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"ABSTRAKDiabetes melitus merupakan penyakit metabolik dengan karakteristikhiperglikemia terjadi karena kelainan sekresi insulin, kerja insulin atau kedua?duanya. Pasien diabetes berisiko mengalami infeksi yang umumnya terlokalisir disaluran kemih. Penelitian bertujuan mengidentifikasi determinan infeksi salurankemih pasien diabetes melitus perempuan di RSB Bandung. Desain penelitiancross sectional dengan consecutive sampling didapatkan 60 sampel. Instrumenmenggunakan kuesioner, timbangan berat badan, alat pengukur tinggi badan, danhasil urinalisis. Hasil penelitian menunjukkan usia dan upaya pengendaliandiabetes melitus berhubungan dengan infeksi saluran kemih. Usia merupakandeterminan utama terjadinya infeksi saluran kemih pada pasien DM perempuan(nilai p 0.009, OR 16.3) setelah dikontrol riwayat infeksi saluran kemih. Perawatperlu melakukan pengkajian mendalam dan edukasi terkait faktor risiko dan upayapencegahan infeksi saluran kemih agar komplikasi dapat diminimalkan.

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ABSTRACTDiabetes mellitus is an endocrine disease characterized by hyperglycemia thatresult from defect in insulin secretion, or its action or both. Diabetes patient is atrisk to have infection that is commonly localized in urinary tract. This research isaimed to identify determinant of urinary tract infection of women diabetes patientin RSB Bandung. This research design is cross sectional with consecutivesampling and have 60 samples. Instruments used in this research are questionaire,weight scale, height scale, and urinalysis check result. The result of the researchshows that age and diabetes control effort related to urinary tract infection. Age isthe main determinant to urinary tract infection in women diabetes patient (p value0.009, OR 16.3) after being controled by urinary tract infection history. Nursesneed to held deeper assesment and education related to risk factors and an effort toprevent urinary tract infection in order to minimize the complication."

"ABSTRAKSetiap tahun semakin terjadi peningkatan jumlah anak penderita DM tipe-1. Tanpa dukungan sosial yang mencukupi, DM tipe-1 sering mengganggu kehidupan normal penderitanya. Tujuan penelitian adalah untuk mengeksplorasi kebutuhan dukungan sosial pada remaja dengan DM tipe-1. Penelitian ini menggunakan metode kualitatif dengan pendekatan fenomenologi. Jumlah partisipan dalam penelitian ini adalah sebanyak enam orang remaja dengan DM tipe-1. Teknik pengambilan sampel menggunakan purposive sampling. Analisis data menggunakan analisis tematik. Hasil penelitian mengidentifikasi 4 tema, yaitu ketergantungan pada orang sekitar, hidup dikontrol, kebahagiaan akan dukungan, dan keinginan seperti remaja lainnya. Berdasarkan hasil penelitian, direkomendasikan bagi perawat anak dapat berkolaborasi dengan pihak lain untuk mengembangkan inovasi pelayanan keperawatan dalam memberikan asuhan keperawatan secara holistik dan komprehensif pada remaja dengan DM tipe-1 sehingga kebutuhan dukungan sosialnya dapat terpenuhi.

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ABSTRACTIn every year, there is an increase in the number of type 1 DM patients. Type 1 DM often disrupted the normal life of the patients when there is no adequate social support for them. The aim of this research was to explore social support needs for the adolescents with type 1 DM. This research employed a qualitative method using phenomenology approach. The number of participants in this research was six adolescents with type 1 DM. The purposive sampling technique was used in this research. The analysis used thematic analysis. There were four themes identified dependence with around people, controlled living, happiness when support was given, and desire to be similar to other adolescents. Researcher is recommended that pediatric nurses and other parties collaborate to develop an innovation which provides holistic and comprehensive nursing care for adolescents with type 1 DM in order to fulfill their social support needs. "

"Latar Belakang: Insidensi dan prevalensi diabetes melitus tipe 2 (DMT2) terus meningkat. Penurunan imunitas yang terjadi pada DMT2 dapat meningkatkan risiko infeksi. Kontrol gula darah yang baik bermanfaat dalam pengendalian infeksi dan pencegahan komplikasi makro dan mikrovaskuler tetapi penelitian yang melibatkan pasien DMT2 usia lanjut masih belum konklusif. Serial kasus ini dilakukan untuk melihat efektivitas kontrol gula darah terhadap kesintasan pasien DMT2 yang dirawat di rumah sakit, dan untuk implementasi tatalaksana nutrisi sesuai kebutuhan dan kondisi klinis pasien. Metode: Pasien pada serial kasus ini berusia antara 47 ? 65 tahun. Penyulit infeksi pada keempat pasien ini yaitu gangren diabetikum, selulitis, dan sepsis dengan infeksi paru dan infeksi saluran kemih. Tatalaksana nutrisi pasien dilakukan sesuai dengan rekomendasi American Diabetes Association dan Therapeutic Lifestyle Changes disesuaikan dengan kondisi klinis dan toleransi pasien. Perhitungan kebutuhan nutrisi menggunakan rekomendasi untuk perawatan pasien sakit kritis bagi pasien yang dirawat di intensive care unit (ICU), dan menggunakan perhitungan dengan formula Harris-Benedict bagi yang dirawat di ruangan dengan faktor stres sesuai derajat hipermetabolisme pasien. Pasien dipantau selama 7 ? 11 hari. Edukasi diberikan kepada pasien dan keluarga selama perawatan dan saat akan pulang. Hasil: Dalam pemantauan, tiga pasien menunjukkan perbaikan klinis, toleransi asupan, dan laboratorium, dan dapat dipulangkan, sedangkan satu pasien meninggal dunia. Kesimpulan: Kontrol gula darah, asupan nutrisi yang adekuat, dan edukasi yang sesuai, dapat meningkatkan kesintasan pasien DMT2 dengan penyulit infeksi yang dirawat di rumah sakit.

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Background: The incidence and prevalence of type 2 diabetes mellitus (T2DM) is increasing. Immune disfunction in T2DM patient may increase the risk of infection. The appropriate blood glucose control has a benefit in infection control and macro and microvascular complication prevention. The Studies of glycaemic control included older patients did not find convincing evidence. The aim of this case series is to assess the association between glycaemic control and clinical outcome of hospitalized T2DM patient with comorbid infection, and to provide appropriate nutrition therapy based on individual nutrition needs.

Method: Patients in this case series were between 47 - 65 years old. There of those patients were diagnosed T2DM with comorbid gangrenous diabeticum, cellulitis, and sepsis with lung infection and urinary tract infection. Two patients need intensive care in ICU, and another patients in the ward. Two patients received nutrition therapy as critically ill condition, and the rest as American Diabetic Association recommendation, with basal calorie requirement were calculated using Harris-Benedict formula and stress factor suitable for metabolic changes. Monitoring was done for 7 - 11 days. Education was done for the patient and family during hospitalization and discharge planning.

Results: Three patients showed the improvement of clinical conditions, intake tolerance, and laboratory results, whatever one patient was pass away.

Conclusion: Glycaemic control, adequate nutrition intake, and intensive education, may improve survival rate in hospitalized T2DM patient with infection as comorbid."

"[ABSTRAKLatar belakang : Hiperglikemia kronik pada pasien Diabetes melitus tipe 1 (DMT1) dihubungkan dengan kerusakan jangka panjang, gangguan fungsi dan kerusakan berbagai organ tubuh lain seperti mata, ginjal, saraf, jantung dan pembuluh kapiler. Salah satu gangguan fungsi organ yang sering diabaikan sebagai akibat hiperglikemia adalah faal paru. Uji fungsi paru dapat membedakan kelainan paru obstruktif, restriktif atau campuran antara obstruktif dn restriktif. Uji fungsi paru dengan spirometri tidak dapat dilakukan dengan baik pada anak dibawah usia 7 atau 8 tahun karena memerlukan koordinasi yang cukup sulit. Penelitian tentang dampak DMT1 terhadap paru di Indonesia belum ada sampai saat ini.Tujuan : Mengetahui gambaran uji fungsi paru pada pasien DMT1 usia 8-18 tahun.Metode : Penelitian potong lintang dilakukan di Poliklinik Endokrinologi dan Respirologi Rumah Sakit Cipto Mangunkusumo (RSCM), serta Laboratorium Prodia Salemba pada bulan Januari 2015. Wawancara orangtua dilakukan dan data kadar HbA1c dalam rentang satu tahun terakhir diambil dari rekam medis subjek atau berdasarkan hasil pemeriksaan sebelumnya. Uji fungsi paru dilakukan sebanyak tiga kali dan diambil salah satu hasil yang terbaik. Kemudian subjek menjalani pengambilan darah untuk pemeriksaan kadar HbA1c dengan metode cation-exchange high pressure liquod chromatography (HPLC) di Laboratorium Prodia.Hasil : Tiga puluh lima subjek berpartisipasi dalam penelitian, terdiri dari 68,6% perempuan. Rerata usia 14 ± 2,7 tahun dan median durasi DM adalah 4 tahun (1,3-10,2 tahun). Rerata parameter FEV1 adalah 86,8 ± 14%, FVC 82,7 ± 12% dan V25 83,1 ± 26,2%. Median FEV1/FVC adalah 92,4 % (77,6-100) dan V50 91,5 % (41,1-204). Fungsi paru normal didapatkan pada 19 subjek (54,3%) dan fungsi paru terganggu sebanyak 16 subjek (45,7%), terdiri dari 10 subjek (28,6%) gangguan restriktif, 2 subjek (5,7%) gangguan obstruktif dan 4 subjek (11,4%) gangguan campuran. Rerata HbA1c dalam 1 tahun terakhir pada subjek dengan gangguan restriktif adalah 10,3%. Simpulan : Nilai parameter uji fungsi paru pasien DMT1 usia 8-18 tahun masih dalam batas normal. Gangguan fungsi paru didapatkan pada 16 subjek (45,7%) dengan gangguan restriksi terbanyak yaitu 10 subjek (28,6%).

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ABSTRACTBackground: Chronic hyperglycemia in patients with type 1 diabetes mellitus (T1DM) is associated with long term functional impairment and damage of several parts of the body, such as eyes, kidneys, nerves, heart, and capillary blood vessels. Among all systems, disorder of pulmonary function due to hyperglycemia is often neglected by physicians. Pulmonary function test could determine whether the lung impairment is obstructive, restrictive, or mixed. Pulmonary function test using spirometry could not be applied to children below 7 or 8 years old because they are not capable to do the test. Until now, research about the effect of T1DM to pulmonary function has never been done in Indonesia.Objective: To obtain pulmonary function test profile in type 1 diabetes mellitus patients aged 8 to 18 years old.Methods: This cross sectional study took place at Endocrinology and Respirology Outpatient Department of Cipto Mangunkusumo Hospital (RSCM) and Prodia Laboratory Service in Salemba in January 2015. Parents of subjects were interviewed for history disease. HbA1c level of recent year was collected from medical records or from previous test results. Pulmonary function test were conducted three times to each subjects and among those three results, the best was chosen as data. Blood samples were collected for HbA1c level measurement. The HbA1c level was measured by cation-exchange high pressure liquod chromatography (HPLC) method in Prodia Laboratory.Results: Thirty five subjects participated in the research, 68.6% of them were female. The average age was 14 ± 2.7 years and the median duration of diabetes melitus was 4 years (1.3-10.2 years). FEV1, FVC, and V25 average was 86.8 ± 14%, 82.7 ± 12%, and 83.1 ± 26.2%, respectively. The median of FEV1/FVC and V50 was 92.4 % (77.6-100) and 91.5% (41.1-204) respectively. Nineteen subjects (54.3%) had normal pulmonary function and among 16 (45.7%) abnormal subjects, 10 (28.6%) had restrictive disorder, 2 (5.7%) had obstructive disorder, and 4 (11.4%) had mixed disorder. Average of HbA1c level of restrictive group was 10.3%.Conclusions: Pulmonary function test parameter profile in type 1 diabetes mellitus patients aged 8 to 18 years old lies in normal range. Pulmonary function disorder was found in 16 subjects (45.7%). Among those 16 subjects, 10 (28.6%) had restriction disorder.;Background: Chronic hyperglycemia in patients with type 1 diabetes mellitus (T1DM) is associated with long term functional impairment and damage of several parts of the body, such as eyes, kidneys, nerves, heart, and capillary blood vessels. Among all systems, disorder of pulmonary function due to hyperglycemia is often neglected by physicians. Pulmonary function test could determine whether the lung impairment is obstructive, restrictive, or mixed. Pulmonary function test using spirometry could not be applied to children below 7 or 8 years old because they are not capable to do the test. Until now, research about the effect of T1DM to pulmonary function has never been done in Indonesia. Objective: To obtain pulmonary function test profile in type 1 diabetes mellitus patients aged 8 to 18 years old. Methods: This cross sectional study took place at Endocrinology and Respirology Outpatient Department of Cipto Mangunkusumo Hospital (RSCM) and Prodia Laboratory Service in Salemba in January 2015. Parents of subjects were interviewed for history disease. HbA1c level of recent year was collected from medical records or from previous test results. Pulmonary function test were conducted three times to each subjects and among those three results, the best was chosen as data. Blood samples were collected for HbA1c level measurement. The HbA1c level was measured by cation-exchange high pressure liquod chromatography (HPLC) method in Prodia Laboratory. Results: Thirty five subjects participated in the research, 68.6% of them were female. The average age was 14 ± 2.7 years and the median duration of diabetes melitus was 4 years (1.3-10.2 years). FEV1, FVC, and V25 average was 86.8 ± 14%, 82.7 ± 12%, and 83.1 ± 26.2%, respectively. The median of FEV1/FVC and V50 was 92.4 % (77.6-100) and 91.5% (41.1-204) respectively. Nineteen subjects (54.3%) had normal pulmonary function and among 16 (45.7%) abnormal subjects, 10 (28.6%) had restrictive disorder, 2 (5.7%) had obstructive disorder, and 4 (11.4%) had mixed disorder. Average of HbA1c level of restrictive group was 10.3%. Conclusions: Pulmonary function test parameter profile in type 1 diabetes mellitus patients aged 8 to 18 years old lies in normal range. Pulmonary function disorder was found in 16 subjects (45.7%). Among those 16 subjects, 10 (28.6%) had restriction disorder., Background: Chronic hyperglycemia in patients with type 1 diabetes mellitus (T1DM) is associated with long term functional impairment and damage of several parts of the body, such as eyes, kidneys, nerves, heart, and capillary blood vessels. Among all systems, disorder of pulmonary function due to hyperglycemia is often neglected by physicians. Pulmonary function test could determine whether the lung impairment is obstructive, restrictive, or mixed. Pulmonary function test using spirometry could not be applied to children below 7 or 8 years old because they are not capable to do the test. Until now, research about the effect of T1DM to pulmonary function has never been done in Indonesia. Objective: To obtain pulmonary function test profile in type 1 diabetes mellitus patients aged 8 to 18 years old. Methods: This cross sectional study took place at Endocrinology and Respirology Outpatient Department of Cipto Mangunkusumo Hospital (RSCM) and Prodia Laboratory Service in Salemba in January 2015. Parents of subjects were interviewed for history disease. HbA1c level of recent year was collected from medical records or from previous test results. Pulmonary function test were conducted three times to each subjects and among those three results, the best was chosen as data. Blood samples were collected for HbA1c level measurement. The HbA1c level was measured by cation-exchange high pressure liquod chromatography (HPLC) method in Prodia Laboratory. Results: Thirty five subjects participated in the research, 68.6% of them were female. The average age was 14 ± 2.7 years and the median duration of diabetes melitus was 4 years (1.3-10.2 years). FEV1, FVC, and V25 average was 86.8 ± 14%, 82.7 ± 12%, and 83.1 ± 26.2%, respectively. The median of FEV1/FVC and V50 was 92.4 % (77.6-100) and 91.5% (41.1-204) respectively. Nineteen subjects (54.3%) had normal pulmonary function and among 16 (45.7%) abnormal subjects, 10 (28.6%) had restrictive disorder, 2 (5.7%) had obstructive disorder, and 4 (11.4%) had mixed disorder. Average of HbA1c level of restrictive group was 10.3%. Conclusions: Pulmonary function test parameter profile in type 1 diabetes mellitus patients aged 8 to 18 years old lies in normal range. Pulmonary function disorder was found in 16 subjects (45.7%). Among those 16 subjects, 10 (28.6%) had restriction disorder.]"

"ABSTRAKDiabetes merupakan penyakit progresif yang tidak hanya membutuhkan perawatan kuratif dan rehabilitatif tetapi juga perawatan paliatif.. Kepuasaan merupakan salah satu indikator penting tercapainya perawatan paliatif yang efektif sehingga pengukuran kepuasan pasien terhadap perawatan menjadi hal yang penting dilakukan. Penelitian ini dilakukan untuk mengetahui gambaran tingkat kepuasan pasien diabetes yang mendapatkan perawatan paliatif. Desain yang digunakan dalam penelitian ini adalah desain penelitian cross sectional menggunakan sampel pasien diabetes di balai asuhan keperawatan Jabodetabek sebanyak 43 responden yang dipilih dengan teknik purposive sampling. Instrumen yang digunakan adalah Home Care Client Satisfaction Instrument-Revised (HCCSI-R), Clien Satisfaction Inventory (CSI), dan Long-form Patient Satisfaction Questionnaire (PSQ-III). Hasil penelitian ini menunjukkan sebanyak 14% responden merasa cukup puas, 60,5% merasa puas, dan 25,6% merasa sangat puas. Pada penelitian ini juga ditemukan tidak ada perbedaan yang bermakna antara karateristik responden dengan tingkat kepuasan (p>0,05). Penelitian ini merekomendasikan kepada praktisi kesehatan untuk memperdalam pengetahuan mengenai perawatan paliatif dan mengaplikasikannya pada pelayanan kesehatan.

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ABSTRACTDiabetes is a progressive disease that needs palliative care aside from curative and rehabilitative. Satisfaction play as one of the most important indicator to get effective achievement of palliative care, so the measurement of patient satisfaction with treatment is necessary. This study was conducted to describe the level of satisfaction of diabetes patients who receive palliative care. This study used cross sectional approach with 43 respondents of diabetic patients accommodate under nursing care centers in Jabodetabek selected with purposive sampling technique. This study used Home Care Client Satisfaction Instrument-Revised (HCCSI-R), Clien Satisfaction Inventory (CSI), and the Long-Form Patient Satisfaction Questionnaire (PSQ-III) to measure satisfaction level. The results showed that 14% of respondents felt quite satisfied, 60.5% were satisfied, and 25.6% felt very satisfied. This research also found that there is no significant differences between the characteristics of the respondents with the level of satisfaction (p> 0.05). The study recommend healthcare practitioners to deepen their knowledge about palliative care and apply it to health services."

"Diabetes melitus merupakan masalah kesehatan yang serius dan menurut survei PAPDI (1993) menempati urutan nomor lima sebagai penyebab ra\'vat inap1. Berdasarkan surYei epidemiologis, kekerapan diabetes melitus di Indonesia berkisar 1,4%-2,3% 2. Sejak ditemukannya insulin oleh Banting dan Best pada tahun 1921, komplikasi diabetes melitus berangsur-angsur bergeser ke komplikasi menahun. lmpotensi merupak.an salah sa tu komplikasi menahun diabetes melitus. lmpotensi adalah suatu keadaan ketidakmampuan penis untuk ereksi baik parsial maupun menyeluruh dan atau mem.pertahankannya agar dapat penetrasi ke dalam vagina 3. Penelitian yang dilal.-ukan The h1assachussets h1ale Aging Study (MMAS) pada tahun 1987-1989 yang melibatkan 1290 orang, mendapatkan angka kejadian impotensi 5% - 15% pada pria sehat usia 40 - 70 tahun. Angka ini menjadi 3 kali lipat apabila menderita diabetes melitus4. Penelitian di Indonesia yang melibatkan subyek dalam jumlah besar belum ada. Ian Effendi dkk5, mendapatkan angka kejadia11 impotensi pada pasien diabetes melitus sebesar 43% sedangkan Nasution AW dkk6, mendapatkan angka sebesar 46%. Angka yang tepat sukar ditentukan karena kelainan ini, apabila ti.dak ditanyakan, tidak selalu dikemukak.an pasien karena malu. Meskipun demikian, tidak jarang bahwa in1potensi merupakan keluhan utama yang membawa pasien maupun istrinya mengunjungi dokter.

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Diabetes mellitus is a serious health problem and according to the PAPDI survey (1993) ranks number five as a cause of hospitalization1. Based on epidemiological surveys, the frequency of diabetes mellitus in Indonesia is around 1.4% -2.3% 2. Since the discovery of insulin by Banting and Best in 1921, diabetes mellitus complications have gradually shifted to chronic complications. Impotence is one of the chronic complications of diabetes mellitus. Impotence is a condition of the inability of the penis to erect either partially or completely and/or maintain it so that it can penetrate into the vagina. 3. Research carried out by The Massachusetts Age Aging Study (MMAS) in 1987-1989 involving 1290 people, found an incidence of impotence of 5% - 15% in healthy men aged 40 - 70 years. This figure triples if you suffer from diabetes mellitus4. There is no research in Indonesia involving large numbers of subjects. Ian Effendi et al5, found that the incidence rate of impotence in diabetes mellitus patients was 43%, while Nasution AW et al6, obtained a figure of 46%. The exact figure is difficult to determine because this disorder, if not asked, is not always brought up by the patient because of embarrassment. However, it is not uncommon for in1potency to be the main complaint that brings the patient and his wife to visit the doctor."

"Depresi merupakan gangguan mental yang keberadaannya berkaitan erat dengan penyakit kronis. Salah satu penyakit kronis yang penderitanya paling banyak mengalami depresi adalah diabetes melitus. DKI Jakarta merupakan provinsi di Indonesia dengan prevalensi depresi dan diabetes melitus yang terus meningkat. Penelitian ini bertujuan untuk mengetahui determinan kejadian depresi pada penderita diabetes melitus di DKI Jakarta. Penelitian ini merupakan penelitian kuantitatif dengan desain studi potong lintang. Sumber data yang digunakan, yaitu data Riset Dasar Kesehatan (Riskesdas) 2018. Sampel terdiri dari 421 penderita diabetes melitus yang memenuhi kriteria inklusi dan eksklusi. Analisis yang digunakan pada penelitian ini adalah uji regresi logistik ganda. Hasil analisis menunjukkan bahwa dari 421 subjek penelitian, sebanyak 13,8% mengalami depresi. Hasil analisis pada penelitian ini menunjukkan hasil yang signifikan antara faktor biologis, yaitu jenis kelamin (POR = 7,97 (95% CI = 3,23-19,62), p = <0,001) dan lama menderita diabetes melitus (POR = 2,72 (95% CI = 1,48-5,01), p = 0,001), faktor psikologis, yaitu status merokok (POR = 5,45 (95% CI = 2,43-12,24), p = <0,001), konsumsi alkohol (POR = 5,76 (95% CI = 1,32-25,04), p = 0,020), dan tingkat aktivitas fisik (POR = 2,38 (95% CI = 1,28-4,43), p = 0,006), serta faktor sosial, yaitu tingkat pendidikan, (POR = 2,79 (95% CI = 1,43-5,46), p = 0,003).

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Depression is a mental disorder whose existence is closely related to chronic diseases. One of the chronic diseases that suffer from the most depression is diabetes mellitus. DKI Jakarta is a province in Indonesia with an increasing prevalence of depression and diabetes mellitus. This study aims to determine the determinants of the incidence of depression in patients with diabetes mellitus in DKI Jakarta. This research is a quantitative study with a cross-sectional study design. The data source used, namely the 2018 Basic Health Research (Riskesdas) data. The sample consisted of 421 people with diabetes mellitus who met the inclusion and exclusion criteria. The analysis used in this study was multiple logistic regression test. The results of the analysis showed that of the 421 research subjects, 13.8% experienced depression. The results of the analysis in this study showed significant results between biological factors, namely gender (POR = 7.97 (95% CI = 3.23-19.62), p = <0.001) and duration of diabetes mellitus (POR = 2.72 (95% CI = 1.48-5.01), p = 0.001), psychological factors, namely smoking status (POR = 5, 45 (95% CI = 2.43-12.24), p = <0.001), alcohol consumption (POR = 5.76 (95% CI = 1.32-25.04), p = 0.020), and physical activity level (POR = 2.38 (95% CI = 1.28-4.43), p = 0.006), and social factors, namely education level, (POR = 2.79 (95% CI = 1.43-5.46), p = 0.003)."

"Diabetes mellitus (DM) adalah suatu keadaan dimana ditemukan peninggian kadar gula darah kronik yang dapat menimbulkan komplikasi akut dan kronik. Perawatan DM harus meliputi aspek emosional, sosial, perilaku, spiritual dan psikologis serta perubahan fisik dengan menerapkan lima pilar manajemen DM yakni kontrol gula darah, diit, latihan, pengobatan, dan pendidikan kesehatan yang dapat membantu meningkatkan kemampuan pasien dalam perawatan diri dan mencegah komplikasi.Penelitian ini bertujuan untuk menganalisis hubungan kesadaran diri pasien dengan kejadian komplikasi DM di RSUD dr. Adnan W.D Payakumbuh Sumbar. Penelitian ini menggunakan desain Cross Sectional Study. Jumlah sampel pada penelitian ini adalah 69 responden yang terdiri dari pasien rawat inap dan pasien rawat jalan bagian penyakit dalam di RSUD dr. Adnan W.D Payakumbuh. Tehnik pengambilan sampel yang digunakan adalah consecutive sampling.Hasil penelitian menunjukkan kesadaran diri berhubungan dengan kejadian komplikasi DM (p=0,000). Pasien dengan kesadaran diri kurang berisiko 20 kali untuk terjadi komplikasi dibanding pasien dengan kesadaran diri baik setelah dikontrol variabel usia, jenis kelamin, tipe DM, pendidikan, pekerjaan, dan penyuluhan. Diperoleh juga ada hubungan antara penyuluhan dengan kejadian komplikasi DM (p=0,027). Pasien yang tidak mendapatkan penyuluhan berisiko 9 kali untuk terjadi komplikasi dibanding dengan pasien yang pernah mendapat penyuluhan. Faktor konfonding hubungan kesadaran diri dengan kejadian komplikasi DM pada penelitian ini adalah usia, jenis kelamin, tipe DM, tingkat pendidikan, pekerjaan dan penyuluhan. Penelitian ini merekomendasikan perlunya meningkatkan kesadaran diri pasien sebagai salah satu intervensi mandiri perawat dalam mencegah komplikasi DM dan perlu penelitian lebih lanjut terkait strategi yang efektif dalam meningkatkan kesadaran diri pasien DM dengan komplikasi.

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Diabetes mellitus (DM) is a condition manifested by chronic high level of blood sugar that resulting in acute and chronic complications. Nursing care of DM must be concern to emotional, social, behavior, spiritual, psychological, and physical problem by applying five keys of DM management which consists of blood sugar control, diet, exercises, insulin treatment, and health education. These can help to increase patient?s self care and prevent from complications.The purpose of this study was to analyse the relation between self awareness and DM complications at Adnan Hospital Payakumbuh West Sumatera. A design cross sectional study was used in this research. The total samples were 69 DM patients who selected from outpatient and inpatient of Medical Unit Adnan Hospital. The sample was selected by a consecutive sampling method.The result showed that self awareness was correlated to DM complications (p=0,000). The patients which low self awareness have risk 20 times to complications after controlled by age, gender, DM type, level of education, occupation, and health education. Health education was correlated to DM complications too (p=0,027). The patients who never got health education have risk 9 times to complications after controlled by other variables. Confounding factors of correlated self awareness to DM complications in this study were age, gender, type of DM, level of patient education, occupation, and health education. This study recommended on the needs to improve patient self awareness as one of the independent nursing interventions and need future research about the effective strategy to increase patient self awareness with diabetes complications."

"ABSTRAKLatar Belakang. Kalsifikasi vaskular yang ditandai dengan penebalan tunika intima-media(TIM) karotis pada pasien diabetes melitus (DM) tipe 2 merupakan faktor prediktor terhadapkejadian serebro-kardiovaskular. Osteoprotegerin (OPG) merupakan petanda disfungsiendotel yang dapat digunakan sebagai prediktor terhadap penebalan TIM karotis.Penggunaan ultrasonografi (USG) karotis untuk menilai ketebalan TIM karotis masihterbatas di Indonesia sehingga diperlukan metode diagnostik lain yang lebih cost effective.Tujuan. Menentukan faktor-faktor determinan yang bermakna dan nilai tambah diagnostikpemeriksaan OPG dalam mendeteksi penebalan TIM karotis pada pasien DM tipe 2.Metodologi. Studi potong lintang dilakukan di poliklinik Metabolik Endokrin dan poliklinikspesialis Ilmu Penyakit Dalam RS Cipto Mangunkusumo (RSCM) pada bulan April – Juni2012 pada pasien DM tipe 2 tanpa komplikasi serebro-kardiovaskular, tanpa komplikasipenyakit ginjal kronik (PGK) stadium III – V dan tidak merokok. Pada penelitian inidilakukan analisis bivariat dan multivariat pada variabel lama menderita DM, hipertensi,dislipidemia, HbA1c dan OPG, kemudian ditentukan nilai tambah pemeriksaan OPG dalammendeteksi penebalan TIM karotis pada pasien DM tipe 2.Hasil dan Pembahasan. Dari 70 subyek penelitian, didapatkan jumlah subyek denganpeningkatan OPG dan penebalan TIM karotis adalah sebesar 45,7 % dan 70 %. Dari49 subyek dengan penebalan TIM karotis, didapatkan 61,2 % subyek dengan peningkatanOPG. Lama menderita DM (OR 26,9; IK 95 % 2 – 365,6), hipertensi (OR 22; IK 95 % 2,3 –207,9), dislipidemia (OR 85,2; IK 95 % 3,6 – 203,6) dan OPG (OR 12,9; IK 95 % 1,4 –117,3) berhubungan secara bermakna dengan penebalan TIM karotis. Pemeriksaan OPGmempunyai spesifisitas dan nilai duga positif tinggi (90,5 % dan 84 %). Nilai tambahdiagnostik OPG hanya sebesar 2,3 % dalam mendeteksi penebalan TIM karotis.Kesimpulan. Faktor-faktor determinan yang bermakna untuk mendeteksi penebalan TIMkarotis pada pasien DM tipe 2 adalah lama menderita DM, hipertensi, dislipidemia danOPG. Nilai tambah diagnostik dari pemeriksaan OPG adalah sebesar 2,3 % dalammendeteksi penebalan TIM karotis pada pasien DM tipe 2.

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ABSTRACTBackground. Vascular calcification measured by carotid intima-media thickness(CIMT) in type 2 diabetes mellitus (DM) patient is a predictor for cerebrocardiovascularevent. Osteoprotegerin (OPG) as a marker for endothelial dysfunctioncan be used as a predictor for increased CIMT. Applicability of carotid ultrasonography(USG) in Indonesia is still limited, therefore other diagnostic method that is more costeffective is needed.Objective. To determine the significant determinant factors and the diagnostic addedvalue of OPG to detect increased CIMT in type 2 DM patient.Methods. Cross sectional study was conducted in Metabolic Endocrine and InternalMedicine outpatient clinic Cipto Mangunkusumo Hospital between April and June 2012in type 2 DM patient without history of cerebro-cardiovascular event, without history ofchronic kidney disease (CKD) stage III – V and without smoking. Bivariate analysis andmultivariate analysis were performed to variables duration of DM, hypertension,dyslipidemia, HbA1c and OPG, followed by determining the diagnostic added value ofOPG to detect increased CIMT in type 2 DM patient.Results. From 70 subjects, there were 45,7 % subject with increased OPG and 70 %subject with increased CIMT. From 49 subject with increased CIMT, 61,2 % subject hadincreased OPG. Duration of DM (OR 26,9; IK 95 % 2 – 365,6), hypertension (OR 22;IK 95 % 2,3 – 207,9), dyslipidemia (OR 85,2; IK 95 % 3,6 – 203,6) and OPG (OR 12,9;IK 95 % 1,4 – 117,3) were correlated significantly to increased CIMT. OPGmeasurement had high specificity and positive predictive value (90,5 % and 84 %).Diagnostic added value of OPG was only as 2,3 % to detect increased CIMT in type 2DM patient.Conclusion. The significant determinant factors for detection of increased CIMT intype 2 DM patient were duration of DM, hypertension, dyslipidemia and OPG. Thediagnostic added value of OPG was 2,3 % to detect increased CIMT in type 2 DMpatient."

"Tesis ini membahas bagaimana klien Diabetes Melitus memberikan makna kehidupan dalam kondisi sakitnya. Tujuan dalam penelitian ini menguraikan persepsi, respon psikososial, kebutuhan penatalaksanaan, harapan dan makna kehidupan klien. Penelitian ini adalah penelitian kualitatif dengan desain deskriptif. Hasil penelitian menemukan tujuh tema besar yang sesuai dengan tujuan penelitian dan satu tema tambahan yaitu beban yang dihadapi klien. Kesimpulannya makna kehidupan klien didapatkan dalam kondisi penderitaan dan pendalaman nilai spiritual. Penelitian ini menyarankan penggunaan model Adaptasi Roy dalam pengembangan teori keperawatan khususnya masalah psikososial; tersusunnya format pengkajian psikososial sebagai panduan mengidentifikasi masalah psikososial di keluarga, rumah sakit maupun masyarakat.

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This thesis discussed how the client Diabetes Mellitus give life meaning in the pain condition. The purpose of this study described the perceptions, psychosocial responses, needs management, client expectations and the meaning of life. This study is a descriptive qualitative research design. The study found seven broad themes consistent with the purpose of research and one additional theme is the burden faced by the client.

In conclusion the meaning of the life of the client obtained under conditions of suffering and deepening of spiritual values. This study suggests the use of Roy's adaptation model in nursing theory development in particular psychosocial problems; compilation format psychosocial assessment as a guide to identify psychosocial problems in families, hospitals and the community."