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