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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
on 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
Keterangan
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
osteomyelitis.
5. 4 level: phalange
gangrene or distal
with or without
cellulitis.
6. 5 level: complete
or 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
observation 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. Family Status of Respondent
Source: Data Primer, 2011.
No Status in family Frequency Presents (%)
1. Head 5 41,7
2. Member 7 58,3
Account 12
2. Respondent’s Gender
Source: Data Primer, 2011.
No Gender Frequency Presents (%)
1. Male 8 66,7
2. female 4 33,3
Total 12 100,0
3. Respondent’s Age
Source: Data Primer, 2011.
No Age Frequency Presents (%)
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
4. Marital status’ respondent
Source: Data Primer, 2011.
No Marital status Frequency Presents (%)
1. unmarried 0 0,0
2. married 10 88,3
3. Widow/widower 2 16,7
Total 12 100,0
5. History of education
Source: Data Primer, 2011.
No Level of education Frequency Presents (%)
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
6. Occupation's respondent
Source: Data Primer, 2011.
No Occupational Frequency Presents (%)
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
7. Family Earning
Source: Premere Data, 2011.
No Source Frequency Presents (%)
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 0,0
Total 12 100,0
FOCUSED DATA
1. Diabetic Gangrene level
Source : Primere Data, 2011.
No Diabetic gangrene Frequency Presents (%)
1. Derajat 0 0 0,0
2. Derajat 1 3 25,0
3. Derajat 2 3 25,0
4. Derajat 3 0 0,0
5. Derajat 4 5 41,7
6. Derajat 5 1 8,3
Total 12 100,0
2. Self Concept
Source: Primere Data, 2011.
No Self Concept Frequence Prosents (%)
1. Positif (tidak terganggu) 6 50,0
2. Negatif (terganggu) 6 50,0
Total 12 100,0
3. Cross Tabulation gangrene diabetic with delf concept disturben
Source: Primere Data, 2011.
Diabetic
gangrene
Self Concept Total
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
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 of respondent with negative and positive self concept
are 12 consist each other 50%, 6 respondent.
The result of calculation with SPSS Sperman Rank Correlation
show ρ = 0,009 < 0,05 .
That means Ho rejected and H1 receive. There are significance
correlation with gangrene diabetic and self concept at
Paviliun Dahlia Ward RSUD Jombang.
Value correlation coefficient are 0,712 between 0,60 - 0,799
that means stronge correlation.
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. Teoritis
2. Practice
Patient
Health Worker
Reseacher Future