DOI: https://doi.org/10.14710/nmjn.v16i2.82691

Mental Health Problems and Regularity of Health-Seeking Behavior among Older Adults with Diabetes

*Intansari Nurjannah orcid scopus  -  Department of Community and Mental Health Nursing, Faculty of Medicine, Public Health, and Nursing, , Indonesia
Nurullya Rachma orcid  -  Department of Nursing, Faculty of Medicine, Universitas Diponegoro , Indonesia
Ema Madyaningrum orcid scopus  -  Department of Community and Mental Health Nursing, Faculty of Medicine, Public Health, and Nursing, , Indonesia
Probosuseno Probosuseno orcid  -  Geriatric Division, Department of Internal Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Indonesia
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Abstract

Background: Older adults with diabetes are vulnerable to mental health problems, such as depression, anxiety, and cognitive impairment, as well as inappropriate medication use. These conditions may affect their health-seeking behavior (HSB), including the regularity of visits to healthcare facilities. However, studies examining the regularity of HSB and associated factors among older adults with diabetes remain limited.

Purpose: This study aimed to examine the associations between mental health problems and the regularity of HSB among older adults with diabetes.

Methods: A cross-sectional study was conducted among 301 older adults with diabetes recruited from three community health centers in Semarang, Indonesia, using proportionate stratified random sampling. Data were collected on sociodemographic characteristics, mental health status, medication appropriateness, and regularity of healthcare visits as a measure of HSB. Healthcare visits were categorized as routine or irregular based on participants’ self-reported visits during the previous three months. Data were analyzed using chi-square tests and logistic regression.

Results: Most participants were aged 70 years or younger (75.7%), female (64.1%), and married (68.1%). Overall, 8.6% were at risk of depression, 22.6% screened positive for anxiety symptoms, 18.9% were at risk of inappropriate medication use, and 88.7% had normal cognitive functioning. Irregular HSB was reported by 61.8% of participants. HSB regularity was significantly associated with age (p = .003), gender (p = .004), education (p < .001), marital status (p = .043), risk of depression (p = .019), cognitive impairment (p = .001), and inappropriate medication use (p = .001), but not with anxiety (p = .11). In multivariable analysis, participants at risk of inappropriate medication use had lower odds of routine HSB (OR = 0.044, 95% CI: 0.017–0.106). Participants aged over 70 years also had lower odds of routine HSB (OR = 0.423, 95% CI: 0.182–0.979).

Conclusion: Sociodemographic characteristics, mental health problems, and inappropriate medication use were associated with the regularity of HSB among older adults with diabetes. Integrating mental health screening, appropriate medication management, and family support into diabetes care may promote regular healthcare visits and improve health outcomes.

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Keywords: Diabetes; health-seeking behavior; mental health; older adults; primary health care

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