PENGARUH EDUKASI PERAWATAN KAKI DAN SENAM KAKI TERHADAP UPAYA PENCEGAHAN RISIKO FOOT ULCER PADA KLIEN DIABETES MELITUS

Selpina Embuai

Abstract


Pendahuluan: Diabetes melitus merupakan salah satu penyebab masalah kesehatan yang paling utama dan sering muncul hampir pada setiap negara (Fujiwara et al, 2011; Bakker & Riley, 2005). Sekitar 15% dari semua penderita diabetes akan mengalami ulkus pada kaki yang merupakan komplikasi serius dan berdampak pada amputasi ekstremitas bawah (Bakker et al, 2012; Bakker & Riley, 2005). Tingkat terjadinya ulkus pada kaki bisa terjadi selama rentang waktu lima tahun sebesar 70% (Kotru et al, 2015). Peran perawat sebagai pemberi pelayanan kesehatan adalah dapat melakukan upaya pencegahan terhadap ulkus diabetik melalui edukasi perawatan kaki dan senam kaki. Tujuan dari penelitian ini adalah untuk mengetahui pengaruh edukasi perawatan kaki dan senam kaki terhadap upaya pencegahan risiko foot ulcer pada klien diabetes mellitus. Metode: Desain penelitian yang digunakan adalah quasy experiment (pre-post test with control design). Penelitian ini dilakukan di RSUD Dr. M. Haulussy Ambon. Penelitian ini terdiri dari 2 kelompok yaitu perlakukan dan kontrol dengan masing-masing responden sebanyak 47. Teknik sampling dengan consecutive sampling. Instrumen yang digunakan monofilament 10 g neuropathy diabetic test jenis Semmes-Weinstein monofilament, Garpu tala 128 Hz, pedoman pengambilan sampel darah untuk pemeriksaan HbA1c dan glukosa plasma 2 jam puasa post beban glukosa 75 gram, pedoman pemeriksaan Tes toleransi glukosa oral, Tensimeter untuk mengukur tekanan darah dan panduan pemeriksaan Ankle Brachial Index, pengukuran arteri dorsalis pedis serta format checklist perawatan kaki dan senam kaki. Analisis yang digunakan adalah paired t-test. Hasil: Terdapat pengaruh edukasi perawatan kaki dan senam kaki pada kelompok intervensi dilihat dari 4 variabel yang diukur yaitu penilaian neuropati menggunakan monofilament dan garpu tala, penilaian vaskuler dengan pemeriksaan HbA1c, TTGO dan ankle brachial indeks, penilaian struktur kulit dan penilaian diabetes self care dengan nilai signifikansi masing-masing variabel yang diukur 0,00 (α < 0,05). Kesimpulan: edukasi perawatan kaki dan senam kaki efektif mencegah risiko foot ulcer pada klien diabetes mellitus.

Kata Kunci : Edukasi Perawatan Kaki dan Senam Kaki, Risiko Foot Ulcer, Diabetes Melitus

Keywords


Edukasi Perawatan Kaki dan Senam Kaki, Risiko Foot Ulcer, Diabetes Melitus

References


Aalaa M, Malazy TO, Sanjari M, Peimani M & Tehrani-Mohajeri MR, (2012). Nurse’s role in diabetic foot prevention and care : a review. Journal of diabetes & metabolic disorder. Hal. 1-6

Alligood, M. R. (2014). Nursing theory & their work (8 th ed). The CV Mosby Company St. Louis. Toronto. Missouri: Mosby Elsevier. Inc

American Diabetes Association. (2008). Standards of medical care in diabetes—2008. Diabetes Care. ;31(Suppl 1):S12-S54.

American Diabetes Association. (2016). Standar of Medical Care in Diabetes. The Journal of Clinical and Applied Research and Education. Diabetes Care 2016;39(Suppl. 1):S1–S2 | DOI: 10.2337/dc16-S001ISSN 0149-5992

Ayello A E, Sibbad R G, Ostrow, B and Smart H (2012). Teaching health care professional in resource challenge countries to construct monofilament for purposes of diabetic foot screening. World council of esterostomal therapist journal. 32, 4

Bakker K, Rilley P (2005). The Year on the Diabetic Foot, Diabetes Voice; Vol. 50. Hal. 11-14. Diakses tanggal 30 Oktober 2016.

Bakker K, Apelqvist J, Schaper C. N (2012). Practical Guidelines on the Management and Prevention of the Diabetic Foot 2011. Diabetes/Metabolism Research and Reviews. Hal. 225-231.

Baraz S , Zarea K*, Shahbazian H B and Latifi S. M. (2014). Comparison of the accuracy of monofilament testing at various points of feet in peripheral diabetic neuropathy screening. Baraz et al. Journal of Diabetes & Metabolic Disorders 2014, Page 1-7

Bautista, Santos, F. J. & Asencio, J. M. (2014). Systematic review of the psychometric properties and theoretical grounding of instruments evaluating self-care in people with type 2 diabetes mellitus. Journal of Advanced Nursing, 70, 1209–1227.

Bryant RA & Nix D. P, (2009). Acute and chronic wounds current management concept (3rd ed) Mosby Elsevier. St. Louis Missouri

Chiwanga FS, Njelekela MA, (2015), Diabetic foot : prevalence, knowledge, and foot self care practice among diabetic patient in Dar es Salaam, Tanzania, journal of foot and ankle research. Vol. 8. No. 20 Hal. 1-6.

Dutch Association of Neurology (NVN), Dutch Association of Clinical Neurophysiology (NVKNF). (2005). Guideline Polyneuropathy of the Dutch Institute for Healthcare Improvement (CBO). Alphen a/d Rijn, the Netherlands: van Zuiden;

Fortmann et al (2011). Glycemic Control Among Latinos with Type 2 Diabetes: The Role of Social-Environmental Support Resources. Health Psychol. 30(3): 251–258.

Fujiwara Yuko, Kishida Ken, Terao Mika, Takahara Mitsyuyoshi, Matsuhisa Munehide, Funahashi Tohru, Shimomura Iichiro & Shimizu Yasuko. (2011). Beneficial Effect of Foot Care Nursing for People With Diabetes Mellitus : an Uncontrolled Before and After Intervention Study. Journal of Advanced Nursing. Hal. 1952-1961.

International Diabetes Federation, (2013), Diabetes Atlas, diakses tanggal 31 Oktober 2016, http://www.idf.org/sites/default/files/EN_6E_Atlas_Full_0.pdf

Kalus, A. A., Chien, J. A., and Olerad. 2008. Diabetes Melitus and Other Endocrine Disease in, wolf, k, Fitzpatrick’s Dermatologi in General Medicing. Edisi 7 Vol 2. USA The McGraw-Hill Companies, pp: 1479- 1481.

Kavitha VK, Tiwari S, Purandare BV, Khedkar S, Bhosale SS, Unnikrishnan AG. (2014). Choice of wound care in diabetic foot ulcer: A practical approach. World Journal Diabetes. Vol. 5, Isuue. 4, Hal. 546-556

Kotru S, Kotru B, Joshi K. (2015). Intervention of Diabetes Foot Care Practices on the Prevention of New Diabetic Foot Ulcers in Patient With Type 2 Diabetes Mellitus. Research Article Diabetes & Metabolism. Vol. 6. Issue. 2 Hal. 1-6.

LeMone P, Burke KM, Bauldoff G. (2015). Buku Ajar Keperawatan Medikal Bedah. Volume 2, Edisi 5, EGC : Jakarta

Liu Z, Wang W, Xu B. (2010). Prevalence f chronic complication of type 2 diabetes mellitus in out patient a cross sectional hospital based survey in urban China. BioMed Central health and Quality of life otucomes. 8;62

Lunes et al. 2014. Self-Care Associated with Home Exercises in Patients with Type 2 Diabetes Mellitus. /journal.pone.0114151. Hal 1-13.

Naicker, Ohnmar, Choon, Chin Yee, Naicker, Das, Roohi, 2009, A study of risk factors associated with diabetic foot, knowledge and practice of foot care among diabetic patients. International Medical Journal, 16(3), 189-193.

NHS National Institute for Clinical Excellence (NICE). (2004). Type 2 Diabetes Prevention and Management of Foot Problems, Clinical Guideline 10. London, UK: National Institute for Clinical Excellence (NICE)

Perkins BA, Olaleye D, Zinman B, Bril V. (2001). Simple screening tests for peripheral neuropathy in the diabetes clinic. Diabetes Care. ;24(2):250-256

Priyanto S (2012). Pengaruh Senam Kaki Terhadap Sensitivitas Kaki dan Kadar Gula Darah Pada Agregat Lansia Diabetes Melitus di Magelang, Tesis, Universitas Indonesia, Depok

Purwanti. (2013). Analisis Faktor-Faktor Risiko Terjadi Ulkus Kaki pada Pasien Diabetes Melitus di RSUD Dr. Moewardi. Tesis. Universitas Indonesia : Depok

Reiber GE, Vileikyte L, Boyko EJ, del Aguila M, Smith DG, Lavery LA, Boulton AJ.(1999). Causal pathways for incident lower extremity ulcers in patients with diabetes from two settings. Diabetes Care. Vol. 22, No.1, Hal. 157-162.

Richard JL, Sotto A, Lavigne JP (2011). New insights in diabetic foot infection. World Journal of Diabetes. Vol. 2. Issue. 2 Hal. 24-32.

Shrivastava, S. R., Shrivastava, P. S. & Ramasamy, R. (2013). Role of self-care in management of diabetes mellitus. Journal of Diabetes & Metabolic Disorders, 12-14.

Singh N, Armstrong DG, Lipsky BA. (2005). Preventing Foot Ulcer in Patient With Diabetes. Clinical Review Journal American Medical Association, Vol. 293. No. 2. Hal. 217-228.

Silbernagl S & Lang F (2007). Teks & Atlas berwarna patofisiologi. EGC : jakarta

Smeltzer & Bare. (2002). Buku Ajar Keperawatan Medikal Bedah. Volume 2, EGC : Jakarta

Sreedevi C, Car N, Pavlic-Renar I. (2002). Dermatologic lesions in Diabetes Mellitus. Diabetologica Croatica

Sudoyo AW, Setyohadi B, Alwi I, Simadibrata KM, Setiati S, (2007) editor. Buku ajar ilmu penyakit dalam. Jakarta: Pusat Penerbitan Departemen Ilmu Penyakit Dalam FKUI: 1852-1859

Suriadi. (2004). Perawatan Luka. Cetakan ke I. Jakarta. CV Sagung Seto.

Tambunan, M. (2006). Perawatan Kaki Diabetes, Jakarta: FK UI

Vancouver Costal Health. (2010). Diabetic foot care : you and your feet. Vancouver costal health.http:/www.vch.eduhealth.ca. diakses tanggal 13 Juni 2017

Wahyuni A, Arisfa N. (2015).Senam Kaki Diabetik Efektif Meningkatkan Ankle Brachial Index Pasien Diabetes Melitus Tipe 2. Jurnal IPTEK terapan Vol. 9. No.2.

Waki, Shimizu, Uchiumi, Asou, Kuroda, Murakado, Seto, Masaki and Ishii (2016). Structural model of self-care agency in patients with diabetes: A path analysis of the Instrument of Diabetes Self-Care Agency and body self-awareness. Japan Journal of Nursing Science. Vol. 13; 478-486.

Waspadji, S., (2006), Komplikasi Kronik Diabetes : Mekanisme Terjadinya, Diagnosis, Dan Strategi Pengelolaan. Jakarta : Fakultas Kedokteran Universitas Indonesia.

Wattana C, Srisupan W, Pothiban L, Upchurch S L. (2007). Effect of diabetes self management program on glycemic control, coronary heart disease risk and quality of life among thai patient with type 2 diabetes. Nursing and health science. 9 ; 135-141

Xu Yin, Toobert D, Savage C, Pan W, & Whitmer K. (2008). Factor influencing diabetes self management in chinese people with type 2 diabetes. Research in nursing & health, 31 ; 613-625


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