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"Hipoglikemia adalah komplikasi akut diabetes melitus yang seringkali terjadi secara berulang yang ditandai dengan gula darah kurang dari 70 mg/dl. Kondisi tersebut akan berdampak secara psikologis yaitu ketakutan akan serangan ulang yang menciptakan perasaan traumatis pada penyandang diabetes melitus. Penelitian ini bertujuan untuk memperoleh pemahaman yang mendalam tentang pengalaman penyandang diabetes melitus yang pernah mengalami episode hipoglikemi di Persadia Kota Depok. Penelitian ini merupakan penelitian kualitatif deskriptif dengan pendekatan fenomenologi terhadap enam partisipan. Hasil penelitian didapatkan enam tema utama yaitu penurunan fungsi fisik sementara sebagai respon hipoglikemia, perasaan traumatis ketika mengalami hipoglikemia, pemahaman partisipan terhadap penyebab hipoglikemia, kesadaran untuk pencegahan hipoglikemia, keyakinan internal menjadi sumber koping utama dalam menghadapi hipoglikemia, kebutuhan pelayanan keperawatan. Hasil penelitian ini diharapkan dapat menjadi masukan dalam meningkatkan edukasi pada pasien yang mengalami hipoglikemia.

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Hypoglycemia is an acute complication of diabetes mellitus which frequently occur repeatedly marked by blood glucose less than 70 mg/dl. The condition will affect the psychological fear of repeated attacks that create a traumatic feelings in people with diabetes mellitus. This study aims is to gain an in depth understanding of experiences of persons with diabetes mellitus who had experienced of hypoglycemia episodes in Persadia Depok. Qualitative descriptive phenomenology approach was applied to 6 participants. The findings revealed 6 themes: decline in physical function while in response to hypoglycemia, traumatic feelings when experiencing hypoglycemia, participants understanding that caused of hypoglycemia, awareness of hypoglycemia prevention, internal beliefs became the main source of coping to faced of hypoglycemia and nursing care needs. The results of this study suggest a need of improvement in nursing education for patients with hypoglycemia."

"Hipoglikemia merupakan salah satu komplikasi diabetes melitus tipe 2. Anggota keluarga biasanya menjadi orang pertama yang mengetahui kejadian hipoglikemia pada klien. Penelitian ini bertujuan untuk mengetahui pengalaman keluarga klien diabetes melitus tipe 2 menghadapi hipoglikemia. Penelitian ini adalah penelitian kualitatif dengan desain fenomenologi deskriptif. Wawancara mendalam terhadap 11 partisipan mengidentifikasi empat tema yaitu: keluarga mempersepsikan hipoglikemia adalah sesuatu yang biasa, keluarga mampu mengenali gejala awal hipoglikemia, keluarga memberikan dukungan positif bagi klien dalam menghadapi hipoglikemia, dan hipoglikemia memiliki dampak negatif bagi keluarga. Hasil penelitian menunjukkan peran penting perawat untuk memberikan edukasi yang komprehensif mengenai hipoglikemia terhadap keluarga klien diabetes melitus tipe 2.

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Hypoglycemia is one of diabetes complications. Hypoglycemia can increase risk of cardiovascular diseases or even lead to death. Family members are usually the first people to recognize hypoglycemia. Hypoglycemia is an unpredictable condition which make they should aware with it. A qualitative study using a phenomenological description design was utilized. In depth interviews were conducted with 11 family members of the person with type 2 diabetes. Family rsquo s experiences dealing with hypoglycemia were described into four main themes family perceive hypoglycemia is a common thing, family is capable in recognizing early symptoms of hypoglycemia, family provide positive support to person dealing with hypoglycemia, and hypoglycemia affects the family negatively. This study denotes a major role of nurse to provide a comprehensive education about hypoglycemia to the family of the person type 2 diabetes."

"ABSTRAKHipoglikemia bisa terjadi selama pasien dirawat di rumah sakit yang disebabkan oleh iatrogenic. Tujuan penelitian ini untuk mengeksplor pengalaman perawat dalam pemantauan, penanganan dan penggunaan protokol hipoglikemia di rumah sakit. Penelitian ini dilakukan dengan wawancara mendalam pada 10 perawat tentang pengalaman mereka dalam pemantauan, penanganan, dan penggunaan protokol hipoglikemi, sehingga memperoleh enam tema yakni: perawat memahami hipoglikemia berdasarkan gejala fisik dan nilai gula darah; kecemasan perawat menghadapi hipoglikemi; ketidakberadaan dokter dan hambatan komunikasi dalam penanganan hipoglikemi; perawat melakukan pemeriksaan gula darah dan keluhan pasien untuk mengkaji hipoglikemia; memutuskan untuk melakukan tindakan medis secara mandiri sesuai kebiasaan; dan merasa tidak familiar dengan keberadaan protocol hipoglikemia. Kesimpulan dari penelitian menunjukkan bahwa dalam penanganan hipoglikemia perawat masih mengalami kecemasan dan cenderung memberikan intervensi sesuai dengan kebiasaan.

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ABSTRACTPatients may experience hypoglycemia during hospitalization which is caused by Iatrogenic. This study aimed to describe experience of nurses in monitoring, treating and using guideline of Hypoglycemia in patients with diabetes mellitus. An indepth interview was conducted that involved 10 nurses. There were six themes identified through this method, they were nurses anxiety facing hypoglycemia the absence of physician and communication barriers in the treatment of hypoglycemia nurses undertaking blood glucose check and complains of patients in monitoring hypoglycemia deciding to follow medical treatment independently based on routine and found unfamiliar with the existence of protocol. The conclusion indicates that nurses are still struggling with anxiety and tend to apply their routine in dealing with hypoglycemia. "

"Tesis ini membahas bagaimana klien Diabetes Melitus memberikan makna kehidupan dalam kondisi sakitnya. Tujuan dalam penelitian ini menguraikan persepsi, respon psikososial, kebutuhan penatalaksanaan, harapan dan makna kehidupan klien. Penelitian ini adalah penelitian kualitatif dengan desain deskriptif. Hasil penelitian menemukan tujuh tema besar yang sesuai dengan tujuan penelitian dan satu tema tambahan yaitu beban yang dihadapi klien. Kesimpulannya makna kehidupan klien didapatkan dalam kondisi penderitaan dan pendalaman nilai spiritual. Penelitian ini menyarankan penggunaan model Adaptasi Roy dalam pengembangan teori keperawatan khususnya masalah psikososial; tersusunnya format pengkajian psikososial sebagai panduan mengidentifikasi masalah psikososial di keluarga, rumah sakit maupun masyarakat.

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This thesis discussed how the client Diabetes Mellitus give life meaning in the pain condition. The purpose of this study described the perceptions, psychosocial responses, needs management, client expectations and the meaning of life. This study is a descriptive qualitative research design. The study found seven broad themes consistent with the purpose of research and one additional theme is the burden faced by the client.

In conclusion the meaning of the life of the client obtained under conditions of suffering and deepening of spiritual values. This study suggests the use of Roy's adaptation model in nursing theory development in particular psychosocial problems; compilation format psychosocial assessment as a guide to identify psychosocial problems in families, hospitals and the community."

"Latar Belakang. Hipoglikemia merupakan komplikasi penting dan berbahaya yang seringkali terjadi pada pasien diabetes yang menjalani rawat jalan ataupun rawat inap. Hipoglikemia yang terjadi selama perawatan dapat disebabkan oleh berbagai faktor, baik itu faktor internal pasien atau faktor institusional.Tujuan. Mengetahui insidens kejadian hipoglikemia dalam perawatan, mengetahui hubungan antara faktor internal pasien dan faktor institusional dengan kejadian hipoglikemia pada perawatan, dan mengetahui luaran dari kejadian hipoglikemia dalam perawata, yaitu mortalitas dan pemanjangan lama rawat.Metode. Penelitian ini menggunakan desain kohort retrospektif dengan mengolah data sekunder rekam medik 477 pasien diabetes yang menjalani perawatan di RSUP Fatmawati sejak Januari 2016 hingga Desember 2018. Pada penelitian ini dilakukan analisa bivariat menggunakan uji chi-square dan uji fisher untuk data yang berskala nominal, dan uji mann-whitney untuk data dengan skala numerik. Selanjutnya, untuk variabel independen dengan nilai p<0,25 diikut sertakan dalam analisa multivariat regresi logistik.Hasil Pada penelitian ini didapatkan insidens kejadian hipoglikemia dalam perawatan mencapai 17% dan 7,4% diantaranya merupakan kejadian hipoglikemia berat. Setelah dilakukan analisa multivariat, faktor yang berperan terhadap kejadian hipoglikemia adalah terapi hiperglikemia, asupan nutrisi yang tidak adekuat, dan riwayat hipoglikemia sebelumnya. Median lama rawat ditemukan lebih panjang pada pasien yang mengalami hipoglikemia dalam perawatan (13 (1-58) vs 7 (1-48), p <0,001). Mortalitas ditemukan pada 16% kelompok pasien hipoglikemia dan pada 10,9% kelompok pasien yang tidak mengalami kejadian hipoglikemia (p=0,18).Kesimpulan Kejadian hipoglikemia dalam perawatan dipengaruhi oleh faktor terapi hiperglikemia menggunakan insulin dan/atau sulfonilurea, asupan nutrisi yang tidak adekuat, serta riwayat hipoglikemia sebelumnya.

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Background. Hypoglycemia is an important and harmful complication that often occurs in inpatient and outpatient settings. Hypoglycemia during hospitalization may arise from various risk factors, either from patients’ internal factors or institutional factors.

Objective. The aim of this study was to assess the incidence of inpatient hypoglycemia, and its association with patients’ internal factors and institutional factors. We also assessed mortality and length of stay as the outcomes of inpatient hypoglycemia.

Methods. We performed a cohort retrospective study of 477 patients with diabetes that were hospitalized during January 2016- December 2018 in Fatmawati General Hospital, Jakarta, Indonesia. In this study we used chi-square and fisher test to do bivariate analysis for nominal scale variables, and for numerical variables we used mann-whitney test to get the relative risks. Independent variables with p values <0.25, will be furthered analyzed using logistic regression multivariate analysis to get the odds ratio.

Result. The incidence of inpatient hypoglycemia was 17% with 7.4% of them were severe hypoglycemia. After performing multivariate analysis, we found that the risk factors of inpatient hypoglycemia were hyperglycemia therapy administered, inadequate daily nutritional intake, and previous history of hypoglycemia. The median length of stay was found longer in hypoglycemic subjects (13 (1-58) vs 7 (1-48), p <0,001). The mortality rate was higher in subjets with hypoglycemia, but was not statistically significant (16% vs 10,9%, p=0,18).

Conclusion. the incidence of inpatient hypoglycemia may be affected by several risk factors such as, hyperglycemia therapy administered, inadequate daily nutritional intake, and previous history of hypoglycemia.

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"[Peningkatan jumlah lansia berkontribusi pada peningkatan penyakit degeneratifkronis seperti diabetes melitus yang memerlukan penatalaksanaan manajemendiri. Penelitian bertujuan untuk mengetahui arti dan makna pengalamanmanajemen diri lansia dengan diabetes melitus di Kota Depok. Penelitianmenggunakan metode kualitatif fenomenologi deskriptif dengan wawancaramendalam pada sembilan partisipan, Hasil wawancara dianalisis menggunakanmetode Colaizzi. Penelitian mengidentifikasi 11 tema yaitu mengenali gejalaawal, pengetahuan tentang diabetes melitus, upaya terhadap respon padaperubahan kadar gula darah, perawatan diri, faktor pendukung perawatan diri,faktor penghambat perawatan diri, dampak diabetes melitus, upaya mengeloladampak diabetes melitus, perubahan aktivitas, dukungan keluarga yang dirasakan,dan kualitas hidup lebih baik.

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ABSTRACTIncreasing number of older adult population have contributed to chronicdegenerative disease such as diabetes mellitus that require self management. Theaim of research were explored self management experienced of older adult withdiabetes mellitus in Depok. This research used descriptive phenomenology by indepthinterview to nine participants. Data were transcribed and analyzed usingCollaizi?s method. It identified 11 themes, consist of knowing of earlysymptomps, knowledge of diabetes mellitus, responds of symptoms, self care,support factor of self care, barrier factor of self care, impact of diabetes mellitus,managing the impact of diabetes mellitus, activities changing, family support, andbetter quality of life.;Increasing number of older adult population have contributed to chronicdegenerative disease such as diabetes mellitus that require self management. Theaim of research were explored self management experienced of older adult withdiabetes mellitus in Depok. This research used descriptive phenomenology by indepthinterview to nine participants. Data were transcribed and analyzed usingCollaizi?s method. It identified 11 themes, consist of knowing of earlysymptomps, knowledge of diabetes mellitus, responds of symptoms, self care,support factor of self care, barrier factor of self care, impact of diabetes mellitus,managing the impact of diabetes mellitus, activities changing, family support, andbetter quality of life.;Increasing number of older adult population have contributed to chronicdegenerative disease such as diabetes mellitus that require self management. Theaim of research were explored self management experienced of older adult withdiabetes mellitus in Depok. This research used descriptive phenomenology by indepthinterview to nine participants. Data were transcribed and analyzed usingCollaizi?s method. It identified 11 themes, consist of knowing of earlysymptomps, knowledge of diabetes mellitus, responds of symptoms, self care,support factor of self care, barrier factor of self care, impact of diabetes mellitus,managing the impact of diabetes mellitus, activities changing, family support, andbetter quality of life.;Increasing number of older adult population have contributed to chronicdegenerative disease such as diabetes mellitus that require self management. Theaim of research were explored self management experienced of older adult withdiabetes mellitus in Depok. This research used descriptive phenomenology by indepthinterview to nine participants. Data were transcribed and analyzed usingCollaizi?s method. It identified 11 themes, consist of knowing of earlysymptomps, knowledge of diabetes mellitus, responds of symptoms, self care,support factor of self care, barrier factor of self care, impact of diabetes mellitus,managing the impact of diabetes mellitus, activities changing, family support, andbetter quality of life.;Increasing number of older adult population have contributed to chronicdegenerative disease such as diabetes mellitus that require self management. Theaim of research were explored self management experienced of older adult withdiabetes mellitus in Depok. This research used descriptive phenomenology by indepthinterview to nine participants. Data were transcribed and analyzed usingCollaizi?s method. It identified 11 themes, consist of knowing of earlysymptomps, knowledge of diabetes mellitus, responds of symptoms, self care,support factor of self care, barrier factor of self care, impact of diabetes mellitus,managing the impact of diabetes mellitus, activities changing, family support, andbetter quality of life., Increasing number of older adult population have contributed to chronicdegenerative disease such as diabetes mellitus that require self management. Theaim of research were explored self management experienced of older adult withdiabetes mellitus in Depok. This research used descriptive phenomenology by indepthinterview to nine participants. Data were transcribed and analyzed usingCollaizi’s method. It identified 11 themes, consist of knowing of earlysymptomps, knowledge of diabetes mellitus, responds of symptoms, self care,support factor of self care, barrier factor of self care, impact of diabetes mellitus,managing the impact of diabetes mellitus, activities changing, family support, andbetter quality of life.]"

"Hemodialisis (HD) dapat memicu terjadinya hipoglikemia intradialisis. Insidensi terjadinya hipoglikemia intradialisis cukup sering ditemui pada pasien rawat inap. Hipoglikemia intradialisis dapat mengakibatkan komplikasi lebih lanjut, memperpanjang lama rawat bahkan dapat menyebabkan kematian intradialisis. Hipoglikemia intradialisis dapat disebabkan oleh banyak faktor. Penelitian ini bertujuan untuk mengidentifikasi kejadian hipoglikemia intradialisis dan menganalisis faktor-faktor yang mempengaruhi terjadinya hipoglikemia intradialisis pada pasien gagal ginjal rawat inap yang menjalani HD. Penelitian ini merupakan penelitian obervasional (non eksperimental) dengan rancangan kuantitatif deskriptif-analitik dengan pendekatan potong lintang, melibatkan 266 pasien HD yang dirawat inap. Analisis data menggunakan uji Chi Square dan Regersi Logistik Ganda. Hasil penelitian ini mendapatkan sebanyak 54,1% subjek penelitian mengalami hipoglikemia intradialisis, dengan 39,6% diantaranya tanpa disertai tanda dan gejala hipoglikemia serta 38,2% mengalami hipoglikemia berulang. Waktu kejadian hipoglikemia intradialisis paling tinggi terjadi pada jam ke-2 intradialisis dengan rerata penurunan kadar gula darah pada jam pertama intradialisis sebesar 37,9 mg/dl ± 53,7 standar deviasi. Terdapat pengaruh yang signifikan antara ultrafiltration goal, sakit DM, hipertensi, asupan nutrisi, terapi obat anti diabetik, dan terapi β Bloker dengan kejadian hipoglikemia intradialisis (p < 0,05; α 0,05). Faktor yang paling berpengaruh terhadap kejadian hipoglikemia intradialisis adalah asupan nutrisi dengan nilai OR 6,113. Hasil penelitian ini merekomendasikan agar pemeriksaan gula darah intradialisis dilakukan secara rutin dan upayakan asupan nutrisi adekuat pada pasien HD, terutama pada pasien yang memiliki risiko tinggi.

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Hemodialysis (HD) induces intradialytic hypoglycemia. The incidence of intradialytic hypoglycemia commonly occurred in hospitalized patients. Inpatient intradialytic hypoglycemia leads to further complications, prolongs the length of stay, and even causes intradialytic death. Intradialytic hypoglycemia is caused by many factors. This study aims to identify the incidence of intradialytic hypoglycemia and analyze the influencing factors of the occurrence of intradialytic hypoglycemia in inpatients with renal failure undergoing HD. This study used a descriptive-analytical quantitative design with a cross-sectional approach and recruited 266 inpatients who undergoing HD. Data analysis used the Chi-Square test and Multiple Logistic regression. This study’s result found that 54.1% of the subjects experienced intradialytic hypoglycemia, where 39.6% of subjects had no signs and symptoms, and 38.2% of subjects experienced recurrent hypoglycemia. The highest incidence of intradialytic hypoglycemia occurred in the 2nd hour of intradialytic, with an average decrease in blood glucose levels in the first hour of intradialytic of 37.9 mg/dl (SD± 53.7). There were significant effects between the ultrafiltration goal, diabetes mellitus, hypertension, nutritional intake, anti-diabetic, and beta-blocker therapy with intradialytic hypoglycemia (p < 0.05; α 0.05). The most influencing factor of intradialytic hypoglycemia incidence was nutritional intake, with OR value of 6.113. Based on this study’s result, it is recommended to conduct continuous blood glucose monitoring during hemodialysis, and also monitor nutritional intake among those patients, especially in high-risk patients."

"ABSTRAKDiabetes Mellitus Tipe 2 (DM Tipe 2) adalah kelainan metabolik yang ditandai dengan hiperglikemia yang diakibatkan kurangnya sekresi insulin, resistensi insulin, atau keduanya. Kondisi hiperglikemia yang kronis dapat menyebabkan berbagai komplikasi salah satunya adalah kaki diabetik yang menjadi penyebab utama dilakukannya amputasi pada klien dengan DM tipe 2. Tujuan penelitian ini adalah untuk mengetahui pengalaman klien DM tipe 2 pasca amputasi mayor ekstremitas bawah. Penelitian ini menggunakan metode kualitatif dengan pendekatan fenomenologi deskriptif. Hasil analisa data menghasilkan enam tema, yaitu: perubahan dalam kehidupan setelah amputasi, respon atau perasaan terkait amputasi, mekanisme koping, dukungan sosial yang diterima, makna hidup, dan pelayanan kesehatan yang diterima. Hasil penelitian ini diharapkan dapat menjadi masukan dalam meningkatkan kualitas asuhan keperawatan melalui peningkatan dukungan rehabilitasi secara fisik, psikososial, dan spiritual pada klien DM tipe 2 pasca amputasi mayor ekstremitas bawah.

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ABSTRACTType 2 Diabetes Mellitus (Type 2 DM) is a metabolic disorder characterized by hyperglycemia as a result of insulin deficiency, insulin resistance, or both. Chronic hyperglycemia conditions can lead complications such as the diabetic foot as a major cause of amputation in clients with type 2 DM. The purpose of this study was to determine the experience of client with type 2 DM following major lower limb amputation. This study used a qualitative method with descriptive phenomenology approach. Result of the data analysis revealed six themes: live changes of amputees, amputation response or related feelings, coping mechanisms, social support received, the meaning of life, and health care received. The results of this research are expected to contribute positively in improving the quality of nursing care through physical, psychosocial, and spiritual rehabilitation support enhancement in client with type 2 DM following major lower limb amputation."