The Roles of Medical Doctor and Family on Patient Health Behavior in Controlling HbA1C Level Among Patients with Type 2 Diabetes Mellitus at Dr. Moewardi Hospital
Abstract
Background: Diabetes Mellitus is one of non-communicable diseases with high prevalence of complication and mortality at productive age. Patients with type 2 DM need to control their blood glucose level to attain optimal blood glucose. Thereby, it is expected to prevent or minimize the incidence of complication. This study aimed to examine the roles of medical doctor and family on patient health behavior in controlling HbA1C level among patients with type 2 diabetes mellitus at Dr. Moewardi Hospital, Surakarta.
Subjects and Methods: This was an analytic observational study with case control design. This study was conducted at Dr. Moewardi Hospital, Surakarta, from April to May, 2017. A sample of 50 patients with type 2 Diabetes Mellitus and 100 control group were selected by fixed disease sampling. The dependent variable was HbA1C blood level. The independent variables were roles of medical doctor, roles of family, treatment compliance, physical activity, diet, and duration of illness. HbA1C blood level was measured by clinical laboratory test. The independent variable was measured by a set of questionnaire. The data were analyzed by path analysis.
Results: HbA1C blood level was affected by duration of illness (b= 0.04; SE= 0.01; p<0.001), diet (b=0.18; SE=0.09; p=0.044), and physical activity (b=0.16; SE=0.07; p=0.024). Diet was affected by the role of medical doctor (b= 0.02; SE= 0.07; p= 0.766), the role of family (b= 0.13; SE=0.07; p=0.082), duration of illness (b=0.01; SE=0.01; p=0.063), and treatment compliance (b=0.32; SE=0.11; p=0.002). Physical activity was affected by the role of medical doctor (b=0.17; SE=0.08; p=0.025), the role of family (b=0.21; SE=0.09; p=0.017), diet (b=0.27; SE=0.10; p=0.005) and duration of illness (b= 0.03; SE= 0.01; p< 0.001). Treatment compliance was affected by the role of medical doctor (b= 0.18; SE= 0.05; p<0.001) and the role of family (b=0.24; SE= 0.05; p< 0.001).
Conclusion: HbA1C blood level was directly affected by duration of illness, diet, and physical activity. HbA1C blood level was indirectly affected by the role of medical doctor, the role of family, duration of illness, and treatment compliance, and diet.
Keywords: HbA1C level, diabetes mellitus, healthy behavior
Correspondence: Hosea Puspitasari Pranoto. Masters Program in Public Health, Sebelas Maret University, Surakarta. Email: hoseapuspita@gmail.com. Mobile: +6281804452941.
Indonesian Journal of Medicine (2017), 2(1): 21-34
https://doi.org/10.26911/theijmed.2017.02.01.03
References
Alam R, Sturt J, Lall R, dan Winkley K (2009). An updated meta-analysis to assess the effectiveness of psychological specialists and generalist clinicians on glycaemic control and on psychological status. Patient Education and Counseling.75(1): 25–36.
Ali MK, Feeney P, Hire D, Simmons DL, O’Connor PJ, Ganz-Lord F, Goff Jr D, Zhang P, Anderson RT, Narayan KMV, Sullivan MD (2012). Glycaemia and correlates of patientreported outcomes in ACCORD trial participants. Diabetic Medicine. 29(7): 67–74.
Al-Kaabi J, Al-Maskari F, Saadi H, Afandi B, Parkar H, Nagelkerke N (2009). Physical Activity and Reported Barriers to Activity Among Type 2 Diabetic Patients in the United Arab Emirates. Diabetic Studies. 6(4):271-278.
Angamo MT, Melese BH, Ayen WY (2013). Determinants of glycemic control among insulin treated diabetic patients in Southwest Ethiopia: hospital based cross sectional study. 2013. PLOSE ONE. 8(4): 1-8.
Arisman (2011). Obesitas, Diabetes Melitus, dan Dislipidemia. Jakarta: EGC.
Astuti CM, Setiarini A (2013). Faktor-faktor yang berhubungan dengan pengendalian kadar glukosa darah pasien diabetes melitus tipe 2 rawat jalan di poliklinik penyakit dalam RSJ Prof. Dr. Soerojo Magelang. Jurnal Kesehatan Masyarakat Nasional.
Ciechanowski PS, Katon WJ, Russo JE, Walker EA (2001). The patient provider relationship: attachment theory and adherence to treatment in diabetes. American Journal of Psychiatry. 158:29–35.
Dinas Kesehatan Kota Surakarta (2015). Profil Kesehatan Kota Surakarta Tahun 2015. 1-92.
Gannon MC, Nuttall FQ (20060. Control of blood glucose in type 2 diabetes without weight loss by modification of diet composition. Nutrition & Metabolism. 3(16):1-8.
International Diabetic Federation (IDF) (2014). IDF Diabetes Atlas. Edisi 6. http://www.idf.org/diabetesatlas. Diakses 9 November 2016.
Jiang J, Qiu H, Zhao G, Zhou Y, Zhang Z, Zhang H, Jiang Q, Sun Q, Wu H, Yang L, Ruan X, Xu W (2012). Dietary fiber intake is associated with HbA1c level among prevalent patients with type 2 diabetes in Pudong new area of Shanghai, China. PLOS ONE. 7(10): 1-7.
Kassahun T, Gesesew H, Mwanri L, Eshetie T (2016). Diabetes related knowledge, selfcare behaviours and adherence to medications among diabetic patients in Southwest Ethiopia: a cross sectional survey. BMC Endrocine Disorders. 16(28):1-11.
Kassahun T, Eshetie T, Gesesew H (2016). Factors associated with glycemic control among adult patients with type 2 diabetes mellitus: a cross sectional survey in Ethiopia. BMC Research Notes. 9(78):1-6.
Kementrian Kesehatan RI (2012). Penyakit Tidak Menular. Buletin Jendela Data dan Informasi Kesehatan. 2(2):1-41. Jakarta.
Kerlinger FN (2003). Asasasas Penelitian Behavioral. Terjemahan Landung R Simatupang. Yogyakarta: Gadjah Mada University Press.
Kusnetsov L, Long GH, Griffin SJ, Simmons RK (2015). Are changes in glycaemic control associated with diabetes specific quality of life and health status in screen detected type 2 diabetes patients? Four-year follow up of the ADDITION Cambridge cohort. Diabetes/Metabolism Research and Reviews. 31:69-75.
Marrero DG, Ard J, Delamater AM, Peragallo V, Mayer EJ, Nwankwo R, Fisher EB (2013). Twenty-first century behavioral medicine: a context for empowering clinicians and patients with diabetes. Diabetes Care. 35(2): 463-470.
Mayberry LS, Osborn CY (2012). Family Support, Medication Adherence, and Glycemic Control Among Adults With Type 2 Diabetes. Diabetes Care. 35: 1239-1245.
McElfish PA, Bridges MD, Hudson JS, Purvis RS, Bursac Z, Kohler PO, Goulden PA (2015). Family Model of Diabetes Education With a Pacific Islander Community. Diabetes Education. 41(6): 706-715.
Murti B (2013). Desain dan Ukuran Sampel untuk Penelitian Kuantitatif dan Kualitatif di Bidang Kesehatan. Yogyakarta: Gajah Mada University Press.
Umpierre D, Ribeiro PA, Kramer CK, Leitao CB, Zucatti AT, Azevedo MJ, Gross JL, Riberio JP, Schaan BD (2011). Physical activity adviced only or structured exercise training and association with hba1c levels in type 2 diabetes. Journal American Medical Association. 305(17): 1790-1799.
Walker RJ, Gebregziabher M, Martin-Harris B, Egede LE (2015). Under-standing the influence of psychological and socioeconomic factors on diabetes selfcare using structured equation modeling. Patient Education and Counseling. 98(1): 34-40.
WHO (2015). Noncommunicable Diseases. http://www.who.int/mediacentre/factsheets/fs355/en/. Diakses 15 November 2016.
_____ (2016). Global Report on Diabetes. http://www.who.int/ diabetes/globalreport/en/. Diakses 15 November 2016.
_____ (2016). Diabetes. http://www.who.int/diabetes/en/. Diakses 15 November 2016.
Yates T, Davies MJ, Henson J, Troughton J, Edwardson C, Gray LJ, Khunti K (2012). Walking away from type 2 diabetes: trial protocol of a cluster randomised controlled trial evaluating a structured education programme in those at high risk of developing type 2 diabetes. BMC Family Practice. 13(46): 1-10.
Yates T, Griffin S, Bodicoat DH, Brierly G, Dallosso H, Davies MJ, Eborall H, Edwardson C, Gillett M, Gray L, Hardeman W, Hill S, Morton K, Sutton S, Troughton J, Khunti K (2015). Promotion Of Physical activity through structured Education with differing Levels of ongoing Support for people at high risk of type 2 diabetes (PROPELS): study protocol for a randomized controlled trial. Trials. 16(289).
