AMINO PCC EAMSC 2021: Philippines (Public Infographic Poster, White Paper, Videography) by AMSA-Indonesia

All the woks published in this volume are the submitted works of AMSA-Indonesia members in the Pre-Conference Competition East Asian Medical Students' Conference 2021: Phillipines

The EAMSC 2021 oral presentation videos can be accessed through: bit.ly/OralPresentationEAMSC2021

AMINO | PCC EAMSC 2021: Philippines

FOREWORD

Steven Millenio Widjaja Secretary of Academic AMSA-Indonesia 2020/2021

The AMSA-Indonesia Competition Archive or AMINO for short is a program by AMSA-Indonesia to facilitate all members to get inspiration on how to make a scientific masterpiece. AMINO acts as an archive where all the works submitted by participants in competitions in AMSA, including Pre-Conference Competition East Asian Medical Students’ Competition (PCC EAMSC), Indonesia Medical Students’ Training and Competition (IMSTC), Pre-Conference Competition Asian Medical Students’ Competition (PCC AMSC) and from AMSA International Competitions, are published. In the first volume of AMINO, all the scientific masterpieces of PCC EAMSC 2021: Philippines have been compiled, which consists of the following categories: Scientific Paper, Public Infographic Poster, White Paper and Videography. We hope that through this volume of AMINO, we are able to further motivate and inspire our members to construct more scientific masterpieces. On behalf of AMSA-Indonesia, I would like to extend my deepest gratitude to personal to all the participants of PCC EAMSC 2021: Philippines, the Academic Team of AMSA-Indonesia, Executive Board of AMSA-Indonesia 2020/2021, and other parties that have contributed to the creation of AMINO. Without each and every single contribution, AMINO would not have been possible. May the release of AMINO increase the academic enthusiasm and ignite the potentials of AMSA-Indonesia members. “Igniting Potentials, Unleashing Possibilities” Viva AMSA!

AMINO | PCC EAMSC 2021: Philippines

TABLE OF CONTENTS

AMINO | PCC EAMSC 2021: Philippines

PUBLIC INFOGRAPHIC POSTER

TESTIMONY

AMINO | PCC EAMSC 2021: Philippines

Haniefatul Azzizah AMSA-Universitas Jember 1st Winner of Public Poster Category

Initially, we like to participate in competitions, especially in videography and poster. PCC EAMSC 2021 is an international event makes our team challenged to try the competitions. Such a golden opportunity our team represent AMSA-Indonesia in the public infographic competition. We’re very excited. It’s a lil bit pity the event has to be held virtually, but it turns out that from the beginning to the last day the event did not disappoint. It’s truly packed very interesting so that the philosophy of action, knowledge and friendship remains channeled. If you ask me how can you be a winner? Actually it was also kind of surprise to me. Maybe the tips, from the competitions that you follow, look for interesting topics and evidence based materials. From that make an interesting ending, such as smart solutions, abbreviation, etc. While making of the poster at that time we were in each other’s homes so that we could only meet through online platforms. Even it has to be far away, our team still works well together and support each other, we shared the tasks, after that design the poster and discuss together. Distance is not a obstacle, the most important thing is to be passionate and conﬁdent you can do it.

AMINO | PCC EAMSC 2021: Philippines

Michael Sugiyanto AMSA-Universitas Indonesia 2nd Winner of Public Poster Category

For me, joining medical competitions gives me life purpose because I know if I keep on making many works and learning from my past mistakes, eventually I will achieve something. Also, as medical students, we should be able to contribute to the advancement of medicine by having academic and research skills and communicate health messages to society creatively. For me, public posters can be a creative way to communicate health messages because they contain both aesthetic and informative aspects. The ﬁrst step of making a perfect public poster is identifying a crucial issue that needs to be conveyed using your public poster. That issue should be urgent enough to tackle in your society. After that, you should assemble a team to make a poster that contains creative people and “design masters”. Last, a public poster should be easily remembered by the public therefore it usually uses mnemonics. Make sure that you make unique and unforgettable mnemonics so they can catch the audience’s eyes. Also, you should be open to many references to make a public poster, such as AMINO. Above all, you can’t achieve anything if you don’t have the courage to start.

AMINO | PCC EAMSC 2021: Philippines

Shuffa Chilla Mayhana AMSA-Universitas Indonesia 3rd Winner of Public Poster Category

Personally, I think joining PCC EAMSC was an exhilarating experience! I have longed to join scientific competitions and I wasn’t sure where to start. Luckily, AMSA provides endless opportunities for me to take the leap. So, when my friends and I came across PCC EAMSC, we didn’t hesitate to give it a try. It was scary at first, because we did not have a lot of experience in joining scientific competitions. However, one tip I could give those who want to join EAMSC is that you should just go for it. There will be a lot of room for improvement, but that wouldn’t be possible if you didn’t enter the room itself. In addition to that, I think it’s important to seek advice from your seniors, especially those who have joined your branch of competition before because they could share very interesting insight on how to make your poster one-of-a-kind! Not every day that you could come across an opportunity like PCC EAMSC and who knows, you might get lucky and go home with a prize!

Misinformation about COVID-19? How Can We Stop it? Dandy Bachtiar Hidayat, Aldy Bachtiar Hidayat, Siti Zulaikha Risqiyani, Haniefatul Azzizah University of Jember, Indonesia Asian Medical Students’ Association Indonesia

Background: The WHO officially declared the coronavirus (COVID-19) as a pandemic on March 9, 2020. It means that the coronavirus has spread widely in the world. At the same time as the world responds to the COVID-19 pandemic, we face the challenge of overloading information related to the virus, we need to notice for misinformation. Sometimes the spread of misinformation is faster than the virus itself. It also occurred in Southeast Asia, spreading massively on social media. This is not surprising because most Asians are social media users. The WHO has identified several cases of misinformation related to COVID-19 such as the treatment, its symptoms, transmission patterns, prevention, diagnosis, its cause, and origins of the virus. Misinformation about COVID-19 could put people at risk as it may give them a false sense of security. Therefore, we make a poster with easy to remember abbreviation to reduce and stop misinformation regarding COVID-19. Objective: This poster aims to increase public knowledge and reduce the spread of COVID-19 misinformation Key Findings: COVID-19, misinformation, prevention

446

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THIS Is for The OLDIES: A Guide to Effective Communication with Geriatric Patients Michael Sugiyanto, Liovicinie Andarini, and Madeline Belda Faculty of Medicine, University of Indonesia

Good communication between doctors and patients is an essential part of a good healing process. Research has shown that a good doctor-patient relationship significantly correlates with the patients’ compliance towards medication or therapy. Effective communication between doctor and patients have some benefits, such as helping prevent malpractice, improving outcomes, strengthening the doctorpatient relationship, and maximizing the interactions between them, abbreviated as THIS. 1 A demographic survey stated that people over the age of 65 visit their doctors approximately eight times a year, therefore doctors should prepare themselves with adequate communication skills with geriatric patients. The challenge of building a good rapport with them will present in their wide range of life experiences, beliefs, and cultural backgrounds, which influences their perception about the illness and their compliance towards medication or therapy. Besides, their communication skill can also be accompanied by their loss of sensory and memory, also the decline in information-processing ability.2,3 Good communication with geriatrics can be achieved by obtaining trust, listening, compensating deficits, reviewing important points, making eye contact, and speaking clearly, abbreviated as OLDIES. This poster aims to raise the awareness to use a different approach to communicate with geriatric patients in order to achieve a better medical outcome. Reference 1.

National Institute on Aging. Tips for Improving Communication with Older Patients [Internet]. 2017 [cited 2020 Oct 19]. Available from: https://www.nia.nih.gov/health/tips-improvingcommunication-older-patients

Robinson II TE, White Jr GL, Houchins JC. With Older Patients : Tips From the Literature. Fam Pract Manag. 2006;13(8):73–8.

Sanecka A. Social Barriers to Effective Communication in Old Age. J Educ Cult Soc. 2014;5(2):144–53.

448

Abstract Project Title

: Break Health Media Hoaxes with “DRAKE”

Name of the University

: Universitas Indonesia

Authors

: - Shuffa Chilla Mayhana -

Ilma Ranjani Wijaya

Valerie Josephine Dirjayanto

Zhahna Siti Maharani

Background & Objective Our growing dependency on the internet has influenced every part of our lives, including our way of attaining health-related information.1 Approximately 87% of people look for health-related information through the internet. However, only 33% obtain information from official health websites, while the other 47% opt for unreliable health blogs and forums.2 Since the COVID-19 pandemic, around 1401 hoaxes have been widely spread in Indonesia, and these numbers appear to be increasing every day.3 Thus, a public intervention is needed in order to raise awareness on how one could effectively sort health information obtained from various media.. The implementation of this intervention to our daily lives will not only improve one’s health literacy; it could save millions. Thus, we propose a step-by-step guide for the general public to break health media hoaxes with “DRAKE”. It consists of five simple strategies, ranging from recognizing the date of the article, to comparing it with other sources.4,5 Moreover, the campaign design illustrates various media platforms, whereas the mnemonic represents an iconic singer of the century. We hope that these memorable guide can impact society by promoting the right attitude in selecting health information to enhance health communication via digital media References 1. Kanekar AS, Thombre A. Fake medical news: Avoiding pitfalls and perils. Fam Med Community Health. 2019;7(4). 2. Sahni H, Sharma H. Role of social media during the COVID-19 pandemic: Beneficial, destructive, or reconstructive?. Int J Acad Med. 2020 Apr 1;6(2):70. 3. Yusuf. Kominfo temukan 1.401 sebaran isu hoax terkait covid-19 [Internet]. Jakarta: Kementerian Komunikasi dan Informatika RI Direktorat Jenderal Aplikasi informatika; 2020 May

[updated

2020

May

cited

2020

Oct

10].

Available

from:

https://aptika.kominfo.go.id/2020/05/kominfo-temukan-1-401-sebaran-isu-hoaks-terkaitcovid-19/

450

4. Abu-Fadil M. Combatting disinformation and misinformation through Media and Information Literacy (MIL). Journalism, “fake Paris: United Nations Economic and Social Council;2018:70-80. 5. Wineburg S, McGrew S. Lateral reading: reading less and learning more when evaluating digital information. Stanford History Education Group;2017 Oct 6.

451

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BREAK THE BARRIER TO REACH THE PATIENT Raisa Sabila, Alfiyah Munawwaroh Abdullah, Adira Sukmaningtyas AMSA – Universitas Sriwijaya

Background: Doctor-patient communication is the key to obtain a diagnose, where doctors gather all the information needed from patients. According to Indonesia’s Ministry of Health (2018), patient satisfaction is rated based on five dimensions: reliability, assurance, tangible, empathy, and responsiveness. The average patient satisfaction rate in Riau, East Java, East Nusa Tenggara, Maluku, West Kalimantan, Central Sulawesi, and West Papua is 82,8% (82,9% for reliability, 84,7% for assurance, 80,7% for tangible, 81,1% for empathy, and 82,8% for responsiveness). Unfortunately, we are currently under standard as the minimum percentage stated by the Ministry of Health is ≥ 90 %. Most doctors are lack of empathy and have insufficient time to give plenty of explanation about patient’s disease that they sometimes ignore if the patient asks them. On the other hand, patients are reluctant to ask further about the disease they are experiencing due to the social hierarchy gap and end up not understanding about what happen and what to do about it. Ineffective communication may result in unsatisfied patients and different understanding on both doctors and patients.

Objective: The aim is to give solutions to extinguish the barriers in doctor-patient communication to prevent different understanding.

Key Findings: doctor, patient, communication, empathy

References

Claramita, M. et al., 2020. A Partnership-Oriented and Culturally-Sensitive Communication Style of Doctors Can Impact the Health Outcomes of Patients with Chronic Illnesses in Indonesia. Patient Education and Counseling, CIII(2), pp. 292-300. Ministry of Health Republic of Indonesia. 2018. Patient Satisfaction towards Hospital's Outpatient Service Quality in 7 Provinces in Indonesia. Jakarta: Department of Health. Ministry

Health

Republic

Indonesia.

2008.

Ministry

Health

Decree

Number:

129/Menkes/SK/II/2008 about Hospital's Standard Minimum Service. Jakarta: Department of Health.

453

Pasaribu, B. S., Aulia, D. & Rochadi, R. K., 2019. Effect of Doctor's Interpersonal Communication on Patient Satisfaction at Royal Prima General Hospital Medan. International Journal of Research and Review, VI(11), pp. 162-187.

454

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Teleconsultation: Constructing a Solid Communication Architecture with “3C” Aileen Alessandra Suryohusodo, Bethea Manuela Mulyono , Irene Vanessa, Sharren Shera Vionnetta Atma Jaya Catholic University of Indonesia, Indonesia Asian Medical Students’ Association Background: Teleconsultations have increased markedly in the past few years especially during this unprecedented COVID-19 pandemic, which coerced the community to go through this online alternative to do medical consultations. The number of eHealth applications users in Indonesia has increased dramatically in the first few months of 2020, which proves the significance of teleconsultations in our current daily lives. However, there is still much to improve in terms of building an environment that can emulate ones that are in the hospital or clinical settings. Communication in healthcare is a critical factor in determining the quality of medical attention that someone receives. Consequently, in an online setting, building a decent doctor-patient relationship is extremely consequential to make sure that the patient can still obtain the care and empathy that they deserve. To accomplish this objective, qualities such as clarity, considerate, and caring are especially essential when shifting from a physical to an online setting. Objectives: The aim of this poster is to inform doctors how to build a favourable doctor-patient relationship by focusing on effective communication in teleconsultation. Key Findings: Teleconsultations, Communication, Healthcare, Online. References 1. Teleconsultations during a pandemic. (2020). Retrieved 19 October 2020, from https://www.paho.org/ish/images/docs/covid-19-teleconsultations-en.pdf?ua=1 2. Kapur, V., & Boulton, A. (2020). Covid-19 Accelerates the Adoption of Telemedicine in AsiaPacific Countries. Retrieved 19 October 2020, from https://www.bain.com/insights/covid-19accelerates-the-adoption-of-telemedicine-in-asia-pacific-countries/# 3. Kaidan, M. (2020). Indonesia's health care relies on surprising apps for coronavirus consultations.

Retrieved

October

2020,

from

https://www.express.co.uk/news/world/1267419/coronavirus-indonesia-health-care-covid-19telehealth-consultation-app 4. More demand for telemedicine as Indonesians stay away from hospitals amid COVID-19. (2020).

Retrieved

October

2020,

https://www.channelnewsasia.com/news/asia/indonesia-covid-19-telemedicie-halodocalodokter-demand-rises-12829088

456

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5. Media, K. (2020). Survei: 84,4 Persen Masyarakat Puas dengan Layanan Kesehatan Digital Halaman

all

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Retrieved

October

2020,

from

https://money.kompas.com/read/2019/08/19/134000926/survei--84-4-persen-masyarakatpuas-dengan-layanan-kesehatan-digital?page=all 6. Top 10 Tips for Virtual Visits Clinician Communication. (2020). Retrieved 19 October 2020, from

https://my.clevelandclinic.org/-/scassets/files/org/landing/preparing-for-

coronavirus/covid-response-digital-health-communicationtips?_ga=2.123612687.580691226.1602821947-38745642.1602821947 7. Fourianalistyawati, E. (2020). Komunikasi yang Relevan dan Efektif Antara Dokter dan Pasien. Retrieved

October

2020,

from

https://www.researchgate.net/publication/320100052_Komunikasi_yang_Relevan_dan_Efekti f_antara_Dokter_dan_Pasien

457

TELECONSULTATION :

Constructing a Solid Communication Architecture what is Teleconsultation?

Teleconsultation, sometimes known as remote consultation or telehealth, refers The increase OF telemedicine to interactions that happen between a users due to covid-19 : clinician and a patient for the purpose of providing diagnostic Bain’s Asia-Paciﬁc Front Line of Healthcare Survey March 2020, percentage increase of daily active users in Indonesia or therapeutic advice through electronic Alodokter +39% means. (PAHO, 2020)

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Halodoc

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15,6% of users still feel unsatisfied due

to several reasons, including poor communication

Deloitte Indonesia

CONSIDERATE

CLARITY

• Communicate thoroughly without rushing • Video call when possible • Use simple language

CARING

• Convey empathy with patient in verbal and nonverbal means

• Construct the agenda and treatment plan with patients collaboratively • Ask permission before taking pictures and videos • Give opportunities to ask questions

8 RED FLAGS OF HEALTH MISINFORMATION THAT WILL SHOOK YOU TO THE CORE! Raina Maharani Tasyandita, Salsabila Shofa Sofwan Putri, Satria Angga Widitama AMSA-Universitas Padjadjaran The Internet, especially social media platforms, has become one of the most frequently used modes of communication nowadays. It is estimated that health related searches account for about 5% of all internet searches. Social media also has a high number of user accounts which create massive interactions between one user and another worldwide. Unfortunately, these platforms are prone to be medium for spreading the highest number of hoaxes. Based on research conducted by Indonesian Telematics Society, up to 87.5% of hoax spread through social media in 2019. This issue could spark numerous problems especially individuals with low health literacy levels. It could lead them to have poorer use of preventive health service, delay or not receive health care, and have poorer overall health status. As a result, it will worsen their condition and give rise to higher morbidity and mortality rate. Objectives : ●

To raise awareness on the importance of critical thinking and skeptical behavior when it comes to medical and health related information, either after getting or before sharing it.

●

To highlight the characteristics of health misinformation, especially for social media users to prevent the widespread and minimize the exposure to people without prior knowledge of the misinformations.

459

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PCC EAMSC MANILA 2021

The Danger of Self-Medication Christopher William Purnomo1, Brenda Angelique1, Catherine Natasya2 1

Second Year of Medical Student, Medical Faculty of Universitas Sebelas Maret

Second Year of Medical Student, Faculty of Medicine, Public Health, and Nursing of Universitas Gadjah Mada

Abstract The widespread public information mediated by the internet makes people prone to diagnosing themselves based on their symptoms, which is called self-diagnosis. Self-diagnosis is dangerous since accuracy and credibility of information available in the internet is very low (Ryan and Wilson, 2008). People could also exaggerate or understate their symptoms. After self-diagnosing, people tend to buy medicines on their own without prescription, which we refer to as self-medication. Antibiotics are often bought without prescription, including in Indonesia, where one of its cities reached 45% in antibiotics self-medication prevalence (Kurniawan, Posangi, & Rampengan, 2017). This could lead to antibiotics misuse, which gives rise to bacterial resistance (Odonkor and Addo, 2011). One of the solutions to this problem is to suppress the sale of antibiotics without prescription. A more realistic solution is educating people about the dangers of self-diagnosis including self-medication of antibiotics and its effect in inducing antibiotics resistance, which is the focus of this public poster. Through this poster, we aim to spread information about the dangers of self-medication and how to stop it through “4S” so that people could reduce self-medication and be encouraged to consult with related health workers about their health problems. Keywords: self-diagnosis, self-medication, antibiotic resistance References: Kurniawan, Posangi, J., & Rampengan, N. (2017). ‘Association between public knowledge regarding antibiotics and self-medication with antibiotics in Teling Atas Community Health Center, East Indonesia’, Medical Journal of Indonesia, 26, p62-69 Odonkor, S. T. and Addo, K. K. (2011) ‘Review article Bacteria Resistance to Antibiotics : Recent Trends and Challenges’, 2(4), pp. 1204–1210. Ryan, A. and Wilson, S. (2008) ‘Internet healthcare: Do self-diagnosis sites do more harm than good?’, Expert Opinion on Drug Safety, 7(3), pp. 227–229. doi: 10.1517/14740338.7.3.227.

462

ABSTRACT •

Project Title

The title for our public poster is “REACH for Better Comunnication in Healthcare”. •

Authors

There are 4 authors and all of us from Faculty of Medicine of University of Jember (UNEJ). This is the list of our names : 1. Betzy Riani Kesuma 2. Muhammad Farrel Ravidiata Masoga Bintang 3. Ni Made Agustina Indraningsih 4. Ichlasul Mahdi Fardhani •

Background

There are 45% of disciplinary violation by doctors are caused by miscommunication in healthcare. This show us that communication, especially in healthcare between doctors and patients is a really important thing that we should pay more attention on it. That’s why in our public poster, we are more focused in how to developed the quality of medication by using a simple and effective way of communication, that we called it REACH. REACH stands for Respect, Emphaty, Audible, Clarity, and Humble, which means as the healthcare providers, the perfect communication they should do must depends on that concept. First, they are must respect towards the person they’re talking to, also learn about how to understand others situation. After that, the message we want to give should be easy to understand and received by the patients. And the last one, humble, the healthcare providers should be humble toward everyone to make a better chemistry especially to their patients. •

Objectives 1. To reduce any kind of miscommunication in healthcare which can followed by another problems. 2. To provide a simple concept of communication that should be use in healthcare. 3. To show that communication is really important for the quality of medication in healthcare.

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LET’S START FILTER, STOP THE FALSE! Maria Alvenia Chaterina Revita; Yason Nikolaus Liyadi; Wynne Elysia Suriady; Andrea Melynda Panggalo Hasanuddin University, Makassar, South Sulawesi. ABSTRACT Background: Health misinformation is health-related claim of fact that is currently false due to a lack of scientific evidence. Health misinformation is on the third place (41.2%) of the most misinformation or hoax that people received in Indonesia following social politics on the first place (91.8%) and “ethnicity, religion, race, and inter-group” topic on the second place (88.6%). Social media is on the first place (92.4%) in the spreading of misinformation in Indonesia, followed by chatting application on the second place (62.8%) and websites on the third place (34.9%). Some characteristics of health misinformation that we can identify such as a provocative headline and evocative content, obscure and untraceable sources, heavily biased, push people to reshare, and meant to distort emotions. The effect of health misinformation on community can make a mass panic, make people to waste time and money, and even worse losing someone’s life due to a misinformation or a false information. Objective: Through our public poster, we aimed to raise public awareness and reduce the number of health misinformation by filtering the content that people get from any media of the spreading of health misinformation and how to stop the spreading of false medical information in any condition. Keyword: Health Misinformation, False Claim, Hoax, Provocative Headline References: 1. Chou, W. S., Oh, A., Klein, W. M. P. (2018). Adressing health-related misinformation on social media. Jama, 320(23), 2417-2418. 2. Sarosa, A. P. (2017). 3 Dominant Characteristics of Internet Hoaxes. Jakarta: Tempo.co. 3. The Indonesian Telematics Society (2019). 2019 National Hoax Outbreak Survey. Jakarta, Indonesia. 4. Thompson Rivers University Library (2019). Characteristics of Fake News & Media Bias. Kamloops, Canada.

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r a t t F s ILTER, s ' t e l stop the false ! HEALTH misINFORMATION

protect yourself and

Health misinformation can be defined as a health-related claim of fact that is currently false due to a lack of scientific evidence.

others by

reporting misinformation

Wen-Ying Sylvia Chou, April Oh, William MP Klein, 2018

DID YOU KNOW? TYPES OF HOAX

HOAX MEDIA DISTRIBUTION

Social Politics

91.8%

SARA *

88.6%

92.4%

62.8%

34.9%

Health

41.2%

Social Media

Chatting Apps

Websites

Food & Beverages

32.6%

Financial Fraud

24.5%

*) SAR A: Ethic, Religion, R ace, and I nter- Group

8.7%

Television

Printed Media

**) S ource: The I ndonesian Telematics S ociet y (2019)

CHARACTERISTICS OF A HOAX 1. 2. 3. 4. 5.

Provocative headline and evocative content Obscure and untraceable sources Heavily biased Push people to re - share Meant to distort with emotions

i DO

F ind the source I dentify author before L ook share T ake it easy E ase mass panic R ead beyond

DON’T without F orward knowing its truth mass panic with A mplify provocative news L ack of reliable sources only because S haring it ’s viral others to do E ncourage so

PUBLIC INFOGRAPHIC POSTER “MISS Communication”

Albert Yohanes Axel Yoagnesto AMSA-Sebelas Maret University

ABSTRAK Miscommunication is often referred to as a misconception, which in the Big Indonesian Dictionary means wrong acceptance or misconception of a communication. This can happen anytime and anywhere when we talk to other people or hear other people's conversations, including in medical environments where communication is one of the most important factors when dealing with patients. Doctors are seen not only as service providers but also as someone extraordinary who understands many things, yet doctors sometimes forget to communicate well to patients and assume that the patients already understand what they meant. This can result in various problems for both the patient and the doctor themselves. The purpose of this public infographic poster is to help make not only patients but also doctors aware of the importance of communication in healthcare settings. Keyword : miscommunication, patient, doctor

References 1. Belasen, A., & Belasen, A. (2018). Doctor-patient communication: a review and a rationale for using an assessment framework. Journal Of Health Organization And Management, 32(7), 891-907. https://doi.org/10.1108/jhom-10-2017-0262 2. Ha, J. F., & Longnecker, N. (2010). Doctor-patient communication: a review. The Ochsner journal, 10(1), 38–43. 3. Kemkes.go.id. 2020. Kementerian Kesehatan Republik Indonesia. [online] Available at: https://www.kemkes.go.id/article/print/1519/dugaan-pelanggaran-disiplin-terbanyak-akibatkurangnya-komunikasi-dokter-dan-pasien.html [Accessed 19 October 2020].

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Something Simple, and might be Ignored Anthonius Christopher Wisnu, Nathalie Widjaja, Alega Greacia Florensita

Abstract Effective communication is the most important thing when health workers provide care. There are various components of effective communication. If any of these components is compromised, effective communication doesn’t occur. Effective communication is two way interaction between patients and the health workers system. Patients must be able to convey information about their health complaints to health workers. On the other hand, health workers must be able to understand and interpret information adequately to treat health complaints properly. To reduce the risk of recurring health complaints, health workers must provide adequate information to patients to help them take precautions to safeguard their health. The method that health workers can apply as strategies for clear communication is using “WE BARE” system, including giving Warm greetings, maintaining Eye contact, Be Aware of the patient's body language, listening caREfully, and speaking slowly and clearly in non-medical language so that health workers can give BEARS (Believe, Empathy, Advice, Remind, Specify) to patients. The first one is believe because it is important to have trust between the patient and health workers. Empathy is the ability to feel what other people feel and give respond. Without getting involved in their feelings. Engagement must limited so that optimal help can be given. It is also important to health workers to be a good listener and be a good health provider in giving responses. Advice, so that health care can suggest what patients should and should not do, what is went wrong, what patients need to do and why, how they do it, what to expect and alternatives. Remind to warn patients not to be negligent and to pay more attention to their health. Last but not least, Specify, in terms of conveying suggestions about what should be done if there is a complaint of an illness. It must be focused on the disease so that treatment can be maximized.

References Ratna, H., 2019. Harvard Public Health Review. The Importance of Effective Communication in Health workers Practice, [online] 23(5). Available at: <http://harvardpublichealthreview.org/healthcommunication/> [Accessed 3 October 2020]. Vermeir, P., Vandijck, D., Degroote, S., Peleman, R., Verhaeghe, R., Mortier, E., Hallaert, G., Van Daele, S., Buylaert, W. and Vogelaers, D., 2015. Communication in health workers: a narrative review of the literature and practical recommendations. International Journal of Clinical Practice, 69(11), pp.1257-1267.

470

ABSTRACT Health Illiteracy Among Pregnant Women : Fight MYTHS With FACTS Arden Gabrian1, Nathaniel Gilbert Dyson2, Priscilla Geraldine3, Violine Martalia4 Second Year Medical Student, Asian Medical Students’ Association Universitas Indonesia,

arden.gabrian@ui.ac.id Second Year Medical Student, Asian Medical Students’ Association Universitas Indonesia,

nathaniel.gilbert@ui.ac.id Second Year Medical Student, Asian Medical Students’ Association Universitas Indonesia,

priscilla.geraldine@ui.ac.id Second Year Medical Student, Asian Medical Students’ Association Universitas Indonesia,

violine.martalia@ui.ac.id

Background : An average of 810 women die everyday due to preventable causes related to pregnancy and childbirth with health illiteracy being one of its most significant causes.1,2 Despite commendable efforts by governments seeking to reduce maternal mortality rates through improving health literacy, the results are still far below the target stated in the Sustainable Development Goals (SDG) 2030. In Indonesia, health illiteracy is a complex issue caused by substandard education and difficult access to reliable information, further exacerbated by hoaxes and established but inaccurate traditions surrounding pregnancy and infant care.3,4 Therefore, we created an infographic titled “Fight MYTHS With FACTS for Healthy Mother and Baby’ to raise awareness on the issue and to summarize the current challenges and solutions involving health communication using the mnemonics “MYTHS” and “FACTS” respectively.5 As stated in our title, fighting MYTHS with FACTS is a crucial step towards improving global maternal and infant health. Objectives : This infographic aims to raise awareness and knowledge regarding health literacy and its role in reducing the mortality rate of pregnant women and neonates to support the Sustainable Development Goals 2030.

Key Findings : health literacy, pregnant women, challenge, solution, infant care

References : 1. WHO. Maternal health [Internet]. [cited 2020 Oct 20]. Available from: https://www.who.int/health-topics/maternal-health#tab=tab_1

472

2. Yee L, Silver R, Haas D, Parry S, Mercer B, Iams J et al. Association between health literacy and maternal and neonatal outcomes. American Journal of Obstetrics and Gynecology. 2020;222(1):S6-S7. 3. WHO. Maternal mortality ratio (per 100 000 live births) [Internet]. World Health Organization. 2020 [cited 18 October 2020]. Available from: https://www.who.int/data/gho/data/indicators/indicator-details/GHO/maternal-mortality-ratio(per-100-000-live-births) 4. WHO. Neonatal mortality ratio (per 1000 live births) [Internet]. World Health Organization. 2020 [cited 18 October 2020]. Available from: https://www.who.int/data/gho/data/indicators/indicatordetails/GHO/neonatal-mortality-rate-(deaths-per-1000-live-births) 5. Corrarino JE. Health literacy and women’s health: challenges and opportunities. J. Midwifery Women’s Heal.2013;

473

•

♦. FOR HEALTHY MOTHER AND BABY

SITUATION

HEALTH LITERACY

-wH� 1s�1T IMPORTANT-?

plays an important role in doctor-patient communication, thus ensuring proper care during and after pregnancy

women die everyday due to preventable causes related to pregnancy & childbirth

MORT-ALll:Y RAT-E of ---:::-

Mothers per 100,000 births ---

Infants

2030SDG Target

■

•

••• •

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Use herbal medicine only

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Arden Gabrian Nathaniel Gilbert

Priscilla Geraldine Violine Martalia

Effective Communication in Healthcare Audrey Shafira Anindyaputri, Elisheva Marcelyn Budiono, Ghillyant Tendra, Nesty Angelica AMSA-Universitas Pelita Harapan

ABSTRACT

Communication is the process of delivering and receiving messages from someone which is shared with others. Effective communication is achieved when there is an exchange of information with both parties understanding the meaning and intentions behind the information. An effective communication between doctors and patients is the main key to the success of doctors in providing medical services to patients. Vice versa, if there is no good communication between the doctor and the patient, disputes and misunderstandings could occur. It is a doctor’s responsibility to prioritize patients’ convenience and satisfaction, giving them reassurance and consolation through the whole process. The goals of achieving communication effectiveness are to create a good relationship between doctors and patients, to exchange important information that needs to be understood, and lastly, to help make the best medical decisions.

475

Effective Communication in Healthcare

Effective Communication in Healthcare is a two-way communication between patients and healthcare provider, exchanging information clearly, that results in making others feel heard and understood. Came to the doctor with a hope to be healed by telling the complaints

Exchange of information Creating a good interpersonal relationship

Listen to the patient, show interest, responding, and give treatment

Medical decision making

Improve patient's health, convenience, and satisfaction

Avoiding the possibility of malpractice

Lower the risk of conflict between the doctor and the patient

Bad News – How to Break Them and How to Handle Them Authors: Bella Renata, Tsamara Nurwina Nugroho, Adara Kirana Putri, Eigieneo Elmattana Nosatiya AMSA-Universitas Diponegoro

Abstract Breaking bad news is one of the most complicated challenges that physicians encounter in their medical practice(1). Receiving bad news is also a significant and burdensome moment for patients and their family. It is a highly emotional process that include reactions such as shock, sadness, anger, disbelief, or denial(2). It results in a cognitive, behavioral, or emotional deficit that persists for some time after the news is received(3). Studies have shown that many doctors lack competence as well as confidence in their ability to deliver bad news(4). An improper way of communicating with the patient may have a significant impact on the way they discern their disease(5). It also can cause patient’s emotional breakdown, loss of fighting spirit, and have a negative impact on further cooperation(2). Thus, revealing bad news is a complex art that consists of both verbal component of the actual news breaking and empathetic response of the doctor to handle the reaction elicited from the patient(6). That is why we made this poster which is aimed to educate doctors about the ABCDEs of how to break bad news appropriately, and to educate patients about how to handle bad news in order to prevent further emotional distress. References 1. Hulsman RL, Pranger S, Koot S, Fabriek M, Karemaker JM, Smets EM. How stressful is doctorpatient communication? Physiological and psychological stress of medical students in simulated history taking and bad-news consultations. International journal of psychophysiology : official journal of the International Organization of Psychophysiology. 2010 Jul;77(1):26-34. PubMed PMID: 20399815. 2. Fallowfield L, Jenkins V. Communicating sad, bad, and difficult news in medicine. Lancet (London, England). 2004 Jan 24;363(9405):312-9. PubMed PMID: 14751707. Epub 2004/01/31. eng. 3. Ptacek JT, Eberhardt TL. Breaking Bad News: A Review of the Literature. JAMA. 1996;276(6):496-502.

477

4. Adebayo PB, Abayomi O, Johnson PO, Oloyede T, Oyelekan AA. Breaking bad news in clinical setting - health professionals' experience and perceived competence in Southwestern Nigeria: a cross sectional study. Annals of African medicine. 2013 Oct-Dec;12(4):205-11. PubMed PMID: 24309408. Epub 2013/12/07. eng. 5. Sobczak K, Leoniuk K, Janaszczyk A. Delivering bad news: patient's perspective and opinions. Patient Prefer Adherence. 2018;12:2397-404. PubMed PMID: 30519005. eng. 6. Ranjan P, Kumari A, Chakrawarty A. How can Doctors Improve their Communication Skills? Journal of clinical and diagnostic research : JCDR. 2015 Mar;9(3):JE01-4. PubMed PMID: 25954636. Pubmed Central PMCID: PMC4413084. Epub 2015/05/09. eng.

478

Take “TALK” Everytime you see your Patient. Caesaria H. Wijaya1, Marsja R. Hutapea1 1

Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia

Abstract

According to Harvard Public Health Review , effective communication is important when delivering healthcare, without it, the quality of healthcare would be impaired. Effective communication is bidirectional between patients and healthcare systems, so there are multiple components that healthcare should rely on.

The components are :

Healthcare literacy Health literacy dan be defined as the patient’s ability to obtain, comprehend, communicate and understand healthcare information and services. To improve their health outcomes, patients are better equipped to make appropriate healthcare decisions. Patients with lack basic knowledge about health literacy are more likely passive during health care, so as the result, they are often less satisfied with their care.

Cultural Competency

This component is to prevent racial and ethnic inequality in healthcare. Studies have shown that ethnic minorities are more likely to perceive that the healthcare staff had negatively judged them and treated them with disrespect due to their race or ethnicity. A culturally competent healthcare system provides high quality care regardless of race or ethnicity.

Language Barriers

A culturally competent healthcare system provides high quality care regardless of race, ethnicity, culture or language proficiency for patients.

480

TAKE "TALK" EVERYTIME YOU SEE YOUR PATIENT

TA LK

TURN & FACE THE FRONT WHEN WE COMMUNICATE GIVE AFFIRMATION TO BE MORE POSITIVE AND EMPOWERED LOOK AT YOUR PATIENT AND MAINTAIN EYE CONTACT SPEAK WHEN IT'S YOUR TURN

According to the Australian Commission on Safety and Quality in Health Care, 60 percent of the population has difficulty understanding complex healthcare concepts and information.

No, i want to consult with dr. A , he is more competent than others

Mr. Nico , you can consult with dr. B right now

Safer Sex Over Protection David Clinton Napitupulu, Farianti Wiranda, Anastasya Putri Liara, Fanny Andy Setia Yanti AMSA-UKRIDA Abstract Sexuality education in Asia is considered taboo things to talk about, and barely minimum to be taught for the teenagers. Because many people believes it will encourage them to have sex at young age. That's why many parents avoid talking about this topic openly to their child and also the education system does not provide the proper curriculum for it at school. That is why many teenagers are adrift in a sea of misinformation. With their lack of information, most likely they can’t practice proper safe sexual activity and also they can’t distinguish between healthy and unhealthy sex. That's why the numbers of STDs, especially HIV/AIDS, and unplanned pregnancy rate is high among teenagers. With this concern, we provide the easiest and cheapest solution for the teenagers to practice proper sex with condom because it is proven that condom has the high affectivifity to prevent unplanned pregnancy and STDs more than 95%. We believe it's better to prevent than to cure.

482

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Need to see a doctor from home? Access the HOTLINE! Devi Nurhalizah, Alyssa Andiana, Muhammad Faruqi, Athaya Shaumi Faculty of Medicine, Universitas Indonesia Approximately 800 million people suffer from fundings and access to health, resulting in 8 million deaths annually.1 Progressive innovations in technology, especially smartphones with 3.5 billion users lately, must be appropriately considered.2 Although it has been extensive, only 70% of smartphone users in developed regions have accessed mobile health (mHealth) wisely. The promotion of mHealth ensures reliable communication, prevents misinformation and presents recommended measures of health service delivery to the patient.3,4 It circumvents the limitation of place, distance, and also reduces healthcare access expenditure by doing patient-doctor communication from their location. mHealth plays a significant role in developing countries and remote areas where resources in the medical field have a barrier to patient's access to treatment.5 Furthermore, the utilization of mHealth during a pandemic may guarantee patients' safety as it cuts down the chain of transmission.4 The usefulness of mHealth applications lies in its capability to monitor chronic illnesses and promote a human being's overall wellness. The software helps self-management by tracking an individual's health, raw lifestyle data, and incorporating actionable feedback. It is expected that mobile health applications allow safe and proper communication between healthcare professionals and patients, share knowledge between them, and help treat psychological diseases.6

Reference 1. World Health Organization. World Bank and WHO: Half the world lacks access to essential health services, 100 million still pushed into extreme poverty because of health expenses [Internet]. Who. int. 2020 [cited 18 October 2020]. Available from: https://www.who.int/news/item/13-12-2017-world-bank-and-who-half-the-world-lacksaccess-to-essential-health-services-100-million-still-pushed-into-extreme-poverty-because-ofhealth-expenses 2. Kernebeck S, Busse T, Böttcher M, Weitz J, Ehlers J, Bork U. Impact of mobile health and medical applications on clinical practice in gastroenterology. World Journal of Gastroenterology. 2020;26(29):4182-4197. 3. Kruse C, Betancourt J, Ortiz S, Valdes Luna S, Bamrah I, Segovia N. Barriers to the use of mobile health in improving health outcomes in developing countries: Systematic review. J Med Internet Res. 2019;21(10):e13263.

484

4. Zamberg I, Manzano S, Posfay-Barbe K, Windisch O, Agoritsas T, Schiffer E. A mobile health platform to disseminate validated institutional measurements during the COVID-19 outbreak: Utilization-focused evaluation study. JMIR Public Health and Surveillance. 2020;6(2):e18668. 5. World Health Organization. mHealth: use of appropriate digital technologies for public health. World Health Organization; 2018 p. 1-5. 6. Pires IM, Marques G, Garcia NM, Flórez-Revuelta F, Ponciano V, Oniani S. A research on the classification and applicability of the mobile health applications. J. Pers. Med. 2020 Mar;10(1):11.

485

GOOD COMMUNICATION IN HEALTH CARE IN THE MODERN ERA Dhea Zulrahmania Hermanto, Johanna Valentina, Nugrahini Anindya, Putri Patricia AMSA-Universitas Pelita Harapan ABSTRACT One of the most important parts of healing in the health-care system is good communication. When it’s done well it would give a relieving effect to the patient. A doctor should have this ability, therefore the patient and the doctor can choose the best options they have for the treatment, not only treatment but the doctor could make the patients more open up about the illness they have. Introduction Doctor and patient relationship is considered to be one of the crucial principles in medicine. The relationship between doctor and patient relies on good communication and interpersonal skills which will lead to a better understanding of a patient's health problems. These abilities help doctors to gather the right information to provide accurate diagnosis, the right treatment, and also show empathy to reach the best health outcomes and patients satisfaction, which are the key for effective delivery of healthcare. Good communication skills will sustain a successful therapeutic doctor-patient relationship, which facilitates exchange of information, perceptions, feelings, and helps to regulate patient's emotion. Interpersonal skills also allow appropriate consultation between doctors and patients, including a model of shared decision making and patient centered communication. Aim This poster is aimed to deliver the importance of good communication in doctor and patient relationships which leads us to a greater understanding of patient’s health problems and treatment available, thus positively influencing health outcomes and improves healthcare in the modern era. Brief Research Methodology This poster is based on The Ochsner Journal with the title “Doctor-Patient Communication: a Review”. Key Findings Good communication, healthcare, doctor, patient

487

in the modern era

good communication in healthcare

abstract

THE DOCTOR-PATIENT RELATIONSHIP IS THE HEART AND ART OF MEDICINE.

Doctor Doctor and and patient patient relationship relationship is is considered considered to to be be one one of of the the crucial crucial principles principles in in medicine. medicine. The The relationship relationship between between doctor doctor and and patient patient relies relies on on good good communication communication and and interpersonal interpersonal skills skills which which will will lead lead to to aa better better understanding understanding of of aa patient's patient's health health problems. problems. These These abilities abilities help help doctors doctors to to gather gather the the right right information information to to proprovide vide accurate accurate diagnosis, diagnosis, the the right right treatment, treatment, and and also also show show empathy empathy to to reach reach the the best best health health outcomes outcomes and and patients’ patients’ satisfaction, satisfaction, which which are are the the key key for for effective effective delivery delivery of of healthcare. healthcare.

THE QUALITY OF COMMUNICATION DEFINES THE EXCELLENCE OF HEALTH CARE. A GOOD RELATIONSHIP BETWEEN DOCTORS AND PATIENTS WILL GIVE A GOOD OUTCOME AND SATISFACTION FOR BOTH SIDES.

n o i t a : c i n o u t m y t i m l o i c ab

s ’ e r h t o t asses c o a d mp o c n e

Facilitate accurate diagnosis

“Medicine

is an art whose magic and creative ability have long been recognised as residing in the interpersonal aspects of the patient-physician relationship”

: t n m e e v r o imp o r f e i s t g e a Str Health Beliefs Conflict Management Communication Skills

Counsel appropriately Establish a caring relationship with patients

3 4

: s t i f e n be

Nondisclosure of Information

Resistance by Patients

Collaborative Communication

Have a successful therapeutic doctor patient relationship

Deterioration of Doctor’s Communication Skills

Doctor’s Avoidance Behaviour

Communication Training

: s l m e b r o p

Discouragement of Collaboration

Facilitating exchange of information (including patients in decision making) Creating a good interpersonal relationship Facilitate comprehension of medical information Help regulate patient’s emotions Allow for better identification of patients’ needs, perceptions, and expectations

The High Prevalence Level of Worm Infestation in School-Age Children Dwinnisa Ramadhanty Condrowibowo 1, Ratna Chintya Dewi 2, Widya Widati 3 AMSA-Hang Tuah University Background: Worm infestation is an infection that frequently occurs to school-age children. The worms that were transmitted through soil will affect the child’s nutritional status, causing anemia, loss of appetite, diarrhea, and decreased learning quality. The lack of knowledge and information about the dangers of worm infestation made many parents ignore the symptoms and effects of worm infestation. Objective: Educate and prevent worm infestation to parents and children. Methods: This research used the method of literature study in collecting, taking, and processing data from journals. Results: Approximately 1.5 billion people or 24% of the world’s population suffered from worm infestation and it usually infects school-age children. Indonesia has the worm infestation prevalence of 45%-65%. The species of worms that commonly infect are Ascaris lumbricoides, Trichuris trichiura, Necator americanus, and Ancylostoma duodenale. Worm infestation can happen if we consume contaminated vegetables and water, inhabiting in places with poor sanitation, not using footwear, and not washing our hands after doing activities in soil. Conclusion: The high prevalence level of worm infestation in school-age children is caused by the lack of knowledge in parents and children about worm infestation and its preventive efforts. Key Words: Word infestation, Prevalence, Children, Parents, Preventive

489

HEALTHY HEALTHY CHILDREN CHILDREN WITHOUT WITHOUT WORM WORM iNFECTIONS iNFECTIONS

" Approximately 1.5 billion people or 24% of the world's population suffered from worm infestation and it generally infects school-age children. "

Unprotect contact with soil

Uncooked beff

Vegetables that are not thoroughly washed

In Indonesia, worm infestation prevalence is around 45-46%, it can be considered as very high.

Itching in the area around the anus

The species of worms that commonly infect are Ascaris lumbricoides, Trichuris trichiura, Necator americanus and Ancylostoma duodenale.

Accidentally ingested worm eggs

60-80% of primary-school-age children have a very high risk of getting a worm infection, especially those in low socioeconomic population groups.

The worm infection lowers the intelligence potency of the children.

Decreased appetite

Stomach pain leading to diarrhea

Always wear footwear

Wash your hand with soap regularly

Belly bulgue

Cut nails regularly

Take worm medicine every 6 months

Wash vegetables and fruit thoroughly

1. World Health Organization (WHO). Intestinal Worms, Soil Transmitted Helminths. Geneva; 2015 2. Puteri P,P., Nuryanto, N. and Candra, A. (2019) 'Hubungan Kejadian Kecacingan Terhadap Anemia Dan Kemampuan Kognitif Pada Anak Sekolah Dasar Di Kelurahan Bandarharjo, Semarang', Journal of Nutrition College, 8(2), p. 101. doi: 10.14710/jnc. v8i2.23821

Success of Right Commmunication Ervin Widyantoro Pramono, Christin Kaiwai, Tasya Nadhiratul Husna AMSA – Universitas Kristen Krida Wacana Abstract Many patients face great difficulties in understanding health information and navigating the health care system. Nearly 2 decades of research have linked limited literacy with challenges in health care, including lower health knowledge, misinterpretation of prescriptions, and lower receipt of preventive services. Health literacy must be viewed in the context of language and culture. This important statement, however the relationships between diversity and health literacy have yet to be fully delineated and investigated. This poster have goals to understanding and discussing the interrelationship of literacy, culture, and language, and the importance of addressing their intersection when the health care system cares for diverse populations with method health literacy, cultural competence, and linguistic competence strategies to quality improvement were analyzed.

491

Appreciate DIVERSITY, It's Time to LEARN : A Creative Campaign Media to Raise Awareness and Improve Cultural Competence in Healthcare Euginia Junitha1, Matthew Guillaume1, Yova Nurelya Mayverissa Affandi Prajoko1 1

AMSA-Universitas Gadjah Mada

ABSTRACT Background: Cultural competency is the ability to communicate and interact with people from different cultural backgrounds, it plays an important role in changing the current status quo on medical disparities caused by cultural barriers. Globally, Hispanics, Blacks, and American Indians and Alaska Natives adults are inclined to receive none or delayed healthcare than Whites (Artiga, et al., 2020). In Indonesia, an example of ineffective cultural communication in healthcare is the handling of 13,000 nasopharyngeal carcinoma patients, who are mostly diagnosed at advanced stages of the disease (Fles et al., 2017). The cause of delay is limited knowledge and awareness regarding the disease. These issues arise resulting from environment, economic status, traditions, and religion playing a part in making healthcare decisions, meanwhile, health workers in Indonesia felt morally uncomfortable when caring for patients from different cultural backgrounds due to insufficient knowledge of other cultures and communication problems (Suza, 2019). Therefore, our poster entitled “Appreciate DIVERSITY, It’s Time to LEARN” serves as an eye-opening campaign to prevent the underlying issue by bringing attention to methods to improve cross-cultural interactions in healthcare. Objective: Our aim is to raise awareness and improve cross-cultural interactions between doctor-patient in order to reduce delayed treatment and health disparities. References Artiga, S., Orgera, K. and Pham, O., 2020. Disparities In Health And Health Care: Five Key Questions And Answers. [online] KFF. Available at:

https://www.kff.org/racial-equity-and-health-policy/issue-brief/disparities-in-health-and-health care-five-key-questions-and-answers/ [Accessed 14 October 2020]. Fles, R., Bos, A., Supriyati, Rachmawati, D., Waliyanti, E., Tan, I., Haryana, S., Schmidt, M. and Dewi, F., 2017. The role of Indonesian patients’ health behaviors in delaying the diagnosis of nasopharyngeal carcinoma. BMC Public Health, 17(1), p.510.

Suza, D., (2019). The Cultural Competency Scale for Clinical Pediatric Nurse (Ccs-Cpn) in Indonesia: Scale Development and Psychometric Evaluation. Jurnal Keperawatan Soedirman, 14(1), p.45.

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DIFFERENCES

Remember there are cultural and social diﬀerences in our community.

VALUES & MORALS Some medical practices are considered to be controversial and unethical.

ETHNICITY

Religious beliefs may aﬀect a person’s decisions on their health and treatment choice.

SOCIOECONOMIC FACTORS Includes a person's education, employment and income which may aﬀect healthcare quality received and awareness.

INTERCULTURAL LANGUAGE Language barriers may cause some miscommunication between healthcare workers and patients.

introduction.

Some diseases and conditions may be more prevalent to some ethnicities than others.

RELIGION

TRADITION

In some communities traditional therapeutic practices are still relied on instead of modern medical practices.

YOUTH

Healthcare and medicine has evolved overtime and people of various age have diﬀerent perceptions of healthcare practices.

I 2

The American Medical Association deﬁnes cultural competence as “The knowledge and interpersonal skills that allow providers to understand, appreciate, and work with individuals from cultures other than their own. It involves an awareness and acceptance of cultural diﬀerences, self-awareness, knowledge of a patient's culture, and adaptation of skills”. In the medical world, its importance shouldn't be left unnoticed as it is an essential skill for improving doctor-patient communication and collaboration, increasing patient satisfaction, and enhancing patient adherence to improve clinical outcomes as well as reducing health disparities.

Listen with empathy and understanding to the patient’s perception of the situation.

19% 24% 25% 19% 36% 26%

White Black Hispanic Asian Native Polynesian American Percentage of adults not recieving or delayed care in 2018 (Artiga, et al., 2020)

Elicit culturally relevant information and explain your perception of the situation. Acknowledge the similarities and diﬀerences between your perception and theirs.

Javanese

40.1%

Demographics of Indonesian Ethnicities (2010)

Recommend treatment options or alternatives, and respect the person and their choices. Negotiate agreement.

Sundanese 15.5%

Malay 3.7%

Batak Other 30.2%

3.6%

Betawi

2.9%

Madurese 3.0%

ISSUES IN

INDONESIA

13,000 Indonesians get a late diagnosis of nasopharyngeal carcinoma (NPC) due to limited knowledge and awareness regarding the disease. (Fles et al., 2017)

Studies show nurses in Indonesia have insuﬃcient knowledge and communication problems when caring for patients from diﬀerent cultural backgrounds. (Suza, 2019)

PREVENT CYBERCHONDRIA WITH ABCD Authors : 1. Evane Jovanie Zeeva

(AMSA-Universitas Hang Tuah)

2. Aditya Mahardika Wahono

(AMSA-Universitas Hang Tuah)

3. Nabilah Ayuriestha Wibowo

(AMSA-Universitas Hang Tuah)

4. Monicha Zalzabilla Aldinasyah

(AMSA-Universitas Hang Tuah)

Background/Introduction Nowadays, in the revolutionized digital era, people tend to depend on the internet for everything. The internet provides information, whether it is about news, communications, and even medical advice. In estimation, around 70% of American adults rely on the internet to get medical information. For some people, that acquired information can lead to a better understanding of their condition. However, for others, this kind of knowledge can increase their health-related anxiety to unwarranted levels. This condition is called Cyberchondria. It is the state when exacerbated anxiety regarding one health caused by visiting too many health and medical websites. It concerns many doctors because more people prefer self-diagnose rather than a consultation with a health professional. Most of the time, the information is not accurate and may drive them to jump into catastrophic conclusions. Once this healthrelated stress grows worse, it is advisable to get help from a psychologist or psychiatrist. Objectives Cyberchondria can affect everyone without discrimination, and could cause low quality of life, and other psychological effects, therefore we make this poster in hope to raise the awareness of and prevent cyberchondria especially in this era, where internet and informations are easily accessed.

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TITLE : Between Life and Death : Aid the AIDS AUTHOR : Fresya Tamara Nilamsari Kasilda Pasha Devanda Khofifah Bela Rachmanu Hayati Sherina Ayu Pitaloka From AMSA-Universitas Hang Tuah Dealing with AIDS patients, end-of-life discussion is important to improve the quality of life of the people living with the disease. AIDS patients have a high burden of physical, psychological, and social difficulties that often becomes more complicated with different discrimination and stigma surrounding the patient. Until this day, not only for patients but also physicians, breaking bad news is still a nightmare. Fear that they might cause distress is often the problem, this can be difficult to handle if endof-life discussion is not delivered properly. It is very essential that pyhsicians offer the right exposure towards this topic for the patients facing life-threatening illness and those close to them. Palliative care is an approach that improves quality of life of patients and their families facing the problems associated with life-threatening illness. Unfortunately, up until now not many Indonesian health care workers truly understand the implementation despite understanding the basic concept of palliative care. This leads to slow progress of improvement and distribution across the country. Major works still needs to be done in order to build capacity, advocate to stakeholders, and to create care models that provide services in the community and increase the palliative care workforce. Keywords : AIDS, palliative care, health care workers

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Communication in Clinical Settings : Problems, Challenges, and Solutions Gabriella Belinda, Teresa Jovita Handoko, Audelia Kathleen Sulaiman Undergraduate Medical Program, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia

ABSTRACT

Introduction: Communication in clinical settings consists of communication between physicians and their patients, physicians and other physicians, physicians and nurses, and between hospitals and other hospitals. It has become an important issue due to its arising problems. The Risk Management Foundation of the Harvard Medical Institutions found 38% from general medicine cases, 4% from obstetrics cases, 32% from nursing cases, and 26% from surgery cases are involved in a communication failure. Approximately 7,000 cases of malpractices were communication failures, either among medical staff or between medical staff and patients, resulting in harmed patients. Barriers might be found in few of the difficulties in communicating, such as languages, culture, education, and also religion. Poor communication also leads to poor teamwork between medical personnel. Research groups began to evaluate the claim that poor communication could lead to hostility and mutual distrust between and eventually resulting in ineffectiveness of treatment that patients received. Through this, we are hoping to improve the quality of communication in clinical settings.

Objectives: 1. Raise awareness of the importance of communication in clinical settings 2. Provides an overview of the challenges in communication at clinical settings 3. Provides a solutions of the challenges in communication at clinical settings

References: 1. McCabe R, Healey P. Miscommunication in Doctor-Patient Communication. Topics in Cognitive Science. 2018;10(2):409-424. 2. Kern C. Healthcare Miscommunication Costs 2,000 Lives And $1.7 Billion [Internet]. Healthitoutcomes.com.

2016

[cited

October

2020].

Available

from:

https://www.healthitoutcomes.com/doc/healthcare-miscommunication-costs-lives-and-billion0001 3. Malpractice Risks in Communication Failures: 2015 Annual Benchmarking Report [Internet]. CRICO

Strategies.

2016

[cited

October

2020].

Available

https://psnet.ahrq.gov/issue/malpractice-risks-communication-failures-2015-annualbenchmarking-report

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Illeteracy Authors : Gilbert Sahata Sirait (AMSA UNJA) M. Kholis Dzaky (AMSA UNJA) Nabila Azkafillah (AMSA UNJA) Aulianisa Oktavia (AMSA UNJA) Illiteracy is someone who cannot read, write, and cannot take advantage of these abilities in daily life . The immediate cause is the low levels of enrollment and retention at the primary level. Primary education provides the most opporune time to teach children to read and write. Over 50 percent of sdceduled time in prmary schools is dedicated to language skills and math which form the basis for more diversified learning and higher order thinking later on . The factors that cause illiteracy (Indonesia):  Population poverty is the inability of a person to meet their daily needs  Dropping out of elementary school (SD).  Drop out of the PLS program.  The social conditions of the community  Structural causes Solution of Illiteracy (from government)   

reduce the number of children not in school. Creating new ways in the learning process. The need for the interaction of various parties in the effort to accelerate the eradication of illiteracy. Solution of Illiteracy (from medical facility) 

Instructions for management in health facilities using easy pictures.

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Utter and Spell with Love : A Guide to Communicate with Dementia Patients

A. Authors and AMSA-university : 1. Hepyta Valerie - AMSA UNIKA Atma Jaya 2. Dewi Lastri Yuliyana - AMSA UNIKA Atma Jaya 3. Charens - AMSA UNIKA Atma Jaya B. Background For every 3 seconds worldwide, one person develops dementia - with the number of new cases escalating by 10 million per annum. Dementia itself is a set of symptoms that includes memory, learning, understanding and communication difficulties, as well as disorientation in time and space, and behavioural changes. In Indonesia, it was approximated that there were 1.2 million dementia patients in 2016, by which it will increase to 2 million in 2030. This number will yet to double 20 years later - making Indonesia the sixth out of nine countries in Asia with the highest dementia prevalence. Alas, there is currently no cure for dementia, hence the progression will surely affect patients’ quality of life. Therefore it is important to emphasize the effectiveness of communication towards dementia patients so as to improve it, because having the difficulty to express their thoughts and comprehending others will cause not only stress, frustration and even depression to themselves but also to their caregivers. C. Objectives To broaden our knowledge on how to communicate with dementia patients thus being aware of the need to practice communicating in advance.

Key Findings Dementia care, communication

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REFERENCES : 1. Statistik tentang Demensia - Alzheimer Indonesia [Internet]. Alzi.or.id. 2019. Available from: https://alzi.or.id/statistik-tentang-demensia/ 2. Dementia [Internet]. Who.int. 2020. Available from: https://www.who.int/news-room/factsheets/detail/dementia 3. Tsarbopoulos A. Round Table Discussion on Treatment Prospects for Alzheimers Disease and Dementia. International Journal of Mental Health & Psychiatry [Internet]. 2018;04. Available from: https://www.scitechnol.com/conference-abstracts-files/2471-4372-C3-014-006.pdf 4. Banovic S, Zunic L, Sinanovic O. Communication Difficulties as a Result of Dementia [Internet]. pubmed.ncbi.nlm.nih.gov. 2018. Available from: https://pubmed.ncbi.nlm.nih.gov/30515063/ 5. Merawat Seorang Penderita Demensia [Internet]. Dementia.org.au. 2016. Available from: https://www.dementia.org.au/sites/default/files/helpsheets/Helpsheet-CaringForSomeone01Communication_indonesian.pdf

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The Role of Telehealth in Communication Between Doctors and Mental Disorder Patients During the Covid-19 Pandemic I Wayan Alit Yastika, Sagung Ngurah Anindita Pradnya Dewi, Ayesha Khayana Syarif, Ibrahim Fuadizidane Asian Medical Students’ Association Trisakti University, Jakarta, Indonesia Abstract : Mental disorder is an important problem in Indonesia during the Covid-19 pandemic, in 2018, as many as 9.8% of the population suffered from it, and is increasing every year. During the pandemic, 69% the patients from psychiatric present complaints with depression (50.7%), anxiety (44.7%), insomnia (36.1%), stress symptoms (73.4%), and PTSS (7%). Previously, the number of mental disorder patients who have completed the treatment until recovery with face to face method was 35%, however, due to this pandemic situation from January until May, there was a decrease in the number of doctor-patient visits by 43.7%, which will directly affect the patient's completeness of treatment. One of the solution is using telehealth, when compared to the number of telehealth users who have completed their treatment; there are 11.8% more than the face to face method. Anyhow there are many pros and cons, for patients, 56% proves that telehealth provides more effective time and satisfaction after consultation is more than 89%, but from 64% only 14% of internet users have used telehealth. From the doctor's point of view, handling emergency cases is 68% faster and services in the emergency room are 46% more effective, but only 14% of doctors provide telehealth and 38% of medical error. Regardless the pros and cons of telehealth method it can be the solution of the communication problems for mental disorder patients during the pandemic. Currently the Indonesian government is also continuing to develop a spectrum of telehealth services which is expected to increase 14.44% by 2025. Key findings : Telehealth, mental disorder, pandemic covid-19. References : 1. Khoiriyah R, Handayani S. Kesehatan Mental Emosional Perempuan Penderita Kanker Di Indonesia. Jurnal Kesehatan Masyarakat Maritim. 2020;3(2):1-10. ISSN: 2599-1167 2. Windarwati HD, Oktaviana W, Mukarromah I, Ati NAL, Rizzal AF, Sulaksono AD. In the middle of the COVID-19 outbreak: Early practical guidelines for psychosocial aspects of COVID-19 in East Java, Indonesia [published online ahead of print, 2020 Aug 18]. Psychiatry Res. 2020;293:113-395. doi:10.1016/j.psychres.2020.113395

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3. Ricou M, Marina S, Vieira PM, et al. Psychological intervention at a primary health care center: predictors of success. BMC Fam Pract. 2019;20(1):116. Published 2019 Aug 17. doi:10.1186/s12875019-1005-9 4. Mohr DC, Ho J, Duffecy J, et al. Effect of telephone-administered vs face-to-face cognitive behavioral therapy on adherence to therapy and depression outcomes among primary care patients: a randomized trial. JAMA. 2012;307(21):2278-85. doi:10.1001/jama.2012.5588 5. Shujing S, Susan FL, Huaxia R. Does telemedicine reduce emergency room congestion? Evidence from New York State. ReaserchGate. 2019;1;1-34. DOI: 10.13140/RG.2.2.16242.66243 6. Kusumawati D, Suryanegara M. Spectrum requirement for IoT health sector in Indonesia ISTT Kuala Lumpur. 2016;3:1-5. DOI: 10.1109/ISTT.2016.7918096 7. Atmojo JT, Sudaryanto WT, Widiyanto A, Ernawati, Arradini D. Telemedicine, Cost Effectiveness, and

Patients

Satisfaction:

Systematic

Review.

JHPM.

2020;5(2):103-7.

https://doi.org/10.26911/thejhpm.2020.05.02.02 8. https://www2.deloitte.com/content/dam/Deloitte/id/Documents/public-sector/id-gps-ehealthpublication-Indonesia.pdf (Access : 17 October 2020) 9. PDSKJI (Perhimpunan Dokter Spesialis Kesehatan Jiwa Indonesia) Swaperiksa Web PDSKJI per tanggal 14 Mei 2020 http://pdskji.org/home (Access : 17 October 2020) 10. https://datareportal.com/reports/digital-2020-indonesia (Access : 17 October 2020) 11. http://www.idionline.org/statistik/ (Access : 17 October 2020) 12. https://www.halodoc.com/artikel (Access : 17 October 2020) 13. https://kesehatan.jogjakota.go.id/berita/id/194/tren-kunjungan-puskesmas-kota-yogyakarta-di-masapandemi-covid-19-/ (Access : 18 october 2020)

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The Danger of Vaping Misinformation Indrawati1, Stefanie Belinda2, Kezia Rachel Priscilla3, Josephine Passaretta Riduvan FN4 AMSA-Universitas Hang Tuah Nowadays, vape is becoming a preferred alternative for nicotine delivery with approximately 16.5 million teen vape users worldwide. Famously introduced and marketed as the “healthier alternative” to conventional cigarettes, data claim that there have been a total of 2,807 hospitalization and death cases from vaping as of February 2020 in only two US territories. The main problem here is advertising campaigns unjustifiably focus on adolescents aged 15 to 17, which is 16 times more likely to vape than those in their 20s. Advertisements also claim that vape is safe and the marketing trend may expand the usage and contribute to re-glamorizing smoking. Vape contains variable amounts of nicotine and other toxins such as glycols that have harmful neurological, neuromuscular, cardiovascular, respiratory, immunological and gastrointestinal effects on one’s health. By applying SMS: Send health messages as daily reminders, Manage regulation on vape commercial and usage, as well as Setup school curriculum for vape awareness, we can prevent the increase of vape smokers and misinformation related to vape myths in the society. Keywords: Vape, teenagers, misinformation ads

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STAYING SANE IN THIS PANDEMIC Jeane Kinanti Tandung; Irene Jessica Leonardy; Elvira Horisanto; Ennia Yuniarti Br Bancin Hasanuddin University, Makassar, South Sulawesi. ABSTRACT Background: According to WHO on October 5th, 2020, 93% of 130 countries surveyed has disrupted mental health services due to the pandemic, although 89% of the countries reported that mental health is a part of their response plan. Fear of infection , accused for having the disease, racial-related accusations, and losing jobs has resulted to mental health concerns which are worsen by the absence of mental health services due to the pandemic. This is where adequate communication takes place as a personal intervention to maintain self-mental health. Communication is not only done from one party, but a twoway teamwork. One cannot control the media communications but one can choose to block communication to a second party. One can maintain its mental health by minimizing exposure to news about Covid-19 to prevent anxiety, narrowing news consumption to trusted platforms, present to listen and being supportive to one another, and being productively busy to ease one’s mind. Start from a personal communication to the whole population’s mental health. Objective: Through our public poster we want to convey communication into a personal intervention, we cannot control the media but we can overcome mental health issues by choosing the right communication during pandemic.

Refere rences: 1. WHO. (2020). Coronavirus disease 2019 (COVID-19) Situation Report – 94 (p. 12) 2. Ifdil, I., Fadli, R. P., Suranata, K., Zola, N., & Ardi, Z. (2020). Online mental health services in Indonesia during the COVID-19 outbreak. Asian journal of psychiatry, 51, 102153. https:// doi.org/10.1016/j.ajp.2020.102153 3. Gunawan, J. (2020). Current Mental Health Issues in the Era of Covid-19. Asian Journal Of Psychiatry, 51(102103), 1. Retrieved 13 October 2020.

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STAYING SANE IN

THIS PANDEMIC

Adequate communication starts with you. In this uncertain condition, in this pandemic, we should fight mental issues by controlling our communication, from what we see, hear, say and do.

MINIMIZE EXPOSURE TO NEWS ABOUT COVID-19 TO PREVENT ANXIETY. ̑

LISTENING IS ALSO COMMUNICATING. BE SUPPORTIVE TO OTHERS.

+ +

AMPLIFY POSITIVITY

According to the WHO, over 60% mental health services are reported disrupted and 70% have adopted telemedicine, although 89% of the countries reported in a survey that mental health is a part of their response plans. People respond the pandemic with fear, worry and stress. Communication is necessary to maintain our mental health.

60%

mental health service of fragile populations are disrupted.

30%

limited access to mental health medications.

75%

disrupted mental health services at school & offices

35%

disrupted emergency mental health services including delirium.

67%

disrupted counseling and psychotherapy services.

MENTAL STRUGGLES DURING THE PANDEMIC

fear of getting infected

fear others to misinterpret symptoms

fear of losing jobs

pandemic fear of racial-related hospitalcomments acquired infection

+ FIND PRODUCTIVE ACTIVITIES KEEP YOURSELF BUSY TO HELP EASE YOUR MIND!

HONOUR THE HEALTHCARE WORKERS!

ACKNOWLEDGE THEIR ROLES IN SAVING LIVES.

GET THE FACTS. ACKNOWLEDGE TRUSTED PLATFORMS. LET'S STOP RUMOURS AND MISINFORMATION!

CONSUME POSITIVITY THERE IS STILL HOPE!

+ +

TUBERCULOSIS 101: SPREADING AWARENESS THROUGH PROPER COMMUNICATION ABOUT TB

Author: Jonathan Juniard Anurantha Juneca Prettycia Dharsono Putu Jason Christian Chendana

School of Medicine and Health Science University of Pelita Harapan Asian Medical Students’ Association 2020

513

Abstract Introduction Lately with the rapid spread of COVID-19, people start to realize the danger of respiratory disease. In this pandemic era, the government and people in general take Covid-19 very seriously. But on the other hand there is one respiratory disease that has been overlooked by people till now, which is TB. Tuberculosis is one of the top 10 causes of death worldwide, with 1.4 million deaths from TB in 2019. TB also affected ⅓ population of the world, and incidence of 2% per year. This disease is actually more serious compared to Covid-19, but unfortunately, people’s awareness about TB are still low, especially in developing countries, like Indonesia. Objective Our objectives are to raise the awareness of TB and also to educate people about the cause, risk factor, and how to prevent the spread of Tuberculosis.

References : 1. Tuberculosis (TB) [Internet]. Who.int. 2020. Available from: https://www.who.int/news-room/fact-sheets/detail/tuberculosis 2. Mirali S, Seneviratne A, Dhir P, Genis H, Kerr M. Toronto Notes 2020. 36th ed. TORONTO: TYPE & GRAPHICS INC; 2019.

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PASUNG DISCRIMINATION: BREAK THE CHAIN Kellyn Trycia Zenjaya, Evelyn, Santika Danubrata AMSA - University of Hang Tuah, Surabaya Background: Mental health is one of the fundamental components of health. It involves the psychological well-being of a person. However, recognition of mental health and its importance is often limited due to its stigma, discrimination and society’s lack of understatement. Lack of communication and education to society may cause the growth of these factors, which are significant barriers to seeking help and giving people with mental disorder treatment they deserve. In Indonesia, people with mental disorders are considered taboo, especially if their mental disorders are severe. They are often considered a humiliation and a liability to their family. Therefore, people with mental illnesses are facing prejudice from society and their own families. One kind of discrimination resulting from stigma toward people with a mental disorder is the practice of pasung. Increasing understanding and overcoming stigma through communications are crucial steps towards eradicating the practice of pasung in Indonesia. Objective: The aim of this poster is to highlight the importance of communication and education to reduce stigma surrounding mental illness and the practice of pasung.

516

Telehealth in the Pandemic: Indonesia Kezia Adelize Aurelia Junus (AMSA-Unika Atma Jaya)

As of October 20th 2020, Indonesia has the highest number of COVID-19 cases in Southeast Asia, with 365,240 confirmed cases. Worldwide, numbers has reached more than 40 million cases.1 Thus, the use of telemedicine has been significantly increased to provide healthcare access for people with minimal risk of COVID-19 transmission.2,3 Telehealth use has been significantly increased during the pandemic, with percentage increases reaching 600 to 700 percent in Indonesian telehealth applications.4,5 With Indonesia being the 6th highest number of smartphone users6, and its predicted 3rd biggest smartphone market by 20257, telehealth has big opportunities to be widely implemented in this country. Telehealth has many benefit in this pandemic, however there are still factors hindering its use, one of them is the lower percentage of internet access in rural as compared to urban areas.8 This public infographic poster is aimed to raise the awareness of people from many backgrounds about how telehealth could benefit Indonesia during the pandemic, as well as its limitations.

Sources: 1. WHO [Internet]. WHO; 2020. WHO Coronavirus Disease (COVID-19) Dashboard; 2020 Oct 20 [cited 2020 Oct 20]. Available from: https://covid19.who.int/table. 2. Fisk M, Livingstone A, Pit SW. Telehealth in the Context of COVID-19: Changing Perspectives in Australia, the United Kingdom, and the United States. J Med Internet Res. [Internet]. 2020 Jun 9 [cited 2020 Oct 20]; 22(6): e19264. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7286230/. 3. Wosik J, et al. Telehealth transformation: COVID-19 and the rise of virtual care. Journal of the American Medical Informatics Association [Internet]. 2020 May 17 [accessed 2020 Oct 20] 27(6), 957–962. Available from: https://academic.oup.com/jamia/article/27/6/957/5822868. 4. CNBC Indonesia [Internet]. Gegara Corona, Bisnis Halodoc Tumbuh 600% dalam Dua Bulan; 2020

Jun

[cited

2020

Oct

20].

Available

from:

https://www.cnbcindonesia.com/tech/20200608153553-37-163900/gegara-corona-bisnishalodoc-tumbuh-600-dalam-dua-bulan. 5. CNBC Indonesia [Internet]. Ada Pandemi, Layanan Telekonsultasi Good Doctor Naik 700%; 2020

Jun

[cited

2020

Oct

20].

Available

from:

https://www.cnbcindonesia.com/tech/20200617131027-39-166013/ada-pandemi-layanantelekonsultasi-good-doctor-naik-700.

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6. Newzoo [Internet]. Global Mobile Market Report 2019 [cited 2020 Oct 20]. Available from: https://resources.newzoo.com/hubfs/Reports/2019_Free_Global_Mobile_Market_Report.pdf? utm_campaign=Mobile%20Report%20Launch%202019&utm_medium=email&_hsmi=7692 6953&_hsenc=p2ANqtz-9mCirHUlRskjMXP8an7NO2VVyvsXMSzBbAKoUBmak3Tnh2PyZGKP2RkliWQupiBMMnJR0876rf3yTmojRZ7dzqZkAg&utm_content=76926953&utm_source=hs_aut omation. 7. GSM Association [Internet]. The Mobile Economy Asia Pacific 2020 [cited 2020 Oct 20]. Available

from:

https://www.gsma.com/mobileeconomy/wp-

content/uploads/2020/06/GSMA_MobileEconomy_2020_AsiaPacific.pdf. 8. Indonesian Internet Service Provider Association (AJPII) [Internet]. Penetrasi dan Profil Perilaku Pengguna Internet Indonesia, Survei 2018. Available from: https://apjii.or.id/survei.

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TELEHEALTH IN THE PANDEMIC: INDONESIA INDONESIA has the HIGHEST number of COVID-19 cases in Southeast Asia.*

Pros and Cons of Telehealth

40,114,293 (global) 365,240 (Indonesia)

Healthcare access for rural areas

Time limited online consultations

Health knowledge improvement

Reluctance for sharing personal data online

Mental health support

Technology and internet access requirements

Physical contact reduction

Not as comfortable as face-to-face communication

INDONESIA’S SMARTPHONE USE is 6th highest worldwide, Predicted in 2025 to be 3rd biggest market worldwide

*Data updated on Oct 20, 2020 (WHO)

TELEHEALTH is HEALTHCARE AT-A-DISTANCE using TELECOMMUNICATION technologies.

TELEHEALTH APPS in Indonesia are growing rapidly in the pandemic. (June 2020)

+600% (Halodoc) to

+700%

(Good Doctor)

HOWEVER,

INTERNET USE

in Indonesia is HIGHER IN URBAN than in RURAL areas.

74.2% INTERNET USE

URBAN Tracing and support people with COVID-19

No physical exam performed

61.6% INTERNET USE

RURAL

Sources: 1. WHO COVID-19 Dashboard (2020). 2. American Academy of Family Physicians (AAFP, 2020). 3. CNBC Indonesia (June 2020). 4. Journal of Medical Internet Research (June 2020). 5. Journal of the American Medical Informatics Association (May 2020). 6. Newzoo’s Global Market Report (2019). 7. The Mobile Economy Asia Pacific (2020). 8. Indonesia Internet Service Provider Association (APJII) Survey (2018).

ANTIBIOTICS 101 : Prevent Antibiotics Resistance, Consumed It WISELY 1

La Ode Naufal Arrouf Syahnasti 2Siska Nur Anggraeni 3Muhammad Dipo Muharam 4Lilyana Aritonia Ahmad Asian Medical Students’ Association Halu Oleo University

Background Indonesia is one of the country that located in Southeast Asia. Like many others country in the equator, Indonesia is a convenient place for a number of microorganisms to grow and develop. This facts cause the level of microorganism infections in tropical countries quite high, and one of them is bacterial infection. As the variety of bacterial microorganisms increases, experts are flocking to innovate to determine the specifically and clinically proven antibiotics to fight the pathogenesis of these bacterial infections. Unfortunately, the lack of education, information, and communication between the patient and the health provider regarding the use of these antibiotics becomes very fatal, which lead to the emergence of antibiotics resistance. Antibiotic resistance happened due to the consumption of antibiotics which didn’t based on the indication of usage, so the bacteria can adapt to the response of the antibiotics that have been consumed. Based on data by World Health Organization (WHO) in 2014, there were 700 thousands deaths due to antibiotic resistance. WHO also estimates that in 2050, around 10 millions death will occur due to antibiotic resistance, and the majority wil occur in Asia and Africa.

Objective The purpose of this poster is to provide education and information to the public regarding the urgency of antibiotic resistance so the people need to implement the antibiotic consumption “WISELY”

Keywords : Resistance, Antibiotics, Infection

521

ANTIBIOTIC 101 !!!

Prevent Antibiotics Resistance Consumed it

WISELY

INTRODUCTION

0-5.9 6-11.9 12-29.9

ANTIBIOTIC Resistance is a FATAL effect of using antibiotics WITHOUT considering the INDICATION . The bacteria will adapt with the antibiotics so the effectiveness might decrease

30-49.9 >50 No Data No Applicate

Scan for more info !!

Deaths happened due to of Cases Antibiotic Resistance.

I When it prescribed by health provider

Identify the indication before use the antibiotics

Stay away if the doctor said you don't need them

Educate yourself that Antibiotics is only for bacterial infection

Long term use and excess dose is forbidden

Yeah, You should consumed it "WISELY"

Abstract Telemedicine: Access to Health Care During COVID-19 Pandemic in Indonesia By : Janezca Emanuella Johanes, Lavenia Pangestu, Renalta Yunita from AMSA-Universitas Katolik Atma Jaya

Introduction : Communication relationships between health workers and patients are highly important. Patients' perceptions of the quality of healthcare based on the treatment they received and also the quality of their interactions with their healthcare clinician and team. Meanwhile in Indonesia, telemedicine development is being held by limited infrastructure and inadequate information technology services.1 During COVID-19 pandemic, there are limitations for people who want to get healthcare services. The public has an urgent need for accurate health information. Some of them are experiencing information overload about the virus, but still struggling to find information for their questions and needs.2 There are uncertainties about health informations in social media, which may lead to misinformation as it can undermine public trust in health experts and the effectiveness of action.2 However, social media platforms can provide valid information to the public and the effectiveness of communication. Based on these situations, our team make this poster to provide more information about telemedicine and its impact in health communication.

Objective : 1. Increase public awareness about the importance of maintaining health 2. Improve the quality of community services, especially in terms of health communication 3. Promote effective communication between doctors and patients during pandemic.

References : (1) Jamil M, Khairan A, Fuad A. Implementasi Aplikasi Telemedicine Berbasis Jejaring Sosial dengan Pemanfaatan Teknologi Cloud Computing. Jurnal Edukasi dan Penelitian Informatika (JEPIN) [Internet].

2015

[cited

October

2020];1(1).

Available

from:

https://www.researchgate.net/publication/318962637_Implementasi_Aplikasi_Telemedicine_Ber basis_Jejaring_Sosial_dengan_Pemanfaatan_Teknologi_Cloud_Computing (2) Vraga E, Jacobsen K. Strategies for Effective Health Communication during the Coronavirus Pandemic and Future Emerging Infectious Disease Events. World Medical & Health Policy [Internet].

2020

[cited

October

2020];12(3):233-241.

https://onlinelibrary.wiley.com/doi/10.1002/wmh3.359

523

Available

from:

Telemedicine: Access to Health Care During Covid-19 Pandemic in Indonesia Survey results from Deloitte Indonesia (2019) can access anytime because there are many platforms available, such as Halodoc and Alodokter

keeping COVID-19 away, because there's no direct contact

How telemedicine can help patients

There ar e people w still as many as 61.2% of ho choo se no applicati ons beca t to use health use they trust th do not em. Esp ecially r persona egardin l data, th g diagnos is, and m e sharpness of iscomm unicatio n.

easier health promoting

Online consultation. Communication becomes more free with no limited access

sparing money and cheaper expense

Problems that appear in telemedicine usage

More comfortable

limited information, which can lead to misjudgment Survey results from Association of Internet Service Providers in Indonesia (2017) - for public health application users

Limited access, especially in remoted area

doctor's diagnosis may not be as sharp as examining in person

Many people still prefer face to face consultations

THE 4 ELEMENT TO ACHIEVE MEDICAL ADHERENCE Maria Dyota Bagus Kusumaningrum; Majesty Patu Buana; Ratu Basyasyah Cianora; Revina Raissa Gunawan AMSA-Hasanuddin University, Makassar, South Sulawesi

ABSTRACT Background: Medication adherence is defined as the extent of patient behavior in obeying the medical direction prescribed by the care provider. It is reported 25% of Americans don’t follow their doctor's advice. As a consequence of non-adherence, many patients have worsened the disease, increase healthcare costs, and even death. Most of non-adherence is caused by the patient's inability to understand the medication instructions. Therefore, effective communication is needed when providing health services. The goals of effective communication to achieve the success of diagnosis and medical action for the patient’s recovery.

Objective: the aim of this poster to inform the healthcare provider how to make effective communication with the patient in order to increase the number of medical adherence

Solution: In the application of effective communication, we suggest four important elements to enhance patient adherence and satisfaction, include : 1) Listen and contention. Let the patients talk and listen to them carefully. Besides, don't limit the time spent on them. 2) Be emphatic and respectful By asking their opinion about the therapy 3) Welcoming attitude Smile, show good gesture, and aware of the patient’s body language 4) Communicate clearly Try to explain the detailed information understandably.

Keyword: effective communication, medical adherence

References: 1. Adherence Section Publication. World Health Organization. (2003), https://www.who.int/chp/knowledge/publications/adherence_Section1.pdf 2. Chisholm-Burns, M. A. and Spivey, C. A. (2012) “The ‘cost’ of medication nonadherence: Consequences we cannot afford to accept,” Journal of the American Pharmacists Association, 52(6), pp. 823–826. doi: 10.1331/JAPhA.2012.11088.

525

3. Impact of Communication in Healthcare | Institute for Healthcare Communication. (n.d.). Retrieved October 17, 2020, https://healthcarecomm.org/about-us/impact-ofcommunication-in-healthcare/

526

the

Adherence Adherence is is defined defined as as the the extent extent of of patient patient behavior behavior in in

element to achieve medical ADHERENCE

obeying obeying medical medical instruction instruction or or direction direction prescribed prescribed by by the the care care provider. provider. Certainly, Certainly, we we are are all all aware aware of of the the huge huge problem problem of of non-adherence non-adherence in in public public healthcare. healthcare.

worsen the disease

Failed

Non-

death

adherence

therapy Welcoming Welcoming the increase

attitude (smile, (smile, attitude

in health care cost

good gesture gesture good Listen and and Listen

and eye eye and

contention (focus (focus contention

contact). contact).

Reasons patients didn’t follow their doctor’s advice :

and don't don't and

interrupt). interrupt).

PEOPLE IN SOUTH TANGERANG disagreed with

were concerned

Be empathetic empathetic Be

HAVEN'T

what the clinician

about the cost

wanted to do

and and

OBEYED H E A L T H T H E

P R O T O C O L

C O V I D - 1 9

D U R I N G

P A N D E M I C .

A R O U N D found the instructions too difficult to follow

4 3 6 . 9 7 6 L I V E S

Source :: Source

respectful. respectful.

Communicate Communicate clearly. clearly.

ABSTRACT Stress During Pandemic? The answer is “EXACTLY” Alicia Gani, Christyara Karyadi, Michelle Anggawijaya, Venna Bella Sabatina AMSA-UAJ Stress is not an illness, but can cause an illness.1 Stress is the feeling that arises when we’re under too much pressure. When we encounter stress, our body is stimulated to produce stress hormones that trigger a “flight or fight” response. This response helps us to respond quickly to dangerous situations. So, actually stress is not always a bad thing. For stress response that happens in a short time, it won’t give a negative impact, but if stress persist for a long time, it leads to chronic stress which has a negative impact to our life.2 In this COVID-19 pandemic, it is very possible for us to feel stressed. Study conducted by Nasrullah et al. from Indonesia show that 53.9% of respondents suffered from stress in this pandemic.3 Before stress gives a negative impact and ruins our life, recognizing and managing stress needs to be done. One of the crucial things in managing stress is communication, not only because communication is an inexpensive way and but also it’s very applicable way for managing stress during pandemic.4 Objectives : 1. To raise awareness about stress and the importance of managing stress.

2.To emphasize population more about communication in managing stress.

Reference 1. 10 stress busters [Internet]. nhs.uk. 2020. Available from: https://www.nhs.uk/conditions/stressanxiety-depression/reduce-stress/ 2. Stress [Internet]. Mental Health Foundation. 2020. Available from: https://www.mentalhealth.org.uk/a-to-z/s/stress 3. Data Riset dan Teknologi Covid-19 Indonesia [Internet]. Sinta.ristekbrin.go.id. 2020. Available from: http://sinta.ristekbrin.go.id/covid/penelitian/detail/146 4. Developing resilience [Internet]. Mind.org.uk. 2020 [cited October 2020]. Available from: https://www.mind.org.uk/information-support/types-of-mental-healthproblems/stress/developing-resilience/

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Stress During Pandemic? The Answer IS "EXACTLY"

is stress an illness?

No, it's a normal response in our body, but if stress persist for a long time, it can cause an illness.

When Does stress becomes an illness? Data sh ows tha t 53.9% of Indon esian re sponden sufferd t from str ess during t he pand emic. (Nasrull ah et al. , 2020)

Stress becomes an illness when an individual starts to avoid the problems at hand. They can also find it difficult to make decisions, experience uncontrollable fear, anxiety, loneliness and fatigue.

Symptoms of stress

Headache

Low Energy

Acid Reflux

EXpress your feeling When you feel stress, try to bluntly share your feelings to prevent any misunderstanding that might occur.

Ask for help

Any advice about your problems from others can give you a new perspective to solve it.

Stay Connected

By reaching out to your friends or family it could help you feel less lonely and it also can increase your mood.

Tell Your story

Insomnia

Share your stories or problems with your trusted friends or healthcare professional. By pouring out your feelings can decrease your stress level.

Effective Communications for Cancer Patients : The Heart of the Art of Medicine AMSA-Universitas Pelita Harapan Muhammad Alvin Firdaus, Marlyn Suciningtias, Sabrina Agatha Jean Aswan, Audrey Hadisurya Aim : To raise awareness about the importance of practicing communication in an era that forces us to always be ready to face various challenges. Background / Objectives : Communication is the most difficult part of dealing with cancer patients. Effective communication is known to have multiple benefits such as obtaining information for correct diagnosis, providing information on appropriate therapy and advice, and building good relationships with patients. Effective communication is as important as medical intervention in increasing the success of therapy. When this is achieved, the relationship between the patient and the doctor can be said to be successful. Research Method : We conducted a comprehensive study using literature sources and journals discussing the importance of communication in medical practice. Key Findings : Effective, communications, cancer patients, healthcare 123456

References : 1.

Koul PA. Effective communication, the heart of the art of medicine. Lung India. 2017.

Vermeir P, Vandijck D, Degroote S, Peleman R, Verhaeghe R, Mortier E, et al. Communication in healthcare: A narrative review of the literature and practical recommendations. International Journal of Clinical Practice. 2015.

Hilaire DM. The need for communication skills training in oncology. J Adv Pract Oncol. 2013;

PDQ Supportive and Palliative Care Editorial Board. Communication in Cancer Care (PDQ®): Health Professional Version [Internet]. PDQ Cancer Information Summaries. 2002. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26389370

Chichirez CM, Purcărea VL. Interpersonal communication in healthcare. J Med Life. 2018;

Granek L, Krzyzanowska MK, Tozer R, Mazzotta P. Oncologists’ strategies and barriers to effective communication about the end of life. J Oncol Pract. 2013;

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EFFECTIVE COMMUNICATIONS

FOR

CANCER

PATIENTS

The Heart of the Art of Medicine

GOOD INTERPERSONAL RELATIONSHIP

WHEN IS IT USED?

FACILITATE THE EXCHANGE OF INFORMATION

FIRST DIAGNOSED

INCLUDE PATIENTS IN DECISION MAKING

NEW THEIR TREATMENT DECISIONS REGARDING

GOALS

TIPS & TRICKS PROMOTE CONFIDENTIALITY RESPECT THEIR TIME

CHANGE OF GOALS

USE UNDERSTANDABLE TERMS WATCH FOR VISUAL CUES

PATIENT CENTERED APPROACH

STAY FOCUSED

SUCCESSFUL DOCTOR-PATIENT RELATIONSHIP

ASK OPEN ENDED QUESTIONS

THINGS TO AVOID

WHY IS IT IMPORTANT?

LACK OF EMPATHY

HELP THEM CHOOSE THEIR ALLEVIATE THEIR ANXIETY TREATMENT PATHWAY DESCRIBE THEIR PROGNOSIS AND GOALS BALANCE A HOPE AND REALITY

OUT OF FOCUS

BUILD A TRUSTING RELATIONSHIP

INAPPROPRIATE BODY POSTURE / GESTURES UNNATURAL EYE CONTACT

CRITICISM

MAKE THEM COMFORTABLE AND OPEN

BE EMPATHETIC

FOR CANCER PATIENTS, ONGOING CONVERSATIONS

ABOUT THE DISEASE IS NEEDED BECAUSE SOMETIMES PATIENTS COULD NOT ABSORB

THE INFORMATION IN EARLIER VISITS

ESCALATING THE EFFECTIVENESS OF PICTORIAL HEALTH WARNING WITH 4S AMSA - University of Pembangunan Nasional Veteran Jakarta Nabilah Nurul Fitri, Nirmala Radia Hasanah, Sarah Salsabilla Gaeahanny, Bella Adisya Kansha Background : Pictorial Health Warning (PHW) is one of the government’s way of suppressing the usage of Cigarettes in Indonesia. We feel that although PHW is already being implemented since 2014 in Indonesia, the demand and purchase of Cigarettes are still soaring and exceed the desire number. The percentage of active smokers over the age of 5 in 2015 to 2017 has increased from 22.79% to 23.48% and Indonesia is still one of the country with the highest number of smokers in the world. Around 225.700 people per year in Indonesia has passed away due to smoking or other tobacco related disease. Objective : It shows that the effectiveness of PHW as a form of health communication from the government to public is still not yet adequate in reducing the cigarettes usage, thus we intend to engage Indonesia’s health care to escalate it by proposing the 4S move. The 4S (Stick, Show, Spread, Synergy) move correlates to the PCC theme to provide information and spread awareness with regards to “Communication in Health”, which, in our case, is to improve the effectiveness of PHW in Indonesia through health communication.

532

Abstract Digital Dairy of Covid-19 Annisa Ramadhanti Yusuf, Nur Alni Praditha Daenunu, Nurul Khalisah Maisuri Asian Medical Students' Association Hasanuddin University COVID-19 outbreak was declared as pandemic by the WHO on March 11, 2020. As of October 13, 2020, the number of COVID-19 cases in the world has reached 37,601,848 and in Indonesia has reached 298,626 cases. A study has revealed so-called infodemics exacerbate the suffering of COVID19 through spreading rumors and conspiracy theories. Indonesia is one of the 5 countries in the world with the highest spread of hoaxes about COVID-19. Conspiracy and hoaxes raises public distrust of the pandemic, making many people who don’t comply with health protocols properly and end up with COVID-19 cases in Indonesia difficult to decrease. In this era, smartphones have become part of people's lives, therefore we can use an application to effectively prevent the spread of COVID-19. Digital Diary is an application that allows users to track their own movements and has various self-awareness features such as providing information about where COVID-19 has detected. People can be self-aware and monitoring the development of COVID19 around them. This application also develops Hoax Buster feature that updates about hoaxes that are circulating and inform and educate about the fact. Through this feature, people can confirm whether the news they receive is a hoax or not.

534

DIGITAL DIARY OF COVID-19 "have the app, save your health"

Digital Diary is an application that allows users to track their own movements and has various self-awareness features such as providing information about where COVID-19 has detected.

Hoax buster

Tracking & Self-awareness Tracking your movement

update about hoaxes

Inform about the news

Knowing the places where positive covid-19 detected

Increase self awareness Educate about Confirm the news the true news is a hoax or not

Monitoring the development of covid-19 in vicinity

The Impact of Language Barrier on Quality of Medical Care AMSA Fakultas Kedokteran Universitas Trisakti Shara Rukshana, Nadira Lathifah, Khania Inayah Aini, Nurul Izzah

For the past five years, tourist arrivals in Indonesia shown an increase in numbers. A total of 15,81 million foreign tourists visited Indonesia throughout 2018, seeing a 12,61% increase than that of 2017, having Bali as the principal destination. As the number of tourists in Bali increases, the number of international patients who seek medication also goes up. This situation then leads to an even bigger problem that’s often dismissed, the presence of language barrier between patients who don’t speak local language and the professional medical workers. In medical field, we mainly rely on communication to gain all the information we need in order to understand the patient’s medical situation. With the existence of language barrier, both patients and medical providers may experience difficulties such as patient’s hardship to understand medical instructions and problem with the reliability of information. Thus, increase the risk of harming the patient’s safety and the professional’s reputation. In this case, professionals play an important role to prevent those things to happen by using human services such as interpreter and/or technology to assist them. Key findings: international patients, language barrier, medical care quality References: 1. Badan Pusat Statistik. International Visitors Arrivals Statistics 2019. BPS-Statistics Indonesia. 2020. ISSN: 2085-9309 2. Shamsi H, Almutairi AG, Mashrafi SA, et al. Implications of Language Barriers for Healthcare: A Systematic Review. Oman Med J. 35(2):e122. 2020. doi: 10.5001/omj.2020.40

536

HOW TO SEARCH FOR RELIABLE MEDICAL INFORMATIONS ON THE INTERNET Universitas Pelita Harapan Charlotte A. Jonatan, Elizabeth Marcella, Rivaldo S. Heriyanto, Sharon Chen Background A reliable source is one that is thorough, well-reasoned and backed up by strong evidence1. These days, the internet is one of the main sources of medical information for the general population, including medical students. Around 56% of internet users searched for medical treatments and procedures, while 66% searched information about certain diseases or medical problems2. With the increasing access of the internet over the years, more of these information are brought to the internet from various sources, including those who brought in false and unreliable medical information than could bring harm to those who read it. As of February 2nd 2020, WHO has deemed the COVID-19 pandemic as an “infodemic,” where there is an overabundance flood of inaccurate information. This mass of misinformation poses a great threat to public’s health as it presents false prevention measures and cures.3 Therefore it is crucial for us to know if the information that we got is credible and reliable Objectives The objective of our poster is to raise awareness about the importance of searching for reliable information on the internet so that the general internet users can make sure that the information they are receiving and implementing are valid and reliable.

References 1. Finding Reliable Sources: What is a Reliable Source? [Internet]. [cited 15 October 2020]. Available from: https://guides.libs.uga.edu/reliability 2. Chen YY, Li CM, Liang JC, Tsai CC. Health Information Obtained From the Internet and Changes in Medical Decision Making: Questionnaire Development and Cross-Sectional Survey. J Med Internet Res. 2018;20(2):e47. Published 2018 Feb 12. doi:10.2196/jmir.9370

3. World Health Organization. Novel Coronavirus (2019-nCoV): Situation Report-13. World Health Organization; 2020 p. 2.

538

4. How to Find Trustworthy Health Information from the Internet | Rehabilitation Research and Training Center on Aging With Physical Disabilities [Internet]. Agerrtc.washington.edu. 2020 [cited 15 October 2020]. Available from: http://agerrtc.washington.edu/info/factsheets/internet

539

HO W TO :

SEARCH F O R R EL IA B L E

medical informations O N T H E IN T E RN ET DID YOU KNOW?

56% OF INTE RNE T U S E RS S E A RCH FOR ME DICA L TRE A TME NTS A ND PROCE DU RE S W HILE 66% S E A RCH FOR INFORMA TION A BOU T CE RTA IN DIS E A S E S OR ME DICA L PROBLE MS .

R E LIA B L E S O U R C E MA KE S U RE YOU R SO U R C ES A ND AU THO R S A RE RE LIA BLE ; S U CH A S FROM O FFIC IAL U NIVER SITY INFO R MATIO N O R R ESEAR C H SITES , O NLINE LIB R AR IES , E TC.

C O M P A RE I N F O R M AT I O N W I TH O TH E R S O U R CE S A N INFORMA TION IS MORE LIKE LY TO BE RE LIA BLE A ND FA CTU A L IF 2-3 SITES HAVE SIMILAR INFO R MATIO N WITH SO U R C ES LISTED S O MA KE S U RE TO CHE CK OU T OTHE R S OU RCE S TOO.

C H EC K TH E D A T E MA KE S U RE THE INFORMA TION IS C U R R ENT A ND U P-TO -DATE. .

ABSTRACT

REACH and Its Significance in Health Care

Ryan Mario Christian, M. Aira Hasya Vier, Kenan Fitranto Kiemas, Jayvee Ronald Muhammad

AMSA Universitas Padjadjaran

Healthcare is a service which provides effort to maintain or restore physical, psychological and emotional well-being. Providers of healthcare are often in close contact with patients through verbal or physical contact. Communication is associated with social contact in either one or both ways. In Health Services, communication skills are essential for both healthcare providers and patients in order to establish well conducted coordination. Through the usage of proper communication, healthcare providers can improve the well-being of patients and even influence a life or death situation in the extreme. On the public point of view, understanding proper medical communication will ease the relay of information during medical care. Through the creation of this poster, the writers aim to increase awareness of healthcare providers for the importance of communication in health services as well as to increase the knowledge regarding medical communication

541

How to Educate the Public about Tuberculosis Marcella Scofany Theresia Turot Universitas Kristen Indonesia

ABSTRACT The purpose of this study is to educate the public about Tuberculosis. Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis which is still the world's concern. Tuberculosis to susceptible individuals. METHOD The method used was a cross-sectional study with 10 samples, but only 7 samples met the criteria because these patients liked to move around the place of residence. Interview methods or met directly with TB patients and accompanied by giving masks, additional food, and giving TB prevention posters through PHBS.

PRELIMINARY TB is a disease caused by the bacteria Mycobacterium tuberculosis. The source of transmission is a positive smear tuberculosis patient when coughing or sneezing, the patients spread the germs into the air in the form of droplets (sputum sparks). Some of the factors that cause the spread of this disease are the bad habits of TB patients who spit. arbitrary, besides that cleanliness of the environment also contributes to the spread of diseases such as houses that are less well ventilated. One of the TB prevention efforts with a good and correct PHBS pattern; •

Eat nutritious foods to increase endurance

•

Get an injection of the BCG vaccine for children under 5 years of age to avoid severe TB (Meningitis and Miler)

•

Open windows for sunshine and fresh air

•

Dry the bedding so it is not damp

•

Regular exercise

•

Do not smoke

•

Do not throw phlegm in any place

543

•

Using a maskSelain pencegahan dengan pola PHBS,dapat juga dilakukan bagi individu yang sakit TBC yaitu dengan minum obat secara rutin selama 6 bulan dengan tidak putus,jika minum obatnya putus maka dapat memulainya dari nol atau dari awal.

RESULT There was an increase in the knowledge of respondents, namely TB patients in the Bambu Apus village through pre-post-test. TB knowledge 71.4%. TB disease transmission 71.4%, Treatment of TB disease 80%, How to prevent TB with treatment of a clean and healthy life 100%, so that a total increase in knowledge was obtained 80.7%

CONCLUSION There is still a lack of good and correct public knowledge in the treatment of a clean and healthy life so that continuous education can shape positive personal hygiene attitudes and behaviors related to TB prevention and transmission.

REFERENCES Tohirin,Amaliyah.E.R.Sosrosanjoyo.F.S, Rahmawanti.G, Sasmita.M.T.Edukasi Dan Pemberian Bantuan pada Pasien Tuberkolusis di Tangerang Selatan.Syukur.2018;1:2-3 Pangestika.R,Fadli.R.K,Alnur.R.D. Edukasi Pencegahan Penularan Penyakit Tb Melalui Kontak Serumah.jurnal SOLMA.2019;8:233-235

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UNIVERSITAS KRISTEN INOONESIA

PREVENTION TBC WITH EDUCATE TO THE BAMBU APUS VILLAGE SOCIETY Universitas Kristen Indonesia Marcella Scofany Theresia Turot Mita Desinta Manu Mentaria Naibaho

FOREWORD

ABSTRACT The purpose of this research is to educate community about TBC. TBC is one of the infectious diseases caused by Mycobacterium tuberculosis which is still a concern world community. How to educate community to avoid TBC, where transmitted by droplets of suffering from tuberculosis to susceptible individuals.

TBC is a disease caused by the bacteria Mycobacterium tuberculosis. The source of infection is a patient with smear positive tuberculosis. When coughing or sneezing, the patient spreads the germs into the air in the form of drops (sputum sparks). Some of the factors that cause the spread of the disease are the bad habits of TBC patients who spit randomly. In addition, cleanliness of the environment also contributes to the spread of the disease, for example the house is not good enough in its ventilation regulation.

One of the TBC prevention with the good and right PHBS pattern;

METHOD The method u s e d i s cross

Eat nutritious food for increase endurance

sectional research w i t h 10 samples but that is meet the

criteria only 7 sample due to these patients like to move places Live. Interview method or meet in person with tuberculosis patients and accompanied by giving

Open the window to get the house sunshine and fresh air

Reguler exercise

masks, food addition, and giving

tuberculosis prevention posters through PHBS.

Do not throw phlegm in anywhere

Get an injection of the BCG vaccine for children age under 5 years to avoid TBC severe (Meningitis and Miler)

Drying sleeping pad so its not damp

•

Not smoking

Use mask

Apart from prevention with the PHBS pattern, it can also be done for individuals who are sick with TBC. With consume the medicine routinely for 6 months without stopping, if you take the medicine you can start from zero or from the beginning.

RESULTS

There was an increase in the knowledge of respondents, namely TBC patients in the village Bambu Apus went through the pre-post-test. Knowledge of TBC disease TBC disease transmission

80%

Treatment of TBC disease

71.4%

How to prevent TBC with PHBS

71.4%

CONCLUSION There is still a lack of good and correct publ ic knowl edge in PHB S, so that continuous education can shape positive attitudes and, personal hygiene b e ha vio rs related to TBC prevention and transmission.

TOTAL INCREASE IN KNOWLEDGE

100

REFERENCES Tohirin, Amaliyah. E. R Sosrosanjoyo.F. S, Rahmawanti.G, Sasmita. M.T. Edukasi Dan Pemberian Bantuan pada PasienTuberkolusis di Tangerang Selatan. Syukur.2018;1 :2-3 Rismawati Pangestika. R,Fadli. R. K,Alnur. R. D. Edukasi Pencegahan Penularan PenyakitTb Melalui Kontak Serumah. jurnal SOLMA.2019;8:233-235

MENGEDUKASI MASYARAKAT TENTANG PENCEGAHAN COVID-19 DI TENGAH PANDEMI Alifa Hasna R Fachly. Ruth Sihombing. Sena Pongtuluran Universitas Kristen Indonesia

ABSTRAK Penilitian ini dilatarbelakangi karena masih kurangnya kepudulian masyarkat atas pandemi yang sedang terjadi yaitu covid-19. Untuk itu kami ingin membahas pencegahan covid agar masyarkat dapat mencegah tertularnya penyakit covid-19. PENDAHULUAN Coronavirus Disease 2019 (COVID-19) adalah penyakit menular yang disebabkan oleh Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). SARS-CoV-2 merupakan coronavirus jenis baru yang belum pernah diidentifikasi sebelumnya pada manusia.Tanda dan gejala umum infeksi COVID-19 antara lain gejala gangguan pernapasan akut seperti demam, batuk dan sesak napas. Masa inkubasi rata-rata 5-6 hari dengan masa inkubasi terpanjang 14 hari Pada kasus COVID-19 yang berat dapat menyebabkan pneumonia, sindrom pernapasan akut, gagal ginjal, dan bahkan kematian. Dilihat dari situasi penyebaran COVID-19 yang sudah hampir menjangkau seluruh wilayah provinsi di Indonesia dengan jumlah kasus dan/atau jumlah kematian semakin meningkat Oleh karenanya diperlukan pedoman dalam upaya pencegahan dan pengendalian COVID-19 METODE Dibuat dengan metode kompratif beberapa sumber jurnal . Studi literatur dilakukan secara online melalui penelusuran jurnal-jurnal yang terdapat pada google cindekiaan maupun situs jurnal lainnya. Jurnal dan artikel yang digunakan merupakan jurnal atau artikel nasional maupun internasional dengan kata kunci coronavirus, COVID-19 dan pencegahan HASIL

Tindakan Pencegahan Pre dan Post Edukasi terkait COVID-19 100% 80% 60% 40% 20% 0% Menjaga jarak

Mencuci tangan Pre-edukasi

546

Memakai masker Post-edukasi

Desinfektan

PEMBAHASAN Cara pencegahan COVID-19 di tengah masyarakat sebagai berikut : - Menjaga jarak - Mencuci tangan - Memakai masker jika berpergian - Menyemprotkan desinfektan - Menjaga pola makan serta tetap berolahraga dirumah

KESIMPULAN Pelaksanaan program Balai Edukasi Corona selama 14 hari terbukti cukup efektif dilaksanakan untuk mempengaruhi perilaku dan meningkatkan pengetahuan partisipan dalam upaya pencegahan penyebaran Covid-19. Disisi lain, juga terdapat kendala yang dihadapi dalam penyampaian media edukasi melalui online/daring. Terdapat beberapa partisipan yang mengalami kesulitan dalam mengakses media secara online, dikarenakan adanya gangguan jaringan internet di wilayah tempat tinggal partisipan. Meskipun demikian, penggunaanmedia edukasi berupa video animasi sangat membantu partisipan yang tidak melek huruf dan tidak terbiasa berkonsentrasi pada komunikasi teks panjang dalam waktu yang lama

DAFTAR PUSTAKA 1. Kementrian Kesehatan RI, 2020. Pedoman Pencegahan Pengendalian Coronavirus Disease (COVID-19) 2. Zulfa F, Kusuma H. Upaya program balai edukasi corona berbasis media komunikasi dalam pencegahan penyebaran COVID-19. Jurnal Abdimas Kesehatan Perintis. 2020; 2: 17-24 3. Haribowo C, Larasati AL. Penggunaan desinfektan dan antiseptik pada pencegahan penularan COVID-19 di masyarakat. Majalah Farmasetika. 2020; 3:137-45

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The Importance of Communicating Mental Problems by Using Digital Health Platform during Pandemic

Muhammad Muhibbuddin Hilmy Asari, Putri Brillian Betrista Viorizka, Raynanda Sabta Charis Binti, Saskia Rezky de Lorient, AMSA-Universitas Airlangga

Objectives To raise the awareness of the importance in communicating with people who suffers mental health problem especially during COVID-19 outbreak by seeking help through digital health platforms

Background/Introduction Mental health is one of the serious health issues all over the world. This issue itself can lead to depression, anxiety, and even death. It has been concerning, even before COVID-19 outbreak. According to CDC, a data of 40.9% of 5,470 respondents who completed surveys during June shows an adverse mental or behavioral health condition, including those who reported with symptoms of either anxiety or depressive disorder (30.9%), Trauma and Stressor Related Disorders (TSRD) symptoms related to COVID-19 (26.3%), having started or increased substance use to cope with stress or emotions related to COVID-19 (13.3%), and having seriously considered suicide in the preceding 30 days (10.7%). Lack of communication is the key factor that gets involved in most cases. However, this can be avoided by using digital health platforms to obtain the solution from professionals since online platforms have been viral since it helps people do their routine without going outside. The more you talk, the better.

References Arango, C., Díaz-Caneja, C., McGorry, P., Rapoport, J., Sommer, I., Vorstman, J., McDaid, D., Marín, O., Serrano-Drozdowskyj, E., Freedman, R. and Carpenter, W., 2018. Preventive strategies for mental health.

The

Lancet

Psychiatry,

[online]

5(7),

pp.591-604.

Available

<https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(18)30057-9/fulltext> 18 October 2020].

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[Accessed

Czeisler, M., Lane, R., Petrosky, E., Wiley, J., Christensen, A., Njai, R., Weaver, M., Robbins, R., Facer-Childs, E., Barger, L., Czeisler, C., Howard, M. and Rajaratnam, S., 2020. Mental Health, Substance Use, And Suicidal Ideation During The COVID-19 Pandemic — United States, June 24–30, 2020. [online] www.cdc.com. Available at: <http://dx.doi.org/10.15585/mmwr.mm6932a1> [Accessed 18 October 2020]. Galea, S., Merchant, R. and Lurie, N., 2020. The Mental Health Consequences of COVID-19 and Physical

Distancing.

JAMA

Internal

Medicine,

[online]

180(6),

p.817.

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at:

<https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2764404> [Accessed 18 October 2020] PSDJKI. 2020. Data Jenis Masalah Mental Selama Pandemi. [accessed 18 October 2020]. Who.int.

2020.

Mental

Health

And

Substance

Use.

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<https://www.who.int/teams/mental-health-and-substance-use> [Accessed 18 October 2020].

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TELEMEDICINE: Simplify Health Communication Natasya Ariesta Selyardi Putri, AMSA-Unair Faida Ufaira Prameswari, AMSA-Unair Annisya Adinda Febriyanti, AMSA-Unair

ABSTRACT Health services are facing challenges with COVID-19 pandemic. Strict regulations created to reduce direct interaction between doctors and patients in order to prevent transmission have made conventional health services very limited. This condition has led to the widespread use of telemedicine as an alternative during the pandemic. Telemedicine is a form of information and communication technology application for patient services by increasing access to medical care and information (WHO, 2010). Telemedicine played a significant role during COVID-19 pandemic. Total of 31,905 patients in Sichuan, China obtained drugs through online prescription services (Hong et al., 2020). Approximately 75% of sarcoma patients at Royal Maiden Hospital, UK (Smrke et al., 2020) and chronic liver disease patients at the University Hospital of Naples Feredico II, Italy (Guarino et al., 2020) use videos to consult with a doctor. Patients can use recorders for self-monitoring nowadays, such as heart rate and blood glucose (Mayo Clinic, 2017). Telemedicine got a good response. Patients claim to be very satisfied, feel quality improvement, and find it easier to access health services without significant problems (Dario et al., 2020). From this, we propose the use of telemedicine on our daily healthcare to make communication easier.

References (APA) Dario, C., Luisotto, E., Dal Pozzo, E., Mancin, S., Aletras, V., & Newman, S. et al. (2020). Assessment of Patients’ Perception of Telemedicine Services Using the Service User Technology Acceptability Questionnaire.

Ijic.org.

Retrieved

October

2020,

from

https://www.ijic.org/articles/10.5334/ijic.2219/galley/3265/download/. Guarino, M., Cossiga, V., Fiorentino, A., Pontillo, G., & Morisco, F. (2020). Use of Telemedicine for Chronic Liver Disease at a Single Care Center During the COVID-19 Pandemic: Prospective Observational

Study.

JMIR.

Retrieved

https://www.jmir.org/2020/9/e20874/.

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2020,

from

Hong, Z., Li, N., Li, D., Li, J., Li, B., & Xiong, W. et al. (2020). Telemedicine During the COVID-19 Pandemic: Experiences From Western China. JMIR. Retrieved 11 October 2020, from https://www.jmir.org/2020/5/e19577/. Mayo Clinic. (2020). Managing your health in the age of Wi-Fi. Retrieved 17 October 2020, from https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/telehealth/art-20044878. Smrke, A., Younger, E., Wilson, R., Husson, O., Farag, S., & Merry, E. et al. (2020). Telemedicine During the COVID-19 Pandemic: Impact on Care for Rare Cancers. NCBI. Retrieved 11 October 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392777/. Who.int. (2020). TELEMEDICINE: Opportunities And Developments. Retrieved 11 October 2020, from https://www.who.int/goe/publications/goe_telemedicine_2010.pdf.

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TELEMEDICINE TELEMEDIS Simplify Health Communication

Telemedicine According to Patients Improved Quality of Care Increased Accessibility Level of Discomfort and Privacy Concern Issues with Telemedicine Service Providers

Telemedicine is... the use of information and communication technology to serve patients by increasing access to medical care and information.

Telemedicine Examples

Can Replace Conventional Services Patient Satisfaction 01 12 Strongly disagree

Virtual consultation

65 45 Strongly agree

Telemedicine during the COVID-19 pandemic P ati en ts ar e m or e sa tis fied u sin g v i d e o c o n s u l t a t i o n s th an co m in g to cl ini cs

Medical application

Automatic recording devices

3 1 9 0 5 p ati en ts in S ich ua n, Ch in a ca n g et m ed ic ine w ith ou t le av ing th e h ou se d ue to o nli ne p re sc rip tio n se rvi ce s Heart rate Blood sugar

Improve healthcare communication with telemedicine!

7 5 % of sa rc om a p ati en ts at Ro ya l M aid en H osp it al, U K s w i t c h t o t e l e m e d i c i n e f o r consultations 7 5 % of ch ro ni c liv er d ise ase p ati en t u se te le m ed ic ine at th e U niv ers ity of N ap les Fe de ri555 co II Ho sp it al, It aly

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94.9% of patients are satisfied with video consultations during the pandemic

.9 94

Fight COVID-19 Hoax by Taking ACTION Bendix Samarta Witarto, Clonia Milla, Visuddho, David Nugraha Asian Medical Students’ Association, Universitas Airlangga, Surabaya, Indonesia

Abstract Background: The spreading of hoax has become a serious problem during the COVID-19 pandemic. False news about COVID-19 has worsened the situation by creating public’s distrust towards health workers and government. Fallacious information uses healthy behavior to cover the promotion of false practices, which can lead to the increase in morbidity and mortality of COVID-19. Such false information has drastically increased in number from 147 to 1,920 hoaxes in just five months. In addition, a research revealed that around 4.9 - 36.2% people believed fake news about COVID-19. Objectives: Recently, it is believed that social media is a promising platform to increase awareness and spread information during the pandemic. Reliability is the key to maximize its use; hence, a few ways called “ACTION” to fight COVID-19 hoax is suggested which can be implemented by everyone. Through “ACTION”, people are suggested to Avoid vague information with alarmist tone, Confirm the news' references, Try to seek from credible sources, Increase awareness on online messages, Observe and follow updates on COVID-19, and lastly Neglect panic or fear-triggering news. “ACTION” is believed to make the society aware so that they can shield themselves from the current situation when there are many circulating false news about COVID-19. Key Findings: COVID-19, hoax, social media

References Aghagoli G, Siff EJ, Tillman AC, Feller ER. COVID-19: Misinformation Can Kill. R I Med J [Internet].

2020

[cited

2020

Oct

18];

Available

from:

https://doi.org/10.1101/2020.04.08.20057067 Kementerian Komunikasi dan Informatika. Hingga 10 Agustus Kominfo Tangani 1.082 Hoaks Covid19 di Berbagai Platform [Internet]. 2020 [cited 2020 Oct 18]. Available from: https://aptika.kominfo.go.id/2020/08/hingga-10-agustus-kominfo-tangani-1-082-hoaks-covid-19di-berbagai-platform/ Kementerian Komunikasi dan Informatika. Selama 23 Januari-3 Maret 2020, Kominfo Deteksi 147 Hoaks soal Virus Corona [Internet]. 2020 [cited 2020 Oct 18]. Available from: https://kominfo.go.id/content/detail/24958/selama-23-januari-3-maret-2020-kominfo-deteksi147-hoaks-soal-virus-corona/0/sorotan_media Lembaga Penelitian, Publikasi dan PM. Perbincangan Isu Corona COVID-19 di Media Daring dan Media Sosial di Indonesia Big Data Analysis. 2020.

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Nasir NM, Baequni B, Nurmansyah MI. Misinformation Related To Covid-19 in Indonesia. J Adm Kesehat Indones. 2020;8(2):51. O’connor C, Murphy M. Going viral: Doctors must combat fake news in the fight against covid-19. Ir Med J. 2020;113(5). Tasnim S, Hossain M, Mazumder H. Impact of rumors and misinformation on COVID-19 in Social Media. J Prev Med Public Heal. 2020;53(3):171–4.

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FACTS Fallacious information about COVID-19 has drastically increased from 147 to 1,920 hoaxes in just 5 months

FIGHT FIGHT COVID-19 COVID-19 HOAX HOAX BY BY TAKING TAKING https://taking-ACTION/Combat-COVID-19-Hoax

In addition, a research revealed that around 4.9 — 36.2% people believed fake news about COVID-19

Positive 17%

Negative 47% Neutral 36%

onfirm the news' references ry to seek from credible sources

ncrease awareness on online messages

Almost half of the sentiments regarding on COVID-19 in Indonesia are found to be negative

YOUR ACTION ACTION DOES MATTER!

A C T I O N

void vague information with alarmist tone

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1. Kementerian Komunikasi dan Informatika. Selama 23 Januari-3 Maret 2020, Kominfo Deteksi 147 Hoaks soal Virus Corona [Internet]. 2020 [cited 2020 Oct 18]. Available from: https://kominfo.go.id/content/detail/24958/selama-23-januari-3-maret-2020-kominfo-deteksi-147-hoaks-soal-virus-corona/0/sorotan_media 2. Kementerian Komunikasi dan Informatika. Hingga 10 Agustus Kominfo Tangani 1.082 Hoaks Covid-19 di Berbagai Platform [Internet]. 2020 [cited 2020 Oct 18]. Available from: https://aptika.kominfo.go.id/2020/08/hingga-10-agustus-kominfo-tangani-1-082-hoaks-covid-19-di-berbagai-platform/

bserve and follow updates on COVID-19 eglect panic or fear-triggering news

3. Nasir NM, Baequni B, Nurmansyah MI. Misinformation Related To Covid-19 in Indonesia. J Adm Kesehat Indones. 2020;8(2):51. 4. Lembaga Penelitian, Publikasi dan PM. Perbincangan Isu Corona COVID-19 di Media Daring dan Media Sosial di Indonesia Big Data Analysis. 2020.

WHITE PAPER

TESTIMONY

AMINO | PCC EAMSC 2021: Philippines

Megan Janice Nawing AMSA-Universitas Hasanuddin 1st Winner of White Paper Category

We actually didn’t expect much other than to gain new experiences and knowledge. It was actually the ﬁrst competition that we joined that are held by AMSA, there were a saying that ‘If you never try, you’ll never know’, I really believed that experiences are essential especially as a future doctor. The peak of joining PCC EAMSC is that it gave me an opportunity to participate in an international conference, not only that I believe I learned a lot of new values and knowledge in life especially how to work together as a team. I think that teamwork is the vital thing in the whole process, from searching for team mates, until making it all work together. It was really lucky for me to ﬁnd my team mates that are Tiara, Venna, and Vinson. All of us actually don’t have any experiences in making white paper which luckily we have our senior to guide us from searching for ideas until revising the paper itself. Each team members have their own specialty, we really tried our best and I guess the fruit of our hardwork is the sweet taste of victory. But nevertheless, we will never stop to join another competition.

AMINO | PCC EAMSC 2021: Philippines

Ausi Syazana Manurung AMSA-Universitas Diponegoro 2nd Winner of White Paper Category

Joining PCC EAMSC has been a great experience for me. My reasons to join this competition was to fulﬁll my personal needs. I felt like I need to give something more to my AMSA-University. One of the ways that I hope I could do was to make some achievements. I also felt that I need to upgrade my skills and knowledge. Be it practicing scientiﬁc thinking, writing skills or even team management skills. Based on my experience, focusing on the theme you chose could avoid unnecessary elaboration on your work and emphasize your team’s goals. It is also important to stick on the guideline to prevent unwanted mistakes. Great teamwork should also be maintained so you could give one another more feedbacks. My experience on PCC EAMSC was making a white paper. I made it together with three of my friends. We did some searching towards the theme we chose by looking up for articles and asking for some people’s opinion. Turns out we found some valuable points we could include in the paper. We divided our jobs equally, held weekly follow ups and brainstormed possible ideas to achieve our goal.

AMINO | PCC EAMSC 2021: Philippines

Ivena Leonita AMSA-Universitas Brawijaya 3rd Winner of White Paper Category

PCC EAMSC is my ﬁrst ever AMSA competition I participated in. Here in AMSA-Brawijaya, I am surrounded by tons of talented people who have won various academic competitions in AMSA. I aspire to be like them. In my attempt to follow in their footsteps, I joined PCC EAMSC in the white paper branch. By doing so, I was hoping to learn as much as I could regarding the white paper. My team brainstormed ideas related to this year’s theme, which is communication in healthcare. We decided to go with a topic that recently has become very concerning during the pandemic and rather neglected by society, that is mental health. From there, we generated solutions to resolve problems in communication in mental health and proposed our idea in the white paper. Everybody has to start somewhere. Personally, this might be the starting point of my journey in academic competitions. If you want to try to participate in competitions, don’t be afraid to try joining one, even when you feel like you don’t have the experience needed to win. Trust me, I’ve been there. Believe in yourself, ask for advice from your seniors if you need one, and go for it!

COMMUNICATION IN HEALTH THROUGH MULTIDISCIPLINARY ASPECTS OF LIFE WITH HEALTHME! PLATFORM TO RAISE HEALTH LITERACY IN INDONESIA Megan Janice Nawing, Tiara Resky Anugrah Mahmud, Venna Regita Cahyani, Vinson Evan Thenardy

Medical Faculty, Hasanuddin University

Abstract. Surfing in cyberspace is something very often done for most people nowadays. However it cannot be denied that a lot of hoaxes circulating today, especially regarding health sector. People tend to assume the information should be immediately spread because it is useful for others and this makes hoax spreading faster. Even worse, people who have been attached by hoaxes will be very difficult to provide education about the real facts. It can be happened due to the low level of public knowledge about the health sector. This is why health literacy is an important component of effective health communication. In fact, the level of literacy of Indonesian people is still very low compared to other countries. Due to these problems we come up with a solution to invent a platform named HealthMe!. By providing innovations in the form of easy access to health information that has high validity and accuracy, this platform has various features that package various health information into something interesting to learn, such as movies, songs, comics, podcasts, etc. All features are accessible by all users and we can also share the contents to the other social media too. Even though it seems fun, it will not eliminate the essence of the health information since all contents are checked and approved by the doctors. We hope this platform can help the society to understand the real information related to the health sector. Keywords : Health Literacy, Health Communication, Health Platform, Health Information

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COMMUNICATION IN HEALTH THROUGH MULTIDISCIPLINARY ASPECTS OF LIFE WITH HEALTHME! PLATFORM TO RAISE HEALTH LITERACY IN INDONESIA

By: Megan Janice Nawing Tiara Resky Anugrah Mahmud Venna Regita Cahyani Vinson Evan Thenardy

AMSA UNIVERSITAS HASANUDDIN

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INTRODUCTION The use of social media in Indonesia is currently growing tremendously. This social media allows us to be able to exchange information with everyone who is a fellow user of the media. However, the behavior of the use of social media in Indonesian society tends to confuse right and wrong information. The share, like, hashtag, and trending topic features on social media are very influential in attracting social media users and spreading the information as fast as lightning. This situation can be beneficial, but on the other hand it can cause the negative impact such as misleading information or what is commonly known as a hoax (Hunt, 2016). Hoax is an effort to reverse facts using information that seems convincing but cannot confirm the truth. Hoax is deliberately made to deceive the reader or listener to believe something and lead their opinions as the hoax maker wants. This problem causes a negative impact on various areas of life, including the health sector (Pulido et al., 2020). According to the survey done by Indonesian Journalists Association (PWI), which was published on World Press Freedom Day 2017 held by UNESCO (1/5/2017), the most hoaxes in Indonesia are information about health. The hoax is propagated by people accidentally. They assume the information should be immediately spread because it is useful for other people (UNESCO, 2016). It is difficult to reduce the spread of hoax because any individual or group can easily spread this. With the lack of public knowledge, misleading the public opinion through hoax is very easy to do (Celliers & Hattingh, 2020). Also, the dynamics of new knowledge can catalyze the formulation of effective strategies in protecting society from the threat of hoax spread (Talwar et al., 2019). No wonder hoaxes in the health sector are more easily spread nowadays and this also has a direct impact on the hindrance of effective communication in health care settings (Hopf et al., 2019). Health communication is really important to the health care system to improve the public health, including improving the quality of life, increasing the number of disease prevention, increasing life expectancy, and changing social norms to be more health-focused (Rider University, 2019; ODPHP, 2020). According to European Centre for Disease Prevention and Control (ECDC, 2017) there are six main areas that contributes to more effective implementation of health communication, these are as followed: 1. Health Literacy, 2. Health Education, 3. Social Marketing, 4. Risk Communication, 5. Crisis Communication, and 6. Health Advocacy.

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One of the main ideas that correlates with this problem is health literacy. Health Literacy itself has been defined as the use of a wide range of skills such as cognitive and social skills which determine the motivation and ability of individuals to gain access to, obtain, process, understand, and effectively use health-related information in ways to make “well-informed” health decisions and which promote also maintain good health (ECDC, 2017; NLM, 2016). In the health care setting, patient health literacy becomes one of the important points in establishing good communication between health workers and patients themselves (Chahardah-Cherik et al., 2018). This relates to the tendency of patients to accept explanations from health workers. People who have been attached by hoaxes will be very difficult to be educated about the real facts and prefer to believe in hoaxes that have been neatly packaged so that they sound more reasonable (Bronstein et al., 2019). Although currently there are many media that facilitate access to literacy sources, in fact there are still many layers of society that have low literacy, especially those related to the health sector. This is exacerbated by the low reading interest of the Indonesian people.According to a new study conducted by Central Connecticut State University in 2016, Indonesia is the second-least literate nation in the world in a list of 61 measurable countries, only higher than Botswana. This study actually looked at literacy and literate behavior characteristics in 200 countries, but only 61 countries made the list because the rest lacked relevant statistics. Although, it cannot be denied that Indonesia is in the second-lowest position and this indicates that our country is in a state of literacy emergency (Miller & McKenna, 2016). In addition, according to a survey conducted by the Research Center for Education and Culture Policy in 2019, a research institute under the Ministry of Education and Culture of Indonesia (Kemendikbud), the Alibaca Index (reading literacy activity index) in South Sulawesi is relatively low, with a score of 38.82 from a perfect score of 100 (Solihin et al., 2019). This is why it tends to be hard to do effective health communication nowadays in our society.

OUTLINE PROBLEMS Low health literacy is associated with negative health outcomes, including decreasing in preventive health service, poor disease outcomes, and high hospitalization and mortality rates. We can examine the relationship by looking at the reality of the condition of society where people with a low level of literacy will have a difficulty to function effectively in the health care system such as experiencing obstacles in their prevention or treatment procedures. This is because the people have lack of knowledge about their medical condition and related treatment caused by the barriers to accessing and understanding health information, specifically written and calculated information, which can lead to ineffective communication between doctors and patients. Low health literacy will also make it difficult

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for people to face health problems because of insufficient skills and abilities related to the problems and complexity required (Oktarina, 2018; Ann-Marie Lynch & Vinceroy Franklin, 2019; Rasu et al., 2015).

The European Health Literacy Survey demonstrates a correlation between health literacy and personal health where low health literacy also impacts on limited involvement in health promotion, early detection, activities that pose a risk to health, occupational accidents, management of chronic diseases, increasing numbers of patients with hospitalization, and increased morbidity and premature mortality (WHO, 2013).

Low health literacy can occur not only in patients but also in health workers. It is related to the information service and educating ability of the health workers, so they can communicate with the patients effectively. Some health problems that also can arise due to low health literacy in health workes, such as inadequate health services, inappropriate drug use, poor management and slow response to chronic conditions, low self-esteem and self-confidence, depletion of individual and community finances, and discrimination socially. This makes health literacy also one of the spearheads of health development in Indonesia (Hadisiwi & Suminar, 2016).

In order to increase health literacy, it is very dependent on all components of society, health institutions, as well as the government through information dissemination tools and policies issued. Based on the study, one of the determinants of health literacy is information technology as a means of disseminating health information so that access to information technology greatly influences people's health literacy (Putri, 2016). Aydın et al. (2015) argue that increasing people's access to health information and their capacity to use it effectively is very crucial in the problem of health literacy. Easily access of information, the packaging of the media which is in an attractive manner and understandable language, and also the reliable and valid sources will increase health literacy in the society..

As the conclusion, Health literacy in Indonesia is still below average where health literacy can affect the quality of individual health. By providing a media with accessible and simply packaged information, it is hoped that the health literacy in Indonesia will increase so that the quality of Indonesian health will be better.

SOLUTION As we all know, there are four elements involved in basic communication: messages, senders, channels, and audiences (NCI, 2011). We come up with HealthMe!, a solution that combines visual and auditory channels to deliver this health information. Dewan (2015) through their studies concludes that using

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pictures linked to written or spoken text can gain more attention than the text by itself. This is in line with CDC (2019) statement that visuals might be a promising solution to communicate health information. People can understand the information easier, while visuals can be used to confirm the written and spoken health information.

All is combined through one platform: HealthMe! (coming from: Help Me, to help people). HealthMe! is a multidisciplinary platform that invites all health care workers, designers, animators, singers, dubbers, and medical students to contribute together. HealthMe! platform are available in the form of website and mobile application. HealthMe! will provide a simple and fun way to understand many aspects of healthy life. Its features are wide-coverage, but can be simplified as D-SPACE which consisting of :

Detective: to detect any false information or misinformation spread out in the public. Detective will allow the users to directly type any keywords they want to find out, and this feature will show up the right information with a little bit of simple explanation and catchy look. This feature will be run by doctors, collaborating with medical students and designers.

Songs: to meet the needs of music lovers who are curious about health information. The essence of Songs is to enrich the users health knowledge through meaningful and “eargasm” songs. This feature will be run by singers, collaborating with doctors and medical students.

Podcasts: to spread healthy lifestyles from the health care workers, therefore educate the users. In Podcasts, the users can listen to the doctors’ and medical students’ experiences. This feature will be run by doctors, collaborating with dubbers and medical students.

Animation Movies: to provide health information through an interactive story, served in a short movie. This feature brings up a superb way to figure out many aspects of health. Animation Movies will speak up many sides about healthy life. This feature will be run by designers, animators, dubbers, collaborating with doctors and medical students.

Comics: to pack up many health aspects through serial stories. It is mainly made for kids and teens in plain language, without diminishing its medical significance. Its colorful story combined with valid health information made Comics are officially fun and highly recommended to read. This feature will be run by designers, collaborating with doctors and medical students.

Extras: to offer many life hacks, DIY (Do It Yourself) things at home, and fun mnemonics about healthy life. This feature will be run by doctors and medical students, collaborating with designers.

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Figure 1. The features of HealthMe! Mobile Application

Figure 2. The features of HealthMe! Website

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All features are accessible by all users which will be provided in two different languages Indonesian and English. The users can download the contents of every features to enjoy them in the offline mode. The users are suggested to sign up their information, such as email and username, so we may share our newest developments and latest contents. Also, our team allows the users to share the contents preview to the other social media, so other people who have not downloaded our application might feel the benefits too. HealthMe! platform will be runned by several teams, including Verification, Design & Editing, Technology, Customer Service, Social Impact, and Human Resources & General Affair Team. The content is made by everyone who has graduated from a medical degree program. They can send their content which will be checked for the truth and the quality of the content by the Verification team. If it is verified, then the content will be submitted to the Design & Editing team. Every doctors who contribute in making HealthMe! contents will receive a certificate for each content. The technology team will manage and develop the platform so that it runs smoothly and users can use it easily. The Customer Service team is in charge of communicating with users about their experience using this platform. The Social Impact team task is developing programs so that this platform can be widely known by the public. This team will also collaborate with media workers, government, and health organization so that this platform can be more massive and active. And the last, for Human Resources & General Affair tasks are recruiting employees and monitoring the performance of all teams. Due to its multidisciplinary workers, we need a wide-scale publication to promote this platform to the public. In consideration for people who do not have a gadget, we propose an idea to provide a gadget or a desktop that comes with the HealthMe! Platform in public places such as hospitals, health centers, public libraries, schools, and certain selected places which to achieve this we need great support from everyone especially the government and health organization. Prior to achieving our goal in raising people's awareness of health literacy by HealthMe!, we highly require massive support from governments and health care workers to introduce this new platform to everyone.

CONCLUSION Health literacy is an important component in the implementation of effective health communication. In fact, the level of literacy of Indonesian people is still very low compared to other countries where access to information using information technology is an important factor affecting the level of health literacy. By providing innovations in the form of easy access to health information that has high validity and accuracy, this application has various features that package various health information into something interesting to learn, such as movies, songs, comics, podcasts. The different concepts of the presentation will not eliminate the essence of the health information provided as can be obtained from health

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journals, etc. This new solution can help in increasing Indonesian health literacy. Still, to ensure this solution runs well, it requires good collaboration from the government, application developers, doctors, and citizens.

RECOMMENDATION We believe that the government and especially every health organization could be allocating more on Health Literacy by supporting the funding of the research of this platform also to help in providing gadget or desktop in selected places as to promote this platform, and especially create new policy concerning Health Literacy. Other than that, we also hope illustrator, producer, and every media worker especially health care workers in every clinical phase such as medical students, nurses, doctors, and specialists to contribute as volunteer in developing and giving socialization of this platform to the public society. We hope that all hospitals participate and cooperate on the development and the carrying out of this platform. Not forgetting the public society as the user to actively use this platform and giving advice on the feature available. At last, we hope all stakeholders that are involved can socialize this platform to be well known in the society.

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communication.html Chahardah-Cherik, S., Gheibizadeh, M., Jahani, S., & Cheraghian, B. (2018, January). The Relationship between Health Literacy and Health Promoting Behaviors in Patients with Type 2 Diabetes. Int J Community Based Nurs Midwifery, 6(1), 65–75.

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Dewan, P. (2015). Words Versus Pictures: Leveraging the Research on Visual Communication. Partnership: The Canadian Journal of Library and Information Practice and Research, 10. https://doi.org/10.21083/partnership.v10i1.3137 European Centre for Disease Prevention and Control. (2017, June 21). What is health communication?. Retrieved from https://www.ecdc.europa.eu/en/health-communication/facts Hadisiwi, P., & Suminar, J. R. (2016). Literasi Kesehatan Masyarakat Dalam Menopang Pembangunan Kesehatan di Indonesia. Prosiding Komunikasi, 1(1). Hunt, E., 2016. What Is Fake News? How to Spot it and what You Can Do to Stop it. The Guardian. Hopf, H., Krief, A., Mehta, G., & Matlin, S. A. (2019). Fake science and the knowledge crisis: Ignorance can be fatal. Royal Society Open Science, 6(5). https://doi.org/10.1098/rsos.190161Miller, J. W., & McKenna, M. C. (2016). World Literacy: How Countries Rank and Why It Matters. Routledge. National Cancer Institute - Office of Communications and Education. (2011). Making Data Talk: A Workbook.

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communication/making-data-talk.pdf National Library of Medicine. (2016). Health Literacy. Network of the National Library of Medicine. Retrieved from https://nnlm.gov/initiatives/topics/health-literacy Office of Disease Prevention and Health Promotion. (2020). Health Communication and Health Information

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objectives/topic/health-communication-and-health-information-technology Oktarina, D. (2018). Literasi Kesehatan Di Tengah Pandemi. Kemendikbud. Pulido, C. M., Ruiz-Eugenio, L., Redondo-Sama, G., & Villarejo-Carballido, B. (2020). A New Application of Social Impact in Social Media for Overcoming Fake News in Health. International journal of environmental research and public health, 17(7), 2430. https://doi.org/10.3390/ijerph17072430 Putri, S. N. (2016). Hubungan Akses Informasi Kesehatan dengan Health Literacy Mahasiswa Universitas Dian Nuswantoro Semarang. eprints.undip. Rasu, R. S., Bawa, W. A., Suminski, R., Snella, K., & Warady, B. (2015). Health Literacy Impact on National Healthcare Utilization and Expenditure. International Journal of Health Policy and Management, 4(11), 747–755. https://doi.org/10.15171/ijhpm.2015.151 Rider University. (2019, October 15). What Is Health Communication? Its Importance in Health Care and

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communication/ Solihin, L., Utama, B., Pratiwi, I., & Novirina, N. (2019). Indeks aktivitas literasi membaca 34 provinsi. Pusat Penelitian Kebijakan Pendidikan dan Kebudayaan. Talwar, S., Dhir, A., Kaur, P., Zafar, N., & Alrasheedy, M. (2019). Why do people share fake news? Associations between the dark side of social media use and fake news sharing behavior.

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Back to Back Broadcasting Authors: Ausi Syazana Manurung, Naily Fairuz Salma El Milla, Hanun Nabila Putri, Muh. Arifqi Rustam (AMSA-Diponegoro University) Abstract Amidst the COVID-19 pandemic, Indonesian citizens are in dire need of accurate information regarding health which is easy to be accessed and comprehended. This will prevent them to be confused or misguided by the disorganized information and hoax. However, the challenge arises with Indonesia’s low rate of literacy, which makes information on books or infographics less effective for the public. Even worse, our current circulating public service announcements (PSAs) are also considered ineffective. On the other side, we observed that the government has not really made an optimal use of media such as television and social media, despite of its massive platform and wide range of audience. Hence, we propose this solution of Back to Back Broadcasting (BBB) which aims to provide the public with an upgrade in health promotion material through television and social media. We propose the mechanism of inserting public health promotion in television programs and publishing creative PSAs during television commercial breaks and through social media. With those solutions, it is expected that public awareness and knowledge in matters concerning health would increase.

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Back to Back Broadcasting

AMSA-Universitas Diponegoro

Ausi Syazana Manurung Naily Fairuz Salma El Milla Hanun Nabila Putri Muh. Arifqi Rustam

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Background In situations such as COVID-19 pandemic, the spread of information is extremely crucial. To inform the public, the government usually publishes public service announcements (PSA) mostly in the form of infographics and videos. Unfortunately, our current situation shows that Indonesia still lacks healthcare knowledge. One of the reasons is that too much information circulating around makes people harder to distinguish the right and the false ones. Moreover, the public has low interest in reading. By 2019, Indonesia’s Ministry of Education and Culture stated that among 34 provinces in Indonesia, not even one is categorized with a high literacy index (Solihin et al., 2019). Another reason is our current PSAs are not effective to raise awareness of the public due to their low quality. Therefore, the government's current approach on sending the right message is inadequate. There are some media platforms which are potential to broadcast information. One of them is the television. According to a study conducted by Nielsen, Indonesian citizens spend nearly 5 hours on television programs (Nielsen, 2020). Contents such as drama (typically inferred to as “sinetron”), talkshow, news broadcast, and competition shows have been proven to be an entertainment sought by audiences. During the COVID-19 pandemic, the audience ratings for television programs have been improving, due to the shutdown of schools, offices, and public spaces. This phenomenon allows the potential for television programs to be the tool for promotion and education concerning health. However, the government's health promotion approach through television is not enough. The same case also happened in the government's utilization of social media which has about 160 million active users in Indonesia (Hootsuite, 2020). Its usage to broadcast PSAs is still in the minimum level. Thus, an enhancement in television and social media broadcasting is needed to elevate the quality of our health promotion campaign. Outlined Problems 

Abundance of circulating information in the community without further verification

With how easy the mass media can publish information to the public, the media’s pattern of information processing changes as well. Information, which depended on how detailed and accurate it is in the past, now depends on how fast it can reach the public’s ears. The faster an information is distributed, the more information can be accepted by the public. This, however, does not guarantee the accuracy from the information itself. When published in a big amount, someone might have difficulty in sorting and filtering the information they get. Because it takes a lot of effort to verify the accuracy of an information, the public tends to instantly believe the information they acquired from the media with basic knowledge and emotional factors as a basis, most of the time without rational and more thorough consideration.

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Too much information will result in less interest of reading. Not to mention, Indonesia’s current literacy index is already in a low state. This matter is worsened by how disorganized health informations released by the government are, just like when the Minister of Health, Terawan prematurely stated that the SARS-CoV-2 was not too big of a threat for Indonesian citizens (Newsroom, 2020). Unfortunately, it was followed by the death of 12.156 SARS-CoV-2 patients in Indonesia (Kementerian Kesehatan, 2020). This unreliable information raises the public’s trust issue in the governmental institutions, especially the ministry of health. The public then becomes reluctant to accept and comply with the ministry’s instructions, though the infographic from the government contains more credible and valid data. 

Current public service announcements are not effective enough

Public service announcement is a way to share social messages to people with the objective to raise awareness and change people’s behavior towards an issue. In most cases, PSA is used to deliver health and safety topics. Unfortunately, our current circulating public service announcements are not effective enough to reach their objectives. A journal published by Jakarta Mercu Buana University explained their study about the effectiveness of television’s PSA (Haddy & Morissan, 2017). Their result shows that there are no significant behavioral changes from the respondents caused by particular reasons. First of all, there is not enough time to deliver the details since the PSA’s duration is only 30 seconds long. Secondly, this PSA is only delivered through television’s commercial break. Meaning, there are no extensive approaches through any other television programs or any other media which causes less number of audience. Lastly, this typical format of PSA is considered boring and outdated which lessens its engagement to the public. In general, these main problems are the cause of why our current PSAs are not working effectively anymore. Proposed Policy/Solution To solve these problems, we propose a solution called “The BBB Program” which refers to Back to Back Broadcasting. This program aims to serve audiences with healthcare information back to back on television programs, during commercial breaks and through social media. With content and messages being provided form The Ministry of Health, the public will be firmly informed that these information are valid which will help them distinguish between the correct and false information. Contents are to be updated regularly on the urgent matters concerning health in Indonesia. 1. TV Program From the problems and background mentioned above, we propose a solution where tv programs must include health promotion campaigns in their show with certain mechanisms. Certain television

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programs are obligated to implement this, specifically those broadcasted in public television channels. For programs like talkshow or news broadcast, health promotion messages will be delivered to viewers by the host or announcer in the beginning and in the end of the show. As for sinetron or other entertainment programs, the messages will be conveyed by the leading actors in a small clip aired in the beginning and the end of each episode. Since citizens from higher economic class tend to consume content from cable channels or the internet-based platform such as YouTube or Netflix, the public health promotion through television programs targets the citizens from low to middle economic class. 2. Social media program Since our current PSAs are not effective enough to raise people’s awareness, we propose a program where PSAs will be upgraded in its quality and quantity aspect through television and the help of social media. We propose a mechanism where a promotion campaign is being made in a creative video advertising format to draw people’s attention. A short film format is one of the best options available. For example, Thailand Life Insurance advertisement is proven to be interesting enough for people to watch thoroughly because it has a creative plot and 3 minute long duration with suitable moral value by the end of the video (Chaiyawan, 2018). Aside from using creative formats, the government can also collaborate with celebrities to attract audiences. Therefore, we can deliver PSAs with these mechanisms to increase their persuasive value. In television platforms, PSA videos will be shown in every commercial break through all television channels. Since video is suitable for most features of social media, these PSAs will also be broadcasted through the government’s official social media account. This will convince people that the information being provided is valid. We also propose that PSAs will also be shown in social media’s advertisements such as unskippable Youtube ads or other advertising platforms where most people will be obligated to watch them before the desired content shows. This will increase the number of audiences. With users that vary in age and background, social media can be used to share messages extensively. Moreover, the tendency of an interesting video being viral is greater than any other media. Thus, the purpose of delivering messages to people is successfully done. Conclusion Indonesia is currently in a situation with low healthcare knowledge. Various reasons which caused this issue are the massive disorganized spread of information, Indonesia’s low index reading rate and ineffective public service announcements. On the other side, television and social media as the most used platforms in Indonesia are not still utilized maximally. Therefore, our Back to Back

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Broadcasting Program is a great solution where we deliver messages and broadcasting PSAs through television programs, commercial breaks and social media. Recommendations To further strengthen the implementation of our proposed solutions, more research from the government on the public’s popular culture is necessary. Since this solution depends heavily on people's interest and fluctuates according to trends, regular updates are needed. For example, general research on the current favorite television program, celebrities and music taste is needed to enhance the quality content of our broadcast. The government should also be able to read opportunities on new potential platforms to be used. References Chaiyawan, C. (2018). How Thai Life Insurance is successfully pioneering the use of ‘sadvertising.’ https://www.worldfinance.com/wealth-management/how-thai-life-insurance-is-successfullypioneering-the-use-of-sadvertising Haddy, L. R., & Morissan. (2017). Efek Iklan Bahaya Merokok. 16(02), 27–43. https://doi.org/http://dx.doi.org/10.22441/jvk.v16i2.3803 Hootsuite. (2020). Hootsuite (We are Social): Indonesian Digital Report 2020. https://andi.link/hootsuite-we-are-social-indonesian-digital-report-2020/ Kementerian Kesehatan. (2020). Peta-Sebaran @ Covid19.Go.Id. https://covid19.go.id/peta-sebaran Newsroom, N. (2020). Cuap-Cuap Pejabat Soal Corona. https://www.narasi.tv/narasinewsroom/cuap-cuap-pejabat-soal-corona Nielsen. (2020). Nielsen: Covid-19 Tingkatkan Jumlah Penonton Televisi. Media Indonesia. https://mediaindonesia.com/read/detail/298392-nielsen-covid-19-tingkatkan-jumlah-penontontelevisi Solihin, L., Utama, B., Pratiwi, I., & Novirina. (2019). Indeks Aktivitas Literasi Membaca 34 Provinsi (L. Solihin (Ed.); 1st ed.). Puslitjakdikbud. https://books.google.co.id/books?hl=id&lr=&id=xss9DwAAQBAJ&oi=fnd&pg=PA1&dq=peng ertian+unity&ots=8jiXmjqV6g&sig=F762ZZVgGQ1rzOdDvQmGTPskMcE&redir_esc=y#v=o nepage&q&f=false%0Ahttp://repositori.kemdikbud.go.id/13033/1/Puslitjakdikbud_Indeks Aktivitas Litera

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MENTAL HEALTH TELEMEDICINE INNOVATION BY PSYCHSPACE APPLICATION WITH PSYCHOLOGICAL SUPPORT SYSTEM Ivena Leonita, Aurielle Annalicia Setiawan, Anita Dominique Subali, Silvia Husodo Faculty of Medicine, Universitas Brawijaya

ABSTRACT The COVID-19 pandemic is a global concern that affects many aspects of life. Many changes have been made in the world in order to survive this pandemic’s negative impacts, including its effect on mental health. The general public, COVID-19 patients, and health workers are dealing with symptoms of stress, depression, and anxiety due to the increasing pressure during this time. Depression has amassed a large number of victims and cause many atrocities such as loss of productivity, raise of suicide rates, etc., followed by rising depression rate during this outbreak. A large portion of society still struggles with stigmas surrounding depression, which makes it difficult to seek help. With the abundance of gadgets and internet users today, a new mental health buddy app with innovative features can contribute in helping people with depression, even preventing someone from having it. PsychSpace, our proposed innovation, is a one-stop-mental health buddy application. PsychSpace has numerous features to support holistic mental support, such as providing safe space for private daily journals, thought-sharing, community access, reliable educational information, and access to consultation with professionals. This app accommodates users to express themselves while serving as a media to reach and get reached out by care-givers and fellow users, as well as serving as a media to promote mental health education and as a telemedicine monitoring tool. This idea brings a solution towards commonly-neglected-mental health issues right into your hand for your whole wellbeing. Keyword: Depression, Mental Health, Mobile Application, Telemedicine

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MENTAL HEALTH TELEMEDICINE INNOVATION BY PSYCHSPACE APPLICATION WITH PSYCHOLOGICAL SUPPORT SYSTEM

Authors: Ivena Leonita Aurielle Annalicia Setiawan Anita Dominique Subali Silvia Husodo

AMSA-UNIVERSITAS BRAWIJAYA

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INTRODUCTION The COVID-19 pandemic and its disastrous effects has become a global concern. COVID-19 is an infectious disease caused by a virus that belongs to the coronavirus family. It is highly infectious and can be transmitted through contact, droplet, airborne, fomite, fecal-oral, bloodborne, mother-to-child, and animal-to-human (WHO, 2020b). COVID-19 cases in Indonesia have not slowed down since its first emergence in January. As of October 18, 2020, confirmed COVID-19 cases in Indonesia have reached 344.749 patients, with 12.156 deaths related to COVID-19 and 267.851 patients recovered (WHO, 2020c). With this amount of death cases, Indonesia has placed themselves among the highest case-fatality rate in the world (John Hopkins Coronavirus Research Center, 2020). To reduce the rate of transmission, people are forced to do physical distancing and quarantine themselves in their homes, which has been going on for almost 6 months. Recently, the government is again taking serious measures in effort to slow down COVID19 transmissions due to constantly growing numbers of cases and the hospitals are on the brink of collapse (Washington & Hasibuan, 2020). The government’s strategy to handle this problem is by placing those who are experiencing none to mild symptoms in an isolation centre (CNN Indonesia, 2020a). Every person on earth has the right to health. One of the goals in SDGs published by the United Nations is to ensure health and well-being for all, including mental health. COVID-19 has negatively impacted many people’s lives, including the general public and health workers. Not only that it causes physical damage, it also affects mental health. The most common psychological disorders inflicted by this pandemic are depression, stress, and anxiety. Stress is a feeling of nervousness, anger, or tension. Meanwhile, depression is an illness that affects how one can feel. Patients with depression often feel sad and no longer feel interested in things that they used to love (American Psychiatric Association, n.d.). Stress and depression in the general public are due to the hardship of maintaining a job during these hard times and economic challenges that the public are facing. Furthermore, according to an mini online survey that we held, which managed to obtain 146 respondents, 104 (71.2%) stated that they have experienced anxiety, stress, or burn out during this pandemic. This shows that even in people around us, maybe without us knowing, suffer from some kind of mental distress in this pandemic.

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Figure 1. The result of our mini online survey. Question is in Bahasa Indonesia, translated as:”During this pandemic, have you experienced anxiety, stress, or burn out?”. Blue (Ya) (71.2%) representing a portion of respondents who answered yes, and red (Tidak) (28.8%) representing a portion of respondents who answered no.

People who follow COVID-19 news experience more anxiety. The anxiety comes from the fact that the novel COVID-19 virus is not yet well explored, as well as the fear of getting infected and the high mortality rate. The general population experiences stress, anxiety and depression due to the pandemic, with the prevalence of 29,6%, 31,9% and 33.7% respectively (Salari et al., 2020). 6,21% of quarantined individuals experienced depressive symptoms (Peng et al., 2020). Aside from the general public, COVID19 patients also experience similar psychological disorders, such as stress, anxiety, depression, and posttraumatic disorder (Guo et al., 2020). Asymptomatic patients that are being treated in an isolation center suffer from severe or extremely severe stress, anxiety, and depression, which account for 46%, 14%, and 8% respectively. Separation with family and ones they loved, limited freedom, and ambiguity of disease status, and boredom can make someone develop psychological conditions (Upadhyay et al., 2020). Not only the general public and patients, mental health of healthcare workers is also affected by this pandemic. Study found that with an increasing risk of medical staff exposure to COVID-19, tendencies of anxiety, depression, and bad sleep quality are also increasing (Wang et al., 2020). Untreated depression can often lead to unproductiveness and suicidal thoughts, or even suicide itself (WHO, 2020a). In Jakarta, one of the patients undergoing quarantine in an isolation centre has been reported to have jumped out of a window and died instantly. It was likely caused by depression (CNN Indonesia, 2020b).

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Figure 2. COVID-19-related suicide and mental health problem in Indonesia (clockwise) COVID-19 Patient committed suicide from the hospital, student suicide due to stressful online learning; pandemic results mental health problems (source: The Jakarta Post, Kompas)

Now that COVID-19 has forced everyone to stay at home, it changes our daily lives. Almost all daily activities that we used to do outside have to be done in our homes. The use of digital means of communication is the only way for us to do our activities while being quarantined, and the Indonesian government is making an effort to make this means of communication available for everyone during this time of pandemic. Free phone credits and data plans for students and teachers are being provided, and cheap tablets are available for purchase. This way, the public are more familiar with gadgets and the digital world.

OUTLINED PROBLEMS Depression is truly not a laughing matter. It has affected the society in many ways and has amassed large numbers of victims, both diagnosed and undiagnosed. According to WHO, in 2017 there are 264 million people globally affected by depression (WHO, 2019). Numbers are rising, especially in this pandemic era. The BBC reported depression doubling in the UK during the pandemic (Schraer, 2020) and the CDC has reported anxiety disorder and depressive disorder rising considerably in the US during the pandemic compared to last year (CDC, 2020). Depression can cause many atrocities, such as the decline of productivity rates, quality of life, and can even cause suicide. According to WHO, depression is the leading cause of disability worldwide and is also a major contributor to the global burden of disease (WHO, 2019). Depression and anxiety also contributed a US$ 1 trillion loss in productivity globally (WHO, 2019). More importantly, there has been multiple reports of suicide attempts related to COVID-19 in USA, UK, Italy, Germany, Bangladesh, India and other countries (Sher, 2020). As we can see, an individual’s mental health does matter, and when ignored can cause grim consequences, even to a global scale. Despite these concerning facts, are we still going to regard depression as something to be pushed aside, especially during these times?

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Unfortunately, there are still negative stigmas surrounding mental health awareness, including for depression, anxiety, and stress disorders. Apparently in the East, societies still view people with depression as ‘weak’ (Nakane, et al., 2005), even seen as ‘not relying on god enough’. Their problems are not considered as ‘serious’ and are more seen as them ‘not trying hard enough’, and they may even be avoided by their peers. In an effort to overcome this problem, a person with depression may try to share their problems to their loved and most trusted ones, or even seek help from professionals. But with the existing stigma viewing them as ‘needy’ or ‘weak’, and the possibility of being ignored, they may be reluctant to seek help. They may also be reluctant to consult professionals, due to fear of being perceived as a ‘crazy’ or ‘dangerous’ person. They may try to solve their own problems by keeping it to theirselves, which may lead to the deterioration of their psychological state and may also lead to suicide attempts. This is very unfortunate because as we know, everybody has a right to be happy, without exceptions. Mental health is often perceived as less important compared to physical health, but in reality, they are interconnected and equally as important. To achieve true good health, we must achieve both. Therefore, by working together to achieve good mental health, we can improve the public’s overall health and their quality of life. Is there any hope to achieve this? After all, it is quite obvious that mental health issues may seem like an iceberg phenomenon. We can only see the tip and not the base, and that is why it does not seem that big from afar. We may ignore it, just like Titanic did and all of a sudden, it is too late to turn back. The key to approach this issue is by early detection and prevention. Gadgets are now becoming people's must-have item. The majority of the public now, both in rural and urban areas, in varied economic classes, has access to the internet and gadgets, by receiving subsidized data packets. A national survey performed by BPS-Statistic Indonesia recorded increment on Indonesian cellular phone usage, with 62,4% citizens or a total of 89% households own gadgets. Cellular phones and the internet had reached more than 15,000 sub-districts and 78% households had accessed the internet (BPS, 2018). It is obvious that we spend a long time accessing the internet, especially social media. Nowadays, the preferred method for communication is through social media In fact, when viewed according to the internet access purpose, social media and news up-to-date predominates the use of the internets, with the percentage of 79.13 and 65.97% respectively (BPS, 2018). Sometimes, social media can cause several negative issues from addiction to cyber-bullying. On the other hand, gadgets connected with the internet provide increasing access to an abundance of health apps along with rising awareness towards health, for example healthy diet programs to your routine physical training buddy. Conversely, plentiful options for physical health apps does not

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correspond to the development of mental health based applications, especially ones fit the current pandemic situation. Furthermore, based on the mini online survey that we held, where we asked respondents whether they think an effective mental health app which can facilitate them for consultation with a professional already exists, 104 (71.2%) of respondents answered “no”. In another question where we asked respondents whether they need a media for consultation regarding mental health, 144 respondents (99.3%) answered “yes”. This shows a truly high demand for a novel, innovative app which can facilitate multiple needs to cater to mental health, including consultation with a professional, especially during this pandemic era.

Figure 3. The result of our mini online survey. Questions are in Bahasa. Graphic in the left can be translated as:”Do you think an application which can facilitate consultation with a professional effectively already exists?”. Blue (Ya) (28.8%) representing a portion of respondents who answered yes, and red (Tidak) (71.2%) representing a portion of respondents who answered no. Graphic in the right translated as:”Do you need a media which can facilitate consultations regarding mental health?”. Blue (Ya) (99.3%) representing a portion of respondents who answered yes, and red (Tidak) (0.7%) representing a portion of respondents who answered no.

Therefore, based on the points we made above, we would like to propose a multi-functional mental health buddy app, PsychSpace.

SOLUTION We came up with an idea to optimize the broad accessibility of the internet and gadgets; also to renew the “toxic” social media into a solution for mental health issues. We would like to bring you a holistic psychological support system right into your hand, that can be accessed anytime and anywhere. The name ‘PsychSpace’ itself is derived from “Psychology” and “Space”. PsychSpace is a free one-stop-

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mental health buddy application with easy access and available in common application platforms, namely App Store and Google Play Store. As reflected from the name, PsychSpace aims to provide a safe media for people to express themselves freely, without judgment; and to connect them with people who may experience the same problems. Users' daily mental health state can be monitored by routinely filling out journals, with corresponding feedback provided regarding their conditions. This app also functions as an education platform which facilitates better understanding about mental health for the general public through various features such as credible newsletters that are constantly updated and reviewed. Moreover, this app offers an easier way for people to seek help to professionals. There are numerous features provided in this proposed application:

Figure 4. PsychSpace User Inferface from left to right: PsychSpace Welcome Screen; PsychSpace Home Screen; Get to Know Yourself

a. Get to Know Yourself Users can fill out their personal information, such as age, occupation, contact information, and address (for emergencies). This data can also be utilized by the algorithm to find suitable communities and user timeline viewers for optimal experience. b. Choose Your Today’s Emoji This feature is adapted from “Wong-Baker Pain Rating Scale”, a self-assessment measurement tool to help people communicate their pain. As a self-assessment tool, it is required to be easily understood by the patients to be able to choose the face that best illustrates the pain they experience. In our daily life, these faces, or more familiarly: “emojis”, are a common and practical way to

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express our emotion in written form. The majority of netizens are familiar with the use of emojis. Considering this fact, emoji can be used to represent users' current mood and mental state by selecting the most-appropriate available emoji. Moreover, emojis serve as a low-effort way to state their daily feelings, rather than to write it.

Figure 5. “Wong-Baker Pain Rating Scale” and Emojis

c. Which terms fit your day? Besides emojis, PsychSpace also allows users to describe their feelings regarding their day by choosing terms. Several terms that may suit how they feel that day are provided to be selected (such as anxious, sad, happy, joyful, and the others). These terms are personally customized for each user according to their data they provided in the beginning (age, occupation, etc). This feature accommodates feelings that may be unable to be represented by emojis. d. Safe share One of the greatest strengths of this app is that PsychSpace provides an anonymous sharing feature, which works similarly to expressing feelings in social media timelines, without getting recognized. Sharing allows users to unload their mental burdens and therefore improve their mental condition. By sharing anonymously, users can freely share their thoughts with a reduced risk of harmful judgement from the public. Contents from other users will be directed and shown more frequently to suitable communities (based on their biodata) and fellow users who share common problems or concerns. Thus, it facilitates users to get both support and help from other suitable background’s users, which increases reliability.

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Figure 6. PsychSpace ‘Fill My Journal’ Features from left to right: Choose Your Today’s Emoji; Which terms fits your day?; Safe Share

e. Responsive operators PsychSpace is equipped with a chat feature to accommodate users making consultations within seconds. Algorithms are used to answer basic and common complaints. If their complaints are considered quite serious, the algorithm will suggest to continue their session with the professionals. f.

Help Others Help Themselves This feature allows users to encourage and give help to other fellow users by replying their timeline posts. Users can simply leave an encouragement or stickers below the writer's post. This particular feature contributes to make this app a true mental health help app by enabling and encouraging users to give back help to the community. Giving back help and support strengthens user-to-user bond and therefore provides a strong support system. It also helps users to improve their mental health.

g. You Are Not Alone PsychSpace can refer users to communities with similar backgrounds. Communities that are based on their occupations, age, hobbies may help them reach those who experience the same problems. Here they can share their stories if they choose to do so, and hopefully they find that they are not alone in this journey and they can overcome this chapter in their lives together. h. What’s Up? PsychSpace functions as a mental-health literation strategy which provides the most up-to-date and credible information regarding mental health issues and COVID-19 news. The content suggestions

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shown here can also be customized based on the user’s latest update in the ‘Choose Your Today’s Emoji’ feature. Furthermore, users are able to read as well as share their success stories combatting their inner side problem. These success achievements can inspire and help others to fight their own battles. i.

Find the Right One This feature provides an option for users to connect and create an appointment with a professional such as psychiatrists or psychologists to seek help, similar to that of common telehealth apps. Consultation can be done privately, or if both users and professionals do live in the same region, users can choose to book an appointment and do the consultation in person.

Figure 7. PsychSpace Education and Consultation Features from left to right: What’s Up?; Find The Right One

Stay Connected Daily journals that are submitted by users are periodically reviewed by the system. In advance, professionals can make use of this feature for online-monitoring, which provides routine and upto-date patients’ mental health status information. Thus, this app possibly can serve as an credible electronic health record, which later could be connected by respective health care providers.

k. Press the Red Button PsychSpace can serve as an emergency button for users in critical psychological conditions. When certain keywords that express severe symptoms of depression or other mental health conditions are detected, users will receive an automatic message that suggests they consult professionals, such as psychiatrists or psychologists.

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No.

Step

Description

Planning

Identification of problems, specifically mental health, especially in this pandemic era and designing the applicable and innovative solutions.

User research with mini survey

Collecting information related to the recent problem from literature and a mini survey was made in the form of an online questionnaire that 146 participants have responded to.

Development

Innovating development process based on Android and iOS application software (programming and designing).

Testing

Application trials (initiating phase-completion phasefinishing phase).

Implementation

App usage on a national level, with a tutorial video provided to help users understand how to use the app.

Reporting

Collecting data to evaluate our application impact: - Quantitative: Total downloads, amount of stars (rating) obtained in Google Play and App Store. - Qualitative: User reviews and surveys.

Improvement

Continuous improvement based on critics and inputs.

Table 1. Description of the steps in future PsychSpace Implementation

CONCLUSION COVID-19 pandemic has negatively impacted a large number of sectors, especially in the health field. Even though physical health is currently the main attention for the public, the mental health aspect deserves more concern, moreover due to the fact of rising depression numbers worldwide compared to previous year. Depression, one of the most common problems people faced during this period of hardship, not only is the leading cause of disability worldwide, but also contributed a significant loss in global productivity. Moreover, this stressful outbreak also accounts for multiple reports of COVID-19-related suicide attempts in many countries around the world. Regarding these facts, solutions are urgently needed in order to solve this critical “unseen” disease. An innovation of online application, PsychSpace, performed as a mental health buddy application is proposed to answer this problem. This application accommodates safe spaces and communities for its users to express themselves as well as getting help from the community and professionals. PsychSpace also helps users to find a suitable community to grow together as well as facilitate consultation with the professionals.

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Beyond everything, PsychSpace aims to bring inner well-being and prevent the public from harmful deeds due to their neglected mental health. Lastly, it is a noble purpose of all medical students and agents of change to be able to contribute to the improvement of our future patients’ health as well to society's well-being. By creating this innovation, we sincerely hope that this app will be able to raise awareness towards mental health and give answers to people with mental health issues, especially in this pandemic era. Here we propose an innovation of PsychSpace as an application combining technology and health in order to provide a safe online space to help everyone conquer their mental health problems and achieve the Sustainable Development Goals.

RECOMMENDATION We hope that this mental health buddy app, ‘PsychSpace’, can soon be realized by going hand in hand with the government, especially with the Ministry of Health and the Indonesian Psychiatric Association (Perhimpunan Dokter Spesialis Kedokteran Jiwa Indonesia). Next, a prototype of this app can be built with the help from both the Ministry of Communication and Informatics and app developers before its launch in Google Play and App Store.

Stay Connected, Stay Alive

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REFERENCE

American Psychiatric Association. (n.d.). What Is Depression? Retrieved October 18, 2020, from https://www.psychiatry.org/patients-families/depression/what-is-depression Badan Pusat Statistik Indonesia. (2019). Statistik Telekomunikasi Indonesia 2018. CDC. (2020, August 13). Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic - United States, June 24–30, 2020. Retrieved October 19, 2020, from https://www.cdc.gov/mmwr/volumes/69/wr/mm6932a1.htm CNN Indonesia. (2020a). Hapus Isolasi Mandiri di Rumah, 2 Tower Wisma Atlet untuk OTG. https://www.cnnindonesia.com/nasional/20200913003849-20-545763/hapus-isolasi-mandiri-dirumah-2-tower-wisma-atlet-untuk-otg CNN Indonesia. (2020b). Pasien Corona Bunuh Diri, Loncat dari RS Wisma Atlet Jakarta. https://www.cnnindonesia.com/nasional/20200909213718-20-544676/pasien-corona-bunuh-diriloncat-dari-rs-wisma-atlet-jakarta Guo, Q., Zheng, Y., Shi, J., Wang, J., Li, G., Li, C., Fromson, J. A., Xu, Y., Liu, X., Xu, H., Zhang, T., Lu, Y., Chen, X., Hu, H., Tang, Y., Yang, S., Zhou, H., Wang, X., Chen, H., … Yang, Z. (2020). Immediate psychological distress in quarantined patients with COVID-19 and its association with peripheral inflammation: A mixed-method study. Brain, Behavior, and Immunity, 88(May), 17–27. https://doi.org/10.1016/j.bbi.2020.05.038 John Hopkins Coronavirus Research Center. (n.d.). Mortality Analyses - Johns Hopkins Coronavirus Resource Center. Retrieved October 18, 2020, from https://coronavirus.jhu.edu/data/mortality Nakane, Y., Jorm, A. F., Yoshioka, K., Christensen, H., Nakane, H., & Griffiths, K. M. (2005). Public beliefs about causes and risk factors for mental disorders: a comparison of Japan and Australia. BMC psychiatry, 5(1), 33. Peng, M., Mo, B., Liu, Y., Xu, M., Song, X., Liu, L., Fang, Y., Guo, T., Ye, J., Yu, Z., Deng, Q., & Zhang, X. (2020). Prevalence, risk factors and clinical correlates of depression in quarantined population during the COVID-19 outbreak. Journal of Affective Disorders, 275(July), 119–124. https://doi.org/10.1016/j.jad.2020.06.035 Salari, N., Hosseinian-Far, A., Jalali, R., Vaisi-Raygani, A., Rasoulpoor, S., Mohammadi, M., Rasoulpoor, S., & Khaledi-Paveh, B. (2020). Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: A systematic review and meta-analysis. Globalization and Health, 16(1), 1–11. https://doi.org/10.1186/s12992-020-00589-w

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Schraer, R. (2020, August 18). Depression doubles during coronavirus pandemic. Retrieved October 19, 2020, from https://www.bbc.com/news/health-53820425 Sher, L. (2020). The impact of the COVID-19 pandemic on suicide rates. QJM: An International Journal of Medicine. Upadhyay, R., . S., Singh, B., & Singh, U. (2020). Psychological Impact of Quarantine Period on Asymptomatic Individuals with COVID-19. SSRN Electronic Journal, 2(1), 100061. https://doi.org/10.2139/ssrn.3599773 Wang, L. Q., Zhang, M., Liu, G. M., Nan, S. Y., Li, T., Xu, L., Xue, Y., Zhang, M., Wang, L., Qu, Y. D., & Liu, F. (2020). Psychological impact of coronavirus disease (2019) (COVID-19) epidemic on medical staff in different posts in China: A multicenter study. Journal of Psychiatric Research, 129, 198–205. https://doi.org/10.1016/j.jpsychires.2020.07.008 Washington, J., & Hasibuan, S. (2020). Restrictions return in Jakarta as hospitals, cemeteries fill up | Indonesia | Al Jazeera. https://www.aljazeera.com/news/2020/09/14/restrictions-return-in-jakartaas-hospitals-cemeteries-fill-up/ WHO. (2019, August 09). Mental health in the workplace. Retrieved October 19, 2020, from https://www.who.int/mental_health/in_the_workplace/en/ WHO. (2020a). Depression. https://www.who.int/news-room/fact-sheets/detail/depression WHO. (2020b). Novel Coronavirus. https://www.who.int/indonesia/news/novel-coronavirus WHO. (2020c). Transmission of SARS-CoV-2: implications for infection prevention precautions. https://www.who.int/news-room/commentaries/detail/transmission-of-sars-cov-2-implications-forinfection-prevention-precautions

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Sit.Back: Platform for Effective Communication System Involving Multifunction Integration of Telemedicine and 4.0 Industrial Revolution to Optimize Pandemic Response in Indonesia Muhammad Faruqi, Gideon Hot Partogi Sinaga, Rania Rifdah Taufiq AMSA-Universitas Indonesia Abstract December 2019 was the month when disease with pneumonia-like symptoms started to spread among the Chinese population in Wuhan. This infection spread in large numbers within months, causing an outbreak which then led to a global pandemic. Around the world, health systems are faced with countless adversities from limited human resources and lack of knowledge of the disease. As new outbreak measures are being implemented, healthcare workers struggle to communicate with patients. On top of the scarcity of health communication platforms, medical workers have to battle misinformation which influences the behavior of the masses. The sit.back initiative is made to combat these problems with a telemedicine format. This platform helps medical officials execute detection, prevention, response, and recovery without having to interact in-person. Prevention can be carried out by notifying new cases in the local area to the local officials via the app. Through the application, the public can also access ambulance service, arrange doctor visits, and read trusted information. Furthermore, research advances can be made by utilizing consented user information which will then be pooled into integrated data centers. We recommend the government to aid with this project through the creation of policies and encouragement of experts in the fields of system information, public health, and biostatistics. Non-governmental organizations may also support in terms of socialization and improvement of user experience. Keywords: COVID-19 pandemic, communication, information, telemedicine initiative

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Sit.Back: Platform for Effective Communication System Involving Multifunction Integration of Telemedicine and 4.0 Industrial Revolution to Optimize Pandemic Response in Indonesia

By: Muhammad Faruqi Gideon Hot Partogi Sinaga Rania Rifdah Taufiq

AMSA UNIVERSITAS INDONESIA

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INTRODUCTION / BACKGROUND December 2019 was the month when a mysterious disease with pneumonia-like symptoms started to spread among the Chinese population in Wuhan. Originated from Hunan Seafood Market, this infection spread in large numbers within months (Wu et al., 2020). Once known as an outbreak, the disease that is caused by the SARS-CoV-2 virus was considered to be a global pandemic in early March. Lives were restarted as social activities stopped, the school closed, and the financial-related activities ceased (World Health Organization, 2020). John Hopkins Coronavirus Resource Center reported that there are more than 40 million global cases with over a million deaths by September 18, 2020 (Coronavirus Resource Center, 2020). The COVID-19 is an infection caused by a pathogenic virus named SARS-CoV-2. This disease is considered as a highly transmitted one that originates from bat viruses, considering them as a possible reservoir. Cases of COVID-19 are unique in terms of the clinical manifestation, as people can suffer from various severity levels and symptoms. Commonly, people who are infected will experience fever, tiredness, and dry cough accompanied by other minor conditions such as diarrhea, sore throat, aches, headache, anosmia, and rashes (Shereen et al., 2020). Transmitted through droplets and airborne, COVID-19 is more contagious for 3 to 4 more days than flu. Cases keep on increasing because people are unlikely to isolate and adopting preventive behaviors as they are unaware of this condition. Currently, there are no drugs that are specifically designated for COVID-19 cure and the development of vaccines continues to progress. (Zheng et al., 2020) Countries around the world are shattered in pieces as they continue to deal with issues in several aspects, mainly health. The health systems of various countries are tested at their maximum capacity with limited human resources, low testing capacity, and unknown curable drugs for treatment. In the hospitals and clinics, providers and enterprises need to deal with issues of preparedness, adaptivity to new microorganisms, cases increase anticipation, biosafety level examination, switchboard organization, pre-hospital care linkage, and management of hazardous waste. As the pandemic struck in sudden, the solution to these issues had not been prepared, resulting in local ones being implemented. On the other hand, there are concerns relating to the healthcare workers including anxiety, increased quantity demand of workers, double standards. Lastly, the problems intertwining with care and teaching activities such as collateral effects evaluation, bed number availability, research projects development, and teaching activities maintenance. (Peiffer-Smadja et al., 2020) A significant problem in response to this pandemic is the communication between healthcare professionals and infected patients. (Rubinelli et al., 2020) Effective communication is crucial in healthcare practices which are done bi-directionally with the patient and must match several objectives (Ratna, 2019). Other issues originating from the public health sector are misinformation

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through social media, news, and even, government officials. This issue has been stranded for quite in prolonged duration as it psychologically affects people’s behavior towards certain issues (Roozenbeek et al., 2020). Effective communication also supports the implementation of public health efficiently. Effective communication leads to changes in behavior, political commitment increasing, the effectiveness of programs towards the civil sectors as it changes their perception. Currently, there is a revolutionizing way to provide long-distance health care services with the integration of technology. Telemedicine elevates the potentials inpatient care such as information access improvement, deliverable care provision, delivery and access to care improvement, screening quality control, professional education improvement, and cost reduction. However, the presence of the current platform has not provided ultimate integration within users, enterprises, healthcare professionals, and government. Services scattered all around, creating ineffectiveness to the accessibility and care delivery to the patients. (Hong et al., 2020) The problems above mentioned the clinical communication problems, lack of effective public health communication in trusted information, and disintegration in telemedicine services. Based on those issues, we propose an innovation about the new platform for a holistic COVID-19 approach. This platform will fix the chain of clinical communication and healthcare approach as it possesses all aspects of the healthcare approach (detection, prevention, response, and recovery) collectively in one platform. It will also help people in conducting real-time information filtration made by the system apprehended through this platform as it helps in shaping the people’s public health behavior. Furthermore, the data interpreted throughout one’s care may be stored as big analytics to be wisely used as a research and policy implementation. OUTLINE PROBLEMS Coronavirus Disease 2019 or COVID-19 is rapidly spreading resulting in a global pandemic that has infected at least 40 million people and killed more than one million people worldwide. While several nations have thoroughly recovered from the impact and entered the second wave, Indonesia is still in an endless first wave with up to three thousand cases daily, while the citizen’s compliance in health protocol is suspected to below. One of the concerning issues in this pandemic is the communication problem between healthcare professionals and infected patients. From the perspective of a physician, they are unable to deliver effective communication (Rubinelli, 2020). Effective communication must be done in two directions with the patient to achieve several objectives: patient’s conveying capability, physician’s understanding and interpretation skills, and physician’s information deliverance ability (Frieden, 2014). On top of that, it needs to fulfill several aspects: risk communication, uncertainty, collective

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decision making, care goals, bad news deliverance, isolation, and grief (Rubinelli et al., 2020). On the other hand, patients are incapable to receive optimum care as the health officials warned cautiously about the necessities of meeting face-to-face. At this time, normally expected things during clinical and ward visits such as non-verbal gestures, positive messages, facial expressions, and messages with clear intonations and volumes, will probably opt out along this pandemic (Houchens & Tipirneni, 2020). Beyond the issue of not being able to effectively communicate, factors such as health literacy, language barriers, and cultural competence also play a role in the discourse between doctors and patients (Frieden, 2014). Another problem that puts Indonesia in this endless first wave epidemic is information distribution and public communication. First, public misinformation and lack of communication among government levels triggered a misleading interpretation through instant social media tools, such as herbal medication with particular commodities or activities that claimed to be the cure but have not been clinically tested. Combined with the current technology and freedom of the internet, spread of various information, both the correct and incorrect ones, are minimally screened and may create confusion and uncertainties. (Rubinelli et al., 2020) A journal published in The Royal Society Publishing mentioned that people in the world are prone to behavioral influence due to misinformation. Some of those are people’s willingness to undergo COVID-19 vaccination and people’s obedience in following public health measures. In other words, the governments will waste their time posting more measures if the information is not strictly regulated and people do not read verified information about COVID-19 (Roozenbeek et al., 2020). Therefore, an integrated solution is needed for providing correct new information on a timely basis, while also providing less distrust and confusion (Frieden, 2014). A concrete resolution towards these problems in this decade is the advancements of technology and the introduction of telemedicine. Physicians started to use telemedicine in the early 1960s which enabled television links in closed-circuit between a psychiatric institute and state hospital for consultation in psychiatry. Since then, it evolved continuously especially during the 4.0 industrial revolution era, characterized by advanced interfaces, the internet of things, big analytics, location detection, and mobile devices. (Hong et al., 2020) Amid the rapidly evolving COVID-19 environment, telemedicine has been playing an important role in mitigating the COVID-19 response. Importantly, telemedicine helps to send the correct direction and message to patients in a clinical setting and societies in public health action. Especially in this pandemic era, communication in clinical settings becomes significantly important for people infected by the virus that needed treatment or even, the community to get the right message about the reliable

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source on several matters. However, until now, there is no substantial movement from the government that utilizes telemedicine to help in diagnosis or symptom reporting, which has great potential in the management of infections. Additionally, the integration of relevant epidemiological data and geographical information of transmittable disease prevalence in a region that will allow the tracing of cases have not been implemented, which can potentially be an effective tool to control the spread of infection.

PROPOSED SOLUTION One of the most effective ways to deliver health-related information and conduct telemedicine is through mobile platforms as information can be exchanged rapidly and updated dynamically. The precision of the message with minimum errors due to its synchronization will allow the exchange to be worth-taking. Mobile platforms can potentially prevent the occurrence of a particular disease as exchanged texts through a mobile app can promote communication, storage of information, and message delivery that drives users to make healthy lifestyle changes. However, the heterogeneity of platforms as well as incomplete features between platforms might prevent the deliverance of a holistic care approach. Therefore, in developing a holistic mobile application, two important notes needed to be implemented, which are basic features and functionalities. On basic features, an application at least needed to included seven basic features, which were: (1) ability for online and offline availability, (2) size of app less than 50MB, (3) no subscription needed (i.e., free), (4) educational content (COVID-19 teaching), (5) export data (sharing of user’s data with other platforms), (6) automated data entry (automatic update of data without user interference) and (7) advisory function. (Ming et al., 2020) Based on purpose and functionality, a holistic application needed to have five functionalities of mobile platforms, which were (1) daily updated knowledge of screened information on COVID-19, (2) tracing/mapping of COVID-19 cases, (3) home monitoring surveillance, (4) online consultation with a health authority, and (5) official mobile platforms run by a health authority which might help in ambulatory service and drug delivery. The COVID-19 pandemic response must be accessible, widely used, and efficient ways, especially in delivering the best care to the patients. The solutions offered must encounter every problem in a real-time and adequate manner to act simultaneously. Furthermore, this will fulfill the clearances needed in providing the healthcare service. Also, that will help to overcome the communication obstacles by protecting and elevating the community. In creating better approaches, the platform must achieve the health, technology, and communication aspects.

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Figure 1: Mechanism of Sign Up and Pretesting Survey We came up with an idea to develop an integrated platform, involving the use of smartphones as a comprehensive and novel communication tool in an application called sit.back. As the name suggested, this initiative is created to encourage people to stay back at their homes while obtaining health services related to COVID-19. The application has multifunctional capacities in conducting detection, prevention, response, and recovery in a holistic way. Early detection of COVID-19 indication through questionnaires can be referred through the testing sites, displayed with its price, provider, and maps. The result inputs through the online database can be shown in individual applications, as Online User ID connects with the electronic ID Card. Thus, sit.back implements the continuity in 4.0 development to deliver active medical communication collectively in combined measures. Prevention procedures start to conduct classification to protect the community. Local officials (i.e. neighborhood leaders and community leaders) will receive information through their mobile phones if anyone in the area is infected. Furthermore, people that needed to stay in hospitals or specified quarantine places can be linked to the government ambulance system to get there safely. In people with an obligation for self-quarantine, the platforms will automatically flag them and track their mobile GPS transmitters to prevent any wrongdoings.

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Figure 2: Mechanism of Test Result Algorithm and Quarantine Daily Task Collaborative purposes are available in the platform and increasing the early and sustainable responses. This method serves as the center of communication which changed the classical way of meeting in clinical settings. People suffering from COVID-19 could be apprehended with daily care with the help of clinical professionals through telemedicine in that platform. That will be beneficial in conducting better tracing as it promotes less physical visits to the healthcare facilities or from the doctor itself. Systems of daily clinical assessment and one-on-one consultation will create an effective and efficient practice in the patient’s care and carrying out evidence-based treatment, personalized to each patient. Long-distance prevention efforts via individual tracking and mapping need to be continuously carried on to eradicate the chain of infection. On top of that, individual controls are especially crucial for post-COVID-19 patients. However, mutual agreement between the patients and the healthcare society (including the community) is required before performing long-distance control. The platform integrates with other applications for daily necessities to limit hesitation in going outside to prevent any repeated infection. Furthermore, psychological and physical treatment needs to be done for the patient's concern, also reporting any risk factor in the surroundings. Patients will link to telemedicine in the applications that give them the opportunity to solitude any urges during the recovery process. As patients recommend to consume a healthy diet and conduct physical exercise, the platform will provide the interactive questionnaire for the patient to submit those stuff where they can take pictures for verification.

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Figure 3: Mechanism of Fact-Checking and News Platform linked to WHO and Journals Other important issues that this platform will be useful are its competence to eradicate any misinformation. The first one, any information searched by the people about COVID-19 will receive real-time scoring on its bias and misinformation level, allowing the people to report those sites collectively. Whether that is a social media post or a news article, the platform will filter the information based on the correct data received from the World Health Organization and trusted medical journals. The platform also provides infographics and quotes which emphasize attractivity and validity in grabbing and giving real-time information.

Figure 4: Mechanism of Big Analytics Integrated with Platform

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Besides its capacity in promoting trusted public health promotion, this platform serves as a pool of integrated data centers based on the information individually recorded from every patient. The platform will send the data anonymously to the government and research institutes to conduct extensive research on COVID-19 and implement efficient health policies based on the data approach. CONCLUSION The COVID-19 global pandemic resulted in the paralysis of the health system of many countries. As new outbreak protocols and infection control measures are being implemented to sustain the health system, healthcare workers find it hard to communicate with patients and the public. Therefore, the sit.back initiative sets out to combat this problem by providing a telemedicine platform for health officials to educate and communicate. Through the application, users can access ambulance service, arrange doctor visits, and read trusted information. Relevant data can also be collected via user surveys, hence allowing for research advancement. RECOMMENDATION As the spearhead of this project, the government should create enabling policies that allow for sit.back to be developed in a timely manner. Policies that may help with this initiative include the integration of the telecommunication and health sectors. Government officials should also ensure there is adequate financial support. On top of that, the government should encourage experts’ participation, especially those in the field of systems information, public health, and biostatistics. Non-governmental organizations (NGOs) may also aid the development of this project in terms of socialization and improvement of user experience. This is because many NGOs have close communication with the general public. Thus, they have better insight into what the users need. Socialization may also be carried on through non-profit campaigns and social media outreach. REFERENCES (APA Style) Coronavirus Resource Center. (2020). Johns Hopkins Coronavirus Resource Center. Johns Hopkins Coronavirus Resource Center. https://coronavirus.jhu.edu/ Frieden, T. R. (2014). Six Components Necessary for Effective Public Health Program Implementation. American Journal of Public Health, 104(1), 17–22. https://doi.org/10.2105/ajph.2013.301608 Hong, Z., Li, N., Li, D., Li, J., Li, B., Xiong, W., Li, W.-M., & Zhou, D. (2020). Telemedicine during the COVID-19 pandemic: experiences from western China (Preprint). Journal of Medical Internet Research. https://doi.org/10.2196/19577

Houchens, N., & Tipirneni, R. (2020). Compassionate Communication Amid the COVID-19 Pandemic. Journal of Hospital Medicine, 15(7), 437–439. https://doi.org/10.12788/jhm.3472

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Peiffer-Smadja, N., Lucet, J.-C., Bendjelloul, G., Bouadma, L., Gerard, S., Choquet, C., Jacques, S., Khalil, A., Maisani, P., Casalino, E., Descamps, D., Timsit, J.-F., Yazdanpanah, Y., & Lescure, F.-X. (2020). Challenges and issues about organizing a hospital to respond to the COVID-19 outbreak: experience from a French reference centre. Clinical Microbiology and Infection, 26(6), 669–672. https://doi.org/10.1016/j.cmi.2020.04.002

Ratna, H. (2019). The Importance of Effective Communication in Healthcare Practice | Harvard Public Health Review: A Student Publication. Harvardpublichealthreview.Org. http://harvardpublichealthreview.org/healthcommunication/

Roozenbeek, J., Schneider, C. R., Dryhurst, S., Kerr, J., Freeman, A. L. J., Recchia, G., van der Bles, A. M., & van der Linden, S. (2020). Susceptibility to misinformation about COVID-19 around the world. Royal Society Open Science, 7(10), 201199. https://doi.org/10.1098/rsos.201199 Rubinelli, S., Myers, K., Rosenbaum, M., & Davis, D. (2020). Implications of the current COVID-19 pandemic for communication in healthcare. Patient Education and Counseling, 103(6), 1067–1069. https://doi.org/10.1016/j.pec.2020.04.021

Shereen, M. A., Khan, S., Kazmi, A., Bashir, N., & Siddique, R. (2020). COVID-19 infection: origin, transmission, and characteristics of human coronaviruses. Journal of Advanced Research, 24. https://doi.org/10.1016/j.jare.2020.03.005

World Health Organization. (2020, March 11). WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020. Www.Who.Int.

https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media -briefing-on-covid-19---11-march-2020 Wu, Y.-C., Chen, C.-S., & Chan, Y.-J. (2020). Overview of The 2019 Novel Coronavirus (2019-nCoV). Journal of the Chinese Medical Association, 83(3), 1. https://doi.org/10.1097/jcma.0000000000000270

Zheng, K. I., Feng, G., Liu, W., Targher, G., Byrne, C. D., & Zheng, M. (2020). Extrapulmonary complications of COVID-19: A multisystem disease? Journal of Medical Virology. https://doi.org/10.1002/jmv.26294

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E-SEX : APPLICATION AS A SOLUTION TO IMPROVE SEXUAL HEALTH SERVICES, SEX EDUCATION IN PUBLIC SPACE AND HELP OVERCOME MASTURBATION-PORNOGRAPHY Bagas Danadipa, Nabila Fikri A., Nadhiva Nur A., Siti Alfiah AMSA-University Of Muhammadiyah Malang Abstract Health communication is the study and practice of communicating promotional health information, such as in public health campaigns, health education, and between doctor and patient. Sex education refers to “an age-appropriate, culturally relevant approach to teaching about sex and relationships by providing scientifically accurate, realistic, non-judgmental information. That the aim of sex education extends beyond the transfer of knowledge on human physiology, reproductive system, or the prevention of STIs. In indonesia sex education is since as a taboo thing to talk about. The lack of comprehensive sexuality education in Indonesia can have various negative impact to adolescent. For instance, pornography addiction decreasing the gray matter volume, and most of them indulge in masturbation. Therefore we make an application called E-Sex. The aim of it is to increase public awareness sexual knowledge and it’s problem. Key Finding : Health communication, sex education, Indonesia, pornography, masturbation, and E-Sex

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Introducing/Background Health communication is the study and practice of communicating promotional health information, such as in public health campaigns, health education, and between doctor and patient, it is a unique way in healthcare that allows professionals to use communication strategies to inform and influence decisions and actions of the public to improve health (Subijanto, 2016). The lack of comprehensive effective communication in health, especially in sexual health, is a real problem that is not discussed because of the assumption of "taboo", even though the age range from adolescence to adulthood requires more attention in this regard. Sex education refers to “an age-appropriate, culturally relevant approach to teaching about sex and relationships by providing scientifically accurate, realistic, non-judgmental information”. This definition acknowledges that the aim of sex education extends beyond the transfer of knowledge on human physiology, reproductive system, or the prevention of STIs. To empower youths to better understand their sexuality and relationships, which will ultimately improve adolescents’ sexual health and overall quality of life (Francis, 2010). Sex education programs may be school-based that are led by teachers, social workers, health professionals, or peers; community-based; or family-based. Also, there are various approaches to sex education including abstinence-only, abstinence-only-until-marriage, abstinence, and comprehensive sex education. According to the Sexuality Information and Education Council of the United States, comprehensive sex ed “includes age-appropriate, medically accurate information on a broad set of topics related to sexuality including human development, relationships, decision-making, abstinence, contraception, and disease prevention,”. So, education about all matters relating to sexuality and its expression. Comprehensive sexuality education covers the same topics as sex education but also includes issues such as relationships, attitudes towards sexuality, sexual roles, gender relations, and the social pressures to be sexually active, and it provides information about sexual and reproductive health services (Leung et al., 2019). It may also include training in communication and decision-making skills”. Healthy sexuality plays a crucial role in holistic positive youth development. Without healthy sexual attitudes and behaviors, adolescent development will be adversely affected . It is widely known that Indonesia is home to millions of people with various backgrounds and cultures. Especially when it comes to religion, Indonesia is also known for its majority of religious people. Although, there are still misinterpretations that occur among Indonesia masses that is mostly involving religion and its application to everyday life, including a matter of sex education. Sex is seen as a taboo thing to talk about in Indonesia. But, what is wrong about the general view of this topic is how sex is only seen as a way for two individuals to overcome their lust. When in fact, sex is a matter of biological activity which is fundamental for everyone to comprehensively understand.

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Compared to relatives countries such as Malaysia, a recent survey involving 1,071 respondents from various racial backgrounds aged 18 to 29 revealed that a large number of females lack sufficient knowledge of their bodily functions, in the other hand the same survey found that over a one-third of Malaysians have been exposed to pornography on the Internet by the time they are aged 13 to 14 years – with 4.8% of them having already been engaged in sexual intercourse. According to obstetrics and gynecology specialist from Sultanah Aminah Hospital, Dr. Eliza Mohd Noror, a majority of teenagers are unaware of the health implications once they start becoming sexually active, especially if they have more than one partner. In the Netherlands, From age 4, all children in schools receive compulsory age-appropriate sexuality education classes, the main emphasis is on building respect for one’s own and others’ sexuality. Data suggest that the Dutch approach to sexuality education is incredibly effective. On average, teens in the Netherlands do not have sex at an earlier age than those in other Asian countries, and they tend to have positive first sexual experiences, and they are one of the lowest rates of teen pregnancy in the world, as well as low rates of HIV and other STIs. By centering love, empowerment, and respect in the sexuality education curriculum, rather than fear, shame, and stigma, makes for a healthier and happier society. Research in 2015, a global review by UNESCO found that in-depth sexuality education led to better sexual and reproductive health, consequently reducing the number of sexually transmitted infections, HIV, and unintended pregnancies. Comprehensive sexual education was also found to promote gender equality, encourage safer sexual behaviors, delaying first sexual experience, and increase the use of barrier contraceptives (Francis, 2015). Research conducted by Durex Indonesia on Reproductive and Sexual Health shows that 84 percent of adolescents aged 12-17 years have not received sex education.The lack of comprehensive sexuality education in Indonesia can have various negative impact to adolescent (Phipps, 2015). For instance, it is known that Indonesians is not foreign to the fact that its country’s sexual harassment cases are on the rise. The high rate of unsafe sexual behaviors that causes sexually transmitted disease. Indonesia is the 5th country most at risk of HIV / AIDS in Asia (Ministry of Health, 2013). The highest increase in positive cases was in 2016 which reached 41,250 cases, when compared to the previous year there was a difference of 10,315 cases with an age range of 25 - 49 years. Lack of formal knowledge and education about sexual health is one of the bad effects caused. The results of a survey by the National Population and Family Planning Board (BKKBN) in 2014, every year 15 million adolescents aged 15-25 years give birth and 20 percent of the approximately 2.5 million cases of unwanted pregnancy and abortion in Indonesia are performed by adolescents (Kim et al., 2017). This shows how the presence of sexual education is really needed,

Not to mention in a digital age, where everyone have almost unlimited access

to the Internet or other media, where they are exposed to various poor role models, false images

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of sexual life or erroneous standards of beauty, sexual needs of adolescents can raise fears and be a cause of distress. The internet is also a common source of pornographic materials and online pornography is associated with frequency of masturbation (Chowdhury et al., 2019). Recent studies about pornography addiction have shown that the damage that it cause affects the executive functions of the brain, rewiring its structure, and decreasing gray matter volume, the particular area that most affected is the prefrontal cortex. The prefrontal cortex, which oversees regulating selfcontrol, decreases in size when exhibiting addictive behaviors. The cause of behavioral addictions like pornography addiction comes from prefrontal cortex areas such as the DLPFC, vlPFC, and vmPFC (dorsolateral,ventrolateral,ventromedial prefrontal cortex) (Wéry & Billieux, 2016). Masturbation is always related to pornography. Although the history of masturbation is filled with myths and negative connotations, evidence suggests that it is a normal part of human sexual development and behaviour. Difficult friendships, stress and anxiety, family problems, lack of affection and related social factors were also have an association with masturbation. Based on a survey conducted by the Ministry of Health in 2017, 94% of students have accessed pornographic content accessed through comics as much as 43%, internet as much as 57%, games as much as 4%, movies / TV as much as 17%, social media as much as 34%, magazines as much as 19% , Books as much as 26%, and others 4%. Masturbation itself is a form of someone's curiosity about himself, sexual roles, the reproductive system, and the release of pornography. It is considered normal to be in the addiction stage which can interfere with concentration, productivity, and sexual deviations.

Survey Conducted by The Ministry of Health in 2017 6% Have Accessed Pornographic Content 94%

Never Accessed Pornographic Content 6%

94%

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Picture 1. Survey Conducter by The Ministry Of Helath in 2017

Source of pornography 60% 50% 40% 30%

20% 10% 0% movies/tv

games

internet

comics

social media magazine

books

others

Picture 2. Source of Pornography Outline Problems Communication is one of the most important components of health services, Having the ability to communicate well with patients and the community is one of the competency standards for Indonesian doctors. Unfortunately, awareness of the potential impact of health communication on every aspect of public health is generally considered lacking. The lack of discussion of the topic of sexual health among adolescents has resulted in the younger generation being less aware of their future health, both psychologically and physically. As a result, the increase in cases of a sexually transmitted disease in the last five years, rampant teenage pregnancy and abortion, and abuse to addiction to pornography. Solution From the data and facts that have been described the lack of sex education in the community around us. So that many adolescents do not have sufficient knowledge about sex and sexual health, thus increasing the risk of getting sexually transmitted diseases and experiencing sexual behavior deviations. Ineffective health communication from experts such as doctors or psychologists to the community, especially for adolescents to adults. Therefore we make an application as a media to improve Communication of Health Care about sex education to the community, especially adolescents to adults. E-Sex or Education-Sex is an application that serves to increase public awareness of sexual problems. The E-Sex application has 3 main features. The first is the Expert Consultation feature, which is a feature where users can consult about sexual health problems or sexual life to experts, namely doctors or psychologists. Then the second feature is Sex Education, where there will be various kinds of articles on sexuality

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education, experiences, or stories related to health and sexual life as well as how we value and position ourselves in a relationship. And the third feature is Masturbation and Pornography Update, where this feature can be used by users who are addicted to masturbation or pornography, where later users can update their daily masturbation or pornography behavior so that they can be a reminder for application users to be able to control this behavior.

Picture 3. E-Sex Fiture Conclusion Comprehensive sexuality education is needed to support a better future for Indonesian public health. Unfortunately, people awareness is very lacking about sexuality education, that is where the doctor’s role to educate people in order to increase public awareness and improve overall public health status. It is crucial to provide a comprehensive knowledge for adolescent to prevent them from getting the wrong role model in the internet and having sexual behavior deviations. Based on our concerns about the lack of sexuality knowledge and education among Indonesian adolescents, we created a free application called E-Sex with the aim of being able to help increase understanding, public awareness, especially teenagers to adults about the importance of understanding not only about our health and sexual life, but also controlling the intensity of unhealthy masturbation with porn. Recommendation Later on, there are several recommendations to be able to upgrade the features of the E-Sex application so that it can be more widely useful to the public. You can add features such as specifically for women about managing menstrual schedules or other features to control pregnancy, and so on. So that people don’t need to be complicated to download and have several applications to increase their awareness of their health and sexual life, by only having one application, namely E-Sex, is expected to help improve the quality of Communication of Health Care in the realm of sex education.

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References Chowdhury, M. R. H. K., Chowdhury, M. R. K., Nipa, N. S., Kabir, R., Moni, M. A., & Kordowicz, M. (2019). Masturbation experience: A case study of undergraduate students in Bangladesh. Journal of Population and Social Studies. https://doi.org/10.25133/JPSSv27n4.024 Francis, D. A. (2015). Sexuality education in South Africa: Three essential questions. International Journal of Educational Development. https://doi.org/10.1016/j.ijedudev.2009.12.003 Kim, S., Kwok, S., Mayes, L. C., Potenza, M. N., Rutherford, H. J. V., & Strathearn, L. (2017). Early adverse experience and substance addiction: dopamine, oxytocin, and glucocorticoid pathways. In Annals of the New York Academy of Sciences. https://doi.org/10.1111/nyas.13140 Leung, H., Shek, D. T. L., Leung, E., & Shek, E. Y. W. (2019). Development of contextuallyrelevant sexuality education: Lessons from a comprehensive review of adolescent sexuality education across cultures. In International Journal of Environmental Research and Public Health. https://doi.org/10.3390/ijerph16040621 Phipps, S. (2015). Consequences of inadequate sex education in the united states. In Obstetrics and Gynecology. https://doi.org/10.1097/AOG.0b013e318163c833 Subijanto, A. A. (2016). Peran komunikasi dalam menjalankan profesi dokter yang berkualitas dimasyarakat. Universitas Negeri Sebelas Maret. Wéry, A., & Billieux, J. (2016). Online sexual activities: An exploratory study of problematic and non-problematic usage patterns in a sample of men. Computers in Human Behavior. https://doi.org/10.1016/j.chb.2015.11.046

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RELIGIOUS LEADER: INDONESIA’S UNDER-EXPLORED INVALUABLE POTENTIAL IN HEALTH COMMUNICATION

Gideon Hot Partogi Sinaga, Nico Gamalliel Medical Faculty, Universitas Indonesia

Abstract: Coronavirus Disease 2019 is a global pandemic. While several nations have thoroughly recovered and are entering the second wave, Indonesia is still in an endless first wave with 265.240 positive cases and 12.617 deaths, which is the highest overall toll in Southeast Asia. As a religious country with more than 260 million religious’ worshippers, religious leaders become potential resources for any communication intended to the community. Several literatures suggest religious leaders play an important factor in the success of faith-based health promotion, reducing several non-communicable diseases. Hence, COVID-19 urge Indonesia to optimize religious organizations for tackling this pandemic. Due to this problem, we propose a solution called ‘AGAMA SEHAT, INDONESIA KUAT’ as a comprehensive religious-leader-based health communication program to optimize the role of religious leaders in sending correct and on target messages in health communication. The principles of this program are continuous, effective, and extensive, which is not only limited as a short-term response, but maintained in a continuous and consistent manner. The implementation of the core pillar of this program, which is continuous cooperation between government and religious organizations, periodic coaching and training of religious leaders managed by the local health office, as well as consistent monitoring and evaluation systems, may be the key to success in tackling not only COVID19 but also future outbreaks. Still, to ensure that this solution is working well, it is a necessity for the government to strengthen coordination and synergy with the religious organizations.

Keywords: COVID-19, religious leader, communication

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RELIGIOUS LEADER: INDONESIA’S UNDER-EXPLORED INVALUABLE POTENTIAL IN HEALTH COMMUNICATION

By: Gideon Hot Partogi Sinaga Nico Gamalliel

AMSA UNIVERSITAS INDONESIA

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INTRODUCTION / BACKGROUND At the end of 2019, a novel coronavirus was identified as the cause of pneumonia cases in Wuhan, China. The virus, known now as Coronavirus Disease 2019 or COVID-19, then spread rapidly resulting in a global pandemic which has infected at least 26 million people and killed more than 800 thousand people worldwide. While several nations have thoroughly recovered from the impact of this pandemic and are entering the second wave, Indonesia, a large archipelago located in the crossroads of world trade, is still in an endless first wave with new cases continuing to rise daily. As of October 2020, Indonesia has reached 265.240 cases with mortality of 12.617 lives, which is the highest overall toll in Southeast Asia and the fastest infection spread in East Asia (Muhtada, 2020). Indonesia is also known as a religious nation. Data from the Ministry of Religious Affairs (MoR) (2018) showed that there are a total 370.620 worship places across the country where more than 260 million of the citizens worship, making worship places (and religious leaders who manage them) become potential resources for any communication intended to be delivered to the community. (Levin, 2020). However, one of the challenges during the solution to the spread of COVID-19 is the counterproductive attitude shown by some communities. Although the government has issued to stay at home and social distancing, some religious groups still recommend holding gatherings that involve large crowds. Not only that, social media, which should help mitigate COVID-19, instead provides misinformation with wrong religious content and messages, such as fear only to God and not staying away from places of worship. This communication problem is one of the key factors of the endless first wave of COVID-19 in Indonesia. Faith-based organizations have reached a large portion of the population within countries and remain an influential community institution. The clergy members who lead these organizations have significant influence on the daily functioning, programs, policies, and social or cultural environment within these organizations, creating suitable health programs. The current literature suggests that the support and participation of faith leaders is an important factor in the success of faith-based health promotion, including reducing several non-communicable disease such as heart disease (Bopp et al., 2007, Campbell et al., 2007); cancer (Campbell et al., 2000), and chronic lower respiratory disease (Demark-Wahnefried et al., 2000, Peterson et al., 2002), through influential health promotion and intervention. Regarding this matter, COVID-19 as well as various health problems urge Indonesia, as one of the countries that upholds religion, to optimize religious organizations for rectifying misconceptions of religion regarding the response to COVID-19. A study by Muhtada et al, shows that the ability of these local religious leaders is often more effective to provide information to the public than even the government (Muhtada, 2020). By using religious idioms that are well known to the public, they can communicate with their congregation about why a religious ritual can be performed independently in their respective homes and social distancing for the greater benefit. In addition, these mass organizations generally also have multilevel structures, from the branch to the central level, which are well known throughout the archipelago. This multilevel

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structure with a national network has the potential to be synergized in efforts to mitigate COVID-19 which need to be disseminated throughout Indonesia. Therefore, coordination and synergy between the government and religious organizations may be the key to success in tackling COVID-19. Strong coordination and synergy like this will help the government remove any uncertainty, especially when dealing with religious communities. The government can get strong support from religious leaders, as well as legitimacy in the community, to stop being resolute in overcoming counterproductive attitudes and actions of religious adherents to COVID-19 mitigation efforts. Strong coordination and synergy between the government and religious organizations is not only important in dealing with the COVID-19 outbreak, but also for future disasters in Indonesia.

OUTLINED PROBLEMS Healthcare services are often out of sync with religious fields. In this pandemic and for healthcare service in the future, Indonesia should explore any possible solution to improve quality of communication in health, including the invaluable potential of religious leaders that spread across the country. On the other hand, we should keep in mind that this potential solution has probably the same probability to be a challenge in health communication, especially in Indonesia. One of the difficult challenges in efforts to combat the spread of COVID-19 is the counterproductive attitude exhibited by some religious communities. Although the government has called on the public to stay put and avoid the crowds (physical distancing), some religious groups still intend to hold gatherings involving many people. (Post, 2020) In general, faith and health care has become a source of controversy, ranging from sanctity of human life and acceptable behavior, to health-care technologies and health-care services. Those controversies were also linked with social factors, culture, and politics. (Tomkins et al., 2015) So, any solution proposed should be able to address or even prevent the potential of religious leaders' involvement to be a boomerang for health communication. Therefore, Indonesia should be able to formulate a solution that is able to utilize its vast religious penetration across the country to enhance or even boost health communication, but at the same time to make sure that the solution won’t become a backlash because of confounding factors related to religion teachings and habits.

SOLUTION / PROPOSED POLICY Looking at the invaluable potential of religious leaders across the country, the endless first wave pandemic and other countless unsolved health problems, therefore Indonesia should optimize and maximize the role of religious leaders. We propose a solution called ‘AGAMA SEHAT, INDONESIA KUAT’ (Healthy Religion, Strong Indonesia), a comprehensive religious-leader-based health

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communication program to optimize the role of religious leaders in sending correct and on target messages in health communication. The principles of this program are continuous, effective, and extensive. In order to make this program able to give effects that are not only limited to a short amount of time, the program should be maintained in a continuous and consistent manner. Indonesia has another invaluable advantage in its health system: a combination between decentralization and centralization. In short, the decentralization system allows each regional government to manage the health system in their region, mainly managed by the health office of the local government. On the contrary, the centralization system lets the Ministry of Health (MoH) manage health problems and health programs from the office to be applied throughout the country (Mahendradhata et al., 2017) Therefore, the proposed solution may be concentrated to be a local-based solution for easier and more extensive implementation, but also optimize the centralization system to enhance the program even farther. The core pillar(s) of this program can be divided into three points: 1) Continuous cooperation between MoH and religious organizations at the national level, 2) Periodic coaching and training of religious leaders managed by the local health office, and 3) Consistent monitoring and evaluation system to improve the program. 1. Continuous cooperation between MoH and religious organizations at the national level Indonesia has several religious organizations at the national level, such as Indonesian Ulema Council (MUI) for Islam, Council of Churches in Indonesia (PGI) for Protestant, Indonesian Bishops’ Conference (KWI) for Catholic, Indonesia Hinduism Society (PHDI) for Hinduism, Representative of Indonesian Buddhists (WALUBI) for Buddhism, and Supreme Council for the Confucian Religion in Indonesia (MATAKIN) for Confucius. These organizations manage policies of the religious community under their coordination and also manage communication with the MoR and other religious organizations to maintain harmony and peace among religious communities in Indonesia. Those organizations have enough power to influence the religious community under their coordination, including the religious leaders. So, building (continuous) cooperation with them is a must to make the policy become extensively implemented. It also should be noted that this plan involves at least two different ministries: MoH and MoR. The involvement of the Ministry of Home Affairs (MoHo) also should be considered because this plan needs the involvement of regional governments under coordination of MoHo. So, coordination or even agreement between those three ministries and religious organizations should be made, with detailed terms of agreement which will be obeyed by the parties involved in the agreement. Continuity of the plan should be ensured by specific monitoring, evaluation, and improvement terms.

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Periodic coaching and training of religious leaders managed by local health office Religious leaders from national to local level are basically laymen in the perspective of health. In order to make them able to deliver health communication effectively, and most importantly correctly, they should be trained adequately by health officials. If the implementation of this plan fails in this important step, it is not impossible that this plan will be a health communication disaster, when religious leaders spread false information which is based on hoax or false understanding instead of the correct ones. Considering the vast territory of Indonesia, therefore local governments under the decentralization system should be optimized to prepare the religious leaders. Coaching and training for religious leaders can be managed by the health office of local governments. Centralization of the coaching and training can be done at district level, since district is the lowest government level that still has a dedicated health office. Support and monitoring to the district health office can then be done by the provincial health office. Coaching and training should be done several times with well-prepared materials and test systems, and can be done by collaborating with health professionals in their corresponding fields or even local health academic institutions to ensure the quality of the materials provided for the religious leaders. Some incentive-disincentive system may be applied so that religious leaders may show more compliance to this plan. One of the proposed incentives that may be quite simple but effective are performance-based honorariums. The religious leaders may get this incentive after they have considered optimally done certain tasks in delivering health communication to their community. Health is a consistently developing field, so periodic coaching should be considered for the religious leaders. Knowledge about certain diseases given at certain times probably will already have development at another time, so updates must be given to religious leaders to make sure the information provided to the community are the most updated ones. The period should be adjusted depending on the necessity and development of the disease. For example, in terms of COVID-19, the religious leaders can be given weekly updates as the knowledge of the disease is rapidly evolving.

Consistent monitoring and evaluation system to improve the program A good program is the one that is consistently implemented, but also consistently being monitored and evaluated. It should be highly noted that this plan is very depending on external parties that, as stated before, basically laymen in health. So, a monitoring and evaluation system should be built to ensure the effectiveness of the program and quality of information provided by the religious leaders. In the early phase of the implementation, health officials from the district health office may directly involve in the communication to the community. Involvement of health officials ranging from providing assistance to religious leaders to giving a direct example so that the

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leaders may learn and model them. This phase is important to provide a good and comfortable template for the leaders in future health communication that may be conducted by them independently. After the monitoring in the early phase of implementation, consistent monitoring and evaluation should be implemented so the quality of the program and information provided can be maintained or even improved to be even better. The monitoring and evaluation program should be done top-down and bottom-up to get more comprehensive evaluation about the program. Top-down evaluation can be conducted by the health office and/or MoH based on the macro achievement of the program and health statistics in general. Effect of the program on the improvement of public health should become a main basis of monitoring and evaluation. Bottom-up evaluation can be conducted by exploring challenges, complaints, and testimony from the religious leaders about their experience regarding delivering health communication. They may feel that the information provided by the professionals and officials was inadequate, the community showed resistance to the information they provide, etc.. Those problems should be addressed, evaluated, and solved in order to make the program implemented better. As stated, those three points above are the core pillar(s) of this program. Detailing of the program should be conducted in order to make this program applicable. The scheme provided in Figure 1 may show the broad overview of the plan. It is clear that this program needs strong collaboration, but contrary to what used to happen (or at least issues said so), the collaboration scheme can be designed and conducted as simply as possible. Simplicity means less bureaucracy, as the program itself from the beginning already has to involve many parties.

Figure 1. Comprehensive, simple, and effective coordination scheme of ‘AGAMA SEHAT, INDONESIA KUAT’

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CONCLUSION Cases of COVID-19 in Indonesia have been set as the highest overall death toll in Southeast Asia and the fastest infection spread in East Asia. This pandemic and for healthcare service in the future urge Indonesia to explore any possible solution to improve quality of communication in health, including the invaluable potential of religious leaders that spread across the country. Religious movements have been proven to be effective in health communication in COVID 19 and several chronic diseases through faith-related health monitoring and intervention. Hence, by implementing continuous cooperation between government and religious organizations at the national level, periodic coaching and training of religious leaders managed by the local health office, as well as consistent monitoring and evaluation system, may be the key to success in tackling not only COVID-19 outbreak, but also for future outbreaks in Indonesia. Still, to ensure that this solution is working well, it is a necessity for the government to strengthen coordination and synergy with the religious organizations.

RECOMMENDATION It has been clear that involvement of religious leaders in health communication is of invaluable potential and may become an effective solution in tackling public health problems in Indonesia. COVID-19 pandemic and various health problems urge Indonesia to maximize any potential they have, including the involvement of religious leaders. In the short term, the government and religious organizations should sit together and make the most effective plan to tackle pandemic-related problems such as Indonesians low compliance in pandemic health protocol. The pandemic plan then can be continued for future massive systemic health communication in order to tackle Indonesia’s public health problem. Plans to involve religious leaders should be arranged in the principle of continuous, effective, and extensive.

REFERENCES Bopp, M., Lattimore, D., Wilcox, S., Laken, M., McClorin, L., Swinton, R., et al. (2007). Understanding physical activity participation in members of an African American church: A qualitative study. Health Education Research, 22(6), 815–826. Campbell, M. K., Hudson, M. A., Resnicow, K., Blakeney, N., Paxton, A., & Baskin, M. (2007). Churchbased health promotion interventions: Evidence and lessons learned. Ann Rev Public Health, 28, 213–234. Campbell, M. K., Motsinger, B. M., Ingram, A., Jewell, D., Makarushka, C., Beatty, B., et al. (2000). The North Carolina Black Churches United for better health project: intervention and process evaluation. Health Educational Behaviour, 27(2), 241–253.

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Demark-Wahnefried, W., McClelland, J. W., Jackson, B., Campbell, M. K., Cowan, A., Hoben, K., et al. (2000). Partnering with African American churches to achieve better health: lessons learned during the Black Churches United for Better Health 5 a day project. Journal of Cancer Education, 15(3), 164–167. Djalante, R., Lassa, J., Setiamarga, D., Sudjatma, A., Indrawan, M., Haryanto, B., et al. (2020). Review and analysis of current responses to COVID-19 in Indonesia: Period of January to March 2020. Progress in Disaster Science, 6, 100091. Levin, J. (2020). The Faith Community and the SARS-CoV-2 Outbreak: Part of the Problem or Part of the Solution? Journal of Religion and Health, 59(5), 2215–2228. Mahendradhata, Y., Trisnantoro, L., Listyadewi, S., Soewondo, P., Marthias, T., Harimurti, P., et al. (2017). The Republic of Indonesia Health System Review. World Health Organization. Muhtada, D. (2020). Agama dan Mitigasi Wabah COVID-19. 4. Peterson, J., Atwood, J. R., & Yates, B. (2002). Key elements for church-based health promotion programs: Outcome-based literature review. Public Health Nursing, 19(6), 401–411. Post, T. J. (2020). Religion and COVID-19 mitigation. The Jakarta Post. Retrieved October 18, 2020, from https://www.thejakartapost.com/academia/2020/03/26/religion-and-covid-19mitigation.html Tomkins, A., Duff, J., Fitzgibbon, A., Karam, A., Mills, E. J., Munnings, K., et al. (2015). Controversies in faith and health care. The Lancet, 386(10005), 1776–1785.

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EFFECTIVE COMMUNICATION IN INTERPROFFESSION COLLABORATION AS AN EFFORT OF IMPROVEMENT SERVICE QUALITY Alma Mutia Ningrum1, Musfirah Indar Pratiwi2 AMSA- University Of Alkhairaat Palu INTRODUCTION IPC is a partnership between health workers from different background to collaborate solving health problem together and providing health service. But in reality, in few big hospitals in Indonesia, there is no good team cooperation shown. One obstacle of inter-profession collaboration practice is because of the lack of communication between the profession PROPOSED POLICY/SOLUTION a. The Role of Transformational Leadership Transformational leadership has a role in improving communication. Transformational leadership provides inspiration, motivation to achieve goals and changes the attitudes, behaviors and basic values of subordinates to make changes. Transformational leadership owned by health workers focuses on building relationships and communication with others and creating change by emphasizing values Transformational leadership supports the extent to which members engage in two-way communication such as listening, motivating and involving others in decision making. b. Integrated Patient Progress Record A single integrated treatment plan is more scalable and better than a separate treatment plan. The patient care plan must reflect the unique treatment goals for each individual so that assessment and re-planning can be carried out. c. Hospital Accreditation Commission Patient care information and outcomes care must be communicated between health professionals while working in shifts. Communication between health professions is essential for the ongoing process of care. Communication and information between health professions is recorded integrated patient development (CPPT).

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KEYWORDS Transformational Leadership, Interprofessional Collaboration (IPC), Communication And Integrated Patient Development Notes

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EFFECTIVE COMMUNICATION IN INTERPROFFESSION COLLABORATION AS AN EFFORT OF IMPROVEMENT SERVICE QUALITY Alma Mutia Ningrum1, Musfirah Indar Pratiwi2 AMSA- University Of Alkhairaat Palu

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INTRODUCTION According to Law number 44 of 2009 article 1 paragraph 1 concerning hospitals,

understanding the hospital is an institution that provides comprehensive health services provide services through outpatient, inpatient and emergency services. Service plenary health according to Law number 44 of 2009 article 1 paragraph 3 is service which includes promotive, preventive, curative and rehabilitative services. Health services provided in hospitals are carried out by various professions health workers. The various professions involved in health services consist of medical personnel, clinical psychologists, nursing staff, midwifery personnel, personnel pharmacy, nutrition, physical, medical and technical personnel biomedicine (Law Number 36 of 2014). Health services in the hospital are services from various health professions who collaborate to optimize health services (Sitorus, 2006). Institute of Medicine (IOM) and World Health Organization (WHO) asks health professionals to cooperate in interprofessional Collaboration (IPC) to improve health services (IOM, 2010). Interprofessional Collaboration (IPC) is a partnership between people with different professional backgrounds and working together for solving health problems and providing health services (Morgan et al, 2015). According to WHO, IPC occurs when various health professions collaborate with patients, families and communities to provide comprehensive and high-quality services (WHO, 2010). IPC is intended to achieve goals and provide mutual benefits to all involved (Green and Johnson, 2015). Health workers must do collaborative practices properly and not carry out health services individually (Orchar et al, 2005 and Fatalina, 2015). Interprofessional communication is a core competency in interprofessional collaborative practice. To carry out a good collaboration requires effective communication with other health teams, so that they can take safe and effective health service actions. This is also regulated in Permenkes 1691 / MENKES / PER / VIII / 2011 which states that one of the goals of patient safety is effective communication. II.

OUTLINED PROBLEMS

a. Poor communication Between Professions The factors that hinders the implementation of interprofessional collaboration is poor communication between professions (Setiadi, 2017). The

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impact of poor collaboration is the high number of errors in making recipes at Indonesia (as much as 98.69%) due to errors in writing prescriptions for doctors and pharmacists improper preparation of drugs and providing information about these drugs (Easton, 2009). In addition, according to the Australian National Prescribing Service that 6% of cases that occurred in hospital were due to side effects of drugs and errors during treatment. This occurs due to poor collaboration between professions health (Perwitasari, 2010). b. Documentation in eparate Records Between Members of The Profession A sign of a lack of communication between professions is the use of separate documentation between members of the profession. Separate records do not reflect patient responses in activities between health professions (Iyer, 2004). A documentation system that is not integrated causes inefficiency because data is inputted repeatedly in reporting in medical records (Mishra,2015).

III.

PROPOSED POLICY/SOLUTION a. The Role of Transformational Leadership The factors that influence communication in the implementation of interprofessional collaboration are leadership, knowledge (Kesrianti, 2014) and length of work (Hilda, 2017). Transformational leadership has a role in improving communication. Transformational leadership provides inspiration, motivation to achieve goals and changes the attitudes, behaviors and basic values of subordinates to make changes (Suryo, 2010). Transformational leadership owned by health workers focuses on building relationships and communication with others and creating change by emphasizing values (To, Tse & Ashkanasy, 2015). Transformational leadership supports the extent to which members engage in two-way communication such as listening, motivating and involving others in decision making (Ratih, 2008). The government has an important role to play in improving communication between health professionals. The government issued Permen Kes 1691 / MENKES / PER / VIII / 2011 which explains the safety of hospital patients. In Permenkes 1691 / MENKES / PER / VIII / 2011 article 7 paragraph 2 it is explained that one of the patient safety standards is the communication of health staff to achieve patient safety.

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b. Integrated Patient Progress Record To improve the quality of communication between professions, health professional records are used to form one which is called integrated patient development records. Integrated Patient Development Records is documentation between nursing care professionals regarding patient development in an integrated form in patient medical records (KARS, 2017). A single integrated treatment plan is more scalable and better than a separate treatment plan. The patient care plan must reflect the unique treatment goals for each individual so that assessment and re-planning can be carried out (Iyer, 2004). c. Hospital Accreditation Commission Hospital

Accreditation

Commission

(KARS,

2017)

MKE

(Management Communication and Education) 5 regulates communication management and education between health professions. MKE standard 5 describes patient care information and outcomes care must be communicated between health professionals while working in shifts. Communication between health professions is essential for the ongoing process of care. Communication and information between health professions is recorded integrated patient development (CPPT). IV.

CONCLUSION Increasing effective communication with other health teams is needed in the Collaboration Interprofessional so that health workers can carry out safe and effective health service actions. Efforts made to improve communication between professions include integrated patient development records. In order for recording to be more optimal, minimize miscommunication, and improve patient safety which has an impact on the quality of service

RECOMMENDATION Effective communication in interprofessional Collaboration is needed because it is an effort to improve the quality of communication services with patients, so that the capabilities of health services can be integrated and a functional team is formed. The quality of health services and the number of good

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service offerings can make it easier for people to reach health services. With interprofessional collaborations that provide quality health services can maximize productivity, effectiveness and efficiency of health services in hospitals. Integrated treatment plan and single, more scalable and better separate treatment plan that can be applied in the use of patient progress notes (CPPT) because the patient care plan must reflect goals. Patient-centered services performed by interprofessional nursing care professionals. With the existence of a record, it is obligatory to oblige every profession to make records on the same document. So that more optimal recording, communication errors, and improve patient safety which has an impact on quality which can facilitate the transfer of information between health workers so that the services provided to patients are more comprehensive and directed.

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REFERENCES Easton K, Margon T. 2009. Medication Errors in Outpatients of A Government Hospital in Yogyakarta Indonesia. 1(1) : 8 – 10 Fatalina Femi, Sunartini, Widyandana, Sedyowinarso Mariyono. 2015. Persepsi dan penerimaan Interprofessional Collaborative Practice Bidang Maternitas pada tenaga kesehatan. Universitas Gadjah Mada : Fakultas Kedokteran. Jurnal Kedokteran Indonesia. Hilda, Nurhidayah and Arsyawina. 2017.factorc affecting application of communication by nurses in inpatient rooms. Samarinda: Mahakam nursing journal Institute of Medicine, 2010. The future of nursing: leading change, advancing health. Retrieved

from.

http://iom.nationalacademies.org/Reports/2010/The-Future-

ofursingLeading-Change-Advancing-Health.aspx. Iyer Patricia W, & Nancy H Camp. 2004. Dokumentasi Keperawatan. Jakarta: EGC. Kesrianti. 2014. Faktor-faktor yang mempengaruhi komunikasi pada saat handover di ruang rawat inap RSUH Makassar. Retrieved from http://skripsiU12013://top.news 2016 Komisi Akreditasi Rumah Sakit. 2017. Standar Nasional Akreditasi Rumah Sakit Edisi 1 Morgan, S., Pullon, S., McKinlay, E., 2015. Observation of interprofessional collaborative practice in primary care teams: an integrative literature review. Int. J. Nurs. Stud. 52 (7), 1217–1230. Orchar, CA, Curran , V, Kabene, S. 2005. Creating a culture for Interdiciplinnary Collaboration Profesional Practice. Med. Educ Perwitasari, Dyah Aryani et al, 2010. Medication errors in outpatients of a goverment hospital in Yogyakarta Indonesia. International journal of pharmaceutical sciences review and research page 8 volume I. Issue I, Article 002 Ratih, Agnes. 2008. Hubungan Komunikasi Antar Pribadi dengan Peningkatan Kinerja Karyawan PT Asa Globalindo Pratama. Universitas Pembangunan Nasional : FISIP.

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Setiadi, Adji dkk. 2017. Factors contributing to interprofessional collaboration in Indonesia health centres : A focus group study. Journal of Interprofessional Education & Practice 8 (2017) 69-74 Sitorus, R. 2006. Model Praktik Keperawatan Professional di Rumah Sakit. Jakarta : EGC To, M., Tse, H., & Ashkanasy, N. (2015). A multilevel model of transformational leadership, affect, and creative process behavior in work teams. The Leadership Quarterly, 26, 543– 556. Suryo B. D. 2010. The influence of transformational leadership style, culture, organization, and innovation on performance. Management application journal volume 8 number 2, 391-404. To, M., Tse, H., & Ashkanasy, N. (2015). A multilevel model of transformational leadership, affect, and creative process behavior in work teams. The Leadership Quarterly, 26, 543– 556. Undang-Undang Republik Indonesia Nomor 44 tahun 2009 tentang Rumah Sakit. Undang-Undang Republik Indonesia Nomor 36 tahun 2014 tentang Tenaga Kesehatan. World Health Organisation (WHO), 2010. Framework for Action on Interprofessional Education and Collaborative Practice. World Health Organisation, Geneva. World Health Organisation (WHO), 2009. Human Factors in Patient Safety Review of topics and Tools.World Health Organisation, Geneva.

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APPENDIX This research was conducted by Yani Lestari, Ariyanti Saleh, Syahrir A. Pasinringi at the Hospital. Prof. Dr. H.M. Anwar Makkatutu, Bantaeng Regency, to see the The relationship between Interprofesional Collaboration and the Integrated record of patient progress. The population in this study were all health service providers who provided health services to patients in the treatment room of Prof. Dr. H.M. Anwar Makkatutu Bantaeng. Samples were health workers, namely doctors, nurses / midwives,

nutritionists,

and

physiotherapists

internal

care,

surgical,

neurological, child and obstetric care which consisted of 81 people. Sampling using a proportionate stratified random sampling approach. Table 1. Based on the research conducted, the following is the Frequency Distribution of Health Personnel Respondents Characteristics by Age, Gender, Education, Length of Work, and Type of Profession in the Hospital. Prof. Dr. H.M. Anwar Makkatutu Bantaeng Regency (N = 81) by using non-experimental research methods, with a quantitative approach, descriptive correlation and cross sectional design.

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Table 2. Distribution of Respondents by Interprofessional collaboration Variables include Cooperation, Partnership, Coordination, Retrieval Joint Decree at Prof. Dr. H.M.Anwar Makkatutu Bantaeng.

Table 3. Interprofessional collaborative relationships aspects of cooperation, partnership, coordination, joint decision making with implementation of patient progress records integrated.

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In the Interprofessional collaboration aspect of the partnership with the Chi-Square test, the value of p = 0.000 (p <0.05) means that there is a relationship between the interprofessional collaboration aspects of the partnership with the integrated patient development record. The correlation value r = 0.590 indicates moderate correlation strength with positive correlation direction, which means that the better the partnership in interprofessional collaboration, the better the implementation of integrated patient development records. Chi-Square test results p value = 0.000 (p <0.05) which indicates that the statistically there is a relationship between interprofessional collaboration aspects of coordination with integrated patient development records. The correlation value r = 0.686 indicates the strength of a strong correlation with a positive correlation direction, which means that the better the coordination in interprofessional collaboration, the better the implementation of the integrated patient progress notes. Interprofessinal Collaboration aspects of joint decision-

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making obtained by the results of the Chi-Square statistical test showed p = 0.001, (p <0.05), it can be concluded that there is a relationship between Interprofessional Collaboration aspects of decision making along with integrated patient development records with a correlation value of r = 0.531 showing The strength of correlation is moderate with a positive correlation direction, which means that the better joint decision making in interprofessional collaboration, the better the implementation of integrated patient development records.

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ABSTRACT Connect to communicate: Challenges in Communication Health Teresa Jovita Handoko, Audelia Kathleen Sulaiman, Gabriella Belinda Undergraduate Medical Program, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia

Introduction: Communication in clinical settings consists of communication between physicians and their patients, physicians and other physicians, physicians and nurses, and between hospitals and other hospitals. It has become an important issue due to its arising problems. One study found that poor communication was responsible for causing around 44,000 and 98,000 patient deaths annually in American hospitals in the 1990s. Approximately 7,000 cases were communication failures, either among medical staff or between medical staff and patients, resulting in harmed patients. The poor communication could also lead to poor teamwork between medical personnel. It is important to combine knowledge, communication skill, attitude and also medical practice experiences to be a step closer in achieving a great medical ecosystem. Through this, we are hoping that there will be improved understanding of the importance of communication in clinical settings and improve the quality of communication in clinical settings. Solutions: Since there are gaps in education, doctors are required to be able to provide simpler explanations so it's easier for the patients to understand. The easiest step that could provide these collaborations is the patient's medical record. In Indonesia, a lot of health service centers still use the conventional way of medical records as there is limited access for electronic medical records. These conventional medical records can have many errors caused by humans. Key findings: communication in clinical settings, malpractice, challenges in communication

REFERENCES 1. McCabe, R., & Healey, P. (2018). Miscommunication in Doctor-Patient Communication. Topics in

cognitive science, 10(2), 409–424. https://doi.org/10.1111/tops.12337 2. Claramita, M., Utarini, A., Soebono, H., Van Dalen, J. and Van der Vleuten, C., 2010. Doctor–patient

communication in a Southeast Asian setting: the conflict between ideal and reality. Advances in Health Sciences Education, 16(1), pp.69-80. 3. Ong, L., de Haes, J., Hoos, A. and Lammes, F., 1995. Doctor-patient communication: A review of the

literature. Social Science & Medicine, 40(7), pp.903-918.

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WHITE PAPER

Connect to communicate : Challenges in Communication Health

Audelia Kathleen Sulaiman Gabriella Belinda Teresa Jovita Handoko

School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia

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ABSTRACT Connect to communicate : Challenges in Communication Health Teresa Jovita Handoko, Audelia Kathleen Sulaiman, Gabriella Belinda Undergraduate Medical Program, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia

Introduction: Communication in clinical settings consists of communication between physicians and their patients, physicians and other physicians, physicians and nurses, and between hospitals and other hospitals. It has become an important issue due to its arising problems. One study found that poor communication was responsible for causing around 44,000 and 98,000 patient deaths annually in American hospitals in the 1990s. Approximately 7,000 cases were communication failures, either among medical staff or between medical staff and patients, resulting in harmed patients. The poor communication could also lead to poor teamwork between medical personnel. It is important to combine knowledge, communication skill, attitude and also medical practice experiences to be a step closer in achieving a great medical ecosystem. Through this, we are hoping that there will be improved understanding of the importance of communication in clinical settings and improve the quality of communication in clinical settings. Solutions: Since there are gaps in education, doctors are required to be able to provide simpler explanations so it's easier for the patients to understand. The easiest step that could provide these collaborations is the patient's medical record. In Indonesia, a lot of health service centers still use the conventional way of medical records as there is limited access for electronic medical records. These conventional medical records can have many errors caused by humans. Key findings : communication in clinical settings, malpractice, challenges in communication

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Introduction Communication in clinical settings consists of communication between physicians and their patients, physicians and other physicians, physicians and nurses, and between hospitals and other hospitals. It has become an important issue due to its arising problems. Problems regarding communication may create some disturbance, but the foremost problem is malpractices. One study found that poor communication was responsible for causing around 44,000 and 98,000 patient deaths annually in American hospitals in the 1990s. Other studies found that poor communication was one of the main causes of preventable deaths in hospitals. Yet, communication is still underestimated within the clinical settings. The Risk Management Foundation of the Harvard Medical Institutions found 38% of all general medicine cases, 4% of all obstetrics cases, 32% of all nursing cases, and 26% of all surgery cases are involved in a communication failure. In the U.S., there were 23,678 malpractice cases from 2009 to 2013. Approximately 7,000 cases were communication failures, either among medical staff or between medical staff and patients, resulting in harmed patients. Barriers might be found in few of the difficulties in communicating, namely barriers in languages, culture and also religion. Research groups began to evaluate the claim that healthy physicianpatient dialogue could improve strong rapport between the two parties, while its counterpart, namely poor communication, could lead to hostility and mutual distrust between and eventually resulting in ineffectiveness of treatment that patients received. The poor communication could also lead to poor teamwork between medical personnel. It is important to combine knowledge, communication skill, attitude and also medical practice experiences to be a step closer in achieving a great medical ecosystem. Through this, we are hoping that there will be improved understanding of the importance of communication in clinical settings and improve the quality of communication in clinical settings.

Outlined Problems The outcome of poor communication problems leads to a bigger problem which is malpractices, neglect between patient and doctors or physician, and also deaths. There are a lot of factors that might create troubles in communicating. Communication between doctor and patient is further complicated due to the educational gap in Southeast Asian countries. According to the Ministry of National Development Planning of Indonesia, approximately 4,3 million students in Indonesia dropped out of school with a variety of levels in 2019. There are many things taken into consideration. For example, differences in culture and language plays a big part in it. In Indonesia, there are over 300 ethnicities and covers over 13,000 islands. This variety makes it harder for some people to communicate due to differences in these settings. A different communication style might be one of the most highlighted communication problems. Inadequate teamwork between medical personnel might also influence these traits above. This leads to degradation of the quality of healthcare in hospitals. Due to poor communication, negative outcomes tend to be shown more. Bad manners and attitude might also provoke communication

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difficulty. Therefore, selecting the right words and actions might help strengthen a great conveyance in the clinical settings. Communication failures are known to contribute to many medical errors. Lack of experience and sharpness in making decisions are also the reasons that might lead to distrust, hostility, and also bad impressions in communicating. This may lead to disconnection of relationships and misinformation of both parties. Dissatisfaction of patient feedback could affect the hospital reputation and management due to lack of awareness in communication, or even worse could lead to malpractice lawsuits.

Solution According to the outlined problems, there are several solutions proposed. First, because there are gaps in education, doctors are required to be able to provide simpler explanations so it's easier for the patients to understand. It’s still challenging for doctors to make a simple explanation that reaches to each patients' understanding, as the standard for a simple explanation might be diverse. On the other hand, patients might have an inferiority complex as they couldn’t understand the doctor's explanation and thus don't ask questions. These can lead to a misunderstanding between patient and doctor, or even create a mutual distrust. Second, differences in culture, language, and communication style demand the willingness of the health workers to understand the culture in their place of work and also the patient's cultural background. These problems can be resolved over time and experiences, as the health workers get used to the working environment. Third, Enhancing collaboration within physicians and hospitals to take care of patient’s case one-by-one to minimize the conduction of diagnosis and even treatment being overlapping or even worse. The easiest step that could provide these collaborations is the patient's medical record. In Indonesia, a lot of health service centers still use the conventional way of medical records as there is limited access for electronic medical records. These conventional medical records can have many errors caused by humans. On the other hand, the policies managing medical records are still very limited, especially regarding electronic medical records.

Conclusion and Recommendation Communication may be the simplest but the most crucial for the patient’s treatment. There are many benefits but also challenges in implementing good communication in clinical settings. Choosing the right words and manners for physicians or any medical personnel to gain mutual understanding with patients is one of the methods. Therefore, knowing the purposes and implementing the right use of communication in medical school is crucial. Learning by practicing might help to improve medical personnel’s communication skills. Giving the best behaviour and care for the patient also boosts up trust and communication between physicians and patients. Electronic medical records must be implemented to every hospital to prevent human error and to contribute in the easier way of communication between physicians and hospitals. The government is

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required to make a law that clearly regulates implementation of electronic medical records. Technologies are developing fast, so it is important to keep up with the updates. Using the proper tools and methods, we are able to connect faster and properly. However, it is necessary to use them carefully, knowing there might be an improper use of technology for some people. In conclusion, communication problems aren't something to be solved in a short time. Varieties and barriers in communication need more exploration as time goes by. By doing our best and improving skills from time to time through experience helps many problems to be solved in the future. Rising awareness is not enough to make changes, but by doing these actions creates a better future for the medical ecosystem.

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REFERENCES 1. McCabe, R., & Healey, P. (2018). Miscommunication in Doctor-Patient

Communication. Topics in cognitive science, 10(2), 409–424. https://doi.org/10.1111/tops.12337 2. Claramita, M., Utarini, A., Soebono, H., Van Dalen, J. and Van der Vleuten, C., 2010.

Doctor–patient communication in a Southeast Asian setting: the conflict between ideal and reality. Advances in Health Sciences Education, 16(1), pp.69-80. 3. Ong, L., de Haes, J., Hoos, A. and Lammes, F., 1995. Doctor-patient communication: A

review of the literature. Social Science & Medicine, 40(7), pp.903-918.

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ABSTRACT Radio and Local-Language Booklet as an Efficient Rural Community Approach To Increase Awareness Towards COVID-19 Bernadine Tiara Maharani, Shintya Octaviana Baliulina, Kartika Palmasari, Yolandita Chrisan Berliana 2nd year medical student, 2nd year medical student, 3nd year medical student, 3nd year medical student Asian Medical Students’ Association - Universitas Brawijaya

COVID-19 is still a focus point heretofore, especially due to the lack of public attention and awareness towards it. A recent survey revealed that even the simplest health protocols as maintaining hand hygiene is only known by 14.5% of the public. Meanwhile, rural communities live their daily lives as usual, as indicated by the absence of social distancing. Latest datas showed that around 43,6% of Indonesians lived in rural areas and another data shows 45% of all Indonesians are not covered by the internet and these people are living in the utmost frontier rural areas. Ironically, governments take most actions by spreading awareness through websites where internet coverage is needed. Thus, an effective educational approach which can reach rural areas is essential. Before providing the educational services, the first crucial step in approaching rural society is gaining trust and attention from the community leaders as they play an important role as a bearer of change and are able to have a positive impact on the development of rural communities. Here, we propose an AM signals radio broadcast as an educational approach that has the potential to reach almost anyone, accompanied by local language booklets. The method will be supported by a series of follow up sessions. We hope that this method will eventually give a significant effect as resulting in the raise of community awareness, moreover, to decrease the COVID-19 infection prevalence and incident rate in this pandemic state.

Key findings: rural, educational, community approach, awareness, COVID-19

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RADIO AND LOCAL-LANGUAGE BOOKLET AS AN EFFICIENT RURAL COMMUNITY APPROACH TO INCREASE AWARENESS TOWARDS COVID-19

By: Bernadine Tiara Maharani, Shintya Octaviana Baliulina, Kartika Palmasari, Yolandita Chrisan Berliana 2nd year medical student, 2nd year medical student, 3nd year medical student, 3nd year medical student ASIAN MEDICAL STUDENTS’ ASSOCIATION - UNIVERSITAS BRAWIJAYA

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Radio and Local-Language Booklet as an Efficient Rural Community Approach To Increase Awareness Towards COVID-19 Bernadine Tiara Maharani, Shintya Octaviana Baliulina, Kartika Palmasari, Yolandita Chrisan Berliana 2nd year medical student, 2nd year medical student, 3nd year medical student, 3nd year medical student Asian Medical Students’ Association - Universitas Brawijaya

INTRODUCTION Starting from the end of 2019, COVID-19 is still a focus point, especially due to the lack of public attention and awareness towards it. It has been reported by WHO per October 17th, about 39 million people were confirmed as positive cases of COVID-19 and 1.09 million people from around the world had died due to COVID-19 (WHO, 2020). Based on COVID-19 Handling Task Force there have been 12.431 deaths and 357.762 persons with confirmed cases reported from Indonesia (Kemenkes RI, 2020). According to an article in the journal Wellness and Healthy Magazine which analysed the impact of the COVID-19 pandemic on the level of public awareness in implementing health protocols, it is stated that 95.4% of the public understood the importance of implementing health protocols during a pandemic. Yet, many of those people did not holistically understand the procedure of health protocols. A recent survey revealed that the simplest yet essential protocols such as maintaining hand hygiene which reduce the risk of spreading the virus by 55% is only known by 14.5% of the public. Furthermore, 52.3% and 56.9% of people who do not wash their hands before eating and do not carry hand-sanitizers when traveling, respectively (Pinasti, 2020). Thus, it can be concluded that public awareness in Indonesia is still lacking to implement health protocols properly, despite understanding that health protocols are important things to be correctly done and implemented in daily routine. Today all kinds of COVID-19 credible information are being spread mostly through the internet and the people of rural areas do know that there is a COVID-19 outbreak which is currently hitting the country and even the globe. Even though they already know about the presence of this outraging virus, people in Cikarawang Village as an example, still live their daily lives as usual like nothing happened. A journalist who traced this rural area found that there was no social distancing among its people. Street food stalls were still actively open as usual with a crowd of buyers and people were busy chatting and joking around without minding any feelings of fear that COVID-19 can be easily transmitted from one individual to another without proper protection (Febrian, 2020).

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Furthermore, regarding worshiping at the mosque, a lot of people in rural areas did not know that the Indonesian Ulema Council (MUI) had advised moslems to pray at home. With the informations and news gathered, we draw our own conclusions, that we will rarely find people who bring their own worship equipment (known as sajadah salat or prayer rug) as suggested, even after worshiping there are still a ritual of shaking hands as if the current outbreak is just a wind passing by which does not raise people’s precaution at all. Interestingly, there were villagers who explained that the virus was all about China’s revenge in a subtle or a smooth way to Indonesia for the past conflict, Natuna Sea. This actually exacerbated the situation in which the public received wrong information, instead of getting the truth from facts and warning about awareness. A villager who was interviewed said that he knew of an appeal to keep his distance from television, while the rest admitted that they didn’t know anything about this important information. In fact, there was no brief socialization and outreach conducted by the local authorities (Febrian, 2020). In these circumstances we can not totally blame the whole society. Their lack of access to proper knowledge and education about the COVID-19 pandemic eventually put them in a dangerous situation and lack of selfawareness today.

OUTLINED PROBLEMS Raising awareness and information distribution against facts about COVID-19 is a tricky procedure and regulation to deliver in Indonesia, especially in the rural areas. Rural villages as we know, are not as modernized as the big cities and according to recent datas of 2020 which showed that it is projected around 56,4% of the total of Indonesians lives in the urban and the rest 43,6% or approximately 117,102,194 Indonesians are living in the rural areas. This data is also supported by datas from the Ministry of Communication and Information of the Republic of Indonesia and the Indonesian Internet Service Providers Association, which stated that approximately 117 million Indonesians are not covered by internet connection (Kominfo, 2018). The 45% of the population who are not internet-covered are mainly located in the villages categorized as one of the lagging, frontier and the utmost villages in Indonesia. The Central Bureau of Statistics in 2018, displayed the recent datas that there are about 14.461 lagging and underdeveloped villages currently in Indonesia assessed with the village development index. This data showed that spreading facts and raising awareness nationally is challenging especially to these 14.461 villages. Rural villages also pay major attention the cultural and religious values such as highly respecting the village chief and elders to be the decision makers of the village and could very easily influenced the village’s overall development and opinion, so informations are mainly spread from mouth to mouth and as a custom or cultural thing a lot of Indonesians do, people tend to put additional stories or personal points to each information that could eradicate or misinterpret the point of an information. This is concerning, as with this method of information spreading, it tends to create a big misunderstanding against the virus and

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encourages them into thinking that the health protocol can still be compensated in the execution, making the numbers of active cases in Indonesia keep soaring highly. That is why, based on these facts are the reasons why we would like to discuss further about the best information distribution media that are capable of spreading awareness and facts about COVID-19 especially to the people living in rural areas. As we know, many efforts have been made to spread awareness and informations regarding COVID-19 such as: 1. The ministry of health (Kemenkes RI, 2020) drafted and updated the latest Permenkes such as PERMENKES No. 9 tahun 2020 or the Kepmenkes HK.01.07/MENKES/248/2020 concerning Guidelines for Large-Scale Social Restrictions in the Context of Accelerating Handling of Corona Virus Disease 2019, which gave the latest guidance against PSBB policy to apply PSBB on numerous provinces to reduce the number of positive cases as a primordial prevention for Indonesians. 2. Kominfo (2020) websites organized by the government such as www.covid.go.id gives the latest case numbers and statistics, information and instructions about preventions against COVID-19 3. National committee for handling COVID-19 and national economic recovery (KPCPEN, 2019) created websites and applications that are ready to be downloaded in Appstore and Playstore. Hotlines are also provided by the all ministries to answer questions and act as a hoax buster account to retain hoax spreading all over society 4. Socialization by giving out flyers and guidebooks to people or giving education based on the flyers and guidebooks topics by explaining COVID-19 in a simple and interactive way to the rural citizens by adding videos, pictures and simulations (Sulaeman,2020) These solutions are not as effective to the rural society as it is to the urban society as a lot of these solutions are very highly dependent on access to the internet and these requirements are available only to urban cities and developed villages that are internet covered. People in the rural areas that are not internet covered cannot access these information easily because there isn't any decent internet coverage, even getting a signal to make a phone call could be seen as a relief. Handing out flyers and guidebooks could be an effective solution as well, but this solution has a downside, as giving out flyers and guidebooks requires socializations and follow ups that could increase the prone level of COVID-19 transmission to the families and not all citizens have enough time to read the flyer and guidebook by themselves thoroughly to gain information and education. Therefore, we decided to find a more efficient way to educate rural communities about all important things related to COVID-19 amid the outbreak of the Corona virus infection.

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SOLUTION In handling the community approach, four major things need to be considered by the provider, in this case are health workers in association with social workers. Those four steps are: define the target group, prefer the human resources based on the target group needs, define the kind of services that will be provided, and determine the technology used in terms of giving the services. It has been discussed that the target group to focus on this community approach is rural society group and the focus of services is to educate rural communities about COVID-19. In this section, the further kind of services, human resources, and technology used will be discussed. According to studies, rural society is a society with a strong history and social cohesion (National Academy of Sciences, 2018). It refers to a community's leader who has a major influence on the community. Other findings showed that effective leadership in society plays an important role as a bearer of change and is able to have a positive impact on the development of rural communities. In addition, effective leadership from community leaders can bring changes in social, economic and cultural aspects, as well as changes in the way of thinking of rural communities, even inspire other community leaders (Rami, 2016). Human resources, in this case, are needed in terms of influencing the target group community so that a deeper intervention of giving COVID-19 education to rural communities as the target using radio media can have an optimal impact. Here we take advantage by engaging community leaders to understand the importance of better knowledge about COVID-19. Hence, the first crucial step is gaining trust and attention from the community leader. The community leader needs to be educated thus having strong basic knowledge that giving COVID-19 education into his community is necessary. After that, comprehensive information spreads about the schedule of educational approach supported with brief explanation must be conducted. This action will be provided by the social workers with the help from local community leaders. We recommend the use of local mosque’s speaker or simple public poster, depending on the rural demographic condition or the usual method used by local villagers to spread information. Then we can proceed to the next step which is providing the educational services and intervention related to COVID-19. As previously explained due to social distancing practice, most of COVID-19 information has been spread mostly through apps and websites. The internet today may have the potential to reach a wide audience. But apart from all the sophistication of those internet dependent mass media today, there are other mass media communication tools that have been used and replaced dynamically over years. The dominant mode of mass media is started with newspaper, telephone, motion pictures, radio, television, cable television, and internet (Neuman, 2010).

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Radio is communication media through the use of radio waves that has the potential to reach almost anyone. It reaches illiterate people to busy scheduled people. This wide reach makes radio a tool of social cohesion because it brings together members from various classes and backgrounds to have equal opportunities in gaining information. In rural communities with the difficulty of basic education that lead to alliteration, electricity, and the internet, radio holds an important role to bring all kinds of information. Studies in African rural communities have revealed that radio in Africa is very effective at reaching smallscale farmers across remote areas. Radio programs can encourage the community to formulate problems and find local solutions. The radio also provides other useful information like the weather forecast. Thousands of radios in Africa can play an important role to disseminate the result of research that aims to make listeners able to understand and take advantage of the results of the studies (McKay, 2009). There are two commonly used radio signals: FM and AM. The advantages of AM radio are even if the signal is not very strong, the signal is relatively easy to detect with simple equipment. The other advantage is that it has a wider coverage compared with FM radio. But an AM signal is affected by electrical storms and other radio frequency interference. Also, although the radio transmitters can transmit sound waves of frequency up to 15 kHz, most receivers are able to reproduce frequencies only up to 5 kHz or less. A distinct advantage that FM has over AM is that FM radio has better sound quality than AM radio. The disadvantage of FM signal is that it is more local and cannot be transmitted over long distance. Thus, it may take more FM radio stations to cover a large area. Moreover, the presence of tall buildings or land masses may limit the coverage and quality of FM. Thirdly, FM requires a fairly more complicated receiver and transmitter than an AM signal does (Plonus, 2020). Due to both advantage and disadvantage of the two signals, considering the wide area of rural and lack of high-level equipment in communities, the AM signals is preferred in order to give a wider range of rural areas and wider affect to the community. Considering the things that have been explained about radio, our team decided to host a radio broadcast as a platform of education about COVID-19 to the people in rural areas, in which radio is still widely used as one of the sources of information and entertainment. Radio education will be broadcasted four times. The broadcasts will be separated into a few sessions, on Friday and Saturday for two weeks straight. The first main session will be held on the first Friday, which will invite a medical professional to educate the people by explaining things about the COVID-19 pandemic that are considered essential to know and understand. The rest of the broadcast sessions will provide opportunities for people to interact by telephone or text with the broadcaster and health professional. People are encouraged to ask questions or even share their thoughts and doubts about the situation. Interactive broadcasts are expected to attract people to know and understand more deeply about the COVID-19 pandemic.

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In order to maximize the delivery and comprehension of the COVID-19 information, the radio broadcast will be accompanied by an in-hand guide booklet. Customized booklets containing information about COVID-19 will be handed to people in the rural community. Booklets will be customized based on the sociocultural background of a particular rural area. For example, the language used will be the local language, the visual design will be accustomed to the typical culture and interest of the community. The booklets will be titled “Get to Know COVID-19” written in each area’s local language. Therefore, people will become more interested in reading the booklet which offers familiarity with them. Content of the radio broadcast and booklet will include the followings: ● What is COVID-19 ● What are the symptoms and what to do if we experience those symptoms ● Terms and abbreviations widely used during the pandemic ● How is it transmitted ● How to prevent transmission ● Who are at risk ● Essential health practices during pandemic

One of the health practices that are essentials to understand and to be done is WHOstandardized six steps of handwashing, which can be done while singing a short part (2030 seconds) of the community’s local or traditional song. Other essential health practices are sneeze and cough etiquettes, putting on and putting away masks appropriately, physical distancing, and quarantine. ● Burial procedures of infected patients ● Information of important numbers & contacts

There will be contact information alongside well drawn and easily understood maps to the nearest health facility and referral hospital. Numbers of regional and national COVID-19 emergency services will also be attached. ● Do It Yourself (DIY) Cloth Masks Tutorial

Steps of how to make your own cloth masks with simple tools and materials that are easy to find in the area. After four radio broadcast sessions and distribution of booklets, we will conduct follow up sessions for people of the community. People will be encouraged to approach the community’s health facility when experiencing physical or psychological signs or symptoms regarding COVID-19. Our team will do a weekly visit to the community’s health facility, recapitulate and review complaints from the people. Complaints that need further attention will be addressed to more advanced health facilities.

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CONCLUSION AND RECOMMENDATION People in urban and rural areas should have the same opportunity to get a holistic knowledge about COVID-19, in order to raise awareness, moreover, to decrease the COVID-19 infection prevalence and incident rate in this pandemic state. But today most of the information is given through internet dependents methods, resulting in the lack of proper knowledge and awareness from rural areas communities. Here we propose an efficient way to educate rural communities through AM radio signals educational broadcasting accompanied by “Get to Know COVID-19” booklets with comprehensive yet easy-to-understand knowledge content with the initiation help of local community leader's influence. The radio broadcast will consist of two session, educational session and Question-and-Ask session while the booklet will be customized with local language. Lastly, the method will be supported by a series of follow up sessions. We hope that this method will give a significant effect on the educational approach towards rural communities. May in the future be found a better radio signal to reach a wider range of areas equipped with better sound quality can be used in this method of rural community approach.

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REFERENCES Badan Pusat Statistik. (2018). Hasil Pendataan Potensi Desa 2018. Retrieved October 14, 2020 from https://www.bps.go.id/website/materi_ind/materiBrsInd-20181210111801.pdf Febrian, Ramdan. (2020). Pengetahuan dan Teori Konspirasi COVID-19 di Kepala Masyarakat Desa. Retrieved October 17, 2020 from https://voi.id/jurnalisme-rasa/3891/pengetahuan-dan-teorikonspirasi-COVID-19-di-kepala-masyarakat-desa Kementerian Kesehatan Republik Indonesia. (2019). Hoax buster. Retrieved October 14, 2020 from https://covid19.go.id/ Kementrian Kesehatan Republik Indonesia. (2020). Analisis Data COVID-19. Retrieved October 17, 2020 from https://covid19.go.id/ Kementerian Kesehatan Republik Indonesia (2020). Keputusan Menteri Kesehatan Republik Indonesia Nomor. HK 01.07. Menkes/248/2020. Penetapan Pembatasan Sosial Berskala Besar Di Wilayah Kabupaten Bogor, Kota Bogor, Kota Depok, Kabupaten Bekasi, Dan Kota Bekasi, Provinsi Jawa Barat Dalam Rangka Percepatan Penanganan Corona Virus Disease 2019 (COVID-19) Kementerian Komunikasi dan Informatika. (2018). Belum Tersentuh Meski Tak Terpencil. Retrieved October 14, 2020 from https://kominfo.go.id/content/detail/13518/belum-tersentuh-meski-takterpencil/0/sorotan_media McKay, B (2009). Radio: Sarana Petani Bertukar Strategi Adaptasi. Majalah Salam Edisi 26 Januari. National Academies of Sciences, Engineering, and Medicine. (2018). Achieving rural health equity and well-being: Proceedings of a workshop. National Academies Press. Neuman, W. R. (2010). Theories of media evolution. Media, technology, and society: Theories of media evolution, 1-21. Pinasti, F. D. A. (2020). Analisis Dampak Pandemi Corona Virus Terhadap Tingkat Kesadaran Masyarakat dalam Penerapan Protokol Kesehatan. Wellness and Healthy Magazine, 2(2), 237-249. Plonus, M. (2020). Electronics and communications for scientists and engineers. Butterworth-Heinemann. Rami, A. A. M., Abdullah, R., & Simin, M. H. A. (2017). Influence of leadership in rural community development in the state of Terengganu, Malaysia. ASIAN JOURNAL FOR POVERTY STUDIES (AJPS), 3(1).

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Sulaeman, S., & Supriadi, S. (2020). Peningkatan Pengetahuan Masyarakat Desa Jelantik Dalam Menghadapi Pandemi Corona Virus Diseases–19 (Covid-19). Jurnal Pengabdian UNDIKMA, 1(1). World Health Organization. (2020). WHO Coronavirus Disease (COVID-19). Retrieved October 17, 2020 from https://covid19.who.int/

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E-HM: Electronic Hospital Management The Next Generation of Digitalized Hospital Management Danielle Katarina Winarta, Triana Amelia Lasdianto, Vincentius Mario Yusuf, Silvia Husodo nd

2 year medical student, 2nd year medical student, 2nd year medical student, 3rd year medical student ASIAN MEDICAL STUDENTS’ ASSOCIATON-UNIVERSITAS BRAWIJAYA ABSTRACT Health care quality has set the focus on health services, including a broad set of services of acute, chronic, preventive, promotion, restorative, and rehabilitative care, which are delivered by various health care providers on individuals and populations. Hospital Information System (HIS), or also known as hospital management software (HMS), or hospital management system is a comprehensive health informatics that focuses on the medical, administrational, financial, and legal issues needed by hospitals. Radio Frequency Identification (RFID) is a technology in which digital data encoded in tags or smart labels are captured by a reader via radio waves automatically. RFID is similar to barcoding in that data from a tag or label are captured by a device that stores the data in a database. Since RFID shows great promise in helping healthcare improving patient safety and also in achieving operational and communicational efficiency, we are proposing a RFID-based Information System in an application called E-HM: Electronic Hospital Management. This application comprises two features, which are portable electronic medical record for patient monitoring and collection of data and tracking medical staff for shifting and workload division. However, the different advantages and disadvantages expressed of RFID usage in various studies have been met with skepticism by managers of healthcare organizations. The aim of this paper is to express and display the role of RFID technology in improving patient safety and increasing medical staff’s workload quality, which would increasing the quality of healthcare service. Keywords: RFID, Hospital Information System, Hospital Management System, healthcare quality

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E-HM : ELECTRONIC HOSPITAL MANAGEMENT THE NEXT GENERATION OF DIGITALIZED HOSPITAL MANAGEMENT SYSTEM

By: Danielle Katarina Winarta, Silvia Husodo, Triana Amelia Lasdianto, Vincentius Mario Yusuf 2nd year medical student, 3rd year medical student, 2nd year medical student, 2nd year medical student ASIAN MEDICAL STUDENTS’ ASSOCIATON-UNIVERSITAS BRAWIJAYA

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E-HM: Electronic Hospital Management The Next Generation of Digitalized Hospital Management Danielle Katarina Winarta, Triana Amelia Lasdianto, Vincentius Mario Yusuf, Silvia Husodo nd

2 year medical student, 2nd year medical student, 2nd year medical student, 3rd year medical student ASIAN MEDICAL STUDENTS’ ASSOCIATON-UNIVERSITAS BRAWIJAYA A. BACKGROUND Health care quality has set the focus on health services that includes a broad set of services including acute, chronic, preventive, promotion, restorative, and rehabilitative care, which are delivered by various of health care providers and on individuals and populations (Busse, R. et al, 2019). Hospital information system (HIS) is a comprehensive health informatics that focuses on the medical, administrational, financial, and legal issues needed by hospitals. HIS is also known as hospital management software (HMS) or hospital management system. Sadly, most hospitals in developing countries are unable to provide optimal quality healthcare services due to a lack of funds and resources likes Indonesia. Indonesia has a vision to provide optimal healthcare services to all regions through its Universal Health Coverage program, which was established in early 2014. The government of Indonesia launched a comprehensive UHC programme called National Health Insurance System (Jaminan Kesehatan Nasional). Achieving UHC is one of the targets the nations of the world set when adopting the Sustainable Develompent Goals in 2015. Good health allows children to learn and adults to earn, helps people escape from poverty, and provides the basis for long term ecomic development (WHO, 2019). Hospital plays an important role in public health so it must have a good hospital information system as well. RFID is an acronym of radio frequency identification. RFID is a technology whereby digital data encoded in RFID tags or smart labels are captured by a reader via radio waves. RFID is similar to barcoding in that data from a tag or label are captured by a device that stores the data in a database. However, the reality of RFID adoption is far behind previous expectations. We pointed out that most of the service providers indicated that RFID is functional and useful in asset tracking and patient identification. The main barriers to adoption of RFID in health care include high costs, technological limitations, and privacy concerns. Although RFID offers health care practitioners the advantage of improving clinical practice, a better designed RFID system is needed to increase the acceptance and proper use of RFID in health care. After discussing the existing shortcomings and some currently proposed hospital information architectures, this paper suggests a location, identification, communication, and simulation system that is capable of overcoming some of the deficiencies of the existing system and significantly increasing the efficiency and throughput of the system. various hospital setting units. The system is based on RFID and a wireless sensor network based location and information management framework and a necessary technology platform that enables hospital assets,

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personnel and patients to be tracked in real-time for the purpose of optimizing operations in all aspects of the organization's day-to-day activities (Ya Owe, 2010). The system is also intended to provide a continuous visual simulation and analysis platform to streamline operations, improve process efficiency and service levels. Radio Frequency Identification (RFID) technology not only offers to track the ability to locate equipment and people in real-time but also provides efficient and accurate access to medical data for doctors and other healthcare professionals (Fuhrer P., 2006). The strategic actions required in this issue are: 1.

Increasing understanding of the need for cooperation in primary to secondary-tertiary services; and

Increase the number and cooperation between professions in SDG3. All health issues in the SDGs are integrated into one goal, namely goal number 3, which is to ensure a healthy life and promote welfare for all people of all ages.

B. OUTLINED PROBLEMS Patient safety incidents due to faulty Health Services and Medical System Failures Most of the available information about patient safety risks in primary health care settings comes from research on reported errors and events, including studies that have attempted to develop taxonomies for classifying the types of errors and incidents that occur in these settings (Australian Commission on Safety and Quality in Health Care, 2010). This type of research has generally been based on anonymous personal reports or voluntary confidentiality, and has until recently been limited to general practice. Varying the definitions of the terms error, event, and report have been used in the research described in this section. These different definitions limit the comparison of results, and do not always conform to the existing definitions of these terms developed in the patient safety literature. In this module the term "patient safety incident" will be used in general terms, which are defined according to the WHO International Classification of Patient Safety, namely: the event or situation may result in, or result in, unnecessary harm to the patient. Australia has been one of the pioneers of incident reporting in general practice, and the study by the Threats to Australian Patient Safety (TAPS) is one of the most comprehensive analyses of patient safety incidents in the world (Australian Commission on Safety and Quality in Health Care, 2010) TAPS and other studies have identified two broad types of patient safety incidents: 1. Incidents related to the treatment process, including administrative, investigation, treatment, communication and payment processes. This is a common type of incidence reported (ranging from 70% -90% depending on study). 2. Incidents related to the knowledge or skills of the practitioner, including missed or delayed diagnoses, mistreatment and errors in the performance of tasks.

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C. SOLUTION Radio Frequency Identification (RFID) is believed to be the next generation technology for tracking and data-collection and has successfully been applied in several industries such as manufacturing, retail and logistics. Over the past years, RFID has emerged as a powerful technology for data collection and automated tracking of the identity, location and movement of people, products and assets. Quality patient care and safety is currently a global public health concern. It is believed that the majority of the medical errors caused by misidentifications and miscommunications are preventable by introducing integrated IT into the healthcare scene (Haddara and Staaby, 2018). Radio Frequency Identification (RFID) is a fast developing technology that uses radio waves for data collection and transfer; it can capture data efficiently and automatically without human intervention (Yao et al, 2010). It is seen as the next disruptive innovation in healthcare and represents several opportunities for increased safety, operational efficiency and cost savings by tagging inventory, assets, even personnels (Haddara and Staaby, 2018). Since RFID shows great promise in helping healthcare improve patient safety also in achieving operational and communicational efficiency, we are proposing a RFID-based Information System for Patients and Medical Staff. Portable & Electronic Medical Record: Patient Monitoring & Collection of Data RFID passive tags with unique codes will be given to each patient in the form of a card upon arrival and registration to the hospital administration desk. Using PC or mobile phones with RFID readers attached, the hospital staff are able to write/edit necessary medical information about the patient that will be stored in the tag (e.g. biodata, allergies, health history, blood type). Not only that, the hospital staff is also able to check and update the patient’s current medical status/ vital signs (e.g. blood pressure, body temperature, pulse rate) and interventions (e.g. drug administrations, examinations) digitally and effectively. Reducing the risk of misinformation and miscommunication between internal medical staff significantly, especially in emergency cases. Every update done on the patient’s RFID card will also be uploaded to the web database server, easily accessible to the medical staff if needed. Patient databases will also be linked through Internet into other hospitals databases, facilitating a more effective way of interhospitals coordination.

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Shematic 1. Portable and electronic medical record feature

Figure 1. Subfeature of portable and electronic medical record

Tracking Medical Professional : A New Era of Shifting and Dividing Workload Occupational stress has been a long-standing concern of the healthcare industry. Studies indicate that health care workers have higher rates of substance abuse and suicide than other professions and elevated rates of depression and anxiety linked to job stress. In addition to psychological distress, other outcomes of job stress include burnout, absenteeism, employee intent to leave, reduced patient satisfaction, and diagnosis and treatment errors (CDC, 2008). There are some stressors that are common in healthcare settings. These include inadequate staffing levels, long work hours, and shift work. Studies of occupational stress in healthcare

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settings have revealed overload working, time pressure, exposure to infectious diseases, and sleep deprivation as some factors to be linked with stress (CDC, 2008). One of the most effective ways of reducing occupational stress is by making organizational changes to eliminate the stressors (CDC, 2008). These changes include ensuring that the workload is in line with workers’ capabilities and resources. Based on what we’ve described, we want to propose a solution that would help the problem, in particular regarding work hours and shift work. This solution includes an application with RFID basis used in determining and retrieving information about healthcare workers’ flow of work. In our second feature, RFID tags would be put in each name tag of the medical workers. The reader would then be installed throughout the hospital, on every front side of the door room. This reader would be able to read the radio signal transmitted by the tag and input the medical professionals’ location information to our database. As the information is updated automatically every time the RFID reader transcripts the radio signal, it would be easier to detect each medical professional’s workflow. Therefore, the hospital would be able to get precise information about the medical professional’s workload every day, in this case through the hours they spent in a room. With the hours of workflow better known, the hospital system can make sure that every medical professional get equal amount of workload and rest, minimizing the effect of occupational stress in healthcare settings. Steps on How to Use Shifting Feature 1. Opening display 2. Medical staffs who want to use the application should sign in using name and password. 3. Then, on home page, medical staffs can click on the shifting feature icon Figure 2. Sign in and home page

4. The page would turn into shifting feature display, with two subfeatures to choose:

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Table of workload

Medical staffs’ status

5. When you choose table of workload, the application would show a table consisting of: a. Date b. Name c. Department d. Occupation e. Time of scan f.

Location, which would be noticed from the location of RFID used Figure 3. Shifting table

6. When you choose medical staff’s status, the application would show a table consisting of: a. Date b. Name c. Department d. Occupation e. Duration of work for the day f.

Medical staff’s status 1) Available Available status means that the medical staff is available for accepting workshifting in case of emergency or staff shortage. This status would be written in green. 2) Busy

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Busy status means that the medical staff is on duty in the particular rooms, such as surgery room and emergency unit in which he or she cannot be disturbed. This would be written in yellow. 3) Limit Limit status means that the medical staff’s workload is almost reaching the limitation determined by the management of the hospital. The corresponding color for this status is orange. 4) Unavailable Rest time status means that the medical staff has reached the determined limitation of workload, and therefore should take time off for the day. The corresponding color for this status is red. 5) Danger Danger status means that the medical staffs have exceeded workload limitation that has been determined. This status would be written in black. 7. The medical staffs would be able to search for their colleagues’ name through the search feature on the right corner of the screen to get information on which medical colleague is available for workshifting and who is unavailable and has reached the workload limitation of the day. Schematic 2. RFID shifting feature

Table 1. Description of the steps in the future implementation No.

Step

Description

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Planning

Identification problems which are poor hospital information management systems and high number of iatrogenic cases in Indonesia. Next, we design the applicable innovation solutions.

User Research

Collect information that related to the recent problem.

Development

Innovation development process based android & iOS application software (programming and designing).

Testing

Application trials (initiating phase-completion phase-finishing phase).

Implementation

National application usage process with a training system using video tutorials and manuals.

Reporting

Collecting data to evaluate our application impact in quantitative: total downloads, amount of stars (rating) obtained in Google Play and App Store.

D. CONCLUSION & RECOMMENDATION In the healthcare industry, there are other advantages for example; increase accuracy tasks, reduce human errors, improve safety, and patient satisfaction. No doubt, in coming years, using of the RFID will be a requirement in the healthcare industry. Although, the sole usage of RFID will not be able meet expectation of health care organizations. If it is used alone, health care organizations will be faced with numerous challenges. But, if we integrate it with hospital information systems (HIS) and electronic health records (EHRs) and support it by clinical decision support systems (CDSS), it facilitates magically processes and reduce medical, medication and diagnosis errors. Summary points 1. What was already known on this topic? There are critical successes in improving health services for patients through tracking (staff, patients, and properties), inventory management, and validation (medication, documents, treatment, and specimen). But, there are also barriers to adopt the RFID that can classify into lack of information, insufficient budget available, and the complexity of technology and systems. 2. What has this study added to our knowledge?

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This technology can facilitate to access individuals (medical staff and patients) and shorten wait time of care processes. The RFID technology also has tangible benefits such as reduced cost and time, reduced human resources, theft prevention, improve productivity. In addition, this management system would be able to increase accuracy tasks, refining business processes and reduce human errors, which will ultimately improve safety and patient satisfaction. On the other hand, use of the RFID in health care industry alone will be faced with numerous challenges. Highlights To minimize medical errors and improve clinical workflow, we can implement the RFID system with the clinical system. If the RFID integrate with hospital information systems (HIS) and Electronic Health Records (EHRs) and supported by clinical decision support systems (CDSS), it can facilitate processes, reduce medication and diagnosis errors, and increase patient safety.

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References: Ajami, S., & Rajabzadeh, A. (2013, September 1). Radio frequency identification (RFID) technology and patient safety. Journal of Research in Medical Sciences, Vol. 18, pp. 809–813. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24381626/?tool=EBI Exposure to Stress Occupational Hazards in Hospitals. (n.d.). Retrieved from www.cdc.gov/niosh. Haddara, M., & Staaby, A. (2018). RFID applications and adoptions in healthcare: A review on patient safety. Procedia Computer Science, 138, 80–88. https://doi.org/10.1016/j.procs.2018.10.012 Kantaş Yılmaz, F., Uğur, T., & Rese, M. (2019). A Comparative Study of the Turkish and German Health Care Systems with regard to Quality Management in Psychiatric Hospitals. International Journal of Management, Economics and Social Sciences, 8(3), 223–241. https://doi.org/10.32327/IJMESS.8.3.2019.14 Landt, J. (2005). The history of RFID. IEEE Potentials, 24(4), 8–11. https://doi.org/10.1109/MP.2005.1549751 Xu, J., Yang, L., Jin, P., & Sheng, J. (2016). Endoscopic Approach for Superficial Colorectal Neoplasms. Gastrointestinal Tumors, 3(2), 69–80. https://doi.org/10.1159/000447128 Yao, W., Chu, C. H., & Li, Z. (2010). The use of RFID in healthcare: Benefits and barriers. Proceedings of 2010 IEEE International Conference on RFID-Technology and Applications, RFID-TA 2010, 128–134. https://doi.org/10.1109/RFID-TA.2010.5529874

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Internet Pornography Addiction: A New Communication Challenges

In a country that is heavily influenced by eastern culture like Indonesia, a lot of things are still deemed taboo by the people, like pornography. A pornography addict will have impaired self-evaluation towards their pornography usage and not being able to control their pornography consumptions. While internet pornography addiction is something that can be treated, the stigma that lingers around the topic is execrable, causing people to be reluctant to seek for help. We conducted a research in online databases such as PubMed, Research Gate, and Google Scolar to find articles related to pornography addiction. From the articles we have collected, it is known that pornography addiction is related to dopamine release and myelinazation in the brain which creates new sexual habits. This shows that there is a medical treatment to it but for this to be accessible to every single person, improving communication, education, and safe spaces about this matter remains a priority for now. The more people shy away from discussing things related to pornography addiction, the less likely people will be aware of the problem, despite the growing numbers of addicts. This low awareness might cause people to not be aware that they have a pornography addiction or it can cause known addicts to feel helpless and isolated, potentially causing further mental health problems such as depression and anxiety. Or in other cases, the sufferers themselves do not know they have pornopraphy addiction.

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Internet Pornography Addiction: A New Communication Challanges

Jeanette Sefanya Yefta Luigi Collins Aribowo Michelle Joshalyn Natasha Richard Jefferson

AMSA-Universitas Kristen Krida Wacana 2020

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Introduction In Indonesia, a country that is heavily influenced by eastern culture, a lot of things are still deemed taboo by the people, one of which being internet porn addiction. As the use of the internet becomes more widespread, people now have easy access to any information on a level never experienced before. This however, does not come without downsides. Not only does the internet just give us ease of access to helpful information, but it also means that inappropriate materials are easier to access now more than ever. This, in turn, will make it more likely that people can access porn, which is highly addicting. This can cause someone to lose their ability to control use to the point that it interferes with their life. Having a porn addiction is viewed as taboo and because it is considered taboo, people are not usually willing to talk about this as this makes them feel uncomfortable. This reluctance to talk about said issue can prove to be an obstacle towards communication in health. The more people shy away from discussing things related to porn addiction, the less likely people will be aware of the problem, despite the growing numbers of addicts. This low awareness might cause people to not be aware that they have a porn addiction or it can cause known addicts to feel helpless and isolated, potentially causing further mental health problems such as depression and anxiety. And in other cases, the sufferers themselves do not even know that they have pornography addiction.

Problems According to the American Society of Addiction Medicine, addiction is defined as a primary chronic disease of brain reward, motivation, and related circuitry. Damage in these circuits can cause problematic biological, psychological, social, and spiritual manifestations. This can be seen from how an individual seeks reward and relief by engaging in certain behaviors, including indulging pornography. A porn addict will often times have impaired self-evaluation towards their pornography usage. This phenomenon is called “self-percieved problematic pornography use” and it causes the porn addict to not be able to control their pornography consumptions. Although moderate pornography usage is not inherently problematic, pornography addiction will affect an individual’s overall physical, psychological, and social wellbeing. People who cannot control their pornography usage also show a decrease in their vocational functioning, as well as an impaired judgment. This can lead to pornography being the center of one’s life. In some extreme cases, an individual might leave everything in their daily life only to indulge in pornography, resulting in a decrease of productivity and quality of life in general. People who cannot control their pornography consumption are also reported with declines in interpersonal skills and this almost always affects their relationship with their family, friends, partners, and colleagues. Pornography might also change someone’s perspective towards others, instead of seeing other people or a certain group of people as

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humans, the porn addict might view them as sex objects. In some extreme cases, this could lead to a porn addict to commit crimes such as rape and possesion of illegal pornography. Pornography addiction is reversible. Just like other types of addiction, it is possible to reverse the adverse effects and help the individual regain a normal life. The rehabilitation process itself is also relatively easier compared to other types of addiction. The main problem here is that the stigma that lingers around porn addiction remains execrable, especially in conservative countries like Indonesia. The conversation on sex itself is already a taboo, let alone conversations on sexual deviations like porn addiction. This is a huge barrier for the porn addicts in getting any help or to even realize that what they are doing is not in the moderate range anymore. Pornography addicts might feel ashamed, afraid, and anxious when they think about how people around them would react if they opened up about their addiction, despite opening up being one of the very first step towards getting the proper help they need. Being avoided, scorned, beaten up, or even exiled from society only shows a glimpse of the consequences of admitting to having a pornography addiction. In many cases, the addiction progresses silently and only becomes noticeable once the person is caught red handed, or in severe cases, when they start doing things that are against the law for inappropriate sexual behaviours. The lack of early sex education is another factor that contributes towards someone’s addiction of pornography. There are many cases where someone searches up porn and starts consuming porn because they are curious and do not have the access to the appropriate sets of information to satisfy that curiosity. This causes them to revert to the easiest source they can get, which is online pornography. This case often happens in teens who are just starting puberty. It is no secret that since the invention of the internet and the world wide web, looking up information has never been easier. This includes free access pornography that can be seen by anyone, anywhere, and regardless of age. The internet also facilitates possibilities of sexual interactions aside from pornography. Dopamine release seems to be the key to a deeper understanding about pornography addiction. Dopamine which is released when someone does sexual activities is related to the reward system in our brain. Adaptive process of myelination also has a role in creating new sexual habits after long-term exposure to pornography. This new neuron route is enhanced by dopamine release after consuming pornography. This also suggests that pornography abuse might also lead to damage in our reward system and dopamine release, one of it being desensitisation that can cause a snowball effect in self-perceived problematic pornography use. This shows how pornography addiction is not just a small threat. It is an important topic that should be communicated enough to create a better environment for the addicts to recover and safe enough for the rest of us to receive proper information about it.

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Solution and Recommendation Young people need to be lead by others and not self-educate on online pornography due to its harmful and victimizing character. Gaining a teenager’s trust by a social pedagogue or school social worker plays an important role for beginning the process by establishing discussion groups on sensitive topics such as online pornography. It is clear that the understanding of teenagers and adults about youth interests, experiences and expectations can be increased and adults often have no idea what children are interested in and what relations they are involved in. A good suggestion is to provide discussion clubs and groups in schools catered to different age groups. By having these discussions with the social pedagogues or school social workers and/or parents they are comfortable with, they could have the chance to ask questions of bewilder, create precedents of openness and trust and, respectfully, develop critical consciousness towards the ambiguous phenomena of the present day by elaborating the culture of reflection and collegial communication. Another way of treating online pornography addiction is by using medications such as naltrexone. Naltrexone could be a potential treatment for behavioral addictions and hypersexual disorder by theoretically reducing cravings and urges. This is done by blocking the euphoria associated with the behavior. Psychodynamic psychotherapy and others like family therapy, couple’s therapy and psychosocial treatments may also prove vital when addressing themes of shame and guilt alongside restoring trust among the user’s closest relationships. Acceptance and Commitment Therapy is the only randomized controlled trial that exists for experimental study to specifically address problematic online pornography users. ACT may rely on the facts that are rooted in mindfulness and acceptance frameworks. The increase acceptance of pornography use might be equally or more important than reducing its use. Aside from prevention and rehabilitation for the affected person, it’s also important to create a safer environment to have sex and pornography usage related conversation in terms of health and psychology. This will encourage people who feel like they need help to speak up more freely without being afraid of judgment, stigma, and condemnation. The rehabilitation process of someone who has pornography addiction might seem easy compared to other addictions. But it cannot be denied the fact that they need as much support as other addicts. It is also important to implement mandatory sex education in schools and new parents to prevent misinformations about sex as well as grant a more accessible proper sex-related information. This will hopefully prevent curious children and teens from accessing pornography to satisfy their curiousity. Sex and pornography is a very touchy and sensitive subject to be talked about, but the conversation itself plays a major role in creating better quality of life for everyone.

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Conclusion In conclusion, the subject of pornography use is still regarded as taboo and is condemned in a lot of communities. Pornography in itself is a highly addicting substance, which can ultimately lead to addiction. An addiction, if not properly managed, can cause the addict to decline in physical, mental, and emotional wellbeing. Opening up and seeking help is the first step to solve any addiction, but this proves to be difficult in places where the substance the addict is addicted to is highly stigmatized. Pornography addicts are fearful of being judged, looked down upon, or scrutinized to the point of thinking that seeking help won’t yield any good results. This may prove even more difficult especially in more conservative countries such as Indonesia, where even the subject of sex is deeply denounced. This is proof that the stigma surrounding pornography addiction hinders communication in health, where a specific group of people are not able to open up and get the help that they need. With more awareness and openness around the topic, it is to be hoped that the addict can speak up about their addiction and gradually wean themselves from their obsession. Aside from that, conversations regarding these subjects should also be normalized in medical and psychological terms as it is related to one’s health and wellbeing.

References 1. de Alarcón, R., de la Iglesia, J. I., Casado, N. M., & Montejo, A. L. (2019). Online Porn Addiction: What We Know and What We Don't-A Systematic Review. Journal of clinical medicine, 8(1), 91. https://doi.org/10.3390/jcm8010091 2. Love, T., Laier, C., Brand, M., Hatch, L., & Hajela, R. (2015). Neuroscience of Internet Pornography Addiction: A Review and Update. Behavioral sciences (Basel, Switzerland), 5(3), 388–433. https://doi.org/10.3390/bs5030388 3. Duffy, A., Dawson, D., & das Nair, R. (2020). Pornography Addiction in Adults: A Systematic Review of Definitions and Reported Impact. Retrieved 20 October 2020 4. Voros, F. (2009). The invention of addiction to pornography. Sexologies, 18(4), 243-246. doi: 10.1016/j.sexol.2009.09.007 5. Sniewski, L., Farvid, P., & Carter, P. (2018). The assessment and treatment of adult heterosexual men with self-perceived problematic pornography use: A review. Addictive Behaviors, 77, 217224. doi: 10.1016/j.addbeh.2017.10.010 6. Grubbs, J., Grant, J., & Engelman, J. (2017). Self-Identification as a Pornography Addict: Examining the Roles of Pornography Use, Religiousness, and Moral Incongruence. doi: 10.31234/osf.io/s6jzf

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7. Alves, C., & Cavalhieri, K. (2019). Self-perceived Problematic Pornography Use: An Integrative Model from a Research Domain Criteria and Ecological Perspective. Sexuality & Culture, 24(5), 1619-1640. doi: 10.1007/s12119-019-09680-w 8. Sniewski, L., & Farvid, P. (2020). Hidden in shame: Heterosexual men’s experiences of selfperceived problematic pornography use. Psychology Of Men & Masculinities, 21(2), 201-212. doi: 10.1037/men0000232 9. Wilson, G. (2017). Your brain on porn. UK: Commonwealth Publishing. 10. Sujeta, I., & Ruškus, J. (2014). An Educational Response to the Issue of Online Pornography for Schoolboys: The Case of Participatory Action Research in Lithuania. International Journal Of Social Pedagogy. doi: 10.14324/111.444.ijsp.2014v3.1.005

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ELDERLY GATHERINGS: HEALTH PROMOTION TO REDUCING SOCIAL ISOLATION AND LONELINESS FOR ELDERLY

ABSTRACT Jeremi Setiawan, Alieftya Paramitha, & Shintya Kurniawati University of Muhammadiyah Malang, Malang, Indonesia

Currently, the world's population is dominated by the elderly. The elderly have several conditions that make them have limitations due to aging. The elderly have a higher risk of mental health declines such as loneliness and social isolation which may require long-term care. Social isolation has several impacts on the health of the elderly, risk factors that arise resulting in morbidity and mortality with outcomes comparable to smoking, obesity, lack of exercise, and high blood pressure. It also has been associated with infectious diseases, cognitive decline, and mental health conditions. Interventions that promote health are called elderly gatherings. Elderly gatherings are group-based interventions aimed at issues of loneliness, social networking, and social support. Social support is generally defined as the presence or availability of reliable people from whom one can feel caring, value, and love. Social support can be measured as a person's perception of having help, receiving real help, or being integrated into social networks. Key Findings: elderly, loneliness, social isolation, health promotion, intervention

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Background Currently, the world's population is dominated by the elderly (Pirhosseinlou, Mansour Razavi, and Sadat Razavi, 2017). The Elderly is someone who has reached the age of 60 years and over. Based on the Ministry of Health of the Republic of Indonesia, it is estimated that in 2017 there are 23.66 million elderly people in Indonesia (9.03%). It is predicted that the number of elderly people in 2020 (27.08 million), 2025 (33.69 million), 2030 (40.95 million), and 2035 (48.19 million) (Kemenkes, 2017). The elderly have several conditions that make them have limitations due to aging. The elderly experience cognitive changes such as decreased power in processing information, have a tendency to be easily distracted, and experience a decrease in memory, then many elderly also experience problems with vision, and decreased hearing (Laksmidewi, 2016). The elderly have a higher risk of mental health declines such as loneliness and social isolation which may require long-term care (WHO, 2017). This is due to poor health conditions, family dispersal, decreased mobility and income, loss of loved ones, living alone, reduced inter-generational living, greater geographical mobility, and less cohesive communities have also contributed to higher levels of loneliness in the older population (Fakoya, OA., McCorry, NK., & Donnelly, M, 2020). Based on Landeiro et al., 2017 nearly more than 50% of the population over the age of 60 has a risk of social isolation, and approximately one-third of older people will experience loneliness later in life and also according to Ercole, V & Parr, J., 2020 the population above 80 years are at significant risk of severe loneliness. Social isolation has several impacts on the health of the elderly, risk factors that arise resulting in morbidity and mortality with outcomes comparable to smoking, obesity, lack of exercise, and high blood pressure. It has also been associated with infectious diseases, cognitive decline, and mental health conditions such as depression and dementia and with increased emergency admission to hospital and longer hospitalizations (Landeiro et al., 2017) Understanding the aging situation experienced by the elderly, health promotion interventions aimed at reducing social isolation and loneliness in the elderly suggest that interventions with groupbased formats, where individuals are required to actively participate in group-based activity were more effective than Individual interventions. Seeing that the elderly population in Indonesia is increasing from year to year, interventions can be used to improve the quality of life of the elderly.

Outlined Problems Currently, the world's population is dominated by the elderly (Pirhosseinlou, Mansour Razavi, and Sadat Razavi, 2017). Sustainable Development Goal 3, aims to ensure a healthy life and improve well-being, the aging process has a risk of deteriorating ill health so that the elderly or the elderly require greater health care needs than the young age group, the elderly also face difficulties in accessing appropriate, affordable and quality care (Department of Economic and Social Affairs, 2016). Elderly people are at risk of decreased mental health due to decreased health, decreased economic status with

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retirement, and sad events such as mourning. All of these stressors can result in isolation, loneliness, or psychological distress in the elderly, which may require long-term care (WHO, 2017). Social isolation and loneliness are major health concerns and serious problems from a public health perspective. Social isolation is understood as the opposite of social integration which means a lack of social interaction resulting in few confidants, close or no relationships with other people. The loneliness that is distinguished from isolation does not mean being alone and isolated, but feeling alone, unsupported, and isolated (or socially disconnected) (Hämmig, 2019). Several studies identified a wide range of health outcomes associated with loneliness and social isolation including depression, cardiovascular disease, quality of life, general health, biological markers of health, cognitive function, and mortality (Courtin and Knapp, 2017). The health level of people suffering from social isolation is poor. In addition, social isolation has a correlation with mental health, distress, dementia, suicide and premature death. According to Edelbrock, factors that affect social isolation are poor physical health, mental illness, low morale, having caregivers, geographic location, and communication and transportation difficulties (Püllüm and Çevik Akyıl, 2017). Generally, the elderly feel lonelier and more isolated due to fatal events, such as retirement or loss of loved ones (Seyfzadeh, Haghighatian, and Mohajerani, 2019). The elderly who live with their family is not enough to be happy, because 45% of the elderly are happy in the family, while 55% feel sad and lonely, therefore this feeling may be considered a problem related to aging (Püllüm and Çevik Akyıl, 2017). This depends on their being with their family, spouse, and children. The negative effects of living alone in an individual's life are lack of self-confidence, fear, depression, longing for close relationships, and anxiety for the future. The elderly expressed their longing for a busy home, children, and a warm family environment. People in later periods desire to live together with their family members. They develop bonds with family, relatives, and relatives far more than they did in youth and adulthood (Püllüm and Çevik Akyıl, 2017). Elderly who live alone not only experience psychological conflict, sadness, and loneliness due to the loss of family relationships and the loss of friends around them, but are often in a bad environment where it is difficult to get social support and financial support. Therefore, they have been reported to have lower levels of physical and mental health and lower performance of health promotion activities compared to elderly people who live with a partner or family (Park and Sohng, 2019). Elderly health is the existence of social participation, which leads to attention to parental rights, maintaining social involvement, and improving the quality of life of the individual. The presence of the elderly in meaningful activities (generally in the form of friendship and organizational participation) is one of the key elements to improve the quality of life and health of the elderly, which causes a decline in health during aging. In addition, social participation prevents psychological problems during old age because most parents are faced with social isolation when separated from their families and communities. In addition, one of the fundamental factors in dealing with social isolation is an

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educational intervention that can alleviate social isolation and its unfavorable impact on parents. (Seyfzadeh, Haghighatian, and Mohajerani, 2019) (Seyfzadeh, Hagighatian, and Mohajerani, 2017).

Solution Health promotion is a targeted intervention for the elderly living in the community, becoming increasingly important to enable the growth of the elderly population to increase motivation and to improve their health (Golinowska et al., 2016). The excellence of healthcare organizations in providing health promotion is supported by the principles of aging - to be able to stay at home as long as possible, which is supported by the desire of the elderly themselves. For the elderly, health promotion needs to address a large number of objectives to provide strategies for fighting loneliness and for supporting social networking and social support. This goal is motivated by the fact that improving social conditions has shown a positive impact on life satisfaction and well-being of the elderly (Gustafsson et al., 2017). According to some literature, interventions in social isolation are divided into two types of interventions aimed at reducing social isolation and loneliness, namely group-based interventions (support groups, video meetings) and personal interventions (computer training, owning pets). According to a review of health promotion interventions aimed at reducing social isolation in parents, it shows that interventions with group-based formats and in which individuals are required to actively participate in society or interact with the public are more effective than personal interventions (Landeiro et al., 2017). The effectiveness of health promotion interventions targeting social isolation and loneliness among the elderly, and found that educational and social activity interventions targeting specific groups can reduce social isolation and loneliness among parents (Fakoya, McCorry and Donnelly, 2020). Therefore, if the elderly who live alone who live in their neighborhood form a small group to carry out a customized health promotion program for them at home, it will not only improve physical function, but also provide emotional support, facilitate adjustment of meeting places and schedules, and create an inclusive atmosphere. Participation will increase and the quality of life will increase (Park and Sohng, 2019). Interventions that promote health are called elderly gatherings. Elderly gatherings are groupbased interventions aimed at issues of loneliness, social networking, and social support. Previous interventions have been shown to have a beneficial effect on slowing down decreased health and comorbidity, with the aim of independence and the ability of elderly people living in the community to maintain or improve various aspects of health and quality of life (Gustafsson et al., 2017). Social support is an important concept closely related to loneliness and depression and is very important in fighting depression among the elderly. Social support is generally defined as the presence or availability of reliable people from whom one can feel caring, value, and love. Social support can be measured as a person's perception of having help, receiving real help, or being integrated into social networks. Emotional social support, such as having an intimate bond with a partner or with children, is

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considered to have an effective protective effect against the risk of depression, support from family and friends prevents the risk of depression, and maintains good mental health (Liu, Gou, and Zuo, 2016). Health promotion intervention in the form of social support that needs to be provided by the government is the existence of a forum and transportation to bring together the elderly to do socialization in the form of doing something together, sharing feelings, and supporting one another will help remind that they are elderly people are not alone and feel that each other support and help each other in their lives in their old age. As well as the need for family education about the importance of socialization among family members to prevent feelings of loneliness and social isolation so that feelings of not being considered or ignored will disappear because of the loving interaction of all family members.

Conclusion The elderly are the age group at high risk of mental health declines, such as loneliness and social isolation. Several studies identified a wide range of health outcomes associated with loneliness and social isolation including depression, cardiovascular disease, quality of life, general health, biological markers of health, cognitive function, and mortality (Courtin and Knapp, 2017). The health level of people suffering from social isolation is poor. Based on these problems, an intervention is needed to overcome loneliness and social isolation in the elderly. The result of this paper suggests that health promotion can be used as an intervention for loneliness and social isolation in the elderly. Interventions that promote health are called elderly gatherings, Elderly gatherings are group-based interventions aimed at issues of loneliness, social networking, and social support. Social support can be measured as a person's perception of having help, receiving real help, or being integrated into social networks.

Recommendation The implementation of elderly gatherings requires the participation of various parties such as the government, elderly families, the community around the elderly. Awareness of these various parties about the urgency of mental health problems in the elderly is needed for the implementation of this health promotion. Therefore, solutions are needed to increase government and public awareness in overcoming mental health problems, especially loneliness and social isolation in the elderly.

References Courtin, E., & Knapp, M. (2017). Social isolation, loneliness and health in old age: a scoping review. Health & social care in the community, 25(3), 799–812. https://doi.org/10.1111/hsc.12311. Ercole, V., and Parr, J. 2020. Problems of Loneliness and Its Impact on Health and Well-Being. Switzerland: Springer Nature Switzerland AG. https://doi.org/10.1007/978-3-319-696270_127-1.

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Fakoya, OA., McCorry, NK., & Donnelly, M. 2020. Loneliness and social isolation interventions for older adults: a scoping review of reviews. BMC Public Health 21:(129). Kementerian Kesehatan Republik Indonesia. 2017. Analisis Lansia Indonesia. Laksmidewi, A.A.Ayu Putri. 2016. Cognitive Changes Associated With Normal Aging. The 4 th Bali Neurology Update, Neurology in elderly, Denpasar 22-24 Juli 2016. Liu, L., Gou, Z., & Zuo, J. (2016). Social support mediates loneliness and depression in elderly people.

Journal

health

psychology,

21(5),

750–758.

https://doi.org/10.1177/1359105314536941. Pirhosseinlou, M., Mansour Razavi, S. and Sadat Razavi, M. (2017) ‘A Preventive Approach to Elderly People Health Problems’, Journal of Gerontology & Geriatric Research, 06(05). doi: 10.4172/2167-7182.1000450. Püllüm, E., & Akyil, R.Ç. (2017). Loneliness and Social Isolation among Eldely People. Meandros Medical and Dental Journal, 18, 158-163. Seyfzadeh, A., Haghighatian, M., & Mohajerani, A. (2019). Social Isolation in the Elderly: The Neglected Issue. Iranian journal of public health, 48(2), 365–366. WHO. (2017). Mental health of older adults. Available at: https://www.who.int/news-room/factsheets/detail/mental-health-of-older-adults (Accessed: 17 October 2020).

Appendix Communication errors that occur in the elderly due to several factors such as hearing and cognitive impairment can affect the incidence of social isolation and loneliness. A state of social isolation in which there are not enough people to interact with the debilitating limitations of the elderly and the scales refer to subjective feelings about loneliness. Given the increasing burden of solitude and its effects on health and well-being, it's no surprise that there has been a growing academic literature, public and there is a worldwide policy interest in loneliness and social isolation, but in Indonesia this is still rarely discussed. In Indonesia, there is a great need for academic literature in discussing health promotion to reduce loneliness and social isolation, given the unique source of Indonesia's population and its cultural diversity, this will affect the interventions that will be carried out, because not all elderly people experience loneliness in the same way in the same manner or degree and hence there is an urgent need to tailor interventions to meet individual needs.

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ABSTRACT C-Line: Bring COVID-19 Down The Line Pierre Harold A., Adrian Desmar P.R.R., Nanda Ayu S., Fahrani Yossa P. rd

3 year medical student, 3rd year medical student, 3rd year medical student, 3rd year medical student Asian Medical Students’ Association-Universitas Brawijaya

During the COVID-19 pandemic, many countries decided not to carry out lockdown to save the economy while the numbers of those infected by the disease are increasing rapidly. Raising public awareness of COVID-19 is required an intervention between the government and the society, one of the actions that can be implemented is sending the right message by improving public understanding of actual health threats and helps to make the best possible decisions for their health and well-being. We proposed C-Line as a method to lower COVID-19 spread by keeping people traced especially in public places where COVID-19 transmission is very likely to occur. C-Line works using a check-in system to track people anytime they visit places outside their homes. The data shown in C-Line are expected to make people keep aware of any risk of COVID-19 transmission around their places. The goals that we targeted through CLine besides than to lower the COVID-19 transmission, is to be able to help other affected sectors to keep running their places but still in strict monitoring. To keep the efficacy of C-Line, we need cooperation between the public and the government so that we could bring the number of COVID-19 cases down the line.

Keyword: C-Line; COVID-19 cases; pandemic; application; tracking system

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C-LINE: BRING COVID-19 DOWN THE LINE

By: Pierre Harold A., Adrian Desmar P.R.R., Nanda Ayu S., Fahrani Yossa P. rd

3 year medical student, 3rd year medical student, 3rd year medical student, 3rd year medical student ASIAN MEDICAL STUDENTS’ ASSOCIATION-UNIVERSITAS BRAWIJAYA

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C-Line: Bring COVID-19 Down The Line Pierre Harold A., Adrian Desmar P.R.R., Nanda Ayu S., Fahrani Yossa P. rd

3 year medical student, 3rd year medical student, 3rd year medical student, 3rd year medical student Asian Medical Students’ Association-Universitas Brawijaya

1. BACKGROUND COVID-19 is the infectious disease caused by the Coronavirus, SARS-CoV-2, which is a respiratory pathogen (WHO, 2020). As of April 2020, over 210 countries and territories are affected by the virus, with Europe, the USA, and Iran forming the new cluster of the virus. The disease can spread by droplet transmission. As of April 2020, the total number of infected individuals stands at around 3 million, with ∼200,000 deaths and more than 1 million recoveries globally (Keni et al, 2020) As of 14 October 2020, the Government of the Republic of Indonesia has reported 344.749 persons with confirmed COVID-19. There have been reported 12.156 deaths related to COVID-19 and 267.851 patients have recovered from the disease (WHO, 2020). The Indonesian Government has already taken numerous strategies to combat COVID-19, such as contact tracing, rapid tests, and adequate treatments. These strategies worked better particularly at the regional level than the central government level. The central government was indecisive with the situations and made decisions too late, and thus the COVID-19 spreading so fast (The Jakarta Post, 2020). One of the strategies taken by the government is socializing the “Social Distancing” movement. This concept explains that in order to reduce and break the chain of transmission of COVID-19, everyone must keep a safe distance from others at least 2 meters, and must not make direct contact with people. However, there are some people who do not respond well to this concept, as an example, the government made a decision that the students can attend school or college from home, thereupon this condition is used by some people to have a vacation, it could be the best mediator for the spread of the coronavirus on a much larger scale (Buana, 2020). During the COVID-19 pandemic, many employers have recommended their staffs to work-fromhome. Some employees are happier to work at home as they have already been familiar with multimedia technology to effectively communicate with other employees and employers. However, there were still 36% of Indonesians who could not use technology and more than half of employees realized that fostering collaboration with co-workers during work from-home can be challenging since they have difficulties in separating work-life and home-life. Raising public awareness of COVID-19 health issues is not as easy as the society may differently interpret the importance of stay-at-home policy for their own health. Therefore, people were urged to follow the Government’s advice and instruction about COVID-19 (Setyawan and Lestari, 2020).

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2. OUTLINED PROBLEMS Uncertainty is something that will continue to emerge during the COVID-19 pandemic in 2020 which is sure to have an impact on all aspects of life. Public policies always keep changing until the government determines to enforce the new normal with Increased Discipline and Law Enforcement of Health Protocols in the Prevention and Control of Corona Virus Disease 2019 (Instruksi Presiden (INPRES) Pemerintah Pusat No.6 Tahun 2020). Since the implementation of the new normal, there are still many people who are increasingly worried because it will open up access to greater virus transmission and there is no concrete protection to ensure whether the community is protected or not. From an economic aspect, the result of a survey conducted by Universitas Gadjah Mada shows that the Ministry of Micro, Small and Medium Enterprises (MSME) is really affected by the COVID-19 pandemic that is currently happening. This is indicated by a decrease in orders, and a decrease in income as well as other constraints related to business activities such as the production, marketing, and distribution processes (YANMAS,2020). Based on the results of the study from Universitas Sumatera Utara, the impact of the COVID-10 pandemic cause low investor sentiment towards the marker, which in turn led the market to tend to be negative (Nasution, 2020). Since MSMEs have a very important strategic role in the Indonesian economy until the government decided not to carry out lockdown to save the economy while the numbers of those whom infected by the disease are increasing day by day. Office, restaurants, shopping centers, malls are still visited by many people. Those activities will certainly have a bad impact if it is not planned and monitored properly. This problem will lead to the addition of several cases and new clusters for COVID-19. According to Undang-Undang Dasar 1945 article 28H verse 1 “Everyone has the right to live in physical and spiritual prosperity, to have a place to live, to have a good and healthy living environment and the right to obtain health services”. In reality in the field, they travel and go everywhere without any complete traces of data collection every day. The travel data collection is only used for plane domestic route between cities and islands, there is no integrated data collection to track the spread of COVID-19 in a city based on the daily activities of local people. All these problems are issues related to health threats, a composite of potential enemy actions than can lead the occurring of crisis. Whenever a crisis occurs, communicators must be primed to provide all the information to help people make the best possible decisions for their health and well-being. The necessity of protection measurements that provides to trace people in daily activities can contribute to resulting clear information and ensuring people's life.

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SOLUTION Indonesian Government decided not to carry out lockdown to save the economy while the numbers of those whom infected by the disease are increasing day by day. We proposed C-Line as a method to lower Covid-19 spread by keeping people traced when they are doing everyday activities. CLine is a mobile application that can be used to track people’s activities using a check-in system when visiting places where Covid-19 transmission is very likely such as, office, mall, and many more. This application works by using a QR code as a checkpoint then the data will be kept in C-Line database. Hopefully, this innovation will decrease the number of transmission in public places. How to use “C-Line”: 1. This is the Main Menu. There are currently 4 features in C-Line, QR Code check-in, Covid-19 update, maps, and health status

Figure 1. C-Line Main Menu

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2. When the user wants to check-in at the checkpoint, they can tap on the “Checkin” button and this page will show up.

Figure 2. QR Code scanner

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3. After scanning the QR Code, a check-in pop-up will show. The user can add more people if there are more than 1 person that checking in. Their check-in data will be automatically recorded in CLine database. The user will be notified about

the

number

visitors,

transmission level, and recent Covid-19 cases in that place.

Figure 3. Check-in Pop-up

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4. Then, the user will be directed to the venue page. On this page, the user can see the current number of visitors, the increment per hour, total venue capacity, and current transmission level that increase according to the duration of stay. The user also has an option to check-out when they are leaving the venue.

Figure 4. Venue Info Page

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5. If the user selects the map button, this page will show up. They could see the live number of visitors in numerous places

and

also

the

transmission

probability. Figure 6. Venue information Pop-

Figure 5. Map interface

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6. Next, the user can access the Covid-19 update (per day) depends on the country they are living in.

Figure 7. COVID-19 Updated Data Per Day

Figure 6. Venue information Pop-up

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Table 1. Description of steps in implementing C-Line No.

Step

Description

Planning

Problem identification and discussing the solution.

User research

Collecting venue information such as building capacity, area coverage, and air circulation.

Application development

Designing, coding, and developing the application.

Testing

Carrying out beta version to test the application.

Implementation

Public policy and socialization about the application

Reporting

Collecting feedback from C-Line users for future improvement.

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3. CONCLUSION & RECOMMENDATIONS This year of 2020, when the world is facing an existential global health crisis which is the coronavirus-caused respiratory disease (COVID-19) has forced us to start a new decade in developing medicine and science technology that can be applied to tackle this problem (Ting et al, 2020). As time went by, the number of COVID-19 cases also continued to increase rapidly especially in Indonesia and we still could not find any drop on the graphic yet. This pandemic has given a serious impact on Indonesia not only in the health aspect but also in other aspects such as the economy and education. And if we are not in a hurry to try solving this problem, this would be a catastrophe for Indonesia in the future. A lot of misinformation that is spreading massively across Indonesian citizens is one of the main causes of the rising number of new cases. We all know that combating the COVID-19 pandemic has become the responsibility not only for health workers and governments but also for all of us (Nasir et al, 2020). We all have been told to be better to stay at home during this pandemic to flatten the curve, but we also know that particularly in Indonesia, not all of us have the same option of staying at home such as health workers, laborers, etc. But until now because of the unclear information about the real number of cases, many people are still worried about going outside even though it's necessary. To solve this problem, we would like to propose an innovation of implementing technology to handle one of the main problems here which are the data about COVID-19 in Indonesia itself. We named it “C-Line” which is the check-in-based application that is able to track the real number of cases all across Indonesia and give the up to date information about COVID-19 history of cases in public places, which we expect to be able to provide concrete data to make people keep aware of any risk of transmission around their places. Not only that, but we also expect through this application to be able to help other affected sectors to keep running their places but still in strict monitoring. Therefore, we need to cooperate together to keep the efficacy of this application later on, so that we could possibly bring the number of COVID-19 cases down the line.

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REFERENCES Buana, D. R. (2020). Analisis Perilaku Masyarakat Indonesia dalam Menghadapi Pandemi Virus Corona (Covid-19) dan Kiat Menjaga Kesejahteraan Jiwa. Salam: Jurnal Sosial dan Budaya Syar-i, 7(3), 217226.

Instruksi Presiden (INPRES) Pemerintah Pusat No.6 Tahun 2020. Tentang Peningkatan Disiplin dan Penegakan Hukum Protokol Kesehatan Dalam Pencegahan dan Pengendalian Corona Virus Disease 2019.

Keni, R., Alexander, A., Nayak, P. G., Mudgal, J., & Nandakumar, K. (2020). COVID-19: Emergence, spread, possible treatments, and global burden. Frontiers in public health, 8, 216.

Nasir, N. M., Baequni, B., & Nurmansyah, M. I. (2020). Misinformation related to COVID-19 in Indonesia. Jurnal Administrasi Kesehatan Indonesia, 8(2), 51-59.

Nasution, Dito., Aditia Erlina., Muda Iskandar. (2020). Dampak Pandemi COVID-19 terhadap Perekonomian Indonesia. Jurnal Benefita, vol.5, 1-4.

Setyawan, F. E. B., & Lestari, R. (2020). Challenges of Stay-At-Home Policy Implementation During the Coronavirus (Covid-19) Pandemic in Indonesia. Jurnal Administrasi Kesehatan Indonesia, 8(2), 15-20. Susan Olivia , John Gibson & Rus’an Nasrudin. (2020) Indonesia in the Time of Covid-19, Bulletin of Indonesian Economic Studies, 56:2, 143-174.

The Jakarta Post (2020) Leadership in Crisis, Editorial. Retrieved from https://www.thejakartapost.com/academia/2020/03/16/leadership-incrisis.html

Ting, D. S. W., Carin, L., Dzau, V., & Wong, T. Y. (2020). Digital technology and COVID-19. Nature medicine, 26(4), 459-461.

Undang Undang Dasar Republik Indonesia 1945 pasal 28H ayat 1

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WHO. (2020, April 17). Coronavirus disease (COVID-19). Retrieved from https://www.who.int/newsroom/q-a-detail/coronaviruse-disease-covid-19

WHO. (2020). Update on coronavirus disease in Indonesia. Retrieved from https://www.who.int/indonesia/news/novel-coronavirus

YANMAS DPKM-UGM. (2020). Dampak Awal Pandemi COVID-19 terhadap UMKM. Retrieved from https://pengabdian.ugm.ac.id/dampak-awal-pandemi-covid-19-terhadap-umkm/

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Solution for Drug Supervisor's (PMO) Communication and Follow Up Method on TB Cases Through YouC (Your Supervisor TB) Mobile Application in Indonesia Shabrina Izzata Afiyati Ahmad, Hammam Arif Shabri, Dela Putri Pratikno, Nabil Athoillah Medical faculty, Jember University Abstract Tuberculosis as known as TB is one of the infections caused by a bacterium that is identified as Mycobacterium tuberculosis that usually infects the lung. This bacteria can spread during a sneeze, talk, spit, or cough. Consuming RHZE (Rifampicin, Isoniazid, Pyrazinamide, Ethambutol) still being the guideline standard for the new case of TB. However, this treatment must be done regularly and in a disciplined manner. There are several problems regarding the realization of the DOTS strategy that taken by WHO. First, according to Becker, incomplete treatment correlates with the failure of information provided by health workers. In this context, it is not only the communication problem among the health worker but also the information delivery method that is used by the PMO or drug TB supervisor. The second problem in TB treatment is the lack of contribution of PMO in supervising and following up the patient during their treatment. We come up with a solution using a mobile application called YouC (Your Supervisor TB). This application is designed to be a multifunctional application that provides easy access to information that is lacking due to the disruption of the communication process. The YouC application also has a chat feature from doctors and PMOs that are integrated into phone numbers and google accounts, this is used to overcome distance problems to report the condition of TB patients regularly. We hope that the government can help with various processes in this application such as funding for research and publication. Key Findings : TB, communication, drug supervisor, YouC application

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Solution for Drug Supervisor's (PMO) Communication and Follow Up Method on TB Cases Through YouC (Your Supervisor TB) Mobile Application in Indonesia

By : Shabrina Izzata Afiyati Ahmad Hammam Arif Shabri Dela Putri Pratikno Nabil Athoillah

AMSA-JEMBER INDONESIA 2020

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Introduction Tuberculosis as known as TBC is one of infection caused by bacteria that identified as Mycobacterium tuberculosis that usually infect the lung. This bacteria can spread during a sneeze, talk, spit, or cough (through the air) (WHO, 2018). It occurs everyplace in the world, in 2018 based on data of WHO there were 1,5 million people died because they suffer from TB (WHO, 2020). Things that we need to pay more attention to was in 2018, South East Asia is the largest country with a big contributed to TBC. And Indonesia is one of eight countries, which belong to TB burden countries (WHO, 2020). In May 2019, total TBC cases in Indonesia were 842.000 cases, and 32% is not reported yet (Kementrian Kesehatan Republik Indonesia, Direktorat Jenderal Pencegahan dan Pengendalian Penyakit, 2019).

People with TB need important treatment to recover. They need full course TB treatment in some period to prevent bacteria to multiply more and more. Consuming RHZE (Rifampicin, Isoniazid, Pyrazinamide, Ethambutol) still being the guideline standard for the new case of TB (Marcelo Fouad Rabahi, 2017). But, this treatment needs to be routine and discipline. If the patient is not able to consume the drug routinely, it will be a complicated case and transformed into DR TB (Drug Resistance Tuberculosis) (U.S. Department of Health & Human Services, 2017). A shocking fact was drug resistant TB cases in Indonesia reach 4.413 people (Kementrian Kesehatan Republik Indonesia, Direktorat Jenderal Pencegahan dan Pengendalian Penyakit, 2019). So, for the effectiveness of this case, since 1990 WHO recommended a solution to directly observed treatment short course (DOTS) strategy (Marcelo Fouad Rabahi, 2017). DOTS consists of five strategies. First, political commitment with increased and sustained financing. Second, case detection through quality-assured bacteriology. Third, standardized treatment, with supervision and patient support. Fourth, an effective drug supply and management system. And the last one is monitoring and evaluation system, and impact measurement (WHO, 2020). If DOTS' recommendation published for a long time, why DR TB still happen? Let’s see how these five elements take an important role in TB patients. Based on the research, the third and fifth elements of the DOTS strategy focus on controlling and motivating the patient to regularly take antibiotic drugs were very crucial. It refers to if we do not consume it regularly, the bacteria will be resistant. This condition made the DOTS strategy about reporting and assessment of treatment result for patient’s tuberculosis control program is a must. (Marcelo Fouad Rabahi, 2017). Based on a systematic review about drug supervisor in Indonesia which shows a correlation between patient and drug supervisor (based on DOTS strategy) told us about this program had some factor that makes DOTS can not fully help TB patient. It includes the minimum information about their role as an educator and also supervisor (Putri, 2019).

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On the other hand, Lawrence Grees’s theory about human behavior (related to behavior on routinely consuming anti TB drug), a patient needs predisposing factor that is an internal factor, enabling factors that established in the physical environment, and reinforcing factors such as family and drug supervisor (Dimas, 2016). At this point, we know drug supervisor as a reinforcing factor isn’t optimal yet, it because of minimum controlling and evaluation from decision maker. The consequence made TB patients felt they recover well and stop before the right time because no one reminds them (Wiwit Febrina, 2018).

Indonesia as a vast archipelagic country is one of the factors that made the decision maker feel difficult to do a follow up to the drug supervisor on the spread places. But it must not be a problem anymore during the development of technology such as gadgets or smartphones that connected us by the internet. Supporting fact, by January 2020 more than 380 million Indonesian people connected to the internet (Hootsuite, 2019). Not only that, by 2019 Indonesian people spend their 195 minutes per day using social media (GlobalWebIndex, 2019) which means they always use the internet for about more than 3 hours per day so we can always connect every time and everywhere. This new behavior of Indonesian is a big good chance for us as a millennial and future health workers to explore the benefits of this condition. And we can change it from addiction to gadget as a solution to improve this benefit to another system of doing communication between decision maker (doctor) to drug supervisor by software that connected us on the internet to educate and follow up TB patient, so prevalent on DR TB can decrease.

Outline Problem Tuberculosis or TB is one of an immense global issue which is still being the top three issue of health problem in Indonesia. Tuberculosis includes to the infection is caused by bacillus mycobacterium tuberculosis. These bacteria usually attack the lungs that causing pulmonary TB, but it can’t be denied that this bacteria spreading and infecting other parts. Incomplete treatment of this disease can cause serious complications, as we called Multi Drug Resistant (MDR) TB. (Ministry of Health of the Republic of Indonesia, 2020) Multi Drug Resistant Tuberculosis (MDR TB) is a condition in which Mycobacterium tuberculosis resistant to the type of first-line drugs treatment such as rifampicin and isoniazid simultaneously, with or without being followed by other first-line drugs resistance treatment (Farihatun & Bungsu, 2018).

The incidents number of MDR TB in the world by 2014 was estimated to be 300.000 new cases of MDR TB and by 2014 increased to 480.000 new cases of MDR TB. (WHO, 2016) In Indonesia, the number of confirmed cases of MDR TB discovery was likely to increase from 2009 to 2015. The spread of MDR TB cases is mostly found in the provinces of Jakarta, West Java, and East Java (Farihatun & Bungsu, 2018).

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One of the solutions taken by WHO in 1993 is the DOTS (Directly Observed Treatment Short Course) strategy. This strategy aims to ensure the right drug is taken at the right time for the full duration of treatment. There are several problems regarding the realization of the DOTS strategy. First, according to Becker, incomplete treatment correlates with the failure of information provided by health workers (Safri, Sukartini, & Ulfiana, 2014). In this context not only the health worker communication problem but also the information delivery method used by PMO or drug TB supervisor. Two factors that influence this communication problem, 1) The patient should understand the health problems that they faced. 2) The patient must be able to memorize the medical advice given by health workers or PMO. In giving information to the patient, health workers suggested to not use medical language which is difficult for general patients to apply the information so the patient can easily understand (Metta, 2012). These two factors have a close correlation to the level of PMO and patient education. The low education and lack of health knowledge of PMO will hinder the treatment process and causing an increase in MDR tuberculosis cases(Atmojo, 2016).

Study conducted at the Wango Banyumas Health Center on 20 January 2015 - 20 February 2015, data was obtained that the TB patients with low education were 38 people (70.37%), while the number of highly educated respondents was 16 people (29, 63%). The increase in tuberculosis correlates with the level of education or knowledge. The low level of patient education will of course giving indirectly impact to the treatment process because of the lack of understanding of the impact and incomplete of TB treatment which causes drug dropping out (DO) so the risk of becoming a patient with Multi Drugs Resistant Tuberculosis (MDR TB) continues to increase(N & Putri, 2015).

The second problem in TB treatment is the lack of PMO contribution in supervising and follow up the patient during their treatment. The results of Lupitayanti's (2014) study show 80.8% of PMOs have a lack of contribution. This indicates that PMO awareness of health is needed especially in TB treatment. PMO's personal business is one of the reasons used by PMO cannot communicate with the doctor. Moreover, the distance between PMO and the doctor is being the reason for PMO's difficulty in reporting the condition of TB patients periodically (Hayati & Elly, 2016).

Another thing that influences TB treatment is self-motivation (intrinsic) and environmental support, especially PMO (extrinsic) (Yustina & Kim, 2017). Intrinsic motivation fluctuates due to depression and the level of TB patients, especially MDR-TB, due to inadequate social environmental support while the disease is getting worse. so, there is also a need for a psychiatrist's role during the treatment process. However, this can be controlled by maintaining communication between the PMO, doctors, psychiatrists, and patients. The difficulty in finding the time and space for communication between PMOs, doctors, psychiatrists, and patients is also an important issue that must exist (Faizah et al., 2016).

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From this, we can conclude that TB treatment in Indonesia is still poorly organized and far from perfect. We must start to resolve the problems related to failure in treatment, especially in the aspect of communication strategies. Of course, this requires cooperation between PMOs, doctors, patients, and psychiatrists.

Patient The level of education Knowledge about The effect of incomplete TB treatment

Health worker

The leanguage in delivering information

The knowledge about tb treatment guideline Communication method

Application of the Strategy model in TB treatment

Increasing MDR TB cases Family support PMO’s personal business Family and drug supervisor (PMO)

Health service distance The knowledge about tb and the treatment

Self motivation severity

Other factors

Solution To deal with PMO's lack of knowledge about TB, we must understand that a person's ability to receive a message is different. This can be caused by the communication process where the process of receiving messages and giving messages is interrupted. Therefore, we need a method to equalize the knowledge between PMOs to provide standard therapy for every TB patient. This method must be simple and efficient so it can be used by all PMOs in various circles. In an era where technology is very developed, we can use the communication process using electronic media such as mobile phones to overcome this problem. We come up with a solution using a mobile application called YouC (Your Supervisor TBC). This application is designed to be a multifunctional application that provides easy access to information that is lacking due to the disruption of the communication process. There are two types of this application,

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first is YouC for a doctor which is integrated with a doctor’s account and the second is YouC for PMO. The YouC application has a PMO training feature, where PMOs are given material about TB and its treatment. This training feature will be grouped into several chapters containing material and practice questions. Some of the materials included in this training are about how PMO communicates with TB patients, general information about TB, and how to use TB drugs which all of it will be written in Indonesian. The questions given will be replaced automatically every month based on the existing material. The score of each question will be sent to the doctor’s account as feedback to evaluate PMO's knowledge. The YouC application also has a chat feature from doctors and PMOs that are integrated into phone numbers and google accounts, this is used to overcome distance problems to report the condition of TB patients regularly. Also, YouC has a reminder feature to remind TB patients when to take their medication. To ensure that this application can be used by all PMOs in Indonesia and successfully executed, a massive publication is required. The doctor in charge and the government must be able to socialize the existence of this application to PMOs. Another support that can be done is to promote massively through social media about the existence of this application. Conclusion TB is one of many diseases with a large number of sufferers. To fully recover from tuberculosis, patients need many antibiotics over some time or they may develop to be drug-resistant tuberculosis. WHO already gave a solution using the DOTS strategy where a drug supervisor is needed in the process. But many studies show that drug supervisors also have some problems such as lack of knowledge and discipline. This could be caused by the communication problem where the process of giving information from doctor to drug supervisor is disrupted. Upgrade TB treatment knowledge and effective communication between drug supervisors and doctors may prevent the number of DR TB cases. By making a mobile application called YouC (your supervisor TB) that include TB treatment training and chat feature we hope will overcome this communication problem. Recommendation We hope that the government can help with various processes in this application such as funding for research and publication on social media and television. The government also needs to help by making regulations and policies regarding the obligations of using this application. In addition, we hope that doctors in all parts of Indonesia can provide education to the public in using this application so that it can be used massively. We also want the public, especially supervisors, to be able to take full advantage of the application by understanding the existing features so that services for TB sufferers are better and better. In the end, we also expect all parties involved to improve the quality of this application both in terms of improvement and application usage.

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Reference Dimas, ,. S. (2016). DRUGS SUPERVISOR ACTIVENESS CORRELATED WITH MOTIVATION AND TUBERCULOSIS MEDICATION ADHERENCE. 7th International Nursing GlobalWebIndex. (2019). The Most "Social" Country. London: GlobalWebIndex. Hayati, D. dan M. Elly. 2016. HUBUNGAN kinerja pengawas menelan obat dengan kesembuhan tuberkulosis di upt puskesmas arcamanik kota bandung. Jurnal Ilmu Keperawatan,. IV(1):10–18. Hootsuite, W. A. (2019). Data Pengguna Internet Indonesia. German: Hootsuite, We Are Social. Kementrian Kesehatan Republik Indonesia, Direktorat Jenderal Pencegahan dan Pengendalian Penyakit. (2019, May 1). Situasi TB di Indonesia. Retrieved from TB Indonesia: https://tbindonesia.or.id/informasi/tentang-TB/situasi-TB-di-indonesia-2/ Kementrian Kesehatan Republik Indonesia. 2020. Tuberkulosis Marcelo Fouad Rabahi, J. L.-S. (2017). Tuberculosis treatment. Journal Brasileiro de Pneumolgia, 472–486. Putri, F. R. (2019). SISTEMATIK REVIEW : KRITERIA DAN PERAN PENGAWAS MENELAN OBAT . Jurnal Surya Medika Volume 4 No. 2 . U.S. Department of Health & Human Services. (2017, January 17). Drug-Resistant TB. Retrieved from Centers for Disease Control and Prevention: https://www.cdc.gov/tb/topic/drtb/default.htm WHO. (2018, January 18). What is TB? How is it treated? Retrieved from World Health Organization: https://www.who.int/westernpacific/news/q-a-detail/what-is-tb-how-is-it-treated WHO. (2020). The Five Elements of DOTS on TB. Retrieved from World Health Organization: https://www.who.int/tb/dots/whatisdots/en/index4.html WHO.

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Atmojo, J. (2016). HUBUNGAN TINGKAT PENGETAHUAN PENGAWAS MENELAN OBAT DENGAN KEBERHASILAN PENGOBATAN PASIEN TUBERKULOSIS PARU DI KABUPATEN KLATEN Joko Tri Atmojo. 19–28. Faizah, U., Agiananda, F., Winarsih, N. S., Ginting, T. T., Isbaniah, F., & Elvira, S. D. (2016). Gangguan psikiatri pasien TB-MDR (Multi Drug Resistant) dan stres psikososial yang

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memengaruhi di RSUP Persahabatan. Journal of The Indonesian Medical Association, 66(10), 473–480. Farihatun, S., & Bungsu, P. (2018). DETERMINANT FACTORS OF DROP OUT ( DO ) AMONG MULTI DRUGS RESISTANCE TUBERCULOSIS ( MDR TB ) PATIENTS AT JAKARTA PROVINCE IN 2011 TO 2015. 7(3), 87–92. Hayati, D., & Elly, M. (2016). HUBUNGAN KINERJA PENGAWAS MENELAN OBAT DENGAN KESEMBUHAN TUBERKULOSIS DI UPT PUSKESMAS ARCAMANIK KOTA BANDUNG. Jurnal Ilmu Keperawatan, IV(1), 10–18. Metta, R. (2012). Jurnal Psikogenesis. Vol. 1, No. 1/ Desember 2012. Jurnal Psikogenesis, 1(1), 88– 94. N, A. H., & Putri, P. M. (2015). THE EFFECT OF PATIENTS EDUCATION BACKGROUND TO REGULARITY OF PULMONARY TUBERCULOSIS TREATMENT IN Oleh : PSYCHO IDEA. Safri, F., Sukartini, T., & Ulfiana, E. (2014). Analysis Factors which Correlate with Pulmonary Tuberculosis Patient’s Adherence on Medication Based on Health Belief Model. E-Journal UNAIR. Yustina, I., & Kim, Y. (2017). 2nd Public Health International Conference ( PHICo 2017 ). 9(PHICo). TB

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from

Appendix Multi Drug Resistant Tuberculosis (MDR-TB) is drug resistant TB against at least two of the major anti-TB drugs (INH and Rifampisin together) or with resistance to other first-line TB drugs (ethambutol, streptomycin and pyrazinamide). The success rate of TB treatment decreases when the bacteria become resistant (shown in the two figures below). This is a problem in the medical field.

The success rate of TB treatment in Indonesia is around 74%

RO TB treatment success rate is an average of 50%,

Resistance to TB drugs can occur for several reasons: 1. the patient does not complete the given treatment 2. Improper treatment by health personnel 3. Problems with the supply of drugs that are not always available.

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STRAINING: SEMINAR and TRAINING Coaching Based on SBAR Method to Enhance Communication Skill Amongst Medical Personnel Siti Zahra Arfiani1 , Faiza Nabila2, Siti Faizatul Aliyah3, Salsabila Rahmani4 1

Second Year Medical Student, Faculty of Medicine, University of Jember

Abstract Communication is a crucial component in all steps of the health care process. Effective collaboration and communication between physician and nurse may improve patient safety. However, throughout the entire history nurses and physicians have shared a complicated relationship. Tensions, conflicts, as well as misunderstandings caused by the difference in opinions and interest among nurses and physicians leads to poor interprofessional communication that will pose a risk to patient safety. The WHO Cooperation Centre has proposed the solution to overcome this problem by using the SBAR (Situation, Background, Assessment, and recommendation) checklist to transfer the information about patient’s safety among staff members. Nevertheless, the SBAR tool also faces some operational challenges. In order to solve this problem, we created a program called “STRAINING: SEMINAR and TRAINING Coaching Based on SBAR Method to Enhance Communication Skill Amongst Medical Personnel”. The words ``Seminar” and “Training” are actually the abbreviations of what activities we will input into our program. By using abbreviations, we hope the implementation of this program will be easy to remember and easy to carry out both regularly and periodically. Furthermore, collaboration on every element in the health sector including government actions are very important though policymaking to improve the scope of this program. Keywords: SBAR method, Interprofessional communication, Seminar, Training.

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STRAINING: SEMINAR and TRAINING Coaching Based on SBAR Method to Enhance Communication Skill Amongst Medical Personnel

By : Siti Zahra Arfiani Faiza Nabila Siti Faizatul Aliyah Salsabila Rahmani

AMSA-JEMBER INDONESIA 2020

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Background In healthcare organizations, the type of nurse-physician relationship and effectiveness of internal communication is one of the critical elements in deciding the quality of patient care. [1]. Accurate and efficient communication is a key component of providing high quality care to patients. According to research conducted by The Joint Commision (TJC), almost 70% of medical errors are the direct result of a communication breakdown. While there are many possible reasons for medical errors, poor communication between physician and nurses are the root cause of these errors, such as the failure to pass on important patient information [2]. Poor interprofessional communication poses a risk to patient safety especially at change-of-shift in emergency departments (EDs). Emergency departments (EDs) are complex, high-risk clinical environments where interprofessional teams of doctors,nurses and allied health staff care for a wide range of patients in settings of uncertainty [3]. National and international solutions presented to improve clinical handoff and reduce adverse effects of ineffective communication bring about major changes in the nursing handoff process. Introduction of a structured clinical handoff process accompanied by bedside handoff has resulted in boosted self confidence of nursing staff, enhanced communication, and reduction of medical errors. The communication tool should include a flexible, modifiable framework that can be used along with other tools to ensure the relevance of shift content to the clinical context [4]. The World Health organization Cooperation Center has proposed the standard approach of situation, background, assessment, and recommendation (SBAR) to transfer information about patients' safety solutions among staff members [5] The SBAR checklist was introduced by the treatment deputy in 2013 to carry out a nursing handoff. This checklist was first designed by the United States military and developed by Michael Leonard & Suzanne Graham to be applied in healthcare systems [6]. The checklist was deployed to detect errors and neglects by the presentation of an expected pattern and revision of available information, patient background, and latest services, thereby improving communications among healthcare staff [7]. Outline Problems On the second point of International Patient Safety Goals (IPSG) standard mentioned that Effective Communication between health care workers must be improved. Many factors have been reported to potentially hinder nurse-doctor communication such as lack of structure, hierarchy, language, culture, sex and difference in communication style. Up to 65% of serious adverse events (SAEs) include communication as a contributing factor[8]. Approximately 180,000 patients die annually in the United States because of adverse medical events. Most of these events are related to miscommunication among health care teams[9]. According to the Hospital Patient Safety Committee, in Indonesia, the incidence

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of people who almost injured was 53.33%, while the unexpected incidence was 46.67%. Based on the results of a data study, the main cause of unexpected events and almost injured events in Indonesian hospitals is communication[10] To overcome this problem, it has been proposed to use the SBAR method. In some countries the introduction of this SBAR can be through the provision of seminars or it has even been included in the learning curriculum in the health sector. Accurate use of the SBAR tool has produced positive impacts among patients and reported that, “reliability of a patient progress report improved from 54.5% to 83.73%” after surveying 83 nurses within a single hospital setup [11]. Nevertheless, the SBAR tool also faces some operational challenges. For instance, the concept of filling the tool is hard to learn and this clues the user's resistance and poor compliance. Further, filing the hard copy forms is regarded to be time consuming [12].

In order to even the empirical evidence that support the significance of the SBAR tool and the benefits of standardized communication tools in general, the report has shown that compliance to the use of such tools is still poor [13]. Consequently, the inconsistent use and poor compliance with the SBAR model have been blamed for the poor patient outcomes. For instance, Williams et al. reported that most of the anesthetists (67% in their experiment) in the clinical setup could not provide accurate information during the handover process [14]. The recorded failure could be due to the inconsistency in the use of SBAR in the clinical setups. As such, a critical gap exists in the reinforcement of how the caregivers use the tool.

Solution To overcome this problem, we need a mechanism that can be remembered and implemented in a logical manner so that the purpose of this mechanism can be achieved and the problems we raise can be solved gradually. As medical students we thought of an idea to organize an action for the creation of an interpersonal community with other medical healthcare. Because of that we package a solution in the form of conducting seminars and training coaching which is made as an acronym like STRAINING so that it is easy to remember and is carried out regularly and periodically.

In the bellow, we are explaining more about STRAINING (SEMINAR and TRAINING coaching).

SE - Set a schedule to be able to attend seminars on SBAR coaching In order for this training to run well, all medical healthcare who need training must be able to set aside time by making a schedule to attend seminars. Given the density of schedules owned by health workers, this seminar can be conducted in several shifts in order to provide space for all the officers who want it.

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M - Make motivation for yourself so you are willing and able to learn SBAR through seminars Results of this study were conducted in the hospital ward of dr. Zainoel Abidin Hospital Banda Aceh in June 2015 explained the result so consistent with the research conducted by Murdyastuti about the motivation of nurses toward the implementation of the patient safety program in the hospital ward of Surakarta Hospital. Murdyastuti states that motivation has a significant impact on patient safety programs. In addition, nurses' motivation are able to make a positive contribution in maintaining and improving the quality of health services. For instance, nurses who have high motivation are able to demonstrate their professionalism in providing health care, including patient safety programs based on the standards of health care that are independent, responsible and accountable. Moreover, nurses will be able to develop their knowledge in accordance with the development of science and technology. One factor that causes the high motivation of nurses is the existence of socialization and training of the SBAR communication that the nurses get which are beneficial to the improvement of their understanding and health services they provided [15].

IN - Increase your knowledge about the SBAR method through seminars Actually, studying the SBAR method can be done through a valid literature search. However, if no guidelines are made, it is possible that the problem of material misunderstanding can still occur. For this reason, through this seminar, participants are expected to be able to take the material that has been presented in accordance with the curriculum and to increase knowledge of the SBAR method. A study proved that the observed changes in the communication abilities of nurses occurred mainly because of the educational intervention. This is consistent with previous studies that determined the significance of training nurses on how to use SBAR methodology before it is implemented [16].

A - Accept and review the SBAR material presented at the seminar After attending the seminar, the material or curriculum that is described must be accepted. Apart from that, reviewing the material presented will make it easier for us to understand and remember it.

R - Remember and take notes in order to be able to carry out the concepts described in the work Taking notes is a good mechanism for remembering and also applying the material presented. if you only come and hear the possibility of knowledge being read and heard is only around 50%, whereas if we receive knowledge then we note it and also say it, the presentation reaches 70%.

TR - Try putting the theory into practice directly through the SBAR method training De Meester et al. identified the training received by nurses in the study in relation to the use of the SBAR methodology as being instrumental to the improvements in communication within the care teams as well as the decline in unexpected patient mortality. Achrekar et al. also reiterated the importance of

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individual and team training on the different features of SBAR in increasing its utility and efficacy for quality patient care. Andreoli and colleagues also came to similar conclusions observing that an educational intervention to equip healthcare professionals with the necessary knowledge on how to use the SBAR tool within the clinical setting was important in achieving the envisioned quality outcomes in fall reduction [17]. The study found significant improvements in the use of the SBAR methodology in the pretest and posttest results of the experimental and control groups. Findings suggest that nurses who are trained to use the SBAR are more likely to perform an immediate patient assessment and call for assistance sooner than nurses who did not receive training [13].

A - Always aware and focus on practicing the SBAR method in the available training To apply the SBAR method, maximum training is required. Physicians and nurses are required to be able to communicate in situations that may be very precarious in a fast time. In general, the things that are conveyed include a summary of the patient's current medical status, recent changes in condition, potential changes to watch for, resuscitation status, recent laboratory values, allergies, problem lists, and many other conditions that may need to be reported[18]. Therefore, being aware and focused in training is important to be able to run the SBAR method.

IN - Inform this method to fellow colleagues who are unable to attend the training Health care providers may not work alone in serving patients. The similarity of perceptions in the team to implement the SBAR method is needed to prevent adverse events in the patients. Although poor communication can lead to tragic consequences, a review of the literature also shows that effective communication can lead to the following positive outcomes: improved information flow, more effective interventions, improved safety, enhanced employee morale, increased patient and family satisfaction, and decreased lengths of stay [19] . Therefore, it is important to inform this method to fellow colleagues who are unable to attend the training.

IN - Include this tutorial as an activity that can be done routinely Habits can be defined as psychological dispositions to repeat behavior. They are acquired gradually as people repeatedly respond in a recurring context (e.g., performance settings, action sequences) [20]. So, the step to include the tutorial of SBAR method into a routine will greatly contribute to an effective communication habit.

G - Grow your skills in using the SBAR method through personal evaluation Personal evaluation makes a person confident about the abilities they have. In practicing the SBAR method, it is hoped that physicians and nurses can make corrections to themselves and then improve their abilities. This eliminates or reduces fear and uncertainty regarding the use of the SBAR method.

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In addition, this personal evaluation will trigger continuous development of skills in practicing the SBAR method.

Conclusion To overcome miscommunication between doctor and nurse and the other medical healthcare we have a curriculum from WHO and it is called SBAR method. But we must know if the mechanisms of the SBAR method are not completely understood for medical healthcare. Because of that we offer solutions which are called STRAINING : Seminar and Training coaching. Each word of this seminar and training has its own meaning which can represent the content or solution of the problems above.

Recommendation As a continuation of the realization of effective communication, we recommend this SBAR method to be applied to all health workers, such as doctors, nurses, pharmacists, and health service administrators. Thats why, we have several strategies to introduce the SBAR method early to future health workers and continue to develop this SBAR method evenly through: 1. Looking for external partners such as private clinics to implement and test the SBAR method within a certain timeframe. 2. Then, together with external partners, cadres will be formed who will synergize together in introducing this method through seminars and training 3. Introducing the SBAR method to medical students and other future health workers through some platforms such as webinars, radio broadcasts, talk shows, and posters which are distributed through social media accounts. 4. Conduct training as a continuation of the introduction of the SBAR method We believe that fast, responsive, and maximum health care begins with the creation of effective communication between all health workers who work together in realizing patient healing.

References 1. P.A., Hamidah, K,A., N,A. Effective Communication between Nurses and Doctors: Barriers as Perceived by Nurses. Journal of Nursing & Care. 2018. 7(3): 1-6. 2. Clapper, T. C., & Ching, K. Debunking the myth that the majority of medical errors are attributed to medication. Medical Education. 2019. 54(1): 74-81 3. Redley, B., Botti, M., Wood, B., & Bucknall, T. Interprofessional communication supporting clinical handover in emergency departments: An observation study. Aistralasian Emergency Nursing Journal. 2017. 20(3): 122.

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4. Spooner A, Aitken L, Corley A, Fraser JF, Chaboyer W. Nursing team leader handover in the intensive care unit contains diverse and inconsistent content: an observational study. Int J Nurs Stud. 2016;61:165-72. 5. Raymond M, Harrison MC. The structured communication tool SBAR (Situation, Background, Assessment and Recommendation) improves communication in neonatology. S Afr Med J. 2014;104(12):850-2. 6. Kostoff M, Burkhardt C, Winter A, Shrader S. An interprofessional simulation using the SBAR communication tool. Am J Pharm Educ. 2016;80(9):157. 7. Ashcraft AS, Owen DC. Comparison of standardized and customized SBAR communication tools to prevent nursing home resident transfer. Appl Nurs Res. 2017;38:64-9. 8. De Meester, K., Verspuy, M., Monsieurs, K. G., & Van Bogaert, P. (2013). SBAR improves nurse–physician communication and reduces unexpected death: A pre and post intervention study. Resuscitation, 84(9), 1192–1196. https://doi.org/10.1016/j.resuscitation.2013.03.016 9. Martin, H. A., & Ciurzynski, S. M. (2015). Situation, Background, Assessment, and Recommendation–Guided Huddles Improve Communication and Teamwork in the Emergency Department. Journal of Emergency Nursing, 41(6), 484–488. https://doi.org/10.1016/j.jen.2015.05.017 10. Astuti, N., Ilmi, B., & wati, R. (2019). Penerapan Komunikasi Situation, Background, Assesment, Recomendation (SBAR) Pada Perawat Dalam Melaksanakan Handover. IJNP (Indonesian Journal of Nursing Practices), 3(1). https://doi.org/10.18196/ijnp.3192

11. Arumugam Y, Hassan H, Shah PP, Irwan S (2016) Managing patient progress report through SBAR tool in non-critical areas. Int J Curr Innov Res 2: 495-503. 12. Achrekar MS, Murthy V, Kanan S, Shetty R, Nair M, et al. (2016) Introduction of situation, background, assessment, recommendation into nursing practice: A prospective study. Asia Pac J Oncol Nurs 3: 45-50. 13. Ludikhuize J, de Jonge E, Goossens A (2011) Measuring adherence among nurses one year after training in applying the Modified Early Warning Score and Situation-Background Assessment-Recommendation instruments. Resuscitation 82: 1428-33 14. Williams RG, Silverman R, Schwind C, Fortune JB, Sutyak J, et al. (2007) Surgeon Information Transfer and Communication Factors Affecting Quality and Efficiency of Inpatient Care. Ann Surg 245: 159-70. 15. Fajri, R., & Yuswardi, Y. (2016, May). The Motivation of Nurses in Applying Technique of Sbar at dr. Zainoel Abidin Hospital Aceh, Indonesia. In ASEAN/Asian Academic Society International Conference Proceeding Series.

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16. Andreoli A, Fancott C, Velji K, Baker GR, Solway S, et al. (2010) Using SBAR to communicate falls risk and management in inter-professional rehabilitation teams. Healthc Q 13: 94-101. 17. Toghian Chaharsoughi N, Ahrari S, Alikhah S (2014) Comparison the effect of teaching of SBAR technique with role play and lecturing on communication skill of nurses. J Caring Sci 3: 141-147. 18. Achrekar, M., Murthy, V., Kanan, S., Shetty, R., Nair, M., & Khattry, N. (2016). Introduction of Situation, Background, Assessment, Recommendation into Nursing Practice: A Prospective Study. Asia-Pacific Journal of Oncology Nursing, 3(1), 45. https://doi.org/10.4103/2347-5625.178171 19. Hughes, R. (2008). Patient safety and quality : an evidence-based handbook for nurses. Agency For Healthcare Research And Quality, U.S. Dept. Of Health And Human Services. 20. Neal, D. T., Wood, W., Labrecque, J. S., & Lally, P. (2012). How do habits guide behavior? Perceived and actual triggers of habits in daily life. Journal of Experimental Social Psychology, 48(2), 492–498. https://doi.org/10.1016/j.jesp.2011.10.011 Appendix 1 RECOMMENDED READINGS To know more about the problem of communication between medical personnel and how the solution, we recommended the following readings to all participants. These readings highlight the solution about the SBAR method worldwide. We hope these readings can stimulate critical thinking which will be helpful for everyone to understand our solution which will increase the SBAR method in knowdays. 1. P.A., Hamidah, K,A., N,A. Effective Communication between Nurses and Doctors:

Barriers as Perceived by Nurses. Journal of Nursing & Care. 2018. 7(3): 1-6. 2. Clapper, T. C., & Ching, K. Debunking the myth that the majority of medical errors are attributed to medication. Medical Education. 2019. 54(1): 74-81 3. Redley, B., Botti, M., Wood, B., & Bucknall, T. Interprofessional communication supporting clinical handover in emergency departments: An observation study. Aistralasian Emergency Nursing Journal. 2017. 20(3): 122. 4. Raymond M, Harrison MC. The structured communication tool SBAR (Situation, Background, Assessment and Recommendation) improves communication in neonatology. S Afr Med J. 2014;104(12):850-2.

5. Kostoff M, Burkhardt C, Winter A, Shrader S. An interprofessional simulation using the SBAR communication tool. Am J Pharm Educ. 2016;80(9):157.

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6. Ashcraft AS, Owen DC. Comparison of standardized and customized SBAR communication tools to prevent nursing home resident transfer. Appl Nurs Res. 2017;38:64-9.

7. De Meester, K., Verspuy, M., Monsieurs, K. G., & Van Bogaert, P. (2013). SBAR improves nurse–physician communication and reduces unexpected death: A pre and post intervention study. Resuscitation, 84(9), 1192–1196. https://doi.org/10.1016/j.resuscitation.2013.03.016

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SOCIAL MEDIA FOR EDUCATIVE COMMUNICATION IN BATTLING INFODEMIC AND CASE INCREASE DURING COVID-19 PANDEMIC IN INDONESIA

By : Tania Isabella Waspodo, Indy Zahrotul Firdaus, Tegar William Valentino Tae Asa, Sherly Natalie Widiasmoko 3rd year medical student, 2nd year medical student, 2nd year medical student, 2nd year medical student ASIAN MEDICAL STUDENTS’ ASSOCIATION- UNIVERSITY OF BRAWIJAYA

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Social media for educative communication in battling infodemic and case increase during COVID19 pandemic in Indonesia Tania Isabella Waspodo, Indy Zahrotul Firdaus, Tegar William Valentino Tae Asa, Sherly Natalie Widiasmoko 3rd year medical student, 2nd year medical student, 2nd year medical student, 2nd year medical student Asian Medical Students’ Association- University of Brawijaya

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SOCIAL MEDIA FOR EDUCATIVE COMMUNICATION IN BATTLING INFODEMIC AND CASE INCREASE DURING COVID-19 PANDEMIC IN INDONESIA

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Social media for educative communication in battling infodemic and case increase during COVID-19 pandemic in Indonesia Tania Isabella Waspodo, Indy Zahrotul Firdaus, Tegar William Valentino Tae Asa, Sherly Natalie Widiasmoko 3rd year medical student, 2nd year medical student, 2nd year medical student, 2nd year medical student Asian Medical Students’ Association- University of Brawijaya

Amidst the chaos of the COVID-19 pandemic in Indonesia we haven’t seen a significant reduction in confirmed cases numbers yet. The reasoning may vary, however, we aim to see and analyze the factors that may contribute to the constant, and at times exponential, increase in confirmed COVID-19 cases in Indonesia. In this paper we are going to talk about the inhibiting factors of information spread to the community and why it has a direct impact on the success in handling the cases of COVID-19. We have decided that the prominent spreading of hoax information has a direct impact on the way the general public perceive the pandemic itself, the false beliefs, and thus impacts on the number of cases in Indonesia and the rate in which it increases daily. Through both our literature reading and discussions we have found three root problems to the main cause of rigorous hoax spreading, which are the lack of reading interest and illiteracy among varying ages of Indonesians, bad social media habits, and the inadequacy of COVID-19 information spread combined with lack of transparency from the government. Hoax information is synonymous with false information or fake news, and the latter should be defined as news articles that are intentionally and verifiably false and could mislead readers. We believe that hoax information itself is not a problem that appears solely since the appearance of the COVID-19 pandemic here in Indonesia; in fact, it has been a problem that Indonesian officials have been tackling on especially since the emergence of the massive use of social media. That said, however, hoax information have been present even before the era of social media, albeit in different forms and spread through different methods. And not specifically the existence of it that becomes a problem for the officials to monitor the cases and the public in general, it is the abundance of hoax information that exacerbates the spreading of COVID-19 in that it further serves as a reliance for people to have faith in false information, leading them to do, for example, bad hygiene practices. The impact from this can later be divided into two main categories, false positive perception and false negative perception. The first one, however, affects the number of COVID-19 cases more than the latter.

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The main issue here is the increase of COVID-19 cases in Indonesia, which seems like it won’t slow down in terms of rate anytime soon. As we have stated there are three main roots to the main cause of the issue, with the main cause being the rapid spreading of hoax information. The first main root is bad social media habits among Indonesians, which includes sharing and liking online content without fully reading the context, preferring unverified news instead of official ones, and the tendency of people to debate on both relevant and irrelevant topics behind their online persona. One of the main root problem of hoax spreading in Indonesia is lack of reading interest and media literacy. Based on the data, Indonesian people who are actually reading with purpose looking for an information only 23,5 % from all Indonesia population and the other using another media such as television with 85,9 % and other electronic media. This shows that our society in Indonesia prefers to get information from electronic media where they don’t have to read the information and interpret the information by them self. In conclusion, the public prefers to have information "read out", so that they only act as a "passive reader" that accept all the perceptions expressed on television or other electronic media without have to review the information whether its true or false information. According to Baudrillard term, this type of audience acts as “silent majority” in which they will voluntarily throw away their identity in order to achieve an imaginary union with other perceptions (the majority of other people). There are several psychological explanations behind the ease of hoaxes spreading among Indonesia society. First, a person's opinion or attitude is the same as the false information in circulation this will make them think that the information is trust worthy. When the person already has a liking or bias for the information, a positive feeling will arise in a person if his opinion or belief is acknowledged and tend not to care whether the information he receives is true or false and immediately pass it on to others in their circle. Second, the limited knowledge of a person about the information that spreading around. A person's ignorance of the clarity of the information causes them to get trapped and easily carry out the orders contained therein. Another tendency that can lead someone to spreading hoax easily is that user behavior only sees the headline without seeing the content of the news and they immediately think that the information is correct. This is just one of the bad social media habits and may result in the propagation of fake news spreading, as readers play a crucial role in becoming news spreaders. Abundance of fake news equals to abundance of spreaders, and at least half of Indonesians are actively engaging in social media. Contact via social media, or just online in general, is easy to find in Indonesia. And although fake news will only spread rapidly given the right circumstances, it is not a farfetched idea that the interaction and social habits of Indonesians will propel hoax spreading as fast as possible.

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Moreover, it is supported by people sending information from trusted friends or from credible media, so they immediately make comments based on the news headline. In the perspective of the general Indonesian netizens, the general public tends to listen and/or accept information mainly from close relatives. And this serves as a basic logic on why people like to share things immediately; they care about their close relatives, their family and friends, and so they share information as soon as possible to ensure information update. In reality, however, the information given might not be the most accurate. And also given the event that these people, serving as news spreaders, actually read the full context or fact checks the news, perhaps hoax would not be as abundant as it currently is. It is also important to analyze the common medium for hoax information and the thinking mode of these people as they are exposed to fake news. For example, Whatsapp and Facebook are the two most common mediums for false information spread. These two platforms are designed for leisure thinking, or relaxed mode, instead of critical mode intended for studying or working. Hence why it is plausible that when the people are exposed to various forms of information in these two platforms, they are not as analytic on the content if compared to the event in which they are exposed to information from actually credible sources, such as official government websites or news broadcasting. And so, they are more lenient in filtering the information available. On the other hand, there are symptoms of people on social media to participate in commenting on a theme so that it can be considered understanding. A news that becomes a trending topic or viral in the media has a tendency to be disseminated more, without any prior verification efforts, so as not to appear left behind. By spreading news that is widely discussed, people can feel that they know and are considered to have legitimacy as people who are knowledgeable. Hoax information is made so that the general public no longer focuses on the real problem and then gets stuck on bombastic things that are not the main problem. It seems that information problem takes a role in this case. One that should been shout out is the information quality and transparency in Indonesia. The availability of Covid-19 updates is unequal with the transparency of information that should be provided. A qualitative journal that elaborates on the condition of Covid-19 information in Indonesia stated that Indonesia has lack of informational transparency. This journal stated that Indonesian people should receive more information than what is issued in the official website of Covid19. The journal compared Indonesian Official COVID-19 Website with another country such as Singapore. It compared the data that served in Indonesian Official Website and one owned by the Official COVID19 team in Singapore. We can find that Singapore provides the latest data about health facilitation such as ICU and general wards that are available for COVID-19 patients, and it helps a lot for people that need this data to get immediate treatment or consultation about COVID-19 which we can't know it through Indonesian Official Website.

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The information problem doesn’t stop there. As we can see, an official information giver should provide a credible information as a lot of people will read it or even make a scientific article based on it. In the case of COVID-19 pandemic, where people should gain more information to adequate their background of knowledge on the rapid increase of new information, a big space has been found. As a credible information giver, Official Indonesian Website should state the factors that make the information which provided in it is credible, such as the way government collect those data. As a credible resource, this portal should state the origin and the method of the data that stated. People should know about the potential spread of disease and the path of cases are tracked, but somehow people can’t find those information by updating their information through this portal. This is critical as a national official website that should be a source of information for the country. This lack information transparency and low-quality data based on credibility might lead to misreport or the worst is the underreporting of the actual data in, which may lead to unorganized data which stated by regional government or the national team of COVID-19. And the unorganized data updates between the regional government and national team of COVID-19 which happens in the Official Indonesian Website of COVID19 can conduct confusion among Indonesian people. The journal stated that score friction can be found between the data that is displayed on the Indonesian official Covid-19 website and regional case reports. And it shows that the website is still at a low rate on updating information that should be gathered based on current data. Not only the data stated on the Official Indonesian Website of COVID-19, the journal also judge the statement and speech that given by Indonesia Health Ministry, as we can see, is the one that should be the primary information for Indonesian people, inconstantly change along the time. Information transparency and quality actually the most essential part for government to take a move in facing this pandemic. Inadequate flows of data and misinformation lead to slow response which build lack of emergency sense or even awareness on facing this big case. We can say that the quality and transparency of the information could indicated level of the government response which this response is the one factor that contribute in building people awareness and risk perception. Decreased awareness level may lead to people ignorance of the COVID-19 information where, as stated before, induced the spread of hoaxes among the society. The correlation between hoaxes related to COVID-19 with pandemic situation in Indonesia are indirectly but quite influential. With still the hoaxes around in this pandemic situation, people tend to follow wrong advice about COVID-19 and have even become more susceptible to infection. The community is become ignorant of the rules set by the government, make opinions against health professionals, and invites others to ignore protocol during the COVID-19 pandemic.

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Bad Social Habits Decreased reading interest and literacy

Inadequatee infromation and lack of transparentcy Abundance of Hoax

Community Ignorance about COVID-19

Increased COVID19 cases in Indonesia

We present our problems here with an acknowledgement that there is a limitation in which we can introduce possible solutions to the case. In this time of global pandemic the solutions given should follow the general rule given by the government in that people should distance themselves physically, hence any kinds of program requiring mass gatherings and massive groups of people is not allowed. Obviously, this creates a massive barrier for the execution of the solution shouldn't include any forms of physical contact. Hence, any projects to tackle the case should adapt to the current situation and must be held online in forms of social media post, online meeting, or something personally such as apps. We all know that Indonesian covid-19 cases have grown rapidly, in this case, we need solutions that grows social awareness of covid-19 in a short time to suppress the number of covid-19 cases. As stated before, the community needs to raise their awareness and sense of emergency in facing this global pandemic in order to build a habit

based on health protocol, hence a rapid response is needed. Social media is one of online

platform where we can get free open access for any information and easily spread latest information. And

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this may lead to our first solution, which is the short term solution, where we will be using the social media as hoax buster and to educate the community as previously mentioned that social media has critical function in distributing information. For the long term solution, we came up with an idea to make one model of campaign that can collaborate between the society that is frequently exposed with hoax and health practitioners to make clear the health information especially in this pandemic. The idea is to held routine open discussion that will be conducted by health practitioner and experts which may involve the society. In this open discussion, we aimed to spread valid information about COVID-19 that has been confirmed by WHO, and to build a community of critical thinkers.

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References Al Farizi, S., & Harmawan, B. N. (2020). Data transparency and information sharing: Coronavirus prevention problems in Indonesia. Jurnal Administrasi Kesehatan Indonesia, 8(2), 35-50. Chan, A. K., Nickson, C. P., Rudolph, J. W., Lee, A., & Joynt, G. M. (2020). Social media for rapid knowledge dissemination: early experience from the COVID‐19 pandemic. Anaesthesia. Juditha, C. (2019). Literasi Informasi Melawan Hoaks Bidang Kesehatan di Komunitas Online. Manalu, R., Pradekso, T., & Setyabudi, D. (2018). Understanding the Tendency of Media Users to Consume Fake News. Marchi, R. (2012). With Facebook, blogs, and fake news, teens reject journalistic “objectivity”. Journal of Communication Inquiry, 36(3), 246-262. Masyarakat Telematika Indonesia. (2017). Hasil survey Mastel tentang wabah hoax nasional,Jakarta, Indonesia: Mastel. Rahadi, D. R. (2017). Perilaku pengguna dan informasi hoax di media sosial. Jurnal Manajemen dan Kewirausahaan, 5(1), 58-70. Saepudin, E. (2015). Tingkat Budaya Membaca Masyarakat (Studi Kasus Pada Masyarakat Di Kabupaten Bandung). Jurnal kajian informasi & perpustakaan, 3(2), 271-282. Setiati, S., & Azwar, M. K. (2020). COVID-19 and Indonesia. Acta Medica Indonesiana, 52(1), 84-89. Sularso, P. (2020). BUDAYA TULISAN DIBAYANGI BUDAYA LISAN. Artikel (Daring), http://gpmb. perpusnas. go. id,, diunduh pada Oktober. Taryadi, A. (Ed.). (1999). Buku dalam Indonesia Baru. Yayasan Obor Indonesia. Watie, E. D. S. (2016). Komunikasi dan media sosial (communications and social media). Jurnal The Messenger, 3(2), 69-74.

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AMINO | PCC EAMSC 2021: Philippines

Karen Kurnia AMSA-Universitas Hasanuddin 1st Winner of Videography Category

It’s all about experience, knowledge, and friendship. By joining PCC EAMSC, we could get those advantage that we wanted. By involving ourselves in this competition, we gained a lot of experience, we gained a lot of knowledge on how to make a good and meaningful video, and we also got to know each other more by spending time together in the making of this video. Since this is a group competition, I can say the most useful tips is to find a good partner. A good partner is not only about the smart ones or the creative ones, but what matters most is they want to work together, they want to share their knowledge, and they respect each other’s idea. Since this is our first work that has been submitted in AMSA competition, at first we had no idea what a good video was like. But with the help of our seniors, and by doing a lot of discussion, we decided to give it a try. We arranged our meetings, took the scenes, edited our video, fixed our mistakes, and finally did the submission and hoped for the best.

AMINO | PCC EAMSC 2021: Philippines

Aldy Bachtiar Hidayat AMSA-Universitas Jember 2nd Winner of Videography Category

Hello everyone, introduce my name is Aldy Bachtiar Hidayat from AMSA-Jember University. This time I want to share with all of you my experiences in participating in PCC EAMSC. Previously, I really liked making videos, then I got an announcement that PCC EAMSC has opened registration for the videography category competition. Because I was really interested in taking part in AMSA competitions, I immediately invited some of my friends to join my team. So even though in this pandemic, we are far apart, we can divide tasks according to our respective talents. Of the four people, let's call his name Dandy the camera part, Ifa as the dubbing, and Sizuka as the script writer. And I'm in charge of directing the video. In the video I took the theme "Telemedicine" because in my opinion telemedicine is very much needed in this pandemic, and in Indonesia actually already has several telemedicine applications, it's just that there is a lack of socialization so that people still don't know telemedicine. For friends who have talent in the ﬁeld of videography, writing articles, making posters, don't give up in this pandemic. You have to stay productive and keep up the spirit

AMINO | PCC EAMSC 2021: Philippines

Rani Permata AMSA-Universitas Indonesia 3rd Winner of Videography Category

As we know, AMSA has a lot of competition that we can join. Participating in competitions has been my dream since joining AMSA and joining PCC EAMSC has been a great opportunity for me. Another reason why I join PCC EAMSC is that PCC EAMSC is the gate to enter EAMSC an international competition and conference. Although our team didn’t get ﬁrst place, my team and I gain more experience. We learn how to communicate and work efﬁciently to produce a better video to educate others. The most important thing besides research and creativity is don’t be hesitate to ask for other’s opinions about your work. Other opinion is important because you need feedback for your work so you can keep improving. For me, videography is a complex thing. You have to harmonize audio and visuals, but the message need to be clear. This isn't an easy task. By doing this from time to time, you will get used to it.

The Power of Celebrities’ Social Media Posts Akhmad Zani Tasir, Nurul Izza Sanusi, Alya Fatimah Darmawan, Karen Kurnia Faculty of Medicine, Univeritas Hasanuddin Background Influencers or celebrities are seen as role-model by their fans and it is seen often that these fans would follow their behaviors. Neuroscience research has shown that celebrity endorsements activate brain regions involved in making positive associations, building trust and encoding memories. When the advices congruent with the fans’ self-conception, they will follow them. If not, the fans would go through cognitive dissonance that the fans would follow advices from the celebrities to decrease a psychological discomfort caused by different opinions (1). The reason for celebrities’ tendency to share unverified information is caused by self-promotion and entertainment (2). With the increasing number of social media activity during this pandemic (3), the fans would get more exposed to unverified information, including the behaviors of celebrities that might impact the people’s actions towards the health protocol of COVID-19. Objectives We aim to educate people the importance of seeking the right information from a credible source to avoid wrong actions influenced by celebrities. Therefore we can stop the chain reaction of COVID-19 and reduce the mortality rate due to this disease. Reference : 1.

Hoffman SJ, Tan C. Biological, psychological and social processes that explain celebrities’ influence on patients’ health-related behaviors. Arch Public Heal [Internet]. 2015 Jan 19 [cited 2020 Oct 19];73(1):1–11. Available from: https://link.springer.com/articles/10.1186/2049-3258-73-3

Islam AKMN, Laato S, Talukder S, Sutinen E. Misinformation sharing and social media fatigue during COVID-19: An affordance and cognitive load perspective. Technol Forecast Soc Change [Internet].

2020

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[cited

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19];159:120201.

Available

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/pmc/articles/PMC7354273/?report=abstract 3.

Keeping Our Services Stable and Reliable During the COVID-19 Outbreak - About Facebook [Internet]. [cited 2020 Oct 19]. Available from: https://about.fb.com/news/2020/03/keeping-ourapps-stable-during-covid-19/

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Telemedicine? How does it work? Aldy Bachtiar Hidayat, Dandy Bachtiar Hidayat, Siti Zulaikha Risqiyani, Haniefatul Azzizah University of Jember, Indonesia Asian Medical Students’ Association Indonesia Background: Indonesia is an island nation consisting of various regions. 265 million people in Indonesia need social, economic, and health welfare. Safe, quality, and affordable health care is everyone’s right. But health problems are still a focus in Indonesia. According to the ministry of health, by 2020, five focuses on health problems in Indonesia, including maternal and infant mortality rates, prevention and control of diseases, the movement of healthy living societies (GERMAS), and the governance of health systems. The difficulty of health care coverage is one of the contributing factors to health problems that never end. Not all regions in Indonesia have adequate health services in term of facilities and medical personnel. Mostly, people will only go to the hospital if they feel themselves helpless. Their reasons are partly because they feel they are not in a serious disease, and with conditions far to reach the hospital, so they are reluctant to treat. Objectives of the video: the aim of the video is to realize the Indonesian that emerging technologies can at least help address health problems. Telemedicine is an electronic communication facility in the health sector that is very useful to support personal health.

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“DO RE MI, is something wrong with me? Rani Permata1, Ade Gautama1, Ayers Gilberth Ivano Kalaij1, Ariestiana Ayu1 1

Faculty of Medicine, Universitas Indonesia

The Internet is the source of many things. People nowadays are using the internet to answer their daily life questions, including their own health. Researches have shown that many people look up to the internet seeking information related to their mental health condition. When this deed meets their/ others past experiences and is used to diagnose their own disease, it is called self-diagnosis.1-3 Self-diagnosis can give bad effects on one's health, including inappropriate self-medication and anxiety. People tend to be ashamed and rely on their own coping mechanism if they know that they have mental illness. This thing, when not accompanied by consultation with professionals, could be a barrier that hinders the doctor-patient relationship and their chance to get help. While we all know, mental illness itself should be diagnosed by professionals through reliable instruments. In order to avoid that, we propose our videography “Do-Re-Mi” as a simple remembered solution. Our video tells people to crosscheck information from the Internet, improve health literacy, and contact professionals regarding mental health. We hope that our video could raise awareness about the danger of mental health self-diagnosis and the importance of health literacy, therefore people can get the perfect help from the professionals.4-6

References 1. Leykin Y, Muñoz R, Contreras O. Are consumers of internet health information “cyberchondriacs”? characteristics of 24,965 users of a depression screening site. Depression and Anxiety [Internet]. 2011 [cited 17 October 2020];29(1):71-77. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3177983/ 2. Robinson J. Over half of adults in Great Britain self-diagnose, reveals RPS survey. The Pharmaceutical Journal. 2016. 3. Why the internet cannot diagnose your mental illness [Internet]. White Swan Foundation.

2016

[cited

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2020].

Available

from:

https://www.whiteswanfoundation.org/mental-health-matters/understanding-mentalhealth/self-diagnosing-of-mental-illness 4. Gass MA. Risks and benefits of self-diagnosis using the internet. Honors Theses. 2016; 96. Available from: https://digitalcommons.salemstate.edu/honors_theses/96 5. Cline RJW, Haynes KM. Consumer health information seeking on the internet: The state of the art. Health Education Research: Theory & Practice. 2001; 16 (6), 671-692

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6. Parkes L. Don’t even try to self-diagnose these 5 ailments [Internet]. Hackensack Meridian

Health.

2019

[cited

October

2020].

Available

from:

https://www.hackensackmeridianhealth.org/HealthU/2019/08/28/dont-even-try-toself-diagnose-these-5-ailments/

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Abstract Project Title

: Urgency of Proper Health Communication

Name of the University : Universitas Indonesia Author

: Abraham Tombe

Background & Objective Health communication is vital. In the hospital set-up, without proper health communication, it will lead to lower quality of care to the patient. 1 In the US alone, there is a study conducted that analyzes what factor causes malpractice in there. As a result, there are 30% that malpractice happens because the communication failure which mostly will cause high severity of injury cases to the patient. 2 So what is health communication? One way to define it is the information strategies in how we impact the patient decisions and actions for its well being. 3,4 It can be concluded that health communication has patients for its target. Thus, the video I make I talk about several examples of communication failure in hospitals both from doctors to doctors and doctors to patient along with its solution. Common problems such as language barrier, health literacy, delayed communication, and the gap between professions are discussed in the examples.5-9 Moreover, the video contains about what a pre-clinical student can do within applying health communication to the society, which is health promotion and discussing the importance of information and communication technologies regarding health promotion and health care. 10,11 References 1. Nichols B. The importance of health communication : CHCR [Internet]. Center For Health Communication

Research

Excellence.

2018

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2020

Oct

19].

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from:

https://www.chcr.org.uk/importance-health-communication/ 2. CRICO Strategies. Malpractice Risks in Communication Failures, CRICO Benchmarking Report. Crico. 2015; 3. Rider University. What Is Health Communication? Its Importance in Healthcare [Internet]. Rider University. 2020 [cited 2020 Oct 19]. Available from: https://online.rider.edu/blog/what-is-healthcommunication/ 4. What is health communication? [Internet]. European Centre for Disease Prevention and Control. [cited 2020 Oct 19]. Available from: https://www.ecdc.europa.eu/en/health-communication/facts

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5. Taran S. An examination of the factors contributing to poor communication outside the physician-patient sphere. McGill J Med [Internet]. 2010 [cited 2020 Oct 19];13(1):86–91. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3277343/ 6. Al Shamsi H, Almutairi AG, Al Mashrafi S, Al Kalbani T. Implications of language barriers for healthcare: A systematic review. Oman Med J [Internet]. 2020 Mar 1 [cited 2020 Oct 19];35(2):1–7. Available from: /pmc/articles/PMC7201401/?report=abstract 7. Oktarina D. LITERASI KESEHATAN DI TENGAH PANDEMI – KANTOR BAHASA KEPULAUAN BANGKA BELITUNG [Internet]. Kantor Bahasababel. 2020 [cited 2020 Oct 19]. Available from: https://kantorbahasababel.kemdikbud.go.id/2020/05/18/literasi-kesehatan-di-tengah-pandemi/ 8. Osborne H. Understanding Health Literacy | Health Literacy | CDC [Internet]. Centers for Disease Control

and

Prevention.

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2020

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19].

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from:

https://www.cdc.gov/healthliteracy/learn/Understanding.html 9. European Centre for Disease Prevention and Control. Health literacy [Internet]. European Centre for Disease

Prevention

and

Control.

[cited

2020

Oct

19].

Available

from:

https://www.ecdc.europa.eu/en/health-communication/facts/health-literacy 10. Health Promotion - Programs and Strategies | VicHealth [Internet]. VicHealth. [cited 2020 Oct 19]. Available from: https://www.vichealth.vic.gov.au/about/health-promotion 11. Rouleau G, Gagnon MP, Côté J. Impacts of information and communication technologies on nursing care: An overview of systematic reviews (protocol). Syst Rev [Internet]. 2015 May 23 [cited 2020 Oct 19];4(1). Available from: /pmc/articles/PMC4449960/?report=abstract

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Pre-Conference Competition East Asian Medical Students’ Conference Manila 2021

CADRE: CONNECTING THE COMMUNICATION BETWEEN DOCTOR AND PATIENT TO RAISE THE EFFECTIVE HEALTH PROMOTION Ali Habibi1, Muhammad Aqib Husni Fadhli2, Dwi Ari Santi Putri3, Faiza Nabila4 1Third Year Medical Student, Faculty of Medicine, University Of Jember, alisegaf21@gmail.com 2Third Year Medical Student, Faculty of Medicine, University Of Jember, aqibhusni@gmail.com 3Third Year Medical Student, Faculty of Medicine, University Of Jember, dwiarisanti16@gmail.com 4Second Year Medical Student, Faculty of Medicine, University Of Jember,

fnabilaf6@gmail.com

Abstract Background: Jember Regency is part of the province of East Java. With 2.4 million citizens, health is still one of the problems in Jember, such as tuberculosis. Data from the East Java Provincial Public Health Office, In 2018, There are 3.397 of tuberculosis patients in Jember. Long-term tuberculosis treatment is also a problem because doctors cannot always control the patient's, many patients stop taking the drugs because they feel hopeless and tired about their condition. World Health Organization (WHO) recommends directly observed therapy like cadre to supervised the patient to take their medications to reduce the number of the patient not appropriately taking the antibiotics. Not only supervised the medication, but cadre also has the function of finding cases, providing information, and motivating patients. This is where cadre comes as a channel for communication between doctors and patients. Which hopefully can reduce the prevalence of tuberculosis and increase the effectiveness of tuberculosis treatment. Objectives: The video aims to show how important the role of cadre, connecting the communication between doctor and patient to raise the effective health promotion especially in tuberculosis cases.

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PRESCRIPTION IN COMMUNICATION Richard Pinarto, Trixie Nathania Zelig, Da’watul Khair, Alma Sutyono Medical Faculty, Hasanuddin Univeristy ABSTRACT Introduction : Communication is an important aspect in society, spesifically in health services. Through effective communication, the good quality of healthcare will also be established. The problems in Indonesia are essentially caused by the distribution of health workers that are centralized on a certain region and also the lack number of health workers compared to the population, where the ratio of doctors and population in Indonesia in 2019 is 1:3.925 (BPS, 2020). The number is considered very low compared to WHO recommendation regarding the ideal ratio of doctors to patients in a country, which is 1:1000. These problems have made healthcare communication limited and ineffective. In facing the current COVID-19 pandemic, Indonesia’s government have already given full support in online doctor consultation as a novel innovation to healthcare communication (Kemenkes RI, 2020). The use of online doctor consultation services has helped health services to be more evenly distributed and made communication between doctor and patients more adequate. We believe this application will be more effective with E-medical record to provide additional information about patient’s disease history and treatment to the doctor and improves health services. Objective : The aim is to introduce online health consultation with the adding of new feature in order to solve the problem of communication in health services as it may leads to the miscommunication between doctors and patients. Keywords : Healthcare Communication, Online Consultation, E-Medical Record REFERENCES Badan Pusat Statistik (2020). Persebaran Dokter di Indonesia 2019. Jakarta, Indonesia: BPS. Kementrian Kesehatan Republik Indonesia (2020, April 21). Strategi Telemedicine Hadapi COVID-19. Mora Claramita, A. U. (2011). Doctor–patient communication in a Southeast Asian setting: the conflict between ideal and reality. Advances in Health Sciences and Education, 69-80.

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