Exploring the antenatal care challenges faced during the COVID-19 pandemic in rural areas of Indonesia: a qualitative study.

INTRODUCTION: The COVID-19 pandemic affected almost all healthcare services in Indonesia, including antenatal care (ANC). Pregnant women were a vulnerable group during the pandemic since the Indonesian government's policies at the time influenced the delivery of ANC services, particularly in rural areas. Investigating the ANC challenges faced during the pandemic from the perspectives of pregnant women and healthcare providers is important for our understanding of ANC provision. This study, therefore explores barriers to ANC appointments faced during the COVID-19 pandemic in rural areas of Indonesia from the perspectives of pregnant women and health care providers. METHODS: This was a qualitative exploratory descriptive study involving 31 participants, consisting of 25 pregnant women and six healthcare providers who were selected via a purposive sampling method. Thadeus and Maine's Three Delays Model was used as the theoretical framework. Data were collected between March and August 2021, through two focus group discussions (FGDs), ten in-depth interviews, and field notes. Data were analyzed using a thematic analysis method. RESULTS: Three themes describing barriers to ANC during the COVID-19 pandemic in rural areas of Indonesia emerged from this study. Those themes were: (1) The fear of being infected with COVID-19, related to anxiety, perceived vulnerability, and the desire to protect oneself and loved ones; (2) The stay-at-home policy, related to transport barriers and restricted social activity; and (3) Re-designed ANC services, related to ANC adjustments, high-risk pregnancies, insufficient information, and adherence to COVID-19 preventive behaviors. CONCLUSION: Based on the Three Delays Model, several challenges to carrying out ANC during the COVID-19 pandemic in rural areas of Indonesia were identified. These findings demonstrate the need to formulate and implement ANC packages to facilitate pregnant women's access to health care services.

Pilot Study of a Brief Hypnotic Induction: Effects on Blood Pressure, Heart Rate, and Subjective Distress in Patients Diagnosed with Hypertension.

The feasibility of hypnotherapy interventions for lowering blood pressure and psychological stress in hypertensive patients was investigated in a pilot study. The research objective was to determine the effect of audio hypnotherapy on blood pressure, stress levels, and heart rate in primary hypertension patients. The study randomized 64 hypertensive patients to the intervention or usual care. The intervention group received hypnotherapy through audio recordings for 15 minutes, while the control group took a rest for about 15 minutes. Blood pressure and heart rate were measured with digital tensimeter and stress levels with the Subjective Units of Distress Scale. Data analysis used Kruskal Wallis Test. The results showed a significant difference between the intervention and control groups with p value < .001 for decreasing in systolic blood pressure and p value < .001 for decreasing in stress levels. This pilot study suggests that a hypnotherapy intervention may be feasible and of benefit in a clinical population of hypertensive patients, however further study is needed.