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"Exercise pada pasien DM selama ini hanya difokuskan pada latihan daerah ankle saja, namun belum ada latihan fisik yang berfokus melatih seluruh otot kaki. Home‑Based Foot–Ankle Exercise (HBFAE) melatih seluruh otot kaki yang menggabungkan empat jenis exercise yang direkomendasikan American Diabetes Association yaitu stretching, strengthening, resistance dan balance exercises. Tujuan dari penelitian ini mengidentifikasi efektivitas HBFAE terhadap ABI pada pasien DM Tipe 2. Metode penelitian ini adalah Randomized Controlled Trial (RCT) double blind sampel 40 responden (20 intervensi dan 20 kontrol). Kelompok intervensi diberikan perlakuan HBFAE, kelompok kontrol diberikan perlakuan senam kaki diabetes. Perlakuan pada kedua kelompok diberikan sebanyak 24 kali (1 kali/hari, 5 kali dalam seminggu). Hasil penelitian menunjukan HBFAE (p value 0,001) dan senam kaki diabetes (p value 0,003) mampu meningkatkan ABI. Uji efektifitas menunjukan HBFAE efektif dalam meningkatkan nilai ABI dengan skor efektivitas 0,72 (72%), dibandingkan senam kaki diabetes hanya 0,14 (14%). Variabel confounding gula darah, lama DM, riwayat merokok, dan riwayat ulkus kaki pada penelitian ini tidak berhubungan dengan perubahan skor ABI (p value > 0,05). HBFAE dapat menjadi standar terapi exercise di rumah (komunitas) maupun di instalasi pelayanan kesehatan untuk mencegah komplikasi vaskularisasi kaki pada pasien DM karena mudah dan mampu dilakukan secara mandiri.

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Exercise in DM patients so far only focused in the ankle area and there is no exercise that focuses on training all leg muscles. Home-Based Foot-Ankle Exercise (HBFAE) trains all leg muscles by combining the four types of exercise recommended by the American Diabetes Association, namely stretching exercises, strengthening exercises, resistance exercises, and balance exercises. The purpose of this study was to identify the effectiveness of HBFAE on the Ankle Brachial Index (ABI) in Type 2 DM patients. The research method was a Randomized Controlled Trial (RCT) with a sample of 40 respondents (20 intervention and 20 control). Respondents in the intervention group were given HBFAE treatment, while the control group was given Diabetic Foot Exercise (standard treatment). The treatment in both groups was given 24 times (1 time/day, 5 times a week). The results showed that HBFAE (p-value 0,001) and diabetic foot exercise (p-value 0,003) were able to increase ABI. The results of the effectiveness test showed that HBFAE was effective in increasing the ABI value an effectiveness score of 0,72 (72%) compared to diabetic foot exercise was only 0,14 (14%). The results analysis of the confounding variables showed blood sugar levels, duration of DM, smoking and foot ulcers history in this study were not associated with changes in ABI (p-value > 0,05). HBFAE can be a standard exercise therapy both at home (community) and health care to prevent foot vascular complications because it’s implementation is easy and can be done independently.

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"Latar belakang: Prevalensi komplikasi DM semakin meningkat termasuk di Indonesia. Untuk mencegah komplikasi DM diperlukan perubahan perilaku. Setiap pasien DM memiliki kebutuhan dan tujuan kesehatan yang bervariasi, maka person-centered approach perlu diberikan sebagai strategi yang menjanjikan untuk mengubah perilaku dalam mencegah komplikasi DM. Salah satu strateginya adalah dengan coaching. Melalui coaching, diharapkan dapat meningkatkan efikasi diri dan penerimaan diri sebagai mediator dalam mengubah perilaku dalam mencegah komplikasi DM. Tujuan: dikembangkannya model coaching keperawatan berdasarkan analisis eksploratori tentang pengalaman perilaku pencegahan komplikasi dan efektivitasnya terhadap efikasi diri, penerimaan diri, perilaku pencegahan komplikasi dan metabolik markers pada pasien DM tipe 2. Metodologi: Penelitian ini menggunakan mixed-method dengan desain eksploratori sekuensial melalui tiga tahap. Purposive sampling digunakan untuk pengambilan sampel. Tahap pertama melibatkan lima belas pasien DM tipe 2 sebagai partisipan, tahap kedua melibatkan tiga orang sebagai pakar, dan tahap ketiga melibatkan 70 pasien DM tipe 2 sebagai responden. Hasil: Teridentifikasi empat tema yang menjadi dasar pengembangan model. Tersusun empat modul sebagai penjelasan model dan pedoman implementasi model coaching keperawatan. Hasil menunjukkan adanya efektivitas intervensi model coaching keperawatan terhadap efikasi diri, penerimaan diri, perilaku pencegahan komplikasi DM, dan tekanan darah sistol (p < 0,001), serta GDP (p = 0,014), namun tidak efektif terhadap HbA1c, kolesterol total, dan tekanan darah diastol (p > 0,05). Analisis lebih lanjut menunjukkan bahwa tidak ada efek variabel perancu terhadap efikasi diri, penerimaan diri, perilaku pencegahan komplikasi DM, GDP dan tekanan darah sistol (p > 0,05), namun ada efek usia terhadap perilaku pencegahan komplikasi DM (p = 0,011), dan ada efek jenis kelamin terhadap tekanan darah sistol (p = 0,018). Simpulan: Setelah mengontrol variabel perancu, intervensi model coaching keperawatan mampu meningkatkan skor rerata efikasi diri, memperbaiki penerimaan diri, meningkatkan perilaku pencegahan komplikasi DM, menurunkan skor rerata GDP, dan tekanan darah sistol. Saran: Intervensi model coaching keperawatan dapat diadopsi sebagai salah satu intervensi keperawatan dalam mencegah komplikasi DM tipe 2.

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Background: The prevalence of DM complications is increasing, including in Indonesia. To prevent DM complications, behavior change is needed. Each DM patient has varied health needs and goals, so a person-centered approach needs to be provided as a promising strategy to change behavior in preventing DM complications. One of the strategies is coaching. By implementing coaching, it is expected to increase self-efficacy and self-acceptance as mediators in changing behavior in preventing DM complications. Aim: to identify the effectiveness of nursing coaching model intervention on self-efficacy, self-acceptance, prevention DM complications behaviors and the impact on metabolic markers in patients with type 2 DM. Methods: A mixed-method approach with exploratory sequential steps was conducted. Purposive sampling was used to approach the participants. The first step involved fifeteen participants with type 2 DM; the second step involved three experts, and the third step involved 70 participants with type 2 DM. Results: The results showed there were four themes as a basis for developing a model. There were four modules as part of the nurse coaching model. There was an effect of nursing coaching model intervention on self-efficacy, self-acceptance, prevention DM complications behaviors, and systolic blood pressure (p < 0,001), as well as fasting blood glucose (p = 0,014); however, there was no effect of nursing coaching model intervention on HbA1c, total cholesterol, and diastolic blood pressure (p > 0,05). Furthermore, there was no effect of confounding variables on self-efficacy, self-acceptance, prevention DM complications behaviors, fasting blood glucose, and systolic blood pressure (p > 0,05). Conclusion: After controlling confounding variables, a nursing coaching model intervention improves the mean score of self-efficacy self-acceptance, prevention DM complications behaviors, and decreasing the mean score of FBG and systolic. Suggestion: A nursing coaching model intervention can be adopted as one of the nursing interventions to prevent DM complications, especially at the Public Health Center."