Health Belief Model Application in Bone Fracture Treatment-Seeking Behavior: Preferences for Traditional Bone-Setting Treatment versus Orthopedic Surgery
DOI:
https://doi.org/10.26911/theijmed.2026.11.1.885Abstract
Background: Bone fractures are a significant public health issue, with 178 million new cases globally in 2019 and a prevalence of 5.5% in Indonesia. The Indonesian community tends to choose traditional treatment such as herbal medicine or surgical treatment for fractures, influenced by sociodemographic factors, culture, and individual perceptions. This study aims to analyze the Health Belief Model (HBM) factors that affect the choice of bonr fracture treatment services in the community.
Subjects and Method: This cross-sectional study was conducted in Surakarta during April–May 2025, involving 200 participants, comprising 100 users of traditional bone-setting treatment and 100 users of orthopedic care. Data were collected using an online questionnaire covering demographic characteristics and HBM constructs. The data were analyzed using univariate methods, bivariate analysis with simple logistic regression, and multivariate analysis employing path analysis.
Results: The decision to choose type bone fracture treatment care was directly influenced by perceived susceptibility (b = -2.30; 95% CI: -3.09 to -1.50; p < 0.00), benefits (b = 1.80; 95% CI: 0.89 to 2.72; p < 0.00), self-efficacy (b = 1.36; 95% CI: 0.51 to 2.22; p < 0.00), and action cues (b = 3.80; 95% CI: 1.70 to 5.90; p < 0.00), while the perception of barriers indirectly lowers self-efficacy (b = -0.65; 95% CI: -1.29 to -0.02; p < 0.04).
Conclusion: The HBM constructs, especially perceived vulnerability, benefits, self-efficacy, and action cues, significantly influence the choice of treatment for fractures. Educational interventions are recommended to enhance the perception of the benefits of medical services and strengthen the self-efficacy of the community.
Keywords:
Health Belief Model, fractures, limb amputation, bone surgery, health behavior
References
Ampomah IG, Malau-Aduli BS, Seidu A-A, Malau-Aduli AEO, Emeto TI (2023). Integrating traditional medicine into the Ghanaian health system: percep-tions and experiences of traditional medicine practitioners in the Ashanti Region. Int Health. 15(4):414–427. Doi:10.1093/inthealth/ihac059
Arifin UA, Damansya H, Hasanah N, Monoarfa V (2020). Factors influencing the choice of traditional treatment for fracture patients at “Sangkal Putung” (traditional bone setting service) in South Sidomulyo (in Indonesia). J Sisthana. 5(1):54–61. Accessed from https://jurnal.stikeskesdam4-dip.ac.id
Bahtiar R, Kurniasih DH, Alifianto U (2018). The difference of bovine bone graft and iliac crest bone graft effect on closure of bone defect in alveolar bone graft in Dr. Moewardi Hospital and Panti Waluyo Hospitals, Surakarta. Indones J Med. 3(3):151–161. Doi:10.26911/theijmed.2018.03.-03.05
Bretherton C, Al-Saadawi A, Sandhu PH, Baird PJ, Griffin PX (2024). Healthcare professionals’ beliefs and priorities for the rehabilitation of patients after ankle fracture surgery: A qualitative study. Injury. 55(12):-111975. Doi:10.1016/j.injury.2024.111-975
Devy SR, Aji B (2013). Predisposing, enabling, and reinforcing factors among patients using alternative radiesthesia medical treatment by Romo H. Loogman in Purworejo, Central Java (in Indonesia). Indones J Public Health. 3(2):35–44. https://www.-neliti.com/publications/3863/faktor-predisposing-enabling-dan-rein-forcing-pada-pasien-di-pengobatan-alternati
Dong Y, Gao H, Jin Z, Zhu J, Yu H, Jiang Y, Zou J (2022). Application of a knowledge, attitude, belief, and practice model in pain management of patients with acute traumatic fractures and alcohol dependence. Pain Res Manag. 2022:8110896. Doi:10.1155/2022/8110896.
Endeshaw BA, Belay W, Gete A, et al. (2023). Traditional bone setting service users and associated factors among people with trauma in Mecha district, Ethiopia. BMC Complement Med Ther. 23: 142. Doi: 10.1186/-s12906-023-03951-8.
Fernandes JB, Ferreira N, Domingos J, Ferreira R, Amador C, Pardal N, Godinho C (2023). Health professio-nals’ motivational strategies to enhance adherence in the rehabilita-tion of people with lower limb fractures: Scoping review. Int J Environ Res Public Health. 20(22): 7050. Doi:10.3390/ijerph20227050.
Fu Y, Zhu LJ, Li DC, Yan JL, Zhang HT, Xuan YH, Meng CL, Sun YH (2022). Evidence-based intervention on post-operative fear, compliance, and self-efficacy in elderly patients with hip fracture. World J Clin Cases. 10(10): 3069–3077. Doi:10.12998/wjcc.v10.i-10.3069.
GBD 2019 Fracture Collaborators (2021). Global, regional, and national burden of bone fractures in 204 countries and territories, 1990–2019: A systematic analysis from the Global Burden of Disease Study 2019. Lancet Healthy Longev. 2(9):e580–e592. Doi:10.1016/S2666-7568(21)00183-5.
Herdiana RW, Winarti E (2023). Analysis of factors influencing the commu-nity’s choice to seek medical treat-ment following care at “Sangkal Putung” (traditional bone setting ser-vice) (in Indonesia). J Kesehatan STIKES Bethesda Yakkum Yogya-karta. 10(2):122–125. https://jurnal.-stikesbethesda.ac.id/index.php/jur-nalkesehatan/article/view/380/270
Huang B, Wang Y, Wang H, Wang C, Jin F, Li J, Gan L, et al. (2023). Epidemio-logy and the economic burden of traumatic fractures in China: A population-based study. Front Endocrinol (Lausanne). 14:1104202. Doi:10.3389/fendo.2023.1104202
Ibrahim F, Mariyanto I, Wujoso H (2018). The relationship of radiological value and functional scale of lower motion devices in patients with bone defects given synthetic bone graft and BMP-2. Indones J Med. 3(2):77–83. Doi: 10.26911/theijmed.2018.03.02.03
Indonesian Medical Council. (2023). Council Decision No. 233/SNPK-Trauma-Orthopedics Advanced 2023 (in Indonesia). Acessed from https://kolegium-ioa.org.
Ministry of Health of the Republic of Indonesia. (2018). Key findings of the basic health research (Riskesdas) 2018 (in Indonesia). Jakarta: Health Research and Development Agency.
Mohebi S, Azadbakht L, Feizi A, Sharifirad G, Kargar M (2013). Structural role of perceived benefits and barriers to self-care in patients with diabetes. J Educ Health Promot. 2:37. Doi:10.41-03/2277-9531.115831
Seid MA, Walelgn B, Kibret Sendekie A, Walle GT, Geremew MA, Sahlu MH, Mekonen SA and Abate BB (2025). Utilization and associated factors of traditional bone setting service among patients with musculoskeletal injuries in Northeast Ethiopia. Front Rehabil Sci. 6:1484403. Doi: 10.3389/fresc.2025.1484403.
Sumirat WL, Subagya S, Rochani S (2019). Community Behavior Regarding Sangkal Putung Treatment by H. Atmao Saidi in Sroyo Village, Jaten Sub-district, Karanganyar (in Indo-nesia). Jurnal Ilmu Pendidikan Sosiologi Antropologi. 7(1):274–282. https://www.neliti.com/publications/164679/
Suwarni S, Indrasari F, Rahmawati D, Saptawati T (2023). Health Belief model analysis of minor illness therapy by pharmaceutical techni-cians using medicinal plants at com-munity health centers in Semarang City (in Indinesia). J Kesehatan Tambusai. 4(2):2571–2577. Doi: 10.-31004/jkt.v4i2.15845
Umboh JC, Wagiu AMJ, Lengkong AC (2021). An overview of the health belief model in fracture management (in Indonesia). E-CliniC. 9(1):198–203. Doi:10.35790/ecl.v9i1.32364
Utomo P, Arimuqti Z, Santoso A, Sibarani TSMHS, Anwar IB (2020). High energy injury ankle fracture-disloca-tion without neurovascular involve-ment. Indones J Med. 5(3):259–264. Doi:10.26911/theijmed.-2020.05.03.12
