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"Metode self-care atau self-management merupakan salah satu penatalaksanaan standar pada pasien diabetes tipe 2 yang dapat mencegah risiko komplikasi gangguan kardiovaskular. Penelitian ini bertujuan untuk memberikan gambaran karakteristik self-care activities (terdiri dari diet, latihan fisik, rutinitas pengecekan nilai gula darah, merokok, dan kepatuhan medikasi) yang dilakukan oleh pasien diabetes tipe 2 yang dapat menyebabkan risiko komplikasi gangguan kardiovaskular. Desain penelitian adalah deksriptif dengan pendekatan cross sectional yang melibatkan 76 pasien diabetes tipe 2berusia dewasa di kecamatan Cipayung Jakarta Timuryang dipilih secara acak dengan menggunakanmetode simple random sampling. Hasil penelitian menunjukkan distribusi kategori risiko gangguan kardiovaskular berdasarkan karakteristik self-care pada pasien diabetes tipe 2 rata-rata adalah tinggi dan sangat tinggi dengan kualitasself-care atau selfmanagement yang masih kurang baik, terutama pada manajemen latihan fisik (100%), namun hasil penelitian menunjukkan tingkat kepatuhan medikasi yang sudah cukup baik pada pasien diabetes tipe 2. Penelitian ini diharapkan dapat bermanfaat untuk dapat meningkatkan pengetahuan baik perawat maupun pasien mengenai self-care atau self-managementyang dapat memicu komplikasi kardiovaskular pada pasien diabetes tipe 2 berusia dewasa.

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Self-care or self-management is one of the Diabetes Standards of Medical Care which can prevent the risk of cardiovascular disease complication. This study aimed to describe self-care activities characteristics (general & specific diet, exercise, checking blood glucose regularly, smoking, dan medication) of adult patient with type 2 diabetes which could leads to the cardiovascular disease. This research designed as descriptive study with cross sectional approach, involving 76 patients with type 2 diabetes in Kecamatan Cipayung Jakarta Timur which were selected by simple random sampling.

The results of this research shows cardiovascular disease risks categories based on self-care characteristic from type 2 diabetes adult patients are high and very high, with poor quality of selfmanagement especially body exercise, but the result also tell that medication selfmanagement from the patients was good enough. This study is expected to be beneficial to rise the nurses and patients knowledge of self-care or selfmanagement which can cause cardiovascular disease complication in type 2 diabetes adult patients."

"ABSTRAKKontrol glukosa darah dapat dipertahankan melalui perawatan mandiri. Motivasi melakukan self monitoring blood glucose (SMBG) yang baik dapat meningkatkan diabetes self management pada pasien diabetes melitus tipe 2.Tujuan penelitian ini adalah untuk mengetahui hubungan motivasi melakukan SMBG dengan diabetes self management pada pasien diabetes melitus tipe 2.Penelitian ini menggunakan metode kuantitatif observasional analitik dengan pendekatan crossectional, melibatkan 96 pasien. Alat ukur yang digunakan berupa kuesioner karakteristik responden, Treatment Self Regulation Questionare, Diabetes Self Management Questionare, Diabetes Knowledge Scale.Hasil penelitian menunjukkan terdapat hubungan yang bermakna antara motivasi melakukan SMBG dengan diabetes self management (p = 0,001). Hasil analisis regresi logistik menunjukkan motivasi melakukan SMBG berhubungan dengan didabetes self management setelah dikontrol variabel pengetahuan.Kesimpulan diperlukan perhatian khusus dari perawat untuk meningkatkan motivasi melakukan SMBG pada pasien diabetes melitus tipe 2 dalam self care management.

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ABSTRACT

Glycemic control could be maintained through diabetes self-management. Motivation to perform self-monitoring blood glucose (SMBG) could improve diabetes self-management in type 2 diabetes mellitus patients.

The purpose of this study was to explore the relationship between motivation to perform SMBG and diabetes self-management in patients with type 2 diabetes mellitus.

This study applied quantitative method with a cross sectional approach, involving 96 patients. The Instruments used were questionnaires for respondent characteristics, Treatment Self-Regulation Questionnaires, Diabetes Self Management Questionnaire and Diabetes Knowledge Scale.

The results show that there was a significant relationship between motivation to perform SMBG and diabetes selfmanagement (p = 0,001). Results of logistic regression analysis showes that motivation to perform SMBG is associated with diabetes self-management after controlled by knowledge variable.

In conclusion it is a necessarily for nurses to provide attention to increase motivation to perform SMBG in patients with type 2 diabetes mellitus as part of self care management."

"Self management diabetes berdampak positif terhadap peningkatan outcome klinis. Observasi pada fasilitas pelayanan kesehatan menunjukkan pelaksanaan edukasi kurang efektif. Inovasi teknologi dapat menjadi alternatif solusi dalam mengatasi masalah ini. Penelitian bertujuan mengetahui pengaruh aplikasi self management berbasis android terhadap tingkat pengetahuan dan perilaku self management pada pasien diabetes melitus tipe 2. Penelitian ini berdesain quasi eksperimental pre-posttest dengan kelompok kontrol. Partisipan direkrut di poli rawat jalan dan rawat inap sejak Juni-Agustus 2020. Analisis data menggunakan SPSS versi 25 pada 66 responden. Pada analisis bivariat, terdapat peningkatan pengetahuan pada kelompok intervensi di akhir penelitian (p=0,07). Tidak ada pengaruh aplikasi terhadap perilaku self management diabetes (p=0,940). Pada analisis multivariat, didapatkan hubungan yang signifikan antara penggunaan aplikasi (p=0,045) dan tingkat pengetahuan sebelumnya (p=0,0001) terhadap tingkat pengetahuan posttest. Aplikasi D-SyIs berpotensi meningkatkan pengetahuan diabetes. Perbaikan desain aplikasi diharapkan dapat meningkatkan efektivitas penggunaan aplikasi.

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Self management diabetes has positive impact on increasing clinical outcome. Field observation in healthcare setting showed an ineffective implementation of health education. Technology innovation could be an alternative solution to solve this problem. This research was to examine the effect of android based self management apps towards diabetes self management behavior and diabetes knowledge among type 2 diabetes mellitus patients. A pre-posttest quasy experimental design with control group is used. Participants were recruited from outpatient and inpatient from June to July 2020. SPSS version 25 was used to analyse 66 participants. In bivariat analysis, there was enhancement of diabetes knowledge in intervention group (p=0,07) at the end of research. There was no significant different in self management (p=0,908). In multivariate analysis, there were significant effect of D-SyIs apps (p=0,045) and previous diabetes knowledge (p=0,0001) towards diabetes knowledge. This apps has potential effects to increase diabetes knowledge. Upgrading the app design is needed to increase the apps effectiveness."

"Pasien dewasa pertengahan dengan diabetes memiliki risiko lebih tinggi terjadinya komorbiditas. Diabetes self management merupakan hal yang esensial dilakukan untuk mengontrol gula darah. Tujuan penelitian ini menganalisis faktor-faktor yang mempengaruhi diabetes self management pada pasien dewasa pertengahan dengan diabetes tipe 2. Metode penelitian menggunakan pendekatan cross-scetional pada 91 reponden. Semua data pada penelitian ini diambil secara daring. Hasil analisis bivariat hanya dukungan keluarga (p=0,023) dan efikasi diri (p=0,0005) yang berhubungan dengan diabetes self management, sedangkan faktor lain tidak memiliki korelasi. Analisis regresi linear ditemukan bahwa efikasi diri (p=0,0005, R2=0,379) yang paling berpengaruh terhadap diabetes self management. Perawat perlu mengembangkan intervensi dan inovasi keperawatan yang mengacu pada pemberdayaan pasien dalam meningkatan kemampuan dalam perawatan diri sendiri. Fokus utama perawat pada peningkatkan efikasi diri pasien dan kemampuan diabetes self management. Diperlukannya edukasi yang berkelanjutan serta keterlibatan dari anggota keluarga pasien.

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Factors affecting diabetes self management in middle-age adult with type 2 diabetes mellitus. Middle-age adult patients with diabetes have higher risk comorbid conditions. Diabetes self management is an essential thing to control blood sugar.The aim of this study was to analyze the factors affecting with diabetes self-management in middle-age adult with type 2 diabetes. A cross-sectional approach was conducted for 91 respondents. All data in this research were collected from online survey. From the bivariate analysis, there were only family support (p = 0.023) and self-efficacy (p = 0.0005) that associated with diabetes self-management. The other variable had no correlation. Linear regression analysis found that self-efficacy (p = 0.0005, R2 = 0.379) had strongest correlation toward diabetes self-management. Nurses need to develop nursing interventions and innovations that refer to empowering patients to increase their ability to care for themselves. Nurses’ primary focus was on improving patient self-efficacy and diabetes self-management abilities. Patiens need for continuing education and involvement of the patient's family members."

"Skripsi ini membahas faktor-faktor yang berhubungan dengan manajemen diri penyakit diabetes melitus pada peserta JKN di wilayah Jakarta Selatan tahun 2019. Penelitian ini adalah penelitian kuantitatif dengan studi observasional dengan tipe cross sectional. Hasil penelitian didapatkan bahwa terdapat hubungan yang bermakna antara dukungan keluarga dan lama menderita dengan manajemen diri penyakit diabetes melitus.

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This study focuses on the factors that related to self management of type 2 diabetes mellitus on JKN patients in South Jakarta in 2019. This research is quantitative research with observational study and cross sectional type. The result of this study is the positive correlation between family supports and duration of patients in suffering from type 2 diabetes mellitus with self management diabetes mellitus."

"[ABSTRAKLatar belakang: Prevalensi Diabetes Melitus Tipe (DM) tipe 2 semakin meningkat setiap tahun. Kontrol glisemik yang buruk, hipertensi, dislipidemia, dan kebiasaan merokok serta menopause dapat meningkatkan risiko komplikasi penyakit kardiovaskular. Komplikasi kardiovaskular merupakan komplikasi paling sering ditemukan dengan angka mortalitas yang tinggi. Oleh karena itu, untuk menekan progresivitas komplikasi kardiovaskular diperlukan suatu terapi nutrisi medik yang adekuat sesuai dengan kondisi klinis dan edukasi dalam memodifikasi gaya hidup.Metode: Pasien pada serial kasus berusia 55-65 tahun. Tiga pasien didiagnosis DM tipe 2 dengan gagal jantung, satu pasien dengan penyakit jantung hipertensi. Semua pasien memiliki skor skrining malnutrition screening tools (MST) ≥ 2. Dua pasien mempunyai status gizi obesitas, satu pasien berat badan dan pasien lainnya dengan berat badan normal. Kebutuhan energi basal (KEB) berdasarkan rumus Harris-Benedict dengan faktor stress 1,3-1,4 tergantung kondisi klinis dan penyakit penyerta. Komposisi makronutrien sesuai dengan rekomendasi American Diabetes Association dan Dietary Approach to Stop Hypertension. Pemberian mikronutrien dan nutrient spesifik diberikan pada satu dua kasus. Pasien dipantau selama 5-17 hari, meliputi keluhan subyektif, hemodinamik, toleransi dan analisis asupan, antropometri, pemeriksaan laboratorium, imbang cairan, dan kapasitas fungsional.Hasil: Selama pemantauan di RS, keempat pasien menunjukkan perbaikan klinis yaitu tekanan darah turun dan kapasitas fungsional membaik. Satu pasien kadar glukosa darah dipertahankan < 200 mg/dL.Kesimpulan: Terapi nutrisi medik yang adekuat dapat memperbaiki kondisi klinis pasien DM tipe 2 dengan komplikasi sistem kardiovaskular.

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ABSTRACTBackground: The prevalence of type 2 diabetes mellitus (DM) is increasing every year. Poor glycemic control, hypertension, dyslipidemia, smooking and menopause increase the risk for cardiovascular complications. Cardiovascular complications is the most common complications in type 2 DM with a significant high mortality rate. Therefore, a medical nutrition therapy is required to decreased the progresitivity of the cardiovascular complication in DM, based on improvement of clinical conditions and lifestyle modifications.Method: Patients in this case series were between 55-65 years old. There of those patients were diagnosed heart failure and one with hypertension heart disease. All patients had a screening score ≥ 2 with malnutrition screening tools (MST). Two of patients had nutritional status of obesity, one patients was overweight, and another patients was normoweight. Basal calorie requirement were calculating using Harris-Benedict formula with stress factor 1,3-1,4 adjusment according to clinical conditions and comorbidities. Macronutriens were given recommendations by The American Diabetes Association and Dietary Approach to Stop Hypertension. Two patients received micronutrien and specific nutrients. Monitoring was done for 5-17 days included subjective complaints, hemodynamic, tolerance and intake analysis, anthropometric measurement, laboratory test, fluid balance and functional capacity.Results : All the patients showed the improvement of clinical conditions, blood control and functional capacity. Blood glucose levels of one patients was maintained to below 200 mg/dLConclusion: Medical nutrition therapy can improved clinical conditions of patients type 2 DM with cardiovascular complications., Background:The prevalence of type 2 diabetes mellitus (DM) is increasing every year. Poor glycemic control, hypertension, dyslipidemia, smooking and menopause increase the risk for cardiovascular complications. Cardiovascular complications is the most common complications in type 2 DM with a significant high mortality rate. Therefore, a medical nutrition therapy is required to decreased the progresitivity of the cardiovascular complication in DM, based on improvement of clinical conditions and lifestyle modifications.Method:Patients in this case series were between 55-65 years old. There of those patients were diagnosed heart failure and one with hypertension heart disease. All patients had a screening score ≥ 2 with malnutrition screening tools (MST). Two of patients had nutritional status of obesity, one patients was overweight, and another patients was normoweight. Basal calorie requirement were calculating using Harris-Benedict formula with stress factor 1,3-1,4 adjusment according to clinical conditions and comorbidities. Macronutriens were given recommendations by The American Diabetes Association and Dietary Approach to Stop Hypertension. Two patients received micronutrien and specific nutrients. Monitoring was done for 5-17 days included subjective complaints, hemodynamic, tolerance and intake analysis, anthropometric measurement, laboratory test, fluid balance and functional capacity.Results :All the patients showed the improvement of clinical conditions, blood control and functional capacity. Blood glucose levels of one patients was maintained to below 200 mg/dLConclusion:Medical nutrition therapy can improved clinical conditions of patients type 2 DM with cardiovascular complications.]"

"Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan perilaku manajemen diri diabetes melitus tipe 2 pada peserta Prolanis di Klinik Swasta Jakarta Selatan. Jenis penelitian ini adalah kuantitatif dengan desain penelitian cross sectional. Penelitian ini menggunakan data primer dengan cara menyebarkan kuesioner ke responden penelitian. Hasil penelitian menunjukkan 53,2 responden memiliki perilaku manajemen diri diabetes melitus tipe 2 yang baik. Faktor-faktor yang berhubungan dengan perilaku manajemen diri diabetes melitus tipe 2 meliputi efikasi diri P Value = 0,006, keaktifan peserta Prolanis P Value = 0,035, dan dukungan keluarga P Value = 0,014.

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This study aims to determine factors associated with diabetes type 2 self management behaviour in Prolanis participants at South Jakarta Private Clinics. Type of this study is a quantitative research with cross sectional design. This study used primary data obtained by spreading questionnaires to respondents. The result of this study shows that 53,2 respondents have a good diabetes type 2 self management. Factors associated with diabetes type 2 self management behaviour are self efficacy P Value 0,006, Prolanis attendance P Value 0,035, and family support P Value 0,014."

"Penerapan pedoman gizi kedalam menu sehari-hari merupakan tantangan bagi mayoritas pasien diabetes karena memerlukan penyesuaian dan kesukarelaan dari pasien untuk mengubah pola makan yang sudah lama terbentuk dan sering menimbulkan kejenuhan dan stress disebabkan pasien diabetes harus mengikuti program diet seumur hidupnya. Aktivitas self management serta respon psikologis memiliki pengaruh yang besar pada pasien diabetes melitus dalam melakukan usaha pengontrolan diet. Penelitian ini menggunakan desain cross sectional yang dilakukan di RSPAD Gatot Soebroto, RS Fatmawati dan RSUPN Dr. Cipto Mangunkusomo Jakarta dengan jumlah responden 260 orang pasien diabetes melitus tipe 2. Pengukuran respon psikologis menggunakan Problem Areas In Diabetes PAID, aktivitas self management diukur menggunakan Diabetes Self Management Questionare DMSQ yang telah dilakukan uji validitas dan reliabilitas serta pengukuran asupan makanan melalui kuesioner food recall 1x24 jam dan status nutrisi dinilai dengan indeks massa tubuh IMT. Hasil analisis menunjukkan terdapat hubungan bermakna antara respon psikologis dan status nutrisi p = 0,000, OR =4,944 , terdapat hubungan bermakna antara diabetes self management dengan status nutrisi p = 0,002, OR = 2,217 yang tidak dipengaruhi variabel perancu jenis OAD, asupan makanan, dan usia. Diperlukan penambahan materi konseling untuk memenuhi kebutuhan psikologis terkait diabetes serta penguatan edukasi secara berulang-ulang kepada pasien.

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The application of nutritional guidelines into the daily menu is a challenge for the majority of diabetic patients because it requires adjustment and volunteering of patients to change the long established diet and often leads to saturation and stress because diabetic patients should follow a diet plan for the rest of their lives. Self management activities as well as psychological responses have a great influence on diabetes mellitus patients in doing diet control efforts. This research use cross sectional design which done in Gatot Soebroto army hospital, Fatmawati Hospital and Dr. Cipto Mangunkusomo hospital Jakarta with the number of respondents 260 people with type 2 diabetes mellitus. Measurement of psychological response using Problem Areas In Diabetes PAID, self management activity is measured using Diabetes Self Management Questionare DMSQ which has tested the validity and reliability and measurement of food intake through food recall questionnaire 1x24 hours and nutritional status assessed with body mass index BMI. The result showed that there was a significant correlation between psychological response and nutritional status p 0,000, OR 4,944 , there was a significant correlation between diabetes self management with nutritional status p 0,002, OR 2,217 unaffected by confounder type OAD, intake food, and age. Required addition of counseling material to meet the psychological needs related to diabetes as well as the strengthening of education repeatedly to the patient."

"Diabetes melitus tipe 2 merupakan penyakit metabolik kronik dengan komplikasi yang dapat menyebabkan disabilitas hingga kematian. Upaya pencegahan komplikasi diabetes yaitu menerapkan perilaku self-management. Penelitian ini bertujuan untuk mengidentifikasi korelasi antara kualitas edukasi yang dilakukan perawat terhadap perilaku self-management pasien diabetes melitus tipe 2. Data diperoleh dari 126 responden di Puskesmas Cimanggis, Tapos, Sukmajaya, dan Persadia Cabang Kota Depok dengan teknik purposive sampling. Instrumen penelitian yang digunakan telah diuji untuk mengukur Kualitas Edukasi yang Dilakukan Perawat dan self-management diabetes (SDSCA). Hasil analisis korelasi Pearson menunjukkan terdapat hubungan positif yang bermakna antara kualitas edukasi yang dilakukan perawat terhadap perilaku self-management pasien diabetes melitus tipe 2 (p=0,000). Hasil penelitian ini dapat dijadikan evaluasi bagi pelayanan keperawatan untuk meningkatkan kualitas edukasi dengan harapan meningkatkan self-management pasien diabetes melitus tipe 2.

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Type 2 diabetes mellitus is a long-life chronic metabolic disease with  accompanying complications that could lead to disability or death. Diabetes self-management has been considered as an effort to reduce the complications. This study aimed to identify the correlation between the quality of nurse-led education with type 2 diabetes self-management behavior. A total  of 126 subjects with T2DM were recruited from Puskesmas Cimanggis, Tapos, Sukmajaya, and Persadia Cabang Kota Depok with purposive sampling. Previously validated scales were used to measure the quality of nurse-led education and diabetes self-management (SDSCA). The result of Pearson Correlation analysis showed that there is significantly-positive correlation between nurse-led education with self-management of type 2 diabetes mellitus patients (p=0,000; r=0,436). The result of this research could be a suggestion for further nursing care to educate diabetician to improve their self-management."

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Diabetes merupakan permasalahan kesehatan yang masih banyak terjadi di dunia dan jenis diabetes yang banyak diderita adalah diabetes tipe 2. Diabetes yang tidak terkendali dapat menyebabkan komplikasi. Upaya yang dapat dilakukan untuk mengendalikan diabetes tipe 2 adalah dengan memberikan perawatan kesehatan berkelanjutan oleh petugas kesehatan dan melakukan self-management. Self-management dapat diterapkan dengan menggunakan perkembangan teknologi informasi dan komunikasi, yaitu dengan  Mobile Health (mHealth). Oleh karena itu, penelitian ini bertujuan untuk mengetahui efektivitas mhealth dalam self-management diabetes tipe 2. Penelitian ini menggunakan metode literature review. Pencarian studi dilakukan melalui online database PubMed, ScienceDirect dan Cochcrane dengan kata kunci “mHealth” OR “mobile health” AND “self-management diabetes” OR “Self-care diabetes”. Dan ditemukan 15 total studi yang terinklusi. Keefektivitasan dinilai dari perubahan yang nyata pada hasil. Sebanyak 6 studi menunjukkan adanya penurunan kadar Hb1Ac yang signifikan dan sebanyak 5 studi menjukan adanya perubahan yang signifikan pada pola hidup pasien. Sehingga, dapat dikatakan bahwa penggunaan mHealth efektif dalam self-management diabetes.

 

 

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Diabetes is a health issue that still occurs in the world and the type of diabetes that is suffered is type 2 diabetes. Uncontrolled diabetes can cause complications. The efforts to control type 2 diabetes is by providing a continuity health care by health workers and self-management. Self-management can be applied using information and communication technology developments, that is by using Mobile Health (mHealth). Therefore, this study aims is to see the effectiveness of health in self-management of type 2 diabetes. This study used a literature review method. The study search was carried out through the PubMed, ScienceDirect and Cochcrane online database with the keywords "mHealth" OR "mobile health" AND "diabetes self-management" OR "Self-care diabetes". And found 15 total studies. The effectiveness is assessed from real changes in results. A total of 6 studies showed a significant decrease in Hb1Ac levels and as many as 5 studies showed significant changes in the patient's lifestyle. So, it can be said that the use of mHealth is effective in diabetes self-management.

 

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