Pengaruh Patient Decision Aid terhadap Tingkat Pengetahuan, Sikap, Tindakan dan Hasil Klinis Pengobatan Penderita Diabetes Melitus Tipe 2
Abstract
Diabetes melitus (DM) termasuk ke dalam empat besar penyakit kronis yang prevalensinya terus meningkat di seluruh dunia. Jumlah penderita DM di Indonesia pada tahun 2015 adalah sepuluh juta dan diperkirakan akan terus meningkat. Masalah yang dihadapi Indonesia dalam penanganan DM adalah kontrol gula darah yang buruk, tingkat pengetahuan pasien yang rendah tentang pengelolaan penyakit dan terapi, serta sangat sedikitnya puskesmas yang memiliki apoteker. Patient decision aid (PDA) secara substansial dan signifikan mampu meningkatkan pengetahuan pasien. PDA dirancang berdasarkan konstruk health belief model (HBM) dengan target peningkatan pengetahuan, sikap dan tindakan berkaitan manajemen DM tipe 2 (DMT2). Tujuan utama penelitian ini adalah untuk mengetahui pengaruh PDA terhadap tingkat pengetahuan, sikap, tindakan dan hasil klinis pengobatan. Penelitian ini bersifat pra-eksperimental satu kelompok dengan desain intervensi pretest-posttest yang melibatkan 28 penderita DMT2 berumur 21-65 tahun dan merupakan peserta BPJS Kesehatan yang berobat di Puskesmas I Denpasar Utara, serta belum pernah dirujuk ke fasilitas kesehatan lanjut. Subjek diberikan PDA sebagai intervensi dan hasil utama yang diukur adalah perubahan pengetahuan, sikap, tindakan dan kadar gula darah puasa. Penelitian ini menunjukkan terjadi peningkatan tingkat pengetahuan, sikap dan tindakan, serta penurunan kadar gula darah puasa subjek antara sebelum dan sesudah diberikan PDA. Pemberian PDA menyebabkan peningkatan signifikan (p<0,05) tingkat pengetahuan, sikap dan tindakan, serta penurunan signifikan kadar gula darah puasa.
Kata kunci: Diabetes melitus tipe 2, kadar gula darah puasa, patient decision aid (PDA), pengetahuan, sikap, tindakan
Effect of Patient Decision Aid on Level of Knowledge, Attitude, Practice and Clinical Outcome of Type 2 Diabetes Mellitus Patients
Abstract
Diabetes mellitus (DM) is one of four major chronic diseases which prevalence continued to increase worldwide. The number of diabetes mellitus patients in Indonesia in 2015 were ten million and expected to increase. Several problems faced by Indonesia in handling DM were bad blood sugar control, low patient’s knowledge level about disease management and its therapy, and there are few primary health care that have pharmacist. Patient decision aid (PDA) was substantially and significantly able to increase patient’s knowledge. PDA was designed based on the construct of health belief model (HBM) with the target to increase knowledge, attitude, and action related with management of type 2 DM (T2DM). The main purpose of this research was to determine the effect of PDA to knowledge level, attitude, action, and clinical outcome treatment. This research used pre-experimental one group pretest-posttest design that involved 28 DMT2 patients aged 21-65 years old, were participants of Badan Penyelenggara Jaminan Sosial (BPJS) who got treatment at Puskesmas I Denpasar Utara and had never been referred to a further health care facility. The subjects were given PDA as intervention and main results measured were change of knowledge, attitude, action and fasting blood sugar level. Result of this research showed an increase in knowledge level, attitude, and action of the subjects, as well as decrease in subjects’ fasting blood sugar between before and after they had been given the PDA. Giving PDA caused a significant increase (p<0,05) in level of knowledge, attitude, and action, and significant decrease of fasting blood sugar.
Keywords: Attitude, fasting blood sugar levels, knowledge, patient decision aid (PDA), practice, type 2 diabetes mellitus
Keywords
Full Text:
PDF (Bahasa Indonesia)References
International Diabetes Federation. IDF diabetes atlas, 7th Edition. Brussels: International Diabetes Federation; 2015.
American Diabetes Association. Strategies for improving care, Sec. 1. In: Standards of medical care in diabetes 2016. Diabetes Care. 2016;39(1):S6–12. doi: 10.2337/dc16-S004
Ministry of Health. Self-management support for people with long-term conditions, 2nd Edition. Wellington: Ministry of Health; 2016.
Nam S, Chesla C, Stotts NA, Kroon L, Janson SL. Barriers to diabetes management: Patient and provider factors. Diabetes Res Clin Pract. 2011;93(1):1–9. doi: 10.1016/j.diabres.2011.02.002
Zahiri A, Yunivita V, Martha JW. Knowledge, attitude and practice of diabetes mellitus type 2 patients towards compliance to treatment in pusat kesehatan masyarakat. Althea Medical Journal. 2016;3(3):416–20. doi: 10.15850/amj.v3n3.871
McPherson ML, Smith SW, Powers A, Zuckerman IH. Association between diabetes patients’ knowledge about medications and their blood glucose control. Res Social Adm Pharm. 2008;4(1):37–45. doi: 10.1016/j.sapharm.2007.01.002.
Soewondo P, Soegondo S, Suastika K, Pranoto A, Soeatmadji DW, Tjokroprawiro A. The DiabCare Asia 2008 study–Outcomes on control and complications of type 2 diabetic patients in Indonesia. Med J Indones. 2010;19(4):235–44. doi: 10.13181/mji.v19i4.412
Soewondo P. Current practice in the management of type 2 diabetes in Indonesia: Results from The International Diabetes Management Practices Study (IDMPS). J Indon Med Assoc. 2011;61(12):474–81.
Pramestutie HR, Sari MP, Illahi RK. The knowledge level of diabetes mellitus patients for drug therapy in the primary health care of Malang. Pharmaceutical J Indones. 2016;2(1):7–11.
Boyoh ME, Kaawoan A, Bidjuni H. Relationship of knowledge with medication adherence of diabetes mellitus type 2 patients in Poly Endocrine RSUP.Prof. Dr. R.D. Kandou Manado. Jurnal Keperawatan. 2015;3(3):1–6.
Herman MJ, Supardi S, Yuniar Y. Relationship of the availability of phamacist with characteristics of primary health center and pharmacy practice in health center. Bulletin of Health Systems Research. 2013;16(1):88–98.
Bailey RA, Pfeifer M, Shillington AC, Harshaw Q, Funnell MM, VanWingen J, et al. Effect of a patient decision aid (PDA) for type 2 diabetes on knowledge, decisional self-efficacy, and decisional conflict. BMC Health Serv Res 2016;16:10. doi: 10.1186/s12913-016-1262-4.
Fatema K, Hossain S, Natasha K, Chowdhury HA, Akter J, Khan T, et al. Knowledge attitude and practice regarding diabetes mellitus among nondiabetic and diabetic study participants in Bangladesh. BMC Public Health. 2017;17:364–73. doi: 10.1186/s12889-017-4285-9
Notoatmodjo S. Health promotion and health behavior, revised edition. Jakarta: PT. Rineka Cipta; 2012.
Sadeghi R, Tol A, Baikpour M, Moradi A, Hossaini M. Assessing the effects of a health belief model-based educational program on knowledge attitudes and practice (KAP) among patients with Pemphigus vulgaris. Journal of Cosmetics, Dermatological Sciences and Applications. 2014;4(4):244–9. doi: 10.4236/jcdsa.2014.44033
Mathers N, Ng CJ, Campbell MJ, Colwell B, Brown I, Bradley A. Clinical effectiveness of a patient decision aid to improve decision quality and glycaemic control in people with diabetes making treatment choices: A cluster randomised controlled trial (PANDAs) in general practice. BMJ Open. 2012;2(6):1–12. doi: 10.1136/bmjopen-2012-001469
Branda ME, LeBlanc A, Shah ND, Tiedje K, Ruud K, Houten HV, et al. Shared decision making for patients with type 2 diabetes: A randomized trial in primary care. BMC Health Serv Res. 2013;13:1–10. doi: 10.1186/1472-6963-13-301
Avdal Eu, Özyazicioğlu N, Dirik G, Akkurt A. A comparison between HbA1c levels and knowledge and attitudes concerning diabetes among type 1 and type 2 diabetics. Acta Med Mediterr. 2015;31:681–6.
Al-Naggar RA, Osman MT, Ismail N, Ismail Z, Noor NAM, Ibrahim NS, et al. Diabetes mellitus among selected Malaysian population: A cross-sectional study. Int J Med Res Health Sci. 2017;6(4):1–11.
Islam SMS, Niessen LW, Seissler J, Ferrari U, Biswas T, Islam A, et al. Diabetes knowledge and glycemic control among patients with type 2 diabetes in Bangladesh. SpringerPlus. 2015;4:284–90. doi: 10.1186/s40064-015-1103-7
DOI: https://doi.org/10.15416/ijcp.2018.7.2.89
Refbacks
- There are currently no refbacks.
Indonesian Journal of Clinical Pharmacy is indexed by
