Determinan Kebutuhan Pelayanan Kesehatan pada Lansia: Sebuah Studi di Samarinda, Indonesia
Abstract
Meningkatnya kebutuhan perawatan lansia di Indonesia menunjukkan tantangan dalam memenuhi tuntutan kesehatan fisik, mental, dan sosial individu lanjut usia. Penelitian ini bertujuan untuk mengidentifikasi determinan utama yang memengaruhi kebutuhan dan preferensi layanan kesehatan pada lansia. Menggunakan desain observasional potong lintang, data dikumpulkan dari 61 lansia berusia 54 hingga 82 tahun di 14 Posyandu Lansia di Samarinda. Kuesioner terstruktur yang diadaptasi dari alat yang telah divalidasi, termasuk SF-36 dan UCLA Loneliness Scale, digunakan untuk menilai karakteristik demografi, tingkat kelemahan, aktivitas harian, kesehatan kognitif, dan kesejahteraan mental. Hasil penelitian menunjukkan bahwa 32,8% responden membutuhkan bantuan untuk memenuhi kebutuhan kesehatannya, dengan kelemahan fisik (p=0,021), kemandirian aktivitas harian (p=0,039), dan penurunan kognitif (p=0,036) secara signifikan memengaruhi kebutuhan tersebut. Sebagian besar responden menilai kondisi kesehatan fisik (78,7%) dan mentalnya (75,4%) baik, meskipun 39,3% melaporkan gejala depresi. Dukungan sosial cukup umum, dengan 75,4% memiliki pendamping dari keluarga atau pengasuh, namun hal ini tidak secara signifikan memengaruhi kebutuhan kesehatan (p=0,186). Temuan ini menegaskan sifat multidimensi kebutuhan kesehatan lansia, dengan kelemahan fisik, penurunan kognitif, dan kemandirian aktivitas harian sebagai determinan utama. Intervensi yang berfokus pada area ini, disertai dengan peningkatan sistem dukungan, dapat meningkatkan akses dan hasil layanan kesehatan untuk populasi lansia. Studi ini menemukan pentingnya model layanan kesehatan terpadu yang mencakup dimensi fisik, kognitif, dan sosial untuk memberikan perawatan yang komprehensif bagi lansia.
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References
Abreu, W., & Abreu, M. (2021). Current Perspectives on Frailty in the Elderly, Evaluation Tools and Care Pathways. Frailty in the Elderly - Understanding and Managing Complexity, April. https://doi.org/10.5772/intechopen.92281
Azar, N. S., Kamal, S. H. M., Sajadi, H., Harouni, G. R. G., Karimi, S., & Foroozan, A. S. (2020). Barriers and Facilitators of the Outpatient Health Service Use by the Elderly. Iranian Journal of Ageing, 15(4), 258–277. https://doi.org/10.32598/sija.15.3.551.3
Badan Pusat Statistik Provinsi Kalimantan Timur. (2023). Persentase Penduduk Lansia Menurut Kabupaten_Kota , 2024-2025. Badan Pusat Statistik PRovinsi Kalimantan Timur.
Banda, A., Hoffman, J., & Roos, V. (2024). Individual and Community-Contextual Level Factors Associated With Wellbeing Among Older Adults in Rural Zambia. International Journal of Public Health, 69(February), 1–13. https://doi.org/10.3389/ijph.2024.1606571
Bražinová, I., & Chytil, O. (2024). The family as a source of social support for older adults: Implications for gerontological social work. Journal of Social Work, 24(3), 339–356. https://doi.org/10.1177/14680173231222612
Chauhan, S., Kumar, S., Bharti, R., & Patel, R. (2022). Prevalence and determinants of activity of daily living and instrumental activity of daily living among elderly in India. BMC Geriatrics, 22(1), 1–10. https://doi.org/10.1186/s12877-021-02659-z
Dao, A. T. M., Nguyen, V. T., Nguyen, H. V., & Nguyen, L. T. K. (2018). Factors Associated with Depression among the Elderly Living in Urban Vietnam. BioMed Research International, 2018. https://doi.org/10.1155/2018/2370284
de Oliviera, T. L., Griep, R. H., Guimares, J. N., Giatti, L., Chor, D., & da Fonseca, M. de J. M. (2019). Brazilian Longitudinal Study of Adult Health (ELSA-Brasil): socio-occupational class as an effect modifier for the relationship between adiposity measures and self-rated health. BMC Public Health, 734. https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-7072-y
Dehghankar, L., Valinezhad, S., Amerzadeh, M., Zarabadi Poor, F., Hosseinkhani, Z., & Motalebi, S. A. (2024). Relationship between perceived social support and disability with the mediating role of perceived stress among older adults. BMC Geriatrics, 24(1), 1–7. https://doi.org/10.1186/s12877-024-04871-z
Deng, S., Zhang, C., Guo, X., Lv, H., Fan, Y., Wang, Z., Luo, D., Duan, X., Sun, X., & Wang, F. (2022). Gaps in the Utilization of Community Health Services for the Elderly Population in Rural Areas of Mainland China: A Systematic Review Based on Cross-Sectional Investigations. In Health Services Insights (Vol. 15). https://doi.org/10.1177/11786329221134352
Doherty, M., Bond, L., Jessell, L., Tennille, J., & Stanhope, V. (2020). Transitioning to Person-Centered Care: a Qualitative Study of Provider Perspectives. Journal of Behavioral Health Services and Research, 47(3), 399–408. https://doi.org/10.1007/s11414-019-09684-2
Dolenc, E., & Rotar-Pavlič, D. (2019). Frailty assessment scales for the elderly and their application in primary care: A systematic literature review. Zdravstveno Varstvo, 58(2), 91–100. https://doi.org/10.2478/sjph-2019-0012
Ebrahimi, Z., Patel, H., Wijk, H., Ekman, I., & Olaya-Contreras, P. (2021). A systematic review on implementation of person-centered care interventions for older people in out-of-hospital settings. Geriatric Nursing, 42(1), 213–224. https://doi.org/10.1016/j.gerinurse.2020.08.004
Eliyana, E., & Ardiyanti, Y. (2023). Pengalaman Lansia tentang Kebutuhan Layanan Kesehatan pada Pos Pelayanan Terpadu: Studi Fenomenologi. Faletehan Health Journal, 10(03), 301–307. https://doi.org/10.33746/fhj.v10i03.589
Fioritto, A. P., Cruz, D. T. da, & Leite, I. C. G. (2020). Correlation of functional mobility with handgrip strength, functional capacity for instrumental activities of daily living, fear of falling and number of falls in community-dwelling elderly. Fisioterapia Em Movimento, 33, 1–10. https://doi.org/10.1590/1980-5918.033.ao35
Ghzwany, A., Selihem, A. Al, Sharahili, A., Alazmi, A., & Alhwsawi, E. (2021). Perceptions, attitude and practices toward elderly depression among primary health care physicians, Riyadh, Saudi Arabia, 2021. International Journal of Advanced Community Medicine, 4(3), 07–12. https://doi.org/10.33545/comed.2021.v4.i3a.198
Guarnera, J., Yuen, E., & Macpherson, H. (2023). The Impact of Loneliness and Social Isolation on Cognitive Aging: A Narrative Review. Journal of Alzheimer’s Disease Reports, 7(1), 699–714. https://doi.org/10.3233/ADR-230011
Jiang, M., Yang, G., Fang, L., Wan, J., Yang, Y., & Wang, Y. (2018). Factors associated with healthcare utilization among community-dwelling elderly in Shanghai, China. PLoS ONE, 13(12), 1–22. https://doi.org/10.1371/journal.pone.0207646
Jung, M. S., Lee, K. S., Kim, M., & Yun, H. (2019). Gender-specific relationship between executive function and self-rated health. Osong Public Health and Research Perspectives, 10(2), 93–101. https://doi.org/10.24171/j.phrp.2019.10.2.08
Kaur, S., Bhalla, A., Kumari, S., & Singh, A. (2019). Assessment of functional status and daily life problems faced by elderly in a North Indian city. Psychogeriatrics, 19(5), 419–425. https://doi.org/10.1111/psyg.12406
Kim, H., Awata, S., Watanabe, Y., Kojima, N., Osuka, Y., Motokawa, K., Sakuma, N., Inagaki, H., Edahiro, A., Hosoi, E., Won, C. W., & Shinkai, S. (2019). Cognitive frailty in community-dwelling older Japanese people: Prevalence and its association with falls. Geriatrics and Gerontology International, 19(7), 647–653. https://doi.org/10.1111/ggi.13685
Kojima, G., Liljas, A. E. M., & Iliffe, S. (2019). Frailty syndrome: Implications and challenges for health care policy. Risk Management and Healthcare Policy, 12, 23–30. https://doi.org/10.2147/RMHP.S168750
Kong, F., Xu, L., Kong, M., Li, S., Zhou, C., Zhang, J., & Ai, B. (2019). Association between socioeconomic status, physical health and need for long-term care [1] Kong F, Xu L, Kong M, Li S, Zhou C, Zhang J, et al. Association between socioeconomic status, physical health and need for long-term care among the Chinese elderly. . International Journal of Environmental Research and Public Health, 16(12), 1–19. https://doi.org/10.3390/ijerph16122124
Latumahina, F., Istia., Y. J., Tahapary, E. C., Anthony, V. C., Soselisa, V. J., & Solissa, Z. (2022). Peran Posyandu Lansia Terhadap Kesejahteraan Para Lansia di Desa Ihamahu, Kec. Saparua Timur, Kab. Maluku Tengah. Jurnal Karya Abdi Masyarakat Universitas Jambi, 6(43), 39–45. https://mail.online-journal.unja.ac.id/JKAM/article/view/19368
Lee, S. H., Lee, H., & Yu, S. (2022). Effectiveness of Social Support for Community-Dwelling Elderly with Depression: A Systematic Review and Meta-Analysis. Healthcare, 10(9). https://doi.org/10.3390/healthcare10091598
Liotta, G., Ussai, S., Illario, M., O’caoimh, R., Cano, A., Holland, C., Roller-Winsberger, R., Capanna, A., Grecuccio, C., Ferraro, M., Paradiso, F., Ambrosone, C., Morucci, L., Scarcella, P., De Luca, V., & Palombi, L. (2018). Frailty as the future core business of public health: Report of the activities of the A3 action group of the european innovation partnership on active and healthy ageing (EIP on AHA). International Journal of Environmental Research and Public Health, 15(12). https://doi.org/10.3390/ijerph15122843
Liu, M., Zhang, M., Zhou, J., Song, N., & Zhang, L. (2023). Research on the healthy life expectancy of older adult individuals in China based on intrinsic capacity health standards and social stratification analysis. Frontiers in Public Health, 11. https://doi.org/10.3389/fpubh.2023.1303467
Liu, T., Jia, Y., Yang, Y., & Chen, Q. (2023). Conflict with children, psychological depression, and problematic internet use among Chinese older adults: The moderating effect of sociability and living situation. Digital Health, 9. https://doi.org/10.1177/20552076231216417
Ma, S., Zhou, X., Jiang, M., Li, Q., Gao, C., Cao, W., & Li, L. (2018). Comparison of access to health services among urban-to-urban and rural-to-urban older migrants, and urban and rural older permanent residents in Zhejiang Province, China: A cross-sectional survey. BMC Geriatrics, 18(1), 1–10. https://doi.org/10.1186/s12877-018-0866-4
Madyaningrum, E., Chuang, Y. C., & Chuang, K. Y. (2018). Factors associated with the use of outpatient services among the elderly in Indonesia. BMC Health Services Research, 18(1), 707. https://doi.org/10.1186/s12913-018-3512-0
Mamom, J., & Daovisan, H. (2022). Listening to Caregivers’ Voices: The Informal Family Caregiver Burden of Caring for Chronically Ill Bedridden Elderly Patients. International Journal of Environmental Research and Public Health, 19(1). https://doi.org/10.3390/ijerph19010567
Mbaloto, F. R., Mua, E. L., Sekeon, R. A., Susanto, D., Yanriatuti, I., Tarigan, S., Sarman, J. N. R., & Beba, N. N. (2023). The Effectiveness of Puzzle Therapy in Improving the Cognitive Function of the Elderly. Adi Husada Nursing Journal, 9(2), 85. https://doi.org/10.37036/ahnj.v9i2.454
Muhammad Zuhal Darwis, & Imran Safei. (1970). Correlation Between Body Mass Index and Frailty on Activities of Daily Living among Elderly in The Nursing Home. Indonesian Journal of Physical Medicine & Rehabilitation, 11(02), 86–92. https://doi.org/10.36803/ijpmr.v11i02.363
Ngaro, S., Bur, N., & Nurgahayu. (2021). Faktor yang berhubungan dengan pemanfaatan pelayanan kesehatan Posyandu Lansia di Puskesmas Wara Selatan Palopo. Window of Public Health Journal, 02(01), 157–166.
Nugraha, S., & Aprillia, Y. T. (2020). Health-Related Quality of Life among the Elderly Living in the Community and Nursing Home. Jurnal Kesehatan Masyarakat, 15(3), 419–425. https://doi.org/10.15294/kemas.v15i3.21282
Oliveira, E. C. T., Louvison, M. C. P., da Cruz Teixeira, D. S., de Menezes, T. N., da Costa Rosa, T. E., & de Oliveira Duarte, Y. A. (2022). Difficulties in accessing health services among the elderly in the city of São Paulo-Brazil. PLoS ONE, 17(5 May), 1–18. https://doi.org/10.1371/journal.pone.0268519
Oliveira, P. R. C., Rodrigues, V. E. S., Oliveira, A. K. L. de, Oliveira, F. G. L., Rocha, G. A., & Machado, A. L. G. (2021). Factors associated with frailty in Elderly patients followed up in promary health care. Escola Anna Nery, 25(4). https://doi.org/10.1590/2177-9465-ean-2020-0355
Palmes, M. S., Trajera, S. M., & Ching, G. S. (2021). Relationship of coping strategies and quality of life: Parallel and serial mediating role of resilience and social participation among older adults in western philippines. International Journal of Environmental Research and Public Health, 18(19). https://doi.org/10.3390/ijerph181910006
Papathanasiou, I. V, Rammogianni, A., Papagiannis, D., Malli, F., Mantzaris, D. C., Tsaras, K., Kontopoulou, L., Kaba, E., Kelesi, M., & Fradelos, E. C. (2021). Frailty and Quality of Life Among Community-Dwelling Older Adults. Cureus, 13(2), 1–9. https://doi.org/10.7759/cureus.13049
Ph, L., & Susanti Eka Putri, Y. (2019). The Impact of Family Psycho-education Therapy on Family Burden in Caring for Older Adult with Dementiain Bogor. European Journal of Biophysics, 7(2), 46. https://doi.org/10.11648/j.ejb.20190702.13
Portz, J. D., Fruhauf, C., Bull, S., Boxer, R. S., Bekelman, D. B., Casillas, A., Gleason, K., & Bayliss, E. A. (2019). “Call a teenager… that’s what i do!” - Grandchildren help older adults use new technologies: Qualitative study. JMIR Aging, 2(1), 1–6. https://doi.org/10.2196/13713
Putra, J. N., Turana, Y., & Handajani, Y. S. (2024). Relationship between Social Participation and Cognitive Impairment in Low-Educated Older Adults Based on Indonesian Family Life Survey-5. Korean Journal of Family Medicine. https://doi.org/10.4082/kjfm.23.0134
Rowe, J. W., Allen-Meares, P. G., Altman, S. H., Bernard, M. A., Bluementhal, D., Capman, S. A., Fulmer, T. T., & Harris, T. B. (2008). Health Status and Health Care Service Utilization. In Retooling for an Aging America: Building the Health Care Workforce (pp. 1–300). https://doi.org/10.17226/12089
Scholten, L., Betkó, J., Gesthuizen, M., Fransen-Kuppens, G., de Vet, R., & Wolf, J. (2023). Reciprocal relations between financial hardship, sense of societal belonging and mental health for social assistance recipients. Social Science and Medicine, 321(February). https://doi.org/10.1016/j.socscimed.2023.115781
Shaban, M., Mohammed, H. H., Gomaa Mohamed Amer, F., shaban, M. M., Abdel-Aziz, H. R., & Ibrahim, A. M. (2024). Exploring the nurse-patient relationship in caring for the health priorities of older adults: qualitative study. BMC Nursing, 23(1), 1–14. https://doi.org/10.1186/s12912-024-02099-1
Shrivastava, S. R. B. L., Shrivastava, P. S., & Ramasamy, J. (2013). Health-care of elderly: Determinants, needs and services. In International Journal of Preventive Medicine (Vol. 4, Issue 10, pp. 1224–1225).
Susanti, N., & Mitra, M. (2011). Faktor-Faktor yang Berhubungan dengan Pemanfaatan Pelayanan Posyandu Lansia. Jurnal Kesehatan Komunitas, 1(3), 155–162. https://doi.org/10.25311/keskom.vol1.iss3.20
Wahyuni, S., Effendy, C., Kusumaningrum, F. M., & Dewi, F. S. T. D. (2021). Factors Associate with Independence for Elderly People in Their Activities of Daily Living. Jurnal Berkala EpidemiologiEpidemiologi, 9(1), 44–53. https://doi.org/10.20473/jbe.v9i12021.44
Wang, Z., Li, X., Chen, M., & Si, L. (2018). Social health insurance, healthcare utilization, and costs in middle-aged and elderly community-dwelling adults in China. International Journal for Equity in Health, 17(1), 1–13. https://doi.org/10.1186/s12939-018-0733-0
Zanjari, N., Momtaz, Y. A., Kamal, S. H. M., Basakha, M., & Ahmadi, S. (2022). The Influence of Providing and Receiving Social Support on Older Adults’ Well-being. Clinical Practice & Epidemiology in Mental Health, 18(1), 1–7. https://doi.org/10.2174/17450179-v18-e2112241
Zeng, Y., Xu, W., & Tao, X. (2022). What factors are associated with utilisation of health services for the poor elderly? Evidence from a nationally representative longitudinal survey in China. BMJ Open, 12(6), 1–16. https://doi.org/10.1136/bmjopen-2021-059758
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