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Medical Faculty and Health Science
Muhammadiyah University of Yogyakarta
2011
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Diabetic Mellitus tipe 2 is a common endocrine disease
The prevalency of diabetic mellitus tipe 2 in the world andindonesia
The relationship between diabetic mellitus type 2 anddepression
What are the factors that contributed to depression outcomeand make depression better post SHG therapy of diabeticmellitus type 2 in community health center?
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Can self help group therapy which given patients of diabeticmellitus type 2 by comorbid depression:
improved the quality of life
controled blood glucose level controled total cholesterol level
than diabetic mellitus type 2 patient by comorbid depressionwho is not given SHG therapy?
1. General researchTo know and analyze the influence of SHG to quality of life,blood glucose level, total cholesterol level, risk factors andprognose factors on patient by diabetic mellitus type 2 incomorbid depression
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2. Spesific research
To know the factor which relate with quality of life andrisk and prognose factors
To know the influence of total cholesterol and bloodglucose level
To know the percentage of depression
1. Clinic : to give reference to take decision in management.
2. Community : to give information about the function of selfhelp group as alternative therapy.
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The research about result of self help group therapy ondiabetic mellitus type 2 by comorbid depression to qualityof life, control blood glucose level, total cholesterol level,
risk factors and prognose factors never practiced inIndonesia.
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Classification of diabetic mellitus based on ADA, 2010.
1. DM type 1
Diabetic Mellitus is a metabolic disease group byhyperglicemic signs because it has less of of secretioninsulin, insulin action, or both of them (ADA, 2010).
2. DM type 2
3. DM other type (genetic defect of beta cell function,genetic defect of insulin function, ecsocrin pancreasdisease, chemical medicine and imunology).
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The risk factors of depression by Maslim, 2002:Female gender, education level, married statue, income
level, age, smooking, and complication.
1. General signsLost of willingness and funLess of energy, fatigue, and less of activity
2. Extra signs
Less of concentration and attentionThink of bad future
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1. Low depression
2. Middle depression3. High depression without psychotic signs
4. High depression with psychotic signs
Diabetic increase risk depression because of fairly and loss
feeling and it is needed to change life quality to ignore thecomplication (Mezuk, 2008).
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It is group therapy in some situtations and conditions,
concious of two or more than two persons who have thesame problem and share it to better.
1. Share feeling and experiance among group3. To increase the knowlage, to change, the attitude and toincrease quality of life
A. Introduction
B. Problem solving
C. Closing
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DIABETES
MELLITUS
GLUCOSE LEVEL CONTROL :
COMPLIANCE TO TREATMENT
LAZY TO CHECKING BLOOD
EATING / DRINKING EXCESSIVE
MAINTENANCE COSTS
DEPRESSION
GLUCOSE
LEVEL
UNCONTROLED
GLUCOSE
LEVELCONTROLED
SHG
Insulin levels in the blood too low and glucagon levels toohigh.
Inhibited glycolysis and stimulated gluconeogenesis.
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REPAIR
NO
IMPROVEMENT
DIABETES
MELLITUSDEPRESSION
RISK FACTORS:
a. YOUNG AGEb. WOMEN'S GENDER
c. EDUCATION LEVEL
d. INGKAT REVENUE
e. SMOKING
f. SOCIAL STATUS
g. STATUS OF ETHNIC MINORITIES
h. COMPLICATIONSi. COMORBID
SHG
PROGNOSTIC
FACTOR
A. Biologycal Factor
B. Genetic factorsC. Psychosocial Factors
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Cholesterol level controled :
Treatment regulery
Blood ecamination lazynes
Over consumtion of food and drink
Care payment
Diabetic
mellitusDepression SHG
Cholesterol level
controlled
Cholesterol leveluncontrolled
The function of lipid based on (mayes etall, 2003)
1. Arange the cell membranestracture
2. Substancy of energy3. As hormone and vitamine
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Diabetic
MellitusDepression
Quality of life:Physical
Psychological
Social Relation
Family Intimace
Friendship
Financial
Self help
group
Improved of
Life Quality
The definition of life quality based on Dorland, 2003.it is described to measure the emotional, social, and physic
condition of someone and the capibility to do task and it isfunction in daily life.
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Therapy SHG (Self Help Group) capable to controlblood glucose, cholesterol total, have recovery ofbetter depression score, have recovery of better lifequality levels in type 2 diabetic group with comorbid
depression when compared with the control group.
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Quasi-experimental study
PROBE (Prospective, randomized, open, end-Blinded
Evaluation) test design
Target Population : female patients with type 2
diabetesAffordable Population : female patients with type 2diabetes based on Perkeni 2006 criteria which controlat clinic in the district of Bantul, Yogyakarta
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2;)] 22212
22
2ss
n+=-
+= sms b
Sample : 50 people, Each group consisted of 25 people. Toestimate the number of cases dropped out samples of each groupup to 28 people.
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Inclusion Criteria:
(1) Woman with Perkeni 2006 criteria; (2) >20 years old, (3)BDI score over 10; ( 4) self-help therapy group meeting atleast 3 times, (5) not receiving treatment for psychiatricdisorders, (6) signing an informed consent; (7) not active
smokers and alcoholics; (8) can reading. 2. Exclusion Criteria:
(1) Patients in a state of pregnancy, (2) patients using insulintreatment, (3) patients experienced major complications
associated with diabetes.
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Independent Variable (Free): Self help group
Dependent Variable (Depends): Risk and prognose factor
Blood glucose levels Cholesterol levels
Quality of life
Self Help Group (SHG)Type 2 DiabetesDepressionCommunity health centerDrop out
Risk Factor
Prognose Factor
Fasting Blood Glucose
Total Cholesterol
Quality of Life
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Paired Sample T-Test for normally distributed data
Wilcoxon Signed Rank Test when data not normallydistributed
Differences considered significant if p
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Presentase Depresi di Puskesmas Sedayu
Depresi : 36 orang Non Depresi : 16 orang
Persentase depresi : 69,23%
Kasihan IIDepresi : 28 0rang
Non Depresi : 13 orang
Persentase depresi: 68,29%
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NORMALITY TEST
RISK FACTORS-BDI SCORE
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