‘Diabetes is a gift from god’ a qualitative study coping with diabetes distress by Indonesian outpatients

Abstract

Background More than two-thirds of patients diagnosed with type 2 diabetes mellitus (T2DM) in Indonesia encounter medical-related problems connected to routine self-management of medication and the social stigma related to T2DM. The current study aims to explore distress and coping strategies in Indonesian T2DM outpatients in a Primary Healthcare Centre (PHC) in Surabaya, East Java, Indonesia. Methods We conducted a qualitative study using two different data collection methods: focus group discussions and in-depth interviews. The guideline of interviews and discussions were developed based on seventeen questions derived from the DDS17 Bahasa Indonesia (a Bahasa Indonesia version of the Diabetes Distress Scale questionnaire), which covered physician distress domain, emotional burden domain, regimen distress domain and interpersonal distress domain. Results The majority of the 43 participants were females and aged 50 or older. Our study discovered two main themes: internal and external diabetes distress and coping strategies. Internal diabetes distress consists of disease burden, fatigue due to T2DM, fatigue not due to T2DM, emotional burden (fear, anxiety, etc.) and lack of knowledge. Internal coping strategies comprised spirituality, positive attitude, acceptance and getting more information about T2DM. External diabetes distress was evoked by distress concerning healthcare services, diet, routine medication, monthly blood sugar checks, interpersonal distress (family) and financial concern. External coping strategies included healthcare support, traditional medicine, vigilance, self-management, social and family support and obtaining information about health insurance. Conclusion Our study shows that for Indonesian T2DM-patients, spirituality and acceptance are the most common coping mechanisms for reducing DD. Furthermore, our study revealed an overall positive attitude towards dealing with T2DM as well as a need for more information about T2DM and potential coping strategies. Finally, an important finding of ours relates to differences in DD between males and females, potential DD associated with health services provision and the specific challenges faced by housewives with T2DM.

The differences in health-related quality of life between younger and older adults and its associated factors in patients with type 2 diabetes mellitus in Indonesia

“…However, according to our review of the literature, this study was the first to show that when comparing DD and depression, DD was a stronger predictor for HRQOL in younger adults, and depression was a stronger predictor in older adults. DD refers to emotional distress related to living with and managing diabetes [53]. Many of the younger adults in this study had DM for less than five years, and many of the older adults had DM for more than five years.…”

Spiritual, Religious, and Faith-Based Practices in Chronicity

“…Self-management assumes patients can afford nutritious food, clean water, glucometers, testing strips, and to live in a peaceful place, with caregivers for the elderly, amputees, the visually impaired, or other people with complications; many people in Belize cannot afford these things, and rely on a patchwork of volunteer efforts, government, and private systems (key informants, 2020). While gender-based analysis is often missing in the T2DM studies, there are studies that note that such chronicity "homework" falls more often on the shoulders of women than of men (Arifin et al 2020). According to Arifin et al (2020), Indonesian women with diabetes, for example, have both more caregiving duties and greater stress than their male counterparts.…”

“…While gender-based analysis is often missing in the T2DM studies, there are studies that note that such chronicity "homework" falls more often on the shoulders of women than of men (Arifin et al 2020). According to Arifin et al (2020), Indonesian women with diabetes, for example, have both more caregiving duties and greater stress than their male counterparts. These women manage their own diabetes without additional support, despite compounding stresses of paid work, housework, kin work, and chronicity homework, while men feel their diabetes does not contribute stress, because the women in their lives look after them (Arifin et al 2020).…”

Relationship Between Family Support and Activeness of Prolanis Participants With Diabetes Mellitus

“…External diabetes distress was evoked by distress concerning healthcare services, diet, routine medication, monthly blood sugar checks, interpersonal distress (family) and financial concern. External coping strategies included healthcare support, traditional medicine, vigilance, self-management, social and family support and obtaining information about health insurance [8].…”