Majalah Kesehatan Indonesia

Factors Associated With Family Caregivers’ Knowledge and Attitudes Toward Home-Based Geriatric Care in Primary Healthcare: A Cross-Sectional Study

2026-03-17T12:28:37+07:00

Family caregivers play a central role in home-based geriatric care, especially in settings where institutional long-term care remains limited. However, caregiver capacity may vary according to socio-demographic, relational, and service-related factors. This study aimed to identify factors associated with family caregivers’ knowledge and attitudes toward home-based geriatric care in a primary healthcare context. A quantitative analytic study with a cross-sectional design was conducted from September to December 2025 in two Puskesmas working areas in Batam City, Indonesia. A total of 326 family caregivers were recruited using proportional sampling. Data were collected through structured questionnaires and analyzed using univariate analysis, Chi-square tests, and multivariate logistic regression. Most caregivers had low knowledge (86.5%) and negative attitudes (61.0%) despite reporting high communication patterns and positive perceptions of healthcare facility quality. Bivariate analysis showed that economic status, caregiving duration, communication pattern, and perceived quality of healthcare facilities were significantly associated with knowledge, whereas economic status, communication pattern, and perceived quality of healthcare facilities were associated with attitudes. In the multivariate model, only caregiving duration (AOR = 15.790; p < 0.001) and communication pattern (AOR = 0.157; p = 0.013) remained independently associated with caregiver knowledge. No independent predictors were identified for attitudes. These findings indicate that caregiver knowledge was more strongly associated with experiential and relational factors, particularly caregiving duration and family communication. Structured, family-centered, and nurse-led interventions in primary healthcare may help strengthen caregiver preparedness in home-based geriatric care.

Abstrak: Caregiver keluarga memainkan peran sentral dalam perawatan geriatri berbasis rumah, terutama di lingkungan yang layanan perawatan jangka panjang institusionalnya masih terbatas. Namun, kapasitas caregiver dapat bervariasi menurut faktor sosiodemografis, relasional, dan faktor terkait layanan. Penelitian ini bertujuan untuk mengidentifikasi faktor-faktor yang berhubungan dengan pengetahuan dan sikap caregiver keluarga terhadap perawatan geriatri berbasis rumah dalam konteks pelayanan kesehatan primer. Penelitian kuantitatif analitik dengan desain potong lintang dilakukan dari September hingga Desember 2025 di dua wilayah kerja Puskesmas di Kota Batam, Indonesia. Sebanyak 326 caregiver keluarga direkrut menggunakan proportional sampling. Data dikumpulkan melalui kuesioner terstruktur dan dianalisis menggunakan analisis univariat, uji Chi-square, dan regresi logistik multivariat. Sebagian besar caregiver memiliki pengetahuan rendah (86,5%) dan sikap negatif (61,0%) meskipun melaporkan pola komunikasi yang tinggi dan persepsi positif terhadap kualitas fasilitas pelayanan kesehatan. Analisis bivariat menunjukkan bahwa status ekonomi, lama merawat, pola komunikasi, dan persepsi terhadap kualitas fasilitas pelayanan kesehatan berhubungan secara signifikan dengan pengetahuan, sedangkan status ekonomi, pola komunikasi, dan persepsi terhadap kualitas fasilitas pelayanan kesehatan berhubungan dengan sikap. Pada model multivariat, hanya lama merawat (AOR = 15,790; p < 0,001) dan pola komunikasi (AOR = 0,157; p = 0,013) yang tetap berhubungan secara independen dengan pengetahuan caregiver. Tidak ditemukan prediktor independen untuk sikap. Temuan ini menunjukkan bahwa pengetahuan caregiver lebih kuat berhubungan dengan faktor pengalaman dan relasional, khususnya lama merawat dan komunikasi keluarga. Intervensi yang terstruktur, berpusat pada keluarga, dan dipimpin oleh perawat di pelayanan kesehatan primer berpotensi membantu memperkuat kesiapan caregiver dalam perawatan geriatri berbasis rumah.

The Complex Intersection: Barriers to Gender Affirmation Surgery and Mental Health in Pakistan's Transgender Community

2026-02-08T16:57:03+07:00

This study aims to investigate the structural barriers to accessing gender affirmation surgery (GAS) and evaluate the resulting impact on the mental health of transgender individuals in Pakistan. Conducted through a cross-sectional survey from January to March 2025, the study engaged 500 transgender individuals across five major Pakistani cities: Karachi, Lahore, Islamabad, Peshawar, and Quetta. Data were gathered via a structured questionnaire encompassing demographics, healthcare barriers, and mental health metrics. Mental health indicators, including depression (42%), anxiety (38%), and PTSD (21%), were documented based on participant self-report of formal clinical diagnoses received prior to the study. The results reveal a stark reality: only 9% (n=45) of respondents had successfully undergone full GAS, while a substantial majority (61%, n=305) expressed a strong desire for the procedure but faced insurmountable obstacles. The most prominent barriers identified were the prohibitive high cost (73%) and a critical lack of specialized surgeons (56%). A mental health crisis is evident, with 74% of participants reporting regular symptoms of distress. A statistically significant association was established between the desire for surgery and heightened mental distress (x² = 17.94, df = 1, p < 0.001), with a Cramer’s V of 0.19, indicating a moderate effect size. This research highlights a systemic failure at the intersection of healthcare, socio-legal policy, and mental health support, calling for urgent reforms such as financial subsidies and the integration of transgender health into medical education.

The Effect of Salt Hydrotherapy on Foot Pain Intensity in Patients with Gout Arthritis in The Working Area of Karanganyar Community Health Center

2026-05-02T19:56:25+07:00

Gout arthritis is an inflammatory joint disease caused by uric acid crystal deposition, leading to pain, particularly in the lower extremities, and potentially interfering with daily activities and reducing patients’ quality of life. The condition highlights the need for safe, affordable, and accessible non-pharmacological therapies to support pain management in community settings. This study aimed to analyze changes in foot pain intensity after salt hydrotherapy among patients with gout arthritis in the working area of Karanganyar Community Health Center. A pre-experimental study with a one-group pretest-posttest design was conducted involving 17 respondents selected using purposive sampling. Pain intensity was measured using the Numeric Rating Scale before the intervention and after three intervention sessions within one week. The median pain score decreased from 6.00 (IQR 2; range 4–8) before the intervention to 3.00 (IQR 2; range 2–4) after the intervention. Statistical analysis using the Wilcoxon signed-rank test showed a statistically significant difference (Z = -3.671; p < 0.001), with a large effect size (r = 0.89). These findings indicate that salt hydrotherapy was associated with a reduction in foot pain intensity, with a shift in pain category from moderate to mild in the study sample. However, the findings should be interpreted cautiously because the study involved a small sample and no control group.

Factors Associated with Maternal Behavior in Complementary Feeding Practices among Mothers of Children aged 6–24 months

2026-05-18T20:06:04+07:00

This issue is important to address because appropriate complementary feeding (MP-ASI) plays a crucial role in supporting child growth and development as well as preventing stunting. Maternal behavior in complementary feeding practices significantly determines the quality of nutritional intake during the child’s critical growth period. However, complementary feeding practices are still influenced by various factors, including cognitive and sociodemographic aspects. Therefore, it is important to examine whether these factors are associated with maternal behavior within the context of primary health care services. This study aimed to analyze the relationship between maternal characteristics—namely knowledge, attitude, age, education, and occupation—and complementary feeding practices among children aged 6–24 monthsin the working area of Gambirsari Public Health Center, Surakarta. This study used a quantitative approach with a cross-sectional design. The study subjects consisted of mothers with children aged 6–24 months. The sample was selected using a purposive sampling technique. The variables examined included independent variables (maternal knowledge, attitude, age, education, and occupation) and the dependent variable (complementary feeding behavior). Data were collected using a structured questionnaire covering respondent characteristics, knowledge, attitudes, and feeding practices. Data analysis was performed using the Fisher’s Exact test with a 95% significance level (α = 0.05). A total of 34 mothers participated in the study. Most respondents demonstrated good complementary feeding behavior (94.1%), while all respondents had good knowledge (100%). No statistically significant association was observed between maternal attitude (p=0.595), age (p=0.437), education (p=0.795), occupation (p=0.792), and complementary feeding behavior. Knowledge could not be analyzed because all respondents were classified in the same category. Based on the findings of this study, continuous efforts are recommended to improve the quality of education and support provided to mothers regarding complementary feeding practices. Such efforts should not only focus on enhancing maternal knowledge but also take into account other factors beyond individual characteristics that may influence feeding behaviors. Furthermore, future studies are encouraged to explore additional factors that were not examined in the present study, such as family support, cultural influences, and access to health information.

Treponema pallidum Rapid Test Screening Results Among Laboring Women: Associations With Parity and Gestational Age at Delivery

2026-06-28T10:30:26+07:00

Syphilis during pregnancy can cause vertical transmission and adverse perinatal outcomes when not detected and treated early. The Treponema pallidum Rapid Test (TP Rapid) is used for syphilis screening within the Triple Elimination Program, particularly among pregnant and laboring women with unclear antenatal screening status. This study aimed to examine the association of parity and gestational age at delivery with TP Rapid screening results among laboring women at Sele Be Solu Regional Hospital, Sorong City, in 2024. This analytic observational study used a cross-sectional design and secondary data from medical records, delivery registers, and laboratory registers. A total of 762 laboring women were included through total sampling. Data were analyzed using univariate and bivariate analyses, including the Chi-square test and measures of association. Reactive TP Rapid results were found in 148 women (19.4%), whereas 614 women (80.6%) had nonreactive results. Parity was not significantly associated with TP Rapid results (p = 0.459). However, reactive TP Rapid results were more frequent in preterm than non-preterm deliveries (PR = 2.36; 95% CI: 1.78–3.12; OR = 3.09; 95% CI: 2.10–4.55; p < 0.001). Because TP Rapid is a treponemal screening test and this study used a cross-sectional design, reactive results should not be interpreted as active syphilis or causal evidence for preterm birth. Universal syphilis screening, confirmatory testing, treatment, newborn evaluation, and strengthened medical record documentation are recommended.

Enhancing Flood Disaster Knowledge and Preparedness among Health Vocational Students: Evidence from a School-Based Education Program

2026-06-12T01:19:41+07:00

Flood disasters are frequent hydrometeorological hazards in Indonesia and may disrupt school safety, learning continuity, and students’ health. This study examined whether flood disaster preparedness education was followed by improvements in students’ knowledge and preparedness and analyzed the association between both variables at Letris Indonesia 2 Health Vocational School, Tangerang. A quantitative pre-experimental study with a one-group pretest–posttest design was conducted among 30 students who completed all stages of the study. The intervention consisted of three 60-minute educational sessions covering flood causes, early warning signs, evacuation procedures, emergency kits, emergency communication, first aid, post-flood sanitation, and disease prevention. Data were collected using validated and reliable questionnaires. Because score differences were not normally distributed, pretest–posttest changes were analyzed using the Wilcoxon signed-rank test, while the association between knowledge and preparedness was examined using Spearman’s rho. Students’ knowledge increased significantly from a median of 60.00 to 82.00 (Z = -4.72, p < .001, r = 0.86). Preparedness also increased from a median of 52.00 to 78.00 (Z = -4.78, p < .001, r = 0.87). Knowledge was strongly associated with preparedness (rho = 0.871, p < .001). Flood disaster preparedness education was associated with short-term improvements in students’ knowledge and self-reported preparedness.

Prevalence, Trends, and Projections of Overweight and Obesity Among Children and Adolescents in Indonesia, 1993–2050: A Meta-Analysis of Observational Studies

2026-04-05T16:15:16+07:00

Overweight and obesity among children and adolescents are growing public-health challenges with long-term consequences for noncommunicable disease burden. This study primarily aimed to estimate the pooled prevalence of overweight and obesity among Indonesian school-aged children and adolescents; secondarily, we examined temporal trends and estimated number of cases through 2050. We conducted a meta-analysis of cross-sectional studies up to 10 September 2025. Pooled estimates used random-effects models with heterogeneity assessed by I². Publication bias was explored and adjusted using trim-and-fill when indicated. Subgroup analyses included sex, school level, and period. Temporal trends were modelled with Autoregressive Integrated Moving Average (ARIMA) and projected to 2050 using national demographic data. A total of 152 studies were included. The pooled prevalence of combined overweight and obesity was 18.13% (95% CI: 15.02–21.71%); obesity alone 7.49% (95% CI: 5.89–9.47%); overweight alone 11% (95% CI: 10–13%). Substantial between-study heterogeneity (I² = 77.5–99.9%) was observed. Higher prevalence was found in boys and primary-school children. ARIMA projections indicate an increase in combined prevalence to 23.02% by 2050. About one in five Indonesian children and adolescents are affected by overweight or obesity with projected increases, highlighting the urgent need for targeted, multisectoral prevention strategies, especially at primary-school age, to curb future noncommunicable-disease burden. However, given the high between-study heterogeneity consistently observed across all categories, these estimates and projections should be interpreted cautiously as indicative rather than definitive figures.

Early Warning System through Artificial Intelligence in Intensive Care: A Diagnostic Meta-Analysis of Mortality, Deterioration of Consciousness, and Neurological Outcome

2026-06-29T20:05:26+07:00

Prognostication in neurocritical care remains challenging due to patient heterogeneity and the limitations of static conventional scores. This systematic review and meta-analysis evaluated the diagnostic accuracy of artificial intelligence (AI) models as retrospective predictive and prognostic frameworks, assessing their potential utility as clinical early warning systems (EWS). Conducted via PubMed, ScienceDirect, and SCOPUS per PRISMA guidelines, the study evaluated deterioration of consciousness, mortality, and neurological outcomes. Out of 20 included studies, 18 were meta-analyzed. For mortality prediction, AI demonstrated a pooled sensitivity of 0.569, specificity of 0.810, diagnostic odds ratio (DOR) of 9.620, and area under the curve (AUC) of 0.698. In predicting deterioration in consciousness, AI achieved a pooled sensitivity of 0.648, specificity of 0.901, DOR of 38.346, and AUC of 0.796. For neurological outcomes, the pooled sensitivity was 0.864, specificity 0.865, DOR 45.566, and AUC 0.858. AI models demonstrate high accuracy in predicting long-term neurological outcomes and acceptable performance in predicting short-term deterioration in consciousness, but remain highly limited and offer no clear advantage over conventional scoring for ICU mortality. These retrospective findings provide a robust foundation for future prospective designs, though widespread clinical integration is not yet warranted.