The Quality of Life of the Elderly in Surakarta, Central Java, and its Associated Biopsychosocial Factors

Background: The quality of life of the elderly is of major concern in Indonesia and worldwide as the aging population is increasing. Little is known about the association between biopsychosocial factors and the quality of life of the elderly in Indonesia. This study aimed to determine the association between biopsychosocial factors including dementia, family support, peer support, type of residence, marital status, and the quality of life of the elderly in Surakarta, Central Java. Subjects and Method: This was a cross-sectional study conducted in Surakarta, Central Java. A total sample of 218 elderly people in Surakarta, was selected for this study by fixed exposure sampling, with 1:3 ratio consisting of 50 elderly people living in Dharma Bakti nursing home and 168 elderly people living with their families in the community. The dependent variable was health-related quality of life. The independent variables were dementia, family support, peer support, type of residence, and marital status. The data on the quality of life was measured by WHO-BREF. The data on the other variables were collected by questionnaire. The data were analyzed by path analysis. Results: Better quality of life of the elderly showed a positive and direct association with strong peer support (b= 0.25, p<0.001), strong family support (b= 0.59, p= 0.002), mild dementia (b= 1.79, p<0.001), and being married (b= 12.73, p= 0.039). Better quality of life showed a positive but indirect association with strong peer support (b= 0.67, p= 0.012) and living with families (b= 22.93, p<0.001), through family support. Conclusion: Better quality of life of the elderly is directly associated with strong peer support, strong family support, mild dementia, and being married. It is indirectly associated with strong peer support and living with families. Keywords: quality of life, dementia, family support, peer support, elderl

Developing Solo City Conducive for Mentally Healthy Children and Adolescents

Background: The mental wellbeing of children and adolescents is just as important of their physical health. Good mental health allows children and young people to develop the resilience to cope with whatever life throws at them and grow into well-rounded, healthy adults. Currently, however, mental health problems affect about 1 in 10 children and young people worldwide. They include depression, anxiety, and conduct disorder, which are often a direct response to what is happening in their lives. This study aimed to assess the development of Solo city that promotes mental health of the children and adolescents. Subjects and Method: This was a qualitative study conducted in Surakarta, Central Java. A number of key informants were selected for this study consisting of bureaucrat, health planners, health practitioners, psychiatrists, psychiatry students, and community leaders. The theme under study was the development of Solo city that promotes mental health of the children and adolescents. The data were collected by in-depth interview, focus group discussion, and document review. Results: The development of mentally healthy city started from the top level multi sectoral coordination, with Solo city mayor took the central figure. Some activities had been done for the promotion of child and adolescent mental health, including the development of module to achieve competence of psychiatry residents, mental health care services provided by the resident for community members, screening of mental disorder requiring medical treatment at Solo Autistic Service Center (PLA), psychiatric introductory seminars for teachers, training on early detection of mental disorder (including autism) for teachers and health workers, and training on mental health nursing. Conlusion: Positive multi sectoral collaborative coordinated efforts have been initiated and exerted by bureaucrats, health planners, health practitioners, psychiatrists, psychiatry students, and community leaders. Some activities have been carried out for the development of Solo city that promotes mental health of the children and adolescents. Keywords: city, development, mental health, children, adolescents

Religious Belief and Its Influence on Healthy Ageing among The Elderly in Blora, Central Java

Background: WHO defines healthy ageing “as the process of developing and maintaining the functional ability that enables wellbeing in older age”. This study aimed to examine religious belief and its influence on healthy ageing among the elderly in Blora, Central Java. Subject and Method: A cross-sectional study was conducted in Blora, Central Java. A sample of 200 older people was selected for this study by snowball sampling. The dependent variable was healthy ageing. The independent variables were nutrition intake, age, religious (spiritual) belief, education, and income. Data on healthy ageing was collected by WHOQOL-BREF. The other variables were measured by questionnaire. The data were analyzed by a multiple linear regression. Results: Healthy ageing was positively associated with strong spiritual belief (b= 6.57; 95% CI= 3.48 to 9.66; p<0.001), better education (b= 7.43; 95% CI= 3.69 to 11.16; p<0.001), higher income (b= 6.77; 95% CI= 3.30 to 10.23; p<0.001), good nutritional status (b= 7.00; 95% CI= 3.89 to 10.11; p<0.001), but was negatively associated with age (b= -3.56; 95% CI= -6.98 to -0.14; p= 0.041). Conclusion: Healthy ageing is positively associated with strong spiritual belief, better education, higher income, good nutritional status, but is negatively associated with age. Keywords: healthy ageing, religious belief, elderly, agein

Theory of Planned Behavior on Factors Associated with Safe Sex Behavior among Female Sex Workers in Surakarta, Central Java

Background: Practising safe sex is important in order to ensure health and safety. Safe sex means exactly that "safe" is in terms of having sex without getting a contagious disease from your sex partner(s). Safe sex has the following outcomes: (1) It acts as a contraception to prevent pregnancy; (2) It prevents the transmission of sexually transmitted infections and infestations; and (3) It prevents the transmission of HIV, viral hepatitis, and other blood-borne viruses. This study aimed to analyze factors associated with safe sex behavior among female sex workers in Surakarta, Central Java, using Theory of Planned Behavior. Subjects and Method: This was a cross-sectional study carried out in Surakarta, Central Java, from April to May 2018. A sample of 134 female sex workers was selected by simple random sampling. The dependent variable was safe sex behavior. The independent variables were subjective norm, perceived behavior control, intention, attitude, education, and age. The data were collected by questionnaire and analyzed by path analysis. Results: Safe sex behavior was directly affected by intention (b= 0.96; 95% CI= 0.26 to 1.66; p= 0.007). It was indirectly affected by attitude perceived behavior con¬trol, subjective norm, education, and age. Conclusion: Safe sex behavior is directly affected by intention. It is indirectly affected by attitude perceived behavior control, subjective norm, education, and age. Keywords: safe sex behavior, female sex worker, theory of planned behavio

Effect of Dementia, Family Support, Peer Support, Type of Residence, and Marital Status on Quality of Life of the Elderly in Surakarta, Central Java

Background: The aging population is increasing in Indonesia and worldwide. Indonesia is one of the countries that has high aging population structure. As such, the quality of life of the elderly is of major concern. This study aimed to determine the effect of dementia, family support, peer support, type of residence, and marital status on quality of life of the elderly in Surakarta, Central Java.Subjects and Method: This was an analytical observational study with cross-sectional design. A total sample of 218 elderly people in Surakarta, Central Java, was selected for this study by fixed exposure sampling, with 1:3 ratio consisting of 50 elderly people living in Dharma Bakti nursing home and 168 elderly people living with their families in the community. The dependent variable was health-related quality of life. The independent variables were dementia, family support, peer support, type of residence, and marital status. The data were collected by questionnaire and analyzed by path analysis.Results: Better quality of life of the elderly was directly increased by strong peer support (b= 0.25, p<0.001), strong family support (b= 0.59, p= 0.002), mild dementia (b= 1.79, p<0.001), and being married (b= 12.73, p= 0.039). Better quality of life was also increased indirectly by strong peer support (b= 0.67, p= 0.012) and living with families (b= 22.93, p<0.001), through family support.Conclusion: Better quality of life of the elderly is directly increased by strong peer support, strong family support, mild dementia, and being married. It is indirectly increase by strong peer support and living with families.Keyword: quality of life, dementia, family support, peer support, elderlyCorrespondence: Sri Suwarni. School of Health Polytechnics, Ministry of Health, Surakarta. Email: [email protected] of Epidemiologi and Public Health (2018), 3(1): 83-94https://doi.org/10.26911/jepublichealth.2018.03.01.0

IS PRENATAL YOGA EFFECTIVE IN REDUCING ANXIETY AND DEPRESSION DURING PREGNANCY? A NEW EVIDENCE FROM KUDUS, CENTRAL JAVA

Background: Studies have shown that up to 33 percent of women experience clinical depression or an anxiety disorder at some point during pregnancy. Anxiety and depression in pregnancy can lead to low fetal quality, increased risk of pregnancy complication and developmental disorder of the child. Antidepressant treatment may cause recurrence or addiction rate of up to 50%. In theory, yoga can relieve undesirable psychic symptoms such as anxiety and depression during pregnancy. This study aimed to determine the effect of prenatal yoga on anxiety and depression during pregnancy. Subjects and Method: This was a randomized controlled trial conducted at Budi Luhur clinic in Kudus, Central Java, from 27 December 2017 to 7 February 2018. A total of 102 pregnant women was allocated at random into the intervention group (n1=51) and control group (n2=51). The independent variable was prenatal yoga. The dependent variables were anxiety and depression. The data were collected by questionnaire. Difference in the dependent variables between the two groups was tested by Mann-Whitney test and multiple linear regression. Results: The mean level of anxiety was lower in the intervention group than the control group both at two weeks after the intervention (b= -9.25; 95% CI= -10.22 to -8.28; p< 0.001) and four weeks after the intervention (b= -5.79; 95% CI= -7.68 to -3.90; p< 0.001). The mean level of depression was lower in the intervention group than the control group both at two weeks after the intervention (b= -10.82; 95% CI= -12.29 to -9.35; p< 0.001) and four weeks after the intervention (b= -2.58; 95% CI= -3.98 to -1.18; p< 0.001). Conclusion: Prenatal yoga intervention is effective in reducing anxiety and depression during pregnancy. Keywords: prenatal yoga, anxiety, depressio

Indonesian and Western Perspectives on Shackling the Mentally Ill

BACKGROUND: Mental illness has become a serious problem in Indonesia. Many people with severe mental disorders remain untreated or drop out of the care service system and eventually end up being shackled. Although attention to human right in Indonesia has grown, physical restraint of people with mental disorders remains prevalent. This study aimed to compare the Indonesian and Western perspectives pertaining to shackling the mentally ill. SUBJECT AND METHODS: This was a systematic review. The data were mined from news, research and studies pertinent to restrained mentally ill patients. Literature was searched from Google scholar, BMC, BMJ, and the Cochrane library. The key words used in the English language were “shackling and schizophrenia”, and “restraint and mental illnesses”. The Indonesian words included “pemasungan gangguan jiwa”. Searches were conducted until August 2015, resulting in 45 articles that consisted of 36 research articles and 9 non-research articles. Two of the 45 articles were duplicate. RESULTS: The theme of shackling in Indonesian perspective consists of: (1) Misguided perception of families and communities on people with mental illnesses (PMI); (2) Family and community treatment of PMI; (3) Lack of continuity in service programs between psychiatric hospitals, com-munity health centers, and communities. The theme of shackling in Western perspective consists of: (1) The impacts of restraint and shackling; (2) Restraint and shackling prevention; (3) There are no studies on the advantages of physical restraint. CONCLUSION: Research and news obtained from Indonesian articles consist of misguided perception pertaining to PMI and their treatment. Western articles include the impact of shackling PMI and prevention. It is essential to empower communities to raise awareness on mental illness and to provide correct information on treatment and the obligation to prevent shackling the mentally ill persons in Indonesia. Keywords: shackling, restraint, schizophrenia, mental healt

BIOPSYCHOSOCIAL FACTORS OF POSTPARTUM DEPRESSION: EVIDENCE FROM SURAKARTA, CENTRAL JAVA

Background: Postpartum depression (PPD) is one of the emotional disturbances that result from failure to postpartum psychological adaptation process. Untreated postpartum depression can have long-term adverse effects, both on mother and her children. In Indonesia, there is lack of research to explore the risk factors associated with PPD. This study aimed to determine the risk factors of postpartum depression. Subjects and Method: This was a cross-sectional study conducted at Dr. Moewardi hospital, from December 2017 to January 2018. A total sample of 150 postpartum mothers was selected for this study by exhaustive sampling. The dependent variable was PPD. The independent variables were maternal age, stress, parity, unwanted pregnancy, type of labor, family income, family support, and domestic violence. The data were collected by questionnaire and analyzed by path analysis model. Results: The risk of PPD increased with psychological stress (b= 2.15; 95%CI= 1.17 to 3.13; p<0.001), delivery type (b= 1.27; 95%CI= 0.32 to 2.21; p= 0.008), and unwanted pregnancy (b= 1.57; 95%CI= 0.57 to 2.58; p= 0.002). The risk of PPD decreased with family income (b= -1.52; 95%CI= -2.51 to -0.54; p= 0.002), parity (b= -1.24; 95%CI= -2.21 to -0.28; p= 0.011), and family support (b= -1.31; 95%CI= -3.28 to -0.24; p= 0.016). The risk of PPD was indirectly affected by maternal age and domestic violence. Conclusion: Psychological stress, maternal age, unwanted pregnancy, family income, parity, family support, and delivery type, are biopsychosocial risk factors for PPD. Keywords: postpartum, depression, unwanted pregnancy, domestic violence, family suppor

Unjuk Kerja Kolektor Surya dengan Absorber Bentuk V yang Dilengkapi Honeycomb dengan Beberapa Aspek Rasio

A simple apparatus using solar radiation that is essential for people in tropical area like Indonesia is called solar collector. A solar collector can be applied to heat air which can be used to dry some crops or agricultural products. One of some effort to improve the solar collector performance is using a v-corrugated absorber plate or installing slats in a honeycomb shape over the absorber to reduce heat loss. This paper will describe the combination of both. From the research, it was found that a solar collector with v-corrugated absorber plate has its best performance when the velocity of air is 0.5 m/s with aspect ratio H/L = 3/1. The performance includes the collector efficiency and the increase temperature of air flowing through the collector