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"Latar belakang: Kuragnya edukasi dan pengawasan pengobatan pada pasien DM tipe 2 rawat jalan oleh tenaga kesehatan mempengaruhi perilaku pasien dalam proses pengobatan. Perilaku pasien yang tidak tepat meningkatkan risiko hipoglikemia. Salah satu upaya yang dapat dilakukan tenaga kesehatan untuk mencegah hipoglikemia adalah dengan melakukan penilaian terhadap perilaku pasien, sehingga dibutuhkan suatu instrumen untuk menilai perilaku pasien terhadap hipoglikemia di Indonesia.Tujuan: Penelitian ini bertujuan untuk mengembangkan instrumen penilaian perilaku pasien terhadap risiko hipoglikemia yang valid dan reliabel untuk self-assessment.Metode: Penelitian ini terdiri dari 3 tahap yaitu tahap pengembangan instrumen penilaian perilaku (tahap I), uji validitas dan reliabilitas (tahap 2) dan uji coba instrumen (tahap 3). Penelitian tahap 1 melibatkan 5 praktisi kesehatan seperti dokter penyakit dalam, perawat, ahli gizi, apoteker di rumah sakit dan puskesmas. Pada penelitian tahap 2 melibatkan 20 responden dengan metode one-shot test. Penelitian tahap 3 melibatlkan 237 pasien DM tipe 2 rawat jalan di RSUP di Jakarta dengan desain cross-sectional dan consecutive sampling.Hasil: Instrumen penilaian perilaku pasien valid dan reliabel, terdiri dari 9 domain (38 pernyataan) dimana 29 diantaranya untuk menilai perilaku pasien terhadap risiko hipoglikemia. Adapun 9 domain tersebut adalah perilaku pasien terhadap monitoring gula darah, diet, aktivitas fisik, pengobatan, pendampingan oleh nakes, manajemen hipoglikemia, self-care, dukungan keluarga dan penggunaan insulin. Perilaku pasien yang kurang baik berisiko menyebabkan hipoglikemia 2,9 kali lebih tinggi dibandingkan dengan pasien dengan perilaku baik dalam proses pengobatan.Kesimpulan: Instrumen penailain perilaku pasien dapat digunakan untuk menilai perilaku pasien terhadap hipoglikemia pada pasien DM tipe 2 rawat jalan.

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Purpose: The purpose of this study is to develop a valid and reliable instrument for assessing patients’ behavior toward the risk of hypoglycemia through self-assessment. Insufficient education and supervision of type 2 diabetes mellitus (DM) outpatients by healthcare providers is a significant concern, affecting their behavior during the treatment process. In addition, inappropriate behavior typically increases the risk of hypoglycemia. To mitigate this risk, several studies have recommended the evaluation of patients’ behavior, necessitating the development of a new instrument.

Methods: The study procedures were carried out in three stages, including instrument development (Stage I), validity and reliability (Stage II), as well as instrument test (Stage III). Stage I comprised five healthcare practitioners, including internal medicine doctors, nurses, dietitians, and pharmacists in hospitals and community health centers, while Stage II consisted of 20 respondents using a one-shot test method. In addition, Stage III consisted of 237 type 2 DM outpatients at Central General Hospital (RSUP) in Jakarta using a cross-sectional design and consecutive sampling.

Results: The results showed that the developed instrument was valid and reliable, consisting of 9 domains (38 statements) and 29 statements. These 9 domains included behavior towards blood glucose monitoring, diet, physical activity, medication, assistance from healthcare providers, hypoglycemia management, self-care, family support, and insulin use. In addition, poor behavior increased the risk of hypoglycemia by 2.9 times during the treatment process.

Conclusion: Based on these results, the developed instrument could be used to evaluate behavior toward hypoglycemia among type 2 DM outpatients"

"Latar Belakang :Populasi lanjut usia meningkat secara global, diperkirakan 1.5 miliar (15% total penduduk) di dunia tahun 2050. Indonesia merupakan populasi menua, dengan 10.7% (>7%) penduduk lansia pada 2020. Insomnia keluhan kesehatan tersering lansia, memiliki komplikasi salah satunya depresi. Banyak studi meneliti faktor berhubungan dengan insomnia dan depresi pada lansia, dan insomnia prediktor depresi pada lansia. Namun, belum ada studi mengenai faktor berhubungan dengan depresi pada populasi lansia khusus yaitu dengan insomnia.Tujuan :Mengetahui mengetahui faktor yang berhubungan dengan gejala depresi pada lansia dengan insomnia di unit rawat jalan.Metode :Studi potong lintang pada pasien usia ³60tahun di unit rawat jalan RSCM Jakarta, Indonesia dengan seleksi consecutive sampling, dimana pasien dengan insomnia, PSQI (Pittsburgh Sleep Questionaire Index) >5, menjadi subjek penelitian dan dilakukan wawancara untuk mengambil data meliputi sosiodemografi, kesendirian, durasi insomnia, gejala depresi (GDS-15 item), status fungsional (B-ADL), status kognitif (MMSE), status nutrisi (MNA), dan penyakit komorbid (CIRSG skor).Hasil :Subjek penelitian sebanyak 209 lansia insomnia, rerata usia 72.88 (SB 6.98) tahun, proporsi depresi 6.7%. Dari uji bivariat terdapat hubungan signifikan antara ketergantungan (PR 5.24, 95%IK 1.50-18.29), malnutrisi (PR 11.54, 95%IK 4.77-27.92), dan penyakit komorbid, skor CIRSG ³9 (PR 4.15, 95%IK 1.18-14.50) dengan gejala depresi pada lansia yang insomnia. Tidak terdapat hubungan antara sosiodemografi, kesendirian, durasi insomnia, dan status kognitif dengan depresi. Dari analisis multivariat dengan regresi logistik, didapatkan hubungan bermakna secara statistik antara malnutrisi dengan gejala depresi (p <0.0001).Kesimpulan : Terdapat hubungan bermakna antara malnutrisi dengan gejala depresi pada pasien insomnia usia lanjut di rawat jalan.

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Background:

The elderly population is increasing globally, estimated to be 1.5 billion (15% of the total population) in the world by 2050. Indonesia is an aging society, 10.7% (>7%) of the population is elderly in 2020. Insomnia, most often health complained by the elderly, has complications one of which is depression. Previous studies have examined factors associate to insomnia and depression in elderly and insomnia is a predictor of depression. No studies yet examined factors associated to depression symptom in the specific population, elderly with insomnia.

Objective:

To analyze factors associated with depression symptom in the elderly with insomnia in the outpatient_unit.

Method:

Cross-sectional study of patients aged >60 years in the outpatient unit of Cipto Mangunkusumo Hospital Jakarta, Indonesia using consecutive sampling to select the sample, where patients with insomnia, PSQI (Pittsburgh Sleep Questionnaire Index) >5, became research subjects and being interviewed to collect data including sociodemographic, loneliness, duration of insomnia, Depression symptom (GDS-15 items), physical activity which means the ability to do activity that measured by functional status (B-ADL), cognitive status (MMSE), nutritional status (MNA), and comorbidities (CIRSG). Data was analyzed using STATA software to do bivariate and multivariate analysis.

Results:

The research subjects were 209 elderly people with insomnia, mean age 72.88 (SB 6.98) years, proportion of depression symptom is 6.7%. There is an association between dependency (PR 5.24, 95% CI 1.50-18.29), malnutrition (PR 11.54, 95% CI 4.77-27.92), and chronic illness, CIRSG score >9 (PR 4.15, 95% CI 1.18-14.50) with depression symptom in elderly with insomnia from bivariate analysis. From multivariate analysis with logistic regression, malnutrition has a statistically significant association to depression symptom (p <0.0001) in elderly people with insomnia.

Conclusion : There is a significant association between malnutrition and depression symptom in insomnia elderly outpatient."