This study sought to assess actions which Indonesia, Sudan, and Tanzania took to implement the health workforce commitments they made at the Third Global Forum on Human Resources for Health (HRH) in November 2013. The study was conducted through a survey of published and gray literature in English and field research consisting of direct contacts with relevant ministries and agencies. Results show that the three countries implemented interventions to translate their commitments into actions. The three countries focused their commitments on improving the availability, geographical accessibility, quality of education, and performance of health workers. The implementation of the Recife commitments primarily entailed initiatives at the central level, such as the adoption of new legislation or the development of accreditation mechanisms. This study shows that action is more likely to take place when policy documents explicitly recognize and document HRH problems, when stakeholders are involved in the formulation and the implementation of policy changes, and when external support is available. The Recife Forum appears to have created an opportunity to advance the HRH policy agenda, and advocates of health workforce development in these three countries took advantage of it.
The increasing number of people living with HIV infection (PLWH) in Indonesia has led to an increased demand for care. Health care facilities are overburdened. Home-based care (HBC) is a valuable strategy to complement existing health care services and to extend the continuum of care for PLWH and their families. This qualitative study explored the care needs of PLWH that might provide baseline data for developing HBC in Bandung, West Java, Indonesia. Data were collected from 12 key and 25 general participants through observations, interviews, and focus group discussions. Findings indicate that HBC is urgently needed for PLWH, particularly for those who need palliative care and those who encounter major barriers to using available health care services. It is recommended that health care providers and policy makers strengthen the role of the family in taking care of PLWH through trainings and knowledge dissemination.
Background. This study aims to analyze the effect of exercise and learning therapy on the cognitive functions and daily physical activities of older people with dementia in Indonesia. Methods. This was an experimental study with a pretest-posttest design and a control group. Samples were selected using nonrandom sampling methods and were then randomly assigned to intervention and control groups. The study population was older people with mild-to-moderate dementia, and the sample number was 90 people. The intervention group received an Indonesian physical exercise program for older people and reading therapy through 12 sessions over four weeks. The intervention was led by a community health volunteer who has been trained and certified. Results. The mean score for cognitive function in the intervention group showed significant increase between pre- and postintervention, with p value < 0. 001 , and there was no significant difference in the control group before and after intervention, with a p value of 0. 198 . Further, the Mann–Whitney test showed that there were significant differences in the mean scores for cognitive function between the intervention and control groups with p value < 0. 001 and a 95% confidence level. Conclusion. Based on the results, the Indonesian older people exercise program and reading aloud activity had a positive effect on the cognitive function of older people with dementia.
Klinik RSHS Teratai HIV telah merawat pasien dari September 2004 sampai Desember 2009, sebanyak 2.060 ODHA dan 1290 menerima ARV (63%). Selama periode ini, sebesar 11% (141 orang) kehilangan kontak lebih tinggi dari keseluruhan persentase di Indonesia yaitu 10,7% (Depkes, 2009). Tujuan dari penelitian ini adalah untuk menyelidiki hasil yang benar dan faktor hilang tindak lanjut ARV di klinik RSHS Teratai ARV. Penelitian ini menggunakan metode wawancara mendalam dengan 25 pasien HIV / AIDS bawah pengobatan ARV di klinik Teratai RSHS dan mangkir sejak tahun 2009 yang tinggal di daerah Bandung. Informan dipilih secara acak dan dihubungi untuk kunjungan rumah untuk diwawancarai oleh pewawancara yang berpengalaman. Peneliti melakukan wawancara mendalam di rumah pasien sekitar 60 menit. Data direkam oleh pita digital direkam, ditranskrip dan dicetak oleh dua peneliti bidang independen menggunakan analisis tematik.Hasil penelitian ini menunjukkan tujuh tema yang pengetahuan yang tidak benar, optimisme yang tidak realistis, masalah aadministratif, perasaan efek samping negatif, masalah interpersonal, masalah kecanduan, dan kurangnya perawatan diri. Oleh karena itu, penting untuk mengembangkan tindakan pencegahan melalui rincian kontak pasien, meminta pasien persetujuan untuk dihubungi, telepon, kunjungan rumah setelah 3 minggu kehilangan kontak, dan menyarankan pasien untuk mendaftar ke klinik ART lebih dekat dengan rumah mereka , dan mengembangkan sistem reminder untuk mengingatkan pasien untuk mengambil ARV tepat waktu. ABSTRACTTeratai clinic HIV RSHS has treated patients from September 2004 to December 2009, as much as 2060 PLWHA and 1290 receive ARV (63%). Over this period, 11% (141) were lost to follow-up that is higher than overall lost to follow up percentage in Indonesia which is 10.7% (MOH annually report December 2009). The aim of this study was to investigate the true outcomes and factors of lost follow up to ARV. This study used indepth interview method to 25 HIV/AIDS patients under ARV treatment in the Teratai clinic RSHS and lost to follow up since 2009 who lived in Bandung area. Informants were randomly selected and contacted for a home visit to be interviewed by experienced interviewer. The interviewers obtained verbal informed consent and conducted an in depth interview in the patients home. Interview took about 60 minutes. Data were recorded by digital tape recorded, transcribed and scored by two field researchers independently using thematic analysis. The result of this study shows seven themes which are incorrect knowledge, unrealistic optimism, administrative problems, feeling of negative side effect, interpersonal problem, addiction problem, and lack of self-care. Therefore, it is important to develop preventive measure through up-dating patients’ contact details, ask patients consent to be contacted, up date phone contact, home visit after 3 weeks lost of contact, advice patients to register to ART clinic closer to their homes, and develop a reminding system to remind patients to take ARV on time.
Perilaku perawatan kaki merupakan komponen yang penting dalam pencegahan kaki diabetik. Namun, banyakpasien Diabetes Melitus (DM) yang tidak menjalankannya akibat rendahnya pengetahuan dan self-efficacy pasienmaupun keluarga. Di sisi lain, dukungan dan keterlibatan keluarga merupakan aspek penting dalam terlaksananyaperilaku perawatan kaki pasien DM. Pengembangan program peningkatan perawatan kaki DM berbasis keluargapenting dilakukan guna mengatasi kelemahan program sejenis yang berbasis individu. Tujuan penelitian iniadalah untuk mengidentifikasi pengaruh program edukasi perawatan kaki berbasis keluarga terhadap perilakuperawatan kaki pasien DM. Penelitian quasi experiment dengan pre-test and post-test with control group designini melibatkan 72 responden DM Tipe 2 dan keluarganya yang diseleksi secara purposive dari populasi respondenDiabetes Melitus di wilayah kerja Puskesmas Pasirkaliki Kota Bandung. Sampel dibagi menjadi kelompokintervensi dan kontrol dengan masing-masing 36 responden. Responden pada kelompok intervensi mendapatkanprogram edukasi perawatan kaki berbasis keluarga, konseling serta tindak lanjut 1 kali melalui telepon dan tigakali melalui kunjungan langsung ke rumah. Perilaku perawatan kaki dikumpulkan menggunakan kuesioner.Data dianalisis menggunakan paired dan independent t-test. Hasil penelitian menunjukkan tidak ada perbedaankarakteristik antar kelompok. Perilaku perawatan kaki post test (M=84.69, SD=4.49) pada kelompok intervensiberbeda secara bermakna (p = 0.000) lebih tinggi dibanding pre test (M=49.50, SD=9.40), sedangkan padakelompok kontrol ada penurunan skor setelah pengukuran (sebelum M=51,33, SD=8,58; sesudah M=49,50,SD=9,40; p=0,219). Program edukasi perawatan kaki berbasis keluarga efektif meningkatkan perilaku perawatankaki pasien DM. Dengan demikian, perawat dapat mengintegrasikan program edukasi perawatan kaki berbasiskeluarga ke program perkesmas sebagai upaya pencegahan kaki diabetik pada pasien Diabetes Melitus.
AbstrakPerilaku perawatan kaki merupakan komponen yang penting dalam pencegahan kaki diabetik. Namun, banyak pasien Diabetes Melitus (DM) yang tidak menjalankannya akibat rendahnya pengetahuan dan self-efficacy pasien maupun keluarga. Di sisi lain, dukungan dan keterlibatan keluarga merupakan aspek penting dalam terlaksananya perilaku perawatan kaki pasien DM. Pengembangan program peningkatan perawatan kaki DM berbasis keluarga penting dilakukan guna mengatasi kelemahan program sejenis yang berbasis individu. Tujuan penelitian ini adalah untuk mengidentifikasi pengaruh program edukasi perawatan kaki berbasis keluarga terhadap perilaku perawatan kaki pasien DM. Penelitian quasi experiment dengan pre-test and post-test with control group design ini melibatkan 72 responden DM Tipe 2 dan keluarganya yang diseleksi secara purposive dari populasi responden Diabetes Melitus di wilayah kerja Puskesmas Pasirkaliki Kota Bandung. Sampel dibagi menjadi kelompok intervensi dan kontrol dengan masing-masing 36 responden. Responden pada kelompok intervensi mendapatkan program edukasi perawatan kaki berbasis keluarga, konseling serta tindak lanjut 1 kali melalui telepon dan tiga kali melalui kunjungan langsung ke rumah. Perilaku perawatan kaki dikumpulkan menggunakan kuesioner. Data dianalisis menggunakan paired dan independent t-test. Hasil penelitian menunjukkan tidak ada perbedaan karakteristik antar kelompok. Perilaku perawatan kaki post test (M=84.69, SD=4.49) pada kelompok intervensi berbeda secara bermakna (p = 0.000) lebih tinggi dibanding pre test (M=49.50, SD=9.40), sedangkan pada kelompok kontrol ada penurunan skor setelah pengukuran (sebelum M=51,33, SD=8,58; sesudah M=49,50, SD=9,40; p=0,219). Program edukasi perawatan kaki berbasis keluarga efektif meningkatkan perilaku perawatan kaki pasien DM. Dengan demikian, perawat dapat mengintegrasikan program edukasi perawatan kaki berbasis keluarga ke program perkesmas sebagai upaya pencegahan kaki diabetik pada pasien Diabetes Melitus.Kata kunci : Diabetes Melitus, keluarga, perilaku perawatan kaki. Effectiveness of Family Based Foot Care Education Program towards Foot Care Behavior of Type 2 Diabetes Mellitus Patients AbstractFoot care is an important behavior to prevent diabetic foot. However, many Diabetes Mellitus (DM) who have not performed the foot care due to lack of knowledge and the low self-efficacy of patients and their families. Support and involvement of families are important aspects in helping patients performing the foot care. Hence, the development of family based foot care education program is important in order to overcome the weaknesses of individual health education program. This study aimed to identify effectiveness of family based foot care education program towards the foot care behavior of DM patients. Quasi experiment using pre-and prost test with control group design was conducted involving 72 type 2 DM patients and their families which purposively selected from the population of DM patients in working area of Puskesmas Pasirkaliki Kota Bandung....
Introduction This study aims to explore nursing students’ perception and experience of end-of-life care (EoLC) in Indonesia, particularly in the family environment. Methods This study used a qualitative research design to explore the experiences and perceptions of nursing students who have witnessed the dying of their family members. The study recruited 15 nursing students using a purposive sampling method, who were then invited to reflect and write their experiences in witnessing death of their families, and perceptions towards EoLC. The written reflections were analyzed using thematic analysis. Results Thematic analysis showed that the experience of witnessing dying of a family member shaped nursing students’ perceptions and attitudes towards EoLC. Some themes that emerged in this study included the importance of effective communication with patients and their families, symptom management, spiritual, emotional, and social support, as well as the need to improve nursing education and training. Conclusion This present study shows that the experience of witnessing the death of a family member shapes nursing students’ perceptions of EoLC in Indonesia. This present study provides recommendations that the students must be prepared emotionally and psychologically in caring EoL or dying patients. How attitude and readiness to care EoL patients are shaped by the experience in witnessing the dying family or loved one. As such, palliative and EoL curriculum should be included methods that allow desensitization and naturalization of dying for the students in order to make them ready to provide better EoLC for patients and their families. The results of this study can contribute to improving the quality of EoLC in Indonesia.
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