Research Report Amriati Mutmainna 1

Self-Care Behaviors of Patients Diagnosed with Diabetes Mellitus: A
Basis for A Counseling Program,

Amriati Mutmainna1,a, Catherine L. Verzosa, 2,b ,Prapaporn Manorath3,c
1
STIKes Nani Hasanuddin Makassar, South Sulawesi, Indonesia
2
St. Paul University Philippines, Tuguegarao, Philippines
3
Boromarajonani College of Nursing, Uttaradit, Thailand
a
[email protected], [email protected]
c
[email protected]
Keyword: Self-care behaviors, diabetes mellitus, counseling program
Abstract. Diabetes is a serious life-long health condition that occurs when the
amount of glucose in the blood is too high. The purpose of this study was the
assessment of the self-care behaviors of patients with diabetes mellitus to proposed
a counseling program. The descriptive survey research design was used. Seventy-
two (72) respondents were taken as subjects. The frequency and percentage, weight
mean, and chi-square were used to treat quantitative data. Assessment rating for the
self-care behaviors ranges from “very high degree” to “low degree”. There is no
significant difference of the self-care behaviors according to age, gender, and history
of smoking. But then, there is a significant difference on the self-care behaviors of
participants when grouped according to blood sugar levels and body mass index.
The assessment of this self-care behaviors are considered to be an effective
approach to address diabetes mellitus patients varied conditions through a
counseling program.
Introduction
The latest global estimates from the International Diabetes Federation
forecast that by 2040, 642 million people will be living with diabetes (The Lancet,
2017). World Health Organization (2017) stated that the number of people with
diabetes has risen from 108 million in 1980 to 422 million in 2014. The global
prevalence of diabetes among adults over 18 years of age has risen from 4.7% in
1980 to 8.5% in 2014.
South Sulawesi provincial health data showed that patients with diabetes
mellitus treated at community health clinic in 2010 were 9.61%, 2011 was 9.32%,
increased in 2012 by 12.6%. The data of Makassar City health office revelas that the
diabetes mellitus patients in 2012 as many as 14,067 cases, increased by 14,604
cases in 2013, and in 2014 increased by 21,452 cases (Syatriani, 2017).
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.
However, one of the factors of a treatment failure is non-adherence to
planned therapy, one of the most important attempts to improve patient adherence to
therapy is by providing comprehensive, accurate, and structured counseling about
the therapy. The existence of this counseling is very important because diabetes is a
disease associated with patient lifestyle. Therefore, the purpose of this study was the
assessment of the self care behaviors of patients with diabetes mellitus to develop a
proposed counseling program.
Method
In this paper, the researcher used descriptive survey study which described the
self-care behavior of patients diagnosed with diabetes mellitus as a basis for the
purpose of counseling program.
The participants of the study are those included in the criteria inclusion in which
there were 72 participants. The inclusion criteria as following:
1. Hospitalized in Labuang Baji Hospital and Pelamonia Hospital Makassar.
2. Participants aged above 18 years old.
3. Participants are willing to participate in the study.
4. Participants are diagnosed type 1 or type 2 diabetes mellitus.
5. Participants have limited information about control of blood sugar.
6. Participants disposed to cooperate and willing to fill the instrument which the
researcher provided.
Participants who are reluctant to participate in the study are excluded as

participants.
The primary data in this study was the profile of the participants in terms of age,
gender, blood sugar levels, body mass index, and history of smoking. In addition, the
questions for diabetes mellitus patients used Diabetes Self-Management
Questionnaire (DSMQ) by Schmitt, et al. (2013) to assess the self-care behaviors of
the participants.
Result
The summary of finding on this study detailed in the below as following:
1. The profile of the participants
1.1. Majority of the participants are above 45 years old.
1.2. Majority of the participants are female.
1.3. Majority of the participants have high blood sugar levels.
1.4. The most of the participants have normal weight.
1.5. Majority of the participants are non-smokers.
2. 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
2.1. In general terms
2.1.1. Majority of the participants are diabetes mellitus patients have
low degree of self-care behaviors.
low degree of glucose management.
low degree of dietary control.
low degree of physical activity
moderate degree of health-care use.
2.2. In specific terms
2.2.1. Glucose management
2.2.1.1. There is no significant difference on the participant’s glucose
management and their age, gender, body mass index, and
history of smoking.
2.2.1.2. There is a significant difference on the participant’s glucose
management and their blood sugar levels.
2.2.2. Dietary control
2.2.2.1. There is no significant difference on the participant’s dietary
control and their age, gender, body mass index, and history of
smoking.
2.2.2.2. There is a significant difference on the participant’s dietary
control and their blood sugar levels.
2.2.3. Physical activity
2.2.3.1. There is no significant difference on the participant’s physical
activity and their age, body mass index, and history of smoking.
2.2.3.2. There is a significant difference on the participant’s physical
activity and their gender, blood sugar levels.
2.2.4. Health-Care Use
2.2.4.1. There is no significant difference on the participant’s health-care
use and their age, gender, body mass index, and history of
smoking.
2.2.4.2. There is a significant difference on the participant’s health-care
use and their blood sugar levels.
3. Significant difference in the self-care behaviors of the participants when grouped

according to profile variables
3.1. There is no significant difference on the participant’s self-care behaviors
and their age, gender, and history of smoking.
3.2. There is a significant difference on the participant’s self-care behaviors
and their body mass index, blood sugar levels.
4. Counseling program can be purposed to enhance self-care behaviors

4.1. The hospital supports counseling program through build counselors PEDI
(Perhimpunan Edukator Diabetes Indonesia/Educator Diabetes
Association of Indonesia) from health workers.
4.2. The hospital concerns to having the counselors who are registered
counselors which must have licensed from PEDI.
4.3. PEDI counselors show increases the knowledge diabetes mellitus patients
through counseling especially about self-care behaviors, such as glucose
management, dietary control, physical activity, and health-care use.
Conclusion
This study concluded that generally there is poor self-care behaviors of the
participants particularly in low glucose management, dietary control, and physical
activity. In addition, poor self-care behaviors of the participants also are particularly
in moderate health-care use. Furthermore, diabetes mellitus patients experienced
the highest number of cases occurred in this study was above 45 years old, female
participants, high blood sugar levels, normal weight, and had not history of smoking.
The self-care behaviors of the participants in this study described about

glucose management, dietary control, physical activity and health-care use which
had affect from blood sugar levels. On the contrary with age, gender, and history of
smoking which had not affect for glucose management, dietary control, physical
activity and health-care use. In addition, for body mass index and blood sugar levels
depend on self-care behaviors; conversely, for age, gender, and history of smoking
are not depend on affected from self-care behaviors.
The counselors should 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.
References
Franklin, R. (2012). Diabetes reach goals faster. Retrieved from https://www.
medscape.com/ viewarticle/757393
Schmitt, A., Gahr, A., Hermaanns, N., Kulzer, B., Huber, J., and Haak, T. (2013).
The Diabetes Self-Management Questionnaire (DSMQ): Development and
evaluation of an instrument to assess diabetes self-care activities associated
with glycaemic control. Health and Quality of Life Outcomes; 11:138.
Retrieved from http://doi.org/10.1186/1477-7525-11-138
The Lancet. (2017). Obesity and diabetes in 2017: A new year. The Lancet; Vol.389,
No.10064. doi: http://dx.doi.org/10. 1016/S0140-6736(17)30004-1

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Self-Care Behaviors of Patients Diagnosed with Diabetes Mellitus: A

Basis for A Counseling Program,

Participants who are reluctant to participate in the study are excluded as

2. The degree of manifestation of the self-care behaviors of the participants in

3. Significant difference in the self-care behaviors of the participants when grouped

4. Counseling program can be purposed to enhance self-care behaviors

The self-care behaviors of the participants in this study described about

The counselors should notice those entire important subjects to ensure

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