Adapting to People With Schizophrenia: A Phenomenological Study on a Rural Society in Indonesia.

BACKGROUND: The growing prevalence of schizophrenia in Indonesia requires the consideration of the families, caregivers, health care professionals, and the entire society, to serve as a support and coping resource for the patients. The process of recovery is rather difficult, especially in the absence of a decent place to live. Hence, there is the need to provide a supportive environment that facilitates recuperation from psychotic symptoms, enhances interaction with others, promotes self-expression of thoughts and feelings, and helps deal with daily stress and challenges. There are currently no studies on the framework of societal adaptation for people with schizophrenia (PWS). The aim of this research, therefore, was to explore the experiences of rural society inhabitants in adapting to PWS in Indonesia. METHODS: The study uses a qualitative research design and implements an interpretive phenomenological approach. A total of ten society members were recruited from the community by purposive sampling, and the in-depth interviews conducted were audio-recorded and transcribed. In addition, thematic analysis was carried out using the interpretive phenomenological analysis method. RESULTS: The majority of the participants assumed that PWS prompt the feeling of alertness over fear. In addition, the participants revealed a feeling of indecisiveness in related situations and emphasized the value of keeping up traditional beliefs and practices and the effectiveness of a demonstration of indifference. They explained the need to combine traditional and modern health practices as recommended by the spiritual leaders. CONCLUSION: Societal adaptation to PWS entails the understanding of how to deal with the disease's uncertainty and complexity. It is important to create a supportive environment to promote mental health and wellbeing.

Holistic-comprehensive approaches to improve nutritional status of children under five years.

BACKGROUND: Malnutrition has been identified as the leading cause of illness and death in almost half of children under 5 years. Hence, to prevent the impact of malnutrition on physical and psychological development, family physicians need to explore new approaches in the health care delivery models that go beyond the scope of practice. A holistic-comprehensive approach will help the physicians develop a more thorough assessment of nutritional status. This study aims to determine factors associated with the nutritional status of children under five years using holistic-comprehensive approaches. DESIGN AND METHODS: A case-control design was implemented, with emphasis on the identification of cases and control groups; 48 children confirmed malnutrition cases and 48 control without malnutrition were recruited from a Community Integrated Health Center in East Java, Indonesia. The characteristics of agent, host and environment between groups were compared and analyzed using correlation coefficients, odds ratio, logistic regression analysis, and Structural Equation Modeling-Partial Least Square (SEM-PLS). RESULTS: The SEM-PLS results showed that environmental factors have a greater influence on nutritional status (t-value >1.96), compared to the host factors. Furthermore, environmental factors having significant associations with nutritional status were poor socioeconomic status, low maternal educational level and not having exclusive breastfeeding. Also, the results of correlation coefficients and OR showed that birth weight (p=0.000, OR=33) and socioeconomic status (p=0.000, OR=22.3) had strong correlations with nutritional status. CONCLUSION: Holistic-comprehensive approaches can be used as new ways to determine factors that may be associated with nutritional status of children under 5 years of age.

Mental health policy: protecting community mental health during the COVID-19 pandemic.

Despite the growing interest in the treatment and management of COVID-19, communities still end up experiencing multiple stresses with mental health crisis, due to the pandemic. When this is not addressed, it causes stress in the long run, with further mental health damage in individuals and the communities. Furthermore, relevant policy related to the community mental health was identified as awareness in promoting mental issues, yet there are still failures recorded in the aspect of adequately addressing the well-being concerns. This study aims to support community mental health during the crisis, through useful information from relevant articles. It also explains some perspectives from literature reviews, case reports, with society responses from Google Scholar, Science Direct, and Proquest databases concerning recent community mental health issues, and government policy on the impact of the COVID-19 pandemic. The inclusion criteria required articles that were peer-reviewed, by using i) English language March-September 2020; ii) Presented empirical studies related to COVID-19 (quantitative and qualitative); iii) Searched terms related to the general and community mental health, their policy, and COVID-19 pandemic. This study showed 19 articles related to community mental health issues or psychological wellbeing topics. The interventions provided to strengthen community mental health during the pandemic included emergency psychological crisis treatment, hotline assistance, online counseling service with mental care course, and outpatient consultation. Therefore, community mental health issues should be addressed with physical wellness. In addition, the community plays a key role in influencing stakeholders and governments, to increase the priority in supporting mental health.

Understanding patient satisfaction and loyalty in public and private primary health care.

Background: The quality of health centers, patient satisfaction, and loyalty are three key factors that enable health care providers to improve their services and cost-effectiveness. This study, therefore, aims to determine patient satisfaction and loyalty in public and private primary health care centers. Design and Methods: Data were obtained from a cross-sectional design of 1470 self-administered questionnaires and analyzed based on mean, standard deviation, and correlation coefficients. Results: The results showed respectively a strong and moderate correlation between patient satisfaction and loyalty in private (r=0.767) and public (r=0.54) primary health care centers, respectively. In addition, in both centers patients received adequate medical services, with social aspects as the least important factors affecting patient satisfaction. Conclusions: In conclusion, primary health care practices need to recognize the needs that influence patients' satisfaction and loyalty, to improve the quality of their services.