Perilaku diet penderita diabetes mellitus di Rumah Sakit Umum Daerah Curup

BUANA, Chandra, Dra. Yayi Suryo Prabandari, M.Si, Ph.D

2009 | Tesis | S2 Magister Perilaku Promosi Kesehatan

Latar belakang : Penanganan penderita diabetes mellitus (DM) di RSUD Curup diselenggarakan secara terpadu dengan melakukan edukasi dan konseling gizi oleh ahli gizi di Instalasi Gizi RSUD Curup. Sampai saat ini belum ada tindak lanjut penyuluhan untuk menilai penerapan diet sehari-hari penderita DM. Juga belum diketahui persepsi diet bagi penderita DM, faktor-faktor yang mempengaruhi penerapan diet serta strategi penyuluhan kesehatan yang diharapkan bagi penderita DM yang berobat ke RSUD Curup. Tujuan : Penelitian ini bertujuan untuk mengidentifikasi perilaku diet penderita DM setelah mendapatkan konsultasi gizi di Instalasi Gizi RSUD Curup. Metode penelitian : Penelitian ini menggunakan metode penelitian kualitatif dengan rancangan studi kasus. Subjek penelitian ditentukan dengan purposive sampling yang berjumlah 15 orang, terdiri dari 7 orang subjek wawancara mendalam, 5 orang subjek diskusi kelompok terarah dan 3 orang petugas ruangan gizi RSUD Curup. Data diperoleh dengan melakukan wawancara mendalam dan diskusi kelompok terarah. Analisis data menggunakan thematic content analysis. Hasil penelitian : Terdapat perbedaan pemahaman diet antara penderita DM laki-laki dan perempuan. Penderita DM laki-laki menyatakan bahwa diet hanya sebatas mengurangi makan yang tidak bertentangan dengan diet saja. Pemahan penderita DM perempuan tentang diet tidak hanya sebatas pengaturan pola makan, tetapi lebih kepada pemilihan bahan makanan yang dihidangkan sehari-hari. Sikap penderita DM terhadap penerapan diet adalah bahwa penerapan diet sangat penting untuk mempertahankan kadar gula darah normal. Faktor pendukung penerapan diet yaitu adanya keuntungan atau manfaat yang dirasakan dalam penerapan diet serta adanya dukungan yang didapatkan dari keluarga dan teman dalam bentuk perhatian dan dukungan sosial. Faktor penghambat penerapan diet adalah sulitnya mempertahankan pola makan diet ketika menghadiri acara undangan atau hajatan dan pada saat menentukan porsi makan dengan menggunakan alat timbangan. Media leaflet masih sangat teoritis dan letter lux, sehingga sulit dipahami oleh semua penderita DM yang memiliki perbedaan karakteristik seperti perbedaan usia dan tingkat pendidikan Kesimpulan : RSUD Curup hendaknya dapat membentuk kelompok/kelas konsultasi bagi penderita DM, mengembangkan program promosi kesehatan di rumah sakit (PKRS) untuk memperluas jangkauan penyuluhan kesehatan yang telah dilaksanakan selama ini. Untuk selanjutnya, dalam melaksanakan konsultasi gizi, hendaknya petugas konselor gizi lebih memperhatikan karakteristik dan latar belakang serta melibatkan keluarga (isteri/suami) penderita DM. Perlu diadakannya ruangan khusus dan melakukan revisi ulang terhadap leaflet yang digunakan sebagai media konsultasi gizi di RSUD Curup dengan menggunakan bahasa yang lebih mudah dipahami dan bentuk tampilan yang lebih menarik.

Background: The treatment of patients with diabetes mellitus (DM) in the Local Public Hospital of Curup (RSUD Curup) was performed in an integrated manner through conveying education and counseling on nutrient in the Nutrient Installation of RSUD Curup. To date, there is no follow-up on counseling session to evaluate the application of daily diet among the patients with DM. Moreover, it is unrecognized how perception of DM patient on diet, factors influencing the application of daily diet, and the expected strategies of health education for the patients visiting for treatment at RSUD Curup. Objective: The objective of this research was to identify a dietary behavior of the patients with DM after getting a nutrient education and counseling in the Nutrient Installation of RSUD Curup. Method: A qualitative method with a case study approach was used. Subjects of the research were determined by using a purposive sampling technique. Fifteen respondents were participated in the research: seven patients to be in-depth interviewed and five patients joined the focus group discussion, and three personnel of the nutrient installation of RSUD Curup as complementary subjects. Data were obtained by doing in-depth interview and focus group discussion. Data were then analyzed using a thematic content analysis. Result: There was difference in understanding diet among both male and female patients with DM. The male ones stated that diet was only limited to reducing foods relatively that were not contradictory with the diet, while female reported that diet was not only limited to regulation a daily eating pattern, but also to selecting foodstuffs served daily. Attitude of DM patients on the application of diet indicated that the application of diet was particularly important to maintain a normal glucose level. Supporting factors of the application of diet were the perceived benefit in applying daily diet and support obtained from family and fellow in forms of attention and social support. Limiting factors of the application of diet were the difficult ways of maintaining the dietary food pattern when they should attend any functions in society, and when weighting food portion using food scales. Leaflet media was remain too academic and theoretical in presentation, so it was difficult to be understood by DM patients who were various in characteristics, such as age and education level. Conclusion: It is recommended that RSUD Curup should be able to establish consultation groups/classes for DM patients develop health promotion programs in the hospital for expanding the scope of health education that previously performed. Moreover, in performing nutrient consultation, nutrient counselors should more emphasize on the characteristics and background of the DM patients as well as involve their own family, mainly spouse in the counseling process. Finally, RSUD Curup has to prepare a counseling room privately, and leaflet media should be revised by using more easily understood languages, as well as interesting layout and design.

Kata Kunci : perilaku diet, penderita DM, dietary behavior, patients with Diabetes Mellitus