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Dikha Ayu Kurnia
"Penyandang DMT2 memiliki beban fisik dan psikologis pada status kesehatannya setelah menyandang DMT2, yang dapat mempengaruhi pencapaian HbA1c < 7% masih belum optimal. Oleh sebab itu, salah satu keberhasilan dalam mencegah komplikasi kronik adalah pengukuran kesadaran diri status kesehatan penyandang DMT2 yang berlangsung selama seumur hidup. Status kesehatan merupakan kondisi yang menggambarkan kesehatan baik secara fisik dan mental. Sayangnya, penyandang DMT2 belum dapat menilai dirinya sendiri dan memantau status kesehatan karena belum ada instrumen yang mudah dipakai dan digunakan sebagai alat evaluasi. Instrumen tersebut diperlukan untuk mengukur status kesehatan diri agar penyandang DMT2 dapat memperluas kesadaran dirinya sehingga akan terlibat aktif dalam perawatan kesehatan. Penelitian ini bertujuan mengembangkan instrument kesadaran diri status kesehatan. Penelitian dibagi menjadi tiga tahap, yaitu tahap pertama adalah pengembangan instrument; tahap kedua adalah uji validitas secara empirik; dan tahap ketiga adalah penormaan dan interpretasi instrumen. Tahap pengembangan instrumen terdiri dari validasi konstruk oleh 3 pakar, merancang instrumen, dan uji validitas isi rancangan instrumen oleh 6 pakar. Pada tahap uji validitas secara empirik, uji validitas konstruk melibatkan 602 penyandang DMT2 dengan komplikasi kronik. Hasil penelitian tahap 1 mendapatkan 100 butir pernyataan (CVI 1) mencakup 4 dimensi, yaitu kemitraan perawat, dialog, pola kesadaran diri, dan status kesehatan. Uji Confirmatory Factor Analysis (CFA) pada tahap dua menghasilkan 77 butir pernyataan yang fit unidimensional mengukur kesadaran diri status kesehatan. Tahapan ketiga menghasilkan skala dan skor kesadaran diri yang mudah dijumlahkan oleh penyandang DMT2 dengan terdiri dari kesadaran diri rendah (0-23), kesadaran diri sedang (31-57) dan kesadaran diri tinggi (58-77).

People with T2DM have a physical and psychological burden on their health status after having T2DM, which can affect the achievement of HbA1c < 7% is still not optimal. Therefore, one of the successes in preventing chronic complications is the measurement of self-consciousness of the health status of people with T2DM that lasts for a lifetime. Health status is a condition that describes health both physically and mentally. Unfortunately, people with T2DM have not been able to assess themselves and monitor their health status because there is no instrument that is easy to use and use as an evaluation tool. Instruments are needed to measure health status so that people with T2DM can expand their self-consciousness so that they will be actively involved in health care. This study aims to develop a self-consciousness of health status instrument. The research is divided into three stages, namely the first stage is instrument development; the second stage is empirical validity testing; and the third stage is instrument normalization and interpretation. The instrument development stage consists of construct validation by 3 experts, designing the instrument, and testing the content validity of the instrument design by 6 experts. In the empirical validity stage, the construct validity test involved 602 people with T2DM with chronic complications. The results of phase 1 research obtained 100 statement items (CVI 1) covering 4 dimensions, namely nurse partnership, dialogue, self-awareness patterns, and health status. Confirmatory Factor Analysis (CFA) test in stage two resulted in 77 unidimensional fit statement items measuring health status self-awareness. The third stage resulted in a self-awareness scale and score that is easily summarized by people with T2DM and consists of low self-awareness (0-23), moderate self-awareness (31-57), and high self-awareness (58-77)."
Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2023
D-pdf
UI - Disertasi Membership  Universitas Indonesia Library
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Wiwiet Nurwidya Hening
"Peran apoteker dalam upaya peningkatan kepatuhan pengobatan dan perbaikan luaran klinis pasien di Indonesia perlu dievaluasi. Penelitian bertujuan mengevaluasi pengaruh konseling apoteker terhadap peningkatan kepatuhan pengobatan, mengontrol kadar kontrol glikemik, profil lipid dan tekanan darah pasien DM tipe 2 di RSUD Kota Depok dari April-Oktober 2018. Penelitian dilakukan dengan desain kuasi-eksperimental dengan pretest-posttest pada 77 responden terdiri atas kelompok intervensi (KI) (n=39 orang) mendapatkan konseling dan buklet dari apoteker dan kelompok kontrol (KK) (n=38 orang) yang hanya diberikan buklet saja, dengan alat ukur Medication Adherence Questionnaire (MAQ) untuk kepatuhan, pemeriksaan darah untuk gula darah puasa (GDP), gula darah dua jam post prandial (GDPP), glycosylated hemoglobin A1 (HbA1c) dan profil lipid serta pengukuran tekanan darah. KI mengalami perbaikan parameter kepatuhan, HbA1c dan profil lipid sedangkan pada KK tidak ada perubahan yang bermakna pada parameter klinis bahkan mengalami peningkatan ketidakpatuhan (p=0,008) posttest dibandingkan pretest. Hasil uji beda rerata antara KI dan KK menunjukkan perbedaan bermakna pada parameter kepatuhan, GDP, GDPP dan HbA1c. Berdasarkan uji kai kuadrat, KI menunjukkan perubahan signifikan pada GDP (p=0,05) dan HbA1c (<0,0001) terkontrol dibandingkan KK. Hasil analisis multivariat, konseling apoteker memberikan pengaruh 2,0 kali (95% CI: 0,603-7,059) dan 3,5 kali (95% CI: 0,880-14,045) pada kondisi terkontrol GDP dan HbA1c. Hasil penelitian ini dapat disimpulkan konseling apoteker merupakan faktor yang mempengaruhi perubahan GDP dan HbA1c menjadi lebih terkontrol.

The role of the pharmacist to improve medication adherence and clinical outcome of patients in Indonesia needs to be evaluated. The study aimed to evaluate the effect of pharmacist counseling on improving medication adherence, controlling the level of glycemic control, lipid profile and blood pressure of type 2 DM outpatient at RSUD Kota Depok from April-October 2018. The study was conducted with quasi-experimental design with pretest-posttest on 77 respondents divided into intervention groups (IG) (n = 39 people) getting counseling and booklets from pharmacists and control groups (CG) (n = 38 people) who were given booklets only, with a MAQ questionnaire for medication adherence, blood tests for fasting blood glucose (FBG), post prandial blood glucose (PPBG), glycosylated hemoglobin A1 (HbA1c) and lipid profiles and blood pressure measurements. IG improved adherence parameters, HbA1c and lipid profile whereas in CG there were no significant changes in clinical parameters and even increased non-adherence (p = 0.008) on posttest. Mean Whitney test between IG and CG showed significant differences in parameters of medication adherence, fasting blood glucose (FBG), post prandial blood glucose (PPBG) and glycosylated hemoglobin A1 (HbA1c). Based on the chi square test, IG shows a significant change in controlled GDP (p = 0.05) and HbA1c (<0,0001) compared to CG. Based on multivariate analysis, counseling of pharmacists had an effect of 2,0 times (95% CI: 0,603-7,059) and 3,5 times (95% CI: 0,880-14,045) on changes in FBG and HbA1c. Pharmacist counseling is a factor that affects changes in FBG and HbA1c to be more controlled. "
Depok: Fakultas Farmasi Universitas Indonesia, 2018
T52327
UI - Tesis Membership  Universitas Indonesia Library
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Nanny Djaya
"International Diabetes Federation IDF pada tahun 2014 menyatakan penyandang DM yang berusia 20 -79 tahun sejumlah 8 dari seluruh penduduk Indonesia. Jali merupakan tumbuhan serealia yang mengandung 24,9 gram fruktooligosakarida dari setiap 100 gram bijinya. Perpaduan satu porsi yogurt jali yang terdiri dari 100 ml yogurt, mengandung probiotik Lactobacillus acidophilus dan Bifidobacterium masing masing sebesar 109cfu/mL, dicampur dengan 25 g jali rebus dapat menurunkan inflamasi epitel usus yang ditandai dengan penurunan kadar Calprotectine CP feses, meningkatkan kadar Glucagon Like Peptide-1 GLP-1 dan menurunkan resistensi insulin yang berperan dalam mengontrol kadar glukosa darah.
Penelitian ini menggunakan randomized controlled trial parallel group study, untuk menilai pengaruh pemberian yogurt dan yogurt jali selama 12 minggu pada 60 subjek penyandang DM tipe2 masing-masing sebanyak 30 subjek pada kelompok yogurt dan yogurt jali.
Didapatkan penurunan rerata BB p.

Background: International Diabetes Federation IDF in 2014 reported that diabetes mellitus prevalence in Indonesia were 8. Job`s tears is a cereal containing 24.9 grams of fructooligosaccharide per 100 grams of dry seed. The combination of one serving of yogurt with Job`s tears composed from 100 ml yogurt, containing Lactobacillus acidophilus and Bifidobacterium probiotics of 109cfu / mL each, mixed with 25 g of boiled Job`s tears could decrease the inflammation of the intestinal epithelium, decrease the oxidative stress and insulin resistance that will play a role in controlling blood glucose.
Method: This study used randomized controlled trial parallel group study to evaluate the effect of yogurt and yogurt with Job`s tears on FBG, GLP-1, CP and body weight in type 2 diabetes mellitus. The subjects in this study were 60 employees of Atma Jaya Jakarta with randomization block, each of 30 subjects in intervention yogurt with Job`s tears and control yogurt only groups.
Result: A reduced body weight p."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018
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UI - Disertasi Membership  Universitas Indonesia Library
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Imelda Wiradarma
"[ABSTRAK
Latar belakang: mengetahui hubungan antara asupan makronutrien dan gaya
hidup terhadap status HbA1c penyandang diabetes melitus (DM) tipe 2. Metode:
penyandang DM tipe 2 dikategorikan ke dalam 2 kelompok, yaitu kontrol
glikemik (KG) baik (HbA1c < 7,0) dan KG buruk (HbA1c > 7,0). Data
karakteristik dasar seperti usia, jenis kelamin, status gizi, durasi menderita DM,
jenis dan jumlah obat DM yang digunakan, serta ada/ tidaknya komplikasi DM
yang diderita. Asupan makronutrien terdiri dari asupan energi total harian, asupan
karbohidrat, protein, lemak dan serat. Faktor gaya hidup meliputi ketaatan
mengikuti diet sesuai yang direkomendasikan, aktivitas fisik, ketaatan konsumsi
obat, merokok dan minum alkohol. Data-data dari kedua kelompok kemudian
dihubungkan dengan status HbA1c dengan uji Chi square. Hasil penelitian: usia
penyandang DM yang lebih muda (< 55 tahun), asupan karbohidrat dan ketaatan
mengikuti diet berhubungan bermakna secara statistik dengan status HbA1c (P <
0,05). Rasio asupan makronutrien (karbohidrat, protein, lemak) pada kelompok
KG baik adalah 47: 18: 35 dan KG buruk 51: 16: 33. Kesimpulan : Hasil
penelitian ini menunjukkan bahwa status HbA1c berhubungan bermakna dengan
faktor usia, asupan karbohidrat, dan ketaatan mengikuti diet. Edukasi sebaiknya
diberikan kepada penyandang DM tipe 2 dengan KG buruk, terutama yang berusia
< 55 tahun agar mengatur pola makannya sesuai dengan yang direkomendasikan
dengan memperhatikan jenis, jumlah, dan jadwal.

ABSTRACT
Background: Determining the relationship between macronutrients intake and lifestyle
factors and HbA1c status of diabetic type 2 patient in improving the effectiveness of
patient?s nutrition therapy and preventing diabetes complications. Methods: Diabetic
type 2 patients were categorized into 2 groups; patients with good glycemic control (GC)
or HbA1c < 7.0 and patients with poor glycemic control (PC) or HbA1c > 7.0. Clinical
characteristics were differentiated by age, gender, body mass index (BMI), duration of
illness, type and amount of diabetic medication, and other diabetic complication.
Macronutrient intake consisted of total daily calories and carbohydrate, protein, fat and
fiber intakes. Lifestyle factors consisted of the adherence to dietary advice and
medication, physical activities, smoking habit, and alcohol intake. The data were be used
to determine their relationship with HbA1c status using Chi Square test. Results:
Younger diabetic type 2 patients (< 55 years old), carbohydrate intake, and adherence to
dietary advice were identified as statistically significant variables related to HbA1c status
(P <0.05). Macronutrient intake ratio (carbohydrate : protein : fat) for GC was 47 : 18 : 35
and PC was 51 : 16 : 33. Conclusions: The results demonstrate that HbA1c status in
diabetic type 2 patient are related to age, carbohydrate intake and adherence to dietary
advice. Education to be provided to younger diabetic type 2 patients (<55 years old) to
maintain good dietary pattern according to medical nutrition therapy, Background: Determining the relationship between macronutrients intake and lifestyle
factors and HbA1c status of diabetic type 2 patient in improving the effectiveness of
patient’s nutrition therapy and preventing diabetes complications. Methods: Diabetic
type 2 patients were categorized into 2 groups; patients with good glycemic control (GC)
or HbA1c < 7.0 and patients with poor glycemic control (PC) or HbA1c > 7.0. Clinical
characteristics were differentiated by age, gender, body mass index (BMI), duration of
illness, type and amount of diabetic medication, and other diabetic complication.
Macronutrient intake consisted of total daily calories and carbohydrate, protein, fat and
fiber intakes. Lifestyle factors consisted of the adherence to dietary advice and
medication, physical activities, smoking habit, and alcohol intake. The data were be used
to determine their relationship with HbA1c status using Chi Square test. Results:
Younger diabetic type 2 patients (< 55 years old), carbohydrate intake, and adherence to
dietary advice were identified as statistically significant variables related to HbA1c status
(P <0.05). Macronutrient intake ratio (carbohydrate : protein : fat) for GC was 47 : 18 : 35
and PC was 51 : 16 : 33. Conclusions: The results demonstrate that HbA1c status in
diabetic type 2 patient are related to age, carbohydrate intake and adherence to dietary
advice. Education to be provided to younger diabetic type 2 patients (<55 years old) to
maintain good dietary pattern according to medical nutrition therapy]"
2015
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UI - Tesis Membership  Universitas Indonesia Library
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Johanda Damanik
"Type 2 diabetes mellitus (T2DM) is strongly associated with lower performance on multiple domains of cognitive function and with structural abnormalities of the brain. With the growing epidemic of diabetes and aging population, neural complications of diabetes are expected to rise and becoming a challenge for future health implications. Understanding pathophysiology, factors associated with this complication, manifestation of cognitive impairment and various metabolic and neuroradiologic markers suggestive of this pathologic condition is crucial for proper management of this potentially debilitating complication of T2DM. This review will discuss briefly important aspects of cognitive impairment in T2DM."
Jakarta: University of Indonesia. Faculty of Medicine, 2021
610 UI-IJIM 53:2 (2021)
Artikel Jurnal  Universitas Indonesia Library
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Geby Hasanah Jorgy
"Diabetes melitus adalah penyakit metabolisme yang merupakan suatu kumpulan gejala yang timbul pada seseorang karena adanya peningkatan kadar glukosa darah di atas nilai normal. Penelitian ini bertujuan untuk mengetahui faktor risiko yang berhubungan dengan kejadian Diabetes Melitus Tipe 2 pada wanita dewasa di daerah perkotaan di Indonesia tahun 2013. Penelitian ini menggunakan data sekunder Riskesdas 2013 dengan desain studi cross sectional. Sampel adalah wanita dewasa di daerah perkotaan yang tidak hamil dan memiliki kelengkapan data sebanyak 122.880 responden.
Hasil penelitian menunjukkan prevalensi DM berdasarkan diagnosis dan gejala sebesar 2.2 % dan menemukan bahwa prevalensi DM tertinggi berada pada faktor risiko, seperti umur ≥ 45 tahun (5.2%), pendidikan rendah (3.1%), tidak bekerja (2.3%), status cerai (3.6%), aktfitas cukup (2.2%), mantan perokok (4%), jarang makan manis (3.8%) dan berlemak (2.3%), obesitas (2.9%), obesitas sentral (2.9%), dan hipertensi (7.6%). Faktor risiko DM yang memiliki hubungan paling dominan adalah umur ≥ 45 tahun (POR : 9.24; 95 % CI 7.69-11.1), status cerai (POR : 5.95; 95 % CI 4.85-7.30), dan hipertensi (POR : 5.10; 95 % CI 4.70-5.54). Untuk itu, perlu diadakan sosialisasi untuk program deteksi dini faktor risiko DM, serta perlunya kesadaran diri untuk cek gula darah secara teratur untuk wanita dewasa di daerah perkotaan.

Diabetes mellitus is a metabolic disease which is a collection of symptoms that occur due to an increase in blood sugar levels above normal. This study aims to determine the risk factors assosiated with type 2 diabetes mellitus in adult women in urban areas. This study used a data from Riskesdas 2013 and using cross sectional as design study. Samples were adult women above 18 living in urban areas who are nor pregnant and has complete data.
Result shows the prevalence of DM that based on diagnosis and symptoms is 2.2 % and the risk factors with highest prevalence of diabetes are age ≥ 45 (5.2%), low educated (3.1%), umemployed (2.3%), divorced (3.6%), enough activity (2.2%), former smokers (4%), rarely eat sweets (3.8%) and fatty foods (2.3%), obese (2.9%), central obese (2.9%), and hypertension (7.6%). The risk factors that highly associated are age ≥ 45 (POR : 9.24; 95 % CI 7.69-11.1), divorce (POR : 5.95; 95 % CI 4.85-7.30), and hypertension (POR : 5.10; 95 % CI 4.70-5.54). Therefor, screening for DM and self-awareness to check the blood sugar level are s strongly recommended among adult women in urban areas."
Jakarta: Universitas Indonesia, 2015
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UI - Skripsi Membership  Universitas Indonesia Library
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Kemas R. Notariza
"BACKGROUND: type 2 diabetes mellitus (T2DM) and gastroesophageal reflux disease (GERD) are commonly seen in the geriatric population. This study aimed to investigate the prevalence, risk factors, and alarm-symptoms incidence of GERD among elderly patients with T2DM in a rural area of Central Sulawesi. METHODS: this cross-sectional study was conducted from July-September 2019 in Public Health Center of Beteleme, Central Sulawesi. Patients aged ≥60 years old, newly or previously diagnosed with T2DM according to the 2019 American Diabetes Association (ADA) criteria or to the 2015 Indonesian Society of Endocrinology (PERKENI) criteria, were consecutively recruited. We excluded patients being on proton-pump inhibitor or H2-receptor antagonist therapy or having a history of gastric or esophageal surgery. GERD was diagnosed in patients with the score of ≥8 based on the Indonesian version of GERD questionnaire (GERD-Q). RESULTS: among 60 elders with T2DM, 28.3% (95% confidence interval [CI], 16.9-39.7) had GERD. Statistical analysis showed that GERD was significantly associated with consumption frequency of tea (p=0.019) and coffee (p=0.015). No significant relationship was found between gender (p=0.562), obesity (p=0.803), achievement of blood glucose-level control (p=0.478), duration of T2DM (p=0.304), and type of antihyperglycemic drugs (p=0.202) with GERD. Unintentional weight loss was the leading alarm symptom (47.1%; 95%CI, 23.4%-70.8%) found across the GERD group. CONCLUSION: GERD was prevalent among elderly patients with diabetes. Frequent consumption of either tea or coffee was associated with GERD. Alarm symptoms need further evaluation to screen for complications."
Jakarta: University of Indonesia. Faculty of Medicine, 2021
610 UI-IJIM 53:1 (2021)
Artikel Jurnal  Universitas Indonesia Library
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Anita Natasya
"Diabetes Melitus DM penyakit kronis yang membutuhkan terapi jangka panjang dan intervensi untuk adaptasi perubahan gaya hidup dan pengobatan untuk meningkatkan target terapi. Penelitian bertujuan mengetahui pengaruh konseling oleh apoteker pada perbaikan kepatuhan, kadar HbA1c dan kualitas hidup pasien DM tipe 2 di RSUD Kota Depok. Penelitian dilakukan dengan desain pretest-posttest control group design pada 81 responden dengan alat ukur pill count untuk kepatuhan, pemeriksaan darah untuk kadar HbA1c dan kuesioner EQ-5D-5L untuk kualitas hidup. Karakteristik sosiodemografi dan klinis responden DM tipe 2 di RSUD Kota Depok antara kelompok uji dan kontrol tidak terdapat perbedaan yang signifikan p>0,05 . Pasien kelompok uji menunjukkan peningkatan kepatuhan terapi, penurunan kadar HbA1c dan peningkatan kualitas hidup secara signifikan, sementara pada kelompok kontrol hanya kadar HbA1c peningkatan yang signifikan sementara kepatuhan dan kualitas hidup tidak menunjukkan perubahan yang signifikan. Kepatuhan terapi responden dipengaruhi oleh konseling apoteker secara signifikan. Kadar HbA1c responden dipengaruhi oleh kepatuhan terapi dan pola makan secara signifikan. Kualitas hidup responden berdasarkan nilai deskriptif dan nilai VAS dipengaruhi oleh kadar HbA1c secara signifikan. Hasil penelitian ini dapat disimpulkan konseling oleh apoteker menyebabkan perbaikan pada kepatuhan, kadar HbA1c dan kualitas hidup responden pasien DM tipe 2 di RSUD Kota Depok.

Diabetes Mellitus DM a chronic disease requiring long term therapy and interventions for the adaptation of lifestyle changes and medications to improve therapeutic targets. The aim of this research is to know the influence of counseling by pharmacist on improvement of adherence, HbA1c level and quality of life of DM type 2 patient in RSUD Kota Depok. The research was done by pretest posttest control group design design on 81 respondents with pill count methods for adherence, blood tests for HbA1c levels and EQ 5D 5L questionnaires for quality of life. Sociodemographic and clinical characteristics of DM type 2 respondents in RSUD Kota Depok between test and control group were not significantly different p 0,05 . Patients in the test group showed improved adherence to therapy, decreased HbA1c levels and improved quality of life significantly, while in the control group only HbA1c levels were a significant increase while adherence and quality of life did not show significant change. Adherence of respondents influenced by pharmacist counseling significantly. HbA1c levels of respondents is influenced by adherence of therapy and diet significantly. The quality of life of respondents based on descriptive value and VAS value influenced by HbA1c level significantly. The results of this study can be concluded by the pharmacist counseling led to improvements in adherence, HbA1c levels and quality of life of DM type 2 patients in Depok City Hospital. "
Depok: Fakultas Farmasi Universitas Indonesia, 2018
T51627
UI - Tesis Membership  Universitas Indonesia Library
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Dina Nurdiana
"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.

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."
Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2020
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UI - Skripsi Membership  Universitas Indonesia Library
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Malahayati Rusli Bintang
"Diabetes Melitus (DM) meningkatkan risiko terkena TB paru, terutama pada kelompok berisiko tinggi. Meskipun penemuan kasus secara aktif dan peningkatan pelaporan di fasilitas kesehatan sangat penting, namun keterlibatan sektor swasta dalam pengendalian TB masih rendah karena adanya fragmentasi dan dana yang tidak memadai. Sistem Informasi Tuberkulosis (SITB) adalah perangkat lunak utama untuk mencatat dan melaporkan kasus TB, namun aksesnya terbatas dan sistemnya tidak terintegrasi dengan baik. Untuk mengatasi tantangan ini, diperlukan e-screening tool untuk mengintegrasikan skrining TB ke dalam skrining diabetes yang ada saat ini secara efisien sehingga notifikasi TB di FKTP swasta dapat meningkat.
Penelitian ini menggunakan pendekatan mixed exploratory sequential, yang menggabungkan metode kuantitatif dan kualitatif secara bertahap. Penelitian ini terdiri dari 4 tahap.Di tahap pertama, dilakukan analisis faktor determinan TB pada pasien DM menggunakan data Riskesdas 2013 dan 2018. Lalu tahap 2 dilakukan analisis/evaluasi mengenai implementasi proses notifikasi TB pada FKTP swasta dan pada tahap 3, rancangan prototype e-screening tool. Pada tahap 4, uji coba protoype dilakukan di 2 di klinik di Jakarta Timur dan Jakarta Barat.
Hasil penelitian di tahap 1 menunjukkan bahwa variabel diagnosa penyakit kanker, riwayat merokok, ketersediaan rumah sakit swasta dan ketersediaan praktik dokter/klinik secara statistik memiliki hubungan yang signifikan terhadap kejadian TB pada pasien DM. lalu dari hasil uji multivariat diperoleh hasil bahwa kanker merupakan faktor prediktif pada kejadian penyakit TB paru pada penderita DM. hasil penelitian tahap 2 menunjukkan bahwa belum semua FKTP swasta memiliki SITB mandiri yang menyebabkan pencatatan dan pelaporan kasus TB menjadi temuan milik puskesmas dimana hal ini berdampak pada rendahnya notifikasi TB di FKTP swasta. Hasil penelitian tahap 3 dan 4 menunjukkan bahwa untuk meningkatkan notifikasi TB di FKTP swasta dapat dilakukan dengan merancang e-screening tool TB dengan pendekatan kaskade TB 6T.
Dengan mengintegrasikan JKN Mobile, E-RM, P-Care dan SITB dalam bentuk partner satu sehat, serta didukung dengan SDM, sarana prasarana dan pembiayaan yang cukup diharapkan dapat meningkatkan notifikasi TB di FKTP swasta sehingga dapat menurunkan angka kematian atau angka kesakitan akibat TB pada pasien DM.

Diabetes mellitus (DM) increases the risk of developing pulmonary TB, especially in high-risk groups. While active case finding and improved reporting at health facilities are critical, private sector involvement in TB control remains low due to fragmentation and inadequate funding. The Tuberculosis Information System (TBIS) is the primary software for recording and reporting TB cases, but access is limited and the system is not well integrated. To overcome these challenges, an e-screening tool is necessary to efficiently integrate TB screening into existing diabetes screening so that TB notifications at private primary care facilities can increase.
This study used a mixed exploratory sequential approach, which combines quantitative and qualitative methods in 4 stages. In the first stage, the determinants of TB in patients with DM were analyzed using 2013 and 2018 Riskesdas data. Then in stage 2, an analysis/evaluation of the implementation of the TB notification process at private primary care facilities was carried out and in stage 3, an e-screening tool prototype was designed. Stage 4 is the pilot study of protype being carried out in 2 private clinics, at East and West Jakarta.
The results of stage 1 of the study showed that the variables of cancer diagnosis, smoking history, availability of private hospitals and availability of TB screening in DM patients were significantly associated with TB screening in DM patients. The results of the multivariate test showed that cancer was a predictive factor in the incidence of pulmonary TB disease in patients with DM. The results of phase 2 of the study showed that not all private primary health care facilities have independent SITB, which causes the recording and reporting of TB cases to be the findings of the puskesmas, thus has an impact on the low notification of TB in private primary health care facilities. The results of phase 3 and 4, showed that improving TB notification at private primary care facilities can be done by designing a TB e-screening tool with a 6T TB cascade approach.
By integrating JKN Mobile, E-RM, P-care and SITB in the form of the intergrated system of Satu Sehat, and supported by sufficient human resources, infrastructure and financing, these allow room for a better national TB control management. In this light, TB notification rate has a good potential for improvements at private primary care facilities, and thus eventually contributing to a reduction of mortality or morbidity due to TB in DM patients.
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Depok: Fakultas Kesehatan Masyarakat Universitas Indonesia, 2024
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