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

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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Abstract

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
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

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