Background: Non-adherence to treatment regimens is a widespread problem of great clinical relevance among hemodialysis patients. However, only few studies have addressed the factors of non-adherence in End Stage Renal Disease (ESRD) patients, and none conducted in the Indonesia. Objective: The present study explores the reasons of non-adherence in end stage renal disease patients undergoing hemodialysis in Indonesia seen from perspectives of patients, caregivers and health professionals. Methods: The study is conducted using qualitative methods and is set in the hemodialysis unit in a private hospital in Bandung. A total of 23 respondents were recruited in this study. All participants were selected through purposive sampling and invited to participate in semi-structured interviews with open-ended questions. The data obtained were written in verbatim and analyzed using thematic analysis. Results: The six main themes related to non-adherence emerged. These themes were categorized into two clusters namely: (1) factors related to patient (patient related factors) (negative perception and treatment belief, denial, lack of awareness and knowledge and negative feelings) and (2) factors related to the treatment (treatment burden and financial problems). Conclusion: The findings showed determinants of non-adherence in ESRD patients from perspective of patients, caregivers and health professional. The finding from this study can be used as a base for designing an intervention, aimed to increase the adherence to treatment in ESRD patients who are undergoing hemodialysis.

Quality of life (QoL) has become one of important outcome measures of renal replacement therapy, including haemodialysis. However, the assessment of QoL is not comprehensively measured and most research about it use quantitative approach. Since QoL is subjective, assessing and understanding the qualitative evidence are very important. This study aimed to explore QoL in patients with end-stage renal disease (ESRD) undergoing haemodialysis. This research is a cross-sectional study used a mixed method approach. Patients undergoing dialysis were recruited from the dialysis unit in one private hospital in Bandung. They completed the Kidney Disease and Quality of Life (KDQOL-36™) questionnaire and then went on face to face interview. Quantitative data were analysed descriptively and qualitative data were analysed using thematic analysis with qualitative data analysis software. A total of 87 patients completed the questionnaires and 34 of them participated in 20-60 minutes interview. The symptom and problem list had the highest mean score (M= M=63.60), indicated that patients experienced lack of energy, mobility and physical appearance that further produced difficulties in their daily activities. Additionally, mental component summary showed a higher mean score (M=49.23) than the physical component (M=36.22) indicated that patients most likely had worse mental health condition than their general physical health. Worse mental health condition induced with negative feeling among patients. Patient’s inability to do daily activity and change in physical appearance had impact on their confidence for social relationship. Conclusion: ESRD patients undergoing haemodialysis were bothered by the symptom of illness and worsen by the negative feelings.

Adolescents experience abrupt physical and psychological changes. These changes impacted adolescent behavior and the way adolescents respond to their environment. If parents do not understand the changes that occur in their adolescents, parents can experience difficulties in applying their parenting and eventually will impact the quality of the parent-child relationship. Parents need to be educated to understand the characteristics of adolescent development. Therefore, an Online workshop that aims to provide an understanding of the characteristics of adolescent development was conducted. The participant of this online workshop are parents who have adolescents. They were 26 parents aged 35-44 years (average 40.13 years) which were dominated by mothers (92.31%). This three-hour program used the online-zoom platform. It consists of lectures, question and answers session, small group discussions, and making an action plan to be implemented in relation to their adolescents. The results of the reaction evaluation showed that the participants perceived the program as interesting, fun, and useful. The material presented is considered good and applicable in accordance with the conditions of youth and the environment.