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[[alternative]]The Evaluation of the Effects of Implementing Tailored Care Program on Patients with Diabetes in Indonesia
No full text[[abstract]]BackgroundIn Indonesia, the prevalence, health care cost and complication of diabetes has dramatically increased. People with diabetes have low participation in performing self-management because of treatment aligned not match with their preferences and individual needs or known as tailored care approached. Moreover, there was no study in Indonesia have conducted a randomized controlled trial (RCT) of tailored care program used related to diabetes management and risk of cardiovascular diseases (CVD) complication. Therefore, there is particular need for research on tailored care intervention program for people with diabetes in Indonesia. Objectives The aims of this study were to establish and address the effectiveness of tailored care intervention program for patients with diabetes troughed phase I: to discover tailored care elements and develop strategies for treating patients with diabetes by literature review of scientific methods, phase II: to test the validation of a tailored care program on five potential participants by pilot study and phase III: to test the effectiveness of tailored care intervention program on patients with diabetes compared with the standard education in primary health care facilities in Indonesia.MethodsPhase I developed an innovative of tailored care intervention program by systematic review of scientific methods in two stages. The first stage comprised a literature search through a primary search strategy, secondary search through a study quality review, and study extraction. Furthermore, the second stage entails discovered tailored care elements, deriving definitions, and developing clinical strategies for patients with diabetes. In phase II, five potential participants contacted by researcher in the primary health care to be participated in the pilot study. Participants grouped for brainstorming the difficulties on glycaemic target and specific target behaviour. Difficulties which experiencing by participant discussed together then select strategies to overcome. Research assistants made a list of participant needs, then rank participants priorities further setting a goal and writing action as detailed for achieving their glycaemic target and control based on their need and priorities. Based on comments and validation of five samples, the tailored care for diabetes modified before to implemented to the next phase. In phase III, a randomized controlled trial (RCT) (n=163; the intervention group (80); the control group (83)) design was conducted in the main study with pre and post-testing (undertaken at three months following baseline collection). The control group received the standard education in the primary health care facilities (Moyo Hilir and Moyo Hulu Primary Health Care) and intervention group received tailored care intervention program: (1) brief deducting teaching (2) assessment for self-management level and CVD risk (3) brainstorming and support group (4) follow up. Main outcome measures and data analysisInstruments used in data collection included (1) diabetes self-management questionnaire (DSMQ); (2) ISH CVD risk chart; (3) summary of diabetes self-care activity (SDSCA); (4) diabetes quality of life (DQoL); (5) diabetes distress scale (DDS); (6) Physiological outcomes (as measured by the laboratory tested). Data were double entered for verification using SPSS statistical software. Phase II: descriptive and respondent feedbacks were performed to evaluate tailored care intervention program before tested in the main study. Phase III: descriptive analysis was used to examine demographic variables and outcome variables. Paired t-tests were used to analyse differences on continues data between mean scores for pre and post tested data the intervention and control group. Categorical data were analysed using Chi-square statistics to test the significance of different proportions. Results Phase I: Seven elements of tailored care for diabetes were self-management, patient preferences, patient value, interprofessional collaboration, tailored support, glycaemic control, and patient centre. Moreover, broadly the strategies of tailored care for diabetes were (1) brief deducting teaching (2) assessment for self-management level and characteristic among patients (3) making list of patient needs, difficulties in glycaemic control, setting goal, rank the priorities, and writing action through brainstorming and support group (4) follow up.Phase II: Five participants in the pilot study asked researcher to provide a guide and monitoring book while at home. The book should provide safe choices information on diet, exercise, drugs, both chemical drugs and herbal medicines based on their values and preferences while doing self-management at home. Respondents claimed to be able to fill out all measurement tools, followed brainstorming and support group process with accompanied by a research assistant.Phase III: the three months benefits of the tailored care intervention program were increases in diabetes self-management, diabetes self-care activity, diabetes quality of life and decreases in HbA1c, percentage of CVD risk as well as diabetes distress. However, the results of several physiological tests in blood pressure, body weight, body mass index (BMI), triglyceride, blood glucose, cholesterol, triglyceride glucose index indicated that the change over time was not different in two groups (intervention and control groups). Conclusion Results of phase I and II support the implementation of tailored care intervention program for diabetes population in Indonesia. The main study or phase III revealed that tailored care intervention program was culturally acceptable to Indonesian people with diabetes and effective increased in diabetes self-management, diabetes self-care activity, diabetes quality of life and decreased in HbA1c, percentage of CVD risk as well as diabetes distress
PILOT STUDI: MANAJEMEN DIRI PASIEN DIABETES MELITUS DI RUMAH SAKIT HL. MANAMBAI ABDULKADIR: Pilot study: Self-Management Among Diabetes Mellitus Patients at HL. Manambai Abdulkadir Hospital
Get PDFBackground: The population of people with diabetes mellitus is increasing every year, furthermore included into number three of deadliest disease in Indonesia. The total number of patients with diabetes mellitus currently are 10.3 million, predicted in 2045, the population will increase to 16.7 million. The main cause population of people with diabetes mellitus are increasing due to public awareness regarding self-management is still less. No researcher has been conducted research about diabetes self-management in HL. Manambai Abdulkadir hospitals. Objectives of the Pilot Study: the main objective in this pilot study was to understand the self-management of people with diabetes mellitus in HL Manambai Abdulkadir hospitals. Methodology: The participants in this pilot study were people diabetes mellitus type 2 in HL Manambai Abdulkadir hospitals using cross sectional design by diabetes self-management, self-efficacy, diabetes self-management knowledge and diabetes distress scale questionnaire. Results: 60% of patients in HL Manambai Abdulkadir hospitals had lack of self-management. The result from measuring of distress scale, knowledge and self-efficacy of patients are related to self-management of patients with diabetes mellitus with P Value <0.05. Conclusion: further research is needed with additional interventions to overcome the lack of self-management to people who suffer diabetes mellitus in HL Manambai Abdulkadir Hospital
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
THE EFFECT OF TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION (TENS) TOWARDS WOUND HEALING
Get PDFBackground: Instead of reduce pain, TENS is also capable of stimulating the peripheral nerves to work optimally and improving blood circulation where the electrodes are applied. Having good blood circulation enhances good wound healing as well. The decrease in pain level will boost the immune system thus the wound healing can also be improved. It needs further studies on the effect of TENS on wound healing. Objective: The research aimed to explore specific effect of TENS on wound healing. Methodology: The research was conducted by using Science Direct article, Medline, Google Search and Pro Quest to find articles which are appropriate with inclusion and exclusion criteria to be reviewed. Results: The necrosis cases of the post-operative wound were higher in the control compared to the intervention group, there were no complications with significant p-value of (P <0.0001). There were differences in the provision of TEENS with additional of heat protocol before, during and after the intervention towards the blood circulation with the significance p value of (P, 0.05). Good granulation occurs, the hair follicle grew well and Pro-inflammatory declined (TNF-α) with the significance p-value of (P <0.05). The comparison of necrosis percentage in five groups were 43.88%, 39.20%, 38.57%, 32.14% and 44.13% in G1 to G5 respectively. The statistical tests proved the TEENS intervention in group G4 was more effective with the significance p value of 0.032. The TENS with frequency of 10 Hz is more effective compared to 100 Hz TENS and control groups who received placebo towards the adrenergic receptor. TENS intervention at a dose of 100 Hz can improve the reactivity of venous blood circulation well. The amount of oedema in the wound is reduced and capillary refills 2 seconds with the significance p-value of (P <0.001) significantly. Discussion: TENS at a frequency of 10 Hz to 100 Hz is the bioelectrical body frequency. At low frequencies, it will be able to stimulate the secretion of endorphin hormone so the patients who received TENS intervention can be more relaxed and feel better as the pain is relieved. The immune system works well and can help the wound heals properly by inhibition of inflammatory factor. Conclusions: TENS therapy is proven to help wound healing. TENS equipment is available everywhere, easy to use, economical, does not cause addiction, and can be given at any time with fewer side effects to the patients. The results of the study cannot be generalised yet. Further research is needed. Keywords: Transcutaneous Electrical Nerve Stimulation, wound healing, literature review
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
Different Pain Level Of Diabetes Mellitus Patients With Peripheral Neuropathy Who Have Been Given Tens And Deep Breathing Interventions In Diabetic Foot Ulcer Treatment In Yogyakarta General Hospital
Get PDFIntroduction : Regular intervention of diabetic foot ulcers is wound care. Patients often complain of pain when nurse performs wound care. If the pain is not resolved it will result in anxiety feeling. A routine intervention conducted so far is intra-breath in intervention to reduce pain, as it is expected by reducing the pain it will be followed by a decrease of patients’ anxiety. Intra-breath intervention has not been able to reduce pain quickly on a moderate scale, especially high-scale so it is necessary to find out other alternative interventions. The available comparative intervention is TENS. The purpose of this study is to know the difference between intra-breath and TENS intervention in the level of anxiety in diabetic patients with peripheral neuropathy in diabetic foot ulcer treatment. Method : This study used RCT method on 28 respondents divided into 14 intervention groups and 14 control groups. The anxiety of respondents was assessed using Hamilton Scale of Anxiety tools before and after conductin TENS intervention and intra-breath. TENS intervention was given for 15 minutes at a frequency of 100 Hz and intra-breath was given until the wound care intervention was completed. Result : The results showed that there was significant average difference of anxiety level between the use of TENS intervention and the use of intra-breath intervention in intervention group and the control group with value of P <0.05. TENS can reduce the level of anxiety with the value of P 0.000, while intra -breath is able to lower the level of anxiety with the value of P 0.006. Discussion : The respondents admitted the difficulty of experience maximum relaxation when wound care is done, this condition is related to the comfortable position of respondents. When wound care is done, the respondents can not relax maximaly because many of the foot that has ulcers should be padded with a pillow to maximize the treatment. Provision of TENS with a frecuency of 100 Hz is corresponding to the body’s bioelectricity, the patients that receive TENS intervention may become more rrelaxed with endorphine hormone release and decreasing of pain because the electricity blocks pain implans in the neural tube
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