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Summary: Purpose: Mind-body exercise is a promising non-pharmacological approach for managing sleep disturbance and depression that are prevalent among older adults, but its efficacy remains inconclusive across the studies. This study aimed to systematically evaluate and quantify the overall effectiveness of mind-body exercises on sleep disturbance and depression in older adults. Methods: We searched eight databases to identify relevant articles from their inception to April 2024. Experimental studies that evaluate the effects of mind-body movement therapy on sleep disturbance and depression in older adults were included. The Cochrane Risk of Bias tool version 2.0 was used to appraise included studies. The pairwise meta-analysis was performed through the software Comprehensive Meta-Analysis Version 3.0. Moreover, subgroup analysis was utilized to understand the effect size on each form of mind-body exercise and to determine the source of heterogeneity. Results: A total of 27 studies were eligible and synthesized. The mind-body exercise appears statistically significant in reducing sleep disturbance (SMD = −0.60, 95% CI: 0.76 ∼ 0.44) and depression (SMD = −0.56, 95% CI: 0.75 ∼ 0.36) among older adults. Each form of mind-body exercise, including pilates, yoga, qigong, and tai-chi, effectively decreases sleep disturbance and depression, but there were no significant differences in the effects between these practices. Conclusion: The cumulative evidence concludes that older adults who participated in mind-body exercise programs showed potential improvements in sleep disturbance and depression. This finding may serve as evidence for professionals to use this approach as a non-pharmacological approach to help older adults in the community and long-term care facilities who are having sleep disturbance and depression. More clinical trials are needed for an in-depth meta-analysis that can rank and compare the efficacy of each mind-body exercise practice.

Background: Reproductive health, crucial for public health and sustainable development, encompasses family planning and contraceptive use. However, global disparities persist in the adoption of family planning, highlighting the need for a comprehensive understanding of the complex factors shaping these reproductive health choices. Materials and Methods: Following Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines, we conducted a systematic search of the Scopus, ScienceDirect, PubMed, Web of Science, and ProQuest databases from July to August 2023. Inclusive criteria covered various study designs and populations, ranging from individuals to communities, and encompassed sociocultural factors. The review included open access articles published between 2018 and 2023, utilizing a combination of the keywords: Family planning determinants, Contraceptive use factors, Sociocultural factors in family planning, Individual-level influences on family planning, and Factors affecting contraceptive choices. Results: Data from 25 selected studies underscore the critical influence of determinants at both individual and community levels in shaping family planning behaviors. Key drivers at the individual level included education, age, knowledge, and attitudes. At the community level, factors such as geographical disparities and healthcare accessibility played pivotal roles. Sociocultural determinants, including media exposure, gender norms, and spousal dynamics, highlighted the need for culturally sensitive strategies. Conclusions: Advancing equitable family planning requires education, improved access, peer influence, and the active participation of husbands and male partners. Comprehensive programs should bridge the gap between knowledge and action, reduce disparities, and ensure equal access to contraception. Context-specific research and evaluating interventions are crucial steps toward achieving global reproductive health objectives.

This article explores the best practices of mentorship programs in all journals at Universitas Airlangga. The university has established a journal mentoring team, as mandated by the rector’s regulation, which is responsible for guiding journals through preparation, submission, management, policy, and overall quality improvement. A case study was conducted to explore the mentoring mechanisms at Universitas Airlangga. Mentors were selected from among experienced editors at the university, each with a distinguished background in managing their own journals. The mentorship program successfully led to the indexing of 14 journals in Scopus, one in Web of Science (WoS), 85 in the Science and Technology Index (SINTA), and 60 in Directory of Open Access Journals (DOAJ). The strategies used can be shared with other universities to assist their journal editors. The mentorship program at Universitas Airlangga has significantly improved the quality and international visibility of its academic journals. This is evidenced by the successful indexing of numerous journals in prestigious databases including Scopus, WoS, SINTA, and DOAJ. The structured mentoring, clear targets, and comprehensive institutional support were instrumental in achieving these results. This model serves as a scalable best practice for other universities seeking to improve their journal quality and global standing.

The health status of Type 2 Diabetes Mellitus (T2DM) patients is observed to decrease simultaneously along with the length of time. Despite the various treatment management offered in primary care, a decrease in health status is also observed among patients in Indonesia as shown by the low self-care ability. Therefore, this research aimed to analyze the relationship between self-efficacy and the health status of patients in primary care in Indonesia to provide evidence for the development of care management interventions for T2DM patients. The research used a descriptive analytical method with a cross-sectional design, including 327 T2DM patients in primary health care selected through cluster random sampling. Data collection used the Indonesian version of the Diabetes Management Self-Efficacy Scale (DMSES) and Short Form 12 (SF-12) questionnaires which had been tested for validity and reliability. The data obtained were analyzed using the Pearson Product Moment test with a significance value of 0.01. The results obtained an r-value of 0.485 with a p-value of 0.00, showing a significant relationship between self-efficacy and health status in T2DM patients (0.00

Background: Physical inactivity (PA) is an important contributor to morbidity and mortality globally. Adolescence is an important period of engaging in physical activity. 2 systematic reviews before 2022 concluded that studies need more methods and evaluations to prove the continued effect of Online-based interventions. It is therefore prudent to continue this research by considering how we can approach young people to grow healthy values into their day-to-day activities. Purpose: This study aims to determine online-based interventions for physical activity in adolescents. Method: A search of the literature databases Scopus, Science Direct and Springerlink using key words ‘Adolescents’, ’Teenagers’, ’E-health’, ’Internet-based’ , ‘Online-based’, and ’Physical Activity’ limited to 5 articles which fit the criteria for inclusion. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol was used, and papers were excluded if they were disease focused, not specific to adolescents or did not measure PA as an outcome. Results: All of studies had significant increases in PA as a result of an Online-Based intervention Studies include using various implementation mechanisms. The majority of studies use a mix of web- tutorials and based lessons for participants to work on in addition to goal setting via online, app-based (4/5). That remaining studies they were given an accelerometer as a measuring device and instructed online to perform the physical activity used for the rest of the study using online forums and PA experts to emphasize the effect of goal setting. Various intervention such as giving messages about PA or Health related issues were performed few a week for about 2-3 month. Conclusion: Online-based interventions are a very successful way to increase PA. More research is required to look at what theoretical principles are best to underpin interventions and also to assess the length of intervention required for optimal results after intervention. Ideas surrounding implementation require more studies to evidence base these interventions for schools, via intracurriculum or extracurriculum.

Dehydration remains a critical issue in children and can pose a risk of mortality. Nurses play a crucial role in promptly and accurately preventing dehydration, beginning with the recognition of its causes and symptoms in patients. A thorough assessment by nurses is key to ensuring proper and timely treatment of dehydrated patients, especially in high-activity emergency units. The integration of technology into emergency units is essential for enhancing patient services and decision-making processes. This study aims to conduct a systematic review by analyzing the use of mobile phone applications in assessing signs of dehydration and possible management in hospital services. Four databases (Scopus, Science Direct, and Pubmed) were used in this study using the keywords assessment, smartphone, and dehydration management. Access to the quality of this study using a cross-sectional design from Joanna Briggs Institute. Use the PRISMA flowchart to summarize the study selection. Limit for the last eight years, namely 2017 – 2022. The results of this study met the inclusion criteria, including patients with dehydration caused by gastroenteritis problems and pediatric or pediatric patients. inclusion and exclusion criteria applied to the PICOS framework. The result of eleven studies in the article found that a digital-based dehydration management approach is very beneficial for the effectiveness of services and initial assessment of the patient's clinical condition. The integrity of digital technology in healthcare has revolutionized many aspects of healthcare management and delivery. By implementing digital solutions such as dehydration management documents, health workers can improve their ability to prevent and treat dehydration.

Type 2 diabetes mellitus (T2DM) requires dietary compliance to manage elevated blood glucose levels. In calorie counseling, a client and counselor have conversations about calorie consumption problems related to type 2 diabetes. The study aimed to evaluate how calorie counseling affected T2DM patients’ adherence to their diets. A quasi-experimental design was employed to randomly assign 40 T2DM patients to the intervention (n=20) or control (n=20) groups. Food logs were gathered prior to and following counseling, and analysis was done using independent T-tests. The findings revealed a post-intervention mean discrepancy in calorie consumption of 132.08 Kcal. The results of the T-test analysis, however, showed that there was no significant difference between the groups (P=0.26>0.05), suggesting that group-based calorie counseling had no appreciable impact on diabetes diet compliance. Confounding variables like age, education, employment status, and family support could have impacted these results. It is advised that future studies consider how family support and demographic factors might improve diet compliance in T2DM patients. This method can lead to more effective interventions for this population and a more thorough understanding of the variables influencing dietary adherence.

Patients with diabetes often lack the necessary knowledge, leading to inadequate behavior in preventing wounds. To overcome the limitations of traditional learning methods, it is crucial to adopt the flipped classroom approach for effectively educating diabetic patients about wound prevention. This study aimed to explore the relationship between the environment, learning infrastructure, and the flipped classroom learning method among patients with Diabetes Mellitus (DM). Employing a cross-sectional design, the study encompassed patients with DM aged 40-55 years from both genders. A total of 120 patients were selected through purposive sampling techniques. The variables investigated included education factors and the flipped classroom method, which were assessed using a modified questionnaire developed by the researchers and validated for reliability. Data analysis was conducted utilizing Spearman rank analysis. Concerning education factors, 80% of the participants reported having a supportive environment, while 82.5% indicated having access to good learning infrastructure. Regarding the flipped classroom method, 35.8% of the respondents stated that its application in educating patients with DM in the community was effective. There was a statistically significant relationship between the environment and infrastructure and the flipped classroom approach in patients with DM (p-value

Exposure to secondhand smoke is one of the leading causes of death for non-smokers worldwide. The prevalence of exposure to secondhand smoke is higher among adolescents. Research on predictors of secondhand smoke exposure in adolescents is still rarely conducted in Indonesia. This study aimed to analyze the predictors of exposure to secondhand smoke among non-smoking adolescents in Indonesia. This study used data from the Global Youth Tobacco Survey (GYTS) Indonesia 2019 with a cross-sectional design. A total of 7,594 adolescents aged 13 to 15 were selected using purposive sampling. The dependent variables were exposure to secondhand smoke at home and in public. The independent variables included age, gender, smoking parents, smoking friends, and knowledge of the dangers of secondhand smoke. Data were analyzed using STATA with inferential tests, namely chi-square and logistic regression. The prevalence of adolescents exposed to secondhand smoke at home and in public was 49.57% and 71.86%, respectively. At-home exposure was significantly associated with smoking parents [AOR=3.50, 95% CI=2.97 to 4.12], smoking friends [AOR=1.50, 95% CI=1.30 to 1.73], and knowledge of the dangers of secondhand smoke [AOR=2.11, 95% CI=1.52 to 2.93]. Public exposure was associated with ages 13-15 [AOR=1.32, 95% CI=1.10 to 1.58] and older than 15 [AOR=1.77, 95% CI=1.39 to 2.25], male gender [AOR=1.31, 95% CI=1.11 to 1.53], smoking parents [AOR=1.58, 95% CI=1.36 to 1.84], smoking friends [AOR=2.16, 95% CI=1.85 to 2.53], and knowledge of secondhand smoke dangers [AOR=2.84, 95% CI=2.15 to 3.75]. Adolescents’ exposure to secondhand smoke in public spaces is higher in prevalence and has more associated factors compared to exposure at home. Exposure reductions require comprehensive actions from authorities by strictly implementing and expanding non-smoking areas covered by existing regulations. Also, family and school management should be involved in prevention efforts.

Abstract Anemia is a global threat among women of reproductive age (WRA), or 15–49 years old women, both in developed and developing countries. Prevalence of anemia in WRA is higher by fourfold in developing countries, based on extensive studies and surveys conducted by WHO and UNICEF. However, there is limited studies that conducted pooled analysis of anemia prevalence in low resource countries. This study aimed to assess the prevalence and factors associated with anemia among women of reproductive age in low- and middle-income countries (LMICs). This study used secondary data from the Demographic and Health Survey (DHS) in 46 low- and middle-income countries during 2010–2021. Descriptive statistics of proportions between pregnant and non-pregnant mothers were assessed. Multilevel binary logistic regression was used to test the factors associated with anemia among women of reproductive age. A total of 881,148 women of childbearing age in LMICs were included. This study found a high prevalence of 45.20% (95% CI 41.21, 49.16) of anemia was observed in among pregnant women and 39.52% (95% CI 33.88, 45.15) anemia was observed in non-pregnant women. Educational status, wealth status, family size, media exposure, and residence were common factors significantly associated with anemia in both pregnant and non-pregnant women. The high global burden of anemia in LMICs continues to underline the need for unusual approaches and target interventions on an individual basis. Global commitment and movement to reduce the prevalence of anemia need to be revisited and redesigned for current circumstances.

Abstract Introduction Experiences and determinants connected with type 2 diabetes mellitus-associated erectile dysfunction (T2DMED) in health appointments are not well understood and infrequently reported. This systematic review was undertaken to synthesise evidence of the experiences, facilitators, and barriers around screening ED in men with T2DM during health service consultations. Methods The review report was based on the guidelines provided by the Joanna Briggs Institute for conducting mixed-method systematic reviews. Eight electronic databases were searched, including Web of Science, Embase via Ovid, Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCO, ProQuest, PubMed, PsychInfo via Ovid, MEDLINE via Ovid, Portal Garuda. Additionally, the review manually looked through the reference lists of the studies we included. Erectile dysfunction, type 2 diabetes mellitus, screening and barriers were initially used as keywords in the search strategy. All identified primary studies written in English and Bahasa Indonesia, and published between 2001 and 2022 were meticulously screened following an agreed set of inclusion criteria. Findings Out of 3468 papers screened, only six were chosen for the review. These included three cross-sectional studies, two qualitative studies, and one mixed-method study. The study quality of the included studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist. Based on the checklist criteria, the studies ranged between 5/10 to 9/10 in terms of quality. After synthesizing the findings, four main categories were identified including the willingness to discuss T2DMED, the barriers experienced and perceived, the limited understanding of T2DMED, and the support expected by men with T2DM. Discussion Many men kept quiet about their struggles with T2DMED, hoping to bring it up as a topic of discussion during healthcare consultations. Barriers such as embarrassment, a sense of helplessness and reluctance to seek help, financial constraints, and dismissive healthcare professionals hindered them from addressing this issue. Both the participating men and healthcare professionals lacked a comprehensive understanding of T2DMED. Recommendations It is important to provide education tailored to men's specific needs and improve awareness about T2DM-associated ED. Creating a more T2DMED-friendly environment could be a potential solution to increase early screening and management. Future research should investigate potential barriers that prevent HCPs from identifying and addressing T2MED since their absence in the identified studies highlights this need. Systematic review registration CRD42021292454.

IntroductionThe equitable distribution of medical specialists in Indonesia's remote areas remains a challenge. This study investigated the preferences of medical specialists regarding retention programs aimed at addressing this issue.MethodsA Discrete Choice Experiment (DCE) was utilized to collect stated preferences from 341 medical specialist working in district general hospitals across 10 Indonesian provinces. The DCE retention questionnaire focused on eight key characteristics: location, medical facilities, net income, continuing professional development program, security, length of commitment, source of incentives, and caseload.ResultsThe study found that the most influential factors for retention in remote areas were security guarantees from the local government (OR = 6.11), fully funded continuing professional development programs (OR = 2.84), and access to advanced medical facilities (OR = 2.35).ConclusionThe findings indicate that a comprehensive intervention package, with a particular emphasis on security provisions, is necessary to retain medical specialists in remote areas. Financial incentives are also recommended to improve retention. However, it is crucial to acknowledge that no single intervention will suffice, as the factors influencing specialist retention in remote areas of Indonesia are complex and multifaceted.

Statistics from the 2018 National Social and Economic Survey revealed that one out of nine young females in Indonesia have been in female child marriage, and the prevalence remains high. Considering the serious consequences of female child marriage and that Sustainable Development Goal 5 on gender equality has targeted the elimination of female child marriage by 2030, a study concerning the prevalence and determinants of female child marriage needs to be conducted in Indonesia. In this paper, we examined the prevalence of and factors associated with female child marriage in Indonesia using binary logistic regression. We examined data from the Indonesia Demographic and Health Survey conducted in 2017. A sample of 9,333 young females aged 15-20 years was included in the study. Our analysis involved descriptive and binary logistic regression analysis. The results are presented in percentages and odds ratios (OR), with their respective confidence intervals. Our findings indicate that health insurance and sex of household head did not significantly influence female child marriage. The prevalence of female child marriage in Indonesia was quite high, reaching about 12.53%. Females with no education [OR = 76.448; (CI = 29.73-196.70)], not working [OR = 1.662; (CI = 1.41-1.94)], those with the poorest wealth index [OR = 3.215; (CI = 2.336-4.425)], those living in the east of Indonesia [OR = 1.451; (CI = 1.132-1.862)], and those living in rural areas [OR = 0.718; (CI = 0.609-0.844)] had the higher odds of experiencing female child marriage. Meanwhile, females with a secondary education level [OR = 16.296; (CI = 11.098-23.930)], those with a rich wealth index [OR = 1.940; (CI = 1.404-2.681)], and those living in the middle of Indonesia [OR = 1.263; (CI = 1.074-1.487)] were less likely to experience female child marriage. Educational background was the most significant factor influencing the high prevalence of female child marriage in Indonesia. Female empowerment through education as well as poverty alleviation were factors that could be strengthened to ensure that female child marriage is reduced or eliminated in Indonesia. Equality of access to information and better quality of education also need to be prioritized.

Peer group support plays a crucial role in enhancing diabetic foot care. However, diabetic patients often exhibit suboptimal foot care behavior due to a lack of support. This study aimed to explore the correlation between peer group support and foot care practices in individuals with diabetes mellitus. Employing a cross-sectional design, the research focused on diabetes mellitus patients aged 40-55 years, and those with less than five years of diabetes history. A purposive sampling technique was utilized to select 64 participants. The research variables encompassed demographic factors, peer group dynamics, and diabetic foot care behavior. These were assessed through a modified questionnaire, verified for validity and reliability. Data analysis involved descriptive analysis and chi-square analysis. The findings revealed a prevalence of 79.7% for inadequate peer group support and 20.3% for robust support. In terms of diabetic foot care behavior, 56.3% exhibited poor practices, while only 17.2% demonstrated good foot care behavior. All variables displayed significance concerning the dependent variable, with a p-value < 0.003. This underscores the positive impact of peer group support on improving foot care behavior in diabetes mellitus patients. This study highlights the need for further research to delve into the effects of educational interventions and family involvement in enhancing diabetic foot care behavior.

Hypertension has been identified as a causative factor for cardiovascular disease, a leading global cause of death. The accessibility of health services plays a pivotal role in shaping community awareness and engagement in hypertension management. This research aimed to explore the availability of primary health facilities, health control practices, drug consumption, and healthy living behaviors among individuals with hypertension. Utilizing a correlation study with a cross-sectional design, the sample comprised 130 hypertensive individuals selected through purposive sampling. Statistical analysis used the Spearman rho correlation test. The findings revealed that significant correlations between primary health facility availability and health control behavior (α=0.000, r=0.310), antihypertensive drug consumption behavior (α=0.000, r=0.461), and healthy lifestyle behavior (α=0.000, r=0.478) among hypertensive patients. These results underscore the relationship between the availability of primary health facilities and the behavior of hypertensive patients in terms of health control, drug consumption, and healthy lifestyle choices within the community. While the full implementation of these behaviors among hypertensive patients may not be optimal, the observed good availability of primary health facilities serves as an initial step to promote improved behaviors in the management and prevention of hypertension complications within the community.

Introduction The proportion of stunted children in Indonesia is slowly decreasing. In most families, a mother is responsible for child care. The quality of maternal caregiving capability influences the mother’s ability to adopt appropriate childcare practices, which is essential to prevent childhood stunting. Objectives This study aimed to develop a model to enhance maternal caregiving capabilities in preventing childhood stunting based on the UNICEF model of care. Methods The study used an analytical observational design involving a pair of mothers and their youngest 6–23-month-old children registered at Posyandu (Community-based Integrated Health Care Center). Six hundred respondents were taken using a cluster sampling technique across seven healthcare centers in Surabaya City, East Java, Indonesia. The independent variables were child, mother, father, and household factors, then maternal caregiving capabilities. The dependent variable was the nutritional behavior to prevent childhood stunting. Data were collected using questionnaires and then analyzed using the Structural Equation Model-Partial Least Squares (SEM-PLS) test. Results The study found that maternal caregiving capabilities are influenced by child (T-stat 2.605), mother (T-stat 3,800), and household factors (T-stat 10,338). Maternal caregiving capabilities affect stunting preventive behavior in children aged 6–23 months (T-stat 2.493). Household factors were the strongest factor affecting maternal caregiving capabilities. Conclusion Enhancing maternal caregiving capabilities model can be developed using its constituents, especially perceived physical health, psychological well-being, and decision-making. Household factors, including economic level and food security, were also important. High maternal caregiving capabilities were expected to enable mothers to improve their behavior to prevent childhood stunting (6–23 months).

Abstract Aim The first scoping review is to map and synthesize the stressors, problems and coping strategies surrounding the health issues of migrant domestic workers. Design Scoping review using Arksey and O'Malley's five‐stage framework. Methods Ten electronic databases were systematically searched by keywords for literature published between January 1995 and December 2019. Data were extracted into tables and collated and summarized into themes for presentation. Results Twenty‐seven reports were included in the final review. Analysis revealed that stressors to health included abuse, poor health service accessibility, ongoing financial hardship despite demanding working conditions and social isolation. Physical and mental health problems were identified for which migrant domestic workers largely depended on social networks and religion to cope with stressors and health problems. Training para‐professional peer leaders of migrant domestic workers by community nurses and including them in interprofessional teams is a possible way for nurses to promote their health and well‐being.

Background: High-risk pregnancy is a serious problem and needs to be detected early. Pregnant women with risk categories have a direct impact on the fetus. This study aimed to analyze maternal characteristics and the consistency of antenatal care visits in relation to the pregnancy risk status of pregnant women using the Independent Family Health Evaluation (IFHE) Methods: This study used a cross-sectional study with a correlational design. The sample was the third-trimester pregnant women who have a maternal and child health record booklet, with a total sample of 128 respondents. The instrument used was a questionnaire adopted from the identification of family health in the IFHE application system. Data analysis was carried out using multiple logistics regression. Results: The results showed that age (p = 0.004), height (p = 0.027), number of pregnancies (p = 0.0001), history of pregnancy (p = 0.0001), history of childbirth (p = 0.001), having children under 2 years of age (p = 0.001), pregnancy complications (p = 0.0001), and history of regular antenatal care (p = 0.0001) had a significant effect on pregnancy risk status. While history of tetanus toxoid immunization showed no relationship with pregnancy risk (p = 0.332). The final modelling of multiple logistic regression showed that the influential variables were age, the number of pregnancies and consistency of antenatal care. The number of pregnancies was the variable that had the strongest influence on pregnancy risk status (OR= 40.192). Conclusion: This research contributes valuable insights into the factors influencing pregnancy risk, providing a foundation for more effective antenatal care and ultimately better health for expectant mothers and their infants. Healthcare providers can use this information to identify pregnant women at higher risk and implement targeted interventions, thereby improving maternal and fetal outcomes.

The migration of nurses from Indonesia to other foreign countries is an inevitable part of the global mobility of the nurse profession. This phenomenon requires investigation to understand the current trajectories of Indonesian nurses in the global market. This scoping review aimed to investigate the Indonesian nurses' mobility to the international healthcare market. A scoping review of primary research addressing Indonesian nurses migration journey overseas. A range of databases were searched, including Scopus, Web of Science Clarivate Analytics, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PubMed. A systematic process was performed guided by the work of Arksey and O'Malley. Four databases were searched, and 68 articles were retrieved. After screening articles and abstracts, 19 full texts were assessed for eligibility, and finally, 17 studies were further analyzed and synthesized. Eleven qualitative studies, five quantitative study and one literature review study met inclusion criteria, emphasizing the three phases of migration: pre-migration, migration and post-migration. The destination countries of Indonesian nurses including Japan, Kuwait, Saudi Arabia and Taiwan. At the pre-migration stage there are several aspects that must be considered, there were: language, understanding of the job position, reason to work and comprehensive understanding of the destination countries. Migration stage include issues language, deskilling, mental health, unclear career path, cultural adaptation, lack of religious services and homesickness. At the post-migration stage includes deskilling, brain waste and re-integration with brain circulation platform. The comprehensive approach of Indonesian nurses migration from pre-migration, migration and post-migration has shown us the trajectory of Indonesian nurses in international migration. Understanding the bottle neck of each stage with improve policy support is needed to create safe and sound migration channel for Indonesian nurses. This review highlighted to the need for future research in key areas such as the impact of nurse migration on Indonesia's health systems.

Cancer is the second leading cause of death worldwide. Two prominent factors in this regard are a woman's history of contraceptive use and the duration of breastfeeding. This study aimed to delve into these risk factors and their impact on cancer incidence. The research employed a cross-sectional design involving 125 cancer patients undergoing chemotherapy at Abdul Wahab Sjahranie Hospital in Samarinda, East Kalimantan. This study used a total sampling approach to include all available patients. Data on contraceptive use, breastfeeding duration, and cancer status were collected through a questionnaire and subsequently analyzed using the chi-square test. The study revealed that breast cancer was the most prevalent type, affecting 41.6% of patients. Additionally, more than half of the respondents breastfed for less than two years (52%), while only 48% breastfed for two years or more. Notably, a significant majority (66.4%) had a history of using hormonal contraception. Statistical analysis demonstrated a compelling association between contraceptive history, breastfeeding duration, and cancer incidence (p < 0.001). In summary, the findings highlight a substantial relationship between a woman's history of contraceptive use, the duration of breastfeeding, and the incidence of breast cancer. These results underscore the importance of further research and the development of targeted interventions to better understand and mitigate breast cancer risk factors among women.

Nutritional status and health are crucial factors in maintaining a healthy pregnancy, especially during the COVID-19 pandemic. This study aimed to analyze the relationship between CGOL (Chlorophyll, Ginger, Orange, and Lemongrass) consumption and confirmed COVID-19 cases in pregnant women. The research, conducted in East Java with 250 purposively sampled respondents, employed a correlational cross-sectional design. Data were collected through questionnaires, Likert scales, and documentation. Analysis of research data using descriptive analysis and Spearman-Rho analyses. The study revealed that CGOL consumption in pregnant women was 28% less than optimal, 21.2% moderate and 50.8% optimal. Confirmed COVID-19 cases in pregnant women are 10%, and 90% are not confirmed. There was a significant relationship between CGOL consumption and confirmation of COVID-19 in pregnant women (p-value=0.0001). These findings emphasize the importance of integrating CGOL-based nutritional guidelines into prenatal care programs, particularly during pandemics, to enhance pregnant women's and their babies' health.

Objective: Chair-based resistance band exercise (CRBE) is a simple and safe physical activity for persons with limited mobility. This study aimed to review and analyze CRBE effects on physical functioning, sleep quality, and depression among older adults in long-term care facilities (LTCF). Method: A systematic search guided by the PRISMA 2020 approach was performed on specific databases: AgeLine, CINAHL, PubMed, Embase, Cochrane Library, Scopus, and Web of Science. The randomized controlled trial studies that trialed CRBE for older adults in LTCF, peer-reviewed articles published in the English language from inception to March 2022 were retrieved. Methodological quality was established using the Physiotherapy Evidence Database scale. The random and fixed effects model were used to generate the pooled effect size. Results: Nine studies met the eligibility criteria and were synthesized. The results revealed that CRBE significantly promoted the activity of daily living (six studies; SMD = 0.30, P = 0.001), lung capacity (three studies; MD = 40.35, P

Abstract Background Complementary foods with breastfeeding are foods or drinks given to children aged 6–23 months to meet their nutritional needs. The non-optimal provision of complementary feeding influences malnutrition in children of this age. Aims To analyze the factors associated with complementary feeding practices among children aged 6–23 months in Indonesia. Methods A cross-sectional design was employed using data from the 2017 Indonesia Demographic and Health Survey. A total of 502,800 mothers with children aged 6–23 months were recruited through multistage cluster sampling. Data were analyzed using a logistic regression test to determine the correlation between predisposing, enabling, and reinforcing factors and complementary feeding practices. Results A prevalence values of analysis showed that approximately 71.14%, 53.95%, and 28.13% of the children met MMF, MMD, and MAD, respectively. The probability of achieving minimum dietary diversity (MDD) was high in the following: children aged 18–23 months (odds ratio [OR] = 9.58; 95% confidence interval [CI] = 7.29–12.58), children of mothers with higher education (OR = 5.95; 95% CI = 2.17–16.34), children from households with upper wealth index (OR = 2.53; 95% CI = 1.85–3.48), children of mothers who received childbirth assistance by professionals (OR = 1.63; 95% CI = 1.20–2.20), and children of mothers who had access to the Internet (OR = 1.26; 95% CI = 1.06–1.50). Moreover, children from households with the upper wealth index (OR = 1.40; 95% CI = 1.03–1.91), children whose mothers were employed (OR = 1.19; 95% CI = 1.02–1.39) living in urban areas (OR = 1.28; 95% CI = 1.06–1.54) and children of mothers who received childbirth assistance by professionals (OR = 1.33; 95% CI = 0.98–1.82) were more likely to meet Minimum Meal Frequency (MMF). Finally, children aged 18–23 months (OR = 2.40; 95% CI = 1.81–3.17), of mothers with higher education (OR = 3.15; 95% CI = 0.94–10.60), from households with upper wealth index (OR = 1.41; 95% CI = 1.05–2.90) and born with professional childbirth assistance (OR = 1.82; 95% CI = 1.21–2.75) were significantly associated with minimum acceptable diet (MAD). Conclusions The findings revealed that the prevalence of MDD and MAD in Indonesia was low. Strategies such as improving health services, economic conditions, and education level of mothers are needed to improve infant and young child feeding in Indonesia.

Abstract Background Task-shifting, the distribution of tasks among health workers to address health workforce shortage, has been widely used to tackle mental health treatment gaps. However, its implementation in Indonesia has still been rarely explored. This study aimed to explore stakeholders’ perspectives on the implementation of mental health task-shifting to nurses in Indonesia's primary health care. Methods An exploratory descriptive approach using in-depth interviews and focused group discussions (FGDs) was used. The study involved 19 stakeholders from the government's ministry directorates, professional organisations, and mental health practitioners. Thematic analysis was used to analyse the data. Results Three themes emerged namely, task-shifting feasibility and acceptability, shared task implementation, and nurse role enhancement issues, with 14 sub-themes. Conclusions Task-shifting on mental health issues in the eye of Indonesian stakeholders is viewed as a matter of sharing and collaboration. Implementation of task-shifting in Indonesia may require policies in place and political will across stakeholders. Further scrutiny on task-shifting implementation is needed by considering the local context and national environment.

Introduction: UNESCO 2019 said that Indonesia’s education has ranked 54 to 120 countries. The Sustainable Development Goals (SDGs) contain goals 4, target 4a, indicator 4.a.1. Quality education can be achieved with basic drinking water during school hours, basic sanitation facilities, and basic handwashing facilities. School sanitation is covered at targets 3, 4, and 6 of SDGs. The objective of this review is to identify school sanitation, determination of disease, and students’ health status-related school sanitation. Materials and Methods: This research was based primarily on a literature review. Boolean technic was used to define the keywords. The database used for the searching within these documents were School Sanitation, Health, and Students. Data were found from search engines PubMed, Science Direct, Springer, and Google scholar. The literature review of this search was done by the publication range 2019-2022. The search data were conducted on 8 October 2022, which Acquired 7 articles that meet predefined criteria. Results and Discussions: Schools’ sanitation was identified in water supply, drinking water supply, rest room, sanitary facilities, toilet/ latrine, hand washing facilities, cleaning policy, clean and functional toilet, Water Sanitation and Hygiene Programs, and the knowledge of sanitation. The effect of health-related school sanitation was gastrointestinal illness, diarrhea, cholera, dehydration, cavities in teeth, undernutrition, stunting, soil-transmitted helminths, intestinal parasitic infection, toothache, decay missing, filled permanent teeth status, and health status of students. Conclusions: School sanitation affected the student health status, absenteeism at school, and students’ concentration. Sanitation facilities are suggested to include laws and policies.

Background: Erectile dysfunction (ED) often affects men with type 2 diabetes mellitus (T2DM) due to microvascular damage. However, medical interventions are not always appropriate. Aim: This scoping review aimed to answer the following question: What evidence is available about the effects of non-medical and non-invasive healthcare interventions to improve ED in men with T2DM? Method: Potential studies were collected from the Cumulative Index to Nursing and Allied Health Literature via EBSCO, Embase via Ovid, MEDLINE via Ovid, Web of Science, PubMed, ProQuest, and PsycINFO via Ovid. Findings: From 2,611 identified titles, 17 studies, including 11 interventional and 6 observational studies, were included. Four main alternatives to medical interventions were identified from the included studies. Amongst these, four studies recommended patient education on lifestyle modification, twelve studies encouraged dietary changes and physical activities, two studies emphasized the use of vacuum erectile device, and three studies suggested the application of low-intensity extracorporeal shockwave therapy by healthcare professionals. Discussion: Dietary modification and physical activities were promoted as effective interventions to help maintaining the erectile function in men with T2DM. Several methods of patient education were identified as the approach to facilitate lifestyle modification in men with T2DM-associated ED. The positive outcomes of this review support early ED screening to help preventing T2DM complications such as ED in men. Further, T2DM management is a shared responsibility between the men and healthcare professionals. Despite the success of Vacuum Erectile Device and Low-intensity Extracorporeal Shockwave Therapy in regaining erectile function, further research is needed in this area based on the recommendations of the American Urological Association. Moreover, the health and quality of life of men with T2DM must be improved.

Introduction: The utilization of specialist doctors is one of the government's efforts in distributing healthcare workers in Indonesia. This initiative has been led by the Indonesian Ministry of Health as a national regulator in ensuring health workforce, especially medical specialists, availability in communities. It is hoped that communities will have better health services with the presence of specialist doctors in regional hospitals. The main objective of this study was to explore the contextual factors that influence the retention of specialist doctors in placement areas. Methods: The design of this study used a realist evaluation approach through the configuration of context, mechanism, and outcome. Qualitative data were collected through in-depth interviews with specialist doctors, the Provincial Health Office, and professional organizations. The study locations are in eight provinces representing seven regions of Indonesia: South Sumatra, West Java, Bali, East Nusa Tenggara, Central Kalimantan, Southeast Sulawesi, North Maluku, and West Papua. The contextual narrative was obtained from the thematic analysis of the interviews. Results: The research results show that the specialist doctor utilization program has succeeded in attracting specialist doctors to become participants when the context of individual considerations such as geographic, demographic, and socioeconomic factors are met. This program also increases the retention of specialist doctors in the context of regional commitments such as providing appropriate incentives, the fulfillment of infrastructure for program participants and hospitals, and opportunities for career development. Conclusion: This study recommends that local governments fulfill their commitments, so that specialist doctors can work comfortably until the assignment period is over and perhaps extend their assignment period. Furthermore, there is a need for strong coordination between local and central governments regarding the utilization of these specialist doctors to ensure the program's sustainability.

Objective: To study the relationship between anxiety and the spiritual wellbeing of hypertensive elderly patients during the corona virus disease-2019 pandemic. Method: The cross-sectional, correlational, analytical study was conducted from March to May 2022 in Lamongan Regency, East Java, Indonesia, after approval from the Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia, and comprised elderly hypertensive subjects aged >45 years who had good cognitive skills. Data was collected using the Geriatric Anxiety Scale and the Spiritual Wellbeing Scale. Anxiety was the independent variable, while spiritual wellbeing was the dependent variable. Data was analysed using univariate and bivariate analyses. Results: Of the 200 subjects, 107(53.5%) were females and 93(46.5%) were males. Overall, 97(48.5%) were aged 45-49 years, 81(40.5%) had completed primary school, 96(48%) were farmers, 121(60.5%) had moderate anxiety and 80(40%) had moderate spiritual wellbeing. There was a significant relationship between anxiety and spiritual wellbeing (p

Objective: To assess the impact of social support on family caregivers of schizophrenia patients. Method: The cross-sectional, observational study was conducted at Menur Mental Health Hospital, Surabaya, Indonesia, from June to July 2021, and comprised family caregivers aged 20-60 years who lived with schizophrenia patients. Data was collected using the Indonesia version of Zarit Burden Interview and the social support questionnaire. Data was analysed using SPSS 25. Results: Of the 160 subjects, 87(54.4%) were males and 73(45.6%) were females, and 88(55%) were adults, while 36(22.5%) had duration of care >10 years. All the 160(100%) patients had been receiving regular treatment. There were 64(40%) respondents who reported having good social support. The correlation between social support and the family caregiver burden related to schizophrenia patients was significant (p< 0.05). Conclusion: There was a significant relationship between social support and burden on family caregivers of schizophrenia patients. Keywords: Caregiver, Schizophrenia, Burden, Psychiatric, Ambulatory care.

Introduction: The COVID-19 pandemic had made patients scared of coming to clinics or hospitals, and this could affect the treatment of TB. Therefore, one type of service that can be used by nurses to improve compliance to TB treatment is Telenursing. This article aims to ascertain whether telenursing could be a solution in improving the compliance of TB patients to treatments in the COVID-19 pandemic. Design and Method: This research was conducted using the Randomised Controlled Trial design as well as PRISMA. Furthermore, useful research articles were sourced from the database using the keywords, “Message Reminder and Tuberculosis OR Medication Adherence”. The databases used are Scopus, Science Direct, PubMed, and SAGE, all in English text and from 2015 to 2021, with inclusion criteria. 277 articles were obtained, and then filtered to select 3 articles by reading the main focus of the write-up, with regard to the topic of study. Result: Telenursing can be a solution to reduce the spread of COVID-19, and a substitute for remotely motivating individuals, as social support. Furthermore, it could be used as a reminder to patients to be obedient in carrying out treatments, and as a means of educating and improving good relationships with providers. Conclusions: Telenursing is a fairly effective solution in helping TB patients improve treatment compliance, reduce drug dropout rates and missed doses, as well as, raise awareness about the importance of health in the COVID-19 pandemic.

BackgroundA fundamental element of gender equity are women's rights to reproductive choice. Women's empowerment is often linked to enabling decisions around contraceptive use and reduced fertility worldwide, although limited evidence is currently available around contraceptive use and decision making in ASEAN countries.ObjectiveTo examine the association between women's empowerment and contraceptive use in five selected ASEAN member states.MethodsData from the latest Demographic and Health Survey of Cambodia, Indonesia, Myanmar, The Philippines, and Timor-Leste were used. The main outcome was contraceptive use among married women (15-49 years) from these five countries. We considered four indicators of empowerment: labor force participation; disagreement with reasons for wife beating; decision-making power over household issues; and knowledge level.ResultsLabor force participation was found to be significantly associated with contraceptive use in all nations. Disagreement with justification of wife beating was not significantly related to contraceptive use in any country. Decision-making power (higher) was only associated with contraceptive use in Cambodia, while higher knowledge levels were associated with contraceptive use in Cambodia, and Myanmar.ConclusionThis study suggests women's labor force participation is an important determinant of contraceptive use. Policies designed to open the labor market and empower women through education should be implemented to enable women's participation. Gender inequality may also be tackled by engaging women in decision-making processes at national, community and family levels.

The primary frontline healthcare providers who have frequent contact with COVID-19 patients are nurses. Many nurses have been infected with COVID-19 and have experienced severe emotional exhaustion and burnout. It is essential to assess nurses' psychological health during the COVID-19 pandemic. This study aimed to analyze the factors associated with burnout, resilience, and empowerment among Indonesian COVID-19 nurse survivors. In this cross-sectional study, 182 COVID-19 survivor nurses participated from September to November 2022 with convenience sampling. An online survey using the Copenhagen Burnout Inventory (CBI), the Connor-Davidson Resilience Scale (CD-RISC), and the Psychological Empowerment Scale (PES) were used to collect data. The data were analyzed using descriptive and binary logistic regression analyses. The majority of the nurses were aged between 30-45 years (61.6%), and females (67.4%) experienced burnout. Higher resilience was found among nurses contracting COVID-19 (83.1%). In the multivariate logistic regression analysis, the absence of psychological impact (OR = 0.44, 95% CI = 0.21-0.93) is significantly related to higher burnout experience. In addition, workplace, especially in hospital (OR = 4.32, 95% CI = 1.09-17.09) was associated with resilience, and a gap time after receiving negative COVID-19 result (OR = 3.90, 95% CI = 1.27-12.03) was correlated with psychological empowerment, in our results 4-6 month after had a negative result was at higher risk. To maintain a positive psychological aspect for COVID-19 nurse survivors, it needs to implement psychological support in the workplace and ensure an appropriate workload of nurse professionals.

Background and objectiveHealthcare-seeking behavior for children is crucial for reducing disease severity. Such behavior can improve child health outcomes and prevent child morbidity and mortality. The present study sought to analyze the determinants of mothers' engagement in healthcare-seeking behavior for children with common childhood diseases, focusing on mothers of children aged 0-59 months in Indonesia.MethodsThis cross-sectional study comprised a secondary data analysis using the 2002-2017 Indonesia Demographic and Health Survey (IDHS) databases. We included all women surveyed aged 15-49 years old who had children under five years of age. We weighted the univariate, bivariate, and multivariate logistic regression analysis of healthcare-seeking behavior for children aged 0-59 months.ResultsWe analyzed data for 24,529 women whose children were under five years of age at the time of survey. Common diseases, such as diarrhea, fever, and acute respiratory infection (ARI) were the most frequently cited reasons for healthcare-seeking behavior. During 2002-2017, the proportion of mothers seeking healthcare for their children with diarrhea increased from 67.70% to 69.88%, that with fever increased from 61.48% to 71.64% and that ARI increased from 64.01% to 76.75%. Multivariate analysis revealed that child's age, child's birth order, mother's education, ability to meet expenses, distance to nearest healthcare facility, wealth index, place of residence, and region of residence, were significantly associated with healthcare-seeking behavior.ConclusionVarious individual and environmental-level factors influence healthcare-seeking behavior for childhood diseases. Available, accessible, and affordable health service facilities are recommended to assist socio-economically and geographically disadvantaged families.

Background: Neonatal mortality is one of the key impediments in achieving global sustainable development goals, especially in lower middle income countries (LMICs). As an LMIC with the highest reported neonatal mortality rate in Southeast Asia, Indonesia faces inequitable distribution of health facilities across the archipelago. Therefore, in this paper, we aim to evaluate the determinants of neonatal mortality rate in Indonesia to search for better strategies to overcome this problem. Methods: We conducted an analysis of the 2017 Indonesia Demographic Health Survey dataset of 10,838 live-born infants born from singleton pregnancies in 2017. Using a hierarchical approach, multivariate analysis was conducted to identify potential factors (including socioeconomic, household, and proximate determinants) that contributed to neonatal mortality. Results: The lack of participation in postnatal care [odds ratio (OR) = 20.394, p = 0.01)] and delivery complications other than prolonged labour (OR = 2.072, p = 0.02) were the maternal factors that significantly associated with increased risk of neonatal death. Regarding neonatal factors, low-birth-weight infants appeared to be more vulnerable to neonatal death (OR = 12.489, p = 0.01). Conclusion: Low participation in postnatal care, development of labour complications, and low birth weight were associated with higher neonatal mortality. It implies that in a limited resource and geographically challenging country such as Indonesia, improving the quality and optimizing services of public hospitals with equitable distribution of quality health care services in all regions should be prioritized in the efforts of reducing neonatal mortality rate.

Summary: Background: More than 3 billion people do not have access to clean energy and primarily use solid fuels to cook. Use of solid fuels generates household air pollution, which was associated with more than 2 million deaths in 2019. Although local patterns in cooking vary systematically, subnational trends in use of solid fuels have yet to be comprehensively analysed. We estimated the prevalence of solid-fuel use with high spatial resolution to explore subnational inequalities, assess local progress, and assess the effects on health in low-income and middle-income countries (LMICs) without universal access to clean fuels. Methods: We did a geospatial modelling study to map the prevalence of solid-fuel use for cooking at a 5 km × 5 km resolution in 98 LMICs based on 2·1 million household observations of the primary cooking fuel used from 663 population-based household surveys over the years 2000 to 2018. We use observed temporal patterns to forecast household air pollution in 2030 and to assess the probability of attaining the Sustainable Development Goal (SDG) target indicator for clean cooking. We aligned our estimates of household air pollution to geospatial estimates of ambient air pollution to establish the risk transition occurring in LMICs. Finally, we quantified the effect of residual primary solid-fuel use for cooking on child health by doing a counterfactual risk assessment to estimate the proportion of deaths from lower respiratory tract infections in children younger than 5 years that could be associated with household air pollution. Findings: Although primary reliance on solid-fuel use for cooking has declined globally, it remains widespread. 593 million people live in districts where the prevalence of solid-fuel use for cooking exceeds 95%. 66% of people in LMICs live in districts that are not on track to meet the SDG target for universal access to clean energy by 2030. Household air pollution continues to be a major contributor to particulate exposure in LMICs, and rising ambient air pollution is undermining potential gains from reductions in the prevalence of solid-fuel use for cooking in many countries. We estimated that, in 2018, 205 000 (95% uncertainty interval 147 000–257 000) children younger than 5 years died from lower respiratory tract infections that could be attributed to household air pollution. Interpretation: Efforts to accelerate the adoption of clean cooking fuels need to be substantially increased and recalibrated to account for subnational inequalities, because there are substantial opportunities to improve air quality and avert child mortality associated with household air pollution. Funding: Bill & Melinda Gates Foundation.

Background: In Indonesia, maternal health care services are widely available, aiming to improve health and survival among mothers. However, these services remain underutilised, and its determining factor was unknown. This study sought to identify determinant factors of maternal healthcare services utilisation among Indonesian mothers. Methods: This population-based cross-sectional study leveraged the 2017 Indonesia Demographic and Health Survey data. A total of 12,033 mothers aged from 15 to 49 years who had a live birth in the five years preceding the survey were included in the analysis. Multivariable logistic regressions were used to identify the determinant factors. Results: Approximately 93.44% of the mothers had adequate antenatal care, 83.73% had a delivery at the healthcare facility, and 71.46% received postnatal care. The mother’s age and household wealth index were the typical determinants of all maternal healthcare services. Determinants of antenatal care visits were husband’s occupational status, the number of children, and access to the healthcare facility. Next, factors that drive mothers’ delivery at the healthcare facility were the mother’s education level, husband’s educational level, and residential area. The use of postnatal care was determined by the mother’s occupational status, husband’s educational level, number of children, wealth index, access to the healthcare facility, and residential area. Conclusions: The utilisation of each maternal healthcare service was determined by various socio-structural and intermediary determinants, but the mother’s age and household wealth index were emerged as the typical determinants of all maternal healthcare services. Providing maternal healthcare services that are adjusted and tuned with these socio determinant factors may ensure that mothers can adequately utilise each service.

Introduction: Foot problems are a process and complication in patients with diabetes mellitus (DM). Foot complications can be prevented by routine foot exercises. Group support is needed to increase the routine of foot exercise. The effects of foot exercise can be seen by measuring the Ankle Brachial Pressure Index and foot sensation. The objective of this systematic review was to identify the prevention of DM foot complications in an easy way so then he patient can do it independently. Methods: The method used in this study was a systematic review focused on 2015 – 2019 using the PRISMA method. The literature was obtained from Scopus, Science Direct and Proquest. The results found 25 items of literature on foot exercise which was reduced to 4 studies on preventing damage to the feet of DM patients through routine foot exercise. The literature of this study is supported by 3 other studies that state that foot health can also be used to examine the foot’s blood circulation status and sensation. Results: These results have been presented concerning 7 studies regarding special group support in the form of exercise therapy for patients with DM. This study explains the prevention of foot complications through foot exercise. Group support is needed provide motivation to conduct routine foot exercise. Conclusion: Foot exercise can accelerate the blood circulation as can be seen by the Ankle Brachial Pressure Index score and the increase in the neurological system of the foot through foot sensation status.

Introduction: This study was undertaken to verify effect of regular exercise training on insulin sensitivity and the modifiable cardiovascular risk factors, and to determine if there was any effect from the different regular exercises. Methods: A database search using PRISMA examined articles from Scopus, ScienceDirect and ProQuest. The inclusion criteria were that the article used a randomized controlled trial within the last 10 years, that the respondents were people with type 2 diabetes mellitus and that only physical exercise was the intervention involved. In total, 1,303 articles were screened and 16 articles were included that fit the criteria of inclusion in this systematic review. Results: Based on the review of the 15 articles, the findings show that regular exercise training has some benefits related to glycemic control. It can reduce insulin resistance, plasma insulin, fasting blood glucose, postpandrial blood glucose and hbA1c. . Moreover, physical exercise has other benefits for people with type 2 diabetes mellitus, such as an increased peak oxygen consumption (VO2 peak) and decreased c-reactive protein (CRP) level. Conclusion: Regular exercise training has benefits for people with type 2 diabetes mellitus and it can allow them to achieve of optimal glycemic control by improving insulin resistance and decreasing the cardiovascular risk factors. Physical exercise such as combined exercises (aerobic and resistance exercise) or a single exercise such as aerobic exercise can be recommended to improve insulin sensitivity and the modifiable cardiovascular risk factors in patients with T2DM.

A well-balanced diet is one of the four pillars of diabetes self-management. Patient's culture strongly influences intake food. Diabetic dietary guidelines which fit with the patient's culture is expected to improve patient's self-efficacy and diet compliance. This study was aimed to analyze the effect of ethnic foods diet program in improving self-efficacy and diet compliance among Type-2 Diabetes Mellitus (T2DM) patients. This was quasy experiment research with pre and post-test control design. The population was 112 T2DM patients from Sasak Tribes, West Nusa Tenggara. Samples were 36 respondents, divided into intervention (18) and control (18) groups. The independent variable was the ethnic food diet (EFD) program, while the dependent variables were patient's self-efficacy and diet compliance. Data were collected using self-efficacy questionnaire and a 24-hour dietary recall form. Data were then analyzed using Wilcoxon Signed Rank Test and Mann Whitney U Test. The result showed differences in self-efficacy between pre and post-test in the treatment group (p=0,001), but there were no differences in the control group. There were differences in diet compliance in the treatment group (p=0,001), but there were no differences in the control group. There were differences between treatment and control groups on self-efficacy (p=0,000) and diet compliance (p=0,000). Ethnic foods diet program can improve self-efficacy and diet compliance among T2DM patients because more comfortable and easier to be applied. Nurses can apply ethnic foods diet program as an intervention to promote healthy diet for T2DM patients.

Background and objective Coronavirus disease 2019 (COVID-19) survivors face societal stigma. The study aims to analyze the association of this stigma with the mental health and quality of life of COVID-19 survivors. Methods In this cross-sectional study, we observed 547 adults who were previously documented as severe acute respiratory syndrome coronavirus (SARS-CoV-2) positive by a polymerase chain reaction (PCR) test, treated in a hospital or an emergency hospital and proven to be SARS-CoV-2 negative by their latest PCR test. We adopted the Berger HIV Stigma Scale to measure stigma; the World Health Organization Quality of Life Brief Form to measure quality of life; and the Mental Health Inventory-38 to measure mental health. The chi-square and binary logistic regression tests were used to find the correlation between the variables. Results The multivariate analysis revealed that medium stigma was more likely related to quality of life and mental health than low stigma. Females were less likely to experience stigma related to mental health than men, and respondents who worked as laborers and entrepreneurs were less likely to experience stigma related to mental health than those who worked as civil workers/army personnel/teachers/lecturers. COVID-19 survivors experienced medium stigma in society and lower quality of life and mental health status. We found that quality of life and mental health were affected by stigma, sex, and occupation. Conclusion COVID-19 survivors are a vulnerable group that is most at risk when they return to their communities. Creating a safe environment and providing respectful care, including addressing complex stigma factors, is vital for developing appropriate interventions.

Introduction: Cancer-related fatigue (CRF) is one of the symptoms commonly experienced and it is a subjective feeling felt by cancer patients. The aim of this systematic review was to summarize how fatigue has been described from the perspective of adult cancer patients, the impact of fatigue on their quality of life, what the patient reported as contributing factors and potential coping strategies to reduce fatigue. Methods: A systematic review is in line with PRISMA guidelines. Five databases were systematically searched (Scopus, PubMed, Springerlink, ProQuest and Science Direct) from January 2009 to February 2019 for qualitative studies describing the experience of adult cancer patients using a predefined search strategy and any relevant keywords. Results: In total, 13 out of 4692 studies were included. The ages of the included patient cancer ranged from 26 to 84 years. The majority of studies used in-depth interviews and semi-structured interviews to elicit the participant’s experiences of fatigue. Four themes were identified: the perception of cancer-related fatigue, the etiology of cancer fatigue, impact and coping strategies. Conclusion: Fatigue is impactful on quality of life from the perspective of cancer patients. Future research should focus on the prospective exploration of the impact of fatigue on woman's and men's health and identifying approaches to reduce fatigue.

Background: Mental health issues following the occurrence of disaster remain neglected area especially for older people group. The purpose of this study was to explore stakeholders’ perspectives on post-disaster management related to the elderly’s mental health needs. Design and Methods: This qualitative case study was conducted between June and October 2020. The investigators conducted in-depth interviews with policymakers who were in charge of disaster management at national, provincial, and regional levels. The policymakers were selected through purposive sampling. A policy analysis was conducted by the investigators to answer the research question. Results: The results were presented based on actor, content, context, and process. The actors engage in intersectoral collaboration between disaster agencies, health agencies, and social agencies. The content is largely comprehensive; however, the disaster management policy should not neglect to address mental health conditions after a disaster event. The context is the vulnerability and risk of the elderly in terms of experiencing physical and mental issues after a disaster, which should be considered by policymakers in Indonesia. The process is the development of disaster management policies, which are influenced by cultural, economic, political, and international factors. Conclusion: This study reveals that stakeholders need to pay attention to the mental health issue of elderly in national and regional policy, particularly during post-disaster situations. In addition, posttraumatic stress in post-disaster situations should be highlighted in order to formulate a better aged care policy.

COVID-19 vaccination in adolescents is important because the adolescent population has the highest incidence of COVID-19. This study aimed to explore the factors associated with COVID-19 vaccination adherence among Indonesian adolescents. This cross-sectional study involved 7986 adolescents, polled through online and offline surveys conducted in six major islands of Indonesia. The online questionnaire was distributed through popular social messaging and social media platforms. Our team also contacted schools and public places to recruit participants from remote areas. In total, 7299 respondents completed the questionnaire. Binary logistic analysis revealed that higher levels of knowledge, positive attitudes, and confidence in the COVID-19 vaccine were significantly associated with higher COVID-19 vaccination adherence in adolescents. Sociodemographic factors were also significantly associated with higher adherence to vaccination programs. Meanwhile, younger age and habitation in private housing were related to lower adherence to the vaccination program. Parental factors related to adolescent compliance were education level, household income, history of infection of family or friends with COVID-19, and working status. The national authorities and stakeholders should take extensive measures to increase attitude, knowledge, confidence, and family support among adolescence through multiple channels.

Background: In Indonesia, maternal mortality remains high, significantly 61.59% occur in the postnatal period. Postnatal care (PNC) provision is a critical intervention between six hours and 42 days after childbirth and is the primary strategy to reduce maternal mortality rates. However, underutilisation of PNC in Indonesia still remains high, and limited studies have shown the regional disparities of PNC in Indonesia. Methods: This study aims to explore the gaps between regions in PNC service for mothers who have had live births during the last five years in Indonesia. This study was a secondary data analysis study using the Indonesian Demographic and Health Survey (IDHS) in 2017. A total of 13,901 mothers aged 15-49 years having had live births within five years were included. Chi-squared test and binary logistic regression were performed to determine regional disparities in PNC. Results: Results indicated that the prevalence of PNC service utilisation among mothers aged 15-49 years was 70.94%. However, regional gaps in the utilisation of PNC service were indicated. Mothers in the Central of Indonesia have used PNC services 2.54 times compared to mothers in the Eastern of Indonesia (OR = 2.54; 95% CI = 1.77-3.65, p

Background: Tuberculosis (TB) is an infectious disease that is a major problem in Indonesia, placing Indonesia among the three major countries with the highest TB cases in the world. In addition, reporting of TB data from health service facilities, especially hospitals, is still weak. Since the implementation of Directly Observed Treatment Shortcourse (DOTS) in hospitals in 1995, the number of new TB case reports from hospitals is still low. In order to increase hospital participation in TB control, the government has made a breakthrough strategy, which is the integration of the DOTS strategy in hospital accreditation. Design and methods: This study conducted a literature review and document analysis related TB control standards in hospital accreditation and the implication for the involvement of hospitals in national TB program. This study analyzed regulations, policies, and procedures, including hospital accreditation instruments and annual reports of TB. Results: Accreditation standards related to TB control include: i) Hospital must implement a tuberculosis control program in the hospital, including monitoring and evaluation through activities such as health promotion, tuberculosis surveillance, controlling risk factors, detection and treatment of tuberculosis cases, providing immunity and preventive drugs; ii) Hospital prepares resources for service delivery and tuberculosis control; iii) hospital provides facilities and infrastructures for tuberculosis services in accordance with regulations; and iv) hospital conducts tuberculosis services and efforts to control tuberculosis risk factors in accordance with regulations. Conclusions: Standards and elements of the assessment of TB control components in accreditation are adjusted to the national TB control guidelines.

Introduction: Low immunity causes the body to become more easily infected, resulting in inflammation. If the immune system is functioning properly, this inflammation will end in healing. The immune system has a protective role in the body, and its anti-inflammatory role is vital. During trauma, the initial immune response is marked by inflammation. The use of date-seed extract, although not steeped date seeds, has been studied as an anti-inflammatory agent. This study is aimed at demonstrating the anti-inflammatory effect of steeped date seeds (Phoenix dactylifera L.) in rats with CCl4-induced inflammation.Methods: This experiment included a pre- and post-test with control group design. Male Wistar rats (approximately 2–3 months of age, ranging in weight from 150 to 200 g) were assigned to the following groups: negative control (NC), positive control (PC), T1 treatment dose 1 g/kg, T3 treatment dose 3 g/kg, T5 treatment dose 5 g/kg, and healthy control (HC). Groups 1–5 were subjected to CCl4 induction at a single dose of 2 mL/kg before treatment. The levels of tumor necrosis factor (TNF-α), glutathione (GSH), and gamma interferon (IFN-γ) were compared in groups using one-way analysis of variance (ANOVA), followed by a least significant difference (LSD) post hoc test for comparisons between means.Results: Levels of tumor necrosis factor (TNF-α), GSH, and IFN-γ were significantly different among the HC and treatment groups after CCl4 induction. After 14 days of steeped date-seed treatment, TNF-α decreased, but GSH and IFN-γ levels increased significantly (P = 0.001).Conclusion: Administration of steeped date seeds at a dose of 5 g/kg can increase GSH and IFN-γ, and decrease TNF-α, the strongest inflammatory marker in CCl4-induced rats. The findings of this study indicate that date-seed supplementation can support body immunity by regulating pro-inflammatory mediators.

Purpose: Using a quantitative approach, this study aims to assess Indonesian nurses’ perception of their knowledge, skills, and preparedness regarding disaster management. Methods: This study was a descriptive comparison in design. The research samples are Indonesian nurses working in medical services and educational institutions. The variables of nurses’ preparedness to cope with disaster victims were measured using the Disaster Preparedness Evaluation Tool (DPET), which was electronically distributed to all nurses in Indonesia. Data were analyzed using a statistical descriptive one-way Analysis of Variance (ANOVA) and t-test with a significance level of 95%. Results: In total, 1341 Indonesian nurses completed this survey. The average scores of preparedness to cope with disasters, the ability to recover from disaster, and evaluation of disaster victims were 3.13, 2.53, and 2.46, respectively. In general, nurses surveyed in this study are less prepared for disaster management, and do not understand their roles both during the phase of disaster preparedness, and when coping with a post-disaster situation. Conclusion: Nurses’ preparedness and understanding of their roles in coping with disasters are still low in Indonesia. Therefore, their capacity in preparedness, responses, recovery, and evaluation of disasters needs improvement through continuing education. The efforts needed are significant due to potential disasters in Indonesia and adequate nurses resources. Keywords: Disasters, Knowledge, Nurses, Preparedness

Women’s susceptibility to HIV/AIDS infection is related to socio-economic and demographic factors. This study sought to analyze socio-economic and demographic factors related to knowledge and attitude of HIV/AIDS among women aged 15–49 years old in Indonesia. We conducted a secondary data analysis using the 2017 Indonesian Demographic and Health Survey (IDHS). Among 49,627 women, our study analyzed 25,895 women aged 15–49 years familiar with HIV terminology. Multiple logistic regression was utilized to analyze associations between socio-economic and demographic factors with knowledge and attitudes toward HIV/AIDS. Women’s age, education level, wealth quintile, residential area and region, access to information, owning cell phones and autonomy were significantly associated with positive knowledge and attitudes toward HIV/AIDS. These findings revealed that several demographical and social factors contribute to knowledge and attitudes toward HIV/AIDS among women aged 15–49 years in Indonesia.

Background: In Indonesia, maternal mortality remains high, significantly 61.59% occur in the postnatal period. Postnatal care (PNC) provision is a critical intervention between six hours and 42 days after childbirth and is the primary strategy to reduce maternal mortality rates. However, underutilization of PNC in Indonesia still remains high, and limited studies have shown the regional disparities of PNC in Indonesia. Methods: This study aims to explore the gaps between regions in PNC service for mothers who have had live births during the last five years in Indonesia. This study was a secondary data analysis study using the Indonesian Demographic and Health Survey (IDHS) in 2017. A total of 13,901 mothers aged 15-49 years having had live births within five years were included. Chi-squared test and binary logistic regression were performed to determine regional disparities in PNC. Results: Results indicated that the prevalence of PNC service utilization among mothers aged 15-49 years was 70.94%. However, regional gaps in the utilization of PNC service were indicated. Mothers in the Middle of Indonesia have used PNC services 2.54 times compared to mothers in the East of Indonesia (OR = 2.54; 95% CI = 1.77-3.65, p