St.

Paul University Philippines

Tuguegarao City, Cagayan 3500

By
AMRIATI MUTMAINNA
 The latest global estimates from the
International Diabetes Federation forecast
that by 2040, 642 million people will be
living with diabetes (The Lancet, 2017).

 WorldHealth Organization (2017) stated the

number of people with diabetes has risen
from 108 million in 1980 to 422 million in
2014.
 Based on data from the Indonesian Central
Bureau of Statistics in 2003, it is estimated
that Indonesians aged over 20 years are 133
million. With a DM prevalence of 14.7% in
urban areas and 7.2%, in rural areas, it is
estimated that in 2003 there were 8.2 million
people with diabetes in urban areas and 5.5
million in rural areas (Mayasari et al, 2014).
A retrospective cohort study conducted by
Franklin (2012) claimed that regularly
scheduled lifestyle counseling in real-world
settings motivates patients with diabetes to
achieve targeted average blood glucose more
quickly than scenarios in which patients
receive physician advice less frequently.

 Therefore,the purpose of this study was to

come up assess the self care behaviors of
patients with diabetes mellitus.
 INPUT PROCESS OUTPUT

Assessment of
Profile of the self-care
Diabetes behaviors:
Mellitus 1. Glucose
patients management Proposed
2. Dietary counseling
Self- control program
management 3. Physical
questionnaire activity
4. Health-care
use
 What is the profile of the participants in terms of:
 Age;
 Gender;
 Blood sugar levels;
 Body Mass Index (BMI); and
 History of smoking?
 What is the degree of manifestation of the self-care
behaviors of the participants in general and in terms of:
 Glucose management;
 Dietary control;
 Physical activity; and
 Health care use?
 Is there a significant difference in the self-care behaviors
of the participants when grouped according to profile
variables?
 What counseling program can be purposed to enhance
self-care behaviors?
Labuang Baji Hospital is
located in the southern
part of Mamajang District,
Makassar City, precisely in
Jalan Dr. Ratulangi No. 81
Makassar.
The geographical
boundaries of Labuang Baji
Hospital is as follows:
a. The north is adjacent
to Jalan Landak Lama
b. The east is bordered by
Squirrel Street
c. The south is bordered
by Ex-Priestly Housing
d. West side is bordered
by Jalan Dr. Ratulangi
Pelamonia Hospital is
located in the city center
of Makassar, precisely in
Jalan Jenderal Sudirman
No. 27 Makassar.
The geographical
boundaries of Pelamonia
Hospital is as follows:
a. The north is adjacent
to Jalan G.
Bawakaraeng
b. The east is bordered
by Jalan G.
Lompobattang
c. The south is bordered
by Jalan G. Tinggi Mae
d. West side is bordered
by Monumen Mandala
 Inthis paper, the researcher used
descriptive study which the researcher
described the self-care behavior of
patients diagnosed with diabetes mellitus
as a basis for the purpose of counseling
program.
 The primary data in this study was the
profile of the participants in terms of age,
gender, blood sugar levels, BMI, and history
of smoking. In addition, the questions for
diabetes mellitus patients used Diabetes Self
Management Questionnaire (DSMQ) by
Schmitt, et al. (2013).
 According to Fatimah (2016) asserted
diabetes self management questionnaire
(DSMQ) in Indonesian language which valid
and reliable already.
 Frequency and percentage distribution (%)
were used to present the age, gender, and
history of smoking.
 Weighted mean (M) were used to describe
the blood sugar level, BMI and self-care
degree.
 Chi-Square was used to determine the
significant difference on self-care behaviors
of the participants when grouped according
to profile variables in general and in terms of
glucose management, dietary control, and
health-care use.
  Interpretation Age of Diabetes Mellitus Patients
Age Frequency Percentage (%)
Less than or equal to 28 38.9%
45 years old
More than 45 years old 44 61.1%
Total 72 100%

 Interpretation Gender of Diabetes Mellitus Patients

Gender Frequency Percentage
(%)
Male 25 34.7%
Female 47 65.3%
Total 72 100%
  Interpretation Blood Sugar Levels of Diabetes
Mellitus Patients

Percentage Decision
Blood Sugar Level Frequency
(%) Value
Below 200 mg/dl 19 26.4%
200 mg/dl or more 53 73.6% >200
Total 72 100% mg/dl
Mean Weight = 281.13
  Interpretation Body Mass Index of Diabetes Mellitus
Patients
Percentage Decision
Body Mass Index Frequency
(%) Value
Underweight 3 4.2%
Normal weight 29 40.3%
Overweight 19 26.4% Normal
Obese 21 29.2% Weight
Total 72 100%
Mean Weight = 26.35

 Interpretation History of Smoking of Diabetes

Mellitus Patients
History of Smoking Frequency Percentage (%)
Yes 19 26.4%
No 53 73.6%
Total 72 100%
 Self-Care Percentage Decision
Frequency
Scores (%) Value
Very high 9 12.5%
degree
High 9 12.5%
degree
Moderate Low
15 20.8%
degree Degree
Low degree 39 54.2%
Total 72 100%
Mean Weight = 4.9781
 Glucose Percentage Decision
Frequency
Management (%) Value
Very high degree 12 16.7%
High degree 9 12.5%
Moderate degree 12 16.7% Low
Low degree 39 54.2% Degree
Total 72 100%
Mean Weight = 4.9072
 Dietary Percentage Decision
Frequency
Control (%) Value
Very high 13 18.1%
degree
High degree 4 5.6%
Moderate 19 26.4% Low
degree Degree
Low degree 36 50.0%
Total 72 100%
Mean Weight = 4.7342
 Percentage Decision
Physical Activity Frequency
(%) Value
Very high degree 6 8.3%
High degree 14 19.4%
Moderate degree 12 16.7% Low
Low degree 40 55.6% Degree
Total 72 100%
Mean Weight = 4.8915
 Percentage Decision
Health-Care Use Frequency
(%) Value
Very high degree 5 6.9%
High degree 6 8.3%
Moderate degree 27 37.5% Moderate
Low degree 34 47.2% Degree
Total 72 100%
Mean Weight = 5.2008
 Glucose Management
Very Decision
Variable High Moderate Low Total
high Value
Degree Degree Degree
degree
≤45
years 2 3 5 18 28
old
Age
>45
Accept
years 10 6 7 21 44
H0
old
Total 12 9 12 39 72
X2 Value = 3.515
P-value = 0.319
 Glucose Management
Variable Very Decision
High Moderate Low Total
high value
Degree Degree Degree
degree
Male 5 2 6 12 25
Gender
Female 7 7 6 27 47
Accept
Total 12 9 12 39 72
H0
X2 Value = 2.380
P-value = 0.497
 Glucose Management
Variable Very Decision
High Moderate Low Total
high Value
Degree Degree Degree
degree
Below
200 11 7 0 1 19
Blood mg/dl
Sugar 200
Levels mg/dl Reject
1 2 12 38 53
or H0
more
Total 12 9 12 39 72
X2 Value = 54.257
P-value = 0.000
 Glucose Management
Variable Very Decision
High Moderate Low Total
high Value
Degree Degree Degree
degree
Under-
0 1 1 1 3
weight
Body Normal
8 6 4 11 29
Mass Weight
Index Over- Accept
2 2 3 12 19
weight H0
Obese 2 0 4 15 21
Total 12 9 12 39 72
X2 Value = 12.744
P-value = 0.175
 Glucose Management
Very Decision
Variable High Moderate Low Total
high Value
Degree Degree Degree
degree
History Yes 3 2 4 10 19
of 53
No 9 7 8 29
Smoking
Accept H0
Total 12 9 12 39 72
X2 Value = 0.401
P-value = 0.940
 Dietary Control
Very Decision
Variable High Moderate Low Total
high Value
Degree Degree Degree
degree
≤45
years 3 2 7 16 28
old
Age
>45
years 10 2 12 20 44 Accept H0
old
Total 13 4 19 36 72
X2 Value = 2.076
P-value = 0.557
 Dietary Control
Variable Very Decision
High Moderate Low Total
high value
Degree Degree Degree
degree
Male 5 1 7 12 25
Gender
Female 8 3 12 24 47
Accept
Total 13 4 19 36 72
H0
X2 Value = 0.315
P-value = 0.957
 Dietary Control
Variable Very Decision
High Moderate Low Total
high Value
Degree Degree Degree
degree
Below
200 13 3 2 1 19
Blood mg/dl
Sugar 200
Levels mg/dl Reject
0 1 17 35 53
or H0
more
Total 13 4 19 36 72
X2 Value = 53.922
P-value = 0.000
 Dietary Control
Variable Very Decision
High Moderate Low Total
high Value
Degree Degree Degree
degree
Under-
0 0 2 1 3
weight
Body Normal
9 3 7 10 29
Mass Weight
Index Over-
3 1 6 9 19 Accept H0
weight
Obese 1 0 4 16 21
Total 13 4 19 36 72
X2 Value = 14.884
P-value = 0.094
 Dietary Control
Very Decision
Variable High Moderate Low Total
high Value
Degree Degree Degree
degree
History Yes 3 1 4 11 19
of 53
No 10 3 15 25
Smoking
Accept H0
Total 13 4 19 36 72
X2 Value = 0.678
P-value = 0.878
 Physical Activity
Very Decision
Variable High Moderate Low Total
high Value
Degree Degree Degree
degree
≤45
years 0 5 3 20 28
old
Age
>45
Accept
years 6 9 9 20 44
H0
old
Total 6 14 12 40 72
X2 Value = 6.929
P-value = 0.074
 Physical Activity
Variable Very Decision
High Moderate Low Total
high value
Degree Degree Degree
degree
Male 3 4 9 9 25
Gender
Female 3 10 3 31 47
Reject
Total 6 14 12 40 72
H0
X2 Value = 12.077
P-value = 0.007
 Physical Activity
Variable Very Decision
High Moderate Low Total
high Value
Degree Degree Degree
degree
Below
200 6 9 3 1 19
Blood
mg/dl
Sugar
200
Levels
mg/dl 0 5 9 39 53 Reject H0
or more
Total 6 14 12 40 72
2
X Value = 38.851
P-value = 0.000
 Physical Activity
Variable Very Decision
High Moderate Low Total
high Value
Degree Degree Degree
degree
Under-
0 0 0 3 3
weight
Body Normal
5 9 5 10 29
Mass Weight
Index Over-
0 4 3 12 19 Accept H0
weight
Obese 1 1 4 15 21
Total 6 14 12 40 72
X2 Value = 14.977
P-value = 0.092
 Physical Activity
Very Decision
Variable High Moderate Low Total
high Value
Degree Degree Degree
degree
History Yes 2 3 6 8 19
of 53
No 4 11 6 32
Smoking Accept
Total 6 14 12 40 72 H0
X2 Value = 4.611
P-value = 0.203
 Health-Care Use
Very Decision
Variable High Moderate Low Total
high Value
Degree Degree Degree
degree
≤45
years 0 1 11 16 28
old
Age
>45
years 5 5 16 18 44 Accept H0
old
Total 5 6 27 34 72
X2 Value = 5.422
P-value = 0.143
 Health-Care Use
Variable Very Decision
High Moderate Low Total
high value
Degree Degree Degree
degree
Male 2 3 10 10 25
Gender
Female 3 3 17 24 47
Accept
Total 5 6 27 34 72
H0
X2 Value = 1.166
P-value = 0.761
 Health-Care Use
Variable Very Decision
High Moderate Low Total
high Value
Degree Degree Degree
degree
Below
200 5 5 7 2 19
Blood mg/dl
Sugar 200
Levels mg/dl Reject
0 1 20 32 53
or H0
more
Total 5 6 27 34 72
X2 Value = 31.327
P-value = 0.000
 Health-Care Use
Variable Very Decision
High Moderate Low Total
high Value
Degree Degree Degree
degree
Under-
0 0 0 3 3
weight
Body Normal
4 5 10 10 29
Mass Weight
Index Over-
0 0 9 10 19 Accept H0
weight
Obese 1 1 8 11 21
Total 5 6 27 34 72
X2 Value = 13.240
P-value = 0.152
 Health-Care Use
Very Decision
Variable High Moderate Low Total
high Value
Degree Degree Degree
degree
History Yes 2 3 7 7 19
of 53
No 3 3 20 27
Smoking Accept
Total 5 6 27 34 72 H0
X2 Value = 2.791
P-value = 0.425
 Self-Care Behaviors
Very Decision
Variable High Moderate Low Total
high Value
Degree Degree Degree
degree
≤45 years
0 4 7 17 28
old
Age
>45 years
9 5 8 22 44 Accept
old
H0
Total 9 9 15 39 72
X2 Value = 6.589
P-value = 0.086
 Self-Care Behaviors
Variable Very Decision
High Moderate Low Total
high value
Degree Degree Degree
degree
Male 5 2 5 13 25
Gender
Female 4 7 10 26 47
Accept
Total 9 9 15 39 72
H0
X2 Value = 2.390
P-value = 0.496
 Self-Care Behaviors
Variable Very Decision
High Moderate Low Total
high Value
Degree Degree Degree
degree
Below
200 9 9 0 1 19
Blood mg/dl
Sugar 200
Levels mg/dl Reject
0 0 15 38 53
or H0
more
Total 9 9 15 39 72
X2 Value = 66.984
P-value = 0.000
 Self-Care Behaviors
Variable Very Moderat Decision
High Low Total
high e Value
Degree Degree
degree Degree
Under-
0 0 1 2 3
weight
Body Normal
6 8 3 12 29
Mass Weight
Index Over-
2 1 6 10 19 Reject H0
weight
Obese 1 0 5 15 21
Total 9 9 15 39 72
X2 Value = 17.097
P-value = 0.047
 Self-Care Behaviors
Very Decision
Variable High Moderate Low Total
high Value
Degree Degree Degree
degree
History Yes 3 2 2 12 19
of 53
No 6 7 13 27
Smoking Accept
Total 9 9 15 39 72 H0
X2 Value = 2.005
P-value = 0.571
 Rationale
 The latest global estimates from the International Diabetes Federation
forecast that by 2040, 642 million people will be living with diabetes (The
Lancet, 2017).
 In addition, the patients who have diabetes then, patient can confirm that
there is a problem with blood sugar levels that are experiencing
hyperglycemia. Therefore, patients should be able to control blood sugar
in order not to increase or experience hyperglycemia. One way to be able
to control blood sugar in patients with diabetes is counseling.
 This is due to the fact that the patient needs the delivery in controlling
patient’s own blood sugar. According to the American Counseling
Association, counseling is defined as, a professional relationship that
empowers diverse individuals, families, and groups to accomplish mental
health, wellness, education, and career goals (Austin, 2017).
 Finally, the very basic needs in this case are knowledge of adult about self-
care behaviors which is very important; before face to complication of
diabetes mellitus disease. In addition, adult will take precautions if they
know the knowledge of self-care behaviors. At this point, assessments of
needs may be made by professional registered counselors which must have
licensed from PEDI (Perhimpunan Edukator Diabetes Indonesia or Educator
Diabetes Association of Indonesia).
 Objectives
 General Objective
 The objectives of counseling program are to
understanding the diabetes mellitus patients’ needs
and increasing self-care behaviors for diabetes
mellitus patients.
 Specific Objectives
 Provide counselors for the provision of knowledge self-
care behaviors to educate diabetes mellitus patients.
 Increase knowledge about self-care behaviors to
diabetes mellitus patients.
 Provide services such as bed side teaching, health
education or health promotion.
 Plan of Action
 The first step, the researcher suggested to the hospital for make
counseling program towards diabetes mellitus patients. The hospital
concerns to having the counselors who are registered counselors
which must have licensed from PEDI. Perhimpunan Edukator
Diabetes Indonesia (PEDI) is Educator Diabetes Association of
Indonesia who is giving education through counseling or health
promotion concern diabetes.
 In addition, the researcher prompted to the hospital also to make
bed side teaching from PEDI counselors which expert in diabetes
mellitus disease. Bed side teaching will be more knowledgeable to
the diabetes mellitus patients because the patients will be more
understand about diabetes mellitus from the expertise.
 Furthermore, diabetes mellitus patients are not only stop counseling
in the hospital. But, diabetes mellitus patients will be still
undergoing counseling to the expertise counselors PEDI. So, the
counseling is never stop although the diabetes mellitus patients at
home. The diabetes mellitus patients can still call and message the
counselors through phone or directly go to the near public health.
 Plan of Action (cont.)
 In addition, the researcher suggested to the public health for willing
infrastructure especially counseling about diabetes mellitus. One of suggest
from the researcher is support counseling program through build counselors
PEDI from health workers. So, the counselor will be more expertise in
diabetes mellitus disease. And then, diabetes mellitus disease will be
protection from beginning. So, no more diabetes mellitus patients
experienced complications of the diabetes mellitus disease.
 Furthermore, the researcher prompted also to the hospital for make health
promotion and health education especially diabetes mellitus disease. The
health promotion and health education which concern young people, females,
high blood sugar levels, obese, and having history of smoking. But, the old
people, male, low blood sugar levels, normal weight, and not having history of
smoking are not close possibility for having diabetes mellitus disease also.
Finally, all of the people must to know about diabetes mellitus disease
through health promotion and health education.
 The researcher added also health promotion and health education must to
having knowledge about self-care behaviors. Because, self-care behaviors
have important roles to changes the lifestyle society. Moreover, the self-care
behaviors include glucose management, dietary control, physical activity, and
health-care use. Those four components are having important roles to the
diabetes mellitus patients for have lifelong in the future.
SUMMARY OF FINDINGS, CONCLUSIONS
AND RECOMMENDATIONS
 The profile of the participants
 Majority of the participants are above 45 years
old.
 Majority of the participants are female.
 Majority of the participants are above 200
mg/dl
 The most of the participants are normal
weight.
 Majority of the participants are non-smokers.
 The degree of manifestation of the self-
care behaviors of the participants in
general and in terms of glucose
management, dietary control, physical
activity, and health care use
 In general terms
 Majority of the participants are diabetes mellitus
patients have low degree of self-care behaviors.
 Majority of the participants are diabetes mellitus
patients have low degree of glucose management.
 Majority of the participants are diabetes mellitus
patients have low degree of dietary control.
 Majority of the participants are diabetes mellitus
patients have low degree of physical activity
 Majority of the participants are diabetes mellitus
patients have moderate degree of health-care use.
 In specific terms
 Glucose management
 There is no significant difference on the participant’s glucose
management and their age, gender, body mass index, and history
of smoking.
 There is a significant difference on the participant’s glucose
management and their blood sugar levels.
 Dietary control
 There is no significant difference on the participant’s dietary
control and their age, gender, body mass index, and history of
smoking.
 There is a significant difference on the participant’s dietary
control and their blood sugar levels.
 Physical activity
 There is no significant difference on the participant’s physical
activity and their age, body mass index, and history of smoking.
 There is a significant difference on the participant’s physical
activity and their gender, blood sugar levels.
 Health-Care Use
 There is no significant difference on the participant’s health-care
use and their age, gender, body mass index, and history of
smoking.
 There is a significant difference on the participant’s health-care
use and their blood sugar levels.
 Significant difference in the self-care behaviors of the
participants when grouped according to profile variables
 There is no significant difference on the participant’s dietary
control and their age, gender, and history of smoking.
 There is a significant difference on the participant’s dietary
control and their body mass index, blood sugar levels.
 Counseling program can be purposed to enhance self-
care behaviors
 The hospital supports counseling program through build
counselors PEDI (Perhimpunan Edukator Diabetes
Indonesia/Educator Diabetes Association of Indonesia) from
health workers.
 The hospital concerns to having the counselors who are
registered counselors which must have licensed from PEDI.
 The hospital also makes bed teaching from PEDI counselors
which expert in diabetes mellitus disease.
 The hospital makes health promotion and health
education especially diabetes mellitus disease about
self-care behaviors, such as glucose management,
dietary control, physical activity, and health-care use.
 Diabetes is a serious life-long health condition that occurs
when the amount of glucose in the blood is too high
because the body can’t use it properly. Therefore,
patients should be able to control blood sugar in order
not to increase or experience hyperglycemia. One way to
be able to control blood sugar in patients with diabetes is
counseling.
 In addition, this study concluded that poor self-care
behaviors of the participants are low glucose
management, dietary control, physical activity, and
health-care use. Furthermore, diabetes mellitus patients
experienced the highest number of cases occurred in this
study was above 45 years old, female participants, blood
sugar levels above 200 mg/dl, normal weight, and had not
history of smoking. The counselors should be notice those
entire important subjects to ensure counseling appositely.
Self-care behaviors were important things to do for
diabetes mellitus patients, because it can help patients
to control blood sugar within normal range.
 Department of Health. The researcher
recommended department of health to be an
input for the preparation of health development
policies and programs especially counseling
program for diabetes mellitus patients.
 Hospital. The researcher suggested hospital to
adhere training of the health worker providers
on DM facilitated by Association of Diabetes
Indonesia or Persatuan Diabetes Indonesia.
 Nursing Education Institution. The researcher
prompted science schools to train the students
better than before which concerns counseling
especially about diabetes mellitus patients, such
as self-care behaviors.
 Diabetic Patients. The researcher also
recommended for people with diabetes who
need counseling to control blood sugar in
diabetes mellitus patients especially for
older people, females, blood sugar levels
above 200 mg/dl, have not history of
smoking, and self-care behaviors low degree.
 Future Researchers. The researcher
suggested to the future researchers within
improves and ascertains cognition to the
future researcher concerning counseling of
diabetes mellitus patients.