Open Access Macedonian Journal of Medical Sciences Open Access Macedonian Journal of Medical Sciences (OAMJMS) is an international peer reviewed journal published four times per year by the ID Design 2012/DOOEL Skopje on behalf of Foundation Macedonian Donor Registry (MKDR), Skopje en-US <p>All rights reserved.</p> (Prof. Dr Mirko Spiroski) (Ivo Spiroski) Sun, 10 Jan 2021 19:18:59 +0000 OJS 60 Reducing Maternal Mortality: A Qualitative Study of Health Workers’ Expectation in Urban Area, Indonesia <p><strong>BACKGROUND:</strong> Maternal mortality is a sentinel event used globally to monitor maternal health and the overall quality of reproductive health care. Globally, maternal mortality is mostly due to direct causes; apparently, it is not limited by the setting or geographic region. However, Indonesia has failed to achieve the Millenium Development Goals (MDGs) target for maternal mortality.</p> <p><strong>AIM: </strong>This study aims to explore health workers' and stakeholders' expectations in maternal health services to reduce maternal mortality in urban areas.</p> <p><strong>METHODS: </strong>It is qualitative research through naturalistic, conducted in one of the regencies in Indonesia, the urban area with the highest Maternal Mortality Rate (MMR) in one province by 2019. Data were obtained in the form of information from Focus Group Discussions (FGDs). FGDs were carried out with stakeholders at the Health Service level (n=3), first-level health facilities or public health centres (n=3), and advanced health facilities or hospitals (n=7). Data analysis in this study employed software (Nvivo Release 1.0) to utilise transcripts in coding and categorising.</p> <p><strong>RESULTS: </strong>The expectations that emerged from health workers' perspectives in the field were an integrated system of collaboration between health facilities, affordability of Hospital with Comprehensive Emergency Obstetric Care (CEmOC) in action for maternal-neonatal referral urgency, and the skilled health workers as a golden opportunity.</p> <p><strong>CONCLUSION: </strong>Health workers’ expectations can improve the quality of maternal health services in urban areas, thereby reducing the MMR with a system of collaboration between health facilities, the affordability of maternal-neonatal emergency referral facilities, and the availability of Obstetricians who standby.</p> Arlina Dewi, Sri Sundari, Nursetiawan Nursetiawan, Supriyatiningsih Supriyatiningsih, Dianita Sugiyo, Dyah Tri Kusuma Dewi, Winda Azmi Meisari (Author) Copyright (c) 2021 Arlina Dewi, Sri Sundari, Nursetiawan Nursetiawan, Supriyatiningsih Supriyatiningsih, Dianita Sugiyo, Dyah Tri Kusuma Dewi, Winda Azmi Meisari (Author) Mon, 01 Mar 2021 00:00:00 +0000 The Determinant Factors of Stunting Among Children in Urban Slums Area, Yogyakarta, Indonesia <p><strong>BACKGROUND: </strong>In Indonesia, health indicators in urban areas are better than in rural areas. It is related to the health services’ accessibility. However, in some regions, the stunting rate among children under five in urban areas is higher than in rural areas, including in Yogyakarta.</p> <p><strong>AIM: </strong>The research purpose was to analyze the determinant factor influencing the stunting incidence in children under five in urban slums areas.</p> <p><strong>MATERIALS AND METHODS: </strong>The study design employed a case control with a sample of mother and 29 children under five as a case group and 42 children under five as a control group in Yogyakarta District during the December–January 2020 period. The inclusion criteria were children aged 6–59 months living in the urban slum area, while the exclusion criteria were children who had physical and mental disabilities, suffering from illness or were hospitalized, and had congenital diseases. The data collection was conducted by questionnaire and anthropometric measurements. Data analysis used central tendency, Chi-square, and logistic regression.</p> <p><strong>RESULTS: </strong>The results showed that the majority of children were girls in the case group and boys in the control group with a history of non-exclusive breastfeeding. Most respondents have mothers with low levels of education and work as housewives. The results of the correlation test showed that of the seven variables studied as a risk factor, there are two factors which were birth weight and mother occupation which were related with stunting in children under five with p = 0.041 and 0.047, respectively.</p> <p><strong>CONCLUSION: </strong>This study concluded that birth weight (AOR = 3.49) and mother’s occupation (AOR = 0.25) are the determinant cause of stunting in children under 5 years of age in urban slums areas. The pregnant women’s health promotion needs to be improved because it will affect birth weight, a risk factor for stunting in children under five.</p> Titih Huriah, Putri Handayani, Tiwi Sudyasih, Bambang Edi Susyanto (Author) Copyright (c) 2021 Titih Huriah, Putri Handayani, Tiwi Sudyasih, Bambang Edi Susyanto (Author) Fri, 05 Feb 2021 00:00:00 +0000 Patient’s Transition Experiences from Hospital to Home after an Acute Cardiac Event <p><strong>BACKGROUND: </strong>Care transition after hospital discharge is challenging for patients and their families. For post an acute cardiac event patients, the 0–14 days period is a vulnerable period. After hospitalization, patients and their families report having unmet information needs at a time of hospital discharge. It can increase the complication and hospital readmission.</p> <p><strong>AIM: </strong>This study aim to explore the patient’s transition experiences from hospital to home after an acute cardiac event.</p> <p><strong>METHODS: </strong>An exploratory qualitative research design with phenomenological approach was used in the study. The data were collected from April to July 2020, using semi-structured interviews with 15 patients diagnosed with acute coronary syndrome (ACS). Transcribed interview data were thematically analyzed.</p> <p><strong>RESULTS: </strong>There are five themes obtained from the study: Positive perception after an acute cardiac event, the changes experienced, the knowledge which was required, the support needs, and expectations and goals.</p> <p><strong>CONCLUSION: </strong>Transition from hospital to home depends on the perceptions of the participants themselves. The experience of transitioning patients from hospital to home was influenced by the existence of support from family, spiritual meaning, and social environment to be able to adapt to health conditions. The finding of this study can assist the nurses in understanding better the needs of patients to prepare the care transition from the hospital to home.</p> Azizah Khoiriyati, Kusnanto Kusnanto, Ninuk Dian Kurniawati, Al Afik Afik (Author) Copyright (c) 2021 Azizah Khoiriyati, Kusnanto Kusnanto, Ninuk Dian Kurniawati, Al Afik Afik (Author) Mon, 22 Feb 2021 00:00:00 +0000 Peer Education and Sexual Risk Behavior Among Adolescents: Does Urban Status Matter? <p><strong>BACKGROUND: </strong>As a result of elevated sexual risk behaviors among teenagers, millions of adolescents face sexual and reproductive health challenges, including high rates of an unfulfilled need for contraceptives, unintended pregnancy, and unsafe abortion. To develop their skills and prevent adolescent sexual activity from being unsafe, especially in urban areas, teachers and peers were advised that teaching adolescents about reproductive health should be carried out at any school.</p> <p><strong>AIM: </strong>This study aims to evaluate the effect of peer education on the prevention of adolescent activity at sexual risk in urban areas.</p> <p><strong>METHODS: </strong>This research was a pre-experimental quantitative approach with a one-group pre-post-test model. The survey used in this study had 63 respondents. Samples were collected using a purposeful sampling process. The research was conducted in April at SMP Negeri X Yogyakarta until June 2017. In this analysis, the independent variable was peer education, while the dependent variable was the prevention of sexual risk activity among adolescents.</p> <p><strong>RESULTS: </strong>The Wilcoxon sign-rank test data analysis showed that there were no significant differences in the prevention of sexual risk behavior among adolescents in urban areas at pre- and post-sexual education through p-value peer education = 0.086.</p> <p><strong>CONCLUSION: </strong>There is no significant impact on reducing adolescent sexual risk behaviors in urban areas through peer education. The media may significantly influence the prevention of the conduct of urban adolescents at sexual risk. To prevent sexual risk behavior among adolescents in an urban environment, further research is recommended to find the best intervention using more profound internal and external relevant variables and media impact association study.</p> Sri Sumaryani, Sri Andini Widya Ningrum, Titi Savitri Prihatiningsih, Fitri Haryanti, Agus Gunadi (Author) Copyright (c) 2021 Sri Sumaryani, Sri Andini Widya Ningrum, Titi Savitri Prihatiningsih, Fitri Haryanti, Agus Gunadi (Author) Fri, 26 Feb 2021 00:00:00 +0000 Nurse’s Roles in Patient-Family Decision Making for Palliative Patients in Indonesia and Malaysia <p><strong>BACKGROUND: </strong>The limited palliative care services can affect the late in palliative care management, such as late in decision making. Decision making is one of the crucial processes that every patient with life-threatening health life-limiting illness needs to overcome. Nurses can be the third party between the patients and physicians in helping them with decision making.</p> <p><strong>AIM: </strong>The aim of this study was to explore the differences perspectives of palliative care decision making for palliative patients and families in Indonesia and Malaysia.</p> <p><strong>METHODOLOGY: </strong>The study design used qualitative method with the phenomenology approach. The sample size of this study was 12 participants from two different study settings. They were three palliative nurses and three physicians from each country, selected by purposive sampling. The study was carried out at PKU Muhammadiyah Yogyakarta Hospital and Tuanku Fauziah Hospital Kangar, Perlis, Malaysia. Data collection used in-depth interview. The interpretative phenomenology analysis was used to analyze the data.</p> <p><strong>RESULTS: </strong>There were differences in the perspectives of palliative care services in Indonesia and Malaysia based on the culture form each of the countries. Nurses played a supportive role in ensuring that the care delivered to the patients and families were effective and efficient. Lack of staff was one of the challenges for Indonesia and Malaysia palliative care services need to face.</p> <p><strong>CONCLUSION: </strong>Three themes emerged from the collected data; there were views on palliative care, nurses’ supportive roles, and limited resources. To encounter the challenges and difficulties that interrupt the care delivery to the patients, nurses need to improve knowledge about palliative and their skills.</p> Madihah Binti Abdullah, Titih Huriah, Arianti Arianti, Rosnani Binti Sarkasi (Author) Copyright (c) 2021 Madihah Binti Abdullah, Titih Huriah, Arianti Arianti, Rosnani Binti Sarkasi (Author) Sat, 20 Feb 2021 21:56:16 +0000 Life Experiences in Parenting: The Perspective of Women with HIV-AIDS <p><strong>BACKGROUND: </strong>The role of mother with HIV/AIDS in caring for their children has its own complexities. The mother plays a role in taking care of the family as well as being the caregiver for her children. Mothers with HIV-AIDS need to take care of themselves and their children who are either infected or not. Mothers can do multiple roles if their partner leaves them.</p> <p><strong>AIM: </strong>The purpose of this study was to determine the life experiences of mothers with HIV-AIDS in childcare.</p> <p><strong>METHODS: </strong>A phenomenological study was chosen as a design to explore the phenomenon of mothers with HIV-AIDS in parenting their children using in-depth interviews. Participants were drawn based on a purposive sample of seven people. The participant’s considerations were the wife who was diagnosed with HIV-AIDS positive and was registered as a patient managed by the HIV-AIDS program at the Serang City Health Center; the participants received ARV treatment, good general condition, able to communicate well, and cooperatively. The data analysis used was Colaizzi.</p> <p><strong>RESULTS: </strong>The results of the study generate four new themes: Expectation of negative status of the loved ones, lamentations of wives with People Living With HIV/AIDS (PLWHA) status, management of sick child care and HIV testing, tendencies of authoritarian, and permissive parenting in children.</p> <p><strong>CONCLUSION: </strong>Therefore, it is important to increase peer group counseling on the process of disease acceptance, management of sick children management, and implementation of HIV testing that can be accessed by family members of PLWHA.</p> Eka Ernawati, Dewi Rahmawati, Indah Wulandari, Firda Afriyani (Author) Copyright (c) 2021 Eka Ernawati, Dewi Rahmawati, Indah Wulandari, Firda Afriyani (Author) Sat, 27 Feb 2021 00:00:00 +0000 The Role of the Family in Preventing Relapse of Schizophrenia Patient <p><strong>BACKGROUND: </strong>The relapse rate of schizophrenia patients is still high. The family has an important role in helping schizophrenia patients to avoid recurrence.</p> <p><strong>AIM: </strong>This study aimed to describe the role of the family in preventing relapse schizophrenia patients.</p> <p><strong>METHODS: </strong>The research used a qualitative design with a phenomenology approach. The sample consisted of 12 families who had schizophrenic patients. The samples were obtained by purposive sampling technique. The data were collected by interview and using field notes, then analyzed by Colaizzi technique.</p> <p><strong>RESULTS: </strong>The results showed that the role of the family in preventing the recurrence of schizophrenia patients was of four themes, namely, acceptance, assistance, hope, and communication from the family.</p> <p><strong>CONCLUSION: </strong>There are four roles of the family to prevent a patient’s recurrence. The government needs to pay attention to the families of schizophrenia patients.</p> Mamnuah Mamnuah (Author) Copyright (c) 2021 Mamnuah Mamnuah (Author) Sat, 20 Feb 2021 00:00:00 +0000