Health Insurance Status and Perceived Quality of Health Service at Community Health Center, Sumenep, East Java

Background: Having health insurance is important for several reasons. As studies have shown, uninsured people receive less medical care and less timely care. They have worse health outcomes, and lack of insurance is a fiscal burden for them and their families. This study aimed to assess the relationship between health insurance status and perceived quality of health service at community health center, Sumenep, East Java. Subjects and Method: This was a cross-sectional study conducted at puskesmas (community health centers) in Sumenep, East Java. A total sample of 250 people who visited the puskesmas in Sumenep were selected for this study. The dependent variable was perceived quality of health services. The independent variables were health insurance status, sex, age, education, and job. The data were collected by questionnaire and analyzed by a multiple linear regression. Results: Member of health insurance (b= 6.21; CI 95% = - 2.75 to -9.68; p<0.001) and female (b= 1.35; CI 95%= -1.35 to -3.23; p<0.001) were associated with better perceived quality of health service. Age (b= 0.50; CI 95%= -2.24 to 3.25; p= 0.72), higher education (b= -0.94; CI 95% = -0.21 to 3.89; p= 0.53), and having a job (b= 0.94; CI 95% = -2.01 to 3.89; p= 0.52) were associated with poorer perceived quality of health services. Conclusion: Member of health insurance and female are associated with better perceived quality of health service. Age, higher education, and having a job are associated with poorer perceived quality of health services. Keywords: perceived quality of health service, national health insuranc

Path Analysis on the Factors Associated with Consistent Use of Female Condom Among Female Sex Workers in Surakarta

Background: Female condom is an alternative method to prevent HIV/ AIDS transmission. However, its utilization is low and scanty among female sex workers. It is important to have knowledge on the factors that determine female condom use. This study aimed to determine the factors associated with the acceptance and use of female condom among female sex workers in Surakarta.Subjects and Method: It was an analytic and observational study using case control design. The study was conducted at a prostitution area in Surakarta, Central Java, from August to September 2016. A total of 230 female sex workers consisting of 110 female sex workers who used female condoms and 120 female sex workers who did not use female condoms, was selected purposively in this study. The dependent variables were acceptance and use of female condom. The independent variables were sex partner support, peer educator support, and pimp support. The data were collected by a set of questionnaire and analyzed by path analysis model.Results: Acceptance of female condom was associated with its use among female sex workers (b = 0.30; p < 0.001). Peer educator support was associated with acceptance of female condom (b = 0.06; p < 0.001). Peer educator support (b = 0.03; nilai p = 0.012) and sex partner support (b = 0.05; p = 0.042). The association between acceptance of female condom and pimp support was not statistically significant (p = 0.133).Conclusion: Peer educator support and sex partner support have direct association with both acceptance and use of female condom among female sex workers. Keywords: path analysis, support, sex partner, peer educator, consistant use, female condom, female sex workersCorrespondence: Rizka Ayu Setyani. School of Midwivery, Respati University, Yogyakarta. Email: [email protected] of Health Promotion and Behavior(2016), 1(2): 120-126https://doi.org/10.26911/thejhpb.2016.01.02.0

Effect of Captopril Rapid Uptitration to Plasma Aldosterone Level in Patients with Acute Myocardial Infarction

Background: Acute myocardial infarction is a myocardial necrosis associated with acute myocardial ischemia of which the incidence keeps increasing over time. Appropriate management of acute myocardial infarction is very important in order to determine the efficacy of the therapy and also to prevent further complications due to acute myocardial infarction. Captopril is essential in the management of acute myocardial infarction to inhibit the renin-angiotensin-aldosterone system whereby aldosterone may increase the probability of heart failure and increase mortality up to approximately 10 times compared to patients with acute myocardial infarction without heart failure. The administration of captopril should be uptitrated the doses in order to obtain optimal results, however there is no such fixed standard on how fast the doses of captopril should be uptitrated in order to obtain a more optimal effect, especially in order to suppress the plasma aldosterone level. This study examined the effect of rapid uptitration of captopril in the first 3 days of treatment of patients with acute myocardial infarction on plasma aldosterone levels compared to the increase in the captopril standard uptitration.Subjects and Method: This is an experimental research with Randomized Controlled Trial (RCT). 28 patients with Acute Myocardial Infarction on Cardiovascular Intensive Care Unit (ICVCU) and Cardiovascular wards of RSUD Dr. Moewardi hospital Surakarta were sequentially involved as research subjects and then randomly divided into a control group who received standard captopril uptitration and treatment group who received captopril rapid uptitration. The blood plasma was taken on the first day before the administration of captopril and on the last day of treatment. The plasma aldosterone level was tested by ELISA. Independent t-tests were carried out for data that qualified the normality test and mann whitney test if not qualified in the normality test with kolmogorov smirnov. It was considered statistically significant if the value of p < 0.05.Results: Plasma Aldosterone levels in treatment group was lower than control group and statistically significant (1133.54 ± 748.81 pg/dl vs 512.16 ± 444.81 pg/dl; p = 0.013 )Conclusion: Treatment with captopril rapid uptitration can decrease aldosterone plasma levels lower than captopril with standard uptitration in patient with acute myocardial infarction.Keywords: Acute myocardial infarction, plasma aldosterone, captopril, captopril rapid uptitation.Correspondence: Verry Gunawan Sohan. Master Program of Family Medicine, Sebelas Maret University, Surakarta.Indonesian Journal of Medicine (2016), 1(3): 160-168https://doi.org/10.26911/theijmed.2016.01.03.0

The Association between Cognitive Level, Spiritual Index, and Depression in the Elderly

Background: The prevalence of depression in the elderly has been increasing for the past few years. Depression in the elderly affects the quality of life. Some factors may cause depression in the elderly. This study aimed to examine the association between cognitive level, spiritual index, and depression level in the elderly. Subjects and Method: This was an analytic observational study with a cross-sectional design. The study was conducted in Karanganyar and Surakarta Districts, from February to December 2017. A sample of 160 elderly was selected by multi-stage random sampling. The dependent variable was depression. The independent variables were cognitive level and spiritual index. The data of depression were measured by Geriatric Depression Scale (GDS). The data of spiritual index were measured by Spiritual Index of Well-being. The cognitive data were measured by Mini Mental Status Examination (MMSE). The data were analyzed by a multiple linear regression model. Results: The risk of depression in the elderly decreased with higher spiritual index (b= -0.32; p= 0.001), but was not significantly affected by cognitive level (b= -0.04; p=0.606). Conclusion: The risk of depression in the elderly decreases with higher spiritual index. Keywords: depression, cognitive level, spiritual index, elderl

The Associations of Education Level and Health Status with Leisure Participation among The Elderly

Background: Leisure participation is important to make a pleasant event and to enhance the quality of life of the elderly. This study aimed to examine the associations of education level and health status with leisure participation among the elderly. Subjects and Method: This was a cross-sectional study carried out in Karanganyar and Surakarta, Central Java, from February to December 2017. A sample of 200 elderly was selected for this study. The dependent variable was leisure participation. The independent variables were education level and health status. The data were collected by questionnaire. The data were analyzed by a multiple linear regression. Results: Leisure participation among the elderly increased with higher education level (b=0.19; p= 0.006) and health status (b=0.16; p=0.022). Conclusion: Leisure participation increases with higher education and health status in the elderly. Keywords: leisure, participation, education level, health status, elderl

The Effect of Extracorporeal Shock Wave Therapy on Inflammation Process of Calcaneal Spur

Background: Plantar heel pain is the most common complaint and occurs in 11-15% of adults. Studies have shown most plantar heel pain is associated with calcaneal spur. This study aimed to examine the effect of extracorporeal shock wave therapy (ESWT) on inflammation process of calcaneal spur. Subjects and Method: This was arandomized controlled trial conducted atthe Medical Rehabilitation Installation, Dr. Moewardi Hospital, Surakarta, Central Java. A sample of 60 calcaneal spur patients was randomized into two groups: (1) 30 patients in the experimental group receiving ultrasound diathermy (USD) and ESWT, (2) 30 patients in the control group receiving USD. The dependent variables were pain and TNF-aplasma level. The independent variables were ESWT and USD. ESWT was given on the pain point with 2000 shock frequency, 2 barr intensity, and 6 times with 7-10 days interval. USD was given on the pain point, continuous, 0.1 W/ cm2, 10 minutes, 6 times at 3-5 days interval. Pain level was measured by visual analogue scale (VAS). TNF-a plasma level was measured by cytometry. The data were analyzed by Mann-Whitney test. Results: There was no significant difference in VAS pain score after treatment in the resting period between the experimental group (median= 3) and control group (median= 3) with p= 0.105. There was no significant difference in VAS pain score after treatment when waking up between the experimental group (median= 5) and control group (median= 5) with p=0.389. There was no significant difference in VAS pain score after activity between the experimental group (median= 4) and control group (median= 4) with p=0.676. TNF-a plasma level was higher in the experimental group (mean=1815.17; SD= 2975.69) than the control group (mean= 245.76; SD= 52.67) with p= 0.001. Conclusion: ESWT increases TNF-aplasma level after therapy indicating an inflammation process. Keywords: ESWT, calcaneal spur, pain, TNF-