Public Health and Preventive Medicine Archive
ublic Health and Preventive Medicine Archive (PHPMA) is an open access, peer reviewed journal published by Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University. Issues covered in the journal are as the following: Environmental and occupational health Field and Clinical Epidemiology Global health Health policy analysis Health promotion Health systems and health care management Maternal and child health Program monitoring and evaluation Public health nutrition Reproductive health, sexually transmitted infections and HIV related issues Travel health and health tourism Population and family planning Disaster management
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<![CDATA[The correlation between knowledge, body image perception and self efficacy with anxiety among perimenopausal women in Dauh Puri Klod Village, Bali ]]>
<![CDATA[Ni Made Ayu Yulia Raswati Teja]]>;
<![CDATA[Ni Komang Ekawati]]>;
<![CDATA[Ni Made Swasti Wulanyani]]>
<![CDATA[ Public Health and Preventive Medicine Archive Vol. 7 No. 1 (2019) ]]>
Publisher : <![CDATA[Universitas Udayana ]]>
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DOI: 10.53638/phpma.2019.v7.i1.p06
<![CDATA[Background and purpose: Level of anxiety among women approaching menopause is often high. This is influenced by knowledge, education, culture and customs, body image perception and self-efficacy. This study aims to determine the relationship between knowledge, perception of body image and self-efficacy with anxiety in perimenopausal women. Methods: This study employed a cross sectional design with 87 perimenopausal women aged 45-55 years in Dauh Puri Klod Village, Denpasar City, Bali Province. Respondents were selected with systematic random sampling from 1,039 women aged 45-55 years recorded in Dauh Puri Klod Village. Interviews were conducted at each respondent’s house in August 2018. Data collected included sociodemographic characteristics, knowledge, perception of body image, self-efficacy and anxiety levels among women approaching menopause. Bivariate analysis with chi square test and multivariate analysis with logistic regression were conducted to identify the association between variables. Results: The results of bivariate analysis showed that variables associated with anxiety were knowledge (p=0.001), perception of body image (p=0.012) and self-efficacy (p=0.001). The results of multivariate analysis with the backward method showed that the variables associated with anxiety were knowledge (AOR=10.83; 95%CI: 3.31-35.37) and self-efficacy (AOR=3.48; 95%CI: 1.09-11.14). Conclusion: Knowledge and self-efficacy have a significant association with anxiety in perimenopausal women. Various efforts to increase knowledge and to build self-efficacy are needed, such as an educational and support program to reduce anxiety in women approaching menopause.]]>
<![CDATA[Association between emotional regulation and family support with quality of life of women with cervical cancer ]]>
<![CDATA[Putu Noviana Sagitarini]]>;
<![CDATA[Putu Cintya Denny Yuliyatni]]>;
<![CDATA[Ni Made Swasti Wulanyani]]>
<![CDATA[ Public Health and Preventive Medicine Archive Vol. 7 No. 1 (2019) ]]>
Publisher : <![CDATA[Universitas Udayana ]]>
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DOI: 10.53638/phpma.2019.v7.i1.p07
<![CDATA[Background and purpose: Cervical cancer ranks third globally and ranks second in Indonesia for all cancers in women. Women with cervical cancer experience physical and psychological disorders that can affect their quality of life. This study aims to determine the association between emotional regulation and family support with the quality of life of women with cervical cancer. Methods: A cross sectional survey was conducted in April 2018 at the Sanglah Hospital Obstetric Clinic. The study samples were chosen consecutively and consisted of 100 women with cervical cancer who underwent outpatient care. Data was collected using questionnaires filled in by the respondents and from the patient's medical records. Bivariate analysis was conducted with chi square test and multivariate with logistic regression. Results: The results showed that emotional regulation and family support were found to be significantly related to the quality of life of women with cervical cancer, each with AOR=17.64; 95%CI: 3.01-103.46; p=0.001 and AOR=11.28; 95%CI: 1.88-67.78; p=0.008. Conclusion: Emotional regulation and family support are related to the quality of life of women with cervical cancer. Efforts to improve emotional regulation and family support for patients should be carried out to improve their quality of life.]]>
<![CDATA[Emotional support is the only social support associated with the quality of life of people living with HIV ]]>
<![CDATA[Ni Wayan Sri Rahayuni]]>;
<![CDATA[Ketut Tuti Parwati Merati]]>;
<![CDATA[Dewa Nyoman Wirawan]]>
<![CDATA[ Public Health and Preventive Medicine Archive Vol. 7 No. 1 (2019) ]]>
Publisher : <![CDATA[Universitas Udayana ]]>
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DOI: 10.53638/phpma.2019.v7.i1.p08
<![CDATA[Background and purpose: The quality of life of people living with HIV is influenced by many factors, one of which is social support. Social support consists of four elements, namely information, instrumental, emotional and appraisal supports. Publication on the association between the quality of life of people living with HIV and the four elements of social support shows inconsistent results. The purpose of this study is to determine the association between the four elements of social support and the quality of life of people living with HIV. Methods: A cross-sectional survey was carried out at the WM Medika Clinic, Kerti Praja Foundation, Denpasar, Bali. Samples were people living with HIV who came to the clinic between July-August 2018 to take antiretroviral (ARV) drugs. The total number of samples was 92 patients selected through the convenience sampling. Data was collected by conducting individual interviews and consisted of respondent characteristics, quality of life, information, instrumental, emotional and appraisal supports. Data were analyzed using logistic regression to determine the association between social support and quality of life of people living with HIV. Results: Emotional support was the only element of social support found to be significantly associated with quality of life of people living with HIV with AOR=4.918 (95%CI: 1.268-19.082). Whereas the other three elements were not found to be related to the quality of life of people living with HIV, these were instrumental support (AOR=0.865; 95%CI: 0.228-3.278); information support (AOR=0.949; 95%CI: 0.248-3.637); and appraisal support (AOR=0.317; 95%CI: 0.095- 1.057). Conclusion: The quality of life of people living with HIV is found to be related to emotional support and is not found to be related to information, instrumental and appraisal supports. Emotional support needs to be addressed in order to further improve the quality of life of people living with HIV.]]>
<![CDATA[Time of colostrum discharge of more than six hours as a risk factor for physiological jaundice in neonates ]]>
<![CDATA[Ni Kadek Muliawati]]>;
<![CDATA[I Gusti Ayu Trisna Windiani]]>;
<![CDATA[Anak Agung Sagung Sawitri]]>;
<![CDATA[Luh Seri Ani]]>
<![CDATA[ Public Health and Preventive Medicine Archive Vol. 7 No. 1 (2019) ]]>
Publisher : <![CDATA[Universitas Udayana ]]>
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DOI: 10.53638/phpma.2019.v7.i1.p09
<![CDATA[Background and purpose: Neonatal jaundice is both a physiological and pathological condition. Neonatal physiological jaundice occurs within 3-5 days after the baby is born. Publications about time of colostrum discharge and neonatal jaundice are still limited. This study aims to determine the risk time of colostrum discharge more than 6 hours to physiological jaundice in neonates. Methods: A case control study was conducted at the Sanglah General Hospital in Denpasar from August to December 2017. The number of cases was 55 neonates with physiological jaundice and the number of controls was 55 neonates without physiological jaundice. Cases and controls were selected by consecutive sampling. The occurrence of physiological jaundice was obtained by direct observation and the degree of jaundice was determined based on the division of Kramer's body zone. Neonates with the Kramer grades I and II at the age of 3-5 days were classified as experiencing physiological jaundice (as cases) and neonates with a Kramer grade of 0 at the age of 3-5 days were classified as not jaundice (as controls). Cases were matched with controls by sex and age of the neonates. Data on maternal socio-demographic characteristics, time of colostrum discharge, early breastfeeding initiation and 24-hour breastfeeding frequency were obtained by interview; data on jaundice was obtained by observation while mode of delivery, parity, history of pre-eclampsia, prematurity, neonatal birth weight, history of birth trauma (cephalic hematoma), history of asphyxia and major congenital abnormalities were obtained from medical records. Multivariate analysis with binary logistic regression was carried out to determine the adjusted odds ratio (AOR) time of colostrum discharge . Results: The characteristics of cases and controls were found to be similar in terms of maternal education, neonatal age and sex, parity and pre-eclampsia history. Significant time of colostrum discharge >6 hours was found to be associated with physiological jaundice with AOR=2.57 (95%CI: 1.04-6.37). In this study, variables that were not found to be the risk factors of physiological jaundice in neonates were: cesarean delivery (AOR=0.36; 95%CI: 0.09-1.41; p=0.14), breastfeeding frequency within 24 hours (AOR=2.20; 95%CI: 0.47- 10.23; p=0.31) and early breastfeeding initiation (AOR=0.71; 95%CI: 0.19-2.59; p=0.60) Conclusion: time of colostrum discharge >6 hours is a risk factor for neonatal jaundice. Efforts should be made to accelerate the release of colostrum in order to prevent neonatal jaundice.]]>
<![CDATA[Weight gain during pregnancy and low birth weight babies: a retrospective cohort study in Gianyar District, Bali ]]>
<![CDATA[Putu Riza Kurnia Indriana]]>;
<![CDATA[Luh Putu Suariyani]]>;
<![CDATA[Ni Ketut Sutiari]]>
<![CDATA[ Public Health and Preventive Medicine Archive Vol. 7 No. 1 (2019) ]]>
Publisher : <![CDATA[Universitas Udayana ]]>
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DOI: 10.53638/phpma.2019.v7.i1.p10
<![CDATA[Background and purpose: Low birth weight (LBW) is a major causal factor for neonatal and perinatal mortality. The aim of this study is to determine the risk of LBW incidence in pregnant women with weight gain not in accordance with the Institute of Medicine (IOM) standards. Methods: This study used a retrospective cohort design with data obtained from three Public Health Centres (PHCs) in Gianyar District over the period of January-December 2017. Samples in this study were 186 pregnant women with the following criteria: complete data on the mother’s medical record, had an antenatal care visit in the first trimester and at the end of the third trimester, at term delivery, not giving birth to twins and no complications during pregnancy. The sample size was determined with 95% confidence level, 80% power, the proportion of LBW in the group of inadequate weight gain of 26%, the proportion of LBW in the group of adequate weight gain of 9% and a relative risk (RR) estimate of 3.0. Data extracted from medical record consisted of weight gain, pre-pregnancy weight, height, upper arm circumference, hemoglobin level, employment, age, parity and birth weight. The cumulative incidence of LBW was calculated to determine the RR. Multivariate analysis with binary logistic regression was conducted to determine the adjusted RR (ARR). Results: The incidence of LBW in the group whose weight gain during pregnancy not in accordance with IOM standards was 59%, while those in accordance with the standards were 8.2% with RR=7.22 (95%CI: 3.96–13.19). The ARR for those with weight gain during pregnancy not in accordance with IOM standards was 15.33 (95%CI: 5.82-40.38). The incidence of LBW in the anemia group was 49% and not anemia group was 10%. The RR and ARR values for LBW in the anemia group were 4.72 (95%CI: 2.66-8.36) and 6.66 (95%CI: 2.53-17.53) respectively. Conclusion: Mothers experiencing weight gain during pregnancy that was not in accordance with IOM standards and anemia were found to increase the risk of LBW. Monitoring of weight gain during pregnancy should be implemented using the IOM standards and anemia prevention among pregnant mothers should be enhanced.]]>
<![CDATA[Association between physical activity, fiber and salt intake with hypertension in adolescents with obesity ]]>
<![CDATA[Ni Luh Putu Sudiasih]]>;
<![CDATA[Dewa Nyoman Wirawan]]>;
<![CDATA[I Gusti Lanang Sidiartha]]>
<![CDATA[ Public Health and Preventive Medicine Archive Vol. 7 No. 1 (2019) ]]>
Publisher : <![CDATA[Universitas Udayana ]]>
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DOI: 10.53638/phpma.2019.v7.i1.p11
<![CDATA[Background and purpose: There are indications that the prevalence of obesity among adolescents is increasing which is one of the main factors of hypertension. This study aims to determine the association between hypertension among obese adolescents with physical activity, fiber and salt intake. Methods: This study used a cross-sectional design among obese adolescents aged 12-15 years. The study was conducted at six public/ private middle schools in the North Denpasar Sub-district, Denpasar City, Bali Province. The samples of 203 children were selected from the results of obesity screening conducted by North Denpasar III Public Health Center (PHC). Data collection was conducted over July-September 2018 with data included social demographics, body weight and height, blood pressure, consumption frequency of vegetables, fruits and high salt content foods, and physical activity carried out in the past week. Data analysis with logistic regression was conducted to determine the association between physical activity, fiber and salt intake with hypertension among obeseadolescents. Results: This study found that of 203 respondents, 14.8% had hypertension. Multivariate analysis showed that hypertension in obese adolescents was associated with salt intake ≥1500 mg/day with adjusted odd ratio (AOR) of 5.19 (95%CI: 2.20-12.22), inadequate physical activity (AOR=5.87; 95%CI: 1.19-29.00) and inadequate fiber intake (AOR=2.43; 95%CI: 0.27-21.76). Conclusion: Salt intake ≥1500 mg/day and inadequate physical activity are associated with hypertension among obese adolescents. A reduction in the consumption of processed foods that are high in salt and increasing physical activity would improve adolescent health.]]>
<![CDATA[The effectiveness of WhatsApp video to increase knowledge of pneumonia early detection among mothers of children under five years ]]>
<![CDATA[Ni Wayan Erviana Puspita Dewi]]>;
<![CDATA[Anak Agung Sagung Sawitri]]>;
<![CDATA[Partha Muliawan]]>
<![CDATA[ Public Health and Preventive Medicine Archive Vol. 7 No. 1 (2019) ]]>
Publisher : <![CDATA[Universitas Udayana ]]>
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DOI: 10.53638/phpma.2019.v7.i1.p12
<![CDATA[Background and purpose: Number of people in Indonesia who have access to smartphones is quite high, but their use for health education media specifically for the detection of pneumonia is still limited. This study aims to determine the effectiveness of use of video information through the WhatsApp (WA) application compared to leaflets in order to increase maternal knowledge about early detection of pneumonia among under-five children. Methods: A pretest-posttest randomized control trial was conducted in three of the six sub-villages (called banjar) in the Gelgel Village, Klungkung District. Banjar was selected purposively by considering the distance between banjar. As many as 30 mothers were selected as samples from around 45-50 mothers of children under five in each banjar. The intervention was conducted randomly where one banjar was given intervention with videos through WA, one banjar with leaflets and one banjar as a control group. The intervention was carried out for three weeks (August-September, 2018). Data were collected before and after the intervention through face-to-face interviews with the mothers in their homes, which included social demographics, mother's knowledge about pneumonia detection and educational media preferences. Bivariate data analysis was conducted with paired t-test and multivariate analysis with General Linear Model. Results: Characteristics of respondents in all three groups were similar in terms of age, education, employment, and parity. The results of interviews on educational media choices showed that most respondents (64%) preferred WA media. The increase in mean knowledge score after the intervention was significantly higher in the WA group which was 6.93 (95%CI: 6.38-7.49) and leaflet 5.90 (95%CI: 5.49-6.44) compared to the control group 1.87 (95%CI: 1.26-2.47). There was no significant difference between the WA and the leaflet group. The results of multivariate analysis showed that educational media (F=110.99; p<0.01) and education (F=16.69; p<0.01) were significantly associated with the increase in knowledge after adjustments were made based on age, employment and parity. Conclusion: WA videos and leaflet were found to be effective in increasing maternal knowledge about early detection of pneumonia in under-five children. Because the use of WA application is increasing, efforts to improve health knowledge with WA videos need to be enhanced.]]>
<![CDATA[Barriers to mental health services at public health centers: Providers’ perspectives ]]>
<![CDATA[Putu Aryani]]>;
<![CDATA[Pande Putu Januraga]]>;
<![CDATA[Komang Ayu Kartika Sari]]>;
<![CDATA[Lisanne Gerstel]]>;
<![CDATA[Willem F Scholte]]>
<![CDATA[ Public Health and Preventive Medicine Archive Vol. 7 No. 1 (2019) ]]>
Publisher : <![CDATA[Universitas Udayana ]]>
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DOI: 10.53638/phpma.2019.v7.i1.p13
<![CDATA[Background and purpose: The disparity between the increasing prevalence of mental health (MH) illness and the availability of treatment in Indonesia remains high, despite the campaign to provide MH services at public health centers (PHCs) initiated by the government in 2014. This study explored barriers to MH service provision at PHCs in Denpasar, Bali, Indonesia in order to identify priorities for service improvement. Methods: This explorative qualitative study was conducted from March to December 2015 and employed in-depth interviews and focus group discussions (FGDs). In-depth interviews were conducted with the Head of Denpasar City Health Office and with general practitioners (GPs) from four PHCs in Denpasar, to explore the perspective of policy and service management and experiences in PHC clinics, respectively. To further explore MH service implementation in the community, two FGDs were conducted with MH program managers and community health workers (CHWs). The interviews and FGDs were recorded, and verbatim transcripts were analyzed using thematic framework analysis. Results: Barriers to MH service provision identified in our study are poor dissemination of the national policy to the local government and PHCs; low prioritization of MH issues; organization workforce issues; funding concerns; poor coordination and supervision; poor management and recording system; scarcity of ancillary facilities and other resources such as psychotropic medicines. Conclusion: The findings of this study highlight the importance of national policy dissemination and collaboration between local government, health providers and CHWs to overcome the barriers in providing MH services at PHC level.]]>
<![CDATA[Stigma and discrimination: Barrier for ending AIDS by 2030 and achieving the 90-90-90 targets by 2020 ]]>
<![CDATA[Dewa Nyoman Wirawan]]>
<![CDATA[ Public Health and Preventive Medicine Archive Vol. 7 No. 1 (2019) ]]>
Publisher : <![CDATA[Universitas Udayana ]]>
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DOI: 10.53638/phpma.2019.v7.i1.p01
<![CDATA[In order to be able to mirror the achievements of other countries towards 90-90-90, addressing stigma and discrimination towards key populations and people with HIV+ is crucial. Without these efforts ending the AIDS epidemic by 2030 will be challenging to realize and remain a lofty aspiration.]]>
<![CDATA[Association between nursing care performance with perception of financial rewards, career development and supervision ]]>
<![CDATA[Ayu Ratih Cempakasari]]>;
<![CDATA[Ni Made Sri Nopiyani]]>;
<![CDATA[Dyah Pradnyaparamitha Duarsa]]>
<![CDATA[ Public Health and Preventive Medicine Archive Vol. 7 No. 1 (2019) ]]>
Publisher : <![CDATA[Universitas Udayana ]]>
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DOI: 10.53638/phpma.2019.v7.i1.p02
<![CDATA[Background and purpose: The performance of nurses in providing care to patients is an important component for patient satisfaction and healing. Nurse's performance is determined by many factors. This study aims to determine the association between nurse performance in providing nursing care with education, nurse perceptions of financial rewards, career development opportunities, and supervision of the ward head. Methods: A cross-sectional survey was conducted on all nurses (164 people) at inpatient wards of Tabanan General Hospital. Data collection was carried out using a self-administered questionnaire in April 2018. Bivariate analysis was performed using chi-square test, and multivariate analysis was conducted using multiple logistic regression to determine the adjusted odds ratios. Results: The results showed that the mean score of nursing care performance was 70.17 from a maximum score of 80. All independent variables were found to be associated with nurse performance, namely perceptions of career development opportunities (AOR=1.6; 95%CI: 1.03-1.3; p=0.01), financial rewards (AOR=1.1; 95%CI: 1.01-1.2; p=0.03) and supervision of the ward chief (AOR=1.1; 95%CI: 1.01-1.2; p=0.02). Conclusion: Nurses' perceptions of financial rewards, career development opportunities, and supervision of the ward chief are associated with nursing care performance. Provision of rewards, career development and supervision need to be considered in the efforts to improve nurse performance.]]>
