Older People In Indonesia Research Articles

EDUCATION'S ROLE IN PRIMARY HEALTHCARE UTILIZATION AMONG OLDER PEOPLE IN INDONESIA

Introduction: The current situation shows that life expectancy is increasing, so the population of older people is also growing. As a vulnerable group, more senior people desperately need primary health care, and barriers to accessing services will increase vulnerability. Aim: The study aimed to investigate the impact of education on primary healthcare utilization among older people. Methods: This cross-sectional study examined 52,893 older people. It employed primary healthcare utilization as an outcome variable and education level as an exposure variable. Furthermore, the study used eight control variables: residence type, age group, gender, marital status, wealth, time travel to primary healthcare, and health insurance. We employed binary logistic regression to examine the data. Results: The study showed that older adults with primary education were 1.050 times more likely than those without to utilize primary healthcare (95% CI 1.046-1.054). Older people with secondary education were 0.643 times less likely to use primary healthcare than those without (95% CI 0.638-0.649). Older adults with secondary education were 0.378 times less likely than those without to use primary healthcare (95% CI 0.372-0.383). Furthermore, the study indicated that all control variables were significantly related to direct healthcare utilization. Conclusion: The study concluded that education level influences primary healthcare utilization among older people in Indonesia. Keywords: elderly people, education, primary healthcare, healthcare evaluation, healthcare access, public health

Health Coaching Intervention to Improve Self-Care Management of Hypertension Among Older People in Indonesia: A Randomized Controlled Study Protocol.

One-third of the global population is predicted to be diagnosed with hypertension (HTN) in 2025, with the percentage highest among older people. Without proper self-care management, uncontrolled HTN causes negative health consequences and decreases the quality of life. The previous scoping review identified various challenges that older adults may face in dealing with HTN and that effective approaches should consider each individual's circumstances and attributes. This study aims to investigate the efficacy and sustainable impact of an Indonesian adaptation of an 8-week nurse health coaching intervention on self-care management and self-efficacy among older people with HTN. The coaching sessions will last for 30 min weekly for 8 weeks. The data will be measured at three points: baseline (initial), 1 week after the eighth health coaching session, and 3 months after concluding the intervention. This study will be the first health coaching intervention research based on motivational interviewing and cognitive behavioral therapy approach with Indonesian background adjustment. The study result will help develop a guideline for nurses and other health workers providing health coaching for older people in Indonesia and other countries with similar characteristics in terms of sociodemographics or lifestyle. thaiclinicaltrials.org Identifier: TCTR20230410001 (Date of registration: April 9, 2023).

Efektifitas SENADA terhadap Peningkatan Fungsi Kognitif Lansia dengan Demensia: Case Report

Older people in Indonesia are experiencing a significant increase in population, often accompanied by a decline in brain function and the risk of dementia. SENADA (Brain Health Exercise) emerges as a potential approach for enhancing cognitive function in older people through simple movements. Further research and information are needed to support its use in elderly healthcare practices. This study employed a case report approach with nursing care to evaluate the effectiveness of SENADA in older individuals with dementia. Interventions were conducted regularly with structured data collection using MMSE. The aim of this research was to assess the effectiveness of SENADA in improving cognitive function in older people with dementia through a case report approach with nursing care. Interventions were given twice daily for five minutes. Data were collected through interviews, interventions, evaluations, and documentation. Results demonstrated that SENADA therapy in patient Ny. A was effective for enhancing cognitive function in older people, as evidenced by the change in MMSE outputs from moderate to no cognitive impairment.

Pemberian Terapi Kelompok pada Lansia di Panti Werdha Kota Salatiga

The increasing number of older people in Indonesia impacts the care process. Culturally, the eldest in Indonesia are cared for by other family members. On the other hand, several older people live in nursing homes during their old age. While in the nursing home, the eldest are cared for by health workers or nursing home administrators physically, psychologically, and spiritually to maintain or improve their quality of life. However, the elderly living in three retirement homes in Salatiga City are at risk of non-communicable diseases such as hypertension (70%) and high cholesterol (23%), loneliness, and sleeplessness (41%). The purpose of the community service is to provide group activities therapy to older people living in nursing homes. The activities included cognitive exercises (drawing, writing) and psychomotor (brain gymnastics and song movements). The service results showed that the eldest expression was happy and eager to follow the activities. The involvement of students also reduces the loneliness of the eldest, who have not received visits from their families for a long time. Group therapy activities can train cognitive and psychomotor skills and reduce feelings of loneliness in the elderly.

Ageing in Place VS Panti Werdha: Menyatukan Dua Konsep yang Bertentangan

As the population of older people grows, ageing issue becomes a priority to overcome in order to facilitate well-being among older people in Indonesia. One of critical factors that contributes to well-being is living arrangement. Ageing in place is a concept that refer to the ability of older people to live safely, independently, and comfortably in their homes as long as possible. However, there are some of older people and families who experience scare resources in caregiving and housing. To overcome these issues, institutional care is provided by the government to assist older people who do not have sufficient social supports. However, transferring older people from home to institutional care are still being a debate in Indonesia. In another words, institutional care is considered taboo by most Indonesians. In addition, international literatures emphasized the important of ageing in place and regard institutional care quite opposite to ageing in place. Therefore, this literature study aims to discuss the concept of ageing in place, institutional care, and to propose the idea to integrate the two conflicting concepts in order to facilitate inclusiveness among older people. This article is also expected to contribute to facilitate well-being among older people in Indonesia.

Effects of types and levels of social capital on emotional well-being for older people in Indonesia: A longitudinal study.

The purpose of this study was to examine the effects of different types and levels of social capital and emotional well-being in older adults in Indonesia by a longitudinal data. The fourth and the fifth waves of Indonesian Family Life Survey data were used for this study. The participants aged 60years or older who participated in both waves were included for analysis (n=1374). Depressive symptoms and happiness were used to assess emotional well-being. Cognitive social capital (neighborhood trust) and structural social capital (participating in arisan, community meetings, volunteers, village improvement programs, and religious activities) were the main independent variables. The generalized estimating equations model was used for analysis. Participation in arisan (B=-0.534) and attending religious activities (B=-0.591) were related to lower depressive symptoms, but the effect of religious activities would offset over time. Both a low or high social participation showed protective effects on depressive symptoms at the intercept and the time slope. Having higher neighborhood trust was related to more chance of feeling very happy (OR=1.518). Structural social capital is protective from depressive symptoms, while cognitive social capital contributes to happiness. Facilitating social participation and improving neighborhood trust through policies and programs is suggested to promote emotional well-being for older people.

Impact of COVID-19 Lockdowns on the Activity and Mental Health of Older People in Indonesia: A Qualitative Study.

The COVID-19 pandemic has caused detrimental impacts on different population groups throughout the world. This study aimed to explore the impacts of the COVID-19 pandemic’s mandatory lockdown protocols on individual and social activities and mental health conditions of community-dwelling older people in Jakarta, Indonesia. A qualitative design using one-on-one in-depth interviews was employed to collect data from the participants (n = 24) who were recruited using the snowball sampling technique. Data analysis was guided by the five steps proposed in a qualitative data analysis framework, including familiarisation with the data, identification of a thematic framework, indexing the data, charting the data and mapping and interpreting the data. The findings showed that before the COVID-19 outbreak participants engaged in different kinds of regular individual and social activities. However, the COVID-19 outbreak and its mandatory lockdown protocols significantly influenced both their activities and social life, which led to social disconnection and financial difficulties for them. COVID-19 outbreak, mandatory lockdown protocols, and the disruption of individual and social activities of the participants also caused mental health challenges to them, including feelings of loneliness, loss, sadness, stress, and anger. The findings suggest that there is a need for intervention programs addressing the socio-economic and mental health impacts of the COVID-19 pandemic on older populations to help them cope with these challenges. Future studies involving large-scale older populations to comprehensively understand COVID-19 impacts on them are recommended.

Acceptance of e-health technology among older people: A qualitative study.

E-health technology has been widely implemented in healthcare systems and has many benefits. However, available studies that focus on the acceptance and adoption of e-health technology, particularly among older people in primary care centers, are still limited. A qualitative approach was adopted in this study to explore the acceptability and adoption of health technology among older people who use primary health care. Semistructured interviews were conducted with 11 older people to gain in-depth insight into their perspectives on health technology. An inductive thematic analysis was conducted to gain insight from older people. Three main themes emerged: (1) "demand of care" refers a situation where participants realized that they had a health problem, sought ways to solve the health problem, and expected to be cared and monitored; (2) "resistance and openness" represent technology acceptance by older people; and (3) "preference for home health monitoring": We found older people preferred home health monitoring in terms of comfort and ease of use. The study has provided important new knowledge in relation to acceptance and preference for health technology that currently exists, particularly among older people in Indonesia.

Risk factors for the metabolic syndrome in non-obese older Indonesians.

The problem of metabolic syndrome among non-obese older people is often ignored. This study examines the risk factors for metabolic syndrome in non-obese older people in Indonesia. We analyzed information collected from 3323 non-obese older respondents interviewed in the 2018 Basic Health Research program. The outcome variable was the metabolic syndrome consisting of three components: high lipid profile, diabetes mellitus, and hypertension. The potential predictors analyzed were socio-demographic and behavioral factors consisting of psychomotor (cigarette smoking + physical activity) and dietary behavior (consumption of fat + fruit/vegetable). Multinomial logistic regression analysis was employed to assess metabolic syndrome risk factors in non-obese older people. We found that the proportion of non-obese older people in Indonesia with metabolic syndrome was 83.8% (95%CI: 82.4-85.2%). The odds of developing 2-3 components of metabolic syndrome increased in respondents from rural areas (aOR=1.26, p=0.033) and those with moderate psychomotor behavior problems (current smoker/ex-smoker with sufficient physical activity) (aOR=1.48, p=0.002). Health promotion activities are vital to improve awareness and promote healthy behaviors, specifically for those living in rural areas and smoking cigarettes.

Non-Communicable Diseases among the Elderly in Indonesia in 2018

Non-Communicable Disease (NCD) is closely related to the aging process, social development, and increased risk factors. The study aims to analyze the prevalence of NCD among the elderly in Indonesia based on demographic characteristics. The study employed the 2018 Indonesia Basic Health Survey data. The survey used the multi-stage cluster random sampling method; it was a weighted sample of 85,358 elderly. In this analysis, the NCDs prevalence in the elderly includes hypertension, heart disease, bronchial asthma, chronic renal failure, diabetes mellitus (DM), stroke, and cancer determined based on a doctor’s diagnosis. The study result shows the prevalence of NCD in the elderly population in Indonesia, most of which are hypertension, mental-emotional disorders, depression, DM, and heart disease. Based on age group, the prevalence of hypertension, mental-health disorders, and depression tends to increase with increasing age, stroke and bronchial asthma are higher in the 70-79. DM and cancer were higher in the 60-69. Heart disease and kidney failure did not differ relatively between age groups. The prevalence of hypertension, mental-emotional disorders, depression, DM, heart disease, and cancer was higher in women. Still, asthma, stroke, and chronic kidney failure tended to be more in men. The study concluded that the most prevalent NCDs among older people in Indonesia were hypertension, mental, emotional disorders, depression, DM, and heart disease. NCDs have demographic characteristics.

Impact of Periodontal Disease on the Quality of Life of Older People in Indonesia: A Qualitative Study.

Introduction:The impact of periodontal disease on oral health–related quality of life (OHRQoL) has often been investigated from a quantitative research perspective, which is based on clinical findings and an OHRQoL questionnaire. Very few studies have examined the issue from the view of qualitative research. To our knowledge, there have been no previous qualitative studies focusing the effect of periodontal disease on OHRQoL in Indonesian older people.Objectives:To explore and understand the impact of periodontal disease on the OHRQoL of older people as a subjective reflection in relation to periodontal disease experiences.Methods:Semi-structured interviews were conducted in a sample of 31 older people with generalized chronic periodontitis. Thematic analysis was used to identify the key issues in participants’ accounts. The analysis was undertaken by 2 independent coders to ensure reliability. To achieve thematic saturation, successive interviews were undertaken until 5 sequential interviews did not bring new themes.Results:Participants reported the negative effects likely related to periodontal disease. The impacts of periodontal disease were described by these older people as affecting more than pain, physical discomfort, and physical function restrictions. Periodontal disease also affected their psychological and social aspects of daily living. In addition, this study identified themes related to individual and environmental factors that may modify and personalize periodontal disease experiences. Furthermore, this study identified a misleading belief that problems related to periodontal disease were a normal part of aging, which might influence individuals’ expectations toward oral health. Relatedly, participants frequently reported that the progression of tooth mobility to tooth loss was an inevitable part of the aging process.Conclusions:Periodontal disease negatively affected participants’ OHRQoL. It is fundamental to understand older people’s perceptions toward their periodontal disease as well as individual and environmental factors that may have an influence on their periodontal disease experiences.Knowledge Transfer Statement:This study is a reflection of Indonesian older people’s subjective periodontal disease experiences. Therefore, the present study can be used to understand older people’s perceptions, attitudes, behaviors, and experiences toward periodontal disease and how this disease may affect their quality of life. This study also highlights a widespread and misleading belief that oral problems related to periodontal disease are an inevitable part of aging in this study population.

Pengaruh Latihan Penguatan Dengan Elastic Band Dalam Meningkatkan Kemampuan Pasien Osteoarthritis Knee Di Rumah Sakit Condong Catur Sleman

Background Osteoarthritis is a degenerative disease caused by joint cartilage damage. The main symptoms of osteoarthritis are pain and movement disorders that can affect the functional disorders. The prevalence of knee osteoarthritis in Indonesia is quite high reaching 15.5% in men and 12.7% in women. It is estimated that 1 to 2 million older people in Indonesia suffer from disabilities due to osteoarthritis. Osteoarthritis treatment is intended to reduce pain improve functional ability and prevent deformity. Elastic band strengthening exercises are exercises that can be used to reduce pain increase muscle strength and functional ability.Objective This study aims at determining the effect of elastic band strengthening exercises in improving knee osteoarthritis functional capabilities.Method The method used in this study was quasi-experimental with pre and post-test control group design. The number of respondents of this study was 20 respondents diagnosed with knee osteoarthritis in Condong Catur Hospital Sleman. Respondents were randomly divided into two groups namely the treatment group that received elastic band strengthening exercise treatment and the control group that received standard treatment given at the hospital. The treatment was given twice a week for four weeks. Measurement of functional ability was done using WOMAC score.Results There was a decrease in pain level in the treatment group while in the control group the pain level was still the same as before. In the functional ability there was an increase in the treatment group. The statistical test showed that there was an influence between the treatment group and the control group.Conclusion Elastic band strengthening exercises effectively improved functional capabilities in knee osteoarthritis in Condong Catur Hospital Sleman.Keywords elastic band strengthening exercises functional capabilities knee osteoarthritis

Translation and Culture Adaptation of Problems and Needs of Palliative Care Questionnaires for Use in Older People in Indonesia

Identifying problems that affect the quality of life and the need for care generally requires using a unique screening tool with the same characteristics as those used to achieve goals. However, in a clinical setting, palliative care problems and needs are given less attention and are poorly understood. In addition, there is currently no validated instrument for measuring the problems and needs of palliative care in older people. This study aimed to develop and validate a new instrument that assessed palliative care problems and needs in older people. Items were generated through a review of the literature and refinement by an expert. The instrument was psychometrically evaluated using construct validity with convergent and discriminant validity. At three community centers in Bandung, Indonesia, 187 older people completed the final instrument. According to the confirmatory validity test, 35 items were found to be valid. For a problem section, the factor loading ranged from 0.17 to 0.67 and for the need section from 0.17 to 0.61. Scale reported good convergent and constructed validity A 35-item psychometric properties assessment of palliative care issues and needs of older people. This instrument will be clinically useful in providing a systematic way to assess problems and needs of palliative care in older people as primary data and care management evaluation. Additional research should be conducted to examine alternative methods for establishing construct validity.

Adult children labour migration and parent health: evidence from Indonesian panel data

PurposeThis study aims to explore the impact of adult child labour migration on the health of parents and the possible mechanism that contributes to the health of families left behind.Design/methodology/approachSeveral indicators of parents’ health are analysed and several subgroups – parents of migrant sons, parents of migrant daughters, parents aged 50+ and parents who live in rural areas are investigated. The data from Indonesia Family Life Survey are used and the fixed effects method is used to address potential endogeneity and instrumental variables are applied in the sensitivity analysis.FindingsThe labour out-migration of adult children has a positive and significant association with the health status of the parent left behind. The parents of migrant children are more likely to have a better self-rated health status, fewer episodes of morbidity symptoms, fewer unhealthy days, fewer visits to outpatient care and are less likely to be on medication than the parents of non-migrant children.Research limitations/implicationsThe study design in a longitudinal setting, however, there is a relatively many years gap between waves could provide insufficient statistical power for measuring health variations. Future studies should consider to explore possible health outcomes for parents who co-resided with an adult child and the types and severity of various disease conditions.Practical implicationsHighlights challenges in health-care provision for older people in Indonesia and the possible contribution of health disparities in developing countries.Originality/valueExplores the impact of out-migration of adult children on the health of parents left behind, using very recent data of over a long period of a longitudinal design.

Correlates of Visuospatial Ability among Older People in Indonesia.

Introduction:The Indonesian elderly population keeps increasing. Aging is related with degeneration process, one of which is a decrease in cognitive function, including visuospatial ability. This is the first study on the visuospatial ability of Indonesian older people.Objective:This research aimed to assess the visuospatial ability and its correlation with sex, age, education, and general cognitive function among older people in Indonesia.Subjects and Methods:The research subjects were older people aged ≥60 years with Mini-Mental State Examination (MMSE) score ≥24. The visuospatial ability was assessed using Wechsler Adult Intelligence Scale-Revised (WAIS-R) Block Design Test (BDT). Regression analysis was performed to reveal the correlation of sex, age, education, and global cognitive function with visuospatial ability.Results:Sixty older people participated in this research, with an average age of 68.08 ± 6.24, mean MMSE score of 27.43 ± 1.71, and mean WAIS-R BDT score of 27.8 ± 7.27. The female and older individuals tended to have lower scores. Subjects with higher education and global cognitive function had higher WAIS-R BDT scores. Regression analysis showed that age and sex did not have significant effect, but education and global cognitive function had positive effect on visuospatial ability.Conclusion:There is a significant correlation between education and global cognitive function with visuospatial ability among older people in Indonesia.

Hand Muscle Grip Strength on Pre- And Post- Rubber Ball Performing Exercises of Older People

Introduction: The number of older people in Indonesia continues to rise. Aging process will cause changes in organ systems, one of which is changes in the musculoskeletal system. One of the significant weakening of function in the elderly is the degrading strength of the handheld muscles, which resulted in a decrease of functional abilities. One method which can be used to increase hand muscle grip strength is by doing rubber ball exercise. Aim: To analyze the difference of hand muscle grip strength on pre- and post- performing rubber ball exercises in elderlies at St. Joseph Nursing Home in Surabaya. Method: This study is a pre-experimental analytic research with one group pretest – posttest design approach. The sampling technique used consecutive sampling, with a total sample of 48 elderlies. The interventions for rubber ball exercises were carried out three times a week for one month. Instruments used for this study were the MMSE and MNA-SF questionnaires. The hand muscle grip strength was measured using the Handgrip Dynamometer. data analysis was done using the SPSS program and the Chi-Square test. Results: The mean total value of the muscle grip strength pre-exercises was 10,8 ± 3,9 kg. The mean total value of the hand muscle grip strength post exercises was 11,97 ± 4,08 kg. The data analysis results show that there was a significant difference between pre- and postperforming rubber ball exercises on the elderly at St. Joseph nursing home in Surabaya. (p=0,025). Conclusion: There is a significant contrast between pre and post-performing rubber ball exercises on the elderly at St. Joseph nursing home in Surabaya.

Correlation of Routinely Given Yoga Exercise With Level of Anxiety in Elderly of Yuswo Widodo Integrated Service Post Surabaya

Introduction: The percentage proportion of older people in Indonesia is increasing, indicating that Indonesia is a country with a population structure leaning towards the elderly. If one does not die before that, every human being will surely experience an aging process that can cause various problems such as health problems. Anxiety is one of the serious health problems in the elderly. Physical exercise, such as yoga, can help reduce anxiety level. Aim: To analyze correlation between yoga exercise and level of anxiety in the elderly in Posyandu Lansia Yuswo Widodo Surabaya. Method: This research used a pre-experimental study with pre-posttest one group design, held on the 26th of July 2019 until the 16th of September 2019. The samples in this study were 22 people, all of whom were elderlies who routinely visited and have participated in 16x yoga exercise for two months. The research instrument this study used was HARS. Kendall’s Tau B was used for the data analysis. Results: data analysis shows that there was a correlation between routine yoga exercise and the level of anxiety in the elderly in Posyandu Lansia Yuswo Widodo Surabaya p=0,030. Pretest results showed that there were 14 elderly with mild anxiety and eight elderly with moderate anxiety. post-test data showed five elderly with mild anxiety levels and 17 people who did not have anxiety. Conclusion: There was a correlation between the routine of yoga exercise and the level of anxiety in the elderly in Posyandu Lansia Yuswo Widodo Surabaya.

Стратегический анализ трендов на рынке труда старшего поколения

Modern society is faced with the negative impact on the economies of population ageing, therefore there is an urgent need to develop a strategy for silver economy. A long-term strategy will help to avoid or to reduce the negative effects that are caused by population ageing, as well as to help to use opportunities that will have a positive effect on the development of the economy as a whole. One of the areas associated with the ageing population that needs to be developed is the labor market for the older workers. Due to increase of the retirement age as in Russia and as in other countries this topic is particularly relevant. Creating conditions of work, changing attitudes towards the elderly, their health, retraining, development of technologies that contribute to the improvement of the labor infrastructure are integral directions for strategic development. It is also necessary to pay attention to the specific vector of development of labor market, which is moving towards the automatization of technology and job cuts, which rather complicates the process of introducing the elderly to the labor market. All of the above areas should be considered when writing a long-term strategy for the development of a labor market for the elderly. The aim of the work is to identify existing trends in labor market for older workers in foreign countries and in Russia. The goal was achieved by analyzing international documents, scientific monographs, official data of state statistics of various countries, ministries of labor, health, internal affairs, and reports of international public organizations. The article discusses general demographic trends, the experience of using the labor potential of older people in Indonesia, Japan, the USA and Russia, reveals global strategic trends in the labor market for older people. The data reflect heterogeneity of attitudes towards older people in labor market in different countries. The rate of protection of elder from dismissal and discrimination is also multiple-valued. For the successful development of labor market and support of high quality of life, it is necessary to create a regulatory framework that will protect older employees, establish government policy and change the culture of perception of older people.

Nutrition research in cognitive impairment/dementia, with a focus on soya and folate.

Observational studies and treatment trials investigating nutrition and cognitive function, with a focus on folate and soya and dementia, were reviewed. Data suggested that effects of folic acid based interventions may only be shown before cognitive decline is evident and/or if people are folate deficient. In older people in Indonesia, Hawai'i and China, tofu, which can contain high levels of phytoestrogens, was found to increase dementia risk. This association was not mediated by a vegetarian diet, socioeconomic status, formaldehyde, thyroid function, or loss of teeth. On the other hand, human observational and animal treatment studies suggested that tempe, a fermented soya product containing phytoestrogens and folate, reduced dementia risk and improved memory. High oestrogen levels were found to increase dementia risk in older women. However, in women with adequate serum folate, high oestrogen levels did not confer additional dementia risk and may protect ageing neurons. In conclusion, reviews seem to suggest that folic acid interventions are only effective on cognitive outcomes in people who are folate deficient and do not have cognitive impairment. Frequent consumption of tofu may have detrimental effects on memory and increase dementia risk in older East Asian people, while tempe may reduce these risks. Possibly folate in tempe offsets the potential negative effects of oestrogenic compounds on ageing neurons.

COMMUNITY SERVICES FOR OLDER PERSONS PROVIDED BY FAMILIES AND THE YOUNG IN INDONESIA

AbstractBy 2050, the number of older people in Indonesia will approach 80 million. To enhance the health status of older persons, a referral program of networking hospitals and health clinics have been created. A survey of health centers in 33 provinces found them to be age-friendly. Our evaluation showed that the health status and daily life activity levels of older persons were maintained but depended on the number and dedication of young generations) providing services. Based on the programs reviewed, we conclude that there is national and community awareness of the issues surrounding the provision of care of older persons. However, it seemed that Indonesia is experiencing a decreasing number of the young supporting older persons. Suggestions are provided to reverse this trend to maintain community resilience and sustainability.