Int. J. Midwifery Res Tarigan et al
Vol 1, No 3, Maret 2022 Toilet Training In Toddler Age Children
Correspondence : Eva Ratna Sari. STIKES Mitra Husada Medan, Indonesia.
[email protected]
43

RELATIONSHIP OF MOM'S KNOWLEDGE ABOUT TOILET TRAINING WITH
MOM'S BEHAVIOR IN TOILET TRAINING IN TODDLER AGE CHILDREN

Eka Falentina Tarigan
1
, Siti Nurmawan Sinaga
2
, Eva Ratna Dewi
3
STIKes Mitra Husada Medan

ABSTRACT
The literature report conducted in Singapore in 2000 showed that 15% of children continued
to wet the bed after 5 years of age and about 1.3% of boys and 0.3% of girls in Indonesia still
had the habit of urinating and defecating indiscriminately. age 7 years, this is due to failure
in toilet training. Failure to toilet training can cause a child to experience enuresis or
bedwetting. This study aims to determine whether there is a relationship between maternal
knowledge about toilet training and mother's behavior in toilet training for toddlers in the
Panei Tongah health center, Simalungun district in 2021. This research is a cross sectional
analytical survey research. The sample in this study amounted to 33. The sampling technique
used in this study used purposive sampling. Of the 33 respondents, mothers with good
knowledge about toilet training had good behavior in training toilet training for toddler age
children, namely 20 people (60.6 %). And based on the results of the bivariate test, the p
value = 0.002 means p value > 0.05 so it can be concluded "There is a relationship between
mother's knowledge about toilet training and mother's behavior in training toilet training in
toddler age children. It is hoped that PMB leaders as health workers need to further increase
mother's knowledge about toilet training, its impact and benefits so that mother's knowledge
will increase about toilet training.

Keywords : Mother's Knowledge, Toilet Training, Toddler

Received : Feb 8, 2022 Received in revised form : Feb 28, 2022 Accepted : Mar 18, 2022
INTRODUCTION

Children are the next generation of
a nation, thus children with good quality
are needed in order to achieve a good
future for the nation. Early childhood is
an individual figure who is undergoing a
development process that is rapidly and
fundamentally for the next life. Early
childhood is at the age of 0-6 years,
children at this age are more sensitive to
receive various stimulations and various
educational efforts from their
environment. To get a good quality child,
it must be ensured that the child's growth
and development is also good. Children as
part of family members, in their growth
and development will not be separated
from the environment that cares for and
also nurtures them.
1
Childhood growth and development
occurs very quickly. This is due to
internal stimuli, namely from heredity and
temperament as well as external stimuli,

Int. J. Midwifery Res Tarigan et al
Vol 1, No 3, Maret 2022 Toilet Training In Toddler Age Children
Correspondence : Eva Ratna Sari. STIKES Mitra Husada Medan, Indonesia.
[email protected]
44

namely from family, peers, life
experiences and elements from the
environment that are obtained by
children.
2
Good growth and development
will produce a quality healthy generation
in the future. One of the important
stimulations during the developmental
period is the stimulation of the child's
independence in urinating. nd defecating
in the toilet. Educating children in
defecating and defecating will be effective
if done early. Good habits in carrying out
urination and defecation that are carried
out from an early age will be carried into
adulthood. One way that parents can do in
teaching defecation and defecation to
children is through toilet training.
3
Toddler age (1-3 years) is usually
used as a benchmark by parents to start
toilet training because at that age all body
functions are mature and stable. Children
aged 3 years in general have been able to
control the bladder during the day and
about 75% of children aged 3.5 years
have not wet the bed at night, because
control of bedwetting at night is usually
achieved at the age of 2.5 - 3.5 years . At
the age of 4.5 years, approximately 88%
of children have been able to control their
bladder adequately and no longer wet the
bed at night. Children aged 5 years will
urinate 5-8 times a day and they will
refuse to urinate if it is not in place and
about 98.5% at this age are able to control
their bladder perfectly (Noer, 2006). Hull
(2008) stated that about 10% of children
aged 5 years still wet the bed and even
less than 5% still wet the bed at the age of
10 years. Behrman et al (1999) also stated
that the prevalence of children who wet
the bed at the age of 5 years was 7% male
and 2% female.
3
Toilet training is an attempt to train
children to be able to control urination
and defecation.
4
This exercise is started
for children aged 1-3 years, because at
this age the ability of the urethral
sphincter to control the urge to urinate
begins to develop. This exercise can be
done by most children independently at
the end of the preschool periode.
5
Through toilet training, children will learn
how to control the urge to defecate which
in turn will make them accustomed to
using the toilet (reflecting regularity)
independently. The close interaction
between parents and children in this toilet
training will make children feel
comfortable, safe and confident. Failures
in toilet training include the habit of
continuous bedwetting (a child who has a
habit of wetting since birth and continues
until he becomes an adult) and the habit

Int. J. Midwifery Res Tarigan et al
Vol 1, No 3, Maret 2022 Toilet Training In Toddler Age Children
Correspondence : Eva Ratna Sari. STIKES Mitra Husada Medan, Indonesia.
[email protected]
45

of defecating carelessly. Reports on the
results of the literature conducted in
Singapore in 2000, namely 15% of
children continue to wet the bed after 5
years of age and about 1.3% of boys and
0.3% of girls in Indonesia still have the
habit of urinating and defecating
indiscriminately at the age of 7 years. ,
this is due to failure in toilet training.
3
The success of toilet training
provides several advantages for children,
such as being able to control urination and
defecation, the beginning of the formation
of independence so that children can do
their own defecation or defecation and
also begin to know some parts of the body
and their functions.
6
Toilet training is also
important in the development of a child's
personality, because toilet training is the
first moral exercise that children receive
and is very influential on subsequent
moral development.
7
The toilet training process carried
out by parents can fail in children. Toilet
training failure may be caused by several
factors, both internal and external.
Internal factors can be in the form of
congenital abnormalities of the urinary
tract, urinary tract infections, polyuria or
neurogenic bladder while external factors
can be in the form of family factors,
especially parents.
5-7

MATERIAL AND METHOD

This research was a cross-
sectional analytic survey research, which
is a study to study the dynamics of the
correlation between Mother's Knowledge
of Toilet Training and Mother's Behavior
in Toilet Training at Toddler Age in the
Panei Tongah Health Center Work Area,
Simalungun Regency in 2021. The
population in this study were all mothers.
who have toddler age children (1 – 3
years) in the Panei Tongah Health Center
Work Area, Simalungun Regency in
2021. The sampling technique used in this
study used purposive sampling, which
was sampling with certain criteria and
goals, namely 33 toddler age children.
This research was conducted in the
working area of the Panei Tongah Health
Center, Simalungun Regency, from May
to June 2021. In the questionnaire,
mothers' knowledge of toilet training was
used. This questionnaire used the
Guttman scale.
The instrument for measuring the
mother's behavior is a questionnaire using
a Likert scale with positive and negative
statements in the form of a checklist.
Univariate analysis aims to explain or
describe the characteristics of each

Int. J. Midwifery Res Tarigan et al
Vol 1, No 3, Maret 2022 Toilet Training In Toddler Age Children
Correspondence : Eva Ratna Sari. STIKES Mitra Husada Medan, Indonesia.
[email protected]
46

research variable. Bivariate analysis was
carried out on 2 variables to determine the
relationship between 2 variables. The
analytical technique used is the chi-square
test using SPSS. The lack of attention and
care of parents so that toilet training is
neglected or toilet training training is too
early.
7
Failure of toilet training caused by
toilet training that is too early can be at
risk of causing urinary tract infections
(UTI) In addition, the failure of toilet
training can cause children to be less
independent, have a selfish attitude,
stubborn, miserly, tend to be careless, and
arbitrarily in carrying out daily activities.
Toilet training failure can also cause
children to experience enuresis or
bedwetting.
7
Factors that influence the success
of the toilet training program include the
motivation of parents and the readiness of
children physically, psychologically and
intellectually. Parents' own motivation is
influenced by intrinsic and extrinsic
factors. Intrinsic factors are
encouragements that come from within a
person in the form of knowledge,
attitudes, mental states, and age maturity
while extrinsic factors are in the form of
facilities, infrastructure, and the
environment.
8
The knowledge of parents,
especially mothers, plays a very important
role in creating good behavior for their
children because parents are a reflection
of their children. The results of research
conducted by Hidayat (2018) on 58
mothers who have preschool-aged
children at Al-Azhar Kindergarten Medan
explain that the description of mother's
knowledge about toilet training in
preschool-aged children is generally good
(60.3%). This is known from the child's
success in carrying out daytime control,
namely being able to maintain and
regulate bowel and bladder in the toilet
throughout the day, without using diapers
or other assistive devices. The results of
another study conducted by Nursila
(2017) on 40 parents with children aged
3-5 years explained that families with
high knowledge had 42.9% of children
who still wet the bed and their families.
9-
10
Humans are born into the world
helpless. According to John Locke's
theory in the 17th century, known as
tabula rasa, explains that every human
being born in the world is like a blank
white paper. And the blank paper is filled
with experience. The blank paper can be
interpreted as the behavior of a child. A
child's behavior is influenced by several

Int. J. Midwifery Res Tarigan et al
Vol 1, No 3, Maret 2022 Toilet Training In Toddler Age Children
Correspondence : Eva Ratna Sari. STIKES Mitra Husada Medan, Indonesia.
[email protected]
47

factors. And the most influencing factor is
family, especially parenting style.
Because a child gains experience and
education for the first time in the family
sphere. And parents have the greatest
control in filling out and writing the white
paper. This means that the role of parents
is very influential in the formation of a
child's behavior.
11
Research conducted by Kurniawati
et al (2007) on preschool children (4-5
years) at TK Sekar Ratih Krembangan
Jaya Selatan, Surabaya stated that 52% of
children wet the bed with a frequency of
very often, 4% often, 36% rarely and 8%
very rarely. This bed-wetting habit, if it
lasts long and long, will interfere with the
achievement of children's developmental
tasks with low knowledge, 66.7% of
children still wet the bed so that the study
concluded that there was no relationship
between parental knowledge and
bedwetting habits in preschool-aged
children.1
0
Based on a preliminary study
conducted by researchers in the Panei
Tongah Health Center Working Area to
10 mothers who had toodler-aged children
(1-3 years) at random, it was found that 6
people (60%) mothers did not teach their
children to go to the toilet and let their
children go to the toilet. their children wet
the bed, 3 (30%) mothers told their
children to go to the toilet but their
children still wet the bed, and only 1
person (10%) mothers ordered and invited
their children to go to the toilet and it was
found that their children rarely wet the
bed. Based on the above phenomenon, it
can be seen that there is still a lack of
attention from parents, especially
mothers, to the toilet training process so
that there are still many children who
have the habit of wetting in the area.
Lack of maternal attention shows
the behavior of mothers who are less
concerned about the toilet training
process. This behavior may be due to the
mother's low level of knowledge about
toilet training. This is in accordance with
Bloom's theory described by Notoatmodjo
(1997 in Sunaryo, 2004) that behavior has
3 domains, namely cognitive, affective
and psychomotor, where the cognitive
domain is measured from knowledge.
12
Based on the above and also
seeing the magnitude of the impact caused
by toilet training failure and not many
studies related to toilet training and bed-
wetting habits, the researchers were
interested in researching "The
Relationship of Mother's Knowledge
About Toilet Training with Mother's
Behavior in Training Toilet Training in

Int. J. Midwifery Res Tarigan et al
Vol 1, No 3, Maret 2022 Toilet Training In Toddler Age Children
Correspondence : Eva Ratna Sari. STIKES Mitra Husada Medan, Indonesia.
[email protected]
48

Toddler Age Children. in the Working
Area of the Panei Tongah Health Center,
Simalu Regency the year 2021"

RESULT

Table 4.1 Frequency Distribution of
Respondents' Knowledge

Knowledge Frequency Percent (%)
Good 22 66,7
Not good 11 33,3
Total 33 100

Based on table 4.1, it can be seen
about the frequency distribution of
respondents' knowledge, the majority of
respondents with good knowledge are 22
respondents (66.7%).

Table 4.2 Frequency Distribution of
Respondents' Behavior

Based on table 4.2, it can be seen
about the frequency distribution of
respondents' knowledge, the majority of
respondents with good behavior are as
many as 24 people (72.7).

Table 4.3 Cross-test between mother's knowledge about toilet training and mother's
behavior in toilet training for toddlers in the Panei Tongah Health Center, Simalungun
Regency in 2021.

No

Knowledge Behaviour
Good Not Good Frequency Sig.p
f % f % f %
1. Good 20 60,6 2 6,1 22 66,7 0,002
2. Not Good 4 12,1 7 21,2 11 33,3
Total 24 72,7 9 27,3 33 100
Based on the table above, it can be
explained that from 33 respondents,
mothers with good knowledge about toilet
training have good behavior in training
toilet training for toddler age children,
namely 20 people (60.6%). And based on
the results of the bivariate test with Chi-
Square, p value = 0.002 means p value >
0.05 so it can be concluded that "There is
a relationship between mother's
knowledge about toilet training and
mother's behavior in training toilet
training for toddler age children in the
work area of the Puskesmas Panei Tongah
Simalungun Regency in 2021"


Behavior Frequency Percent (%)
Good 24 72.7
Not Good 9 27.3
Total 33 100

Int. J. Midwifery Res Tarigan et al
Vol 1, No 3, Maret 2022 Toilet Training In Toddler Age Children

Correspondence : Eva Ratna Sari. STIKES Mitra Husada Medan, Indonesia.
[email protected]
49

DISCUSSION

The results of the study, from 33
respondents, mothers with good
knowledge about toilet training had good
behavior also in training toilet training for
toddler age children, namely 20 people
(60.6%). And based on the results of the
bivariate test with Chi-Square, p value =
0.002 means p value > 0.05 so it can be
concluded that "There is a relationship
between mother's knowledge about toilet
training and mother's behavior in training
toilet training for toddler age children in
the work area of the Puskesmas Panei
Tongah, Simalungun Regency in 2021".
The results of research conducted
by Hidayat (2018) on 58 mothers who
have preschool-aged children at Al-Azhar
Kindergarten Medan explain that the
description of mother's knowledge about
toilet training in preschool-aged children
is generally good (60.3%). This is known
from the child's success in carrying out
daytime control, namely being able to
maintain and regulate bowel and bladder
in the toilet throughout the day, without
using diapers or other assistive devices.
The results of another study conducted by
Nursila (2017) on 40 parents with
children aged 3-5 years explained that
families with high knowledge had 42.9%
of children who still wet the bed and their
families.
10
Research conducted by Kurniawati
et al (2007) on preschool children (4-5
years) at TK Sekar Ratih Krembangan
Jaya Selatan, Surabaya stated that 52% of
children wet the bed with a frequency of
very often, 4% often, 36% rarely and 8%
very rarely. This bed-wetting habit, if it
lasts long and long, will interfere with the
achievement of children's developmental
tasks (Hidayat, 2018) with low
knowledge, 66.7% of children still wet the
bed so that the study concluded that there
was no relationship between parental
knowledge and bedwetting habits in
preschool-aged children.
10
The knowledge of parents,
especially mothers, plays a very important
role in creating good behavior for their
children because parents are a reflection
of their children. Humans are born into
the world helpless. According to John
Locke's theory in the 17th century, known
as tabula rasa, explains that every human
being born in the world is like a blank
white paper. And the blank paper is filled
with experience. The blank paper can be
interpreted as the behavior of a child. A

Int. J. Midwifery Res Tarigan et al
Vol 1, No 3, Maret 2022 Toilet Training In Toddler Age Children

Correspondence : Eva Ratna Sari. STIKES Mitra Husada Medan, Indonesia.
[email protected]
50

child's behavior is influenced by several
factors. And the most influencing factor is
family, especially parenting style.
Because a child gains experience and
education for the first time in the family
sphere. And parents have the greatest
control in filling out and writing the white
paper. This means that the role of parents
is very influential in the formation of a
child's behavior.
11

CONCLUSION

The majority of respondents with
good behavior were 24 people (72.7). Of
the 33 respondents, mothers with good
knowledge about toilet training had good
behavior in training toilet training for
toddler age children, namely 20 people
(60.6 %). And based on the results of the
bivariate test with Chi-Square, p value =
0.002 means p value > 0.05 so it can be
concluded that "There is a relationship
between mother's knowledge about toilet
training and mother's behavior in training
toilet training for toddler age children in
the work area of the Puskesmas Panei
Tongah Simalungun Regency in 2021".
The results of this study can add
insight and knowledge of the author about
knowledge about toilet training will be
related to the behavior of mothers in
training toilet training. Midwives as
health workers need to increase mothers'
knowledge about toilet training, its impact
and benefits so that mothers' knowledge
about toilet training will increase.

ACKNOWLEDGMENT
-
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Vol 1, No 3, Maret 2022 Toilet Training In Toddler Age Children

Correspondence : Eva Ratna Sari. STIKES Mitra Husada Medan, Indonesia.
[email protected]
51

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