The results of this study call for further intervention in supporting Indonesian nurses living in Japan in their struggle with the issue of communication. The emphasis on language acquisition for personal and professional objectives, and the bridging of cultural differences as well, should be considered in an international context.

Purpose The raising of grandchildren by grandparents is a global phenomenon, and it is common in Indonesia. This is because parents are often unable or unwilling to raise their own children. However, the debate around “grandparenting” is still limited in Indonesia. The purpose of this paper is to gain a better understanding of the experience and views of grandparents on “grandparenting.” Design/methodology/approach The methodology employed was qualitative and informed by phenomenology. The authors conducted in-depth interviews with 13 grandparents who were raising their grandchildren who were under five years old. The data were analyzed using thematic content analysis. Findings 5 main themes and 13 subthemes emerged from the analysis of the data. The themes were responses, strategies for overcoming negative responses, the grandparents’ role, the reason for raising grandchildren, and the cultural aspect of “grandparenting” in Java. All of the grandparents enjoyed their roles as grandparents. They felt that they helped fulfill their grandchildren’s physical and educational needs. Social implications The experience of raising a grandchild can be both positive and negative, depending on the cultural aspects in the Java and the family as a whole system. Grandparents require healthcare and informal support to maintain their well-being. Originality/value This paper provides new insights into “grandparenting” closely related to social and cultural aspect within the community. Grandparents enjoy being a part of the Javanese tradition. The supportive role of grandparents in Indonesia is important. However, older adults need to balance the role of “grandparenting” and rest time so that they remain healthy and happy.

Background: Women are a highly vulnerable population for HIV-infection, influenced by biological, cultural, social and eco- nomic factors. Inadequate knowledge about the risk for exposure to HIV will impact the prevention and treatment of HIV. Objectives: The aim of this study was to examine HIV-related knowledge among women in Indonesia and the associated de- mographic determinants that influence their access to accurate HIV-related information. Methods: This was a secondary analysis of the Indonesia Demographic and Health Survey in 2012. Level of HIV-related knowledge was determined by analyzing nine items on the 2012 IDHS instrument. Results: The percentage of women in Indonesia between the ages of 15 and 49 years of age, more than half (53.6%) had high score of HIV-related knowledge. The results from logistic regression showed that women aged 30-34 years old had 2.2 times higher knowledge level about HIV compared to older women. Married women, living in rural area, with a lower level of educa- tion, reported to have limited or no access to HIV related information; thus, had a correspondingly lower knowledge level of HIV. Conclusion: Study findings underscore the lack of knowledge-level among Indonesian women about HIV, especially the pre- vention, transmission, and prevention mother to child transmission (PMCT). Keywords: HIV; Knowledge; prevention; women; demographic health survey.

Purpose The purpose of this paper is to analyze factors associated with post-traumatic stress disorder (PTSD) among elderly who live in a post-earthquake area. Design/methodology/approach This was a cross-sectional study involving 152 elder people who survived the disaster and were selected conveniently. The study was conducted in two worst-affected districts of Lombok Utara regency. PTSD was diagnosed using a modified version of the Clinician-Administered PTSD Scale version 5 (CAPS-5). The demographic data were assessed using a self-developed questionnaire consisting of 13 items. All data were analyzed by descriptive analysis, χ2 test and binary logistic regression with p<0.05. Findings Out of the 152 elder people, 91 (59.9 percent) suffered PTSD. Intrusion symptoms were the most common symptoms experienced by the respondents (94.1 percent). The factors associated with the PTSD in the elderly after the earthquake were having chronic illnesses (OR=2.490; 95% CI=1.151–5.385), public health center utilization (OR=2.200; 95% CI=1.068–4.535) and occupational status before the disaster (OR=2.726; 95% CI=1.296–5.730). These findings highlight that individual factors and access to health care services remain an important aspect of stress identification among the elderly following the disaster event. Social implications Elder people constitute a vulnerable group that is often forgotten and neglected during post-disaster recovery, though they have potentially higher psychosocial distress than younger age groups. This study was conducted to raise awareness about mental health problems suffered by the elderly. Originality/value This is the first study to apply CAPS-5 to assess PTSD among Indonesian elderly people following a natural disaster. This paper also provides insights that can be used by governments and other relevant parties to address PTSD problems suffered by many elderly people in a post-disaster area.

Purpose This study aimed to analyze the effect of Trauma-Focused Cognitive Behavior Therapy (TF-CBT) on the depression level and quality of life of the elderly in an earthquake-affected district of North Lombok Regency, Indonesia. Design/methodology/approach A Randomized Controlled Trial (RCT) with a population of two elderly groups living in an earthquake-affected district was used in this study. The intervention comprised giving TF-CBT. There were three research instruments applied to determine the variables, namely, the Clinician-Administered PTSD Scale (CAPS-5), the Geriatric Depression Scale 15 (GDS 15) and the World Health Organization Quality of Life-BREF (WHOQOL-BREF). All instruments were adopted and translated using back translation to Bahasa Indonesia, which is appropriate at the suggestion of the WHO. To investigate the effect of the intervention, we used hierarchical linear models (HLM) with intent-to-treat analysis. The patent parameter effect was tested using the Wald test (t-test) with a confidence Interval of 95 per cent. Findings The final analysis applied CAPS-5 and showed that there was a decrease in the PTSD of the respondents, which was down to only 8 (17.8 per cent) in the post-test. The same situation happened for the depression variable (2.8 per cent) after it was assessed using GDS-15C. The Quality of life (WHOQoL-BREF) variable was divided into Physical (50.7), Psychological (57.1), Social (53.6) and Environmental (45.7). These components show there to be a significant result in terms of improving the quality of life of the elderly victims of the earthquake. The finding highlights that applying TF-CBT in the elderly population can significantly drop post-traumatic stress disorder and depression level and enhanced quality of life. Social implications The intervention decreased the depression level and improved the quality of life of the elderly as found in the six- week follow-up. Longer training and integration with the structured local wisdom could be necessary to better address the mental health of the elderly affected by the earthquake. Moreover, strengthening the role of the family as the primary caregiver is required to improve the outcome. Originality/value This is the first study that has attempted to use TF-CBT as a method of treatment for the elderly to decrease their depression and to increase quality of life among the Indonesian elderly who have experienced an earthquake. This paper provides knowledge on the effectiveness of TF-CBT that can be used by therapists to treat depression problems suffered by the elderly in a post-disaster area.

Introduction: Stunting is a chronic nutritional issue that happens in the world including Indonesia caused by local cultural factors. Madurese people are one of the races that closely live to their culture. Madurese people practice a culture that is related to nutrition intervention provision for toddlers. This study was aimed to analyse the factors related to specific intervention provision as an effort to prevent stunting from occurring to toddlers aged 6-24 months old.Methods: This study used analytical design in Galis community health care December 2019. The population in this study were 160 mothers with toddlers aged 6-24 months old in which 115 of them were selected as sample based on purposive sampling. The inclusion criteria were the mothers who lived with their child in one house and caring for the child themselves. Exclusion criteria were mothers with a history of Special Economic Zone (SEZ) and mothers who were not present at the time of the study. The independent variables in this study were technological factor, religious and philosophical factor, social support factor, cultural value and lifestyle, political and legal factor, economic factor, and educational factor. Meanwhile, the dependant variable was the provision of specific nutritional interventions, namely colostrum, exclusive breastfeeding – breastfeeding up to 23 months accompanied by complementary foods, worm medicine, zinc supplements, iron, complete immunization, and diarrhoea prevention and treatment. The data were collected by questionnaires with Logistic Regression Analysis.Results: The result of this study showed that social support is related to specific nutrition intervention provision with significance of p= 0.003. Cultural values and life style are related to specific nutrition intervention provision with significance of p= 0.048.Conclusion: According to this study, factors that give significant influence is social support consisting of instruction information and advice. Madurese people still believe that the most influential and experienced persons in child caring are grandmother, mother in law, and parents.

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Purpose A nursing home is a place that is familiar with death, since many older adults will spend the latter part of their lives in such a setting. However, research on this topic is still limited, especially in Indonesia. The purpose of this paper is to explore the barriers to successful palliative and, more generally, end-of-life care (EOLC) for older adults in nursing homes and to explore nurses’ views on the subject. Design/methodology/approach The study is of a qualitative nature and it employs a phenomenological approach. In-depth interviews with 15 nurses who taken care of older adults in a nursing home were conducted. The data were analysed using thematic content analysis. Findings Barriers to effective EOLC include lack of knowledge, ineffectual communication and insufficient resources. Research limitations/implications Better policies are needed, especially in training related to palliative/EOLC subjects and equitable distribution of professional health workers to overcome the barriers. The government should also encourage collaboration involving hospitals, Puskesmas (Health Centre Services), community and resident care settings in sharing knowledge and skills, especially for nurses. Originality/value The barriers identified in palliative and EOLC have been found to be almost identical to those encountered in other health services.