Factors Associated with Adherence to Blood Glucose Test Among Diabetes Mellitus Patients at Prof
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Indonesian Journal of Medicine (2016), 1(1): 12-19 https://doi.org/10.26911/theijmed.2016.01.01.02 Factors Associated with Adherence to Blood Glucose Test among Diabetes Mellitus Patients at Prof. Dr. W. Z. Johannes Hospital, Kupang Dessy Nelciani Timuneno, Deviarbi Sakke Tira, Imelda F. E Manurung Epidemiology and Biostatistics, School of Public Health, Nusa Cendana University, Kupang ABSTRACT Background: Blood glucose level test for the Diabetes Mellitus patients is a procedure to monitor blood glucose level control and early detect complication of the disease. This study aimed to investigate the factors associated with adherence to blood glucose test among diabetes mellitus patientsat Prof. dr. W. Z. Johannes Hospital, Kupang. Subjects and Method: This was an analytic study withcross sectional study. A total of 93 Diabetes Mellitus patientswho had attended Internal Medicine Clinic at Prof. dr. W. Z. Johannes Hospital, Kupang, for at least 10 years, were sampled for this study. This sample consisted of 45 patients who adhered and 48 patients did not adhere to blood glucose test. Association of variables under study was analyze by chi square test. Results: There is a positive but weak relationship between adherence to blood glucose test and distance to health care facility (C=0.28; p=0.005), as well as family support(C=0.21; p=0.043). Conclusion: the health care authority should consider providing health care service for diabetes mellitus patients as close as possible to their home. In addition families of the patient are suggested to support their family members with diabetes mellitus in controlling blood glucose regularly. Keywords: adherence, blood – glucose level, diabetes mellitus. Correspondence: Dessy Nelciani Timuneno. Epidemiology and Biostatistics, School of Public Health, Nusa Cendana University, Kupang. BACKGROUND have diabetes. Number of people with Diabetes Mellitus (DM) or diabetes is a diabetes will increase over 300 million in condition of excessive glucose in the blood, 2025 because it is influenced lifestyle of the caused hormone secretion interference world that will have an impact on the called insulin (too little insulin or an in- quality of human resources and increased effecttive insulin). Insulin is produced by health cost. According to data estimates IDF the pancreas gland and controls the entry of (International Diabetes Federation), presen- glucose into the cells, and converts glucose ted data numbers of diabetes cases in into energy for the needs of normal cells. Indonesia based on the results of the survey Diabetes Mellitus is a metabolic disease that in 2008 ranks fourth highest in the world is associated with the pancreas gland, after China, India and the United States of occurs when excess blood glucose cannot 8.4 million jiwa. This number is expected to enter the body's cells as a result glucose rise to 21.3 million in 2030. According to builds up in the blood and then excreted Dr. Paul Zimmert, director the International through the urine. Diabetes Institute in Victoria, United fore- World Health Organization (WHO) sees that DM would be the most devastating estimates that 177 million people worldwide epidemic in human history. 12 e-ISSN: 2549-0265 (online) Timuneno et al./ Factors Associated with Adherence Based on data obtained from Prof. dr. one closely related to the behavior to be ta- Z. W. Johannes hospital, Kupang recorded ken, because knowledge patients have rea- number of people with diabetes in 2010 as son and basis for determining an option. in 2827, the year 2011 as many as 3093 Cognitive domain knowledge is very impor- people, while in January 2012 - September tant for the formation of a person's actions 2012 as many as 1421 people. Poly DM data or behavior. DM patients knowledge helps in the number of cases recorded in 2010 as people with diabetes treatment during their in 1846 with a history of old cases 96.21%, life. in 2011 as many as 2317 cases with long case More and more people understand the histories 91.58%. While in the year 2012 was disease, so the patients to better understand recorded as many as 3147 DM patients with how to alter their behavior and why it was a history of old cases as much as 97.52%. necessary. Results of research conducted The total cases who have experienced Semana (2011) at the General Hospital of complications (781 patients), i.e. 14.34% of Makassar Baji Labuang in 43 respondents neurological function, hypertension 76.56%, showed a significant relationship between 5.12% impaired renal function, stroke the level of knowledge about the disease and 0.38% and others 3.60%. complications of patients with patient treat- Most of DM patients not aware they ment compliance measures. were being targeted by a great danger. This Patient education is generally regard- is because gesture DM sometimes appears ed as an important component of diabetes as a symptom that can be considered as a management. However, analysis of the role matter of course. Whereas three character- of education and knowledge in the control ristics of diabetes that need to be aware of diabetes is still limited. Patients who have when they appear simultaneously in an a good knowledge of diabetes, but a change unnatural thirst, frequent urination and in the control of diabetes and other clinical weight loss with unclear reason5. parameters are not necessarily followed. Diabetes Mellitus including diseases Family is an important role in deter- cannot be cured, that may be done to con- mining how or nursing care required by trol so that the sufferer can maintain their patients at home so it will decrease the re- quality of life. By knowing the symptoms of currence rate of 10. The study states that the Diabetes Mellitus early disease control family has a strategic function in reducing efforts can be done to prevent other compli- the recurrence rate, improve the inde- cations. One management in patients with pendence and quality of life and patients are DM is check blood glucose levels through la- able to readapt to society and social life 11. boratory tests for diagnosing and moni- DM disease prevention efforts through toring of the incidence of specific compli- examination of blood glucose levels are cations can arise as a result of the DM carried by each patient is different so it is disease. DM complications arise acutely or one of the factors causing the high rate of occur suddenly and also chronic or slowly as complications. It can be seen from the result of DM is not controlled well and pro- number of Poly DM patients at hospitals longed. Prof. dr. Z. W. Johannes hospital, Kupang Attempt to keep blood glucose close to every year. It also had number patient normal also depends on the knowledge of complications cases with quite high and people about the disease. Knowledge some- most patients with complications of long e-ISSN: 2549-0265 (online) 13 Indonesian Journal of Medicine (2016), 1(1): 12-19 https://doi.org/10.26911/theijmed.2016.01.01.02 lines. Therefore, it is important to know the RESULTS causes in order to control and prevention of Prof. dr. Z. W. Johannes hospital, Kupang is diabetes that do work effectively so as to the referral hospital of type B non-edu- prevent complications. Based on the above cation, belonging to the Provincial Govern- description, researchers interested in con- ment of East Nusa Tenggara (NTT), which ducting research with the title: "Factors have health care for the whole society. It has associated with noncompliance with Diabe- a land area of 51670 m2 and a building area tes Mellitus in examinations of blood glu- of 42418 m2. cose levels at Prof. dr. Z. W. Johannes hos- To support the health service Prof. dr. pital, Kupang in 2013 ". Z. W. Johannes hospital, Kupang provide The research objective was to deter- various facilities for the needs of medical mine the relationship of education, know- services. Staff data of Prof. dr. Z. W. ledge, distance health services and family Johannes Hospital, Kupang, consisting 999 support to non-compliance with DM in Civil Servants (PNS) and 178 non-Civil examinations of blood glucose levels. Servants / honorary staff. DM education Polyclinic opened on SUBJECTS AND METHOD April 15, 2008. The number staffs in Poly This type of research was analytic survey DM Educational is one general practitioner, with cross sectional design where the de- one D3 nurse, one D4 nutritionist. pendent and independent variables obser- Poly Educational DM Schedule every ved at the same time12. Saturday include: 1) Counseling held on This study was conducted at Prof. dr. Saturday in the first week in every month, 2) Johannes W. Z. hospital, Kupang on out- Sport/ gymnastics was held on Saturday in patient in Poly Diabetes Mellitus which was the second week, 3) Counseling resumed on patients who suffer diabetes ≤10 years old, Saturday in the third week, 4) Sports/ with 93 patients were taken using purposive gymnastics continued on the Saturday in the sampling technique. Data collection was fourth week. using a questionnaire (education, know- Blood pressure and weighed patients ledge, distance to health services and family who come to Poly DM Education will be support). The research was conducted for measured. The nurse then records the one month, April 2013 to May 2013. complaints of patients, the results of Processing data using SPSS program balanced body weight and blood pressure with chi square analysis methods and sub- measurements as well as the results of sequently presented in table and narration. laboratory tests on the patient status. DM Univariate analysis was used to patients are going to the doctor for checkup, describe the characteristics of the respon- given advice, prescriptions and laboratory dent in a frequency distribution table.