical Package for Social
Science (SPSS) program with the following stages:
a. Editing
Before the data is processed, editing must be done first . Aims to check data from
data collection including the completeness of answers to questions, the answers
are relevant and consistent.
b. Coding
To make it easier to process the data, coding was carried out on the answers.
Coding or coding is very useful in entering data.
c. Data entry
The answers that have been coded are entered into a computer program.
d. Cleaning
If all the data has been entered, it is checked again to see the possibility of errors,
then corrections are made.
e. Tabulating
Tabulating is entering data into appropriate tables using a computer program.
2. Data analysis
Data analysis was carried out in two stages, namely univariate analysis and bivariate
analysis.
a. Univariate analysis
Univariate analysis is used to explain the characteristics of the independent and
dependent variables. All data in the questionnaire is processed and presented in
the form of a frequency distribution table.
b. Bivariate analysis
Bivariate analysis is used to see the relationship between the independent variable
and the dependent variable using the chi-square test analysis . Through the chi-
square statistic, a p value will be obtained , where in this study a significance
level of 0.05 was used . Research between two variables is said to be meaningful
if it has a p value ≤ 0.05 which means Ho is rejected and Ha is accepted and if it
is not meaningful if it has a p value > 0.05 which means Ho is accepted and Ha is
rejected.

H. Research Hypothesis

xviii
 A research hypothesis is a temporary answer to research, a presumptive or
temporary benchmark, the truth of which will be proven in the research. Notoatmodjo S
(2020). Health research methodology. Jakarta: Jakarta : PT Rineka Cipta. The hypothesis
of this research is:
Ha : There is a relationship between the level of anxiety and husband's support with
the choice of IUD (Intra Uterine Device) contraception at the Midwife Clinic ADE
FIRMAN, M.KES.

I. Research Ethics
The issue of research ethics is a very important issue; considering the research is directly
related to humans. Nursalam. (2021). The ethics of this research include:

1. Consent form ( informed consent )

Consent forms were given to the research sample who agreed to participate in this
study to sign. Before the research sample signed the research consent form, the author
provided information to the research sample about the purpose and voluntary nature
of participating in this research.
2. Confidentiality of name (anonymity)
The questionnaire sheet does not include the names of the respondents so that all
information that has been collected is guaranteed confidentiality by the author, only
certain groups of data will be reported in the research results.
3. The right to guarantee the treatment provided ( right to full disclosure ). The author
provides a detailed explanation of the research that will be carried out and promises to
be accountable to the subject if something happens as a result of the research being
carried out.
4. Benefits _ _
In the sense of the principle that writers must do good, respect human dignity. This
principle states that the best treatment for respondents is necessary. Beneficence
means providing convenience and pleasure to respondents, taking positive steps to
maximize good consequences rather than bad ones.
5. Respect for human dignity ( respect for persons ) Freedom of choice, protection of
subjects whose autonomy is disturbed or lacking and confidentiality of
data/information from subjects.
6. Non-maleficence (not harmful)
Research guarantees that the research carried out will not cause
physical/psychological harm to respondents.
7. Justice or justice
Justice is justice, the author will treat all respondents well and fairly, all respondents
will receive the same treatment from the research conducted by the author.

J. Work Plan and Research Schedule

Month 2023
No Activity
Dec Jan Feb March April

xix
 1 Research preparation stage
a. Preparation and 5555555
submission of titles
b. Submission of proposals 555555
5
c. Research approval 5555555
2 Implementation stage
a. Data collection 555555
5
b. Data analysis 555555
5
3 Report preparation stage 5555555

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