Doctor of Medicine Develops Diabetes Mental Health Model to Improve the Quality of Chronic Disease Program Management

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• Selasa, 9 Juli 2024
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Located in the Meeting Room of Dr. A.A. Made Djelantik, Lt. IV Building of the Faculty of Medicine, Udayana University, Denpasar Campus, a Doctoral Promotion examination was held with the promovenda candidate, Ni Luh Gde Ari Natalia Yudha, SKM, MPH, with the dissertation title "Development of the Diabetes Mental Health Model (SEMADI) on Anxiety, Physical Fitness and Blood Sugar Levels of Chronic Disease Management Program Participants (Prolanis) Diabetes Mellitus Type II in Denpasar City". (8/7/2024)

Diabetes Mellitus (DM) is a chronic disease with a high prevalence. DM not only affects changes in body functions but also affects the patient's psychological condition such as mood changes, stress, anxiety and even depression. Feelings of anxiety that are very strong and last long have a negative impact on physical and psychological health. The Chronic Disease Management Program implemented in primary care facilities such as at puskesmas has not accommodated mental health services. The purpose of this study is to develop the Healthy Mental Diabetes Model (SEMADI) and prove the effectiveness of the model on anxiety, physical fitness and blood sugar of Prolanis DMT2 participants.

This research design is exploratory sequential mixed methods consisting of two stages. Phase I is a qualitative study with a descriptive approach, in-depth interviews were conducted with 26 informants. Data were analyzed using thematic analysis. Phase II was a quantitative study with a randomized control group pretest-postest design involving 60 T2DM Prolanis participants in the intervention and control groups. Anxiety was measured by Beck Anxiety Inventory (BAI) questionnaire, fitness assessment by Senior Fitness Test, and fasting blood sugar test by venous blood sampling. Data analysis used independent t-test and Mann-Whitney non-parametric statistics for unpaired t-test. For the difference test of 2 paired samples, paired t-test and non-parametric Wilcoxon Signed Rank Test were used.

The qualitative research results produced the SEMADI model which consists of mental health education, progressive muscle relaxation exercises and 150 minutes of exercise per week. Quantitative research results showed a decrease in anxiety scores in the intervention group (14.43) compared to the control group (1.10) with a p value of 0.0001. Increased fitness in Arm curl measurements in the intervention group (5.83) compared to the control group (0.5) with a p value of 0.003 and 2 Minute step test measurements in the intervention group (-2.368) compared to the control group (-1.871) with a p value of 0.006. Blood sugar reduction in the intervention group (-2.500) compared to the control group (-0.941) with a p value of 0.028.

The conclusion of this study is that the SEMADI model consists of mental health education components, progressive muscle relaxation exercises and 150 minutes of exercise per week. The SEMADI model is effective in reducing anxiety, increasing physical fitness and controlling blood sugar levels in Prolanis DMT2 participants.

The examination was chaired by the Vice Dean for Academic Affairs and Planning of the Faculty of Medicine, Udayana University Dr. dr. I Gede Eka Wiratnaya, Sp.OT (K), with a team of examiners:

1. Prof. dr. I Made Ady Wirawan, S.Ked., MPH., Ph.D (Promoter)

2. Dr. dr. Cokorda Bagus Jaya Lesmana, S.Ked., Sp.KJ (K), MARS (Copromoter I)

3. Dr. dr. Susy Purnawati, M.KK (Kopromotor II)

4. Prof. Dr. dr. Ketut Suastika, Sp.PD-KEMD

5. Prof. Dr. dr. I Made Jawi, M.Kes

6. Prof. dr. Pande Putu Januraga, M.Kes., Dr,PH

7. Ni Made Utami Dwipayanti, ST., MBE.nv., Ph.D.

8. Dr. Ni Ketut Sutiari, SKM, M.Si

9. Dr. drh. I Made Subrata, M.Erg

10. dr. I Wayan Sumardika, S.Ked., M.Med.Ed., Ph.D.

While the academic invitees are:

1. Dr. I Made Yoga Parwata, S.Pd., M.Kes

2. Dr. dr. Ketut Suarjana, MPH

3. Dr. Kadek Tresna Adhi, S.K.M., M.Kes

4. Dr. dr. Ni Made Sri Nopiyani, MPH

5. Dr. I Made Kerta Duana, SKM, MPH.

In this exam, Dr. Ni Luh Gde Ari Natalia Yudha, SKM, MPH, was declared to have graduated as the 421th Doctoral Graduate of the Medical Science Doctoral Degree Study Program, Faculty of Medicine, Udayana University with the title of CUMLAUDE.

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