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"Nama : NurchajatieProgram Studi : Ilmu Kesehatan MasyarakatJudul :Model Prediksi Perubahan Status Gizi Pasien Diabetes MelitusTipe 2 Di Ruang Rawat Inap RSUP Fatmawati Tahun 2018.Pembimbing : Ir. Ahmad Syafiq, M.Sc, Ph.dStatus gizi kurang akibat malnutrisi rumah sakit merupakan penurunan statusgizi karena kurangnya asupan atau daya terima makanan selama perawatan, danmenjadi masalah gizi pasien di rawat inap dan sering mendapat sorotan. Statusgizi kurang seringkali dijadikan prediksi lama rawat pasien di rumah sakit.Malnutrisi rumah sakit atau penurunan status gizi selain akibat dari kekuranganasupan makanan, peningkatan kebutuhan sehubungan dengan kondisipenyakitnya dan juga kepuasan terhadap pelayanan gizi, umur, jenis kelamin,selera makan, dan kepatuhan diet. Tujuan penelitian adalah mengetahui modelprediksi perubahan status gizi pasien diabetes melitus tipe 2. Penelitian iniadalah penelitian observasional analitik dengan pendekatan cross sectional.Hasil penelitian perubahan status gizi berdasarkan IMT rata-rata -0,2 0,3kg/m2. Dari hasil analisis regresi linier multivariate diperoleh model prediksiperubahan status gizi = - 0,764 0,004 Asupan Makan - 0,01 Kepatuhan diet ndash;0,014 Kepuasan terhadap pelayanan gizi 0,011 Selera makan. Kesimpulan:Apabila asupan makan , nilai skor kepatuhan diet, nilai skor kepuasan terhadappelayanan gizi serta nilai skor selera makan menurun, maka perubahan statusgizi akan semakin negatif menurun dan asupan makan merupakan variabelyang berpengaruh dalam perubahan status gizi pasien DM tipe 2.Kata kunci: perubahan status gizi, diabetes melitus , malnutrisi rumah sakit.

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ABSTRACTName NurchajatieStudy Program Public HealthTitle Prediction Model of the Change in Nutritional Status ofHospitalized Diabetes Melitus type 2 Patients inFatmawati General Hospital in 2018.Counsellor Ir. Ahmad Syafiq, M.Sc, Ph.dLack of nutrition caused by malnutrition during hospitalization is a decreasingnutritional status which is caused by lack of intake or the decreasing ability toaccept food intake during hospitalization and become a nutrition problem for apatient of which often becomes focus of attention. Patient 39 s lack of nutrition isoften used to predict the length of treatment in the hospital. Malnutrition ordecreasing nutrition status caused by lack of food intake, moreover caused byincreasing need related to the condition of the sickness and also the satisfactiontoward the services in nutrition provision, age, sex, appetite, and diet obedience.The main research objective is to know the model of prediction in the change ofnutritional status of diabetes mellitus type 2. This research is an analyticalobservational research using cross sectional approach. The research result in thechange of nutritional status is based on average IMT 0.2 0.3 kg m2. From theresult of multivariate linear regression, it is obtained the prediction model of thechange in nutritional status 0.764 0.004 Food intake 0.01 Diet obedience 0.014 Satisfaction towards services in nutrition provision 0.011 Appetite.Conclusion if the food intake, the score of satisfaction towards services innutrition provision, and the score of eating appetite are decreasing, then thechange in nutritional status tends to be more negative decreasing and the foodintake is an influential variable in the change of DM type 2 patient 39 s nutritionalstatus.Key words change in nutritional status, diabetes mellitus, hospital malnutrition"

"Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan kepatuhan diet DM. Penelitian ini menggunakan disain studi cross sectional yang dilakukan pada 19 Maret ? 5 April 2012 di Klinik Gizi dan Klinik Edukasi Diabetes RSUP Fatmawati dengan 100 orang pasien DM tipe 2 usia ≥ 20 tahun. Pengumpulan data melalui wawancara dengan kuesioner, food recall 1x24 jam, dan FFQ. Hasil penelitian menunjukkan bahwa sebanyak 56% responden yang patuh diet. Terdapat hubungan yang bermakna antara tingkat pengetahuan (OR=12,5), persepsi (OR=11), motivasi diri (OR=8,8), dukungan keluarga (OR=5,5), dan keikutsertaan penyuluhan gizi (OR=7,8) dengan kepatuhan diet DM.

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The objective of this study was to identify factors which associated with dietary adherence on diabetes mellitus. The method used in this study is cross sectional design which was conducted by 100 respondents aged 20 years and older with type 2 diabetes at Nutrition Clinic and Diabetes Education Clinic at Fatmawati Hospital Center in March 19th until April 5th 2012. Data were collected through interview referring to the questionnaire, a food recall 24 hours, and FFQ.

The result of this study showed that 56% people in a good dietary adherence of diabetes mellitus. There were significant association between knowledge level (OR=12,5), perception (OR=11), self-motivation (OR=8,8), family support (OR=5,5), and following nutrition education (OR=7,8) with dietary adherence."

"Analisis Implementasi Asuhan Keperawatan dengan Pendekatan Keperawatan Kesehatan Masyarakat Perkotaan dan Intervensi Hipnosis pada Pasien Diabetes Mellitus Tipe 2 dengan Gangguan Pola Tidur di Ruang Rawat Inap Lantai 6 Utara Gedung Teratai RSUP Fatmawati rdquo;Angka kejadian diabetes melitus meningkat setiap tahunnya. Neuropatik merupakan komplikasi tersering diabetes melitus yang ditandai dengan adanya nyeri yang memburuk pada malam hari sehingga menyebabkan masalah gangguan tidur. Intervensi yang dapat digunakan untuk mengatasi gangguan tidur adalah terapi hipnosis. Hipnosis adalah proses membimbing klien untuk relaks. Karya ilmiah ini bertujuan memberikan gambaran asuhan keperawatan pada pasien DM dengan gangguan pola tidur akibat nyeri neuropati dengan intervensi Hipnosis. Intervensi ini diterapkan selama 3 hari dengan durasi 20 menit. Hasil evaluasi didapatkan adanya peningkatan kualitas tidur. Oleh karena itu intervensi hipnosis ini sangat direkomendasikan untuk diterapkan di pelayanan keperawatan. Kata Kunci : Diabetes mellitus, neuropati, tidur, hipnosis

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Analysis of Urban Health Clinical Nursing Practice on Type 2 Diabetes Mellitus Patient Who Experience sleep patterns Disruption through Hipnosis Intervention in 6th North Floor Fatmawati Central General Hospital rdquo The incidence of diabetes mellitus is always increasing every year. Neuropathic is a common complication of diabetes mellitus that characterized by pain which worsened at night and causing sleep problems. One of the interventions that can be used to treat sleep disorders is hypnosis therapy. Hypnosis is the guiding processthat help client to relax. This paper aims to provide an overview of nursing care in diabetic patients with sleep disorders due to neuropathy pain with hypnosis intervention. This intervention is applied for 3 days and the duration of interventionis 20 minutes. The result shows a good improvements in the sleep quality of the patient. Therefore hypnosis therapy intervention is highly recommended to be applied in nursing services. "

"Ulkus diabetikum merupakan salah satu komplikasi dari diabetes melitus. Prevalensi kerjadian ulkus berulang pada pasien diabetes melitus meningkat akibat rendahnya efikasi diri pasien dalam melakukan perawatan di rumah. Efikasi diri dipengaruhi oleh berbagai faktor seperti pengetahuan, perilaku dan motivasi. Salah satu intervensi yang dapat dilakukan untuk meningkatkan efikasi diri pasien yaitu dengan penerapan therapeutic patient education.Karya ilmiah ini bertujuan untuk memberikan gambaran asuhan keperawatan masyarakat perkotaan pada pasien diabetes melitus tipe 2 dengan ulkus diabetikum berulang dengan penerapan therapeutic patient education. Intervensi dilakukan selama 8 hari dengan memberikan motivasi, edukasi, melatih keterampilan dalam perawatan ulkus diabetikum. Evaluasi pelaksanaan intervensi dilkukan dengan pengukuran efikasi diri menggunakan Diabetes Management Self Efficacy Scale DMSES.Hasil menunjukkan terdapat peningkatan efikasi diri yang ditandai dengan peningkatan skor DSMES dari 30 menjadi 80. Intervensi therapeutic patient education direkomendasikan untuk diterapkan di pelayanan keperawatan khususnya pada pasien ulkus diabetikum.

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Diabetic ulcer is one of the complications of diabetes mellitus. The prevalence of recurrent ulceration in patients is increased due to low self-efficacy of patients in self management diabetic Self efficacy is influenced by various factors such as knowledge, behavior and motivation. One of the interventions that can be done to improve patient 39;s self efficacy is by applying therapeutic patient education.This paper aims to provide an image of urban community nursing care in patients with type 2 diabetes mellitus with recurrent diabetic ulcer with the application of therapeutic patient education. Intervention had been done for 8 days by providing motivation, education, training skills in the treatment of diabetic ulcer patient. The evaluation of this program is measuring the level of self efficacy using Diabetes Management Self Efficacy Scale DMSES.The results indicated an increase in self efficacy characterized by DMSES scores increased from 30 to 80. In conclusion, therapeutic patient education interventions are recommended for application in nursing services especially in diabetic ulcer patients."

"The incidence of type 2 diabetes mellitus increase each year in Indonesia. A good nutritional status in patients with type 2 diabetes may improve their quality of life and avoid the complications that may arise in type 2 diabetes mellitus. This study aims to find the factors that can affect nutritional status of type 2 diabetes mellitus patients. A cross ndash sectional study was conducted on 57 patients rsquo medical records obtained from Husada Hospital. The result showed that patients with type 2 diabetes mellitus who have the nutritional status of obese commonly found in women 94.1 , aged 50 64 years 64.7 , active physical activity 52.9 , currently on pharmacological treatment 100 , with the intake of nutrients such as low energy intake 64.7 , high fat consumption 58.8 , and adequate carbohydrates 100 and protein consumption 100 . No association was found statistically significant between the sexes, energy intake, carbohydrates intake, fat intake, protein intake, physical activity, and currently on pharmacological treatment on the nutritional status of patients with type 2 diabetes p 0.05 . A statistically significant relationship was found between age p 0,011, fisher test on the nutritional status of patients with type 2 diabetes. In conclusion, only age of patient is found significant to the nutritional status of type 2 diabetes mellitus patient."

"Latar Belakang: Luka bakar berat dengan komorbid diabetes melitus (DM) secara teoritis dapat mengalami fenomena second hit, rentan terhadap peningkatan respon hipermetabolisme karena efek gabungan luka bakar akut dan patofisiologi DM. Implikasi gabungan efek tersebut meningkatkan morbiditas mortalitas, sehingga dibutuhkan tatalaksana nutrisi adekuat untuk melawan respon hipermetabolik dan hiperkatabolik, yang diharapkan memengaruhi perbaikan kontrol glukosa darah. Metode: Serial kasus ini terdiri atas empat pasien luka bakar berat karena api dengan DM tipe 2 yang dirawat di ICU luka bakar. Tatalaksana nutrisi diberikan dengan nutrisi enteral dini dalam waktu 24 jam pertama, secara bertahap diberikan sesuai kondisi klinis dan toleransi asupan, dengan target kebutuhan energi awal 20-25 kkal/kg BB/hari, protein 1,5-2 g/kg BB/hari, lemak 25-30%, dan karbohidrat 55-60%. Hasil: Pemberian nutrisi pada keempat pasien dapat membantu mempertahankan kadar glukosa darah tidak mengalami peningkatan fluktuasi tajam. Interupsi pemberian nutrisi yang disebabkan berbagai kondisi klinis dan tindakan, menyebabkan target energi dan protein harian sulit tercapai pada keempat pasien. Komplikasi sepsis dan syok sepsis terjadi sehingga pada akhirnya keempat pasien meninggal. Kesimpulan: Luka bakar berat, pengendalian infeksi, obesitas, komorbid DM, variabilitas glikemik, serta tatalaksana nutrisi yang tidak adekuat, dapat meningkatkan morbiditas mortalitas pada pasien ini, karenanya masih menjadi tantangan tim terapi medik gizi.

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Background: Severe burns with comorbid diabetes mellitus (DM) can theoretically experience a second hit phenomenon, susceptible to increased hypermetabolic response due to the combined effect of acute burns and DM pathophysiology. The combined implications of these effects increase mortality morbidity, so that adequate management of nutrition is needed to counteract the hypermetabolic and hypercatabolic responses, which are expected to influence improvement in blood glucose control. Method: The cases series consist of four patients with severe burns due to fire with type 2 DM, treated in ICU burns. Nutritional management is given with early enteral nutrition in the first 24 hours, gradually given according to clinical conditions and intake tolerance, with a target of initial energy requirements of 20-25 kcal/kg body weight/day, protein 1.5-2 g/kg body weight/day, 25-30% fat, and carbohydrates 55-60%. Results: Nutrition therapy to all four patients can help maintain blood glucose levels not experiencing sharp fluctuations. Nutritional interruption caused by various clinical conditions and actions, causes daily energy and protein targets difficult to achieve in all four patients. Complications of sepsis and sepsis shock occur and eventually all four patients die. Conclusions: Severe burns, infection control, obesity, comorbid DM, glycemic variability, and inadequate nutritional management, can increase mortality morbidity in these patients, therefore it remains a challenge for the nutritional medical therapy team."

"Tujuan penelitian ini adalah untuk mengetahui profil kesehatan gigi mulut serta distribusi frekuensi sosioekonomi dan perilaku dari pasien diabetes melitus tipe 2 di RSCM. Studi potong lintang ini dilakukan dengan memberikan kuesioner pada 70 orang pasien dan dianalisis menggunakan uji Pearson. Hasil uji tersebut tidak menunjukkan hubungan bermakna antara pengetahuan, sikap, durasi, dan sosioekonomi pasien terhadap status kesehatan gigi dan mulut (p>0,05). Hasil penelitian memperlihatkan kurangnya pengetahuan pasien diabetes melitus terhadap dampak diabetes melitus terhadap kesehatan gigi dan mulut sedangkan pengetahuan tentang komplikasi diabetes baik. Dari hasil pemeriksaan klinis dapat disimpulkan bahwa kesehatan gigi dan mulut pasien diabetes kurang memuaskan.

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The purpose of this study is to obtain information about the oral health profile, socioeconomic status and dental behavior of Type 2 Diabetes Mellitus patients in RSCM. A cross sectional study was conducted by giving out questionnaire to 70 diabetic patients and were analyzed by Pearson test. There are no significant correlation between diabetic patients’ knowledge, dental behavior, diabetes duration, and socioeconomic status to oral health status. This study showed that patients had lack of awareness of diabetes effects on oral health but good in diabetes complications. From the clinical examination, diabetic patients’ oral health status were not good."

"Diabetes melitus dan gizi kurang secara terpisah dikatakan dapat meningkatkan kejadian tuberkulosis. Studi potong lintang analitik ini bertujuan untuk mengetahui adanya hubungan antara gizi kurang dengan prevalensi tuberkulosis paru (TBP) pada pasien diabetes melitus tipe 2 (DMT2). Dari keseluruhan 462 pasien DMT2, 125 pasien (27.1%) di antaranya menderita TBP. Total pasien DMT2 yang menderita gizi kurang sebesar 125 pasien (27.1%). Sementara itu, dari keseluruhan pasien DMT2 yang menderita TBP, 78 pasien (62.4%) juga menderita gizi kurang. Hasil uji chi-square menunjukkan adanya hubungan antara gizi kurang dengan prevalensi TBP yang bermakna secara statistik (p <0.000).

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Diabetes mellitus and undernutrition separately were proved as risk factors of tuberculosis incidence. This analytical cross sectional study aimed to measure the prevalence of lung tuberculosis (TBP) among type 2 diabetes mellitus (DMT2) patients and its association with undernutrition. A total of 462 DMT2 patients were analyzed and the results showed that 125 patients (27.1%) had TBP and 125 patients (27.1%) were undernourished. Within DMT2 patients who had TBP, there were 78 undernourished patients (62.4%). We concluded there is a highly significant statistical association between undernutrition and prevalence of TBP among DMT2 patients (p <0.000)."

"Terapi Reiki merupakan salah satu terapi komplementer untuk membantu menurunkan kadar glukosa darah pasien DM tipe 2. Terapi ini menggunakan energi alami yang disalurkan pada tubuh pasien DM tipe 2 dengan tujuan menyelaraskan energi yang tidak seimbang dalam tubuhnya. Penelitian ini bertujuan untuk mengetahui pengaruh Reiki terhadap penurunan kadar glukosa darah pasien DM tipe 2 di Klub Diabetes Instalasi Rehabilitasi Medis RSUP Fatmawati, Jakarta. Desain penelitian yang digunakan adalah pra-eksperimental dengan pendekatan the one-group pretest-posttest design (before and after) menggunakan teknik purposif sampling untuk pengambilan sampelnya. Sampel berjumlah 18 responden. Terapi Reiki dilakukan dengan dua metode, secara langsung dan dari jarak jauh (distant healing) yang diberikan selama 30 hari. Terapi Reiki dilakukan oleh peneliti dibantu oleh praktisi Reiki khususnya dalam transfer energi. Instrumen yang digunakan untuk mengukur kadar glukosa darah adalah glukometer. Hasil penelitian menunjukkan ada perbedaan yang bermakna antara KGDS sebelum dan setelah intervensi Reiki (p=0,000). Disarankan pemberian asuhan keperawatan menggunakan terapi komplementer Reiki dalam membantu mengatasi masalah kesehatan pasien.

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Reiki therapy is one of the complementary therapy that is used to decrease blood glucose level of Type 2 Diabetes Mellitus patient. The therapy employs nature energy which was transferred into patient body to synchronize the imbalance energy in the body. This research was aimed to examine the effect of Reiki in decreasing blood glucose level of patient with Type 2 Diabetes Mellitus at Diabetes Club in Medical Rehabilitation Instalation Fatmawati Hospital, Jakarta. Research design in this study was pre-experimental with the one-group pretest-posttest design (before and after). Purposive sampling technique was employed in sample selection and 18 patients participated in this study. Reiki therapy was performed in two methods, directly and by distant healing, which is done for 30 days. The therapy was conducted by the researcher and helped by Reiki practitioner, especially in the energy transferring. To measure blood glucose level glucometer was instrument. The result revealed that there was a significant difference in casual blood glucose levels before and after Reiki intervention (p=0,000). It is recommended to employ Reiki as a complementary therapy in nursing care."

"Tingkat kepatuhan diet di Indonesia rata-rata masih rendah. Diet dalam menjaga makanan seringkali menjadi kendala karena masih tergoda dengan segala makanan yang dapat memperburuk kesehatan. Tujuan dari penelitian ini adalah untuk mengetahui faktor-faktor yang berhubungan dengan kepatuhan diet pada penderita diabetes melitus tipe 2. Penelitian ini menggunakan disain cross-sectional. Sampel yang diteliti adalah seluruh penderita diabetes melitus tipe 2 dengan rentang usia 25-65 tahun yang sedang rawat jalan, sampel diambil dengan metode non-random sampling dengan teknik purposive sampling sebanyak 130 orang. Pengumpulan data dilakukan melalui pengukuran antropometri, pengisian kuesioner, form food recall 1x24 jam dan semiquantitative food frequency questionnaire (SFFQ). Hasil penelitian menunjukkan sebanyak 13,8% responden yang patuh diet. Hasil uji chi-square menunjukkan ada hubungan yang bermakna antara kepatuhan diet diabetes melitus tipe 2 dengan jenis kelamin (p=0,008) dan lama menderita (p=0,044). Hasil uji regresi logistik menunjukkan lama menderita merupakan faktor dominan yang berhubungan dengan kepatuhan diet diabetes melitus tipe 2. Penderita diabetes melitus diharapkan untuk memperhatikan pola makan yang dianjurkan dan melaksanakannya dengan baik, mampu secara aktif untuk meningkatkan pengetahuannya terkait penyakit diabetes melitus dan faktor-faktor terkait lainnya dan tetap mempertahankan pola makan yang sudah dijalankan bagi yang sudah lama menderita diabetes melitus tipe 2.

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The level of dietary adherence in Indonesia is still low. Diet in maintaining food is often become an obstacles because the patient is still tempted by all food that can worsen their health. The purpose of this study is to determine the factors that associated with dietary adherence in type 2 diabetes mellitus patients. This study was using a cross-sectional design. The samples studied were all type 2 diabetes mellitus type 2 with the age range 25-65 years was outpatient, samples were taken with non-random sampling method with purposive sampling of 130 people. Data were collected through anthropometric measurements, filling-out questionnaires, 1x24 hour food recall and dan (semiquantitative food frequency questionnaire) SFFQ form.

The results showed 13.8% of respondents were diet-compliant. There were significant relationship between gender (p=0.008) and length of suffering (p=0.044) with between dietary adherence. The result of logistic regression test showed that the duration of suffering is the dominant factor associated with dietary adherence in type 2 diabetes mellitus patients. Type 2 diabetes mellitus patients were expected to pay attention to the diet recommended and carry it out well, to actively to improve the knowledge related to the disease diabetes mellitus and related to the other factors and still preserve diet that has been run for who has long been suffering from type 2 diabetes mellitus."