Damhudi, Dedi and Kertia, Nyoman and Effendy, Christantie (2021) The effect of modified diabetes self-management education and support on self-care and quality of life among patients with diabetic foot ulcers in rural area of indonesia. Open Access Macedonian Journal of Medical Sciences, 9. 81 – 87. ISSN 18579655
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BACKGROUND: Diabetes self-management education and support (DSMES) programs are patient-centered, holistic solution that enables it one of the best approaches for improving medication adherence enhanced coping, empowerment and self-efficacy, quality of life (QoL), and lower rates of depression, in people with type 2 diabetes mellitus (T2DM). In isolation, DSME strategies have not shown significant improvements to self-care and/or reduction of diabetic foot ulcer (DFU). AIM: This study sought to determine the effect of modified DSMES on self-care, DFU severity, and QoL in rural Indonesian patients with DFUs. METHODS: A quasi-experimental design with pre-test and post-test control group design, in Singkawang, West Kalimantan, Indonesia, with a total sample of 60 patients consisting of 30 patients in the intervention group and 30 patients in the control group. The DSMES has been adapted to cover 2 h of content for a period of 8 weeks and the eight-core components of DSMES. The curriculum was culturally adapted revised to incorporate culturally appropriate nature similarities, such as a prominent change to represent changes in glucose counts; to incorporate photos; to incorporate culturally relevant eating habits, such as fish and fruit; to communicate in detail the significance of medication adherence, with an emphasis on metformin’s organic, plant-based characteristics; and to emphasize engagement. Intention-to-treat analyses were conducted to determine the effect of modified DSMES on self-care, DFU severity, and QoL. RESULTS: The DSMES program improved outcomes in three of the three outcome indicators when compared to the control group at T1: In this study, (1) the DFU degree increased by 3.3 points (95 confidence interval CI: 0.018–0.194), (2) the diabetes foot self-care behavior score increased by a modest 8.8% points (95% CI: 0.021–0.203), and (3) the QoL increased by 32.7% points (95% CI: 00.075–0.689). The degree of DFU (difference-in-difference DID coef. 0.350, 95% CI 0.084–0.572), diabetes foot self-care behavior (DID coef. 0.085, 95% CI 0.065–0.405), and QoL (DID coef. 0.343, 95% CI 0.078–0.436) are all still significantly improved compared to the control at T2. CONCLUSION: The primary outcome analyses indicate that the adapted DSMES was more effective than standard care at improving self-care and QoL and decreasing DFU degree in this sample of Indonesians with DFU, both immediately after and 3 months after the intervention. As nurse educators, it is our responsibility to ensure that we evaluate all of the support options accessible to the patients in our care. © 2021 Dedi Damhudi, Nyoman Kertia, Christantie Effendy.
Item Type: | Article |
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Additional Information: | Cited by: 5; All Open Access, Gold Open Access |
Uncontrolled Keywords: | insulin; adult; Article; controlled study; diabetes education; Diabetes Foot Self-Care Behavior Scale; diabetic foot; female; glucose blood level; human; human experiment; intervention study; male; non insulin dependent diabetes mellitus; pretest posttest design; quality of life; quasi experimental study; scoring system; self care |
Subjects: | R Medicine > RB Biomedical Sciences |
Divisions: | Faculty of Medicine, Public Health and Nursing > Public Health and Nutrition |
Depositing User: | Sri JUNANDI |
Date Deposited: | 25 Sep 2024 03:30 |
Last Modified: | 25 Sep 2024 03:30 |
URI: | https://ir.lib.ugm.ac.id/id/eprint/4695 |