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Journal of Nursing Science Update

Vol. 11, No. 2, November 2023 e-ISSN: 2829-0003 DOI : http://dx.doi.org/10.21776/ub.jik.2023.011.02.04 p-ISSN: 2829-7075 Website : http://www.jik.ub.ac.id

@JNSU. This is an open access article under the CC BY-NC 4.0 license

136 Original Research

Study of Homecare Acceptance by The Elderly in The COVID-19 Era

Nova Sontry Node Siregar^1*, Nadia Hasibuan², Mayes Felda Simamora³, Lidia Silaban⁴, Debora Simamora⁵

1,3,5Program Studi Kebidanan, STIKES Kesehatan Baru

2,4Program Studi Keperawatan, STIKES Kesehatan Baru

*Corresponding author:

Nova Sontry Node Siregar

STIKES Kesehatan Baru, Jl. Bukit Inspirasi, Sipalakki, Dolok Sanggul, Humbang Hasundutan, Sumatera Telp: +62(85270168029)

Email: [email protected]

How to cite this article: Siregar, N. S. N., Hasibuan, N., Simamora, M. F., Silaban, L., Simamora, D.

(2023). Study of Homecare Acceptance by The Elderly in The COVID-19 Era. Journal of Nursing Science Update, 11(2), 136–142

Article Info ABSTRACT

Article History:

Received 3 April 2023 Revised 22 Agustus 2023 Accepted 28 November 2023

During the COVID-19 pandemic, the care of elderly patients underwent significant changes. Society tends to avoid interaction outside the family, encouraging increased care of elderly patients at home. In this situation, the role of medical personnel becomes essential. This study examines how knowledge, culture, and interest influence homecare services during a pandemic. Respondents regarding homecare were collected from 71 families through a questionnaire. Data analysis includes univariate, bivariate and multivariate aspects to provide an overview of the relationship between variables. All data were analyzed using SPSS software. The result of this study shows p-value of each construct is less than 0.10, which indicates a strong relationship between variables. The findings show that knowledge influences family decisions about home care (p- value=0.024<0.10), while culture (pvalue=0.999>0.10) and interests (p-value=0.999>0.10) do not support acceptance of this service for the elderly. Therefore, it is hoped that respondents will increase their knowledge of improving elderly care and utilization of health services, which will positively impact the quality of life in old age. An in-depth discussion of these findings is carried out in a research paper.

Keywords:

COVID-19 Culture Homecare Interest Knowledge

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Study of Homecare Acceptance …

137 Introduction

According to the World Health Organization (WHO), COVID-19 has been declared a pandemic since its first appearance in Wuhan, Hubei province, China, in December 2019 (Wang, Hu .et al., 2020; Dhiman .et al., 2020; Wang .et al., 2021). As a result of its rapid spread worldwide, each country has implemented a variety of strict social restrictions to prohibit access to a variety of public facilities and services (Dhiman .et al., 2020; Eide .et al., 2021). Various factors can lead to infection, such as inhaling or touching infected droplets, allowing the virus to multiply in the eye, mouth, and nose (Fauci .et al., 2020; Ciotti .et al., 2020). Further, COVID- 19 has been associated with various spectrums, such as asymptomatic infections, mild respiratory infections, severe pneumonia, and even death (Singhal., 2020;

Zhou .et al., 2020). As a result of its rapid transmission, this virus poses a particular threat to weak patients and those with a history of disease (Zhou .et al., 2020).

Increasing patient care in hospitals, inpatient care, and home health care is necessary (Caratozzolo .et al., 2020). The elderly are also believed to be at the highest risk of being exposed to COVID-19, so it is necessary to emphasize that the elderly are better protected through social distancing and even self-isolation (Abbaspur-Behbahani .et al., 2022).

The government of Indonesia has implemented homecare measures to deal with COVID-19 patients (Nugroho & Wiseno, 2020).

Due to potential underlying conditions, older patients are at a higher risk of infection due to the difficulty distinguishing COVID-19 symptoms from those associated with old age (Sørbye .et al., 2022). This is because community-acquired pneumonia in the elderly population has been found to decrease activities of daily living and quality of life, accompanied by a decrease in physical and mental function (Liu .et al., 2020). During the pandemic, people have restricted their interactions with other people outside their families due to fear. Therefore, home care may be an alternative to institutional care for patients (Bianchetti .et al., 2020). The application of home care, however, is often a challenge. As a result, the family may not be

aware of how to carry out the treatment in order to achieve the desired results (Dhiman .et al., 2020). In this case, adequate resources are required to ensure the quality and safety of care for the elderly (Dellve & Williamson, 2022). In addition, family members find it challenging to implement homecare for several reasons, such as lack of support from health services through communication and interaction, low interest, a lack of knowledge to implement homecare and cultural factors (Dhiman .et al., 2020). In addition to knowledge, habits of interest, and belief in supporting health services, homecare application is also essential (Cegarra-Navarro .et al., 2015). Accordingly, the health approach is used to identify the factors influencing the acceptance of homecare services, namely knowledge, culture, and interest (Boland .et al., 2017; Sorbye .et al., 2022).

This research will identify the implementation of home care services for the elderly in Indonesia. The three main factors identified to determine the adoption of home care services are the level of knowledge, cultural factors, and interest in the service.

This study will comprehensively analyze various variables related to acceptance and use of homecare services. This study was conducted during the COVID-19 pandemic and focuses on how knowledge, culture, and interests play a role in influencing the adoption of homecare services in the district.

This study aims to provide an in-depth understanding of acceptance of homecare services through a detailed analysis based on the collected data. The SPSS statistical tool was used to identify and analyze all the variables involved in this study.

Method

In order to conduct this research, the non-probability sampling method was used together with the purposive sampling technique. The research sample was selected by referring to predetermined criteria according to the research objectives.

Specifically, the sample in this study was family members who cared for elderly patients in the home environment. Based on calculations using the Slovin formula, 71 people were selected as the sample size. Data collection was carried out through field

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138 observations, interviews, and administering questionnaires to the respondents involved.

Data collected from all samples were collected and then inputted into Excel format, then analyzed using SPSS statistical software.

The data collection period took place from May to July 2022. During this period, field surveys were conducted to obtain data from respondents who were relevant to the research, while observations and interviews were carried out through questionnaires filled out by the family members involved. The collected data is then processed and presented as a percentage or frequency distribution. In data analysis, univariate, bivariate, and multivariate methods were applied regarding

the frequency distribution table and the incorporation of several relevant variables.

Results and Discussion

Based on the data collection results conducted through interviews and distribution of questionnaires, 71 respondents were identified. Based on the demographics of the respondents, the majority of respondents were female, as much as 59.4%. The respondents were overwhelmingly 36-45 years old, with a senior high school graduate educational background comprising 75.4% of respondents. According to the type of work respondents perform, 62.3% work as farmers.

Table 1. Distribution of Respondent Characteristics

Characteristics Total Percentage %

Gender

Male 28 39.4

Female 43 60.6

Age

Late Youth (17-25 years) 6 8.5

Early Adult (26-35 years) 29 40.8

Late Adult (36-45 years) 30 42.3

Early Elderly (46-55 years) 6 8.4

Education

Elementary School 0 0

Junior High School 7 9.8

Senior High School 54 76.1

Higher education 10 14.1

Jobs

Government employees 8 11.3

Entrepreneur 18 25.3

Farmers 45 63.4

The variables in this study are knowledge, culture, interests, and elderly care about home care services distributed in the frequency distribution table.

Figure 1. Framework of The Study Knowledge

Culture Elderly Care

Interest

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139 The distribution of respondents

based on knowledge was from 71 respondents with good knowledge of home care services, as many as 39 people (54.9%) and those with poor knowledge about home care services, as many as 32 (45.1%). The distribution of respondents based on culture was from 71 respondents who received home care services as many as 21 people (29.6%) and who did not accept the culture

of home care services as many as 50 people (70.4%). The distribution of respondents based on interest was from 71 respondents;

22 people (31.0%) were interested in-home care services, and 49 people (69.0%) were less interested in home care services. The distribution of respondents based on elderly care was from 71 respondents; 36 people (50.7%) had good elderly care, and 35 people (49.3%) had poor elderly care.

Table 2. Knowledge, Culture, Interests and Elderly Care

Variable Total Percentage

(%) Knowledge

Good 39 54.9

Not good 32 45.1

Culture

Accept 21 29.6

Less Accept 50 70.4

Interest

Interested 22 31.0

Less Interested 49 69.0

Elderly Care Good

Not good 36

35 50.7

49.3 Bivariate analysis was performed to

process data from several variables using a frequency distribution table, while the correlation test used was the chi-square test.

Of the 39 respondents with good knowledge about home care services and aged care, 27 people (69.2%) had good knowledge, and 12 people (30.8%) had poor care. Of the 32 respondents with poor knowledge about home care services and aged care, nine people (28.1%) had good knowledge, and 23 (71.9%) had poor care. Using the chi-square test where the p-value is 0.001 <α 0.05, Ha is accepted, and Ho is rejected, meaning there is a relationship between knowledge of elderly care.

Based on the distribution of cultural relations, 19 (90.5%) of the 21 respondents received good home care and aged care service culture, and 2 (9.5%) received poor aged care. Of the 50 respondents who did not accept the excellent culture of home care and

aged care services, 17 (34.0%) and those whose aged care was not good were 33 (66.0%) using the chi-square test where the p- value was 0.000 <α 0.05. Ha is accepted, and Ho is rejected, meaning there is a cultural relationship to elderly care.

Based on the distribution of interest relationships, it was found that out of 22 respondents who were interested in home care and aged care services, 19 people (86.4%) were good, and three people (13.6%) had poor elderly care. Of the 49 respondents less interested in-home care and aged care services, 17 people (34.7%) had good care for the elderly and 32 people (5.3%) had poor aged care. By using the chi-square test where the p-value is 0.000 <α 0.05, Ha is accepted, and Ho is rejected, meaning that there is a relationship of interest in caring for the elderly in Pasaribu Village, Doloksanggul District, Humbang Hasundutan Regency.

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140

Table 3. Relationship of Knowledge, Culture and Interest in Elderly Care

To identify variables that have an essential contribution to the model, an approach was chosen that retained the independent variables with a p-value ≤ 0.01. In contrast, variables with a p-value > 0.01 were excluded sequentially, starting from the variable with the most significant p-value up to the smallest p-value. This approach is carried out in stages to test the significance of the variable relationship.

The analysis applied in this context is multivariate logistic regression, which aims to analyze the impact of knowledge, interest, and culture variables on elderly care decisions.

The statistical test results reveal exciting findings. Statistical tests show that the knowledge variable is significantly related to the decision to care for the elderly. The resulting p-value is 0.024, much lower than the significance threshold of 0.10. In other words, knowledge has a strong influence in determining the tendency to use aged care services.

On the other hand, the results of statistical tests for the cultural and interest variables show that no significant relationship can be found for the decision to care for the elderly. The p-value obtained for the culture variable was 0.999, which exceeded the 0.10 significance limit. Likewise, the statistical test results for the interest variable have a p-value of 0.999, again indicating no significant relationship between interest and decisions about caring for the elderly.

These findings underscore the importance of the knowledge variable in influencing elderly care decisions. However, cultural and interest factors could not be identified as significant in this study, as shown by the results of the statistical tests. This information provides a further understanding of the effect of these variables on elderly care choices. It can contribute to developing more effective strategies for optimizing aged care services.

Table 4. Multivariate Analysis of Family Knowledge, Culture, and Interests About Home Care Services for Elderly Care

Variable Co P-value

K Knowledge 1.408 0.024

Culture 23.637 0.999

Interest -20.360 0.999

Constant -7.983 0.000

Elderly Care 1.749 0.001

Constant -2.560 0.000

Variable Aged Care

Total P Value

= 0.05

Good Not Good

N % N % N %

Knowledge

Good 27 69.2% 12 30.8% 39 100% 0.001

Not good 9 28.1% 23 71.9% 32 100%

Culture

0.000

Accept 19 90.5% 2 9.5% 21 100%

Less Accept 17 34.0% 33 66.0% 50 100%

Interest

0.000

Interested 19 86.4% 3 13.6% 22 100%

Less

Interested 17 34.7% 32 65.3% 49 100%

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141 Conclusion

Based on these findings, knowledge has the most significant influence on people's behaviour. This indicates that knowledge strongly impacts decisions and actions taken by individuals. In the context of receiving homecare services, families who decide to receive these services will adjust to the knowledge they have and adapt well to providing homecare care. As a result, families who decide to use homecare services will try to adjust their behaviour appropriately and make good adaptations in providing homecare care. This reflects the diversity of human behaviour in dealing with various homecare services. Given the diversity of human behaviour towards homecare services, further steps from health workers are needed to support families in caring for elderly family members at home.

In conclusion, homecare service strategies can be effective as a treatment and recovery approach for elderly patients. In addition, individuals who tend to avoid uncertainty will choose the best alternative in receiving home care services for the elderly, as explained by previous studies (Cegarra- Navarro .et al., 2015; Huynh, 2020).

Limitations of the study

These findings highlight the critical role of "knowledge" in influencing elderly care decisions. However, it is essential to acknowledge the limitations of this analysis.

The limitations of this study are that the sample used is not homogeneous, and the length of stay with parents (elderly) has not been determined in this study. It is necessary to carry out an in-depth investigation of the respondent's age and length of stay with the elderly. These studies also focus only on a specific set of variables and may not capture the full spectrum of factors that influence care choices in the elderly. In addition, the cross- sectional nature of the analysis may limit the ability to establish causality. Despite these limitations, the insights gained from the significant relationship with knowledge provide valuable implications for improving elderly care strategies. Further research is needed to explore the interplay of additional

factors and the potentially dynamic nature of elderly care decisions.

Acknowledgement

The author thanks the editors and reviewers for their contributions to improving the quality of this manuscript from the writing stage to the publication stage. The researcher is grateful to the Director of the New College of Health Sciences, Doloksanggul, and the Pasaribu village midwife, who facilitated the implementation of this study.

Conflict of Interest

Considering various aspects, this research did not cause any conflict of interest.

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