Exploring the tuberculosis medication program in Indonesia as perceived by patients and their families: A qualitative study.

Background: Tuberculosis (TB) remains a significant public health challenge in Indonesia, with the country experiencing one of the highest numbers of lost cases in TB management. Therefore, there is a need to identify the underlying reasons for this problem. Objective: This study aimed to explore the experiences of TB-diagnosed patients and their families during the time of diagnosis and while undergoing the TB medication program. Methods: This study employed a qualitative descriptive-interpretive approach. The study was conducted in government community health centers (CHC) from May 2022 to July 2022. A total of 22 participants, consisting of 12 TB-diagnosed patients and ten family members, were included in the study. Data were collected through focus group discussions and analyzed thematically. Results: Five themes were developed: (1) Delay in tuberculosis diagnosis, (2) Delay in starting TB treatment, (3) High willingness of patients and their families to recover, (4) Understanding that TB is an infectious disease, and (5) Factors affecting patient recovery. Conclusion: The study findings might contribute to the National TB elimination program. It is recommended that all health workers practicing in the community should be involved in the TB program to improve its management. Collaboration between multiple sectors in the community can also provide an advantage in solving TB problems by increasing new case detection. Additionally, it is suggested that all nurses working with TB patients establish rapport with health cadres and patients' families to enhance medication adherence in patients.

A Qualitative Study Exploring the Perceived Barriers Among Patients After Percutaneous Coronary Intervention

@#Introduction: Cardiovascular diseases, particularly coronary heart disease (CHD), are the third biggest cause of mortality worldwide, and percutaneous coronary intervention (PCI) is one of the available treatments. The patient’s self-efficacy in performing self-care decreases as a result of several post-PCI hurdles, which has an effect on their quality of life. The purpose of this investigation was to explore the barriers that patients experience following PCI. Methods: The study design used was descriptive qualitative in 15 patients after PCI. Purposive sampling was used to conduct the participant recruitment process. Between June 2021 and January 2022, data were collected using a semi-structured interviewing method. The data were analysed through the use of thematic content analysis. Results: The thematic content analysis found four themes: 1) Perceived physical barriers; 2) Perceived psychological barriers; 3) Low adherence; 4) The adverse side effects of medications. Conclusion: The results of this study highlight the value of empowering patients to take care of themselves at home following PCI and assisting in the creation of holistic and continuity nurse intervention models.

Analysis of Modifiable, Non-Modifiable, and Physiological Risk Factors of Non-Communicable Diseases in Indonesia: Evidence from the 2018 Indonesian Basic Health Research.

Purpose: Indonesia is facing an increasing occurrence of non-communicable diseases (NCDs) every year. We assessed the modifiable, non-modifiable, and physiological risk factors of NCDs among the Indonesian population. Methods: Secondary data was analyzed from the 2018 Indonesian basic health research (RISKESDAS). The national survey included participants aged 15-54 years and obtained 514,351 responses. Linear systematic two-stage sampling was conducted by RISKESDAS. Furthermore, chi-square and binary logistic regression were utilized to explore the determinant of NCDs with a significance level of 95%. Results: We found that almost 10% respondents in Indonesia had NCDs. We observed that depression has a higher odd (aOR: 2.343; 95% CI: 2.235-2.456) contributed to NCDs and followed other factors such as no education (aOR: 1.049; 95% CI: 1.007-1.092), passive smoking (aOR: 0.910; 95% CI: 0.878-0.942), fatty food (aOR: 1.050; 95% CI: 1.029-1.073), burnt food (aOR: 1.033; 95% CI: 1.005-1.062), food with preservatives (aOR: 1.038; 95% CI: 1.002-1.075), seasoned food (aOR: 1.057; 95% CI: 1.030-1.084), soft drinks (aOR: 1.112; 95% CI: 1.057-1.169), living in an urban area (aOR: 1.143; 95% CI: 1.119-1.168), living in central Indonesia (1.243; 95% CI: 1.187-1.302), being female (aOR: 1.235; 95% CI: 1.177-1.25), and obese (aOR: 1.787; 95% CI: 1.686-1.893). Conversely, people in Indonesia who undertook vigorous activity (aOR: 0.892; 95% CI: 0.864-0.921), had employment (aOR: 0.814; 95% CI: 0.796-0.834), had access to improved sources of drinking water (aOR: 0.910; 95% CI: 0.878-0.942), and were aged 35-44 years (aOR: 0.457; 95% CI: 0.446-0.467) were less likely to develop NCDs. Conclusion: Modifiable, non-modifiable, and physiological risk factors have a significant influence on NCDs in Indonesia. This finding can be valuable information for Indonesian Government to arrange a cross-collaboration between government, healthcare workers, and society through advocacy, partnership, health promotion, early detection, and management of NCDs.

Investigation of discriminatory attitude toward people living with HIV in the family context using socio-economic factors and information sources: A nationwide study in Indonesia.

Background: The well-being of people living with HIV (PLHIV) remains a concern. In addition to facing discrimination in their communities, many PLHIV have family members who have a discriminatory attitude. This study analyzes the discriminatory attitude toward PLHIV in the family context using socio-economic factors and information sources in Indonesia. Methods: A cross-sectional study design was adopted using secondary data from the 2017 Indonesian Demographic Health Survey (IDHS). A total sample of 28,879 respondents was selected using two-stage stratified cluster sampling. The study variables are information sources, sex, age, education, residence, earnings, and familial discriminatory attitude. We used the STATA 16.1 software to analyze Chi-square and binary logistics with a 95% confident interval (CI) with a significance of 5% (p-value < 0.05). Results: In Indonesia, familial discriminatory attitude has a prevalence of 72.10%. In the survey, the respondents with access to some information about HIV (AOR: 0.794; 95% CI [0.722-0.873]), women (AOR: 0.768; 95% CI [0.718-0.820]), and those living in rural areas (AOR: 0.880; 95% CI [0.834-0.929]) were the least likely to have a familial discriminatory attitude. Meanwhile, the respondents aged 15-24 years (AOR: 1.329; 95% CI [1.118-1.581]) and those with a secondary level of education (AOR: 1.070; 95% CI [1.004-1.142]) were the most likely to have a familial discriminatory attitude. Conclusion: In the study, we found that, the younger the age and the lower the educational level of the respondent, the more likely they were to have a familial discriminatory attitude. The government may consider these factors when designing policies to tackle familial discrimination faced by PLHIV; in particular, education on HIV and AIDS should be promoted.

Prevalence and determinants of diarrhea among under-five children in five Southeast Asian countries: Evidence from the demographic health survey.

PURPOSE: To describe the prevalence and the correlation between individual, environmental and household, health behavior, and source of information factors with diarrhea among under-five children in five Southeast Asian countries based on the National Health Survey. DESIGN AND METHODS: Cross-sectional design conducted in five countries in Southeast Asia. Datasets from Demographic and Health Surveys and Multiple Indicator Cluster Surveys in five countries were analyzed. RESULTS: A total of 12,447 children under 5 years of age from five countries in Southeast Asia (Indonesia 1807, Cambodia 2650, Myanmar 1717, the Philippines 3669, and Timor-Leste 2614) were included in this study. Binary logistic regression was performed to analyze the data. A total of 12,447 under-five children were included in the study. Overall, in five Southeast Asian countries, the prevalence of diarrhea is known from 8.39% in the Philippines to 18.21% in Indonesia. Several factors related to diarrhea are individual; environmental and household; health behavior such as stool disposal, breastfeeding mothers, and children's food history; and source of information factors. CONCLUSION: The findings of this study indicate that diarrhea is a serious public health problem in the Southeast Asian region that must be addressed using preventive and curative approaches. PRACTICE IMPLICATION: The results indicate the need for cross-collaboration among nurses, medical doctor, and sanitarian is needed to tackle the childhood diarrhea and minimize the severity based on those determinants.

Fathers' role in sustainability of exclusive breastfeeding practice in post-cesarean-section mothers.

BACKGROUND: The success of breastfeeding among post-cesarean-section mothers requires strong willingness and commitment, self-confidence, support from various professionals, and internal support (especially from their husband) and the belief and value of their family. Exclusive breastfeeding remains low in some cities such as in West Java, especially in post-cesarean-section mothers, who are influenced by certain factors. The purpose of this study is to identify husbands' role and their support for post-cesarean-section mothers in exclusive breastfeeding. DESIGN AND METHODS: This study used a qualitative phenomenological approach. with a combination of different data collection techniques: focus group discussion and in-depth interviews. Twelve husbands of post-cesarean-section mothers participated in this study. Data were analyzed by thematic content analysis. RESULTS: Four themes were identified namely knowledge about exclusive breastfeeding, the role of the father during breastfeeding, the experience of the husband and the family in supporting breastfeeding, and Women's lack of knowledge, inconvenience due to pain as the most impending factors of exclusive breastfeeding. CONCLUSION: Most fathers seem eager to be involved and assist their partners to give breastfeeding to their baby.  Furthermore, adequate support from family members, health care professionals, and employers can enable fathers to encourage and help their partners initiate and maintain exclusive breastfeeding. Fathers' emotional, practical, and physical supports are also important factors that promote successful breastfeeding and enrich the experience of mothers.