Increasing the quality of life of post-shackling patients through multilevel Health promotion of shackling prevention

Abstract

Introduction: Shackling still poses a significant obstacle to rehabilitate patient with mental disorder and often resorted by family or community. Shackling could have a negative impact toward patient’s mental health and often resorted due to lack of information. Therefore, this study aimed to evaluate the effect of multilevel health promotion to shackling prevention (MHPSP) toward the behavioral component of family/caregivers, neighbors, cadres, and health workers (stakeholders) and also evaluating its effect toward patient’s quality of life. Method: This study uses a quasi exeperimental method with pre-test and post-test model with repetead measures design. The research subjects were 32 post-shackling patients lived in Sukoharjo Regency and 31 from Klaten Regency as well as. MHPSP was given to 32 caregivers and stakeholders who come from Sukoharjo Regency as a treatment group and psychoeducation only to 31 caregivers of control group from Klaten Regency. Quality of life measurments were carried out before treatment and four months after giving MHPSP.Result : The result showed that MHPSP significantly enhance the behavioral component of the family/caregivers as well as neighbors, cadres and health workers (p<0.05). Furthermore, patient quality of life was significantly improved in the treatment group (MHPSP) compared to the control. Conclusion: It can be concluded that MHPSP could significantly enhance the behavioral aspects of the families, neighbors, and health workers toward post-shackled PMD patients and significantly improved their quality of life. Therefore, MHPSP is needed to be implemented not only to the patient but also to the people that directly interact with them.

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“… 36 ) Moreover, neighbors serve as role models of behavior change and can be useful in promoting health. 37 , 38 ) Thus, the HL of older adults is delivered through neighbors. 39 , 40 ) When a neighbor has good HL, the older adults will also have good HL.…”

Restraint and confinement of psychiatric patients in community: a scoping review of pasung in Indonesia

“…Concerning pasung prevention, multilevel health promotion for pasung prevention programs improved the behavioral components of caregivers, fellow villagers and health workers. The patients’ quality of life who participated in the multilevel health promotion program was better than the control group that only received psychoeducation (Widodo et al , 2019). Nevertheless, psychoeducation therapy alone reduced the family’s intention to apply pasung (Suhron, 2017; Susilawati and Andi Buanasari, 2019) and reduced caregivers’ perceived burden (Dewi et al , 2019).…”

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“…The results of this study have shown that caregiver's intentions have positive impact on patient's quality of life. One of the ways of improving the intention of caregivers is by psycho-education intervention using Multilevel Health Promotion to Shackling Prevention (MHPSP) [8]. Social support is the support received by postshackle patients from caregivers/ close family in the form of support, instrument, information or advice, emotional support, and appreciation support.…”

“…Law Number 18 the Year 2014 [3] concerning Mental Health in Chapter 1 Article 1 states that mental health is a condition of an individual who can develop physically, mentally, spiritually, and socially that leads the individual to realize his ability, can overcome pressure and work productively, and to contribute in the community [4,5]. Shackling poses significant health and social problems for the patient with a mental disorder in Indonesia especially in rural areas where help is scarce [6][7][8][9]. Shackling in Indonesia is a person who is chained on the feet or both hands and feet, feet plugged into the hole and in isolation/confined.…”