Background It is well known that diabetes mellitus (DM) affects health-related quality of life (HRQOL) in both younger (aged 18–64 years) and older adults (aged ≥ 65 years). However, to date, no study has compared HRQOL and its predictors between younger and older adults with DM in Indonesia. Such a comparison is important because the results can guide nurses and clinicians to establish evidence-based educational programs that are specific and suitable for patients. Therefore, the aim of this study was to investigate the difference in HRQOL and its predictors in younger and older adults with DM in Indonesia. Methods A cross-sectional study was conducted on 641 patients with type 2 diabetes mellitus (T2DM) who were recruited via simple random sampling from 16 primary health centers in Banyumas Regency, Indonesia. A self-administered questionnaire containing the Summary of Diabetes Self-Care Activities, the DDS17 Bahasa Indonesia, the Beck Depression Inventory II, the Self-Efficacy for Diabetes Scale, the Family APGAR, and the 36-item Short-Form Health Survey was used to measure diabetes self-management (DSM), diabetes distress (DD), depression, self-efficacy, family support, and HRQOL, respectively. Independent t-tests were used to compare the physical component summary (PCS) and mental component summary (MCS) scores between younger and older adults with T2DM. Hierarchical multiple regression analyses were used to examine the factors associated with HRQOL in both groups. Results PCS scores were significantly different between the two groups. Older adults reported lower PCS scores than younger adults. No differences between the two groups were observed in the MCS scores. The hierarchical multiple regression analysis showed that level of education, employment status, number of diabetes-related complications, DSM, DD, depression, and self-efficacy were significant predictors of HRQOL in younger adults, while income, depression, DD, and self-efficacy were significant predictors of HRQOL in older adults. DD was the strongest predictor of HRQOL in younger adults, and depression was the strongest predictor in older adults. Conclusion Older adult patients had lower PCS scores than younger adult patients. This study is the first to show that the predictors of HRQOL differ between younger and older adults with T2DM. It provides insights for nurses and clinicians in Indonesia to establish evidence-based, age-specific educational programs.

Background: Filial piety refers to expectations for children to respect parents and fulfill care responsibility, including provide direct care and support them in their old age. However, socio-demographic changes might shape how young generation would see and practice the value of filial responsibility in parent’s old age.Purpose: This study aimed to explore the meaning of filial responsibility among young adults within the social context of Indonesia.Methods: Symbolic interactionism formed the framework for this study. The constructivist grounded theory method guided the analysis of the data obtained from in-depth interviews with eight university students. The participants were selected using a purposive and snowball sampling technique with the following criteria: 18 years old or over, currently enrolled as a student and had living parents. Results: The result showed that redefining the meaning of filial responsibility was obtained as the main theme which linked all four categories: ‘I am the one’, ‘not institutional care’, ‘the gendering of caregiving’, and ‘it is okay to do so’. The findings revealed that the value of filial responsibility was still upheld by Indonesian young people. However, their views had been changed somewhat from the traditional practices which were family oriented and highly gendered to a more contemporary form where caregiving was extended to non-family caregivers and supposed to be less gendered in the practice.Conclusion: This study offers an insight into the shifting patterns in elderly caregiving and support in Indonesia. The findings also indicate the need to further promote gender equality in elderly caregiving.

Background Cultural beliefs strongly affect the practice of breastfeeding. Interpretations of cultural beliefs change over time, particularly among modern parents; however, knowledge of these changes is limited. Aim To explore cultural beliefs related to breastfeeding and modern Indonesian parents' perceptions. Methods This article reports on the cultural beliefs about breastfeeding from an ethnographic study of 23 participants. Data were collected using focus group discussions, in-depth interviews and observations, and analysed using thematic analysis. Findings Analysis revealed four main themes: ‘suggested food and behaviour’; ‘restricted food and behaviour’; ‘consequences of avoiding taboos’ and ‘the dynamic change in cultural beliefs’. Conclusions Healthcare providers can use the results of this study to develop a culturally sensitive educational programmes that are congruent with modern parents' needs.

BackgroundNursing students are prospective professional nurses. They shall be able to implement health promoting lifestyle behavior to achieve welfare and be a role mode in health promotion to the community. Self-efficacy is a factor affecting hygiene and health promoting lifestyle behavior. Purpose This study aimed to identify the relationship between self-efficacy and health promoting liifestyle behavior of students of Nursing Department, Jenderal Soedirman University. Method The research method was cross sectional study. A total of 267 Nursing students of Jenderal Soedirman University were involved in this study. Data analysis used the Mann Whitney test and the Kruskal Wallis test. ResultThe results indicated that the median score of HPLP II in all domains was 2.58. Significant positive correlation was found between self-efficacy variable and total score of HPLP II and all its sub-domains. There was a significant difference in the domains of physical activity and interpersonal relationship between male and female students. 46.7% of variations in health promoting lifestyle behavior can be explained by self-efficacy. The highest β coefficient was achieved by self-efficacy (0.642). ConclusionIntervention is needed to improve students' health promoting lifestyle behavior by emphasizing on the increasing self-efficacy.

AbstrakPeriode pubertas merupakan masa kritis bagi remaja. Perubahan akibat pubertas sering menimbulkan berbagai perilaku maladaptive seperti membolos, membangkang, dan tawuran. Keluarga sebagai lingkungan utama remaja memegang peranan penting dalam membentuk perilaku remaja. Tujuan penelitian untuk mengidentifikasi pengaruh optimalisasi dukungan keluarga terhadap perilaku adaptif pada usia pubertas. Desain quasi experimental dengan pendekatan pre-post test without control group design. Responden dipilih secara purposive sampling di Rempoah Baturaden. Perilaku adaptif remaja meningkat dari 60% menjadi 97% setelah diberikan perlakuan dukungan keluarga. Kesulitan orang tua dalam memberikan dukungan adalah ketika mengarahkan untuk belajar, menjalin komunikasi terbuka, dan menghadapi emosi remaja. Hasil penelitian menunjukkan terdapat pengaruh optimalisasi dukungan keluarga yang signifikan terhadap peningkatan perilaku adaptif remaja (p value 0.001). Orang tua hendaknya selalu meningkatkan pengetahuan untuk melaksanakan dukungan keluarga kepada anak remaja.Kata kunci: Dukungan, keluarga, perilaku, pubertas, remaja. The effect of Family Support to Enhance the Adaptive Behavior of Adolescent AbstractThe period of puberty is a critical period for adolescents. The consequence of changing puberty is often arise a dis-adaptif behaviour such as a shirker, protester, gang fighter. Family as the primary environment teenager plays an important role in shaping adolescent behavior. The research objective was to identify the influence of family support for adaptive behavior of adolescent puberty. Quasi-experimental design approach without preposttest control group design was applied. Respondents was selected by purposive sampling in Baturaden. Adaptive behavior that increased from 60% to 97% after optimization family support. Difficulties of parents in providing family support when directed to learn, to establish open communication, and teenagers emotional.There is the influence of family support optimization significantly to the increase of adaptive behavior adolescents with p value of 0.001. Parents should always increase their knowledge to implement family support to teenagers.