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The global aging population poses significant challenges to healthcare systems, particularly due to the rising number of older adults living with chronic diseases. Psychological resilience is a crucial capacity that enables older individuals to adapt, maintain emotional well-being, and preserve quality of life amid physical limitations and social transitions associated with aging. This study aims to explore the dynamics of psychological resilience among older adults with chronic illnesses in Depok City, Indonesia, by comparing two intervention contexts: community-based education through the Sekolah Lansia (Elderly School) and primary healthcare services provided by Puskesmas (community health centers). Using an phenomenology qualitative design, data were collected through in-depth interviews with older adults from both groups. Thematic analysis was conducted based on six key dimensions of psychological resilience: self-efficacy, life satisfaction, biological aging, emotional and cognitive appraisal of stressors, reduction of physiological and emotional responses to chronic stress, and engagement in health-promoting behaviors. Findings indicate that older women tend to build resilience through spirituality and familial relationships, while older men emphasize social engagement and problem-focused coping. Participants of the Elderly School demonstrated more reflective and structured resilience patterns supported by community-based education, whereas Puskesmas users adopted practical, experience-based adaptive strategies rooted in daily routines and primary care services. The study underscores the importance of integrated, gender-sensitive approaches to strengthening psychological resilience in later life. The complementary roles of community education and primary healthcare suggest the need for multisectoral collaboration in promoting healthy and dignified aging. These findings provide empirical evidence to inform policy development and the design of inclusive, sustainable, and contextually relevant resilience-building programs for older adults in Indonesia and other low- and middle-income countries.
Hipertensi merupakan penyakit kronik akibat gangguan sistem sirkulasi darah telah menjadi masalah besar bagi kesehatan masyarakat. Survei Kesehatan Rumah Tangga (SKRT) tahun 1995 menyebutkan bahwa penyakit sirkulasi ini pada kelompok umur 45-60 tahun mencapai 20.9%, sedang pada umur diatas 60 tahun angka ini mencapai 29.5%. Demikian juga pada tahun 1995 penyakit sirkulasi menduduki urutan pertama-penyebab kematian pada lansia, yakni sebesar 18.9%.Penelitian pendahuluan terhadap 90 lansia di Kota Depok pada tahun 2001 didapatkan proporsi hipertensi sebesar 50.0%, dan berdasarkan jenis kelamin pada laki-laki sebesar 41.9%, sedang pada perempuan 57.4%, dan angka ini jauh lebih besar dari prevalensi hipertensi yang ditetapkan oleh Depkes RI (20-30%) untuk lansia di tahun 2000.Penelitian ini bertujuan untuk melihat faktor-faktor yang diduga berhubungan dengan hipertensi pada lansia di Kota Depok. Sampel dalam penelitian sebanyak 310 orang lansia (181 perempuan dan 129 laki-laki) berumur 55-93 tahun, dimana pengambilan sampel dilakukan secara rancangan stratifikasi proporsional di 4 wilayah puskesmas dari 24 puskesmas yang ada di Kota Depok.Penelitian ini melihat hubungan antara umur, jenis kelamin, riwayat keluarga, konsumsi natrium, konsumsi lemak, konsumsi kalsium, IMT, merokok, stress, aktivitas fisik, dan faktor sosial ekonomi (status perkawinan, status pendidikan, status pekerjaan, dan penghasilan keluarga), dengan hipertensi. Hasil penelitian menunjukkan bahwa prevalensi hipertensi pada responden di Kota Depok sebesar 57.4%. Persentase ini lebih tinggi dibandingkan hasil penelitian sebelumnya.Berdasarkan analisis multivariat didapatkan hasil sebagai berikut: responden yang berumur 70 tahun berpeluang mendapat hipertensi 2.97 kali (95% CI: 1.3640-6.4610; p=0.0061) dibandingkan yang berumur 55-59 tahun, responden yang berumur 65-69 tahun berpeluang mendapat hipertensi 2.45 kali (95% CI: 1.2517-4.8134; p=0.0090) dibandingkan yang berumur 55-59 tahun dan responden yang berumur 60-64 tahun berpeluang mendapat hipertensi 2.18 kali (95% CI: I.0971-4.3350; p=0.0261) dibandingkan yang berumur 55-59 tahun. Responden yang mempunyai riwayat keluarga hipertensi berpeluang mendapat hipertensi 1.97 kali (95% CI: 1.0816-3.5997) dibandingkan yang tidak punya riwayat keluarga hipertensi. Responden dengan derajat stres tinggi berpeluang mendapat hipertensi 3.02 kali (95% CI: 1.5262-6.0087; p=0.0015) dibandingkan yang derajat stres rendah, dan responden dengan derajat stres sedang berpeluang mendapat hipertensi 2.47 kali (95% CI: 1.3594-4.4900; p=0.0030) dibandingkan yang derajat stres rendah. Responden dengan aktivitas kurang berpeluang mendapat hipertensi 2.73 kali (95% CI: 1.6296-4.5649; p=0.0001) dibandingkan yang aktivitas cukup. Dan responden yang tidak kawin berpeluang mendapat hipertensi 2.07 kali (95% CI: 1.1414-3.7561;p=0.0166) dibandingkan yang kawin. Selanjutnya disimpulkan bahwa dari kelima variabel tersebut, derajat stres tinggi merupakan variabel yang paling dominan berhubungan dengan hipertensi.Berdasarkan faktor-faktor yang berhubungan secara signifikan dengan hipertensi, pada penelitian di atas, maka faktor yang dapat diintervensi adalah aktivitas fisik dan stres.Oleh karenanya sehubungan dengan faktor di atas, serta tingginya angka kejadian hipertensi pada lansia, maka saran yang dapat diberikan kepada Dinas Kesehatan Kota Depok serta jajaran di bawahnya, adalah meningkatkan program promosi penanggulangan hipertensi pada lansia melalui kegiatan latihan fisik berupa senam terapi 2 kali seminggu dan gerak jalan pagi, serta melakukan pembinaan mental/ kerohanian. Perlu diperhatikan untuk membentuk kelompok-kelompok lansia baru, terutama untuk komunitas yang sosial-ekonominya rendah.
Hypertension is a chronic disease, it caused to the problem on blood circulation system, and it has become a big problem to public health. Based on the Household Health Survey (SKRT) in 1995 mentioned that this disease at age group 45-60 years reach 20.9%, while at age over than 60 years this number reach 29.5%. It was also in 1995; this disease lies at the first line of death on elderly, i.e. 18.9%. The previous study to 90 elderly at Depok City in 2001, it was found that the proportion was 50.0%, and based on male it was 41,9%, while on female 57,4%, and this number was bigger than hypertension prevalence that stated by MOH RI (20-30%) for elderly in 2000.The objective of this study was to determine the factors that estimated related to hypertension on elderly at Depok City. The number of sample in this study was 310 elderly (181 females and 129 males) their age 55-93 years, where the sample took proportionally in four areas of Health Centers out of 24 Health Centers that available at Depok City. This study see the relationship among age, sex, family history, sodium consume, fatty consume, calcium consume, IMT, smoking, stress, physic activity, and social economy factors (marital status, education status, profession status, and family income), with hypertension. The result of this study shows that hypertension prevalence on respondent at Depok City was 57.4%. This presentation was higher than the previous study.Based on multivariate analysis it was found that the result as the followings: the respondent whose age z 70 years having tendency of hypertension 2.97 times (95% CI: 1.3640-6.4610; p=0.0061) compared to whose age 55-59 years. The respondent whose age 65-69 having tendency of hypertension 2.45 times (95% CI: 1.2517-4,8134; p=0.0090) compared with whose age 55-59 years. And the respondent whose age 60-64 having tendency of hypertension 2.18 times (95% Cl: 1.0971-4.3350; p=0.0261) compared with whose age 55-59 years. Respondent whose having family history on hypertension tend to have hypertension 1.97 times (95% CI: 1.0816-3.5997) compared to whose not having hypertension on family history. Respondent with higher stress tend to have hypertension 3.02 times (95% CI: 1.522622-6.0087; p=0.0015) compared whose is lower stress, and respondent with moderate stress tend to have hypertension 2.47 times (95% CI: 1,3594-4900; p=0.0030) compared to whose lower stress. Respondent with lack of activity tend to have hypertension 2.73 times (95% CI: 1.6296-4.5649; pO.0001) compared to whose enough activity. And respondent whose unmarried tend to have hypertension 2.07 times (95% CI: 1.1414-3756I;p=0.0166) compared with whose married. Then it concluded that from the fifth variables, the degree of high stress is a variable that the most dominant related to hypertension.Based on the factors that related significantly to hypertension in this study, so the factors that can be intervention, i.e. stress and physical activity. Therefore, referring the factors above, also the high rate of hypertension on elderly, so the recommendation that can be given to the Local Health Service of Depok City also it?s related. They are improving the program on promotion to overcome the hypertension for elderly through physical exercise in the form of gymnastic therapy, twice a week and morning jogging, also doing mental management/spiritual. It is considering establishing the new groups of elderly, especially to community with lower social economy.