ABSTRACT
Background: Type 1 diabetes mellitus (T1DM) is the most common chronic disease in children, with several severe short and long-term complications. Glycemic control is an important aspect of diabetes management with the most influential factor being compliance with self-monitoring blood glucose (SMBG). Mostly, in Indonesia, the finger stick devices as a glucose monitoring tool were frequently used. About 20% of children follow the recommendation to measure blood glucose four to six times daily. Methods: This is a single center, cross-sectional study that was conducted between July-November 2022. The Population is children with T1DM at the Pediatric Outpatient Clinic of Dr. Soetomo Hospital, Surabaya, Indonesia. Children with T1DM aged 4-18 years were enrolled using consecutive sampling. A compliance questionnaire was used to assess SMBG. Psychosocial conditions were assessed using the Pediatric Symptom Checklist 17, and medication adherence was evaluated using the Adherence to Refills and Medications Scale for Diabetes (ARMS-D). Pearson correlation and linear regression were employed for statistical analyses using Statistical Package for Social Sciences version 21.0, with p < 0.05 indicating statistical significance. Results: A total of 36 children were included in this study. SMBG frequency over 4x per day was significantly associated with increased medication adherence as measured by the ARMS-D score (p = 0.012). Higher SMBG frequency was also correlated with decreased HbA1c (p = 0.014, r = 0.406) and nutritional status (p = 0.031, r = 0.360). Less than 50% of the patients in Indonesia adhered to the recommended guidelines for SMBG (ie, ≥4 times per day). Conclusion: Higher SMBG frequency was correlated with better glycemic control. This finding suggests the need for further support in conducting SMBG based on the national guideline. However, due to it being conducted in a single center, we suggest increasing the sample size or conducting multi-centre collaborations in future studies. Originality/Value: By specifically investigating the relationship between adherence to self-monitoring of blood glucose (SMBG) and glycemic control in children with type 1 diabetes mellitus (T1DM), our study represents a novel contribution to the field of pediatric diabetes management in Indonesia. While previous research has explored similar relationships in other populations, our study focuses exclusively on the unique context of Indonesia, where rates of adherence to SMBG in pediatric patients have not been well studied and are relatively low compared to global standards.
ABSTRACT
BACKGROUND: Three medical schools in Indonesia have been collaborating in evaluating the learning process in the current curriculum by administering a collaborative progress test (cPT). The 120 multiple choice questions for cPT was developed by the three schools. This study aimed to assess the validity and reliability of the cPT as a part of curriculum evaluation. METHOD: The cPT was administered to year 1-5 students. A stratified random sampling based on the student Grade Point Average (GPA) was performed. The construct validity was established by assessing the accordant increase of mean score of cPT to the student year level. Finally, the reliability of the cPT was calculated using Cronbach Alpha coefficient. RESULT AND DISCUSSION: A total of 223, 219 and 161 year 1 to 5 students completed the cPT in FM UI, FM UNAND, and FM UNS, respectively. The content and construct validity of the cPT were evident. There was an increase of the mean score from year 1 to 5, either in the pooled data (one way ANOVA F 174.7(4), p < 0.001) and in each school (one way ANOVA FMUI F 102.5 (4) p < 0.001, FM UNAND F 83.0 (4) p < 0.001, FM UNS 28.28(4) p < 0.001). The internal consistency of the cPT was very good in the three institutions. CONCLUSION: The cPT was proven to be a valid and reliable test to measure the increase of knowledge of medical students and was also useful to provide feedback for curriculum evaluation in the three medical schools. Further improvement is required in assuring the test blueprint and the content of the test items.
