The Perceptions and Experiences of Older People Living in the Aftermath of Lombok Earthquakes, Indonesia: A Qualitative Study.

INTRODUCTION: Despite the growing knowledge of people's vulnerability following natural disasters, the perspective of older people has received limited attention. This study aimed to explore the perceptions and experiences of older people encountering the 2018 Lombok earthquakes. METHODS: This exploratory qualitative study involved 16 older people living in one of the villages most affected by the 2018 earthquakes in Lombok Island, Nusa Tenggara Barat, Indonesia. The data were collected in June 2019 using semi-structured interviews. Participants' responses were digitally recorded and transcribed verbatim for analysis. The data were analysed using qualitative content analysis managed in NVivo. RESULTS: From older people's perspectives, three themes were generated: surviving the disaster, dealing with life changes and navigating through challenges and hope. Each theme comprised two categories, which reflected the journey of older people from the early to the later phase of the disaster. CONCLUSIONS: Older people experienced critical conditions and difficulties both physically and mentally. They also experienced various emotional responses before accepting living situations following a disaster. Nurses should play a role in fulfilling the physical and mental health needs of older people in post-disaster conditions. IMPLICATIONS FOR PRACTICE: This study can inform nurses and other key stakeholders about the needs of older people during and after natural disasters. Nurses need to be equipped with the skills and abilities to identify and meet the needs of older people in difficult situations and with limited resources.

Promoting workplace retention during global crises: An international survey of the preventive role of psychological support among victims of social discrimination in long-term care facilities.

This international cross-sectional survey examined the potential role of organizational psychological support in mitigating the association between experiencing social discrimination against long-term care (LTC) facilities' healthcare professionals (HCPs) and their intention to stay in the current workplace during the COVID-19 pandemic. Participants included a convenience sample of 2,143 HCPs (nurses [21.5 %], nurse aids or residential care workers [40.1 %], social workers [12.1 %], and others [26.4 %]) working at 223 LTC facilities in 13 countries/regions. About 37.5 % of the participants reported experiencing social discrimination, and the percentage ranged from 15.3 % to 77.9 % across countries/regions. Controlling for socio-demographic and work-related variables, experiencing social discrimination was significantly associated with a lower intention to stay, whereas receiving psychological support showed a statistically significant positive association (p-value=0.015 and <0.001, respectively). The interaction term between social discrimination and psychological support showed a statistically significant positive association with the intention to stay, indicating a moderating role of the psychological support.

Long-term care facilities' response to the COVID-19 pandemic: An international, cross-sectional survey.

AIMS: To (i) assess the adherence of long-term care (LTC) facilities to the COVID-19 prevention and control recommendations, (ii) identify predictors of this adherence and (iii) examine the association between the adherence level and the impact of the pandemic on selected unfavourable conditions. DESIGN: Cross-sectional survey. METHODS: Managers (n = 212) and staff (n = 2143) of LTC facilities (n = 223) in 13 countries/regions (Brazil, Egypt, England, Hong Kong, Indonesia, Japan, Norway, Portugal, Saudi Arabia, South Korea, Spain, Thailand and Turkey) evaluated the adherence of LTC facilities to COVID-19 prevention and control recommendations and the impact of the pandemic on unfavourable conditions related to staff, residents and residents' families. The characteristics of participants and LTC facilities were also gathered. Data were collected from April to October 2021. The study was reported following the STROBE guidelines. RESULTS: The adherence was significantly higher among facilities with more pre-pandemic in-service education on infection control and easier access to information early in the pandemic. Residents' feelings of loneliness and feeling down were the most affected conditions by the pandemic. More psychological support to residents was associated with fewer residents' aggressive behaviours, and more psychological support to staff was associated with less work-life imbalance. CONCLUSIONS: Pre-pandemic preparedness significantly shaped LTC facilities' response to the pandemic. Adequate psychological support to residents and staff might help mitigate the negative impacts of infection outbreaks. IMPACT: This is the first study to comprehensively examine the adherence of LTC facilities to COVID-19 prevention and control recommendations. The results demonstrated that the adherence level was significantly related to pre-pandemic preparedness and that adequate psychological support to staff and residents was significantly associated with less negative impacts of the pandemic on LTC facilities' staff and residents. The results would help LTC facilities prepare for and respond to future infection outbreaks. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.

Demographic characteristics with compliance on the implementation of health protocol on ship passengers.

Objectives: To analyse the relationship of demographic characteristics with coronavirus disease-2019 protocol compliance among ship passengers. Method: The descriptive, correlational, cross-sectional study was conducted in May 2022 at the harbour in East Java, Indonesia, after approval from the ethics review committee of Universitas Airlangga, Indonesia, and comprised individuals of either gender aged 18-65 years who had a passenger ship departure ticket and were able to communicate well in the Indonesian language. Data related to demographic characteristics and coronavirus disease-2019 standard protocol compliance. Data was analysed using SPSS 25. RESULTS: Of the 157 subjects, 71(45.2%) were males, 86(54.8%) were females, 68(43.3%) were aged 26-45 years, 79(50.2%) had studied up to the bachelor's level,106(66.2%) were employees, 89(56.7%) had earnings below the provincial standard, and 116(73.9%) were married. Health protocol compliance at the harbour had a significant correlation with gender, age, education, occupation and income (p<0.05). CONCLUSIONS: The factors related to the compliance of the coronavirus disease-2019 protocol at the harbour were gender, age, education, occupation and income.

The application of digital health as a nursing solution for leprosy patients during the COVID-19 pandemic: A systematic review.

Objectives: To analyse the effect of using digital health technology on leprosy control programmes. Method: The systematic review comprised search on PubMed, Scopus, ScienceDirect, SAGE and ProQuest databases for interventional studies published in English language from 2013 to 2021 which used digital health technology for leprosy contact tracing, active leprosy detection, monitoring of multi-drug therapy and treatment management during the corona virus disease-2019 pandemic A standard risk of bias tool was used to evaluate bias in the studies, and the Joanna Briggs Institute protocol was used to assess the quality of the studies analysed. RESULTS: Of the 205 studies initially identified, 15(7.3%) were analysed in detail. Quasi-experimental studies had a low risk of bias compared to the rest. The e-leprosy framework was being used along with applications based on smartphones and artificial intelligence Digital health technology was found to be practical, accessible and effective in leprosy control programmes. CONCLUSIONS: Studies reported favourable findings regarding the use of digital health technology in services related to leprosy patients.

Efforts to Improve the Safety Culture of the Elderly in Nursing Homes: A Qualitative Study.

Introduction: The attention to building a safety culture in nursing homes is relatively less when compared to hospitals. Good patient safety will improve the quality of health services and minimize incidents related to patient safety. This study aims to look at efforts that can be made to improve safety culture in nursing homes. Materials and Methods: The research design uses phenomenological qualitative with in-depth interviews. Purposive sampling was used with interpretive phenomenological analysis. Participants were 29 staff from four government and private institutions in East Java, Indonesia. Results: The sub-themes resulting from the research efforts to improve the safety culture of the elderly in nursing homes are the provision of new staff orientation, training, improvement of infrastructure, and procurement of security staff. Conclusion: The analysis shows that efforts to improve safety culture can be carried out with various strategies by paying attention to risk assessment steps, patient risk identification, and management, incident reporting, and analysis, the ability to learn from incidents and their follow-up, as well as implementing solutions to minimize risks and prevent them from occurring injury. Safety culture plays an essential role in improving the quality of care.

The Provision of Texture-Modified Foods in Long-term Care Facilities by Health Professionals: Protocol for a Scoping Review.

BACKGROUND: Malnutrition among older adults with dysphagia is common. Texture-modified foods (TMFs) are an essential part of dysphagia management. In long-term care (LTC) facilities, health professionals have implemented TMFs, but their application has not been fully elucidated, making them heterogeneous. OBJECTIVE: We aim to explore the implementation of TMFs in LTC facilities, particularly focusing on the role of health professionals in nutritional care involving TMFs (eg, deciding the type of food, preparing and giving the food, and evaluating the outcomes). METHODS: A scoping review using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodological approach will be performed. A comprehensive search for published literature will be systematically performed in PubMed, CINAHL, MEDLINE, ProQuest, PsycINFO, and Science Citation Index (Web of Science). Data screening and extraction will be performed by 2 reviewers independently. The studies included will be synthesized, summarized, and reported, following the preferred reporting items of the Mixed Methods Appraisal Tool. Our review will consider the following study designs: mixed methods, quantitative, and qualitative. Studies with patients who are not older adults will be excluded. RESULTS: Data extraction will be completed by February 2023. Data presentation and analyses will be completed by April 2023, and the final outcomes will be completed by June 2023. The study findings will be published in a peer-reviewed journal. CONCLUSIONS: Our scoping review will consider studies related to TMF interventions for older adults in LTC residential facilities, with no exclusion restrictions based on country, gender, or comorbidities. Studies on interventions that address TMF-related issues, such as deciding the type of food, preparing and giving the food, and evaluating the outcomes, are qualified for inclusion. TRIAL REGISTRATION: OSF Registries 79AFZ; https://osf.io/79afz. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/44201.

Predictors of Mortality Among Children with Confirmed and Suspected Cases of COVID-19 in East Java, Indonesia.

Introduction: Coronavirus disease 2019 (COVID-19) increases rapidly and causes mortality in all groups, including children. However, the predictive risk factors of mortality among children remain inconclusive. This study aimed to analyse the predictors related to mortality among children with COVID-19. Methods: Secondary data analysis was conducted using provincial COVID-19 data from April 2020 to May 2021. We selected 6441 children under age 18 to be included in this study. Chi-square and binary logistic regression were used to evaluate the predictors of mortality in children with COVID-19. Results: This study showed that the prevalence of children who died COVID-19 was 2.7%. Age, case definition, treatment status, severity of illness, and travel history had a significant relationship with survival status in children with COVID-19. As the increasing age, the risk of death with COVID-19 will decrease [AOR=0.94; CI 95%=0.91-0.97]. Otherwise, suspected status [AOR=2.12; 95% CI=1.48-3.04], hospitalization with ventilators [AOR=22.25; 95% CI=5.73-86.42], severe illness [AOR=46.76; 95% CI=21.69-100.80], and travel history [AOR=1.78; 95% CI=1.22-2.60] were significantly related with an increased risk of death in children with COVID-19. Discussion: Severe illness in children was the strongest predictor of mortality. Disease prevention and health promotion programs are the key to preventing hospitalizations in children and decreasing the mortality rate.

Indonesian Nurses' Journey in Passing the Japan National Nursing Licensure Examination.

Background: Despite the significant number of Indonesian nurses joining the Japanese National Nursing Licensure Examination (JNNLE), only a few of those were successful. Indonesian nurses as one of active migration player to Japan's market remain a critical support in supporting human resources for health in Japan. However, the successful nurses' perspectives have yet to be understood entirely. This study aimed to explore the experiences of Indonesian nurses who successfully passed the JNNLE. Methods: This study used a descriptive qualitative approach. The participants were twenty Indonesian nurses who have passed the licensure examination. This study was carried out by semi-structured interviews conducted virtually. The data were analyzed using thematic content analysis. Results: Five themes were discovered in this study: language ability as the key to succeeding in the exam, strategies to passing the exam, supporting resources as factors to increase the passing rate, understanding the nature of nursing exam, and internal motivation to be recognized as a professional nurse in a foreign country. Conclusion: Indonesian nurses who passed the Japanese national nursing licensure examination tend to deploy planned strategies. Honing the language skills while working and living in Japan is very important, while structured support systems in the hospital, government, and social network are imperative to learning the new knowledge in the area of nursing care in Japan.

Determinant factors of low birth weight in Indonesia: Findings from the 2017 Indonesian demographic and health survey.

BACKGROUND: Low birth weight (LBW) is still a significant problem in Indonesia because it affects the growth and development of infants. It is also one of the factors that increase the risk of developing chronic disease later in life. PURPOSE: The study aimed to analyse the determinants of LBW in Indonesia. METHODS: This cross-sectional analytic study used secondary data from the 2017 Indonesian Demographic and Health Survey (IDHS). Data on the maternal factors (maternal age, frequency of antenatal care (ANC) visits, education, and maternal smoking status), children's birth order, and socio-demographic factors of the 14,239 respondents were examined. The association between LBW and the independent variables was analysed using bivariate analysis with a chi-square test (X2), followed by multivariate analysis in the form of binary logistic regression. RESULTS: LBW was identified in 960 infants (6.74%). Fewer than four ANC visits [AOR = 1.86; 95% CI = 1.44-2.42], uneducated mothers [AOR = 2.09; 95% CI = 1.00-4.37], and mothers who finished only primary school [AOR = 1.45; 95% CI = 1.05-2.00] were significantly associated with the incidence of LBW. CONCLUSIONS: This study revealed that the frequency of ANC visits was a dominant factor in the incidence of LBW. PRACTICE IMPLICATION: To reduce LBW in Indonesia, the government must increase ANC visits through health promotion programmes and maintain ANC facilities and quality.

Going Global: Insights of Indonesian Policymakers on International Migration of Nurses.

BACKGROUND: The Indonesian policymakers need to respond to the current challenges, particularly the excess of nurses and the increased demand for nurses in the global market. OBJECTIVE: This study aimed to present the perception of policymakers and stakeholders on the management of overseas migration of Indonesian nurses. METHODS: This study is a descriptive qualitative design where data were collected through structured interviews with key stakeholders representing the Indonesian government, namely the Ministry of Health (MOH), the Ministry of Labour (MOL), Ministry of Education (MOE) and the Indonesian Migrant Workers Protection Agency (BP2MI). The in-depth interviews involved participants who were responsible for managing Indonesian nurses' migration. The qualitative data were analyzed thematically using a content analysis approach. RESULTS: The issues involving nurses' migration policy are quite complex and sectoral. Themes emerging from this study include the move towards global market orientation, addressing challenges on international nurse migration, strengthening coordination among stakeholders and making the most of opportunities. All the themes reflect that the country should work hard to achieve the balance between quantity and quality of nursing resources for the international market. CONCLUSION: As regulator and executor of Indonesian nurse migration, various government policies have responded to the low number of Indonesian nurses' migration overseas, emphasizing the three cycles of migration: pre-migration, migration and post-migration. The preparation of resources, regulations and placements for Indonesian nurses abroad open the opportunity to the international nursing labour market. Hence, the policies need to be strengthened from upstream to downstream to make Indonesian nurses more competitive and adaptive in global market.

Policymakers' perspectives on responding to the elderly's mental health needs in post-disaster situations.

BACKGROUND: Mental health issues following the occurrence of disaster remain neglected area especially for older people group. The purpose of this study was to explore stakeholders' perspectives on post-disaster management related to the elderly's mental health needs. DESIGN AND METHODS: This qualitative case study was conducted between June and October 2020. The investigators conducted in-depth interviews with policymakers who were in charge of disaster management at national, provincial, and regional levels. The policymakers were selected through purposive sampling. A policy analysis was conducted by the investigators to answer the research question. RESULTS: The results were presented based on actor, content, context, and process. The actors engage in intersectoral collaboration between disaster agencies, health agencies, and social agencies. The content is largely comprehensive; however, the disaster management policy should not neglect to address mental health conditions after a disaster event. The context is the vulnerability and risk of the elderly in terms of experiencing physical and mental issues after a disaster, which should be considered by policymakers in Indonesia. The process is the development of disaster management policies, which are influenced by cultural, economic, political, and international factors. CONCLUSIONS: This study reveals that stakeholders need to pay attention to the mental health issue of elderly in national and regional policy, particularly during post-disaster situations. In addition, posttraumatic stress in post-disaster situations should be highlighted in order to formulate a better aged care policy.

Effect of community and peer support based healthy lifestyle program (CP-HELP) on self care behavior and fasting blood glucose in patient with type 2 Diabetes Mellitus.

Type 2 diabetes mellitus (T2DM) was one of chronic disease that remain global concern including in Indonesia. Healthy lifestyle is a part of diabetes mellitus treatment to achieve the highest health status and to prevent diabetes complication. PURPOSE: This study aimed to examine the effect of community and peer support based healthy lifestyle program (CP-HELP) on self-care behavior and fasting blood glucose in patient with T2DM. METHODS: The research design was used quasi experimental pre and post-test design. 163 participants with T2DM were divided into two groups, 83 participants as intervention group were given CP-HELP intervention and 80 participants as control group were given usual care. Measurement of self-care behavior used Diabetes Self-Management Questionnaire (DSMQ). Furthermore, measurement of fasting blood glucose was measured by capillary blood test. This study was used paired t test and multivariate analysis of variance. RESULTS: An increase of mean value of self-care behavior was occurred in both of group intervention and control. A significant different between pre-test and post-test in intervention group (p = 0.000). Results of statistical test used paired t test in control group, was not showed significantly different (p = 0.249). Improved of fasting blood glucose only occurred in intervention group (p = 0.020). Results of multivariate statistic test was showed in both outcomes obtained significant value less than 0.05, self-care behavior (p = 0.010), fasting blood glucose (p = 0.042). CONCLUSION: CP-HELP may be a promising interventional strategy to improve self-care behavior and improving of fasting blood glucose in patient with T2DM. The research results can be used as an important reference for improving self care behavior and fasting blood glucose in patient with type 2 Diabetes Mellitus.

HIV-related knowledge level among Indonesian women between 15 years and 49 years of age.

BACKGROUND: Women are a highly vulnerable population for HIV-infection, influenced by biological, cultural, social and economic factors. Inadequate knowledge about the risk for exposure to HIV will impact the prevention and treatment of HIV. OBJECTIVES: The aim of this study was to examine HIV-related knowledge among women in Indonesia and the associated demographic determinants that influence their access to accurate HIV-related information. METHODS: This was a secondary analysis of the Indonesia Demographic and Health Survey in 2012. Level of HIV-related knowledge was determined by analyzing nine items on the 2012 IDHS instrument. RESULTS: The percentage of women in Indonesia between the ages of 15 and 49 years of age, more than half (53.6%) had high score of HIV-related knowledge. The results from logistic regression showed that women aged 30-34 years old had 2.2 times higher knowledge level about HIV compared to older women. Married women, living in rural area, with a lower level of education, reported to have limited or no access to HIV related information; thus, had a correspondingly lower knowledge level of HIV. CONCLUSION: Study findings underscore the lack of knowledge-level among Indonesian women about HIV, especially the prevention, transmission, and prevention mother to child transmission (PMCT).

Lived experience of Indonesian nurses in Japan: A phenomenological study.

AIM: The movement of Indonesian nurses via a bilateral agreement with Japan has led to a substantial number of migrants to work as nurses in that nation's healthcare system. The purpose of this research was to develop a deeper understanding of the meaningful experiences of Indonesian nurses while working in Japanese hospitals. METHODS: In this phenomenological study, sampling was purposive and was based on information shared by five Indonesian nurses. The data were collected in interviews; the analysis was thematic. RESULTS: Six key themes were identified: (i) seeking better than before; (ii) communication challenges; (iii) the nursing examination as a culmination; (iv) differences in nursing practice; (v) cultural differences; and (vi) the benefits of living in developed country. Among these challenges, communication as the basis of shared meaning and understanding was viewed as a complex issue, by both patients and coworkers. CONCLUSION: The results of this study call for further intervention in supporting Indonesian nurses living in Japan in their struggle with the issue of communication. The emphasis on language acquisition for personal and professional objectives, and the bridging of cultural differences as well, should be considered in an international context.