FORMULIR FOOD RECALL. Nama bahan hidangan. makanan. ( gr ) Pagi/jam

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1 Nomor sampel FORMULIR FOOD RECALL Nama sampel :. Tanggal : Waktu makan Nama Nama bahan URT Berat hidangan makanan ( gr ) Pagi/jam Jam Siang/jam Jam Malam/jam Jam Enumerator (.)

2 Lampiran 2. Kuesioner Penelitian Hubungan Asupan Protein Dan Zat Besi Dengan Status Anemia Pada Ibu Hamil Di Desa Naga Timbul Kecamatan Tanjung Morawa Kabupaten Deli Serdang Tahun 2014 A. Data Umum Kode responden : Tanggal Wawancara : Alamat : B. Data Responden Nama : Umur : Pendidikan : Penghasilan : Usia kehamilan : Anak ke : Jumlah anak : Jarak kelahiran :

3 C. Perolehan tablet Zat besi No Daftar Pertanyaan Jawaban 1 Apakah ibu pernah mendengar tentang tablet zat besi? 1. Pernah 2. Tidak pernah 2 Jika pernah dari siapa ibu mendengarkan 1. Bidan penyuluhan tersebut? 2. Mantri/perawat 3. Televisi 3 Bagaimanakah bentuk dan warna tablet zat besi tersebut? 1. Merah dan lonjong 2. Merah dan petak 4 Apakah setiap bulan ibu datang ke Posyandu dan diberi tablet zat besi? 1. Ya 2. Tidak 5 Apakah ibu selalu mengkonsumsi tablet zat besi secara teratur? 1. Ya 2. Tidak 6 Dari mana ibu memperoleh tablet zat besi 1. Bidan Desa 2. Perawat keliling 3. Apotik/toko obat 7 Berapa kali ibu mengkonsumsi tablet zat besi dalam sehari 1. 3 x sehari 2. 2 x sehari 3. 1 x sehari 8 Berapa jumlah tablet zat besi ibu peroleh saat kunjungan ke posyandu atau puskesmas? tablet tablet tablet 9 Menurut ibu apakah ada manfaat tablet zat besi bagi kehamilan ibu? 1. Ya 2. Tidak 10 Jika ibu sakit atau mengalami gejala anemia, kemanakah ibu berobat? 1. Bidan desa 2. Posyandu 3. Dukun

4 Analasis Uniariat (Frequency) Umur Responden (tahun) Frequency Valid Valid < 20 thn Thn > 35 thn Frequency Trisemester Valid Valid Frequency Pddk Res Valid Valid SD SMP SMA

5 Penghasilan Frequency Valid Valid < , , > , Protein_Kategorik Frequency Valid Valid Kurang < 70 % Baik >=70% Frequency Fe_Kat Valid Valid kurang< 65% Baik > 65%

6 Hb Kategory Frequency Valid Valid Anemia < 11 gr/dl Tidak anemial = >= 11 gr/dl

7 Analisis Biariat Crosstab Protein_Kategorik * Crosstabulation Anemia < 11 gr/dl Tidak anemial = >= 11 gr/dl Total Protein_ Kurang < Count Kategori 70 % Expected Count k 83.3% 16.7% 100.0% Protein_Kategorik Baik >=70% 90.9% 22.2% 60.0% % of Total 50.0% 10.0% 60.0% Count Expected Count Protein_Kategorik 12.5% 87.5% 100.0% 9.1% 77.8% 40.0% % of Total 5.0% 35.0% 40.0% Total Count Expected Count Protein_Kategorik 55.0% 45.0% 100.0% 100.0% 100.0% 100.0% % of Total 55.0% 45.0% 100.0%

8 Value Chi-Square Tests df Asymp. Sig. (2-sided) Exact Sig. (2- sided) Exact Sig. (1- sided) Pearson Chi-Square a Continuity Correction b Likelihood Ratio Fisher's Exact Test Linear-by-Linear Association N of Valid Cases 40 Point Probability c a. 0 cells (.0%) have expected count less than 5. The minimum expected count is b. Computed only for a 2x2 table c. The standardized statistic is Interval Interval Ordinal Ordinal Symmetric Measures Value Asymp. Std. Error a Approx. T b Approx. Sig. Exact Sig. by Pearson's R c.000 by Spearman Correlation c.000 N of Valid Cases 40 Fe_Kat * Case Processing Summary Cases Valid Missing Total N N N % 0.0% %

9 Fe_Kat * Crosstabulation Anemia < 11 gr/dl Tidak anemial = >= 11 gr/dl Total Fe_Kat kurang< 65% Count Expected Count Fe_Kat 65.5% 34.5% 100.0% 86.4% 55.6% 72.5% % of Total 47.5% 25.0% 72.5% Baik > 65% Count Expected Count Fe_Kat 27.3% 72.7% 100.0% 13.6% 44.4% 27.5% % of Total 7.5% 20.0% 27.5% Total Count Expected Count Fe_Kat 55.0% 45.0% 100.0% 100.0% 100.0% 100.0% % of Total 55.0% 45.0% 100.0%

10 Value Chi-Square Tests df Asymp. Sig. (2-sided) Exact Sig. (2-sided) Exact Sig. (1-sided) Pearson Chi-Square a Continuity Correction b Likelihood Ratio Fisher's Exact Test Linear-by-Linear Association N of Valid Cases 40 Point Probability c a. 1 cells (25.0%) have expected count less than 5. The minimum expected count is b. Computed only for a 2x2 table c. The standardized statistic is Interval Interval Ordinal Ordinal Symmetric Measures Value Asymp. Std. Error a Approx. T b Approx. Sig. Exact Sig. by Pearson's R c.040 by Spearman Correlation c.040 N of Valid Cases 40 Trisemester * Case Processing Summary Cases Valid Missing Total N N N % 0.0% %

11 Trisemester * Crosstabulation Anemia < 11 gr/dl Tidak anemial = >= 11 gr/dl Total Trisemester 1 Count Expected Count Trisemester 9.1% 90.9% 100.0% 4.5% 55.6% 27.5% % of Total 2.5% 25.0% 27.5% 2 Count Expected Count Trisemester 61.5% 38.5% 100.0% 36.4% 27.8% 32.5% % of Total 20.0% 12.5% 32.5% 3 Count Expected Count Trisemester 81.3% 18.8% 100.0% 59.1% 16.7% 40.0% % of Total 32.5% 7.5% 40.0% Total Count Expected Count Trisemester 55.0% 45.0% 100.0% 100.0% 100.0% 100.0% % of Total 55.0% 45.0% 100.0%

12 Value Chi-Square Tests df Asymp. Sig. (2-sided) Exact Sig. (2-sided) Exact Sig. (1-sided) Pearson Chi-Square a Likelihood Ratio Fisher's Exact Test Linear-by-Linear Association N of Valid Cases b a. 1 cells (16.7%) have expected count less than 5. The minimum expected count is b. The standardized statistic is Point Probability Interval Interval Ordinal Ordinal Symmetric Measures Value Asymp. Std. Error a Approx. T b Approx. Sig. Exact Sig. by Pearson's R c.000 by Spearman Correlation c.000 N of Valid Cases 40

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