PENGARUH FAMILY-BASED DIABETES SELF-MANAGEMENT EDUCATION (DSME) TERHADAP SELF-MANAGEMENT PASIEN DM TIPE 2 DAN CAREGIVER SELF-EFFICACY DI WILAYAH KERJA PUSKESMAS GUNUNGSARI

MUHAMAD SARDIMAN, Sri Warsini, S.Kep.,Ns., M.Kes., Ph.D.; Haryani, S.Kp, M.Kes., Ph.D.

2020 | Tesis | MAGISTER KEPERAWATAN

Latar Belakang: Diabetes melitus dapat menyebabkan berbagai komplikasi, sehingga dibutuhkan perawatan berkelanjutan dan edukasi self-management pada penderita DM. Self-management tidak hanya dalam individu saja, tetapi dalam konteks keluarga, sehingga anggota keluarga yang merawat (caregiver) juga perlu memiliki self-efficacy dalam mendukung self-management pasien. Upaya yang dapat meningkatkan self-management dan self-efficacy adalah program Diabetes Self Management Education (DSME). Tujuan: Penelitian ini bertujuan untuk mengetahui pengaruh family-based DSME terhadap self-management pasien DM tipe 2 dan caregiver self-efficacy. Metode: Penelitian ini adalah quasi eksperimen dengan rancangan non randomized control group pre test - post test design. Sebanyak 48 pasien DM dan 48 caregiver menjadi sampel penelitian yang diambil menggunakan teknik consecutive sampling. Kriteria inklusi pasien adalah didiagnosis DM tipe 2, usia > 18 tahun, bersedia menjadi responden dan berdomisili di wilayah kerja Puskesmas Gunungsari atau Penimbung; Kriteria inklusi caregiver adalah perawat pasien DM yang utama, usia > 18 tahun, bersedia menjadi responden dan dapat membaca. Alat ukur yang digunakan yaitu kuesioner The Summary of Diabetes Self-Care Activities: Indonesian version (SDSCA-I) untuk mengukur self-management pasien dan The Family Self-Efficacy (FSE) untuk mengukur caregiver self-efficacy. Perbedaan data sebelum dengan sesudah intervensi pada setiap kelompok diuji menggunakan uji Paired t-test, perbedaan data antar kelompok diuji menggunakan uji Independent sample t-test dan korelasi antara variabel diuji menggunakan Pearson test. Hasil: Perbedaan sebelum dengan sesudah intervensi pada kelompok intervensi didapatkan nilai p=0,001, d=0,50 pada self-management dan p=0,000, d=1,71 pada self-efficacy. Perbedaan antara kelompok intervensi dengan kelompok kontrol didapatkan nilai p=0,020, d=0,13 pada self-management dan p=0,000, d=0,35 pada self-efficacy. Korelasi antara caregiver self-efficacy dengan self-management pasien didapatkan nilai p=0,000. Kesimpulan: Terdapat pengaruh family based DSME terhadap peningkatan self-management pasien DM tipe 2 dan caregiver self-efficacy serta ada korelasi anatara caregiver self-efficacy dengan self-management pasien DM.

Background: Diabetes mellitus (DM) can cause various complications, hence it requires continuous care and self-management education for patients with DM. Self- management is not only for individuals, but is conducted in a family context. Therefore, families also need to have self-efficacy in supporting self-management for the patients. The Diabetes Self-Management Education (DSME) program is an effort to improve the self-management and self-efficacy. Purpose: This study aimed to determine the effect of family-based DSME on self-management of patients with type 2 DM and caregiver self-efficacy. Methods: This quasi-experimental study used a non-randomized control group pre-test �¢ï¿½ï¿½ post-test design. A total of 48 DM patients and 48 caregiver members were enrolled as the study samples using a consecutive sampling technique. The inclusion criteria for patients were: diagnosed with type 2 diabetes mellitus, age > 18 years, willing to be a respondent, and domiciled in the working area of the Gunungsari or Penimbung Health Center. Meanwhile, the inclusion criteria for caregivers were: the primary DM patient care providers, age > 18 years, willing to be respondents, and able to read. The measuring instruments used were the demographic data questionnaire, The Summary of Diabetes Self-Care Activities: Indonesian version (SDSCA-I) questionnaire to measure patient self-management, and the Family Self-Efficacy (FSE) questionnaire to measure caregiver self-efficacy. The difference in data before and after the intervention in each group was tested using Paired t-tests, while data differences between groups were tested using the Independent sample t-tests and correlation between variables using the Pearson test. Results: The difference before and after the intervention in the intervention group based on the paired t-test showed p value = 0.001, d = 0.50 for self-management and p = 0.000, d = 1.71 for self-efficacy. The difference between the intervention group and the control group based on the Independent sample t-test obtained p value = 0.020, d = 0.76 for self-management and p = 0.000, d = 1.88 for self-efficacy. Conclusion: There is a beneficial effect of family-based DSME on improving self-management of patients with type 2 DM and caregiver self-efficacy.

Kata Kunci : DM tipe 2, Family based-DSME, Self-efficacy, Self-management.