The Relationship Between Health Service Support at Community Health Centers and Family Caregiver Coping for Patients with Type 2 Diabetes Mellitus
Keywords:
Caregivers, type 2 diabetes mellitus, primary health services, coping
Abstract
Type 2 Diabetes Mellitus (T2DM) is a chronic disease that requires long-term treatment and often necessitates the assistance of family caregivers. One of the challenges faced by family caregivers in caring for T2DM patients is the psychological pressure that can affect their ability to cope with the situation. Psychological stress demands external support, particularly from Community Health Center (Puskesmas) services, which becomes crucial. This study aims to explore the relationship between Community Health Center support services and the coping mechanisms of family caregivers for T2DM patients in Malang, Indonesia. This research employs an observational design with a cross-sectional approach involving 324 family caregivers selected through cluster random sampling technique from an average of 1,787 monthly visits, using the Lamesow sample size formula from 1997. Data collection was conducted using the Health Service Support Questionnaire (HSSQ) and the Family Coping Index (FCI). Data analysis utilized the Spearman Rank test. The data analysis indicated a p-value (0.000) < α (0.05), which shows a significant relationship between health service support (Puskesmas) and the coping mechanisms of family caregivers. In conclusion, there is an important relationship between primary health service support and the coping strategies of families caring for T2DM patients. The findings of this study recommend the implementation of special programs for family caregivers of T2DM patients, aiming to improve the skills and effectiveness of home care assistance.
References
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25. Freeman-Hildreth Y, Aron D, Cola PA, Wang Y. Coping with diabetes: Provider attributes that influence type 2 diabetes adherence. PLoS One [Internet]. 2019;14(4):1–21. Available from: http://dx.doi.org/10.1371/journal.pone.0214713
26. Cejalvo E, Martí-Vilar M, Merino-Soto C, Aguirre-Morales MT. Caregiving role and psychosocial and individual factors: A systematic review. Healthc. 2021;9(12):1–33.
27. Ramkisson S, Pillay BJ, Sibanda W. Social support and coping in adults with type 2 diabetes. African J Prim Heal Care Fam Med. 2017;9(1):1–8.
28. Wallace DD, Gonzalez Rodriguez H, Walker E, Dethlefs H, Dowd RA, Filipi L, et al. Types and sources of social support among adults living with type 2 diabetes in rural communities in the Dominican Republic. Glob Public Health. 2019;14(1):135–46.
29. Nakayama G, Masumoto S, Haruta J, Maeno T. Association between family caregivers’ primary care experience when they report as patients and their stress related to caregiving: A pilot cross-sectional study. J Gen Fam Med. 2023;24(4):231–9.
30. Gani A, Budiharsana MP. The Consolidated Report on Indonesia Health Sector Review 2018. Minist Natl Dev Plan Repub Indones. 2019;56.
31. Arsyad DS, Hamsyah EF, Qalby N, Qanitha A, Westerink J, Cramer MJ, et al. The readiness of public primary health care (PUSKESMAS) for cardiovascular services in Makasar city, Indonesia. BMC Health Serv Res [Internet]. 2022;22(1):1–12. Available from: https://doi.org/10.1186/s12913-022-08499-w
32. Khoe LC, Wangge G, Soewondo P, Tahapary DL, Widyahening IS. The implementation of community-based diabetes and hypertension management care program in Indonesia. PLoS One [Internet]. 2020;15(1):1–9. Available from: http://dx.doi.org/10.1371/journal.pone.0227806
33. Ernawati U, Wihastuti TA, Utami YW. Effectiveness of diabetes self-management education (Dsme) in type 2 diabetes mellitus (t2dm) patients: Systematic literature review. J Public health Res. 2021;10(2):404–8.
34. Wulandari I, Kusnanto K, Wibisono S, Haryani A. Family Support in Caring for Diabetes Mellitus Patient : Patient ’ s Perspective. 2021;9:199–205.
35. Arifin B, van Asselt ADI, Setiawan D, Atthobari J, Postma MJ, Cao Q. Diabetes distress in Indonesian patients with type 2 diabetes: a comparison between primary and tertiary care. BMC Health Serv Res. 2019;19(1):773.
36. Luthfa I, Ardian I. Effects of Family Empowerment on Increasing Family Support in Patients with Type-2 Diabetes Mellitus. Nurse Media J Nurs. 2019;9(1):58–68.
37. Dubois SK, Lehrer HM, Whyne EZ, Mary A. A Resilience Intervention for Adults with Type 2 Diabetes: Proof-of-Concept in Community Health Centers. Int J Behav Med. 2022;27(5):565–75.
38. Eshete A, Mohammed S, Deresse T, Kifleyohans T, Assefa Y. Association of stress management behavior and diabetic self-care practice among diabetes type II patients in North Shoa Zone: a cross-sectional study. BMC Health Serv Res. 2023;23(1):1–7.
39. Almubark RA, Althumairi NA, Alhamdan AA, Alnujaidi HY, Alzayer R, Almubark SA, et al. Socioeconomic and Behavioral Disparities Among Diabetics in Saudi Arabia: A Nation-Wide Descriptive Study. Diabetes, Metab Syndr Obes. 2022;15(July):2693–703.
40. Rondhianto R, Nursalam N, Kusnanto K, Melaniani S, Ahsan A. Analysis of the Sociodemographic and Psychological Factors of the Family Caregivers’ Self-Management Capabilities for Type 2 Diabetes Mellitus. J Ners. 2020;14(2):215.
41. Baig AA, Benitez A, Quinn MT, Burnet DL. Family interventions to improve diabetes outcomes for adults. Ann N Y Acad Sci. 2015;1353(1):89–112.
42. Pamungkas RA, Chamroonsawasdi K, Vatanasomboon P. A systematic review: Family support integrated with diabetes self-management among uncontrolled type II diabetes mellitus patients. Behav Sci (Basel). 2017;7(3):1–17.
43. Setyoadi S, Efendi F, Haryanto J, Rosyidawati F, Kristianingrum ND. Family Coping Strategies and Quality of Life of Patients with Type-2 Diabetes Mellitus in Primary Health Care in Indonesia. Nurse Media J Nurs. 2023;13(December):274–85.
44. Newson L, Brown JE, Dugdale S. Being the supporter: an interpretative phenomenological analysis of the role of caregivers in the self-management of type 2 diabetes. Psychol Heal [Internet]. 2023;0(0):1–17. Available from: https://doi.org/10.1080/08870446.2023.2231004
2. Galicia-Garcia U, Benito-Vicente A, Jebari S, Larrea-Sebal A, Siddiqi H, Uribe KB, et al. Pathophysiology of type 2 diabetes mellitus. Int J Mol Sci. 2020;21(17):1–34.
3. Adu MD, Malabu UH, Malau-Aduli AEO, Malau-Aduli BS. Enablers and barriers to effective diabetes self-management: A multi-national investigation. PLoS One. 2019;14(6):1–22.
4. Einarson TR, Acs A, Ludwig C, Panton UH. Prevalence of cardiovascular disease in type 2 diabetes: A systematic literature review of scientific evidence from across the world in 2007-2017. Cardiovasc Diabetol [Internet]. 2018;17(1):1–19. Available from: https://doi.org/10.1186/s12933-018-0728-6
5. Wysham C, Shubrook J. Beta-cell failure in type 2 diabetes: mechanisms, markers, and clinical implications. Postgrad Med [Internet]. 2020;132(8):676–86. Available from: https://doi.org/10.1080/00325481.2020.1771047
6. Magliano DJ, Boyko EJ, Balkau B, Al E. IDF Diabetes Atlas IDF Diabetes Atlas,10th edition [Internet]. 2021. Available from: https://diabetesatlas.org/atlas/tenth-edition/
7. Kementerian Kesehatan Republik Indonesia. Profil Kesehatan Indo-nesia [Internet]. Pusdatin.Kemenkes.Go.Id. 2021. Kementrian Kesehatan Republik Indonesia. Available from: https://kesmas.kemkes.go.id/assets/upload/dir_519d41d8cd98f00/files/Hasil-riskesdas-2018_1274.pdf
8. Dinkes Jatim. Profil Kesehatan JATIM 2022 (JATIM Health Profile 2022) [Internet]. Surabaya: Dinas Kesehatan Provinsi Jawa Timur; 2023. Available from: https://dinkes.jatimprov.go.id/userfile/dokumen/.pdf
9. Dinkes. Profil Kesehatan Kota Malang Tahun 2022 (Malang City Health Profile in 2022). Dinas Kesehat Kota Malang [Internet]. 2023;(45):1–226. Available from: https://dinkes.malangkota.go.id/wp-content/uploads/sites/104/2023/08/profilkes-kota-malang-2022.pdf
10. Ong C. Characteristic of Chronic Complications in Type 2 Diabetic Patient Based on Asian Perspective. Curr Intern Med Res Pract Surabaya J. 2022;3(1):13.
11. Letta S, Goshu AT, Sertsu A, Nigussie K, Negash A, Yadeta TA, et al. Diabetes knowledge and foot care practices among type 2 diabetes patients attending the chronic ambulatory care unit of a public health hospital in eastern Ethiopia : a cross- sectional study. 2023;1–10.
12. Salsabila Z, Sjaaf AC. the Analysis of Diabetes Self-Management Implementation on Type 2 Diabetes Mellitus Patients: a Protocol for Systematic Review and Meta-Analysis. J Ekon Kesehat Indones. 2022;7(2):133.
13. Davies MJ, Aroda VR, Collins BS, Gabbay RA, Green J, Maruthur NM, et al. Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2022;45(11):2753–86.
14. Rondhianto R, Nursalam N, Kusnanto K, Melaniani S. [The effect of family caregiver empowerment interventions on family caregiver capabilities in self-management of type 2 diabetes mellitus in Indonesia]. Enferm Clin (English Ed. 2022;32(6):385–95.
15. Setyoadi, Yusuf A, Kristianingrum ND, Hayati YS, Noviyanti LW, Syafiky NF. The correlation between family support and health status in patients om m er ci al us e on m er al. J Kesehat Komunitas Indones. 2023;11:1–6.
16. Yustisia N, Aprilatutini T, Utama TA, Masdar M. The Burden Experience of Family Caregiver of Older Adults with Chronic Illness. Res Community Public Heal Nurs. 2023;34(2):85–95.
17. Jane OA, Olatunji A, Bamiso MA, Kola OJ, Ayodele OJ, Ideraoluwa BO. Burden of Care and Psychological Distress in Primary Caregivers of Patients with Type -2 Diabetes Mellitus in A Tertiary Hospital in Nigeria. Ethiop J Health Sci. 2019;29(6):697.
18. Alsaedi YE, Almalki AA, Alqurashi RD, Altwairqi RS, Almalki DM, Alshehri KM, et al. Assessment of Type II Diabetes Patients’ Caregivers’ Burnout Level: A Cross-Sectional Study in Taif, Saudi Arabia. Diabetes, Metab Syndr Obes. 2022;15(March):1091–9.
19. Hapunda G. Coping strategies and their association with diabetes specific distress , depression and diabetes self ‑ care among people living with diabetes in Zambia. BMC Endocr Disord [Internet]. 2022;1–11. Available from: https://doi.org/10.1186/s12902-022-01131-2
20. Owusu BA, Ofori-Boateng P, Doku DT. Coping and adaptation strategies among young persons living with type 1 diabetes and their caregivers: textual and photovoice analyses. BMC Public Health [Internet]. 2023;23(1):1–12. Available from: https://doi.org/10.1186/s12889-023-16573-z
21. Chan SL, Matsah NSB, Yusuf AAB, Khaidir ASBM, Hamdan NHB, Kamizi ZNB. A review on family caregiving challenges in Malaysia. ProGCouns J Prof Guid Couns. 2022;3(1):1–9.
22. Sousa FAMDR, Andrade M de LMS, de Oliveira CMGS. Transition from parents to caregivers of a child with type 1 Diabetes Mellitus: a scoping review. Rev Bras Enferm. 2023;76(1):1–15.
23. Rondhianto R. Path analysis of the influence of nurses role on family caregiver diabetes self-management capabilities with empowerment as intervening variables in Indonesia. J Glob Pharma Technol. 2020;12(2):571–9.
24. Niño-de-Guzman Quispe E, Bracchiglione J, Ballester M, Groene O, Heijmans M, Martínez García L, et al. Patients’ and informal caregivers’ perspectives on self-management interventions for type 2 diabetes mellitus outcomes: a mixed-methods overview of 14 years of reviews. Arch Public Heal. 2023;81(1):1–21.
25. Freeman-Hildreth Y, Aron D, Cola PA, Wang Y. Coping with diabetes: Provider attributes that influence type 2 diabetes adherence. PLoS One [Internet]. 2019;14(4):1–21. Available from: http://dx.doi.org/10.1371/journal.pone.0214713
26. Cejalvo E, Martí-Vilar M, Merino-Soto C, Aguirre-Morales MT. Caregiving role and psychosocial and individual factors: A systematic review. Healthc. 2021;9(12):1–33.
27. Ramkisson S, Pillay BJ, Sibanda W. Social support and coping in adults with type 2 diabetes. African J Prim Heal Care Fam Med. 2017;9(1):1–8.
28. Wallace DD, Gonzalez Rodriguez H, Walker E, Dethlefs H, Dowd RA, Filipi L, et al. Types and sources of social support among adults living with type 2 diabetes in rural communities in the Dominican Republic. Glob Public Health. 2019;14(1):135–46.
29. Nakayama G, Masumoto S, Haruta J, Maeno T. Association between family caregivers’ primary care experience when they report as patients and their stress related to caregiving: A pilot cross-sectional study. J Gen Fam Med. 2023;24(4):231–9.
30. Gani A, Budiharsana MP. The Consolidated Report on Indonesia Health Sector Review 2018. Minist Natl Dev Plan Repub Indones. 2019;56.
31. Arsyad DS, Hamsyah EF, Qalby N, Qanitha A, Westerink J, Cramer MJ, et al. The readiness of public primary health care (PUSKESMAS) for cardiovascular services in Makasar city, Indonesia. BMC Health Serv Res [Internet]. 2022;22(1):1–12. Available from: https://doi.org/10.1186/s12913-022-08499-w
32. Khoe LC, Wangge G, Soewondo P, Tahapary DL, Widyahening IS. The implementation of community-based diabetes and hypertension management care program in Indonesia. PLoS One [Internet]. 2020;15(1):1–9. Available from: http://dx.doi.org/10.1371/journal.pone.0227806
33. Ernawati U, Wihastuti TA, Utami YW. Effectiveness of diabetes self-management education (Dsme) in type 2 diabetes mellitus (t2dm) patients: Systematic literature review. J Public health Res. 2021;10(2):404–8.
34. Wulandari I, Kusnanto K, Wibisono S, Haryani A. Family Support in Caring for Diabetes Mellitus Patient : Patient ’ s Perspective. 2021;9:199–205.
35. Arifin B, van Asselt ADI, Setiawan D, Atthobari J, Postma MJ, Cao Q. Diabetes distress in Indonesian patients with type 2 diabetes: a comparison between primary and tertiary care. BMC Health Serv Res. 2019;19(1):773.
36. Luthfa I, Ardian I. Effects of Family Empowerment on Increasing Family Support in Patients with Type-2 Diabetes Mellitus. Nurse Media J Nurs. 2019;9(1):58–68.
37. Dubois SK, Lehrer HM, Whyne EZ, Mary A. A Resilience Intervention for Adults with Type 2 Diabetes: Proof-of-Concept in Community Health Centers. Int J Behav Med. 2022;27(5):565–75.
38. Eshete A, Mohammed S, Deresse T, Kifleyohans T, Assefa Y. Association of stress management behavior and diabetic self-care practice among diabetes type II patients in North Shoa Zone: a cross-sectional study. BMC Health Serv Res. 2023;23(1):1–7.
39. Almubark RA, Althumairi NA, Alhamdan AA, Alnujaidi HY, Alzayer R, Almubark SA, et al. Socioeconomic and Behavioral Disparities Among Diabetics in Saudi Arabia: A Nation-Wide Descriptive Study. Diabetes, Metab Syndr Obes. 2022;15(July):2693–703.
40. Rondhianto R, Nursalam N, Kusnanto K, Melaniani S, Ahsan A. Analysis of the Sociodemographic and Psychological Factors of the Family Caregivers’ Self-Management Capabilities for Type 2 Diabetes Mellitus. J Ners. 2020;14(2):215.
41. Baig AA, Benitez A, Quinn MT, Burnet DL. Family interventions to improve diabetes outcomes for adults. Ann N Y Acad Sci. 2015;1353(1):89–112.
42. Pamungkas RA, Chamroonsawasdi K, Vatanasomboon P. A systematic review: Family support integrated with diabetes self-management among uncontrolled type II diabetes mellitus patients. Behav Sci (Basel). 2017;7(3):1–17.
43. Setyoadi S, Efendi F, Haryanto J, Rosyidawati F, Kristianingrum ND. Family Coping Strategies and Quality of Life of Patients with Type-2 Diabetes Mellitus in Primary Health Care in Indonesia. Nurse Media J Nurs. 2023;13(December):274–85.
44. Newson L, Brown JE, Dugdale S. Being the supporter: an interpretative phenomenological analysis of the role of caregivers in the self-management of type 2 diabetes. Psychol Heal [Internet]. 2023;0(0):1–17. Available from: https://doi.org/10.1080/08870446.2023.2231004
Published
2024-10-25
How to Cite
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Setyoadi, Annisa wuri Kartika, Nunik Nurani, Yati Srihayati, Niko Dima Kristianingrum, Dina Dewi Sartika Lestari Ismail, Haliza Hasan, Mohd Khairul Zul Hasymi Bin Firdaus. The Relationship Between Health Service Support at Community Health Centers and Family Caregiver Coping for Patients with Type 2 Diabetes Mellitus. woh [Internet]. 2024Oct.25 [cited 2025Apr.2];7(4):439 -450. Available from: https://jurnal.fkmumi.ac.id/index.php/woh/article/view/1350
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