J. Appl. Environ. Biol. Sci., 8(4)83-87, 2018 | ISSN: 2090-4274 |
© 2018, TextRoad Publication | Journal of Applied Environmental and Biological Sciences |
www.textroad.com |
1STIKesKaryaHusadaKediri,Kediri,Indonesia 2STIKesInsanSeAgungBangkalan,Bangkalan,Indonesia 3STIKesWiraMedikaBali,Denpasar,Indonesia
Received: November 26, 2017 Accepted: February 18, 2018
Resiliencyof efficacy means the abilityofaperson to rise from adversitythatoccurs in theproblems thatoccur in his life especially if the patient Diabetes Mellitus who must maintain blood sugar levels for life so that no complications occur.The goal of this research is to analyze the factors related to resiliencyof efficacyDiabetes Mellitus Patient's. The design of this study was explanatory with cross sectional approach. Sampling technique used purposive samplinggot100 respondents.Data collectedbyusingquestionnaire and analyzed with multiple linear regression (α = 0.05). The results show that the majority of respondents Diabetes mellitus obtained that 31%ofrespondentshaveaged60to70 yearsandhasfemalegenderof65%.Thisresults acquiredlong suffering Diabetes Mellitus atmostfor3-5 years.Respondentsget information aboutDiabetesMellitusdiseaseas much as 44%. For adherence to the medication as much as 54% have good adherence to treatment. While in the management ofDiabetes mellitus dietary, consider halfof respondentshavediet according to DiabetesMellitus. Based on the results as well as 52%have good adherence to activity management. The majority of respondents Diabetes mellitus captures high resiliencyof efficacy. The multiple linear regression test analysis obtained there are influence ofresiliencyofefficacywithgender, education information aboutdiabetes,long sufferingdiabetes mellitus, medication obedience, dietary adherence and activity adherence in Diabetes Mellitus Patients. The ResiliencyofefficacyDiabetesmellitusneedstobeimprovedbyprovidingsupporttopatientswhocandofamily andcommunity,sothatpatientsareabletoachieveagoodqualityoflife. KEYWORDS: resiliency,efficacy,factor,DiabetesMellitus.
DiabetesMellituspatientsneed ahigh commitmentto thediseasebecausetheyhaveto maintain blood sugar levels to remain stable. This resulted in Diabetes Mellitus patients falling on conditions that make him must continue to maintain blood sugar so that it can become a burden in his life. This triggers the patient to experiencepsychologicalburdensother than thepatienthaving to takemedication forhisillness.Psychological problems in Diabetes Mellitus patients can exacerbate metabolic disorders either directly through hormonal stressor indirectlythroughpoor compliance.Thisconditionneedstobedoneeffectivehandlingsothatpatients areabletoperformthemanagementofDMdiseasetopreventtheoccurrenceofcomplications[1].
Based on the results of Basic Health Research 2013 mentioned an increase in prevalence in patients withDiabetes Mellitus who obtained the number ofpatients from the proportion ofDiabetes Mellitus 5,7% to 6,8%[2]. Riskesdas reported that people with diabetes mellitus in East Java province as much as 2,1% . Data fromRiskesdasEastJava,DiabetesMellitusranked6thwith5.8%inruralareas.Basedonpreliminarystudyon KediridistrictsthathaveDiabetesMellitusdiseasein2016asmuchas16760and2017untilAugustasmuchas 2923.
Resiliencyisneededbytheindividualforhisabilitytosurviveandriseagainsothathecanfeelhappyagain after going through unpleasant issues in his life. Resiliency of efficacyis needed byindividuals in adapting to the problemsofdiseasetobecomeabetterindividualinordertomanagethediseaseDiabetesMellitus.BasedonNuari, managementofDiabetesMellitusistoencouragepatientstotakegreaterresponsibilityfortheircare,and toperform self-care[3].PatientssufferingfromDiabetesMellitusdiseasehaveagreatresponsibilitytoregulatetheirbehaviorto alwayscontroltheirbloodsugar.
Resilienceisinfluencedbymanyfactors.Inconductingeducationtothepatient,thenursemustpayattention to thephysical andpsychologicalaspectsofthepatient.Psychological supportto thesepatients isveryimportant in formingself-resiliencyinsolvingproblems.Thenursemustbeabletomediatethepatient'sconditionbybalancingthe
Nuari et al., 2018
physicalconditionandpsychologicalconditionofthepatient[4].
In the management of Diabetes mellitus there are several focus that must be implemented include the
treatment,diet,physicalactivity,andbloodglucoseexaminationperiodically.Thismustbedonebydiabetesmellitus
patientduringhislife.ThereforeitisnecessarytoanalyzetheresilienceofefficacyofpatientswithdiabetesMellitus
has arelationship with adherence in the management ofDiabetes mellitus. This research aims to identify factors
affectingtheresilienceofefficacyinDiabetesMellitusinKediri.
The design this research was explanatory design with cross sectional approach. The population in this study were Diabetes Mellitus Type II patients without complications of diseases such as kidney failure and heart failure. Sample in this research waspartpatientofDiabetes Mellitus Type IIbyusingpurposive sampling with 100 respondentsinKediri.Thedependentvariables isresilienceofefficacy.Whiletheindependentvariablesin this study are gender, education information diabetes mellitus, long suffering diabetes mellitus, medication obedience, dietary adherence and activity adherence. Research instruments for independent and dependent variables using questionnaires. Data collection was conducted at 2017 in Kediri. Data were analyzed with multiplelinearregressiontest(α=0.05).
Table 1. Analysis of Variable
Variable | Characteristic | N | % |
---|---|---|---|
Age | 30-40 | 6 | 6 |
41-50 | 25 | 25 | |
51-60 | 27 | 27 | |
60-70 | 31 | 31 | |
>70 | 11 | 11 | |
Gender | Male | 35 | 35 |
Female | 65 | 65 | |
LongSufferingDiabetes Mellitus | 1-3 years | 50 | 50 |
3-5 years | 23 | 23 | |
5-8 years | 22 | 22 | |
8-11years | 5 | 5 | |
• 11years | 0 | 0 | |
Education InformationaboutDM | Ever | 44 | 44 |
Never | 56 | 56 | |
MedicationObidience | Obidience | 54 | 54 |
NotObidience | 46 | 46 | |
DietaryAdherence | Adherence | 50 | 50 |
NotAdherence | 50 | 50 | |
ActivityAdherence | Adherence | 52 | 52 |
NotAdherence | 48 | 48 | |
ResiliencyofEfficacy | High | 51 | 51 |
Low | 49 | 49 |
Source:dataanalysis,2017
Based on the above data obtained that 31 people (31%) of respondents have aged 60 to 70 years, and the majorityofrespondentsDiabetesmellitushas femalegender of65 respondents.Basedontheaboveresultsobtained long suffered DM at most for 3-5 years. Respondents get information about Diabetes Mellitus disease as much as 44%.For adherencetothetreatmentofDiabetesmellitusdiseaseasmuchas54%havegoodadherencetotreatment.
84
J. Appl. Environ. Biol. Sci.,8(4)83-87,2018
For adherenceto thedietobtainedhalfofrespondentstodietaccording to DiabetesMellituspatients. Based on the resultsalsoobtainedasmuchas52%havegoodadherencetomanagementactivities.ResiliencyofefficacyDiabetes MellitusPatientsobtained51respondentshavehighresiliency.
Model Sum of Square Freedom of Average F count Significant value degree Square
Based on the result, dependent variable is resiliency of efficacy. The predictor variable is gender, education informationdiabetesmellitus,longsufferingdiabetesmellitus,medicationobedience,dietaryadherence and activity adherence. Based on Durbin-Watson score can be concluded this research suitable with multiple linear regression model. The data above it can be seen that the significance value of 0.000 is lower than the alpha of0.05, it can be concluded thereareinfluenceinthismodel.
Table 4. Data Analysis
Model | Significant value |
Constant | 0.047 |
Gender | 0.016 |
Education information Diabetes Mellitus | 0.000 |
Long Suffering | 0.035 |
Medication Obidience | 0.027 |
Dietary Adherence | 0.018 |
Actvity Adherence | 0.015 |
Thetableaboveshowssignificancebelow0.05 then this gender,educationinformationdiabetesmellitus, long sufferingdiabetes mellitus, medication obedience,dietaryadherence and activityadherencehave correlation withresiliencyofefficacyinDiabetesMellitusPatients.
DISCUSSION
ThemajorityofDiabetesMellituspatientsarebetween60and70 yearsold and27%have51 to60 years of age. This is in accordance with research that Diabetes Mellitus disease suffered by many elderly people. Patients who have Diabetes mellitus have low sensitivity to insulin. With the passage of age can affect the sensitivityofinsulinreceptorstobelessgood.However,Nuari's(2015)studiedthatgenderhasnorelationship to self-empowerment,incontrasttotheresilienceofefficacy[5].
Basedontheresearchfoundthatasmanyas35womenrespondentshaveahighresiliencyofefficacy.This is an important note for nurses who will educate patients need to provide a psychological approach to provide supportforbetterpatientresilience.Psychologicalapproachisveryimportanttoimprovepatientconfidencesothat canadaptinmanagingthedisease[4].
Basedontheresearchfoundthatasmanyas11respondentshavehighresilienceofefficacywiththeperiod ofDiabetesdiseasemellitumellitufor2yearsand6years.Thissuggeststhatlongsufferingalsocontributestothe resiliencelevelofDiabetesMellituspatients. Long sufferingDiabetes can be thebenchmark of aperson whether
Nuari et al., 2018
abletoadapttotheillnessexperienced.
Mellitus Patients
Based on the data of 39 respondents have received educational information about Diabetes mellitus disease. ItissupportedthattheeducationstrategytoDiabetesMellituspatientcan improvepatientunderstanding about the management of the disease[6]. Patients who have a good intellectual ability to understand something willaffecttheabilityofindividualacceptance.UnderstandingofthediseaseDiabetesmellituscanasmediationin improving thecomponentofresilience[7].
Based on this research, it is found that the majority of patients have good adherence to treatment. The
resultsofthestudywere37 respondentswho hadhighresilienceandhadgood adherenceto treatment.Thisisin
accordancewith the intervention doneto improvepatientresilienceresulting in thepatient'sblood sugar level to
becontrolled[8].ThisisalsosimilartoPark's(2010)studywhichstatesthatselfefficacyofpatientswithdiabetes
mellitusalsohasaneffectonadherencetotreatment.Thehighertheselfefficacythemoreobedientthepatientto
themanagementoftreatment[9].
The results also found that patients who have good medication adherence also have good knowledge.
ThisissuitablewithOmar'sstudy(2014)thatpatientswho haveagood cognitiveunderstandingofthetreatment
ofDiabetesMellitusdiseasehaveahighdegreeofadherenceto thetreatmentofthedisease[10].
Basedonthedatafoundthatasmanyas38patientswhohavehighresiliencyhaveadherencetodiet. Diet is important in the management ofDiabetes mellitus. Through good diet management able to stabilize the patient's blood sugar levels. Respondents with high resilience of efficacy are able to manage the diet in accordance with therecommendedportion. This is in accordance with research Ganiyu (2013) that the cause of dietadherencedueto thelackofpsychologicalsupportsothatcausedresiliencyofpatientstobelow[11].
Based on the data found that as many as 38 patients who have high resiliency have adherence to the implementation of regularlyactivities.Physical activitydone regularlycan improveblood sugar control. Patients whohavehighresiliencywillbefreefromstresssothatthedesiretoperformphysicalactivitiesforthebetter.This is in line with Qiu research (2012) that improving self efficacy and psychological support from families can supportDiabetesMellituspatientsto performcontinuousphysical activity[12].Physical activityis doneregularly also can reduce therisk ofDiabetesMellitusdisease,so thatphysical activitycanbeused as apreventiverisk of DiabetesMellitusdisease[13].
The results show that the majorityof respondents Diabetes mellitus obtained that respondents have aged 60 to 70 years and has female gender, long suffering Diabetes Mellitus at most for 3-5 years and respondents ever get informationaboutdiabetes mellitusdisease.Foradherencetothemedicationasmuchas54%havegood adherence to treatment. While in the managementofDiabetes mellitus diet, consider halfof respondentsto diet according to Diabetes Mellitus and 52% have good adherence to activity management. There are influence of resiliency of efficacywithgender,education informationaboutdiabetes,long sufferingdiabetesmellitus,medicationobedience, dietaryadherenceandactivityadherenceinDiabetesMellitusPatients.
1. American Diabetes Association. Diagnosis and Classification of Diabetes Mellitus. Diabetes Care [Internet]. 2011;34(Supplement_1):S62–9. Available from:
J. Appl. Environ. Biol. Sci.,8(4)83-87,2018
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3006051&tool=pmcentrez&rendertype=abstract%5 Cnhttp://www.ncbi.nlm.nih.gov/pubmed/9118500%0Ahttp://care.diabetesjournals.org/cgi/doi/10.2337/dc11S062
87