A scoping review of Islamic pilgrimage to Mecca: Mapping the health concerns and proposed solutions.

OBJECTIVES: To map the current evidence about the health concerns and the potential solutions related to the Islamic pilgrimage to Mecca. DESIGN: A scoping review was applied. Papers published in English between 2012 and 2023 were included but non-human research and sources without any related data were excluded. Data charting and extraction were used to map the current evidence. RESULTS: The total of 36 papers were included with the total number of pilgrims of 17,075,887. The majority of studies were published in the Asia Pacific region (36.11%) as original articles (88.89%). The health concerns were grouped into five main aspects. There were 7603 deaths recorded or about 44 incidences of deaths per 100,000 pilgrims during the pilgrimage. There were recorded 11,018; 6178; 3393; and 17,810 cases for communicable diseases; non-communicable diseases; injuries and trauma; and health services (i.e., cardiac catheterization) and vaccination, respectively. CONCLUSION: Relating to the five health concerns, this study identified the top seven issues in each category (i.e., hypertension, influenza vaccination), except for the death record. Moreover, there were three solutions (for general health, non- and communicable-diseases) presented. Stakeholders could use this evidence to improve healthcare quality particularly related to the annual Islamic pilgrimage to Mecca.

Validity and reliability test for problem areas in Diabetes-Five item short form (PAID-5) Indonesia version.

Background and Objective: Emotional distress experienced by patients with diabetes (PWD) can affect glycemic control and quality of life. However, limited tools are available in Indonesia to detect emotional distress in PWD in clinical setting or research. This study aimed to evaluate the validity and reliability of the Indonesia version of the Problem Areas in Diabetes (PAID-5) scale. Methods: After the cross-cultural adaptation method was conducted, psychometric tests were done from August to November 2019 at affiliated hospitals in Yogyakarta by involving 100 adult PWD. All PWD with no medical records of mental health problems or cognitive disorders were voluntarily included. Content and construct validity and internal consistency measurements were used to evaluate the psychometric properties. Results: The mean age was 61.2 years of the men and women who equally participated in the study and mostly were non-working patients. The PAID-5 resulted in five question items to identify the emotional distress of PWD in the Indonesian language. Some minor modifications were done in items four and five after discussing them with the original authors and experts in Indonesia. The results showed item content validity index for item and scale were 0.6-0.8 and 0.72, respectively. The calculated r-values ranged from 0.751 to 0.888, which were higher than the r table (0.197). The Cronbach alpha of the Indonesia version of PAID-5 was 0.87 with inter-item and item-total correlations of 0.43-0.71 and 0.61-0.79, respectively. Conclusion: The results of the study indicate that PAID-5 is considered valid and reliable to assess emotional distress among PWD and can be useful in clinical setting or for research purposes. Continued assessment of emotional distress is applicable and helps patients to better deal with their emotional distress.

Milk Fermented with Pediococcus acidilactici Strain BE Improves High Blood Glucose Levels and Pancreatic Beta-Cell Function in Diabetic Rats.

This study evaluated the effects of milk fermented with Pediococcus acidilactici strain BE and Pediococcus pentosaceus strain M103 on diabetes in rats (Rattus norvegicus). The bacteria were separately used as starter cultures for milk fermentation, and the products were then fed to diabetic rats for 15 days. Blood glucose levels, immunohistochemical and histological indicators, lipid profiles, and total lactic acid bacterium counts were evaluated before and after treatment. The administration of milk fermented with P. acidilactici strain BE reduced blood glucose levels from 410.27±51.60 to 304.07±9.88 mg/dL (p<0.05), similar to the effects of metformin (from 382.30±13.39 mg/dL to 253.33±40.66 mg/dL, p<0.05). Increased insulin production was observed in diabetic rats fed milk fermented with P. acidilactici strain BE concomitant with an increased number and percentage area of immunoreactive beta-cells. The structure of insulin-producing beta-cells was improved in diabetic rats fed milk fermented with P. acidilactici strain BE or metformin (insulin receptor substrate scores of 5.33±0.94 and 3.5±0.5, respectively). This suggests that the administration of milk fermented with P. acidilactici BE potentially reduces blood glucose levels and improves pancreatic beta-cell function in diabetic rats.

The impact of telehealth on self-management of patients with type 2 diabetes: A systematic review on interventional studies.

BACKGROUND AND AIMS: Self-management is critical to manage the glycemic and metabolic outcomes for patients with diabetes. Telehealth applications are recognized as a potential approach to promote self-management of people with type 2 diabetes. This study aimed to investigate the impact of telehealth on self-management among patients with type 2 diabetes. METHODS: A systematic review was conducted on several databases, including PubMed, EbscoHost Medline, and Science Direct, with the keywords: Diabetes Mellitus AND Mobile-phone based OR Telemedicine OR Telehealth OR Web-based OR Telenursing AND Self-management. Inclusion criteria were articles with type 2 diabetic respondents, published between 2015 and 2020, open-access articles, and had self-management as outcomes. Hence, qualitative, protocol, or review articles, commentaries, letters to editors, and case study/reports were excluded. The Joanna Briggs Institute critical appraisal tools and Cochrane collaboration's tools were used for assessing risk of bias. RESULTS: The total of six studies were included in the qualitative synthesis, with five randomized control trials and one cross-sectional study. Telehealth applications were formed as an online or app-based platform with the key features of educational programs, text or voice messages, consultations and counseling, and active participation of the subjects. Besides improving the self-management outcomes, the telehealth also indicated improvements in positive behaviors, attitudes, and the intention of self-management. CONCLUSION: The study concluded that implementation of telehealth provided positive self-management results among patients with type 2 diabetes. The users need to consider an intensive training, peer or family support, and provision of full support for the patients during the implementation of telehealth.

Self-Efficacy to Obtain Human Papillomavirus Vaccination among Indonesian Adolescent Girls.

OBJECTIVE: This study aimed to examine self-efficacy to obtain the HPV vaccination among adolescent girls in Indonesia. Furthermore, factors affecting HPV vaccination self-efficacy was investigated. METHODS: A cross-sectional study was conducted 337 among adolescent girls in junior high school (aged 12-15 years). Participants were recruited from four junior high schools in Yogyakarta using consecutive sampling. A self-administered questionnaire requested demographic information, knowledge of HPV and HPV vaccine and self-efficacy to obtain HPV vaccine. School teachers facilitate the data collection adolescent girls using the listed questionnaires. Data analysis used Pearson correlation, chi-squared tests and logistic regression analysis. RESULTS: As many as 50.1% of the adolescent girls reported high self-efficacy to obtain HPV vaccine and 57.9% reported high knowledge about HPV and HPV vaccine. There were significant correlations between self-efficacy and age, vaccination experience, recommendation from health care providers, parental support, social persuasion and anxiety. Parental support contributed to almost 18 times (95% CI:3.837 - 83.648; p<0.0001) while social persuasion was nearly 9 times (95% CI: 3.875-20.011; p<0.0001) more likely to predict the self-efficacy to obtain HPV vaccination. CONCLUSION: Parental support and social persuasion significantly predict self-efficacy to obtain HPV vaccination. Parental support is the main factor in the decision making of adolescent to obtain HPV vaccination.

Screening for psychological distress on Indonesian type 2 diabetes: A validation study.

AIM: This study aimed to test the validity and reliability of a four-item patient health questionnaire as a psychological distress screening tool for patients with type 2 diabetes in Indonesia. METHODS: This cross-cultural adaptation study was applied in five public health-care centres in Indonesia in August-October 2018 using a four-item patient health questionnaire. The content, convergent and factorial validity were assessed, and Cronbach's alpha coefficient was the reliability indicator. RESULTS: A total of 147 participants were involved. Content validity resulted in acceptable outcomes (item and scale content validity indexes were 0.95 and 0.75, respectively). Anxiety and depression were associated with total score and psychological distress status (P < 0.001), supporting the convergent validity outcomes. Principal component analysis using varimax rotation revealed two factors, explaining 76.14% of variance (P < 0.001). Cronbach's alpha coefficients for anxiety, depression and total score were 0.780, 0.500 and 0.713, respectively. CONCLUSIONS: The study demonstrated adequate validity and reliability for the Indonesian version of a four-item patient health questionnaire among patients with type 2 diabetes. Therefore, it is applicable as a screening tool for psychological distress in this population.

Palliative Care Quiz for Nurses-Indonesian Version (PCQN-I): A Cross-cultural Adaptation, Validity, and Reliability Study.

AIM: The study is aimed to perform a cross-cultural adaptation of the palliative care quiz for nurses in an Indonesian context to evaluate its psychometric properties. METHODS: A two-phase design was used in this study, including cross-cultural adaptation and psychometric testing. The PCQN-I was tested on a convenience sample of health-care providers recruited from 20 primary health-care (PHC) centers in Yogyakarta, Indonesia, from July to October 2017. RESULTS: The cross-cultural adaptation ultimately resulted in a total of 20 items from the PCQN-I. An expert committee revised the words in Item 4 from "adjuvant therapies" to "adjuvant therapies/additional therapies," in Item 5 from "bowel regimen" to "gastrointestinal therapies," and Item 16 from "Demerol" to "Pethidine" based on the Indonesian context. The experts retained Item 5 "It is crucial for family members to remain at the bedside until death occurs," although none of the participants (n = 40) involved in the pilot testing could answer it correctly, and Item 19 "The loss of a distant or contentious relationship is easier to resolve than the loss of one that is close or intimate" although few participants responded correctly. A total of 150 health-care providers consisting of 100 nurses and 50 physicians were involved in the psychometric testing. The scale-level content validity index/Ave of the PCQN-I was 97 and 93 in terms of its relevancy and clarity, respectively. The reliability was calculated as the Kuder-Richardson formula 20 score was 0.71. CONCLUSIONS: The PCQN-I is a valid and reliable instrument for assessing palliative care knowledge among PHC providers. Further research is warranted to examine its reliability in different clinical settings.

The Attitude of Health Care Workers on Enhanced Recovery After Surgery for Cesarean Delivery: A Scoping Review.

OBJECTIVE: Previous systematic reviews have found that the enhanced recovery after surgery (ERAS) protocol for cesarean delivery can vary from one study to another, and the attitudes of health care professionals regarding ERAS methods and the implementation of the ERAS for cesarean delivery remain unclear. We aimed to identify the attitudes of health professionals toward ERAS in the context of cesarean delivery. DATA SOURCES: Systematic searches were conducted in 6 databases: PubMed, ScienceDirect, EBSCO, Scopus, the Cochrane Library, and Sage Journals from September 2010 to September 2020. STUDY SELECTION: A total of 4 articles were selected for analysis. All articles use survey methods and present health professional attitudes toward ERAS for cesarean delivery. DATA EXTRACTION AND SYNTHESIS: Data were extracted using Excel spreadsheets. The results obtained are presented descriptively. CONCLUSION: This review illustrates that there are many ERAS protocols that health care professionals have not yet implemented for cesarean delivery. Policymakers can use this knowledge to inform the promotion of the ERAS protocol for cesarean delivery.

Determinants of High-Sodium Food Intake Among Indonesian Patients With Hypertension.

BACKGROUND: Sodium restriction is difficult for most individuals with hypertension. Intention to limit sodium intake predicts behavior. Information on the determinants of intention to restrict sodium intake is limited. OBJECTIVES: The aims of this study were to identify (1) determinants of intention to restrict high-sodium food intake and (2) sources of sodium consumed by patients with hypertension in Indonesia. METHODS: A cross-sectional study was conducted among adult patients with hypertension (n = 206) attending cardiac clinics. A researcher-developed and tested, self-administered questionnaire that included questions about sodium restriction and a high-sodium food inventory was distributed. The quantile regression method was used to identify determinants of intention to restrict dietary sodium. RESULTS: The mean age of the patients with hypertension was 59 ± 10 years, and more than three-fourths were obese (n = 162, 78%). The determinants of intention to limit sodium intake included gender (ß = 0.737, P = .036), attitude (ß = -0.141, P = .050), and subjective norm (ß = -0.283, P = .005). Men reported higher sodium consumption, while attitudes and subjective norm were negatively correlated with sodium intake. These determinants predicted 13.2% of the variance in intention to restrict dietary sodium. Subjects reported frequently consuming snacks (n = 82, 39.7%) and seasoning condiments (n = 65, 31.6%). CONCLUSIONS: High-sodium snacks and condiments added while cooking were frequently consumed among patients with hypertension in Indonesia. Understanding the factors associated with intention to follow a low-sodium diet will assist nurses to design effective interventions that promote adherence to the low-sodium diet among those with hypertension.

Diabetes management and specific considerations for patients with diabetes during coronavirus diseases pandemic: A scoping review.

BACKGROUND AND AIMS: The global pandemic of coronavirus (COVID-19) affects almost all countries in the world, which potentially alter diabetes management. Many diabetes patients are experiencing barrier of care due to the policy related to COVID-19. This article aims to review the current evidence on diabetes management and specific considerations during the COVID-19 pandemic for people living with diabetes. METHODS: We conducted a scoping review in PubMed, Science Direct, DOAJ and Microsoft Academics databases from January 1 to April 17, 2020. Searching terms included "COVID-19", "severe acute respiratory syndrome coronavirus 2", and "Diabetes Mellitus" were used. Only scientific articles discussing diabetes management and specific considerations were selected and extracted. RESULTS: A total of 7 articles was selected in the analysis. Most were published in diabetes journals (85.71%). All articles (100%) discussed diabetes management and 71.43% of them provided diabetes care in specific considerations. We discussed issue of diabetes management in glycemic control and monitoring, dietary intake, physical activity, medication, education and prevention of COVID-19 infection that applicable for diabetes patients. In addition, specific considerations explored caring for diabetes in children and adolescents, pregnancy, elderly, emergency or critical care, to offer certain concern for raising the awareness. CONCLUSIONS: This review specifies a summary of diabetes management as well as the particular considerations to care people living with diabetes during COVID-19 pandemic. Patients, health care providers, and policy makers could take advantage of the review to assist diabetic people passing through COVID-19 pandemic session with optimum glycemic outcome.

Effects of yoga on pulmonary functions among asthmatic patients: A protocol synthesis

OBJECTIVE: This study aimed to synthesize protocol of yoga pranayama's practice through combining yoga pranayama's steps into the new integrated formations of yoga pranayama's steps for adult asthmatic patients as a protocol. METHOD: Literature review from the last 20 years publication of original trial articles on adult asthmatic subjects from 4 databases: PubMed, Science Direct, EBSCO, and Scopus was conducted. Review and non-trial articles were excluded. Articles were appraised using Joanna Bridge Institute (JBI) critical appraisal tools. RESULTS: There were 4 out of 252 articles which met the criteria and being included in this study. The synthesized protocol resulting 11 pranayama steps in the new synthesized protocol. CONCLUSIONS: The regular 13 yoga pranayama steps within 11 pranayama steps based on synthesized protocol takes 30-45min for each session and can be conducted 2-5 times a week for 2-6 months to be able to reveal pulmonary function outcomes

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The Indonesian version of the Medical Outcome Survey - Short Form 12 version 2 among patients with cardiovascular diseases.

AIM: The aim of this study is to examine psychometric properties of the Indonesian version of Medical Outcome Survey Short Form 12 version 2 (SF12v2). METHODS: A cross-sectional study was conducted in three primary healthcare units in Yogyakarta, Indonesia. Patients with cardiovascular diseases who were able to respond to questionnaires and provide their consent were invited. The validity test included face, content, discriminant, and construct validity. The internal consistency was used as the reliability indicator. RESULTS: The item and subscale of content validity index were 0.97 and 0.83, respectively. The instrument had 100% for equivalence and clarity outcomes, whereas the readability outcome was 91.7%. More than 80% of participants agreed and considered SF12v2 understandable. The correlations among physical and mental subscales were substantial, supporting discriminant validity. The Bartlett test of sphericity was significant with the Kaiser-Meyer-Olkin test of 0.74. The principal component analysis resulted in eight components, explaining 88.4% of total variance. α coefficients for subscale were ranging from.58 to.81, whereas the physical and mental component summaries were.77 and.67, respectively. CONCLUSIONS: The Indonesian version of SF12v2 indicated a reliable and valid instrument. The SF12v2, available in a Bahasa Indonesia version, is an applicable instrument to assess quality of life on patients with cardiovascular diseases.

Psychometric Testing of the Indonesian Version of Dietary Sodium Restriction Questionnaire Among Patients with Hypertension.

PURPOSE: The purpose of this research was to test the validity and reliability of the Indonesian version of the Dietary Sodium Restriction Questionnaire (DSRQ-I) among patients with hypertension. METHODS: The cross-sectional study enrolled hypertensive patients from a cardiac outpatient department in Indonesia using convenience sampling. Eligible patients received a demographic questionnaire and DSRQ-I during a one-month period of data collection. Content and construct analysis examined the validity, whereas internal consistency assessment checked reliability. Participation required 10-15 minutes on average. RESULTS: One hundred thirty-five patients participated: mostly females (54.1%) and married (82.9%) with mean age of 58.18 ± 10.44 years. The item of content validity index was .97, and subscale content validity index was .81 for DSRQ-I. The Kaiser-Meyer-Olkin test gave a value of .83, indicating adequate sampling, and the Bartlett's test of sphericity reached significant result (p < .001). The principal component analysis indicated three components, with 64.2% explaining variance, including perceived behavioral control (35.5%), attitude (19.3%), and subjective norm (9.4%). Confirmatory factor analysis produced a parsimonious model on the three-factor outcome by removing a single item. The indices of good fit model was achieved at χ2/df = 2.17, goodness fit index = .85, root mean square error of approximation = .09, standardized root mean square means = .07, and Bentler comparative fit index = .90 (p < .001). Cronbach's alpha coefficients for attitude, subjective norm, and perceived behavioral control were .85, .87, and .85, respectively. All interitem and item-total correlations indicated adequate outcome and acceptable result. Consequently, 15 items were determined reliable measurement and included in the final version of DSRQ-I. CONCLUSION: The DSRQ-I is a valid and reliable instrument to measure facilitators and barrier of sodium restriction among hypertensive patients in Indonesia.