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Inpatient-tailored diabetes self-management education and short-term glycemic change in type 2 diabetes: A pilot case series from RSUD dr. Darsono Pacitan Arifah, Kun; Widiastuti, Agung; Ernawati, Ucik; Dwi Kurniawan, Yanti
Avicenna : Journal of Health Research Vol 9, No 1 (2026): MARET
Publisher : STIKES Mamba'ul 'Ulum Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36419/avicenna.v9i1.1741

Abstract

Background: Type 2 diabetes mellitus (T2DM) commonly presents with uncontrolled hyperglycemia among inpatients, where self-management gaps compound clinical instability. Diabetes Self-Management Education (DSME) is recommended, yet evidence for inpatient-tailored, short-horizon DSME remains limited. Objective: To evaluate the short-term effect of a ward-adapted DSME adjunct on capillary blood glucose and self-management behaviors in hospitalized adults with T2DM. Methods: purposive sampling (n=2) in the Wijaya Kusuma Inpatient Ward, RSUD dr. Darsono (July-August 2025). The intervention comprised individual bedside DSME (two sessions; 60-90 minutes total) plus discharge reinforcement, delivered by diabetes-trained nurses. Primary outcome: change in capillary glucose (mg/dL) from baseline to post-intervention over 4 days with consistent testing conditions. Secondary outcome: Diabetes Self-Management Questionnaire (DSMQ-16; 0-64). Analyses emphasized descriptive trajectories; exploratory paired t-test/Wilcoxon and bootstrap 95% CIs were reported with α=0.05 (hypothesis-generating). Results: Baseline glucose was 837 and 511 mg/dL; by day 4, values declined to 130 and 120 mg/dL, respectively (absolute change -707 [-84.5%] and -391 [-76.5%]); no hypoglycemia/adverse events occurred. DSMQ-16 improved from 15 to 50 and 17 to 60 (poor to good). Exploratory tests were underpowered (paired t=3.47, p=0.18; Wilcoxon p=0.25), but the effect size was very large (Cohen’s d=2.46), consistent with observed trajectories. Conclusion: A ward-tailored DSME delivered over four days was feasible and associated with rapid, clinically meaningful glycemic improvement and substantial gains in self-management among acutely uncontrolled inpatients with T2DM. Findings are hypothesis-generating and support larger, controlled studies to confirm efficacy, durability post-discharge, and scalability.
Hubungan Koping dan Kecemasan dengan Nyeri Post-ORIF Ekstremitas Bawah di RS Ortopedi Surakarta Raharja, Muhammad Langlang Tahta; Widiastuti, Agung; Utomo, Endrat Kartiko
Jurnal Pustaka Keperawatan (Pusat Akses kajian Keperawatan) Vol 4 No 2 (2025): Jurnal Pustaka Keperawatan
Publisher : Pustaka Galeri Mandiri

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55382/jurnalpustakakeperawatan.v4i2.1205

Abstract

Lower extremity fractures are a significant musculoskeletal problem with a steadily increasing incidence globally and nationally. The standard treatment for fractures is ORIF. ORIF procedures cause postoperative pain, which is greatly influenced by psychological factors such as anxiety levels and the patient's coping mechanisms. Poorly managed post-ORIF pain can negatively impact physiological responses, emotional status, and slow down the patient's healing process. While pharmacological pain management remains a priority, there is still a need to integrate more optimal non-pharmacological interventions to address anxiety and pain at Prof. Dr. R. Soeharso Orthopedic Hospital in Surakarta, making an understanding of the relationships between these variables essential. This is a quantitative study with a descriptive correlational design and a cross-sectional approach. The study population includes all patients who have undergone lower extremity ORIF, with a sample of 35 respondents selected using purposive sampling techniques that meet the inclusion criteria. Data collection was conducted using standardized questionnaire instruments: the Jalowiec Coping Scale (JCS) to measure coping mechanisms, the Hamilton Anxiety Rating Scale (HARS) to assess anxiety levels, and the Numeric Rating Scale (NRS) to measure pain intensity. Data analysis utilized the Spearman Rank correlation test to test the hypothesis. The results of bivariate statistical analysis showed a significant relationship between coping mechanisms and pain intensity (p-value 0.002, r= -0.509) and between anxiety levels and pain intensity (p-value 0.000, r= 0.797) in patients who had undergone lower extremity ORIF. Conclusion: There is a relationship between coping mechanisms and anxiety levels with pain intensity in patients who have undergone lower extremity ORIF at Prof. Dr. R. Soeharso Orthopedic Hospital in Surakarta.