18 | pISSN: 1858-3598  eISSN: 2502-5791 

 

Jurnal Ners 
Vol. 13, No. 1, April 2018 
http://dx.doi.org/10.20473/jn.v13i1.5690 

This is an Open Access article distributed 
under the terms of the Creative Commons 

Attribution 4.0 International License  

Original Research 

Family-Based Maternal Sensitivity Model as a Strategy to Optimize Family Perception 
on the Role of Parents and the Growth of Infants 

Diyan Indriyani and Susi Wahyuning Asih 

Faculty of Health Sciences, University of Muhammadiyah Jember, Jember, Indonesia 

ABSTRACT 

Introduction: Family perceptions on the role of parents and the growth 
of infants must be seriously considered by healthcare workers since they 
can affect the role of family development in taking care of the babies. A 
family that has optimally understood the role of their development as a 
parent will be able to give the appropriate care for the babies. 

Methods: The study aimed to find out the effects of a family-based 
Maternal Sensitivity Models (MSM) strategy for family perception 
optimization on the role of parents and the growth of infants. It used a 
quasi-experimental design with the samples of 50 families. The samples 
were obtained using purposive sampling technique. The data were 
analyzed using dependent t-test. 

Results: It confirmed that the Family-Based Maternal Sensitivity Models 
(MSM) strategy significantly affects family perceptions on the role of 
parents with t-value 5.915 and p-value 0.000. MSM also significantly 
affects family perceptions on the growth infants with the t-value -11.257 
and p-value 0.000. 

Conclusion: Maternal Sensitivity Models (MSM) can be well applied as 
one of the health models provided by healthcare workers to optimize 
parents’ perceptions and infants’ growth as well as to develop a 
competent family in giving care for their babies. 

ARTICLE HISTORY 

Received: August 27, 2017 
Accepted: April 18, 2018 

KEYWORDS 

maternal sensitivity model; family 
perceptions; role of parents; growth of 
infants 

CONTACT 

Diyan Indriyani 
 diyanindriyani@unmuhjember.ac.id 
 Faculty of Health Sciences, 
University of Muhammadiyah Jember, 
Jl. Karimata 49 Jember, East Java, 
Indonesia 

Cite this as:  Indriyani, D., & Asih, S. (2018). Family-Based Maternal Sensitivity Model as a Strategy to Optimize Family 
Perception on the Role of Parents and the Growth of Infants. Jurnal Ners, 13(1), 18-23. 
doi:http://dx.doi.org/10.20473/jn.v13i1.5690 

INTRODUCTION 

The birth of a baby is a process that can change the 
life of the family. The presence of a new family 
member makes the family, especially parents, have 
new roles, duties and responsibilities. The process is 
a transitional period that can provide both physical 
and psychological impacts on the developmental 
stage of the family (Wright and Leahey, 2009).The 
transitional period of this stage becomes the trigger 
factor of stress and imbalance in the family if they are 
not able to play their new roles as parents (Friedman, 
Bowden and Jones, 2010). Every family has roles 
related to the responsibilities which must be 
accomplished in order to fulfill the needs of the 
family. 

The role of the family related to the baby is to 
provide infant care and to monitor infant growth 

(Kaakinen et al., 2015). The family has an important 
role to support the parents in caring for their baby. 
However, most parents are less skilled in caring for 
babies, including how to monitor their growth and 
development. This is consistent with the 2004 Infant 
Health and Development (IHDP) survey which found 
that parents are low-skilled in caring for their babies. 
Such condition is caused by many factors, such as the 
dominance of the role of grandmother, grandfather 
and other family members (Indriyani, Asmuji and 
Wahyuni, 2016). This phenomenon often occurs in 
most families in Indonesia because it relates to the 
culture adopted by each family (Asmuji and  
Indriyani, 2014). The research (Asmuji and Indriyani, 
2014) recommends the importance of policy makers 
in formulating programs related to the empowerment 
of families in optimizing their parenthood role. 

https://creativecommons.org/licenses/by/4.0/
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mailto:diyanindriyani@unmuhjember.ac.id
http://dx.doi.org/10.20473/jn.v13i1.5690


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One of the efforts which can solve those problems 
is by improving the ability of families regarding a 
parent’s role and the ability to monitor the growth of 
infants. Maternal Sensitivity Models (MSM), 
developed by the researcher, can be performed to 
conduct those efforts by involving the family as social 
support. This model shows its advantages when the 
family perception increases and the family is actively 
involved in the efforts, in which the function of infant 
care will be better and more appropriate (Dokken and  
Ahmann, 2006). The increase will lead the family to 
work actively and to have expertise in providing 
support to the infant’s parents and monitoring infant 
growth. It will also contribute to the optimization of 
the health status of infants, which is actually the 
mother’s responsibility. The involvement of the 
family in caring for the infant is expected to reduce 
infant mortality rate. 

The present research is similar to the research 
conducted by Mendelson et al. (2013) which showed 
that infant-based psychological intervention could 
prevent postpartum depression and affect social 
support. However, the previous research only 
involved mother and baby in preventing postpartum 
depression while family involvement has not been 
performed optimally. Another similar research 
suggests that a continuing education program 
through public health nurses is important to be 
provided to the family, with limitation only for the 
families who have babies with very low birth weight 
(Pridham et al., 2006). Based on the background, the 
development of Maternal Sensitivity Models (MSM) is 
important to make the interventions more complete 
by involving the family to improve their competence 
in carrying out the role of parents and monitoring 
infant growth (Pontoppidan, 2015).  

Therefore, the aim of this study was to analyze the 
effects of Maternal Sensitivity Models (MSM) in 
regards to the optimization of family perceptions on 
parents’ role and infant growth. 

MATERIALS AND METHODS 

The study used quantitative research with quasi-
experiment design and aimed to analyze the 
effectiveness of Maternal Sensitivity Models (MSM) 
that have been formulated to optimize the family 
perception of parents’ role and infant growth. The 
study was conducted in March-June 2017 in 
Sumbersari and Sukorambi Districts, Jember, East 
Java, Indonesia. 

The data collection was started by measuring the 
family's perceptions on parents’ role and infant 
growth (pre-test) using questionnaires. After the pre-
test, the researchers performed the implementation 
of Maternal Sensitivity Models (MSM) which focused 
on training and education about parents’ role and 
stimulation of infant growth. It was implemented for 
three months with six interventions. The last stage 
was to evaluate the changes in family perceptions 
related to parents’ role and infant growth (post-test). 

The variables consisted of Maternal Sensitivity 
Models (MSM) as independent variable and family 
perceptions of parents’ role and family perceptions 
on infant growth as dependent variables. The 
population of the study was families who have babies 
aged 1-12 months. The sample was 50 families taken 
using purposive sampling with inclusions and 
exclusions criteria. The inclusion criteria were 
families who have babies and babies living at home 
with parents. Meanwhile, the exclusion criteria were 
the baby being sick during the intervention and the 
husband was not at home. The instrument used was a 
questionnaires distribution about family perceptions 
on the optimization of parents’ role and infant growth 
developed by researcher. The scoring system of the 
instrument used numerical data from a score of 20-
100 with parameters measured being cognitive, 
affective and conative components. The reliability 
value of the questionnaire perceptions on the role of 
parents used Cronbach’s Alpha of 0.79 and reliability 
questionnaire perceptions on the growth infants of 
0.81. The data analysis used dependent t-test with α 
(alpha) value of 5% (0.05). 

The study has passed ethical clearance with 
Number 003/KEPK/FIKES/III/2017 issued by the 
Health Research Ethics Committee, Faculty of Health 
Sciences, University of Muhammadiyah Jember on 
March 4, 2017. Thus, the implementation of research 
has also applied the principle of non-maleficence 
ethic where the researchers agree the time of 
implementation of the intervention with the families. 
Another ethical principle is beneficence, by applying 
research benefits to respondents by explaining them 
the benefits of intervention. Another ethical principle 
is also respect of human dignity by means of the 
researchers affording freedom to the families in 
thinking and deciding consciously and without 
applying pressure or coercion to take part or refusing 
participation in the present research, conducted by 
using informed consent. Furthermore, the family-
based Maternal Sensitivity Models (MSM) approach 
can be seen in the figure 1. 

RESULTS 

Table 1 shows that the greatest number of age of 
family is 20-35 years old with 29 respondents (58%). 
The greatest number of the family profession is labor 
and trader with 18 respondents (36%). Table 1 also 
shows that the greatest number of family education 
background is senior high school with 32 
respondents (64%). 

Table 2 shows that family-based Maternal 
Sensitivity Models (MSM) application significantly 
affects family perceptions on the role of the family in 
infant care with p-value 0.000. 

Based on the table 3, it can be seen that family-
based Maternal Sensitivity Models (MSM) application 
also significantly effects the family perceptions on 
infant growth with p-value 0.000. 

 



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DISCUSSION 

The family-based Maternal Sensitivity Models (MSM) 
have a significant effect on family perceptions on 
parents’ role in infant care. The family-based 
Maternal Sensitivity Models (MSM) approach in 
improving family perceptions on parent’s role is in 
accordance with nursing intervention step in Nursing 
Intervention Classification (NICs): designing 
educational  programs  based on family strength, 
identifying personal factors that impact on the 
success of the program (e.g., cultural values, negative 
experiences, time commitments, interests), 
facilitating family discussions on parenting methods, 
teaching the families about physiological, emotional 
and infant care, and helping the families to identify 
evaluation criteria for daily infant care. 

The concept is supported by the results of triple 
parenting program interventions that shows that 
infant care programs which are supported by family 
involvement are proven to be effective in increasing 
family satisfaction in carrying out the role of 
parenting (McConnell, Breitkreuz and  Savage, 2012; 
Williams and Hutchings, 2015). Maternal Sensitivity 
Models (MSM) interventions that make families as 
social support for other family members has formed 
a continuous interaction among family members in 
performing their roles, so that these conditions can 
effectively improve communication and harmony 
within the family. Social support of the family 
(physical, emotional and instrumental supports) in a 
parenting role has formed cognitive and affective 

awareness of the family members so as to perform 
their  role (Padden et al., 2013; Pender, Murdaugh and 
Parsons, 2015). It is also in accordance with the 
results of the research conducted by Pontoppidan 
(2015) suggesting that family involvement programs 
in infant care are effective to overcome the physical 
and psychological problems of infants. Family 
involvement programs in infant care also support the 
success of breastfeeding (Langlois and Smith-Sharp, 
2001; Nuzulia, 2011; Daniels et al., 2015; Swigart et 
al., 2017). 

Instrumental support (such as assisting infant 
care, complementary roles and tasks in fulfilling the 
role of infant care), emotional support (such as praise, 
loving relationship), and information support (such 
as ideas and suggestions) are the key support that 
contributes to the role of family care. Therefore, 
family support is very important for families who 
have babies (Hamilton, 2010) . This is consistent with 
the research (Verhage, Oosterman and Schuengel, 
2015) suggesting that family support affects the 
parents’ role in parenting, so that it affects the baby's 
temperament as well. In contrast, a research 
conducted by Hegedus and Mullan (2015) shows that, 
in Australia, which is a developed country, the family 
support for baby care in supporting the breastfeeding 
process has not yet been performed optimally. 

Family support is a key point in Maternal 
Sensitivity Models (MSM) so that  family perceptions 
of the parent role can be increased. The family is the 
main social support for the developmental stage of 

 

Figure 1. Family-Based Maternal Sensitivity Model in Optimization of Infant Care Competence 

 



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the family with babies because there is a transition  
period into a new family at this stage that requires 
optimal support from other family members 
(Kaakinen et al., 2015). 

The parents’ role in undertaking infant care is very 
important because it affects the physical and mental 
conditions of the baby (Dokken  and Ahmann, 2006; 
Day, Bernheimer and Weisner, 2007). The previous 
research shows that poor baby personality is 
associated with self-efficacy or parenting skills in 
infant care (Padden et al., 2013; Verhage et al., 
2015).Therefore, it needs family support from other 
family members to optimally realize the parents’ role 
(Hickey et al., 2016).Therefore, it needs powerful 
support from other family members in realizing the 
optimal parent role. Maternal Sensitivity Models 
(MSM) use family strength resources and family 
potential as key social support in enhancing the 
parental role so that MSM is proven to improve family 
perceptions on the parental role. 

Another result of the present research also 
confirms that family-based Maternal Sensitivity 
Models (MSM) have an effect on family perceptions on 
infant growth. It becomes something that is rarely 
noticed by families who have babies. The family 
perceptions on infant growth can be well improved 
through family-based Maternal Sensitivity Models 
(MSM). This is because the support provided by the 

family becomes a stimulus that can improve the 
perceptions of other family members, so that there is 
an exchange of information from each family member. 
Also, it indicates that support given to families who 
have babies from other family members can improve 
the health status of the babies, one such is related to 
infant growth (Adema, Clarke and Frey, 2016).  

The families who get full support from family 
members get many benefits for both the family and 
the baby. The family which supports the young 
mother in monitoring the growth of babies, e.g., 
accompanying the young mother in monitoring the 
height and weight and monitoring the development of 
infants in Posyandu or in other healthcare services 
can create harmonious and happy conditions for 
families. 

Programs involving family members, in infant 
care, are also evident by studies showing that family 
support greatly contributes to improving infant 
health and lowers stress levels while undergoing 
infant care (Pontoppidan, 2015).  

One indicator of infant health is infant growth. It is 
influenced by many factors, one of which is the parent 
role. In accordance with the related theory, it shows 
that psychosocial factors are the ability of parents in 
stimulating the development of infants, as well as 
motivation in caring for babies and these can affect 
infant growth and development. Parents who often 

Table 1. Frequency Distribution of the Age, the Profession and Education Background of Families (n=50) 

Demographic Data   Number Percentage 

Age < 20 years old 7 14.0 

20-35 years old 29 58.0 

> 35 years old 14 28.0 

Total 50 100.0 

Profession  Labor and Trader 18 36.0 

Farmer 11 22.0 

Civil Servants 9 18.0 

Self-employed 12 24.0 

Total 50 100.0 

Education Background  Junior High School 14 28.0 

Senior High School 32 64.0 

Higher Education 4 8.0 

Total 50 100.0 

Table 2.  The Effects of Family-based Maternal Sensitivity Models (MSM) to Family Perceptions on Parents’ Role 
(n =50) 

Variable Mean Std. Deviation Std. Error Mean p-Value 

Perceptions of the Role of Parents in Infant Care  

Pre-test 61.00 7.626 1.079 0.00 

Post-test 71.80 8.497 1.202 

Table 3  The Effects of Family-based Maternal Sensitivity Models (MSM) to Family Perceptions on Infant 
Growth (n = 50) 

Variable Mean Std. Deviation Std. Error Mean p-Value 

Perceptions on infant growth  

Pre-test 60.60 7.117 1.007 0.00 

Post-test 76.40 6.627 0.937 

 



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stimulate infant development will have a different 
impact on infant development than the parents who 
never give stimulation for infant growth  
(Hockenberry and Wilson, 2009). 

Family perceptions on infant growth is important 
to be improved since it affects infant growth and 
development. Maternal Sensitivity Models (MSM) 
that make the family as the main social support of 
family perception about baby growth can be 
improved. This is due to the support provided by the 
family to other family members. This opinion is also 
supported by a meta-analysis study showing that 
nursing interventions given by involving families are 
more effective in improving parenting tasks, such as 
monitoring infant growth (Tanninen et al., 2015). 

Nurses who involve families in providing 
interventions have the virtue of being able to see the 
potential of the family and exploiting the potential of 
the family in supporting other family members to 
fulfill their duties and responsibilities in providing 
infant care, including about infant growth, so that 
infant growth can be achieved optimally. 

CONCLUSIONS 

Family is major social support in realizing and 
improving infant health status. A family-based 
Maternal Sensitivity Models (MSM) approach as the 
main social support for other family members 
significantly affects the family perceptions on the 
parent role and infant growth. 

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