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"Latar belakang:Diabetes Mellitus (DM) merupakan salah satu penyakt kronis yang berpotensi mengalami komplikasi lebih berat seumur hidup pasien. Hal inilah yang menyebabkan banyak penderita DM mengalami distres. Prevalens distres pada remaja dengan DMT1 mencapai 42%. Kuesioener SDD-T1 merupakan kuesioner penapisan distrs yang yang sahih dan andal. Belum ada penelitian yang khusus menggunakan kuesioner ini pada remaja dengan DMT1.Tujuan:Penelitian ini bertujuan untuk mengadaptasi kuesioner SDD-T1 ke dalam Bahasa Indonesia dan membuktikan kesahihan isi dan keandalan kuesioner tersebut.Metode:Penelitian ini menggunakan desain studi potong lintang yang merekrut subyek remaja berusia 10-18 tahun yang terdiagnosis DMT1 setidaknya dalam kurun 6 bulan. Penerjemahan kuesioner dilakukan oleh penerjemah bersertifikat. Kesahihan isi dinilai oleh 11 orang ahli yang terkait. Hasil penilaian seluruh ahli disajikan dalam bentuk nilai I-CVI dan S-CVI. Kesahihan isi juga menilai korelasi tiap pernyataan terhadapt rerata skor SDD-T1 dan masing-masing subskalanya. Penilaian keandalan dilakukan dengan melihat nilai Cronbach’s alpha. Hasil: Seratus remaja DMT1 dilakukan perekrutan dengan metode consecutive sampling. Nilai rerata I-CVI dan S-CVI adalah 0,97. Korelasi pernyataan SDD-T1 versi Bahasa Indonesia dengan masing-masing subskala adalah 0,7-0,8. Nilai Cronbach’s alpha kuesioner ini adalah 0,9 dengan konsistensi internal yang sangat baik. Kesimpulan:Kuesioner SDD-T1 versi Bahasa Indonesia terbukti sahih dan andal sebagai alat penapisan distres remaja dengan DMT1

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Backgorund:

Diabetes Mellitus (DM) is a chronic disease that has the potential to experience more severe complications for the patient's lifetime. This is what causes many DM sufferers to experience distress. The prevalence of distress in adolescents with T1DM reaches 42%. The T1-DDS questionnaire is a valid and reliable distribution questionnaire. There are no studies that specifically use this questionnaire in adolescents with DMT1.

Objective: This study aims to adapt the T1-DDS questionnaire into Indonesian and prove the validity and reliability of the questionnaire.

Method:

This study used a cross-sectional study design that recruited adolescent subjects aged 10-18 years who had been diagnosed with T1DM for at least 6 months. The translation of the questionnaire was carried out by certified translators. The validity of the content was assessed by 11 related experts. The results of the assessment of all experts are presented in the form of I-CVI and S-CVI scores. Content validity also assessed the correlation of each statement to the mean T1-DDS score and each of its subscales. Reliability testing was assessed using at Cronbach's alpha value.

Result:

A hundred adolescents with T1DM were recruited using the consecutive sampling method. The mean value of I-CVI and S-CVI is 0.97. The correlation of the Indonesian version of SDD-T1 statements with each subscale is 0.7-0.8. The Cronbach's alpha value of this questionnaire is 0.9 with very good internal consistency.

Conclusion:

The Indonesian version of the SDD-T1 Questionnaire is proven to be valid and reliable as a means of screening for distress in adolescents with T1DM"

"Psychology and diabetes care : a practical guide is a concise handbook for the practicing diabetes clinician who is interested in gaining a better understanding of his patients, and in learning simple skills and tips to manage patients more effectively. It identifies and explores key psychological interventions in diabetes care in order to help healthcare professionals support their patients effectively. Edited by an expert on the psychology of diabetes, and with contributions from a group of specialists in diabetes psychology, this book contains a myriad of insights into how to understand and treat the type 1 or type 2 diabetes patient."

"[ABSTRAKLatar belakang : Hiperglikemia kronik pada pasien Diabetes melitus tipe 1 (DMT1) dihubungkan dengan kerusakan jangka panjang, gangguan fungsi dan kerusakan berbagai organ tubuh lain seperti mata, ginjal, saraf, jantung dan pembuluh kapiler. Salah satu gangguan fungsi organ yang sering diabaikan sebagai akibat hiperglikemia adalah faal paru. Uji fungsi paru dapat membedakan kelainan paru obstruktif, restriktif atau campuran antara obstruktif dn restriktif. Uji fungsi paru dengan spirometri tidak dapat dilakukan dengan baik pada anak dibawah usia 7 atau 8 tahun karena memerlukan koordinasi yang cukup sulit. Penelitian tentang dampak DMT1 terhadap paru di Indonesia belum ada sampai saat ini.Tujuan : Mengetahui gambaran uji fungsi paru pada pasien DMT1 usia 8-18 tahun.Metode : Penelitian potong lintang dilakukan di Poliklinik Endokrinologi dan Respirologi Rumah Sakit Cipto Mangunkusumo (RSCM), serta Laboratorium Prodia Salemba pada bulan Januari 2015. Wawancara orangtua dilakukan dan data kadar HbA1c dalam rentang satu tahun terakhir diambil dari rekam medis subjek atau berdasarkan hasil pemeriksaan sebelumnya. Uji fungsi paru dilakukan sebanyak tiga kali dan diambil salah satu hasil yang terbaik. Kemudian subjek menjalani pengambilan darah untuk pemeriksaan kadar HbA1c dengan metode cation-exchange high pressure liquod chromatography (HPLC) di Laboratorium Prodia.Hasil : Tiga puluh lima subjek berpartisipasi dalam penelitian, terdiri dari 68,6% perempuan. Rerata usia 14 ± 2,7 tahun dan median durasi DM adalah 4 tahun (1,3-10,2 tahun). Rerata parameter FEV1 adalah 86,8 ± 14%, FVC 82,7 ± 12% dan V25 83,1 ± 26,2%. Median FEV1/FVC adalah 92,4 % (77,6-100) dan V50 91,5 % (41,1-204). Fungsi paru normal didapatkan pada 19 subjek (54,3%) dan fungsi paru terganggu sebanyak 16 subjek (45,7%), terdiri dari 10 subjek (28,6%) gangguan restriktif, 2 subjek (5,7%) gangguan obstruktif dan 4 subjek (11,4%) gangguan campuran. Rerata HbA1c dalam 1 tahun terakhir pada subjek dengan gangguan restriktif adalah 10,3%. Simpulan : Nilai parameter uji fungsi paru pasien DMT1 usia 8-18 tahun masih dalam batas normal. Gangguan fungsi paru didapatkan pada 16 subjek (45,7%) dengan gangguan restriksi terbanyak yaitu 10 subjek (28,6%).

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ABSTRACTBackground: Chronic hyperglycemia in patients with type 1 diabetes mellitus (T1DM) is associated with long term functional impairment and damage of several parts of the body, such as eyes, kidneys, nerves, heart, and capillary blood vessels. Among all systems, disorder of pulmonary function due to hyperglycemia is often neglected by physicians. Pulmonary function test could determine whether the lung impairment is obstructive, restrictive, or mixed. Pulmonary function test using spirometry could not be applied to children below 7 or 8 years old because they are not capable to do the test. Until now, research about the effect of T1DM to pulmonary function has never been done in Indonesia.Objective: To obtain pulmonary function test profile in type 1 diabetes mellitus patients aged 8 to 18 years old.Methods: This cross sectional study took place at Endocrinology and Respirology Outpatient Department of Cipto Mangunkusumo Hospital (RSCM) and Prodia Laboratory Service in Salemba in January 2015. Parents of subjects were interviewed for history disease. HbA1c level of recent year was collected from medical records or from previous test results. Pulmonary function test were conducted three times to each subjects and among those three results, the best was chosen as data. Blood samples were collected for HbA1c level measurement. The HbA1c level was measured by cation-exchange high pressure liquod chromatography (HPLC) method in Prodia Laboratory.Results: Thirty five subjects participated in the research, 68.6% of them were female. The average age was 14 ± 2.7 years and the median duration of diabetes melitus was 4 years (1.3-10.2 years). FEV1, FVC, and V25 average was 86.8 ± 14%, 82.7 ± 12%, and 83.1 ± 26.2%, respectively. The median of FEV1/FVC and V50 was 92.4 % (77.6-100) and 91.5% (41.1-204) respectively. Nineteen subjects (54.3%) had normal pulmonary function and among 16 (45.7%) abnormal subjects, 10 (28.6%) had restrictive disorder, 2 (5.7%) had obstructive disorder, and 4 (11.4%) had mixed disorder. Average of HbA1c level of restrictive group was 10.3%.Conclusions: Pulmonary function test parameter profile in type 1 diabetes mellitus patients aged 8 to 18 years old lies in normal range. Pulmonary function disorder was found in 16 subjects (45.7%). Among those 16 subjects, 10 (28.6%) had restriction disorder.;Background: Chronic hyperglycemia in patients with type 1 diabetes mellitus (T1DM) is associated with long term functional impairment and damage of several parts of the body, such as eyes, kidneys, nerves, heart, and capillary blood vessels. Among all systems, disorder of pulmonary function due to hyperglycemia is often neglected by physicians. Pulmonary function test could determine whether the lung impairment is obstructive, restrictive, or mixed. Pulmonary function test using spirometry could not be applied to children below 7 or 8 years old because they are not capable to do the test. Until now, research about the effect of T1DM to pulmonary function has never been done in Indonesia. Objective: To obtain pulmonary function test profile in type 1 diabetes mellitus patients aged 8 to 18 years old. Methods: This cross sectional study took place at Endocrinology and Respirology Outpatient Department of Cipto Mangunkusumo Hospital (RSCM) and Prodia Laboratory Service in Salemba in January 2015. Parents of subjects were interviewed for history disease. HbA1c level of recent year was collected from medical records or from previous test results. Pulmonary function test were conducted three times to each subjects and among those three results, the best was chosen as data. Blood samples were collected for HbA1c level measurement. The HbA1c level was measured by cation-exchange high pressure liquod chromatography (HPLC) method in Prodia Laboratory. Results: Thirty five subjects participated in the research, 68.6% of them were female. The average age was 14 ± 2.7 years and the median duration of diabetes melitus was 4 years (1.3-10.2 years). FEV1, FVC, and V25 average was 86.8 ± 14%, 82.7 ± 12%, and 83.1 ± 26.2%, respectively. The median of FEV1/FVC and V50 was 92.4 % (77.6-100) and 91.5% (41.1-204) respectively. Nineteen subjects (54.3%) had normal pulmonary function and among 16 (45.7%) abnormal subjects, 10 (28.6%) had restrictive disorder, 2 (5.7%) had obstructive disorder, and 4 (11.4%) had mixed disorder. Average of HbA1c level of restrictive group was 10.3%. Conclusions: Pulmonary function test parameter profile in type 1 diabetes mellitus patients aged 8 to 18 years old lies in normal range. Pulmonary function disorder was found in 16 subjects (45.7%). Among those 16 subjects, 10 (28.6%) had restriction disorder., Background: Chronic hyperglycemia in patients with type 1 diabetes mellitus (T1DM) is associated with long term functional impairment and damage of several parts of the body, such as eyes, kidneys, nerves, heart, and capillary blood vessels. Among all systems, disorder of pulmonary function due to hyperglycemia is often neglected by physicians. Pulmonary function test could determine whether the lung impairment is obstructive, restrictive, or mixed. Pulmonary function test using spirometry could not be applied to children below 7 or 8 years old because they are not capable to do the test. Until now, research about the effect of T1DM to pulmonary function has never been done in Indonesia. Objective: To obtain pulmonary function test profile in type 1 diabetes mellitus patients aged 8 to 18 years old. Methods: This cross sectional study took place at Endocrinology and Respirology Outpatient Department of Cipto Mangunkusumo Hospital (RSCM) and Prodia Laboratory Service in Salemba in January 2015. Parents of subjects were interviewed for history disease. HbA1c level of recent year was collected from medical records or from previous test results. Pulmonary function test were conducted three times to each subjects and among those three results, the best was chosen as data. Blood samples were collected for HbA1c level measurement. The HbA1c level was measured by cation-exchange high pressure liquod chromatography (HPLC) method in Prodia Laboratory. Results: Thirty five subjects participated in the research, 68.6% of them were female. The average age was 14 ± 2.7 years and the median duration of diabetes melitus was 4 years (1.3-10.2 years). FEV1, FVC, and V25 average was 86.8 ± 14%, 82.7 ± 12%, and 83.1 ± 26.2%, respectively. The median of FEV1/FVC and V50 was 92.4 % (77.6-100) and 91.5% (41.1-204) respectively. Nineteen subjects (54.3%) had normal pulmonary function and among 16 (45.7%) abnormal subjects, 10 (28.6%) had restrictive disorder, 2 (5.7%) had obstructive disorder, and 4 (11.4%) had mixed disorder. Average of HbA1c level of restrictive group was 10.3%. Conclusions: Pulmonary function test parameter profile in type 1 diabetes mellitus patients aged 8 to 18 years old lies in normal range. Pulmonary function disorder was found in 16 subjects (45.7%). Among those 16 subjects, 10 (28.6%) had restriction disorder.]"

"ABSTRAKLatar belakang: Vitamin D dianggap berperan dalam patogenesis diabetes melitus tipe 1 (DMT1), memperbaiki kontrol metabolik dan menurunkan risiko terjadinya komplikasi mikrovaskuler.Tujuan: Mengetahui profil kadar vitamin D remaja DMT1 dan hubungan kadar vitamin D dengan retinopati dan nefropati diabetik.Metode: Penelitian potong lintang pada remaja DMT1 usia 11-21 tahun dengan lama sakit minimal satu tahun. Semua subjek dilakukan wawancara menggunakan kuesioner, pemeriksaan fisis lengkap, kadar 25(OH)D, HbA1c, rasio albumin/kreatinin urin, dan fotografi fundus.Hasil: Terdapat 49 subjek, 34 (69,4%) perempuan dan 15 (30,6%) lelaki dengan median lama sakit lima tahun (1-16 tahun). Sebanyak 96% subjek menggunakan insulin basal bolus. Median HbA1c adalah 9,5% (6,3% - 18%). Tidak ada subjek dengan kadar 25(OH)D ≥ 30 ng/mL, 6 subjek (12,2%) dengan kadar 25(OH)D 21-19 ng/mL dan 87,8% memiliki kadar 25(OH)D ≤ 20 ng/mL. Rerata kadar 25(OH)D adalah 12,6 ng/mL (SD ±5,4 ng/mL). Faktor yang berhubungan dengan kadar vitamin D adalah lama pajanan matahari (RP 13,3; 95%IK = 1,8-96, p= 0,019). Jenis pakaian, penggunaan sunblock, IMT, lama sakit, konsumsi susu tidak berhubungan dengan kadar vitamin D. Prevalens retinopati pada penelitian ini adalah 8,2%, mikroalbuminuria 28,5%, dan nefropati 16,3%. Tidak terdapat hubungan bermakna antara kadar vitamin D dengan retinopati, mikroalbuminuria, dan nefropati diabetik.Kesimpulan: Tidak ada remaja DMT1 dengan kadar vitamin D yang cukup dan tidak ada hubungan antara kadar vitamin D dengan retinopati, mikroalbuminuria, dan nefropati diabetik.;Background: Many studies showed that vitamin D involved in the pathogenesis of type 1 diabetes mellitus (T1DM), metabolic control and decreased the risk of microvascular complication.

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ABSTRACT

Objective: To find out the vitamin D profile in adolescence with T1DM and its association with retinopathy and nephropathy diabetic.

Methods: This was a cross sectional study performed during April to May 2015 involving T1DM adolescence aged 11-21 years old with duration of illness ≥ 1 year. We used questionnaire to know factors associated with vitamin D level. We performed physical examinations, tests for level of 25(OH)D serum, HbA1c, urine albumin/creatinine ratio and fundal photographic.

Results: There were 49 subjects, 34 female (69.4%) and 15 male (30.6%) with median duration of illness was five years (1-16 years). Most of the subjects (96%) were on basal bolus regimen. Median of HbA1c level was 9.5% (range 6.3%-18%). None of the subject had 25(OH)D level ≥ 30 ng/mL, 12.2% with 25(OH)D level of 21-19 ng/mL and 87,8% was ≤ 20 ng/mL. Mean of 25(OH)D level was 12.6 ng/mL (SD ±5.4 ng/mL). Duration of sun exposure was associated with 25(OH)D level (prevalent ratio of 13.3; 95%CI = 1.8-96, p= 0.019); While type of clothing, sunblock, body mass index, milk and juice intake were not associated with 25(OH)D level. Diabetic retinopathy was found in 4 subjects (8.2%), microalbuminuria in 14 subjects (28.5%), and nephropathy in 8 subjects (16.3%). All the subjects who suffered from microvascular complication had 25(OH)D level ≤ 20 ng/mL. None of the subjects with 25 (OH)D > 20 ng/mL suffered had microvascular complication. There was no significant association between vitamin D level with diabetic retinopathy, microalbuminuria, or diabetic nephropathy.

Conclusion: None of the adolescent with type 1 DM had sufficient vitamin D level, and 87.8% had vitamin D deficiency. There was no association between vitamin D level with diabetic retinopathy, microalbuminuria, or diabetic nephropathy."

"Penyakit Diabetes Mellitus (DM) tipe 1 saat ini semakin banyak dialami oleh anak. Prinsip perawatan anak yang berfokus family centered care menuntut orang tua untuk aktif berperan serta dalam mengelola DM tipe 1 pada anak. Penelitian dilakukan dengan tujuan mengeksplorasi pengalaman orang tua dalam merawat anak DM tipe 1. Desain penelitian menggunakan fenomenologi deskriptif yang melibatkan 7 orang tua sebagai partisipan.Hasil eksplorasi didapatkan 8 tema, yaitu:1) tiga fase perubahan respon orang tua,2) dua fase perubahan respon anak yang dirasakan orang tua,3) aktivitas orang tua dalam mengelola DM tipe 1 pada anak,4) penilaian orang tua terhadap pengobatan dengan insulin dan herbal,5) pola komunikasi dan ketrampilan yang ditunjukkan mempengaruhi persepsi orang tua terhadap tenaga kesehatan,6) dukungan sosial sebagai salah satu faktor yang mempengaruhi keberhasilan dalam mengelola DM tipe 1 pada anak,7) perubahan yang dialami orang tua sebagai perawat utama anak, dan 8) harapan orang tua terhadap anak, dirinya sendiri dan tenaga kesehatan.Kesimpulan yang didapatkan yaitu kemampuan orang tua dalam berespon adaptif berpengaruh terhadap pengelolaan DM tipe 1 secara efektif pada anak. Selanjutnya perlu dilakukan eksplorasi kemampuan anak dalam beradaptasi terhadap DM tipe 1 untuk memberikan pemahaman dari segi individu yang mengalami penyakit secara langsung.

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Type 1 Diabetes Mellitus (DM) is now increasingly experienced by children. The principle of family centered care requires parents to actively participate in managing diabetes in children and the factors that influence it. Research conducted with the aim to explore the experience of parents in caring for children with type 1 DM. Descriptive phenomenology used in this research design by involving seven parents as participants.The exploration resulted 8 themes, there are:1) three-phases of parent?s response,2) two-phases of children?s response perceived by parents,3) the activity of parents in managing type 1 DM in children,4) perception of parents to insulin and herbs,5) communication patterns and skills shown affected the perception of parents towards health professionals,6) social support as factor that influence the success in managing type 1 diabetes in children,7) the changes of lifestyle which experienced by parents as primary caregivers of children, and 8) the expectations of parents of children, themselves and health professionals.The conclusion is the ability of parents to respond adaptively influence the effectiveness of managing type 1 DM in children. Further exploration about children's adaption to type 1 DM is necessary to provide an understanding from the individual who experience it directly."

"ABSTRAKDiabetes Mellitus (DM) merupakan salah satu penyakit yang paling sering muncul di dunia. Banyaknya regimen yang harus dipatuhi penderita DM, adanya risiko komplikasi, dan lain sebagainya merupakan faktor yang dapat memengaruhi munculnya diabetes-related distress pada penderita DM. Melalui berbagai penelitian yang telah dilakukan, diketahui bahwa diabetes-related distress memberikan pengaruh negatif terhadap kondisi fisik ataupun psikologis penderita DM. Pengaruh negatif tersebut juga dialami oleh penderita DM, yang juga diperburuk oleh karakteristik lanjut usia.Melihat pengaruh negatif dari diabetes-related distress pada penderita DM yang tergolong lanjut usia (lansia) tersebut, peneliti tertarik untuk memberikan intervensi untuk mengurangi diabetes-related distress dengan menggunakan pendekatan Cognitive Behavior Therapy. Penelitian dilakukan kepada dua orang lansia yang mengalami diabetes-related distress. Kedua partisipan yang menjalani intervensi Cognitive Behavior Therapy mengalami penurunan tingkat diabetes-related distress. Hal tersebut didapatkan melalui wawancara dan observasi, serta pengukuran menggunakan alat ukur PAID (Problem Areas In Diabetes). Setelah intervensi selesai diberikan, para partisipan sudah mampu mempraktikkan teknik-teknik intervensi yang diberikan dalam rangkaian intervensi. Para partisipan juga memahami bahwa keberhasilan intervensi ditentukan oleh kemandirian dan niat mereka untuk menjalankan teknik-teknik tersebut dalam kehidupan sehari-hari.

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ABSTRACT

Diabetes Mellitus (DM) is one of the most frequent diseases to appear globally. Too many regimens to adhere, complication risks, and so on can endorse diabetes-related distress in DM patients. Many studies have found that the presence of diabetes-related distress gives negative impacts to patients, physically and psychologically. In older DM patients, those negative impacts is worsen by the characteristics of older adults.

Knowing those negative impacts to older DM patients, I decided to conduct a study that consists of delivering intervention with cognitive behavior therapy approach to lessen diabetes-related distress for older adults with DM. There are two participants in this study, both are older adults with high level of diabetes-related distress. All participants experienced decreased level of diabetes-related distress from their participation in this intervention, as shown in interview, observation, and an assessment using PAID (Problem Areas In Diabetes). After all the intervention sessions have been delivered, all participants are able to practice the interventions techniques that were given. All participants also understand that the therapeutic success is determined by their independence and their willingness to change by practicing the techniques in daily life."

"Penyakit metabolik yang sering ditemukan di usia kanak – kanak adalah Diabetes Melitus (DM) tipe 1 dengan defisiensi insulin yang diakibatkan oleh penghancuran sel beta pankreas sehingga meningkatkan kebutuhan metabolisme dan menyebabkan resiko anak mengalami fatigue. Penelitian ini bertujuan untuk menganalisis faktor dominan yang mempengaruhi fatigue pada anak dengan DM tipe 1. Penelitian ini menggunakan cross sectional design dengan melibatkan 233 responden yang dipilih menggunakan non probabilty: consecutive sampling. Hasil penelitian menunjukkan adanya hubungan yang bermakna antara fatigue dengan usia (p value= 0,011), lama didiagnosis (p value= 0,011), gangguan tidur (p value= 0,000), kecemasan (p value= 0,000), dan depresi (p value= 0,000) serta faktor yang paling besar mempengaruhi fatigue pada anak dengan DM tipe 1 adalah gangguan tidur. Hasil penelitian dapat digunakan sebagai asuhan keperawatan khususnya dalam memberikan pendidikan kesehatan untuk menurunkan gejala fatigue.

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Metabolic disease that often found in children is type 1 diabetes mellitus with insulin deficiency which caused by the destruction of pancreatic beta cells, thereby increasing metabolic needs and causing the child’s fatigue risk. This study aims to analyze the dominant factors that affect fatigue in children with type 1 diabetes mellitus. This study used cross sectional design involving 233 respondents selected by non-probabilty: consecutive sampling. The results showed a meaningful relationship between fatigue and age (p value = 0.011), length of diagnosis (p value = 0.011), sleep disorders (p value = 0.000), anxiety (p value = 0.000), depression (p value = 0.000) and the factor that affects fatigue the most in children with type 1 diabetes mellitus is sleep disorders. The results of the study can be used as nursing care, especially in providing health education to reduce fatigue symptoms."

"Latar Belakang: Diabetes melitus (DM) Tipe 1 merupakan penyakit kronis yang berlangsung seumur hidup dan membutuhkan pendekatan multidisiplin dari profesional kesehatan yang terkait di bidangnya. Edukator diabetes merupakan tenaga kesehatan yang bertugas membantu penderita diabetes mengubah perilaku hidup penderita untuk mencapai status kesehatan yang optimal dengan memberikan edukasi kepada pasien dan keluarga. Saat ini edukator DM tipe 1 pada anak di Indonesia belum terbentuk. Diperlukan model pelatihan yang efektif untuk membentuk edukator DM tipe 1. Tujuan: Untuk membuat model pelatihan edukator DM Tipe 1 dan mengetahui efektifitas model pelatihan dalam membentuk kompetensi edukator DM tipe 1 pada anak. Metode: Penelitian ini menggunakan metode mixed methods yang menggabungkan data kualitatif dan kuantitatif. Penelitian dilaksanakan dalam tiga tahap yaitu perencanaan dengan melakukan focus group discussion (FGD) atau diskusi kelompok terfokus, pelaksanaan pelatihan, dan evaluasi pelatihan dengan pendekatan Kirkpatrics. Hasil: Pelatihan diikuti oleh 31 peserta dari 13 propinsi di Indonesia. Sebagian besar peserta (94,6%) puas dengan pelaksanaan pelatihan, terdapat peningkatan pengetahuan peserta dari nilai rata-rata pretest sebesar 71,6% menjadi 77,8% dan bermakna secara statistik dengan nilai p 0,00. Sebanyak 77,4% peserta lulus dalam ujian OSCE dengan tingkat kelulusan lebih dari 5 stasion. Umumnya peserta dapat menerapkan hasil pelatihan (92,8%) dan memberikan kontribusi nyata dan perbaikan terhadap organisasi (66,7%). Kesimpulan: Telah terbentuk model pelatihan edukator DM tipe 1. Model pelatihan ini dapat membentuk kompetensi edukator diabetes berdasarkan reaksi peserta pelatihan, peningkatan pengetahuan dan keterampilan edukator diabetes, penerapan hasil pelatihan, dan kontribusi terhadap organisasi.

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Background: Type 1 diabetes mellitus (DM) is a lifelong chronic illness which need professional multidiciplinnary approaches. Educators for diabetic patients are medical personnels who help these patients modify their life styles in order to achieve the optimum health status, by giving proper education to patients and their family. Currently, educators for type 1 DM in Indonesia are not available. An effective training model would be needed to create a good educator.

Objective: This study aimed to created a training model for type 1 DM educators and further to evaluate its effectiveness in building a competent type 1 DM educators for children.

Method: This is a mixed methods study which combined both qualitative and quantitative data. This study was done in three steps: (i) planning by doing a focus group discussion, (ii) training, and (iii) training evaluation with Kirkpatrics approach.

Result: Thirty one candidates from 13 province participated in this study. Most candidates (94,6%) were satisfied with the training program. The mean pre-post score were increased from 71,6% to 77,8%, statistically significant (p=0.00). About 77,4% candidates passed the OSCE examinations. Most candidates (92,8%) were able to implement the training program and gave real contribution for the organization progress (66,7%).

Conclusion: A new training model for type 1 DM educators has been established. This model is able to build a competent educators for DM. Evaluation was done based on the participan’s response during training, increase of knowledge and skill, and their implementation, and also their contribution for organization."

"[ABSTRAK Latar Belakang Diabetes melitus DM tipe 1 paling banyak ditemukan pada masa anak dan remaja dengan prevalens sebesar 1 500 anak Hiperglikemia kronik pada diabetes menyebabkan komplikasi pada berbagai organ Komplikasi ini berhubungan dengan kadar HbA1C sebagai faktor yang memengaruhi fungsi kognitif Pasien DM tipe 1 juga dapat mengalami komplikasi hipoglikemia berat sehingga mengakibatkan atrofi neuron di otak Identifikasi dini terhadap risiko gangguan fungsi kognitif penting untuk intervensi klinis dan psikoedukasi terhadap anak Tujuan Mengidentifikasi prevalens anak DM dengan fungsi kognitif di bawah normal di Indonesia dan menganalisis korelasi antara usia awitan DM durasi sakit DM ketoasidosis diabetikum KAD HbA1C dan hipoglikemia berat dengan fungsi kognitif anak DM tipe 1 Metode Penelitian ini merupakan studi yang mempelajari faktor risiko dengan metode potong lintang dilakukan di Jakarta pada Mei sampai dengan Juni 2015 Pemeriksaan fungsi kognitif menggunakan instrumen the Wechsler Intelligence Scale for Children WISC IV Subyek pada penelitian ini adalah pasien DM tipe 1 yang berusia 5 ndash 18 tahun Analisis statistik dilakukan untuk mencari korelasi antara fungsi kognitif dengan usia awitan durasi sakit kadar HbA1C dan frekuensi kejadian KAD Analisis statistik komparasi dilakukan untuk mencari rerata perbedaan full scale intelligence quotient IQ pasien dengan riwayat hipoglikemia berat dan tidak Hasil Penelitian dilakukan terhadap 58 subyek dengan hasil rerata full scale IQ adalah 100 16 Terdapat 26 subyek dengan full scale IQ di bawah normal Korelasi bermakna secara statistik didapatkan antara fungsi kognitif dengan usia awitan r 0 285 p 0 030 kadar HbA1C r 0 270 p 0 041 dan frekuensi riwayat kejadian KAD r 0 289 p 0 028 Tidak didapatkan korelasi antara durasi sakit dengan full scale IQ dan tidak didapatkan perbedaan full scale IQ antara kelompok dengan riwayat hipoglikemia berat dan kontrol Simpulan Terdapat korelasi negatif antara full scale IQ dengan usia awitan frekuensi KAD dan kadar HbA1C Durasi sakit dan riwayat hipoglikemia berat tidak memengaruhi full scale IQ Kata kunci faktor fungsi kognitif DM tipe 1 ABSTRACT Background Type 1 diabetes is mostly found in childhood and adolescence with prevalence of 1 500 children Chronic hyperglycemia causes complications in organs especially the eyes kidneys nerves blood vessels and heart These complications are associated with HbA1C levels as one of the factors affecting cognitive ability Patients with type 1 diabetes may also experience complications caused by severe hypoglycemia resulting in atrophy of neurons in the brain Early identification to the risk of complication in cognitive ability is important for clinical interventions and psychoeducation Aim To identify the prevalence of diabetic children with under average cognitive ability in Indonesia and to determine the correlation between the age of onset of diabetes duration of illness diabetic ketoacidosis DKA HbA1C severe hypoglycemia and cognitive ability of children with type 1 diabetes mellitus Method This is a cross sectional and risk factors study held in Jakarta from May to June 2015 Assessment of cognitive ability was done with the Wechsler Intelligence Scale for Children WISC IV Subjects in this study were type 1 diabetic patients aged 5 18 years Statistical analysis was performed to find the correlation among cognitive ability and age of onset duration of illness HbA1C levels and frequency of DKA Comparative statistical analysis was performed to find the mean difference in full scale IQ intelligence quotient of patients who had or did not have a history of severe hypoglycemia Result This study had 58 subjects with a mean full scale IQ 100 16 Nineteen percent subjects had full scale IQ under average We found statistically significant correlations between cognitive ability and the age of onset r 0 285 p 0 030 HbA1C levels r 0 270 p 0 041 and the frequency of occurrence DKA history r 0 289 p 0 028 There was no correlation between the duration of illness and full scale IQ There was no full scale IQ difference between groups with a history of severe hypoglycemia and control Conclusion There were negative correlations between full scale IQ and age of onset frequency DKA and HbA1C levels The duration of illness and history of severe hypoglycemia did not affect the full scale IQ Keywords factors cognitive function type 1 diabetes;Background Type 1 diabetes is mostly found in childhood and adolescence with prevalence of 1 500 children Chronic hyperglycemia causes complications in organs especially the eyes kidneys nerves blood vessels and heart These complications are associated with HbA1C levels as one of the factors affecting cognitive ability Patients with type 1 diabetes may also experience complications caused by severe hypoglycemia resulting in atrophy of neurons in the brain Early identification to the risk of complication in cognitive ability is important for clinical interventions and psychoeducation Aim To identify the prevalence of diabetic children with under average cognitive ability in Indonesia and to determine the correlation between the age of onset of diabetes duration of illness diabetic ketoacidosis DKA HbA1C severe hypoglycemia and cognitive ability of children with type 1 diabetes mellitus Method This is a cross sectional and risk factors study held in Jakarta from May to June 2015 Assessment of cognitive ability was done with the Wechsler Intelligence Scale for Children WISC IV Subjects in this study were type 1 diabetic patients aged 5 18 years Statistical analysis was performed to find the correlation among cognitive ability and age of onset duration of illness HbA1C levels and frequency of DKA Comparative statistical analysis was performed to find the mean difference in full scale IQ intelligence quotient of patients who had or did not have a history of severe hypoglycemia Result This study had 58 subjects with a mean full scale IQ 100 16 Nineteen percent subjects had full scale IQ under average We found statistically significant correlations between cognitive ability and the age of onset r 0 285 p 0 030 HbA1C levels r 0 270 p 0 041 and the frequency of occurrence DKA history r 0 289 p 0 028 There was no correlation between the duration of illness and full scale IQ There was no full scale IQ difference between groups with a history of severe hypoglycemia and control Conclusion There were negative correlations between full scale IQ and age of onset frequency DKA and HbA1C levels The duration of illness and history of severe hypoglycemia did not affect the full scale IQ Keywords factors cognitive function type 1 diabetes, Background Type 1 diabetes is mostly found in childhood and adolescence with prevalence of 1 500 children Chronic hyperglycemia causes complications in organs especially the eyes kidneys nerves blood vessels and heart These complications are associated with HbA1C levels as one of the factors affecting cognitive ability Patients with type 1 diabetes may also experience complications caused by severe hypoglycemia resulting in atrophy of neurons in the brain Early identification to the risk of complication in cognitive ability is important for clinical interventions and psychoeducation Aim To identify the prevalence of diabetic children with under average cognitive ability in Indonesia and to determine the correlation between the age of onset of diabetes duration of illness diabetic ketoacidosis DKA HbA1C severe hypoglycemia and cognitive ability of children with type 1 diabetes mellitus Method This is a cross sectional and risk factors study held in Jakarta from May to June 2015 Assessment of cognitive ability was done with the Wechsler Intelligence Scale for Children WISC IV Subjects in this study were type 1 diabetic patients aged 5 18 years Statistical analysis was performed to find the correlation among cognitive ability and age of onset duration of illness HbA1C levels and frequency of DKA Comparative statistical analysis was performed to find the mean difference in full scale IQ intelligence quotient of patients who had or did not have a history of severe hypoglycemia Result This study had 58 subjects with a mean full scale IQ 100 16 Nineteen percent subjects had full scale IQ under average We found statistically significant correlations between cognitive ability and the age of onset r 0 285 p 0 030 HbA1C levels r 0 270 p 0 041 and the frequency of occurrence DKA history r 0 289 p 0 028 There was no correlation between the duration of illness and full scale IQ There was no full scale IQ difference between groups with a history of severe hypoglycemia and control Conclusion There were negative correlations between full scale IQ and age of onset frequency DKA and HbA1C levels The duration of illness and history of severe hypoglycemia did not affect the full scale IQ Keywords factors cognitive function type 1 diabetes]"