Effectiveness of Empowerment-Based Diabetes Education on Diabetes Complication Prevention: A Systematic Review

Rondhianto Rondhianto(1*), Siswoyo Siswoyo(2), Ahmad Fathoni(3)
(1) Faculty of Nursing, Universitas Jember
(2) Universitas Jember
(3) Universitas Jember
(*) Corresponding Author
DOI : 10.30604/jika.v7i4.1308

Abstract

Diabetes mellitus is a chronic metabolic disease that requires continuous medical management and good self-care behavior. Failure in self-management will lead to complications and an increased risk of death. However, most patients do not have good self-management. One strategy to improve self-management is to conduct empowerment-based education, but its effectiveness is still unclearly. This study aims to identify the effectiveness of empowerment interventions in preventing diabetes complications. This study is a systematic review using the PRISMA protocol and JBI Critical Appraisal Tools to determine eligible articles. The articles search from five databases (PubMed, ProQuest, Science Direct, Google Scholar, and ClinicalKey for Nursing). The inclusion criteria were English, published 2012 - 2022, and experimental study. The study result showed that empowerment education could significantly increase knowledge and skills in people with diabetes so that patients can carry out self-management well, including HbA1c management, drug management, physical activity management, and diet management. Effective empowerment education interventions can reduce complications through increasing self-care behavior in diabetics, so educational interventions with empowerment can be used as an effort to prevent complications in people with diabetes mellitus.

 

Abstrak: Diabetes melitus merupakan penyakit metabolik kronik yang membutuhkan tatalaksana medis dan perilaku perawatan diri yang baik secara berkelanjutan. Kegagalan dalam pengelolaan mandiri akan menyebabkan komplikasi dan peningkatan resiko kematian, namun demikian sebagian besar penderita tidak memiliki pengelolaan mandiri dengan baik. Salah satu strategi untuk meningkatkan pengelolaan mandiri yaitu melakukan edukasi berbasis pemberdayaan, tetapi terkait dengan kefektivitasanya belum diketahui dengan pasti. Penelitian ini bertujuan untuk mengidentifikasi efektivitas intervensi pemberdayaan dalam mencegah komplikasi diabetes. Metode penelitian ini adalah systematic review dengan PRISMA protokol dan JBI Critical Appraisal Tools untuk menentukan artikel yang eligible. Database yang digunakan adalah Pubmed, ProQuest, Science Direct, Google Scholar, dan ClinicalKey for Nursing. Studi diterbitkan dalam Bahasa Inggris pada tahun  2012-2022 dengan tipe penelitian eksperimen. Hasil analisis studi menunjukkan  bahwasanya edukasi pemberdayaan secara signifikan dapat meningkatkan pengetahuan dan keterampilan pada penderita diabetes, sehingga pasien mampu melakukan manajemen diri dengan baik meliputi manajemen HbA1c, manajemen obat, manajemen aktivitas fisik, dan manajemen diet. Intervensi edukasi pemberdayaan efektif dapat menurunkan komplikasi melalui peningkatan perilaku perawatan diri pada penderita diabetes, sehingga intervensi edukasi dengan pemberdayaan dapat digunakan sebagai upaya pencegahan komplikasi pada penderita diabetes

Keywords


Education; Empowerment; Diabetes Complications

References


Altshuler, L., Plaksin, J., Zabar, S., Wallach, A., Sawicki, C., Kundrod, S., & Kalet, A. (2016). Transforming the Patient Role to Achieve Better Outcomes Through a Patient Empowerment Program: A Randomized Wait-List Control Trial Protocol. JMIR Research Protocols, 5(2), e68. https://doi.org/10.2196/resprot.5376

American Diabetes Association. (2020). 8. Obesity Management for the Treatment of Type 2 Diabetes: Standards of Medical Care in Diabetes—2021. Diabetes Care, 44(Supplement_1), S100–S110. https://doi.org/10.2337/dc21-S008

American Diabetes Association. (2021). 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2022. Diabetes Care, 45(Supplement_1), S17–S38. https://doi.org/10.2337/dc22-S002

Anggraeni, A., Rondhianto, R., & Juliningrum, P. (2018). Pengaruh Diabetes Self-Management Education and Support (DSME/S) Terhadap Kualitas Hidup pada Pasien Diabetes Melitus Tipe 2. Pustaka Kesehatan, 6(3), 453. https://doi.org/10.19184/pk.v6i3.11688

Aquino, J. A., Baldoni, N. R., Flôr, C. R., Sanches, C., Di Lorenzo Oliveira, C., Alves, G. C. S., Fabbro, A. L. D., & Baldoni, A. O. (2018). Effectiveness of individual strategies for the empowerment of patients with diabetes mellitus: A systematic review with meta-analysis. Primary Care Diabetes, 12(2), 97–110. https://doi.org/10.1016/j.pcd.2017.10.004

Azhdari Mamaghani, H., Jabbarzadeh Tabrizi, F., Seyedrasooli, A., Sarbakhsh, P., Badri Gargari, R., Zamanzadeh, V., & Zanboori, V. (2021). Effect of Empowerment Program with and without Telenursing on Self-efficacy and Glycosylated Hemoglobin Index of Patients with Type-2 Diabetes: A Randomized Clinical Trial. Journal of Caring Sciences, 10(1), 22–28. https://doi.org/10.34172/jcs.2021.001

Belsti, Y., Akalu, Y., & Animut, Y. (2020). Attitude, practice and its associated factors towards Diabetes complications among type 2 diabetic patients at Addis Zemen District hospital, Northwest Ethiopia. BMC Public Health, 20(1), 785. https://doi.org/10.1186/s12889-020-08953-6

Belsti, Y., Akalu, Y., Fekadu, H., & Animut, Y. (2019). Awareness of complications of diabetes mellitus and its associated factors among type 2 diabetic patients at Addis Zemen District Hospital, northwest Ethiopia. BMC Research Notes, 12(1), 1–8. https://doi.org/10.1186/s13104-019-4637-x

Chen, M.-F., Wang, R.-H., Lin, K.-C., Hsu, H.-Y., & Chen, S.-W. (2015). Efficacy of an empowerment program for Taiwanese patients with type 2 diabetes: A randomized controlled trial. Applied Nursing Research : ANR, 28(4), 366–373. https://doi.org/10.1016/j.apnr.2014.12.006

Cinar, A. B., & Schou, L. (2014). Impact of empowerment on toothbrushing and diabetes management. Oral Health & Preventive Dentistry, 12(4), 337–344. https://doi.org/10.3290/j.ohpd.a32130

Cortez, D. N., Macedo, M. M. L., Souza, D. A. S., Dos Santos, J. C., Afonso, G. S., Reis, I. A., & Torres, H. de C. (2017). Evaluating the effectiveness of an empowerment program for self-care in type 2 diabetes: a cluster randomized trial. BMC Public Health, 17(1), 41. https://doi.org/10.1186/s12889-016-3937-5

Funnell, M. M, & Anderson, R. M. (2004). Empowerment and Self-Management of Diabetes. Clinical Diabetes, 22(3), 123–127. https://doi.org/10.2337/diaclin.22.3.123

Funnell, Martha M., & Anderson, R. M. (2004). Empowerment and Self-Management of Diabetes. Clinical Diabetes, 22(3), 123–127. https://doi.org/10.2337/diaclin.22.3.123

Funnell, Martha M., Brown, T. L., Childs, B. P., Haas, L. B., Hosey, G. M., Jensen, B., Maryniuk, M., Peyrot, M., Piette, J. D., Reader, D., Siminerio, L. M., Weinger, K., & Weiss, M. A. (2010). National standards for diabetes self-management education. Diabetes Care, 34(SUPPL.1), 89–96. https://doi.org/10.2337/dc11-S089

Funnell, Martha M, Brown, T. L., Childs, B. P., Haas, L. B., Hosey, G. M., Jensen, B., Maryniuk, M., Peyrot, M., Piette, J. D., Reader, D., Siminerio, L. M., Weinger, K., & Weiss, M. A. (2010). National standards for diabetes self-management education. Diabetes Care, 32 Suppl 1(Suppl 1), S87-94. https://doi.org/10.2337/dc09-S087

Funnell, Martha Mitchell, Tang, T. S., & Anderson, R. M. (2007). From DSME to DSMS: Developing empowerment-based diabetes self-management support. Diabetes Spectrum, 20(4), 221–226. https://doi.org/10.2337/diaspect.20.4.221

International Diabetes Federation. IDF Diabetes Atlas 10th edn. Brussels, Belgium: 2021. Available at: https://www.diabetesatlas.org

Li, Z., Chen, Q., Yan, J., Liang, W., & Wong, W. C. W. (2020). Effectiveness of motivational interviewing on improving Care for Patients with type 2 diabetes in China: A randomized controlled trial. BMC Health Services Research, 20(1), 57. https://doi.org/10.1186/s12913-019-4776-8

McCarrier, K. P., Ralston, J. D., Hirsch, I. B., Lewis, G., Martin, D. P., Zimmerman, F. J., & Goldberg, H. I. (2009). Web-based collaborative care for type 1 diabetes: a pilot randomized trial. Diabetes Technology & Therapeutics, 11(4), 211–217. https://doi.org/10.1089/dia.2008.0063

Mogueo, A., Oga-Omenka, C., Hatem, M., & Kuate Defo, B. (2021). Effectiveness of interventions based on patient empowerment in the control of type 2 diabetes in sub-Saharan Africa: A review of randomized controlled trials. Endocrinology, Diabetes & Metabolism, 4(1), e00174. https://doi.org/10.1002/edm2.174

Norris, S. L., Lau, J., Smith, S. J., Schmid, C. H., & Engelgau, M. M. (2015). Self-management education for adults with type 2 diabetes: a meta-analysis of the effect on glycemic control. Diabetes Care, 25(7), 1159–1171. https://doi.org/10.2337/diacare.25.7.1159

Perkumpulan Endokrinologi Indonesia. Pedoman Pengelolaan dan Pencegahan Diabetes Melitus Tipe 2 di Indonesia 2021. Jakarta: PB PERKENI, 2021.

Ramli, A. S., Selvarajah, S., Daud, M. H., Haniff, J., Abdul-Razak, S., Tg-Abu-Bakar-Sidik, T. M. I., Bujang, M. A., Chew, B. H., Rahman, T., Tong, S. F., Shafie, A. A., Lee, V. K. M., Ng, K. K., Ariffin, F., Abdul-Hamid, H., Mazapuspavina, M. Y., Mat-Nasir, N., Chan, C. W., Yong-Rafidah, A. R., … Low, W. H. H. (2016). Effectiveness of the EMPOWER-PAR Intervention in Improving Clinical Outcomes of Type 2 Diabetes Mellitus in Primary Care: A Pragmatic Cluster Randomised Controlled Trial. BMC Family Practice, 17(1), 157. https://doi.org/10.1186/s12875-016-0557-1

Rasnah, R., Sjattar, E. L., & Yusuf, S. (2019). Efektifitas Pemberdayaan Keluarga Terhadap Kontrol Metabolik Pada Pasien Diabetes Mellitus Tipe 2. Jurnal Keperawatan Muhammadiyah, 4(2). https://doi.org/10.30651/jkm.v4i2.3067

Saputri, R. D. (2020). Komplikasi Sistemik Pada Pasien Diabetes Melitus Tipe 2. Jurnal Ilmiah Kesehatan Sandi Husada, 11(1), 230–236. https://doi.org/10.35816/jiskh.v11i1.254

Shahabi, N., Kolivand, M., Salari, N., & Abbasi, P. (2022). The effect of telenursing training based on family-centered empowerment pattern on compliance with diet regimen in patients with diabetes mellitus type 2: a randomized clinical trial. BMC Endocrine Disorders, 22(1), 36. https://doi.org/10.1186/s12902-022-00953-4

Sigurdardottir, A. K., Benediktsson, R., & Jonsdottir, H. (2009). Instruments to tailor care of people with type 2 diabetes. Journal of Advanced Nursing, 65(10), 2118–2130. https://doi.org/10.1111/j.1365-2648.2009.05040.x

Simamora, F. A., Siregar, H. R., Keperawatan, P. S., Aufa, U., Padangsidimpuan, R., Diri, A. P., & Triyanto, P. (2019). EFEKTIVITAS MODEL PEMBERDAYAAN DIRI TERHADAP AKTIVITAS PERAWATAN DIRI KLIEN DIABETES MELITUS TIPE 2. Jurnal Education and Development Institut Pendidikan Tapanuli Selatan, 7(4), 6–9.

Simmons, D., Gamble, G. D., Foote, S., Cole, D. R., & Coster, G. (2004). The New Zealand Diabetes Passport Study: a randomized controlled trial of the impact of a diabetes passport on risk factors for diabetes-related complications. Diabetic Medicine : A Journal of the British Diabetic Association, 21(3), 214–217. https://doi.org/10.1111/j.1464-5491.2004.01047.x

Souza, D. A. S., Reis, I. A., Cortez, D. N., De Souza Afonso, G., & De Carvalho Torres, H. (2017). Evaluation of home visits for the empowerment of diabetes self-care. ACTA Paulista de Enfermagem, 30(4), 350–357. https://doi.org/10.1590/1982-0194201700052

Sugiyama, T., Steers, W. N., Wenger, N. S., Duru, O. K., & Mangione, C. M. (2015). Effect of a community-based diabetes self-management empowerment program on mental health-related quality of life: a causal mediation analysis from a randomized controlled trial. BMC Health Services Research, 15, 115. https://doi.org/10.1186/s12913-015-0779-2

The JBI Manual for Evidence Synthesis (Issue April). (2021). https://doi.org/https://synthesismanual.jbi.global. https://doi.org/10.46658/JBIMES-20-01

Wiastuti, S. M., Rondhianto, R., & Widayati, N. (2017). Pengaruh Diabetes Self Management Education and Support (DSME/S) Terhadap Stres Pada Pasien Diabetes Melitus (DM) Tipe 2 Di Wilayah Kerja Puskesmas Patrang Kabupaten Jember (The Effect of Diabetes Self-Management Education and Support [DSME/S] on Stress i. Pustaka Kesehatan, 5(2), 268–275. https://jurnal.unej.ac.id/index.php/JPK/article/view/5784

Wong, C. K. H., Wong, W. C. W., Wan, Y. F., Chan, A. K. C., Chung, K. L., Chan, F. W. K., & Lam, C. L. K. (2015). Patient Empowerment Programme in primary care reduced all-cause mortality and cardiovascular diseases in patients with type 2 diabetes mellitus: a population-based propensity-matched cohort study. Diabetes, Obesity & Metabolism, 17(2), 128–135. https://doi.org/10.1111/dom.12397

Xie, Z., Liu, K., Or, C., Chen, J., Yan, M., & Wang, H. (2020). An examination of the socio-demographic correlates of patient adherence to self-management behaviors and the mediating roles of health attitudes and self-efficacy among patients with coexisting type 2 diabetes and hypertension. BMC Public Health, 20(1), 1227. https://doi.org/10.1186/s12889-020-09274-4

Zamanzadeh, V., Zirak, M., Hemmati Maslakpak, M., & Parizad, N. (2017). Distance education and diabetes empowerment: A single-blind randomized control trial. Diabetes & Metabolic Syndrome, 11 Suppl 1, S247–S251. https://doi.org/10.1016/j.dsx.2016.12.039


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