[The effect of family caregiver empowerment interventions on family caregiver capabilities in self-management of type 2 diabetes mellitus in Indonesia]. / Efecto de las intervenciones de empoderamiento de los cuidadores familiares sobre las capacidades de estos para gestionar la diabetes mellitus tipo 2 en Indonesia.

OBJECTIVE: Empowering family caregivers is one of the strategies to increase the family caregiver's capability in T2DM self-management. The adequate capability of family caregivers in T2DM self-management can improve T2DM management, impacting people's health status with T2DM. This study aimed to examine the effect of family caregiver empowerment intervention on the family caregiver's T2DM self-management capability. METHODS: This study is an experimental study with a randomized control group pre-test post-test design. The sample size is 60 respondents by simple random sampling, which is divided into two groups randomly. The treatment group (n=30) received 10-session intervention in 10 weeks (six education and training sessions and four mentoring sessions), and the control group (n=30) received standard care. Data were collected using a questionnaire, twice, before and after the intervention (12 weeks after the last intervention session) and analysed descriptively and statistically (One way-ANOVA test, dependent t-test, and independent t-test). RESULTS: The empowerment intervention significantly increased the family caregiver's T2DM self-management capability, including diet management (t=4.070; p<.001), physical activity management (t=9.493; p<.001), medication management (t=4.021; p<.001), self-monitoring blood glucose levels (t=2.789; p<.001), and foot care skills (t=6.835; p<.001). CONCLUSION: Family caregiver empowerment interventions can improve the capability of family caregivers in self-management of T2DM, including increasing the capability to manage diet, physical activity, medication, self-monitoring blood glucose levels, and foot care. Nurses can empower family members as family caregivers to improve self-management of T2DM.

Efecto de las intervenciones de empoderamiento de los cuidadores familiares sobre las capacidades de estos para gestionar la diabetes mellitus tipo 2 en Indonesia / The effect of family caregiver empowerment interventions on family caregiver capabilities in self-management of type 2 diabetes mellitus in Indonesia

Objetivo: Empoderar a los cuidadores familiares es una de las estrategias para incrementar la capacidad de dichas personas en cuanto a autogestión de la DMT2. La capacidad adecuada de los cuidadores familiares en términos de autogestión de la DMT2 puede mejorar la gestión de esta, repercutiendo en el estatus sanitario de la persona. El objetivo de este estudio fue examinar el efecto de la intervención de empoderamiento del cuidador familiar sobre la capacidad de autogestión de la DMT2. Métodos: Se trata de un estudio experimental con un diseño de grupo control aleatorio pretest postest. El tamaño de la muestra es de 60 participantes por muestreo aleatorio simple, que se divide aleatoriamente en dos grupos. El grupo de tratamiento (n=30) recibió una intervención de 10 sesiones en 10 semanas (seis sesiones educativas y formativas y cuatro sesiones de tutoría), y el grupo control (n=30) recibió cuidados estándar. Los datos fueron recopilados utilizando un cuestionario, dos veces: antes y después de la intervención (12 semanas tras la última sesión de intervención), y fueron analizados descriptiva y estadísticamente (prueba ANOVA unidireccional, prueba t dependiente, y prueba t independiente). Resultados: La intervención de empoderamiento incrementó significativamente la capacidad de autogestión de la DMT2 por parte del cuidador familiar, incluyendo la gestión de la dieta (t=4,070; p<0,001), gestión de la actividad física (t=9,493; p<0,001), gestión de la medicación (t=4,021; p<0,001), automonitorización de los niveles de glucosa (t=2,789; p<0,001), y técnicas sobre cuidados de los pies (t=6,835; p<0,001). Conclusión: Las intervenciones de empoderamiento de los cuidadores familiares pueden mejorar la capacidad de autogestión de la DMT2 por su parte, incluyendo el incremento de la capacidad para gestionar la dieta, la actividad física, la medicación, la automonitorización de los niveles de glucosa, y el cuidado de los pies.(AU)

Objective: Empowering family caregivers is one of the strategies to increase the family caregiver's capability in T2DM self-management. The adequate capability of family caregivers in T2DM self-management can improve T2DM management, impacting people's health status with T2DM. This study aimed to examine the effect of family caregiver empowerment intervention on the family caregiver's T2DM self-management capability. Methods: This study is an experimental study with a randomized control group pre-test post-test design. The sample size is 60 respondents by simple random sampling, which is divided into two groups randomly. The treatment group (n=30) received 10-session intervention in 10 weeks (six education and training sessions and four mentoring sessions), and the control group (n=30) received standard care. Data were collected using a questionnaire, twice, before and after the intervention (12 weeks after the last intervention session) and analysed descriptively and statistically (One way-ANOVA test, dependent t-test, and independent t-test). Results: The empowerment intervention significantly increased the family caregiver's T2DM self-management capability, including diet management (t=4.070; p<.001), physical activity management (t=9.493; p<.001), medication management (t=4.021; p<.001), self-monitoring blood glucose levels (t=2.789; p<.001), and foot care skills (t=6.835; p<.001). Conclusion: Family caregiver empowerment interventions can improve the capability of family caregivers in self-management of T2DM, including increasing the capability to manage diet, physical activity, medication, self-monitoring blood glucose levels, and foot care. Nurses can empower family members as family caregivers to improve self-management of T2DM.(AU)

What I felt as a diabetes fatigue survivor: a phenomenology study.

Purpose: Diabetes has resulted in an increase in diabetic fatigue syndrome, which has a negative influence on health, particularly the risk of worsening quality of life (QoL) due to physical and mental limitations. The purpose of this study was to evaluate the experiences of patients with unregulated type 2 diabetes mellitus (T2DM) and diabetes fatigue syndrome. Methods: This study used a qualitative phenomenological design and focused on patients from four primary health centers (PHCs) in Surabaya, Indonesia with higher incidents of unregulated T2DM. Thirty participants were recruited using purposive sampling with the following inclusion criteria: adult T2DM patients, willing to participate in the study, and able to recount experiences associated with their illness. Data collection took place between April and June 2020 across 36 interview sessions. Semi-structured interviews were carried out face-to-face with each participant with the principles of social distancing applied due to the COVID-19 pandemic. Results: Analysis identified five themes and thirteen subthemes. The first theme was participants' experiences during blood glucose imbalance. Other themes included experiences of boredom with diet, physical and psychological distress, financial problems during treatment, and sexual problems. Conclusion: Participants with T2DM who experienced diabetes fatigue reported negative effects on their life, especially on health, functional daily activity, and finances. The results of this study can provide information for nurses and other healthcare providers to promote interventions for patients with T2DM, such as modifying lifestyle, self-acceptance, and self-efficacy.

Resilience-based Islamic program as a promising intervention on diabetes fatigue and health-related quality of life.

Psychological problems commonly experienced by patients with type 2 diabetes mellitus (T2DM) cause diabetes fatigue conditions that can further worsen the treatment prognosis. We conducted this investigation to determine the effectiveness of a resilience-based Islamic program on diabetes fatigue and health-related quality of life (HRQoL) by measuring the biochemical indicators of T2DM. This was a quasi-experimental study performed from May to August 2021, in which 80 respondents aged 18-64 years diagnosed with T2DM were included through purposive sampling at a male:female sex ratio of 1:1 in the control group and 17:23 in the treatment group. A resilience-based Islamic program (a combination of stress management, mindfulness, prayer, and dhikr (the ritual formula of Sufi brotherhood recited devotionally in praise of Allah and as a means of attaining ecstatic experience)) was implemented in the treatment group for six sessions by blended online and offline interventions. Multidimensional Fatigue Inventory-20 and World Health Organization Quality of Life, Brief Form were used to evaluate diabetes fatigue and HRQoL. Blood tests were performed to measure HbA1c, total antioxidant serum, insulin, cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol (LDL-c) levels from baseline to 3 months. Statistical analyses were conducted using paired t test, Wilcoxon signed-rank test, independent t test, and Mann-Whitney U test. The resilience-based Islamic program had a beneficial impact on the levels of HbA1c (p < 0.001), lipid profile (triglyceride) (p = 0.011), HDL-c (p = 0.01), LDL-c (p < 0.001), total antioxidant serum (p = 0.001), insulin (p < 0.001), diabetes fatigue (p < 0.05), and HRQoL (p < 0.05) in patients of the treatment group. The results of biochemical tests related to T2DM also indicated a reduction in diabetes fatigue and an increase in HRQoL due to the resilience-based Islamic program. Considering that a patient's resilience to diabetes is an important factor in the management of diabetes fatigue, the resilience-based Islamic program can be applied at public health centers and community levels to increase T2DM resilience.

A qualitative study exploring diabetes resilience among adults with regulated type 2 diabetes mellitus.

BACKGROUND AND AIMS: Type 2 diabetes mellitus (T2DM) patients often experience unregulated blood glucose due to the lack of resilience. The aim of this study was to explore diabetes resilience among adults with regulated T2DM. METHODS: This study used a qualitative case study design. A total of 15 participants with T2DM were recruited through snowball sampling. The study was conducted in four Health Primary Centers in Surabaya, Indonesia. The indicators of diabetes resilience were proper management of diet, activity, stress, and drugs. Interview guidelines were used to collect the data through in-depth interviews. The data were subjected to thematic analysis. RESULTS: In this study, the results identified four themes, namely, resilient, support, benefits, and self-care agency. These themes were found among the participants with a resilient condition and regulated blood glucose. CONCLUSIONS: Resilient, support, benefits, and self-care agency are the themes for achieving diabetes resilience by adults with T2DM. Policymakers and health workers need to consider health interventions for increasing the resilience of T2DM patients so that they can achieve a better glycemic control condition, and manage their diet, medication, activity and stress properly.

Depression and functional disability in stroke patients.

Background: Stroke patients often suffer from depression, a mental disorder that worsens their condition and slows down the recovery process. Depression is the leading cause of functional disability due to inability to cope with daily stressors and to function independently in their activities. The purpose of this study is to analyze the relationship between depression and functional disability levels in post-stroke patients. Design and Methods: This is an analytic observational research with a cross-sectional approach. The population in exam consisted of all 4-12 week post-stroke patient in the hospital (about 139 patients). The study focused on 104 respondents, who were selected using simple random sampling techniques. Results: The results show that 62.5% stroke patients suffered mild depressive episodes after the stroke while 58.7% experienced mild disabilities. Analysis results using the Pearson Product Moment Test obtained P=0,000. This shows there is a relationship between the level of depression and the degree of functional disability in post-stroke patients. Conclusions: It can be concluded that there is a significant relationship between the levels of post-stroke depression and the functional disability. Families are expected to provide a safe, supportive, and comfortable environment to lessen the level of depression.

Safety behaviour and healthy diving: a qualitative study in the traditional diverse fishermen.

BACKGROUND: Traditional divers from the Maluku Province of Indonesia have not received formal education and training related to standard diving tools. They only become accomplished at diving generation by generation. The use of non-standard diving tools increases the risk of injury and illness. This study aimed to get an overview of the health and safety behaviours of traditional divers. MATERIALS AND METHODS: The study was qualitative, involving 15 traditional divers who used compressors for at least 1 year and who'd had decompression sickness and barotrauma as a result of diving. The data was obtained through in-depth interviews, analysed through the Colaizzi method. RESULTS: The participants' diving health and safety behaviour is triggered by the perception of the risk of diving. This is supported by the reinforcing social and environmental factors leading to the form of health and safety behaviour when diving. These behaviours include diving without planning, using a compressor, and making "sesajen" (kind of food, leaves, and water that are believed to be a form of surrender to the creator) which is an offering or present to the gods or ancestors. This behaviour causes complaints such as trauma and an increased economic burden. Some participants consider complaints as a threat and plan to stop diving. The participants made a plan before dive and declared that they would change their behaviour to ensure safety. CONCLUSIONS: Health and safety behaviour related to diving must be socialised and facilitated. The establishment of a divers' community that cares about health and safety behaviour needs to become important as a support system.

Self-care model application to improve self-care agency, self-care activities, and quality of life in patients with systemic lupus erythematosus.

OBJECTIVES: This study aimed to examine the effect of the application of a self-care model to improve self-care agency (SCA), self-care operation, and quality of life (QoL) in patients with systemic lupus erythematosus (SLE). METHODS: This study employed a pre-experimental design with one pretest-posttest group. Thirty-six respondents were selected through total sampling. The experimental group was provided self-care management training, followed by four weekly home visits. Self-care agency was measured with the self-care agency scale, the other variables through self-rated abilities on the health practices scale and Lupus quality inventory. Data were analysed using paired t-tests with α < 0.05. RESULTS: SLE was common in actively working married women of childbearing age, most of whom had had SLE for 1-2 years (33.3%), with arthritis being the most common symptom (reported by 61.1%). The major flare trigger factor was physical stress (66.7%), resulting in fatigue. On average, the self-care model was able to improve SCA by 19.93%, self-care operation by 17.53%, and QoL by 12.19%. It was significantly effective in enhancing SCA, self-care operation, and QoL in patients with SLE (p < 0.001). CONCLUSIONS: The application of Orem's self-care model is effective in improving SCA, self-care, and QoL, and this study provides evidence of the benefits of its use in the nursing care of patients with SLE in a community setting. Health care providers should incorporate Orem's self-care model in nursing care to enhance SCA, self-care, and QoL in patients with SLE.