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The Effect of Dietary and Exercise Self-Management Support Program on Dietary Behavior Exercise Behavior and Clinical Outcomes in Muslim Patients with Poorly Controlled Type 2 DM in a Community Setting in Indonesia Pamungkas, Rian Adi; Chinnawong, Tippamas; Kritpracha, Charuwan
Nurse Media Journal of Nursing Vol 5, No 1 (2015): (JUNE 2015)
Publisher : Department of Nursing, Faculty of Medicine, Diponegoro University

Purpose: The objective of this study was to examine the effect of dietary and exercise self-management support program on the dietary behavior, exercise behavior, and clinical outcomes of Muslim patients with poorly controlled type 2 DM in Indonesia. Methods: This study was a quasi-experimental, two group, pre-test and post-test design. The experimental group received the dietary and exercise self-management support program and usual care, whereas the control group only received the usual nursing care.Result: 35 subjects in the experimental group and 35 subjects in the control group completed the program, respectively. The findings indicated that there are significantly differences in dietary behavior (p=.00), exercise behavior (p=.00) and clinical outcomes: fasting blood glucose (FBG) (p=.00), cholesterol total level (p=.01) and systolic blood pressure (p=.00) between the experimental group and control group. However, for the BMI status (p=.84) and diastolic blood pressure (BP) (p=.32) were no significant differences between two groups. Conclusion: The dietary and exercise self-management support program was effective for improving the dietary behavior, exercise behavior, FBG, and total cholesterol level for individuals with poorly controlled type 2 diabetes mellitus. Further studies should be replicated using larger groups over a longer time frame.

Quality of life among Indonesian family caregivers caring for dependent older persons with type 2 diabetes mellitus in the community: A cross-sectional, correlational study Siregar, Rinco; Kritpracha, Charuwan; Chinnawong, Tippamas; Latour, Jos M.
Belitung Nursing Journal Vol. 11 No. 1 (2025): January - February
Publisher : Belitung Raya Foundation, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3683

Background: The global prevalence of older adults with diabetes has increased, and family caregivers in Indonesia play a critical role in managing diabetes and providing personal care. However, caregiving can be complex and challenging, often negatively affecting caregivers' quality of life (QoL). Objective: This study aimed to develop and test a hypothesized causal model of QoL among Indonesian family caregivers who care for dependent older persons with type 2 diabetes mellitus (T2DM) in 2024. Methods: A cross-sectional, correlational study was conducted with 270 family caregivers recruited from five Community Health Centers. Data were collected using various scales: the Center for Epidemiologic Studies Depression Scale, the Zarit Burden Interview, the Duke University Religion Index, the Perceived Knowledge on T2DM Care Scale, the Family-Carer Diabetes Management Self-Efficacy Scale, the Multidimensional Scale of Perceived Social Support, and the Quality-of-Life Index. Descriptive statistics and Partial Least Squares Structural Equation Modeling (PLS-SEM) were used for analysis. Results: The final model explained 89.1% of the variance in the quality of life (QoL) of family caregivers (R² = 0.893, Adjusted R² = 0.891), with 66% predictive relevance. Depression symptoms had the strongest negative direct effect on QoL, followed by caregiver burden. Self-efficacy and perceived knowledge had positive direct effects, while social support showed no significant direct effect. Indirect effects revealed that social support and self-efficacy positively influenced QoL through depression symptoms. The total effect (TE) analysis confirmed that depression symptoms had the strongest negative effect on QoL (TE = -0.744, p <0.001), while social support (TE = 0.443, p <0.001) and self-efficacy (TE = 0.413, p <0.001) had positive effects. Conclusion: Reducing depression symptoms and caregiver burden, strengthening social support, and promoting self-efficacy could significantly improve the QoL of family caregivers who care for older persons with T2DM. Nursing practice should address caregivers' physical and emotional needs, provide education, foster social support, and support caregiver mental health.

Psychometric properties of the Indonesian version of the Quality of Life Index (QLI-I) among family caregivers of dependent older persons with type 2 diabetes mellitus Siregar, Rinco; Kritpracha, Charuwan; Chinnawong, Tippamas; Latour, Jos M.
Belitung Nursing Journal Vol. 11 No. 4 (2025): July - August
Publisher : Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3929

Background: The quality of life (QoL) of family caregivers supporting older persons with functional dependence due to Type 2 Diabetes Mellitus (T2DM) is a growing concern. Accurately assessing caregiver well-being requires culturally appropriate, valid, and reliable instruments. However, such tools remain limited in the Indonesian context. Objective: This study aimed to translate the Quality of Life Index (QLI) into Indonesian and evaluate the psychometric properties of the Indonesian version (QLI-I) among family caregivers of dependent older persons with T2DM. Methods: Brislin’s back-translation method was used to ensure linguistic and conceptual equivalence in the translation process. Content validity was assessed by a panel of five experts. Psychometric evaluation was conducted on a purposive sample of 394 family caregivers recruited from eleven community health centers in Medan, Indonesia. Construct validity was examined using confirmatory factor analysis (CFA), while convergent validity and construct reliability (CR) were analyzed to assess measurement accuracy. Results: The Indonesian version of the Quality of Life Index (QLI-I) demonstrated strong construct validity, with standardized factor loadings ranging from 0.707 to 0.870. CFA indicated an acceptable model fit based on the following indices: Root Mean Square Error of Approximation (RMSEA) = 0.067, ratio of chi-square to degrees of freedom (CMIN/df) = 2.779, Comparative Fit Index (CFI) = 0.906, Incremental Fit Index (IFI) = 0.906, Goodness of Fit Index (GFI) = 0.814, and Tucker-Lewis Index (TLI) = 0.898. Composite Reliability (CR) values were high across all domains: Health/Functioning (HF) = 0.957, Family (FA) = 0.876, Social/Economic (SE) = 0.924, and Psychological/Spiritual (PS) = 0.922. Average Variance Extracted (AVE) values met the recommended threshold for each domain: HF = 0.633, FA = 0.586, SE = 0.605, and PS = 0.627. All constructs demonstrated acceptable discriminant validity, confirming the distinctiveness of each domain. Conclusion: The QLI-I is a valid and reliable instrument for assessing the QoL of family caregivers of dependent older persons with T2DM. Its use in clinical and community settings can support nurses and healthcare professionals in identifying caregiver needs and developing culturally appropriate, evidence-based interventions to enhance caregiver well-being.

Correlation between Coping Strategies and Quality of Life among Myocardial Infarction Patients in Nepal Panthee, Bimala; Kritpracha, Charuwan; Chinnawong, Tippamas
Nurse Media Journal of Nursing Vol 1, No 2 (2011): (DECEMBER 2011)
Publisher : Department of Nursing, Faculty of Medicine, Universitas Diponegoro

Objective: To examine the correlation between coping strategies and quality of life (QoL) among patients with myocardial infarction (MI) Method: A descriptive correlational design was used to examine the relationship between coping strategies and QoL among 88 patients with MI who were older than 18 years, 2 months after the initial diagnosis of MI. QoL was assessed using the cardiac version of the Quality of Life Index. Coping strategy was assessed using Jalowiec Coping Scale. Problem-focused coping and emotion-focused coping were also compared in male and female patients.Results: Problem-focused coping was significantly positively associated with overall QoL (r = .41, p = <.01), particularly the health and functioning dimension (rs = .39, p = <.01) and socio-economic dimension (rs = .46, p = <.01) but not with psychological & spiritual and family dimension. Men used more problem-focused coping strategies than women. The problem-focused coping score was significantly different between men and women (t = 4.9, p <.05).Conclusion: The results revealed that patients who used more of problem-focused coping had better QoL than patients who used less problem-focused coping. Educating patients to enhance the use of appropriate coping strategies may be useful to promote the QoL of Nepalese patients with MI. Key words: Coping, quality of life, myocardial infarction

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