Masalah-Masalah terkait Pengobatan Diabetes Melitus Tipe 2: Sebuah Studi Kualitatif
Abstract
Pengelolaan diabetes melitus tipe 2 (DMT2) yang kompleks memicu masalah-masalah yang menyebabkan sasaran terapi tidak tercapai. Tujuan penelitian ini adalah untuk mengidentifikasi masalah-masalah yang dialami pasien DMT2 dalam pengobatan. Pendekatan kualitatif digunakan dalam desain penelitian ini. Pengumpulan data melalui wawancara semiterstruktur, bertatap muka. Rekrutmen partisipan dilakukan di poliklinik penyakit dalam rumah sakit di Yogyakarta (RSUD Sleman, RS Bethesda, dan RSUD Wates) pada bulan November 2015–Mei 2016. Kombinasi pertanyaan terbuka dan tertutup diterapkan untuk memperoleh jawaban dari partisipan. Pertanyaan-pertanyaan wawancara terkait dengan pemahaman tentang penyakit dan obat, aktivitas perawatan diri diabetes, komunikasi dengan tenaga kesehatan, dukungan sosial, dan kondisi psikologis. Setiap sesi wawancara direkam audio, ditranskrip verbatim, dan dianalisis menggunakan matriks. Partisipan juga diperiksa kadar HbA1c untuk mengetahui baik-buruknya kontrol glikemik. Dua puluh tiga partisipan memenuhi sesi wawancara, berusia antara 35–72 tahun dan didominasi perempuan (n=12). Kadar HbA1c rata-rata 7,9±2,0 %. Hasil analisis data teridentifikasi masalah pasien DMT2 dikategorikan menjadi masalah terkait faktor demografi, sosial, gaya hidup, hubungan dengan tenaga kesehatan, pemahaman mengenai penyakit, efek penyakit, pengendalian penyakit, komorbiditas, pengetahuan tentang pengobatan, dan asupan obat. Pemberian edukasi dan konseling kefarmasian sebaiknya tidak hanya berorientasi pada terapi farmakologi saja, namun juga memberikan motivasi pada pasien untuk mengubah perilaku, serta mempertimbangkan faktor psikologis dalam pengelolaan DMT2.
Kata kunci: Diabetes melitus, edukasi, konseling, masalah terkait pengobatan, wawancara
Medication-related Problems in Patients with Type 2 Diabetes Mellitus: A Qualitative Study
Abstract
The complexity of type 2 diabetes mellitus (T2DM) management offers plenty of challenges to patients. Poor glycaemic control, the presence of complications and comorbidities, and non-adherence furnish the challenges in arranging glycaemic target. This study was performed to explore the medication-related problems experienced by T2DM patients during treatment. Qualitative research was conducted through face-to-face semi-structured interviews. The combination of open- and closed-ended questions was formulated focusing on domains including illness- and medicine-related knowledge, diabetes self-care activities, patient–healthcare professional communication, social support, and psychological conditions. Interview sessions were audio-recorded, transcribed verbatim, and analyzed into matrix. Glycated hemoglobin (HbA1c) were measured to assess glycaemic control. Twenty-three T2DM outpatients from three general hospitals in Yogyakarta (Sleman District Hospital, Bethesda Hospital, and Wates District Hospital) were recruited and completed the protocol. The participants were 35–72 years old, was dominated by female (n=12), and had a mean HbA1c level 7.9 ± 2.0 %. Perceived factors leading medication therapy problems were of three types and related to: patient-, clinical condition-, and medicine-related factors. Patient-related factors were related to sociodemographic, lifestyle, and relationship with healthcare provider. Clinical condition-related factors included knowledge about illness, effects of illness, control over symptoms, comorbidities. Medicine-related factors associated with lack of knowledge about medicines and medicine use. This study concluded that behavior change and psychological well-being should be noticed when leading diabetes education and counseling.
Keywords: Counseling, diabetes mellitus, education, interview, medication therapy problems
Keywords
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DOI: https://doi.org/10.15416/ijcp.2020.9.1.26
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