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All Journal PROSIDING SEMINAR NASIONAL Jurnal Farmasi Sains dan Komunitas Unnes Science Education Journal Majalah Farmaseutik Care : Jurnal Ilmiah Ilmu Kesehatan Cendekia Journal of Pharmacy Jurnal Pelayanan dan Pengabdian Masyarakat (Pamas) Kumawula: Jurnal Pengabdian Kepada Masyarakat Budapest International Research and Critics Institute-Journal (BIRCI-Journal): Humanities and Social Sciences Community Medicine and Education Journal Jurnal Locus Penelitian dan Pengabdian JURNAL FARMASI DAN KESEHATAN INDONESIA
Titien Siwi Hartayu
Universitas Sanata Dharma, Yogyakarta
Religion Aerospace Engineering Arts Humanities Automotive Engineering Biochemistry, Genetics & Molecular Biology Chemistry Decision Sciences, Operations Research & Management Economics, Econometrics & Finance Education Electrical & Electronics Engineering Environmental Science Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Mathematics Medicine & Pharmacology Nursing Public Health Social Sciences

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Journal : Community Medicine and Education Journal

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Deconstructing Self-Medication: The Dominance of Attitude and Social Norms over Perceived Control in Non-Prescription Amoxicillin Use Maria Regina Lusiana Kya; Titien Siwi Hartayu
Community Medicine and Education Journal Vol. 6 No. 2 (2025): Community Medicine and Education Journal
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/cmej.v6i2.778

Abstract

The global escalation of antimicrobial resistance (AMR) is profoundly exacerbated by the irrational self-medication of antibiotics. This study was conducted in the Ende Tengah District, a community within an Indonesian province where non-prescription antibiotic acquisition is highly prevalent. The primary objective was to deconstruct the psychosocial determinants of the intention to self-medicate with amoxicillin, framing the analysis within the context of a recent regulatory change designed to limit antibiotic access. A quantitative, cross-sectional study was undertaken between April and May 2025. Using a purposive sampling strategy, 109 community members aged 18-60 who had used amoxicillin without a prescription were recruited from public-access areas. Data were gathered using a structured, pilot-tested questionnaire based on the Theory of Planned Behavior (TPB), which demonstrated good internal consistency (Cronbach’s α: 0.78-0.85). The instrument measured attitude, subjective norms, perceived behavioral control (PBC), and behavioral intention. Multiple linear regression was used for the primary analysis after all statistical assumptions were confirmed. The regression model was statistically significant (F(3, 105) = 21.267, p < .001) and accounted for 37.8% of the variance in self-medication intention (R² = 0.378). Attitude emerged as the most powerful predictor of intention (β = 0.341, p = .001), followed by subjective norms (β = 0.276, p = .015). Strikingly, perceived behavioral control, the construct most related to access, was not a significant predictor of intention (β = 0.081, p = .459). In conclusion, among the study participants, the intention to self-medicate with amoxicillin is overwhelmingly a psychosocial phenomenon, driven by favorable personal attitudes and deeply ingrained social norms rather than by perceptions of access. This suggests that top-down regulatory policies focused solely on restricting antibiotic supply may be insufficient without parallel, community-focused strategies designed to reshape the beliefs and behaviors that sustain demand.
Patient Cognition Over Social Context: A Theory of Planned Behavior Analysis Reveals Attitude as the Dominant Predictor of Primaquine Adherence Intention for Plasmodium vivax Radical Cure in Hyperendemic Papua, Indonesia Dewi Wijayanti; Titien Siwi Hartayu
Community Medicine and Education Journal Vol. 6 No. 2 (2025): Community Medicine and Education Journal
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/cmej.v6i2.803

Abstract

Relapsing Plasmodium vivax malaria remains a major obstacle to malaria elimination, with its treatment critically dependent on patient adherence to a 14-day primaquine regimen for radical cure. In hyperendemic regions like Papua, Indonesia, non-adherence is a primary cause of treatment failure. This study applied the Theory of Planned Behavior (TPB) to identify the key psychosocial determinants of adherence intention in this population to inform targeted public health interventions. A descriptive analytical study with a cross-sectional design was conducted in the East Sentani District of Papua, Indonesia, from February to April 2024. A total of 100 adult patients diagnosed with P. vivax malaria were recruited via consecutive sampling. A culturally adapted, validated questionnaire was used to measure the TPB constructs: attitude, subjective norms, and perceived behavioral control (PBC), alongside behavioral intention. Initial data analysis revealed quasi-complete separation, necessitating the use of a penalized logistic regression model (Firth's method) to generate stable and reliable estimates of association. The penalized logistic regression model was statistically significant and explained a considerable portion of the variance in adherence intention (Nagelkerke R² = 0.482). After controlling for other variables, a patient's personal attitude toward the treatment was the only significant predictor of their intention to complete the primaquine regimen. A more positive attitude was strongly associated with a higher intention to adhere (Odds Ratio [OR] = 5.21, 95% Confidence Interval [CI]: 2.15 - 12.67; p < 0.001). In contrast, neither subjective norms (OR = 1.12, 95% CI: 0.88 - 1.43; p = 0.354) nor perceived behavioral control (OR = 1.35, 95% CI: 0.91 - 2.01; p = 0.138) demonstrated a significant independent influence on behavioral intention. In conclusion, patient attitude—the individual's cognitive and affective evaluation of the treatment—is the primary driver of the intention to adhere to the 14-day primaquine regimen in this Papuan cohort. While social context and perceived barriers should not be disregarded, these findings strongly suggest that public health strategies must prioritize patient-centered educational interventions that cultivate a deep understanding of the biological necessity of radical cure to foster positive, resilient attitudes towards treatment completion.
Co-Authors Aris Widayati Bili, Juita Putrinda Dewi Setyaningsih DEWI WIJAYANTI Eko Yuliyanto Eko Yuliyanto, Eko Enade Perdana Istyastono Endah Sri Lestari Erna Tri Wulandari Fitria Fatichatul Hidayah Fitria Fatichatul Hidayah Florentinus Dika Octa Riswanto Gavrilayanti, Veronika Livia Ketut Ary Widiasih Kurniasari, Margaretha Wulan Lucia Wiwid Wijayanti Maria Regina Lusiana Kya Maria Wisnu Donowati Mario Yedi Mau Megantara, I Nyoman Arya Purnata Nunung Priyatni Padallingan, Jenni Putu Dyana Christasani Risnah Fisteria Setyono, Deddy Wahyunengsih, Cicilia Tyasti Yosef Wijoyo Yosef Wijoyo Yosef Wijoyo, Yosef