Improving adolescents' HIV/AIDS prevention behavior: A phenomenological study of the experience of planning generation program (GenRe) ambassadors as peer educators

Background

Adolescents face increased vulnerability to HIV/AIDS due to factors such as insufficient knowledge and awareness, stigma, and restricted access to information. The Indonesian government initiated a peer education program through the Planning Generation Program (GenRe) ambassadors. These ambassadors are tasked with educating their peers about HIV/AIDS. However, their experiences are largely underexplored.

Objective

This study aimed to explore the GenRe ambassadors' experience in improving adolescents' HIV/AIDS prevention behavior.

Methods

This study employed a qualitative phenomenological approach, with in-depth and semi-structured interviews of GenRe ambassadors who had served for at least three to six months within the South Jakarta Health Sub-Department, Indonesia. Purposive sampling and data saturation techniques were utilized. Data were collected from 13 May to 31 August 2022, and Colaizzi's steps were used to guide the data analysis.

Results

Nineteen GenRe ambassadors participated, predominantly female university students ages 18-22. Six themes were developed: 1) the impact of GenRe ambassadors' roles in improving HIV/AIDS prevention behavior, 2) activities to improve HIV/AIDS prevention behavior, 3) enhancement of self-concept as GenRe ambassadors, 4) obstacles to activities for improving HIV/AIDS prevention behavior, 5) support for activities to improve HIV/AIDS prevention behavior, and 6) hope for improving the GenRe ambassador program's implementation.

Conclusion

GenRe ambassadors are influencers who play a critical role in promoting HIV/AIDS prevention behaviors and fostering positive change in the broader youth community. Despite their positive self-concept, they encounter challenges in fulfilling their roles. Utilizing their insights, community health nurses can create effective peer-led HIV/AIDS prevention programs and contribute to a model of health promotion for adolescents. Leveraging the role of GenRe ambassadors as peer educators is recommended to enhance HIV/AIDS prevention efforts among adolescents.

Family Resilience With Stunted Children Aged Below 5 Years: A Qualitative Study in Depok City, Indonesia

Stunting is influenced by family and household factors that affect toddler nutrition. As the primary provider of both physical and psychological resources to prevent health problems, the family has a significant role in preventing stunting. Family resilience in supporting child health is mediated by family functioning. A qualitative descriptive study explored the influence of family resilience in fulfilling the nutritional needs of stunted children. This study involved in-depth interviews with 23 mothers of stunted children aged 24 to 59 months. Through content analysis, we identified three main themes: (1) family belief that stunting is hereditary, (2) family belief that stunted children will "grow up," and (3) lack of communication between family members in discussing stunting. Future studies should explore intervention models to increase family resilience and prevent stunting in children under five.

The effect of MARIKERJA, a fatigue management programme, on the management of fatigue among manufacturing shift workers in Indonesia

OBJECTIVES

To evaluate the effects of a workplace fatigue management programme called MARIKERJA on reducing fatigue among manufacturing shift workers in Indonesia.

METHODS

A quasi-experimental pre- and post-test study was conducted among 116 shift workers (58 in the intervention group and 58 in the control group). The MARIKERJA programme was delivered to the intervention group for 12 weeks. Meanwhile, the control groups received the MARIKERJA intervention only at the end of the study period. Fatigue levels were measured using the Fatigue Severity Scale (FSS) in weeks 6 and 12 of the intervention. Data were analysed using a t test and a general linear model repeated measures procedure.

RESULTS

There were significant differences in fatigue scores between the control and intervention groups after the MARIKERJA intervention in week 6 (40.07 ± 8.89 vs. 27.12 ± 11.67; p < 0.001) and week 12 (38.22 ± 9.28 vs. 17.53 ± 6.54; p < 0.001). The MARIKERJA intervention effectively reduced fatigue levels by up to 37.3% (R² = .373; p = 0.001; 95% CI = 15.82-19.25).

CONCLUSIONS

The MARIKERJA intervention effectively reduces fatigue among manufacturing shift workers.

Public Health Interventions to Reduce Stunting in Toddlers: A Systematic Review

BACKGROUND: Handling stunting in toddlers is not only the responsibility of the government, but the most important thing is family and community responsibility. Public health interventions involving the family and community are important for stunting prevention because the family environment is one of the factors that determine the provision of adequate conditions for the nutritional status and development of children. AIM: The purpose of this systematic review is to synthesize various public health interventions that are practice-based evidence derived from programs implemented to reduce stunting in toddlers. METHODS: Initial steps doing this systematic review articles included in this study were retrieved from ProQuest, EBSCOhost, MEDLINE/CINAHL (Academic Search Complete) that were published within 2011–2019 and written in English. Study Quality Assessment was done using keywords and by assessing compatibility of the articles with the study context. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was used to analyze the found articles. RESULTS: After filtering process, there were 11 articles from 859 articles emphasize on using a combination of two or more Public Health Interventions to reduce stunting in toddlers. The most common public health interventions done to reduce stunting in toddlers are health teaching, counseling, collaboration, and community organizing. CONCLUSIONS: Here, we show that public health interventions performed by public health nurses to reduce stunting require the involvement of the community itself, especially the family. Public health interventions can be combined with one or more other public health interventions to increase success in preventing stunting in children under five.

Nurses' efforts to maintain competence: a qualitative study

Background: The clinical competence of nurses should be maintained to ensure patient safety. Competence is the integration of knowledge, skills, and attitudes. Nurse competency also improves the quality of nursing care and reduces the incidence of missed nursing care. This study aimed to explore the experiences of nurses maintaining a nurse competence system in hospitals through continuing education.

Design and Methods: The research method used was qualitative phenomenological research, and the data was collected through an in-depth interview which was consist of six participants.

Results: The results of the research were 1) continuing professional development to maintain the competence, 2) credentialing system in the career ladder system, 3) missed care still occurred in the implementation of nursing services 4) nurses had hopes that managers supported the efforts to maintain competence through continuing professional development.

Conclusions: Nurse managers are expected to improve the supervision program to maintain clinical competence and decrease missed care.

UTILIZATION OF INFORMATION TECHNOLOGY IN PREVENTION OF DEPRESSION IN OLDER ADULTS

Depression is a problem that often occurs in the older adults population. The use of technology in the implementation of health services has succeeded in increasing the effectiveness and quality of providing health services to patients. Several mobile apps that have been available have the potential to improve services for people with depression. The purpose of this study was to determine the use of information technology in preventing depression in older adults. This study uses a simple literature study method based on a specific theme from several databases including the Cumulative Index to Nursing and Allied Health Literature (CINAHL), ProQuest, and SAGE between 2014 and 2020. 27 journal articles that met the inclusion criteria passed the screening process using the PRISMA diagram. Research showed positive results in the use of technology for depressive conditions experienced by older adults. The importance of developing health applications in order to keep up with the conditions needs to be the attention of health workers. Easy, inexpensive, and attractive health applications can increase public curiosity and participation in the health sector.

Dementia: How does spouse perceive it?

The study aimed at finding how spouses perceive the condition of dementia experienced by their husband/wife in Bekasi, Indonesia. This study was qualitative research with a descriptive phenomenology approach involving 10 participants according to predetermined criteria. The results found 3 themes consisting of psychosocial responses of caregivers, caregivers' burden, and positive responses of caregivers during caring for their spouse. There are 3 sub-themes in the first theme, 3 sub-themes in the second theme, and 3 sub-themes in the third theme. The various responses, both negative and positive experienced by caregivers show that being a caregiver for spouse with dementia is not easy. It needs a professional assistance by health personnel to help caregivers understand the dementia-related problems.

Common symptoms of Alzheimer's dementia that are easily recognizable by families

The increase in dementia incidence among the elderly is directly related to aging, which is associated with changes in bodily functions and other health-related risk factors. Alzheimer's dementia is the most prevalent form of dementia, and individuals in the late stages are predominantly dependent on other family members. Therefore, it is important for families, as the closest support group, to recognize common symptoms early.

Coronavirus Disease-19: Public Health Nurses’ Knowledge, Attitude, Practices, and Perceived Barriers in Indonesia

BACKGROUND: The coronavirus disease (COVID)-19 outbreaks and its rapid rise in prevalence has been a major concern internationally. We conducted a short survey to understand the knowledge, attitude, and practices regarding COVID-19 and estimated barriers to disease transmission perceived by public health nurses (PHN) in Indonesia. AIM: The study aimed to identify the association of sociodemographic characteristic with knowledge, attitude, and practices regarding COVID-19 among PHNs in Indonesia and highlight barriers to the control of infection perceived by PHNs. METHODS: A national, online, and cross-sectional survey was conducted from May 28 to June 9, 2020, with a total of 368 participants. A questionnaire was used to assess knowledge, attitude, and practice. An independent t-test was used to compare attitude differences of PHNs in gender and place of work. One-way analysis of variance was used to compare differences in attitude of PHNs by age, work experience, educational level, and source of information. The Pearson’s correlation test was used to measure the correlation between knowledge, attitude, and practices. RESULTS: The majority of participants had good knowledge of COVID-19 (77.4%), had mean scores of attitude toward COVID-19 of 33.0 ± 2.7, and had good practices regarding COVID-19 (84.2%). Factors associated with knowledge were sources of information (p = 0.013). Factors associated with attitude were gender (p = 0.003), work experience (p = 0.010), and sources of information (p = 0.035). Factors associated with practices were gender (p = 0.011) and sources of information (p = 0.029). There were significant, positive linear correlations between knowledge and attitude (r = 0.435, p = 0.000), knowledge and practices (r = 0.314, p = 0.000), and attitude and practices (r = 0.362, p = 0.000). Most participants strongly agreed that limitations on infection control materials (50.8%) and patients hiding their travel history, resulting in screening inaccuracies (59.8%), were barriers. CONCLUSIONS: A significant association between sources of information and knowledge, attitude, and practices, with the addition of other related factors. There were also significant positive linear correlations between knowledge, attitude, and practices. Nevertheless, the majority of the PHN perceived that limitations on infection control materials and patients hiding their travel history, resulting in screening inaccuracy, were major barriers.

Pengalaman Lansia dengan Demensia Ringan-Sedang Dalam Melakukan Komunikasi dengan Pelaku Rawat: Systematic Review

<p><em>Dementia is a progressive decline in cognitive abilities that characterized by memory loss that affects everyday abilities. One of the most common problems in elderly with dementia is communication problem. The purpose of this systematic review is to explore the experience of elderly with mild-moderate dementia in communicating with caregivers. This article uses the systematic review method to all selected articles. Through this systematic review approach, six selected themes in phenomenology journals explain that elderly with mild-moderate dementia can describe the symptoms of dementia experienced, feelings of loss and stress caused of dementia, negative stigma towards elderly dementia, loss of control and desire to make their own decisions, and problems in interpersonal relationships. The ability of elderly with mild-moderate dementia in communicating their experiences when interacting with caregivers can be a consideration for caregivers in making decisions related to the condition of their experience in elderly with dementia</em></p><p> </p><p><em>Demensia merupakan penurunan secara progresif pada kemampuan kognitif yang ditandai dengan </em><em>kehilangan memori yang mempengaruhi kemampuan sehari-hari. Salah satu masalah yang cukup dominan dirasa pada lansia demensia yaitu masalah di dalam komunikasi. Tujuan dari penulisan ini adalah untuk melihat pengalaman lansia dengan demensia ringan-sedang dalam melakukan komunikasi dengan pelaku rawat. </em><em>Artikel ini menggunakan metode penulisan systematic review </em><em>terhadap artikel terpilih. Melalui pendekatan systematic review ini, enam</em><em> jurnal fenomenologi terpilih menyebutkan bahwa </em><em>tema-tema yang muncul saat lansia dengan demensia ringan-sedang melakukan komunikasi dengan pelaku rawat</em><em>, diantaranya lansia mampu untuk menceritakan gejala demensia yang dialami, perasaan kehilangan dan tertekan, stigma negatif orang lain, kehilangan kendali dan keinginan untuk mengambil keputusan sendiri, serta masalah di dalam hubungan interpersonal</em><em>. Kemampuan lansia dengan demensia ringan-sedang dalam mengungkapkan pengalamannya ketika berinteraksi dengan pelaku rawat dapat menjadi pertimbangan bagi pelaku rawat dalam menentukan keputusan pemberian pelayanan berkaitan dengan kondisi demensia yang dialaminya</em></p>

Effectiveness of balance exercise among older adults in Depok City, Indonesia

OBJECTIVE

Falls are a serious problem for older adults. Balance impairment is one of the most significant reasons why adults fall from a standing position. This study aims to investigate the effect of an eight-week postural balance exercise intended to reduce the risk of falls among older adults in a community in Depok City, Indonesia.

METHOD

This quasi-experimental study employed a pre- and post-test design using a control group. The study involved an intervention group of 30 respondents and a control group of a further 30 respondents. The sample was selected using multistage random sampling. The data were analyzed using a t-test.

RESULTS

The balance exercise significantly affected the respondents' postural balance and reduced their risk of falling. There were significant differences between the two groups (intervention group and control group) in postural balance (p < 0.001) and the risk of suffering a fall (p = 0.023). CONCLUSIóN: Balance exercises can be utilized as one of the preventive efforts to maintain postural balance and reduce the risk of falls among older adults. Future studies may consider the variation of age to more accurately determine the effectiveness of this balance exercise.

PENINGKATAN KEMAMPUAN DAN PENURUNAN TEKANAN DARAH PADA AGREGATE DEWASA HIPERTENSI SESUDAH MENGIKUTI INTERVENSI MODIFIKASI PERILAKU DENGAN HYPNOCARING (MOLUCA) DI CURUG, CIMANGGIS, DEPOK

Latar Belakang: Hipertensi merupakan masalah penyakit tidak menular yang terus meningkat dari tahun ketahun. Gaya hidup yang tidak sehat seperti aktivitas yang kurang, obesitas, dan komsumsi tinggi lemak dan garam menjadi faktor risiko penyebab utama hipertensi, diperlukan intervensi untuk meningkatkankesadaran sehingga perawatan hipertensi dapat dipertahankan agar tekanan darah dapat terkontrol. Tujuan: Studi ini bertujuan untuk mengetahui perubahan kemampuan dan penurunan tekanan darah sesudah intervensi Moluca pada agregate dewasa hipertensi. Metode: Desain studi ini menggunakan evidence base practice, pengumpulan data dilakukan dengan purposive sampling dan diperoleh sampel sebesar 58 orang responden. Intervensi Moluca diberikan selama 8 sesi, dan 1 sesi dalam 1 minggu. Hasil: Hasil intervensi Moluca terdapat penurunan rerata tekanan darah sistolik 21,16 mmHg dan diastolik 12,63 mmHg. Kesimpulan: Kesimpulan intervensi Moluca efektif menurunkan tekanan darah dengan nilap p value: 0,001. Saran: Perawat komunitas perlu meningkatkan pengetahuan dan keterampilan untuk mengembangkan diri denganmengikuti berbagai pelatihan untuk pengendalian hipertensi di masyarakat seperti intervensi keperawatankomunitas Moluca untuk meningkatkan pengendalian tekanan darah pada agregate dewasa hipertensi.Kata kunci: Hipertensi – Moluca

Collaborative Model of Teachers, Students, and Families to Improve Parents Knowledge and Skills on Food Safety of Elementary School Students

Introduction: School-age children in Indonesia are at risk of health problems due to food insecurity. Parents have a very important role in preparing safe food, both at home and for lunch at school. The aim of this study was to determine the effect of a collaboration model of teachers, students, and their families (KOGUSIGA) towards the parents’ knowledge and skills on the food safety of elementary school students.Methods: This study applied a quasi-experiment design pre- and post-test with a control group. The subject sample used was the total sampling method, involving 206 parents. The study was conducted for over 10 weeks, supported with modules for nurses and parents, textbooks for the students and their families, and a student workbook.Results: The results showed that the KOGUSIGA model is associated significantly with greater knowledge (p-value = 0.000; with a mean difference of 20.23) and the parent’s skills (p-value = 0.000; with a mean difference of 12.3) to do with food insecurity.Conclusions: The KOGUSIGA model tends to improve the knowledge and skills parents significantly, in relation to the food safety of the students. It is expected that the KOGUSIGA model will be applied under the community health nursing/school health nurses’ supervision.

Family Experience in Handling the Elderly in Cultural Aspects of Indonesia

Introduction: Extended family culture still exists in Indonesia, and this makes it possible for an elderly person to live with a family. In Indonesia, generally an elderly person is highly respected. This research is meant to gain a picture of an experience that a family has in taking care of an elderly person from the aspect of Indonesian culture.Methods: The design implemented is descriptive phenomenology. The participant is the main caregiver taking care of 10 elderly people. The data is analyzed using Collaizi technique.Result: This research have been identi fi ed 4 themes i.e. 1) the reason for doing it is to fulfi ll the tasks as a member of a family, to reciprocate, to have satisfaction, but for the main caregiver it is just because of closeness and pity, 2) the burden of caring is physical, psychological, social and fi nancial, 3) the perception about culture value is the position and role of the elderly person in the family, and 4) the support or encouragement is obtained from the family and the community.Conclusion: The conclusion is that a family as the main supporting system for the elderly people possesses big responsibility in caring the elderly in accordance with the value of culture in Indonesia. The results of the research are expected to give information about the need of a family as the caregiver in caring the elderly so that a proper intervention form of family enforcement according to the Indonesian culture can be designed.

Predictors of Mortality within Prison and after Release among Persons Living with HIV in Indonesia

Objectives

HIV-related mortality is increasing in Indonesia, where prisons house many people living with HIV and addiction. We examined all-cause mortality in HIV-infected Indonesian prisoners within prison and up to 24 months postrelease.

Materials and methods

Randomly selected HIV-infected male prisoners (n=102) from two prisons in Jakarta, Indonesia, completed surveys in prison and were followed up for 2 years (until study completion) or until they died or were lost to follow-up. Death dates were determined from medical records and interviews with immediate family members. Kaplan–Meier and Cox proportional hazards regression models were analyzed to identify mortality predictors.

Results

During 103 person-years (PYs) of follow-up, 15 deaths occurred, including ten in prison. The crude mortality rate within prison (125.2 deaths per 1,000 PYs) was surpassed by the crude mortality rate (215.7 deaths per 1,000 PYs) in released prisoners. HIV-associated opportunistic infections were the most common probable cause of death. Predictors of within-prison and overall mortality were similar. Shorter survival overall was associated with being incarcerated within a specialized “narcotic” prison for drug offenders (hazard ratio [HR] 9.2, 95% confidence interval [CI] 1.1–76.5; P=0.03), longer incarceration (HR 1.06, 95% CI 1.01–1.1; P=0.01), and advanced HIV infection (CD4⁺ T-cell count <200/µL, HR 4.8, 95% CI 1.2–18.2; P=0.02). Addiction treatment was associated with longer survival (HR 0.1, 95% CI 0.01–0.9; P=0.03), although treatment with antiretroviral therapy (ART) or methadone was not.

Conclusion

Mortality in HIV-infected prisoners is extremely high in Indonesia, despite limited provision of ART in prisons. Interventions to restore immune function with ART and provide prophylaxis for opportunistic infections during incarceration and after release would likely reduce mortality. Narcotic prisons may be especially high-risk environments for mortality, emphasizing the need for universal access to evidence-based HIV treatments.

Improvement of family carers' knowledge, skills and attitudes in caring for older people following the implementation of a Family Carers' Training Program in the community in Indonesia

The purpose of this study was to examine family carers' knowledge, skills and attitudes in caring for older people following the implementation of a Family Carers' Training Program (FCTP). Family carers (n = 240) from two villages in Indonesia were randomly selected. All participants were surveyed by questionnaires and their care behaviour observed at baseline, three and six months. Findings indicated significant increases in knowledge, skills and attitudes in the intervention group over six months compared to those of the control group. Hence, the FCTP demonstrated a positive effect on family carers' capabilities and attitudes in caring for older people living in the community in the study setting.