TY - JOUR
T1 - ‘Diabetes is a gift from god’ a qualitative study coping with diabetes distress by Indonesian outpatients
AU - Arifin, Bustanul
AU - Probandari, Ari
AU - Purba, Abdul Khairul Rizki
AU - Perwitasari, Dyah Aryani
AU - Schuiling-Veninga, Catharina C.M.
AU - Atthobari, Jarir
AU - Krabbe, Paul F.M.
AU - Postma, Maarten J.
N1 - Funding Information:
We acknowledge the help of all the participants, the LPDP scholarship (for the first author) from the Ministry of Finance of the Republic of Indonesia, Badan Penyelenggara Jaminan Sosial (BPJS), Dinas Kesehatan Surabaya, East Java, Prolanis BPJS Surabaya, Persadia Surabaya and Jawa Timur, the Governor of Central Sulawesi and the Regent of Banggai Laut (Drs. H. Wenny Bukamo), Selly Ristya Ningsih, M. Ikhsan Jufri, Muh. Ramlan Budi Kusuma, Friyanti Zaman, Suryadin, Endang Prihatin.
Funding Information:
The research was supported by a Grant from Beasiswa Pendidikan Indonesia (BPI)/LPDP (the Indonesian Endowment Fund for Education, Ministry of Finance of Republic of Indonesia) with Contract Number 20130821080334 and the University of Groningen in the Netherlands (Project Code 134502).
Publisher Copyright:
© 2019, The Author(s).
PY - 2020/1/1
Y1 - 2020/1/1
N2 - 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.
AB - 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.
KW - Diabetes distress
KW - Housewives
KW - Indonesian T2DM
KW - Spirituality
UR - http://www.scopus.com/inward/record.url?scp=85073958647&partnerID=8YFLogxK
U2 - 10.1007/s11136-019-02299-2
DO - 10.1007/s11136-019-02299-2
M3 - Article
C2 - 31549366
AN - SCOPUS:85073958647
SN - 0962-9343
VL - 29
SP - 109
EP - 125
JO - Quality of Life Research
JF - Quality of Life Research
IS - 1
ER -
