Pepin Nahariani Presented at The 3rd International Nursing - - PowerPoint PPT Presentation

THE CORRELATION OF DIABETIC GANGRENE WITH SELF CONCEPT DISTURBANCE IN PAVILION OF DAHLIA RSUD JOMBANG

Pepin Nahariani

Presented at The 3rd International Nursing Conference “Innovation on Nursing Education and Clinical Practice” Faculty of Nursing University Airlangga Surabaya, 12-13 May 2012.

PREFACE

INTRODUCTION

Diabetic gangrene is anxiety–caused diseases that complex and negative effect toward human quality of life i.e. amputation. Automatically, it produce anxiety at the patient. Anxiety, naturally happens threatened–feeling, physically or psychologically like self esteem, self ideal, body image and personal identity.

JUSTIFICATION

Data from Department of Health Kab. Jombang, there were 13.753 cases of diabetes mellitus in 2010. On one day survey, 19 April 2011 at pavilion of Dahlia RSUD Jombang, there were 92 patients with diabetic gangrene from 528 patients–cared in that place. Based on the initial study, 5 from 6 patients have self concept disturbance.

The mostly complication of diabetic patient is foot disorder, as gangrene. Gangrene as chronic disease, potentially create anxiety and powerless–feeling caused by under developing wound and spoiled odor. This condition makes embarrassed feeling and self withdrawing.

The result can be used as guidance in comprehensive nursing care

• n diabetic patient with gangrene induced positive and adaptive

response. .

CRONOLOGY SOLUTION

Problem Statement

The Correlation of diabetic gangrene with self concept disturbance on Pavilion of Dahlia RSUD Jombang is still unclear 1 General Proposes 2 Specific Purposes Purposes of Study 1. Theoretical 2. Practical Benefit

LITERACY

1 Concept of Diabetes Mellitus 2 Concept of Diabetic Gangrene 3 Self Concept 4 Concept of Diabetic Gangrene with Self Concept Disturbance LITERACY

CONCEPTUAL DESIGN

Ket eter erang angan an Diteliti : Tidak diteliti :

• Diabetic Gangrene

Affected factors on self concept:

• Education
• Occupation
• Age
• Marital Status

Diabetes Melitus

Complication

• Retinopathies
• Diabetic Neuropathy
• Polyneuropathy

Self Concept:

• Role
• Self Esteem
• Body Image
• Self Ideal
• Self Identity

disturbed

undisturbed

HYPOTESIS

H1 : There is correlation between diabetic gangrene

and self concept disturbance

H1

H0 : There is no correlation between diabetic gangrene and self concept disturbance

H0

METODOLOGY OF RESEARCH

Research Design Cross Sectional: Analytic Correlation Population All diabetic gangrene in pavilion of Dahlia RSUD Jombang Sample All diabetic gangrene in pavilion of Dahlia RSUD Jombang

Sampling Purposive Sampling

Pengumpulan Data Questioner and observation Management Editing, Coding, Scoring, and Tabulating Data Analizer Spearmen Rank Conclution

Definition of Operational

Variable Definition of Operational Parameter/ Indikator Alat Ukur Skala Skor

Independent : Diabetic gangrene Necrotic tissue in peripheral part of body ss resulted diabetes melitus Wound Severity:

• 1. 0 level: No open

lesion, intact skin with food disorder i.e. claw, callus.

• 2. 1 level: Superficial

ulcus limited in skin

• 3. 2 level: Deep ulcus

till tendon and bone

• 4. 3 level: Narrowed

abscess with/without

• steomyelitis.
• 5. 4 level: phalange

gangrene or distal with or without cellulitis.

• 6. 5 level: complete
• r partial gangrene

Observation

O R D I N A L

1 : 0 level 2 : 1 level 3 : 2 level 4 : 3 level 5 : 4 level 6 : 5 level

Dependent: Self Concept Role Self esteem Body image Ideas, through and faith that known well in relation with other peoples Attitude pattern, behavior, value and purpose that respected based on their position in society Self evaluation toward reached-result by analyzing their behavior fulfill self ideal Attitude toward their body, conscious or unconscious included: perception and size- feeling, form, function, performance and potency

• 1. Unwilling to

do/activity

• 2. Inactive
• 3. Dependency
• 4. Stop Working
• 1. Critics her/his self
• 2. Self blame
• 3. Hurt feeling
• 4. Pessimistic
• 5. Self windrowing
• 6. Doubt feeling
• 1. No ideal
• 2. confused
• 3. urgly

Quessionere

Ordinal

1 : Positive statement, score = 4:Very Agree 3:Agree 2: Disagree 1: Very Disagree 2 : Negative statement, score = 4:Very Agree 3:Agree 2: Disagree 1: Very Disagree Total criteria T > 50 = undisturbed T ≤ 50 = disturbed

Self ideal Identity Individual perception about how she/he must behave based on standard, aspiration, purpose or personal value Self awareness source

• bservation and

evaluation synthesized by all self concepts as holistic pattern

• 1. Broken

heart

• 2. Can not

working normally

• 3. Hope

failure

• 1. No Self confidence
• 2. Difficult in

decision making

• 3. Disorder of

interpersonal relationship

• 4. Blamming

RESULT

1. 1. Family y Status tus of Responde pondent nt

Source ce: : Data ta Prime imer, , 2011. 1.

No No Statu tus s in fa fami mily Frequ quen ency cy Presen ents ts (%) 1. Head 5 41,7 2. Member 7 58,3 Account 12

• 2. Respondent’s Gender

Source ce: : Data ta Prime imer, , 2011. 1.

No No Gende der Frequ quen ency cy Presen ents ts (%) 1. Male 8 66,7 2. female 4 33,3 Total 12 100,0

• 3. Respondent’s Age

Source ce: : Data ta Prime imer, , 2011. 1.

No No Age Frequ quen ency cy Present nts s (%) 1. > 50 y.o. 9 75,0 2. 30 – 49 y.o. 3 25,0 3. 20 – 29 y.o. 0,0 4. < 20 y.o. 0,0 Total 12 100,0

• 4. Marital status’ respondent

Source ce: : Data ta Prime imer, , 2011. 1.

No No Marita tal statu tus Frequ quen ency cy Present ents s (%) 1. unmarried 0,0 2. married 10 88,3 3. Widow/widower 2 16,7 Total 12 100,0

• 5. Hist

story y of educati tion

Sour urce: ce: Da Data ta Prim imer er, , 2011. 1.

No No Level of educat ation ion Frequ quen ency cy Present ents s (%) 1. Elementary school 5 41,7 2. Junior height school 4 33,3 3. Senior height school 1 8,3 4. Diploma/Bachelor 0,0 5. Uneducated 2 16,7 Total 12 100,0

• 6. Occupation's

pation's responde pondent nt

Source ce: : Data ta Prime imer, , 2011. 1.

No No Occu cupa pati tion

• nal

al Frequ quen ency cy Presen ents ts (%) 1. PNS 0,0 2. Private 4 33,3 3. Wiraswasta 5 41,7 4. House wife 3 25,0 Total 12 100,0

• 7. Family

y Earni ning ng

Source ce: : Prem emere ere Data, a, 2011. 1.

No No Source ce Frequ quen ency cy Present ents s (%) 1. < Rp. 500.000,00 9 75,0 2.

• Rp. 500.000,00 –

Rp.1.000.000,00 3 25,0 3. > Rp. 1.000.000,00 0,0 Total 12 100,0

FOCUSED DATA

1. 1. Diabeti etic Gangrene ene level

Source ce : Primere rimere Data, a, 2011. 1.

No No Diabeti tic c gangren ene Frequ quen ency cy Presen ents ts (%) (%) 1. Derajat 0 0,0 2. Derajat 1 3 25,0 3. Derajat 2 3 25,0 4. Derajat 3 0,0 5. Derajat 4 5 41,7 6. Derajat 5 1 8,3 Total 12 100,0

• 2. Self

f Concept pt

Source ce: : Primere rimere Data, a, 2011. 1.

No No Self Concept cept Frequ quen ence ce Prosent nts (%) (%) 1. Positif (tidak terganggu) 6 50,0 2. Negatif (terganggu) 6 50,0 Total 12 100,0

• 3. Cross
• ss Tabulation

ation gangre rene ne diabeti etic c with th delf concept pt dist sturb urben

Source ce: : Primere rimere Data, a, 2011. 1.

Diabeti etic gangrene ene Self Concept pt Tot

• tal

Positive (not disturben) Negative (disturben) Frequence Prosents (%) Frequence Prosents (%) Frequence Prosents (%) 0 level 0,0 0,0 0,0 1 level 3 100,0 0,0 3 100,0 2 level 2 66,7 1 33,3 3 100,0 3 level 0,0 0,0 0,0 4 level 1 20,0 4 80,0 5 100,0 5 level 0,0 1 100,0 1 100,0 Total 6 50,0 6 50,0 12 100,0

The total al of respondent pondent with h ne negativ ative e and nd positiv itive e self lf conc ncept pt are 12 consist ist each other er 50%, 6 r resp spond

• nden

ent. t. The The result result of

• f calc

alculation ulation wit with SP SPSS Sperman Sperman Ra Rank nk Correl Correlat ation ion show ρ = 0,009 009 < 0,05 05 . That That mea means ns Ho Ho reject rejected ed and and H1 rec recei

• eive. Th

There ere are are signi significa icanc nce correlation

• rrelation wit

with ga gang ngren rene dia diabe beti tic and nd self self co concept ncept at at Pa Paviliu iliun Dahlia lia Ward RSUD UD Jomba bang ng. Value alue correl correlatio tion coef coefficient icient are are 0,712 be betw twee een 0,60 60 - 0,799 99 that at means ns strong

• nge correlati

relation

• n.

CONCLUTIONS

• Diabetic Gangrene of the patient DM at Dahlia

Pavilliun Ward RSUD Jombang are greter(41,7%) 5 respondent have 4 level, a small respondent(8,3%) have 5 level.

• Self Concept of diabetic Gangrene have self concept

disturben 50% (6 responden), 50% self concept normal.

• Self concept for the patient DM related to self care

deficite

NEXT…

• The result this study that patient with high level of

gangrene diabetic risk to self concept disturben. That means there are significance correlation with diabetic Gangrene and self concept at Dahlia Pavilliun Ward RSUD JOmbang.

SUGGEST

1. 1. Teori riti tis 2. 2. Practi tice ce

• Pat

Patient nt

• Health

h Work rker

• Reseache

cher Futur ure