Predictors of COVID-19 Related Health Literacy among Older People Living in Rural Areas of Indonesia / Predictores de la alfabetización en salud relacionados con el COVID-19 en las personas mayores que viven en zonas rurales de Indonesia / Preditores relacionados à COVID-19 de alfabetização em saúde em idosos que vivem na zona rural da Indonésia

Objective. This study aims to identify predictive factors of COVID-19-related health literacy (HL) among older adults living in rural areas. Method. This study used a cross-sectional design. A total of 106 respondents participated in this study. HL was measured by using a questionnaire modified from the HLS-COVID-Q22, in addition, the scales 'Health Information Seeking', 'Family's Social Support Scale', 'Health Service Utilization'; and information on some socio-demographic variables was also obtained. A multiple linear regression model was used to identify the predictors of HL. Results. About two-thirds of the respondents had a moderate level of HL (63.2%). Multiple linear regression analysis showed that education level, family support, information source, and gender were significant predictors for HL (p<0.01). Conclusion. HL literacy was better among males, highly educated older people, media users, and those with adequate family support. This study provided insight for nurses and healthcare professionals to pay greater attention to vulnerable groups of older people (ie. female gender and those with less formal education) as well as involve family members in education or health promotion activities and use easily accessed media, such as television and radio.

Objetivo. Este estudio tiene como objetivo identificar los factores predictivos de alfabetización en salud (AS) relacionados con el COVID-19 en los adultos mayores indonesios que viven en zonas rurales. Métodos. Este estudio utilizó un diseño de corte transversal. Un total de 106 encuestados participaron en este estudio. La AS relacionada con el COVID-19 se midió con el cuestionario HLS-COVID-Q22, además se utilizaron las escalas 'Búsqueda de información sanitaria', 'Escala de apoyo social de la familia' y 'Utilización de servicios sanitarios'; también se obtuvo información de algunas variables sociodemográficas. Se utilizó un modelo de regresión lineal múltiple para identificar los predictores de la AS. Resultados. Alrededor de dos tercios de los encuestados tenían un nivel moderado de AS (63.2%). El análisis de regresión lineal múltiple mostró que el menor nivel educativo, el apoyo familiar, la fuente de información y el sexo eran predictores significativos de la AS (p<0.01). Conclusión. La AS fue mejor entre los varones, las personas mayores con alto nivel educativo, los usuarios de los medios de comunicación y aquellos con un apoyo familiar adecuado. Este estudio sugirió que las enfermeras y los profesionales de la salud deben prestar más atención a los grupos vulnerables de personas mayores (especialmente las mujeres y las personas con poca educación formal). También mostró la importancia de involucrar a los familiares en las actividades de educación y promoción de la salud, y de usar medios de comunicación accesibles, como la televisión y la radio.

Objetivo. Este estudo tem como objetivo identificar preditores de alfabetização em saúde (AS) relacionados ao COVID-19 em idosos indonésios que vivem em áreas rurais. Métodos. Este estudo utilizou um desenho transversal. Um total de 106 entrevistados participaram deste estudo. A AS relacionada à COVID-19 foi medida com o questionário HLS-COVID-Q22, além das escalas 'Pesquisa de informações em saúde', 'Escala de apoio social familiar' e 'Uso de serviços de saúde'; também foram obtidas informações sobre algumas variáveis sociodemográficas. Um modelo de regressão linear múltipla foi usado para identificar os preditores de HL. Resultados. Cerca de dois terços dos entrevistados apresentaram nível moderado de LH (63.2%). A análise de regressão linear múltipla mostrou que menor escolaridade, apoio familiar, fonte de informação e gênero foram preditores significativos de HL (p<0.01). Conclusão. A alfabetização em LH foi melhor entre os homens, idosos altamente educados, usuários de mídia e aqueles com suporte familiar adequado. Este estudo forneceu ideias para enfermeiros e profissionais de saúde prestarem mais atenção a grupos vulneráveis de idosos (ou seja, mulheres e pessoas com menos educação formal), bem como envolver os familiares em atividades de educação ou promoção de saúde e usar mídias de fácil acesso, como televisão e rádio.

Exploring the antenatal care challenges faced during the COVID-19 pandemic in rural areas of Indonesia: a qualitative study.

INTRODUCTION: The COVID-19 pandemic affected almost all healthcare services in Indonesia, including antenatal care (ANC). Pregnant women were a vulnerable group during the pandemic since the Indonesian government's policies at the time influenced the delivery of ANC services, particularly in rural areas. Investigating the ANC challenges faced during the pandemic from the perspectives of pregnant women and healthcare providers is important for our understanding of ANC provision. This study, therefore explores barriers to ANC appointments faced during the COVID-19 pandemic in rural areas of Indonesia from the perspectives of pregnant women and health care providers. METHODS: This was a qualitative exploratory descriptive study involving 31 participants, consisting of 25 pregnant women and six healthcare providers who were selected via a purposive sampling method. Thadeus and Maine's Three Delays Model was used as the theoretical framework. Data were collected between March and August 2021, through two focus group discussions (FGDs), ten in-depth interviews, and field notes. Data were analyzed using a thematic analysis method. RESULTS: Three themes describing barriers to ANC during the COVID-19 pandemic in rural areas of Indonesia emerged from this study. Those themes were: (1) The fear of being infected with COVID-19, related to anxiety, perceived vulnerability, and the desire to protect oneself and loved ones; (2) The stay-at-home policy, related to transport barriers and restricted social activity; and (3) Re-designed ANC services, related to ANC adjustments, high-risk pregnancies, insufficient information, and adherence to COVID-19 preventive behaviors. CONCLUSION: Based on the Three Delays Model, several challenges to carrying out ANC during the COVID-19 pandemic in rural areas of Indonesia were identified. These findings demonstrate the need to formulate and implement ANC packages to facilitate pregnant women's access to health care services.

Predictors of COVID-19 Related Health Literacy among Older People Living in Rural Areas of Indonesia.

Objective: . This study aims to identify predictive factors of COVID-19-related health literacy (HL) among older adults living in rural areas. Methods: This study used a cross-sectional design. A total of 106 respondents participated in this study. HL was measured by using a questionnaire modified from the HLS-COVID-Q22, in addition, the scales 'Health Information Seeking','Family's Social Support Scale', 'Health Service Utilization'; and information on some socio-demographic variables was also obtained. A multiple linear regression model was used to identify the predictors of HL. Results: About two-thirds of the respondents had a moderate level of HL (63.2%). Multiple linear regression analysis showed that education level, family support, information source, and gender were significant predictors for HL (p<0.01). Conclusion: HL literacy was better among males, highly educated older people, media users, and those with adequate family support. This study provided insight for nurses and healthcare professionals to pay greater attention to vulnerable groups of older people (ie. female gender and those with less formal education) as well as involve family members in education or health promotion activities and use easily accessed media, such as television and radio.

Cognitive impairment among older adults living in the community and in nursing home in Indonesia: a pilot study / Comprometimento cognitivo entre idosos que vivem na comunidade e em casa de repouso na indonésia: um estudo piloto

ABSTRACT The demographic phenomenon of population aging has brought some consequences, including a higher prevalence of cognitive impairment. Objective: This study aimed to assess and compare cognitive impairment and its risk factors between older persons living in the community and in nursing home in Indonesia. Methods: A cross-sectional study was employed among 99 older adults living in the community and 49 nursing home residents. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Results: Older people living in the community showed a higher score on MMSE than those living in nursing home (p=0.044). Age, marital status, education level, and literacy status were significantly related to the cognitive function of older adults living in the community (p=0.003, p=0.007, p=0.005, p=0.001, respectively), while gender, education level, and literacy status were significantly related to that of nursing home residents (p=0.012, p=0.004, p=0.001, respectively). Conclusions: Older adults living in the nursing home were more likely to experience cognitive decline than their counterparts in the community. Factors associated with cognitive decline differ between community-dwelling older adults and nursing home residents.

RESUMO O fenômeno demográfico do envelhecimento da população trouxe algumas consequências, incluindo uma maior prevalência de comprometimento cognitivo. Objetivo: Este estudo teve como objetivo avaliar e comparar o comprometimento cognitivo e seus fatores de risco entre os idosos que vivem na comunidade e no lar de idosos na Indonésia. Métodos: Um estudo transversal foi empregado entre 99 idosos que vivem na comunidade e 49 residentes de casa de repouso. A função cognitiva foi avaliada usando o Mini-Mental State Examination (MMSE). Resultados: Os idosos que vivem na comunidade mostraram uma pontuação mais alta no MMSE do que aqueles que vivem em casa de repouso (p=0,044). Idade, estado civil, nível de educação e alfabetização estavam significativamente relacionados à função cognitiva de idosos que vivem na comunidade (p=0,003, p=0,007, p=0,005, p=0,001, respectivamente), enquanto gênero, nível educacional e alfabetização estavam significativamente relacionados aos idosos residentes da casa de repouso (p=0,012, p=0,004, p=0,001, respectivamente). Conclusões: Os idosos que vivem na casa de repouso tinham maior probabilidade de experimentar um declínio cognitivo do que seus colegas na comunidade. Os fatores associados ao declínio cognitivo diferem entre os idosos que habitam a comunidade e os residentes da casa de repouso.

Cognitive impairment among older adults living in the community and in nursing home in Indonesia: a pilot study.

The demographic phenomenon of population aging has brought some consequences, including a higher prevalence of cognitive impairment. Objective: This study aimed to assess and compare cognitive impairment and its risk factors between older persons living in the community and in nursing home in Indonesia. Methods: A cross-sectional study was employed among 99 older adults living in the community and 49 nursing home residents. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Results: Older people living in the community showed a higher score on MMSE than those living in nursing home (p=0.044). Age, marital status, education level, and literacy status were significantly related to the cognitive function of older adults living in the community (p=0.003, p=0.007, p=0.005, p=0.001, respectively), while gender, education level, and literacy status were significantly related to that of nursing home residents (p=0.012, p=0.004, p=0.001, respectively). Conclusions: Older adults living in the nursing home were more likely to experience cognitive decline than their counterparts in the community. Factors associated with cognitive decline differ between community-dwelling older adults and nursing home residents.

O fenômeno demográfico do envelhecimento da população trouxe algumas consequências, incluindo uma maior prevalência de comprometimento cognitivo. Objetivo: Este estudo teve como objetivo avaliar e comparar o comprometimento cognitivo e seus fatores de risco entre os idosos que vivem na comunidade e no lar de idosos na Indonésia. Métodos: Um estudo transversal foi empregado entre 99 idosos que vivem na comunidade e 49 residentes de casa de repouso. A função cognitiva foi avaliada usando o Mini-Mental State Examination (MMSE). Resultados: Os idosos que vivem na comunidade mostraram uma pontuação mais alta no MMSE do que aqueles que vivem em casa de repouso (p=0,044). Idade, estado civil, nível de educação e alfabetização estavam significativamente relacionados à função cognitiva de idosos que vivem na comunidade (p=0,003, p=0,007, p=0,005, p=0,001, respectivamente), enquanto gênero, nível educacional e alfabetização estavam significativamente relacionados aos idosos residentes da casa de repouso (p=0,012, p=0,004, p=0,001, respectivamente). Conclusões: Os idosos que vivem na casa de repouso tinham maior probabilidade de experimentar um declínio cognitivo do que seus colegas na comunidade. Os fatores associados ao declínio cognitivo diferem entre os idosos que habitam a comunidade e os residentes da casa de repouso.

The differences in health-related quality of life between younger and older adults and its associated factors in patients with type 2 diabetes mellitus in Indonesia.

BACKGROUND: It is well known that diabetes mellitus (DM) affects health-related quality of life (HRQOL) in both younger (aged 18-64 years) and older adults (aged ≥ 65 years). However, to date, no study has compared HRQOL and its predictors between younger and older adults with DM in Indonesia. Such a comparison is important because the results can guide nurses and clinicians to establish evidence-based educational programs that are specific and suitable for patients. Therefore, the aim of this study was to investigate the difference in HRQOL and its predictors in younger and older adults with DM in Indonesia. METHODS: A cross-sectional study was conducted on 641 patients with type 2 diabetes mellitus (T2DM) who were recruited via simple random sampling from 16 primary health centers in Banyumas Regency, Indonesia. A self-administered questionnaire containing the Summary of Diabetes Self-Care Activities, the DDS17 Bahasa Indonesia, the Beck Depression Inventory II, the Self-Efficacy for Diabetes Scale, the Family APGAR, and the 36-item Short-Form Health Survey was used to measure diabetes self-management (DSM), diabetes distress (DD), depression, self-efficacy, family support, and HRQOL, respectively. Independent t-tests were used to compare the physical component summary (PCS) and mental component summary (MCS) scores between younger and older adults with T2DM. Hierarchical multiple regression analyses were used to examine the factors associated with HRQOL in both groups. RESULTS: PCS scores were significantly different between the two groups. Older adults reported lower PCS scores than younger adults. No differences between the two groups were observed in the MCS scores. The hierarchical multiple regression analysis showed that level of education, employment status, number of diabetes-related complications, DSM, DD, depression, and self-efficacy were significant predictors of HRQOL in younger adults, while income, depression, DD, and self-efficacy were significant predictors of HRQOL in older adults. DD was the strongest predictor of HRQOL in younger adults, and depression was the strongest predictor in older adults. CONCLUSION: Older adult patients had lower PCS scores than younger adult patients. This study is the first to show that the predictors of HRQOL differ between younger and older adults with T2DM. It provides insights for nurses and clinicians in Indonesia to establish evidence-based, age-specific educational programs.