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"[ABSTRAKKerentanan lansia terhadap masalah kesehatan seperti diabetes mellitus meningkat seiring dengan bertambahnya usia. Karya Ilmiah Akhir ini mengintegrasikan teori manajemen pelayanan keperawatan dan tiga model keperawatan yaitu Community as Partner, Family Centred Nursing dan Functional Consequencies. Asuhan keperawatan diberikan pada 32 lansia diabetisi di kelurahan Sukamaju Baru selama 9 bulan. Intervensi inovasi yang dikembangkan adalah booklet DM yang didasari pada program CERDIIK Kemenkes RI, Diabetes Self Management Education (DMSE) dan empat pilar penatalaksanaan DM. Hasil intervensi yang dilakukan menunjukkan adanya perubahan perilaku lansia diabetisi, kelompok pendukung dan sebaya dalam melakukan penatalaksanaan DM. Penurunan rata-rata kadar gula darah lansia kelompok sebaya sebesar 101,5 poin. Penggunaan booklet DM efektif dalam mengontrol kadar gula darah lansia diabetisi dengan wadah kelompok sebaya dan dukungan kader kelompok pendukung. program ini diharapkan dapat diteruskan dengan peningkatan keterlibatan keluarga, kader dan tenaga kesehatan.

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ABSTRACTThe vulnerability of the elderly to health problems such as diabetes mellitus increases with age. This final internship report integrated nursing service management theory with three nursing models, which are Community as Partner, Family Centred Nursing dan Functional Consequencies. A nursing care was provided to 32 elderly with diabetic at district Sukamaju Baru for 9 months. An innovative intervention was developed that was DM booklet based on CERDIIK program from Ministry of Health Indonesia, Diabetes Self Management Education (DMSE) and the four pillars of DM management of care. Result of intervention showed changes of healthy behavior from elderly with DM, support group dan peer group in providing DM care management. There was a reduce of elderly blood glucose level in average about 101,5 poin. The DM booklet usage was effective in controlling blood glucose level of elderly with DM who actively involved in peer group and support group of community workers. This program was expected to be sustained and get more family involvement, as well as involvement from community workers and health workers. , The vulnerability of the elderly to health problems such as diabetes mellitus increases with age. This final internship report integrated nursing service management theory with three nursing models, which are Community as Partner, Family Centred Nursing dan Functional Consequencies. A nursing care was provided to 32 elderly with diabetic at district Sukamaju Baru for 9 months. An innovative intervention was developed that was DM booklet based on CERDIIK program from Ministry of Health Indonesia, Diabetes Self Management Education (DMSE) and the four pillars of DM management of care. Result of intervention showed changes of healthy behavior from elderly with DM, support group dan peer group in providing DM care management. There was a reduce of elderly blood glucose level in average about 101,5 poin. The DM booklet usage was effective in controlling blood glucose level of elderly with DM who actively involved in peer group and support group of community workers. This program was expected to be sustained and get more family involvement, as well as involvement from community workers and health workers. ]"

"Penatalaksanaan DM memiliki hubungan erat dengan kadar gula darah diabetisi. Penelitian ini bertujuan untuk mengetahui hubungan penatalaksanaan DM dengan kadar gula darah lansia diabetisi. Disain penelitian menggunakan pendekatan crossectional study. Penelitian dilakukan pada 49 orang lansia di kelurahan Cisalak Pasar. Analisis bivariat menunjukkan bahwa terdapat hubungan antara diit dengan kadar gula darah (p value: 0,035), tidak ada hubungan antara latihan fisik dengan kadar gula darah (p value: 0,246), ada hubungan antara minum obat dengan kadar gula darah (p value: 0,011) dan ada hubungan antara pengendalian stres dengan kadar gula darah (p value: 0,007). Analisis multivariat menyimpulkan bahwa elemen penatalaksanaan DM yang dominan adalah minum obat (OR 10,7).

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Diabetes Mellitus management has close correlation with blood sugar level of Diabetes patient. The purpose of this study was to examine the correlation between Diabetes Mellitus Management with Blood Sugar Level on Elderly with DM. This is descriptive cross-sectional study, where recruiting 49 elderly people from Cisalak Pasar area. The result shows that there is significant correlation between diet (p value: 0,035), take medication (p value: 0,011), stress management (p value: 0,007) with blood sugar level but no significant correlation between physical exercise (p value: 0,246) with blood sugar level. Multivariate analysis result shows that taking medication is the most predominant element in diabetes management (OR 10,7)."

"Pendahuluan: Diabetes Melitus (DM) adalah salah satu penyakit tidak menular (PTM) dengan jumlah populasi tertinggi di Indonesia dan penyebab kematian tertinggi keenam di Indonesia. Dampak dari DM memberikan kerugian kesehatan dari tahun ke tahun, sehingga perlu penanganan yang serius maka dikembangkan inovasi Diet, Senam Kaki dan Relaksasi Benson (DEKADEE). Tujuan: Memberi gambaran tentang pengaruh Intervensi Keperawatan DEKADEE terhadap pengendalian Kadar gula darah pada lansia diabetisi. Metode: Studi kasus keluarga dengan pendekatan asuhan keperawatan keluarga yang melibatkan 10 keluarga sesuai praktik berbasis fakta dan inovasi dalam asuhan keperawatan komunitas pada 44 lansia. Inovasi DEKADEE terdiri 9 sesi selama 14 kali pertemuan. Data sebelum dan sesudah intervensi diukur menggunakan alat pemeriksaan gula darah, perilaku (pengetahuan sikap dan keterampilan), kemandirian, kadar gula darah. Hasil: Adanya peningkatan perilaku pada keluarga meliputi rerata sebesar 3.95%, sikap rerata sebesar 2.53%, keterampilan rerata sebesar 3.66% dan tingkat kemandirian rerata 2 tingkat sebesar 80% dan 3 tingkat rerata sebesar 20% serta penurunan kadar gula darah 61.045 mg/dl. Hasil Uji T dengan nilai rerata signifikan 0,000 (p<0,05). Kesimpulan: Terdapat pengaruh Inovasi DEKADEE terhadap pengetahuan, sikap, keterampilan serta adanya pengaruh yang signifikan intervensi DEKADEE pada penurunan kadar gula darah sewaktu di Kelurahan Jatijajar Kota Depok.

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Introduction: Diabetes Mellitus (DM) is one of the non-communicable diseases (PTM) with the highest population in Indonesia and the sixth highest cause of death in Indonesia. The impact of DM causes health losses from year to year, so it needs serious treatment, so the Benson Diet, Foot Exercise and Relaxation (DEKADEE) innovation was developed.

Objective: To provide an overview of the effect of DEKADEE Nursing Intervention on controlling blood sugar levels in elderly people with diabetes.

Methods: A family case study with a family nursing care approach involving 10 families according to fact-based practices and innovations in community nursing care for 44 elderly people. DEKADEE's innovation consists of 9 sessions of 14 meetings. Data before and after the intervention were measured using blood sugar checkers, behavior (knowledge, attitudes and skills), independence, and blood sugar levels.

Results: There was an increase in family behavior including an average of 3.95%, an average attitude of 2.53%, an average skill of 3.66% and an average level of independence of 2 levels of 80% and 3 levels of an average of 20% and a decrease in blood sugar levels of 61,045 mg/dl. T test results with a significant mean value of 0.000 (p <0.05).

Conclusion: There is an effect of DEKADEE's innovation on knowledge, attitudes, skills and a significant effect of DEKADEE's intervention on reducing blood sugar levels while in Jatijajar Village, Depok City."

"ABSTRAKGula darah tidak terkontrol dan neuropati pada kaki adalah masalah kesehatan yang muncul pada lansia diabetes melitus tipe 2 (DMT2). Upaya pengontrolan masalah pada lansia DMT2 dapat dilakukan dengan kegiatan manajemen pengontrolan gula darah dan kesehatan kaki. Latihan kaki menggunakan bola tenis diberikan pada lansia DMT2 dalam keluarga dan Manajemen Pengendalian Diabetes Melitus (MAPAN DM) diberikan kepada kelompok lansia DMT2 sebanyak 58 orang, intervensi diberikan selama 30-60 menit per sesi sebanyak 12 sesi. Hasil implementasi dalam asuhan keperawatan keluarga dan kelompok, didapatkan penurunan rerata nilai gula darah sebanyak 5,1% dan neuropati pada kaki 41,7%. MAPAN DM berpengaruh terhadap penurunan gula darah (p value<0,05) dan neuropati pada kaki (p value < 0,05). Latihan kaki menggunakan bola tenis berpengaruh terhadap penurunan gula darah dan neuropati pada kaki. Latihan kaki dan Manajemen diri disarankan untuk dilakukan sebagai upaya pengontrolan gula darah dan mencegah komplikasi penyakit pada lansia DMT2.

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ABSTRACTUncontrolled blood sugar and foot neuropathy are health problems that arise in elderly type 2 diabetes mellitus (DMT2). Efforts to control the problem in elderly DMT2 can be done with activities to control blood sugar and foot health. Foot exercises using tennis balls were given to elderly DMT2 in the family and Manajemen Pengendalian Diabetes Melitus (MAPAN DM) was given to a group of elderly DMT2 58 people were selected, intervention was given for 30-60 minutes per session as many as 12 sessions. The results of the implementation in family and elderly group, obtained a mean change in blood sugar values ​​of 5.1% and foot neuropathy 41.7%. MAPAN DM influences the decrease in blood sugar (p value <0.05) and neuropathy in the foot (p value <0.05). Foot exercises using tennis balls affect the decrease in blood sugar and neuropathy in the legs. Foot exercises and self-management are recommended to be done as an effort to control blood sugar and disease complications prevention in DMT2 elderly."

"ABSTRAK Lansia merupakan kelompok rentan yang memiliki penyakit kronik karena menurunnya kemampuan fisik, psikologis dan sosialnya. Prevalensi lansia DM diJawa Barat mengalami peningkatan dari 1,3% menjadi 2% di tahun 2013. Lansiamemerlukan dukungan dari masyarakat sekitarnya, terutama kader dalammemberikan pelayanan kesehatan terkait DM. Salah satu jenis pelayanankesehatan yang diberikan kepada kelompok lansia di posbindu PTM diantaranyapemeriksaan adanya gula dalam urine sebagai deteksi awal adanya penyakitdiabetes mellitus, pemeriksaan aktivitas sehari ? hari, pemeriksaan status gizi, dankegiatan olah raga. Dukungan dari keluarga, teman, dan kader kesehatan sangatpenting untuk membuat perubahan gaya hidup dalam hal diet dan pola aktivitas.Praktik residensi bertujuan memberi gambaran pemantauan diet dan aktivitassebagai bentuk pemberdayaan kader dalam mempertahankan kadar gula darahpada lansia DM. Hasil evaluasi kegiatan didapatkan : terjadi peningkatanpengetahuan kader dari rata-rata 3,29 menjadi 9,84; peningkatan sikap kader darirata-rata 33,29 menjadi 36,50; peningkatan keterampilan kader dari rata-rata 29,29menjadi 32,50, dan penurunan kadar gula setelah dilakukan pemantauan diet danaktivitas sebesar 63%. Pendidikan kesehatan dapat dilakukan secara individualmaupun berkelompok oleh petugas kesehatan atau kader yang telah mendapatpelatihan. Pemberdayaan kader dapat meningkatkan pengetahuan, sikap danketerampilan kader. Puskesmas perlu memberikan bimbingan dan pembinaan bagikader kesehatan untuk meningkatkan asuhan keperawatan lansia DM. ABSTRACT Elderly who is vulnerable groups have the disease chronicle because declines in physicalperformance, social and psychological. The prevalence of seniors dm in west java has increasedfrom 1.3 % to 2 percent in 2013. Elderly requiring support from the community surrounding,especially kaders in providing health services associated dm on elderly. One of the healthservices provided for the elderly in posbindu PTM examination of the sugar in urine as thedetection of the beginning of disease diabetes mellitus, the daily activities investigation day, anutrition status, and activities sports. Support of the family, friends, and healthcare veryimportant to make lifestyle change in the diet and the activity. The research aims to give a senseof monitoring of diet and activity as a form of cadres in empowerment maintain blood sugarconcentration on elderly dm. The evaluation of these activities : increased cadre of knowledgethan average 3,29 become 9,84. Increased cadre of attitude than average 33,29 become 36,50.Cadres increasing skill than average 29,29 become 32,50. The decline in a sugar after monitoringdiet and activity of 63 %. Health education can be carried out individual and groups for healthworkers or cadres have received the training. Empowerment cadres can increase of knowledge ,attitudes and skill cadres. Puskesmas needs to give guidance and flanking for health cadres toincrease the care of nursing elderly dm. ;Elderly who is vulnerable groups have the disease chronicle because declines in physicalperformance, social and psychological. The prevalence of seniors dm in west java has increasedfrom 1.3 % to 2 percent in 2013. Elderly requiring support from the community surrounding,especially kaders in providing health services associated dm on elderly. One of the healthservices provided for the elderly in posbindu PTM examination of the sugar in urine as thedetection of the beginning of disease diabetes mellitus, the daily activities investigation day, anutrition status, and activities sports. Support of the family, friends, and healthcare veryimportant to make lifestyle change in the diet and the activity. The research aims to give a senseof monitoring of diet and activity as a form of cadres in empowerment maintain blood sugarconcentration on elderly dm. The evaluation of these activities : increased cadre of knowledgethan average 3,29 become 9,84. Increased cadre of attitude than average 33,29 become 36,50.Cadres increasing skill than average 29,29 become 32,50. The decline in a sugar after monitoringdiet and activity of 63 %. Health education can be carried out individual and groups for healthworkers or cadres have received the training. Empowerment cadres can increase of knowledge ,attitudes and skill cadres. Puskesmas needs to give guidance and flanking for health cadres toincrease the care of nursing elderly dm. ;Elderly who is vulnerable groups have the disease chronicle because declines in physicalperformance, social and psychological. The prevalence of seniors dm in west java has increasedfrom 1.3 % to 2 percent in 2013. Elderly requiring support from the community surrounding,especially kaders in providing health services associated dm on elderly. One of the healthservices provided for the elderly in posbindu PTM examination of the sugar in urine as thedetection of the beginning of disease diabetes mellitus, the daily activities investigation day, anutrition status, and activities sports. Support of the family, friends, and healthcare veryimportant to make lifestyle change in the diet and the activity. The research aims to give a senseof monitoring of diet and activity as a form of cadres in empowerment maintain blood sugarconcentration on elderly dm. The evaluation of these activities : increased cadre of knowledgethan average 3,29 become 9,84. Increased cadre of attitude than average 33,29 become 36,50.Cadres increasing skill than average 29,29 become 32,50. The decline in a sugar after monitoringdiet and activity of 63 %. Health education can be carried out individual and groups for healthworkers or cadres have received the training. Empowerment cadres can increase of knowledge ,attitudes and skill cadres. Puskesmas needs to give guidance and flanking for health cadres toincrease the care of nursing elderly dm. ;Elderly who is vulnerable groups have the disease chronicle because declines in physicalperformance, social and psychological. The prevalence of seniors dm in west java has increasedfrom 1.3 % to 2 percent in 2013. Elderly requiring support from the community surrounding,especially kaders in providing health services associated dm on elderly. One of the healthservices provided for the elderly in posbindu PTM examination of the sugar in urine as thedetection of the beginning of disease diabetes mellitus, the daily activities investigation day, anutrition status, and activities sports. Support of the family, friends, and healthcare veryimportant to make lifestyle change in the diet and the activity. The research aims to give a senseof monitoring of diet and activity as a form of cadres in empowerment maintain blood sugarconcentration on elderly dm. The evaluation of these activities : increased cadre of knowledgethan average 3,29 become 9,84. Increased cadre of attitude than average 33,29 become 36,50.Cadres increasing skill than average 29,29 become 32,50. The decline in a sugar after monitoringdiet and activity of 63 %. Health education can be carried out individual and groups for healthworkers or cadres have received the training. Empowerment cadres can increase of knowledge ,attitudes and skill cadres. Puskesmas needs to give guidance and flanking for health cadres toincrease the care of nursing elderly dm. ;Elderly who is vulnerable groups have the disease chronicle because declines in physicalperformance, social and psychological. The prevalence of seniors dm in west java has increasedfrom 1.3 % to 2 percent in 2013. Elderly requiring support from the community surrounding,especially kaders in providing health services associated dm on elderly. One of the healthservices provided for the elderly in posbindu PTM examination of the sugar in urine as thedetection of the beginning of disease diabetes mellitus, the daily activities investigation day, anutrition status, and activities sports. Support of the family, friends, and healthcare veryimportant to make lifestyle change in the diet and the activity. The research aims to give a senseof monitoring of diet and activity as a form of cadres in empowerment maintain blood sugarconcentration on elderly dm. The evaluation of these activities : increased cadre of knowledgethan average 3,29 become 9,84. Increased cadre of attitude than average 33,29 become 36,50.Cadres increasing skill than average 29,29 become 32,50. The decline in a sugar after monitoringdiet and activity of 63 %. Health education can be carried out individual and groups for healthworkers or cadres have received the training. Empowerment cadres can increase of knowledge ,attitudes and skill cadres. Puskesmas needs to give guidance and flanking for health cadres toincrease the care of nursing elderly dm. "

"[Gaya hidup yang tidak sehat meningkatkan prevalensi DM di masyarakat perkotaan.Lansia termasuk angregat yang rentan mengalami DM, dikarenakan terjadinyapenurunan fungsi tubuh. Salah satugejala DM yang timbul akibat peningkatan kadargula darah adalah penurunan sensitivitas kaki yang ditandai dengan rasa kebas dankesemutan.Penulisan Karya Ilmiah ini bertujuan untuk memberikan gambaran latihansenam kaki sebagai intervensi keperawatan pada risiko cedera lansia dengan DM.Hasil asuhan keperawatan keluarga yang dilakukan selama 6 minggu menunjukkanperbaikan sensitivitas kaki yang dibuktikan dengan pengukuran Ankle Brachial Index(ABI) meningkat dari 0,7 menjadi 1,2. Dukungan keluarga dibutuhkan untukmempertahankan kepatuhan melakukan senam kaki secara rutin.;Unhealthy life style increase DM prevalence in urban society. Elderly at risk todevelop DM caused by decreasing body function. One of DM symptom caused byhigh blood glucose level was decreased foot sensitivity.This paper purposes to givean illustration of foot exercise as nursing intervention for the risk of injury in elderlywith DM. The result after six weeks intervention show the improvement of footsensitivity which is analyzed based on Ancle Brachial Index measurement increasefrom 0,7 to 1,2.The family?s support is needed in order to increase adherence towardfoot exercise implementation, Unhealthy life style increase DM prevalence in urban society. Elderly at risk todevelop DM caused by decreasing body function. One of DM symptom caused byhigh blood glucose level was decreased foot sensitivity.This paper purposes to givean illustration of foot exercise as nursing intervention for the risk of injury in elderlywith DM. The result after six weeks intervention show the improvement of footsensitivity which is analyzed based on Ancle Brachial Index measurement increasefrom 0,7 to 1,2.The family’s support is needed in order to increase adherence towardfoot exercise implementation]"

"Diabetes melitus menjadi salah satu masalah kesehatan dunia dimana angka kejadian, komplikasi dan mortalitas lebih tinggi pada kelompok lansia daripada kelompok usia yang lebih muda. Prevalensi kejadian diabetes melitus tipe II pada lansia terus meningkat. Diabetes melitus memerlukan perhatian dalam perawatan bagi penderita dan keluarga. Dukungan keluarga dan dukungan sosial menjadi bagian penting bagi lansia DM dalam meningkatkan manajemen diri sebagai upaya pengontrolan kadar gula darah. Tujuan untuk memberikan gambaran implementasi program MADURASA DIABETES (Manajemen Dukungan Rawat Lansia Diabetes) sebagai inovasi dalam asuhan keperawatan komunitas untuk meningkatkan perilaku perawatan diri kelompok diabetesi. Pelaksanaan intervensi MADURASA DIABETES dilakukan pada keluarga dan komunitas di kelurahan Curug Kota Depok selama 6 bulan. Hasil evaluasi menunjukkan terjadi perubahan perilaku, penurunan nilai stress dan penurunan gula darah sewaktu (GDS) pada diabetesi. Terdapat perubahan yang signifikan pada kelompok diabetesi (n=35) sebelum dan sesudah intervensi pada perilaku (p<0,05), nilai stress (p<0,05) dan GDS (p<0,05). serta peningkatan kemandirian keluarga Program MADURASA DIABETES diharapkan dapat diterapkan perawat sebagai salah satu strategi pelaksanaan program perawatan kesehatan masyarakat (PERKESMAS) di lingkup pelayanan kesehatan primer

 

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Diabetes mellitus is one of the world's health problems where the incidence, complications and mortality are higher in the elderly group than in the younger age group. The prevalence of type II diabetes mellitus in the elderly continues to increase. Diabetes mellitus requires attention in the care of patients and their families. Family support and social support are an important part for DM elderly in improving self-management as an effort to control blood sugar levels. The aim is to provide an overview of the implementation of the MADURASA DIABETES (Diabetes Elderly Support Management) program as an innovation in community nursing care to improve self-care behavior in the diabetic group. The implementation of the MADURASA DIABETES intervention was carried out on families and communities in the Curug sub-district, Depok City for 6 months. The results of the evaluation showed that there was a change in behavior, a decrease in stress values ​​and a decrease in temporary blood sugar (GDS) in diabetes. There were significant changes in the diabetes group (n=35) before and after the intervention in behavior (p<0.05), stress scores (p<0.05) and GDS (p<0.05). as well as increasing family independence. The MADURASA DIABETES program is expected to be implemented by nurses as one of the strategies for implementing the public health care program (PERKESMAS) in the scope of primary health services.

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"Lansia dengan diabetes mellitus (DM) merupakan kelompok rentan akibat berbagai faktor risiko sehingga perlu perhatian khusus meliputi pencegahan dan penanganannya. Karya ilmiah akhir ini menggambarkan program Lansia Sehat dengan Diabetes Mellitus (LANSET DM) sebagai strategi intervensi untuk pelayanan dan asuhan keperawatan komunitas dalam pengendalian DM melalui penerapan teori manajemen, community as patner, family entered nursing, preceed-proceed model dan teori konsekuensi fungsional di Kelurahan Cisalak Pasar. Pengambilan data dilakukan dengan wawancara, observasi, penyebaran angket pada 106 responden dengan total sampling. Bentuk intervensi dilaksanakan melalui: terapi komplementer, terapi modalitas, terapi keluarga, coaching, guidance, konseling dan pendidikan kesehatan pada kelompok swabantu maupun kelompok pendukung selama 8 bulan. Hasil kegiatan didapatkan 47,2% penurunan kadar gula darah. Kesimpulannya, program ini efektif dan aplikatif digunakan dalam pengelolaan pelayanan dan asuhan keperawatan lansia dengan DM. Penulis merekomendasikan perlunya perawat komunitas mengembangkan program dan terlibat aktif dalam pencegahan primer, sekunder serta tersier pengendalian DM terutama di Kota Depok.

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Elderly with diabetes mellitus (DM) are a vulnerable population due to multiple risks factors that need special attention in terms of prevention and treatment. This final scientific papers describing Lansia Sehat dengan Diabetes Mellitus (LANSET DM) program as an intervention strategy to give service and community nursing care to control DM through the application of management theory, community as a partner, family entered nursing, preceed - proceed model and the theory of functional consequences in Kelurahan Cisalak Pasar.

Data were collected by interview, observations, questionnaires to 106 respondents with a total sampling. Intervention strategies implemented through: complementary therapies, therapy modalities, family therapy, coaching, guidance, counseling and health education to self-help groups and support groups for 8 months.

The result show a significant changes in 47,2 % decreasing of blood sugar levels. The conclusion, LANSET DM is effective and applicable to be used in the management of service and nursing care for elderly with DM in terms of prevention, health promotion, and controlling Diabetes. I recommend that the need for community nurse to develop the program and actively involved in primary, secondary and tertiary prevention in controlling DM especially in Depok."

"Populasi lansia dengan Diabetes Mellitus (DM) merupakan populasi yang rentan dengan perubahan fisik dan penyakit degeneratif yang dialaminya. Kelompok ini memerlukan bantuan atau dukungan baik secara fisik, ekonomi maupun akses terhadap pelayanan kesehatan. Bentuk dukungan dari masyarakat salah satunya adanya kelompok pendukung. Karya ilmiah akhir ini bertujuan memberikan gambaran pelaksanaan kelompok pendukung dalam upaya pengendalian faktor risiko peningkatan gula darah pada aggregate lansia DM. Karya ilmiah akhir ini telah diaplikasikan dalam manajemen pelayanan keperawatan komunitas, asuhan keperawatan komunitas, dan keluarga melalui pengintegrasian teori dan konsep manajemen pelayanan kesehatan, community as partner model, family center nursing model, dan self care model.Hasilnya terjadi peningkatan pengetahuan, keterampilan dan sikap lansia terhadap upaya pengendalian faktor risiko gula darah yang dibuktikan adanya penurunan gula darah secara signifikan sebanyak 87,5% setelah dilakukan pembinaan oleh kelompok pendukung. Hasil karya ilmiah ini diharapkan dapat menjadi acuan untuk pengembangan intervensi kelompok pendukung lansia dengan penyakit DM.

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Elderly population with Diabetes Mellitus (DM) is a vulnerable population with physical changes and degenerative diseases is going through. These groups need help or support physically, economically and access to health services. One of forms of support from the community is a support group. The goal of this study to give an overview of the implementation of support groups in an effort to control risk factors increase in blood sugar in the aggregate of elderly with DM. This study has recently been applied in the management of community nursing services, community nursing, and families through the integration of theory and concepts of health care management, community as a partnermodel, family center nursing model, and self care model. The result is an increase in knowledge, skills and attitudes toward the effort of controlling therisk factors ofblood sugar which is proved bythe declining value ofbloodsugarsignificantlyas many as 87,5%aftertraining by a support group.The result of this study is expected to be a reference to the development of a support group intervention for elderly with DM."

"ABSTRAKDiabetes melitus merupakan sekelompok gangguan metabolisme tubuh, ditandai dengan hiperglikemik kronis yang dapat mengakibatkan komplikasi akut dan kronis. Salah satu peran perawat sebagai pemberi asuhan adalah memberikan asuhan keperawatan yang berkualitas melalui pendekatan Teori Self Care Orem. Penggunaan pendekatan teori ini diharapkan dapat membantu perawat dalam menanggulangi keterbatasan yang dimiliki pasien dan melibatkan pasien secara aktif dalam proses perawatannya melalui peilaku perawatan mandiri. Tujuan penulisan karya ilmiah akhir ini adalah menganalisis hasil proses belajar residensi keperawatan medikal bedah melalui penerapan asuhan keperawatan, penerapan evidence based nursing practice, dan inovasi keperawatan. Data yang diperoleh selama praktik klinik menunjukkan sebagian besar pasien diabetes melitus mengalami komplikasi ulkus kaki diabetik yang disebabkan oleh perilaku perawatan kaki mandiri belum optimal. Hasil penerapan evidence based nursing practice berupa kegiatan edukasi perawatan kaki mandiri dapat meningkatkan pengetahuan dan membentuk perilaku perawatan kaki sebagai tindakan pencegahan dini. Hasil kegiatan inovasi keperawatan melalui pengkajian kesehatan mandiri adalah pasien dapat melakukan pengkajian mandiri terhadap kebutuhan edukasi dan mendapatkan edukasi sesuai kebutuhan mereka. Kesimpulan dari karya ilmiah akhir ini adalah perlunya peningkatan kualitas asuhan keperawatan pada pasien diabetes melitus melalui pendekatan teori keperawatan untuk meningkatkan kemandirian pasien dalam pengelolaan penyakitnya.

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ABSTRACTDiabetes mellitus is a metabolic disorder that characterized by chronic hyperglycemia which could lead to acute and chronic complications. One of nurse roles in managing diabetes mellitus is deliver nursing care using Orem's Theory of Self Care as guide of nursing practice. With this theoretical approach, nursing is expected to be able to overcome the limitations and inability of the patients and actively involve patients in the treatment process through self-care behaviors. The aims of this paper is to analyze the implementation of nursing care, application of evidence based nursing practice, and innovation program which integrated to clinical practice. Based on patient collective data, that was found that the majority of diabetes mellitus patients had been hospitalized with diabetic foot ulcers complications that caused by non-optimal foot self-care behavior. The results of evidence based nursing practice showed that the diabetic foot care education program can improve the knowledge and build the foot self-care behavior as early prevention action. The results of innovation program through self-health assessment program are patients could assess their needs of educations and get health education according to assessment results. In conclusion, it's needed to improve the quality in caring for diabetes mellitus patients through application of nursing theory to increase the self-care behaviors in management of disease."