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All Journal Nurse Media Journal of Nursing Belitung Nursing Journal
Tippamas Chinnawong
Medical Nursing Department, Faculty of Nursing, Prince of Songkla University
Nursing

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Journal : belitung nursing journal

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Quality of life among Indonesian family caregivers caring for dependent older persons with type 2 diabetes mellitus in the community: A cross-sectional, correlational study Siregar, Rinco; Kritpracha, Charuwan; Chinnawong, Tippamas; Latour, Jos M.
Belitung Nursing Journal Vol. 11 No. 1 (2025): January - February
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3683

Abstract

Background: The global prevalence of older adults with diabetes has increased, and family caregivers in Indonesia play a critical role in managing diabetes and providing personal care. However, caregiving can be complex and challenging, often negatively affecting caregivers' quality of life (QoL). Objective: This study aimed to develop and test a hypothesized causal model of QoL among Indonesian family caregivers who care for dependent older persons with type 2 diabetes mellitus (T2DM) in 2024. Methods: A cross-sectional, correlational study was conducted with 270 family caregivers recruited from five Community Health Centers. Data were collected using various scales: the Center for Epidemiologic Studies Depression Scale, the Zarit Burden Interview, the Duke University Religion Index, the Perceived Knowledge on T2DM Care Scale, the Family-Carer Diabetes Management Self-Efficacy Scale, the Multidimensional Scale of Perceived Social Support, and the Quality-of-Life Index. Descriptive statistics and Partial Least Squares Structural Equation Modeling (PLS-SEM) were used for analysis. Results: The final model explained 89.1% of the variance in the quality of life (QoL) of family caregivers (R² = 0.893, Adjusted R² = 0.891), with 66% predictive relevance. Depression symptoms had the strongest negative direct effect on QoL, followed by caregiver burden. Self-efficacy and perceived knowledge had positive direct effects, while social support showed no significant direct effect. Indirect effects revealed that social support and self-efficacy positively influenced QoL through depression symptoms. The total effect (TE) analysis confirmed that depression symptoms had the strongest negative effect on QoL (TE = -0.744, p <0.001), while social support (TE = 0.443, p <0.001) and self-efficacy (TE = 0.413, p <0.001) had positive effects. Conclusion: Reducing depression symptoms and caregiver burden, strengthening social support, and promoting self-efficacy could significantly improve the QoL of family caregivers who care for older persons with T2DM. Nursing practice should address caregivers' physical and emotional needs, provide education, foster social support, and support caregiver mental health.
Psychometric properties of the Indonesian version of the Quality of Life Index (QLI-I) among family caregivers of dependent older persons with type 2 diabetes mellitus Siregar, Rinco; Kritpracha, Charuwan; Chinnawong, Tippamas; Latour, Jos M.
Belitung Nursing Journal Vol. 11 No. 4 (2025): July - August
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3929

Abstract

Background: The quality of life (QoL) of family caregivers supporting older persons with functional dependence due to Type 2 Diabetes Mellitus (T2DM) is a growing concern. Accurately assessing caregiver well-being requires culturally appropriate, valid, and reliable instruments. However, such tools remain limited in the Indonesian context. Objective: This study aimed to translate the Quality of Life Index (QLI) into Indonesian and evaluate the psychometric properties of the Indonesian version (QLI-I) among family caregivers of dependent older persons with T2DM. Methods: Brislin’s back-translation method was used to ensure linguistic and conceptual equivalence in the translation process. Content validity was assessed by a panel of five experts. Psychometric evaluation was conducted on a purposive sample of 394 family caregivers recruited from eleven community health centers in Medan, Indonesia. Construct validity was examined using confirmatory factor analysis (CFA), while convergent validity and construct reliability (CR) were analyzed to assess measurement accuracy. Results: The Indonesian version of the Quality of Life Index (QLI-I) demonstrated strong construct validity, with standardized factor loadings ranging from 0.707 to 0.870. CFA indicated an acceptable model fit based on the following indices: Root Mean Square Error of Approximation (RMSEA) = 0.067, ratio of chi-square to degrees of freedom (CMIN/df) = 2.779, Comparative Fit Index (CFI) = 0.906, Incremental Fit Index (IFI) = 0.906, Goodness of Fit Index (GFI) = 0.814, and Tucker-Lewis Index (TLI) = 0.898. Composite Reliability (CR) values were high across all domains: Health/Functioning (HF) = 0.957, Family (FA) = 0.876, Social/Economic (SE) = 0.924, and Psychological/Spiritual (PS) = 0.922. Average Variance Extracted (AVE) values met the recommended threshold for each domain: HF = 0.633, FA = 0.586, SE = 0.605, and PS = 0.627. All constructs demonstrated acceptable discriminant validity, confirming the distinctiveness of each domain. Conclusion: The QLI-I is a valid and reliable instrument for assessing the QoL of family caregivers of dependent older persons with T2DM. Its use in clinical and community settings can support nurses and healthcare professionals in identifying caregiver needs and developing culturally appropriate, evidence-based interventions to enhance caregiver well-being.
Predictors of health literacy among older adults with hypertension in Bali, Indonesia: A cross-sectional study Krisnayanti, Putu Mega; Promnoi, Chantra; Chinnawong, Tippamas
Belitung Nursing Journal Vol. 12 No. 2 (2026): March - April
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4270

Abstract

Background: The prevalence of hypertension in Indonesia continues to increase, particularly in Bali. However, existing research focusing on health literacy in Indonesia, especially among older adults with hypertension, is still limited and outdated. Objective: This cross-sectional predictive design study aimed to examine the level of health literacy among older adults with hypertension and its associated factors. Methods: Two hundred ninety-six eligible older adults with hypertension were purposively selected from two regencies in Bali. Data were collected from March to April 2025 using the Demographic Characteristic Questionnaire, the Short-Form Health Literacy Survey (HLS-SF12), the Perceived Severity of Illness Questionnaire (PSIQ), and the Multidimensional Scale of Perceived Social Support (MSPSS). The data were analyzed using descriptive statistics and multiple regression. Results: The findings showed an adequate level of health literacy among older adults with hypertension. The regression model explained 47.80% of the variance in health literacy (R² = 0.478). Significant associated factors of health literacy included perceived severity of illness (β = 0.353, p < 0.001), social support (β = 0.347, p < 0.001), and social activity engagement (β = 0.166, p < 0.001). However, use of media (β = 0.039, p = 0.375) and access to healthcare services (β = 0.001, p = 0.977) were not statistically significant predictors of health literacy among older adults with hypertension. Conclusion: Perceptions of illness severity, along with social support and social activity engagement, play a fundamental role in shaping the health literacy of older adults with hypertension in Bali. These findings can guide nurses in developing a tailored education program to help older adults better understand illness severity and promote social integration.
Co-Authors Bimala Panthee Charuwan Kritpracha Krisnayanti, Putu Mega Latour, Jos M. Promnoi, Chantra Rian Adi Pamungkas Rinco Siregar