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 Diabetic gangrene is anxiety – caused diseases that complex and negative effect toward human quality of life i.e. amputation. INTRODUCTION 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. Data from Department of Health Kab. Jombang, there were 13.753 cases of diabetes mellitus in 2010. On one day survey, 19 April 2011 JUSTIFICATION 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 CRONOLOGY self withdrawing. The result can be used as guidance in comprehensive nursing care on diabetic patient with gangrene induced positive and adaptive SOLUTION response. .

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

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

CONCEPTUAL DESIGN Diabetes Melitus Complication -Retinopathies - Diabetic Neuropathy - Polyneuropathy - Diabetic Gangrene Affected factors on self Self Concept: concept: - Role - Education - Self Esteem - Occupation - Body Image - Age - Self Ideal - Self Identity - Marital Status Ket eter erang angan an Diteliti : Tidak diteliti : undisturbed disturbed

HYPOTESIS H0 : There is no correlation between diabetic gangrene and self concept disturbance H0 H1 : There is correlation between diabetic gangrene and self concept disturbance H1

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 Definition of Parameter/ Indikator Alat Ukur Skala Skor Operational Variable O Independent : Necrotic tissue in Wound Severity: Observation 1 : 0 level R Diabetic peripheral part of body 1. 0 level: No open 2 : 1 level D gangrene ss resulted diabetes lesion, intact skin 3 : 2 level I melitus with food disorder 4 : 3 level N i.e. claw, callus. 5 : 4 level A 2. 1 level: Superficial 6 : 5 level L ulcus limited in skin 3. 2 level: Deep ulcus till tendon and bone 4. 3 level: Narrowed abscess with/without osteomyelitis. 5. 4 level: phalange gangrene or distal with or without cellulitis. 6. 5 level: complete or partial gangrene

Ordinal Dependent: Ideas, through and faith Quessionere 1 : Positive Self Concept that known well in statement, score = relation with other peoples 4:Very Agree 3:Agree 2: Disagree 1: Very Disagree 1. Unwilling to Role Attitude pattern, behavior, do/activity value and purpose that 2 : Negative 2. Inactive respected based on their statement, score = 3. Dependency position in society 4:Very Agree 4. Stop Working 3:Agree 2: Disagree Self evaluation toward Self esteem 1: Very Disagree reached-result by 1. Critics her/his self analyzing their 2. Self blame behavior fulfill self 3. Hurt feeling Total criteria ideal 4. Pessimistic T > 50 = 5. Self windrowing undisturbed 6. Doubt feeling T ≤ 50 = disturbed Body image Attitude toward their body, conscious or unconscious included: 1. No ideal perception and size- 2. confused feeling, form, 3. urgly function, performance and potency

Self ideal Individual perception 1. Broken about how she/he must heart behave based on standard, 2. Can not aspiration, purpose or working personal value normally 3. Hope failure Identity Self awareness source 1. No Self confidence observation and 2. Difficult in evaluation synthesized by decision making all self concepts as holistic 3. Disorder of pattern interpersonal relationship 4. Blamming

RESULT 1. 1. Family y Status tus of Responde pondent nt 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 Source ce: : Data ta Prime imer, , 2011. 1.

2. Respondent’s Gender 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 Source ce: : Data ta Prime imer, , 2011. 1.

3. Respondent’s Age 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 0,0 4. < 20 y.o. 0 0,0 Total 12 100,0 Source ce: : Data ta Prime imer, , 2011. 1.

4. Marital status’ respondent No No Marita tal statu tus Frequ quen ency cy Present ents s (%) 1. unmarried 0 0,0 2. married 10 88,3 3. Widow/widower 2 16,7 Total 12 100,0 Source ce: : Data ta Prime imer, , 2011. 1.

5. Hist story y of educati tion 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 0,0 5. Uneducated 2 16,7 Total 12 100,0 Sour urce: ce: Da Data ta Prim imer er, , 2011. 1.

6. Occupation's pation's responde pondent nt No No Occu cupa pati tion onal al Frequ quen ency cy Presen ents ts (%) 1. PNS 0 0,0 2. Private 4 33,3 3. Wiraswasta 5 41,7 4. House wife 3 25,0 Total 12 100,0 Source ce: : Data ta Prime imer, , 2011. 1.

7. Family y Earni ning ng No No Source ce Frequ quen ency cy Present ents s (%) 1. < Rp. 500.000,00 9 75,0 2. Rp. 500.000,00 – 3 25,0 Rp.1.000.000,00 3. > Rp. 1.000.000,00 0 0,0 Total 12 100,0 Source ce: : Prem emere ere Data, a, 2011. 1.

FOCUSED DATA 1. 1. Diabeti etic Gangrene ene level No No Diabeti tic c gangren ene Frequ quen ency cy Presen ents ts (%) (%) 1. Derajat 0 0 0,0 2. Derajat 1 3 25,0 3. Derajat 2 3 25,0 4. Derajat 3 0 0,0 Source ce : Primere rimere Data, a, 2011. 1. 5. Derajat 4 5 41,7 6. Derajat 5 1 8,3 Total 12 100,0

2. Self f Concept pt No No Self Concept cept Frequ quen ence ce Prosent nts (%) (%) 1. Positif (tidak terganggu) 6 50,0 Source ce: : Primere rimere Data, a, 2011. 1. 2. Negatif (terganggu) 6 50,0 Total 12 100,0

3. Cross oss Tabulation ation gangre rene ne diabeti etic c with th delf concept pt dist sturb urben Diabeti etic Self Concept pt Tot otal gangrene ene Positive (not disturben) Negative (disturben) Frequence Prosents (%) Frequence Prosents (%) Frequence Prosents (%) 0 level 0 0,0 0 0,0 0 0,0 1 level 3 100,0 0 0,0 3 100,0 Source ce: : Primere rimere Data, a, 2011. 1. 2 level 2 66,7 1 33,3 3 100,0 3 level 0 0,0 0 0,0 0 0,0 4 level 1 20,0 4 80,0 5 100,0 5 level 0 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 onden ent. t. The The result result of of 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 H 1 rec recei eive. Th There ere are are signi significa icanc nce correlation orrelation 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 onge correlati relation on.

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