Path Analysis on the Biopsychosocial Determinants of Type 2 Diabetes Mellitus and Depression at Dr. Moewardi Hospital, Surakarta

Esty Budiarti, Didik Gunawan Tamtomo, Rita Benya Adriani

Abstract

Background: Diabetes Mellitus (DM) is a a major disease that is threatening global population health. This disease ranks third by global public health priority. The incidence of type 2 DM in 2014 was 442 million patients worldwide. Indonesia is one of 10 countries with high DM incidence. The incidence of type 2 DM in Indonesia in 2014 was 10 million patients. This study aimed to examine the biopsychosocial determinants of type 2 Diabetes Melitus and depression at Dr. Moewardi Hospital, Surakarta, using path analysis.

Subjects and Method: This was an analytic and observational study with case control design. The study was conducted at Dr. Moewardi Hospital, Surakarta, from August to October, 2017. Sample consisting of 100 patients type 2 DM  and 100 non DM patients were selected for this study by fixed disease sampling. The dependent variable was type 2 DM. The independent variables were body age, mass index, education level, occupation, stres, family income, comorbidity, activity, and family history of type 2 DM. The data were collected using medical record and questionnaire. The data were analyzed by path analysis.

Results: The risk of type 2 DM increased with higher body mass index (b= 2.66; 95% CI= 1.41 to 3.91; p<0.001), higher income (b=-0.93; 95% CI= -1.90 to 0.045; p=0.062), older age (b= 2.88; 95% CI= 0.62 to 5.15; p= 0.013), presence of DM family history (b= 2.56; 95% CI= 1.45 to 3.68; p <0.001), and comorbidity (b= 3.25; 95% CI= 2.07 to 4.43; p<0.001). The risk of depression increased by type 2 DM (b= 1.032; 95% CI= 0.42 to 1.63; p= 0.001). Body mass index increased with higher physical activity (b= -1.41; 95% CI= -2.03 to -0.79; p<0.001). Income increased with high education level (b= 2.58; 95% CI= 1.83 to 3.33; p<0.001). High physical activity increased with occupation (b=0.96; 95% CI= 0.38 to 1.53;p= 0.001).

Conclusion: The risk of type 2 DM increased with higher body mass index, higher income, older age, presence of DM family history, and comorbidity.

Keyword: biopsychosocial determinants, type 2 DM, depression

Correspondence: Esty Budiarti. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email:estybudiarti21@gmail.com.

Journal of Epidemiology and Public Health (2018), 3(1): 1-14
https://doi.org/10.26911/jepublichealth.2018.03.01.01 

Full Text:

PDF

References

Adillah FN (2016). Hubungan Depresi Dengan Kontrol Glikemik Pada Lansia Penderita DM Tipe 2. Universitas Muhammadiyah Semarang.

Alsahli M, Gerich JE (2012). Atlas of Diabetes. Editor: Skyler JS. USA: Springer

Arumsari (2017). Analisis Pengaruh Pertumbuhan Ekonomi, Pengangguran, Pendidikan, UMR Dan Pengeluaran Pemerintah Terhadap Tingkat Kemiskinan Di Provinsi Jawa Tengah Tahun 2011-2014. Universitas Muhammadiyah Surakarta.

Asamsama OH, Lee JW, Morton KR, Tonstad S (2015). Bidirectional Longitudinal Study of Type 2 Diabetes and Depression Symptoms In Black and White Church Going Adults Bidirectional Longitudinal Study of Type 2 Diabetes and Depression Symptoms in Black and White Church Going Adults. Journal of Diabetes & Metabolic Disorders, 14:25. doi: 10.1186/s4020001501505.

Bertalina A (2013). Hubungan Pengetahuan Terapi Diet dengan Indeks Glikemik Bahan Makanan yang Dikonsumsi Pasien Diabetes Mellitus.Jurnal Kesehatan, 7(3):377-387.

Bird Y, Lemstra M, Rogers M, Moraros J (2015). The relationship between socioeconomic status/income and prevalence of diabetes and associated conditions: A crosssectional population based study in Saskatchewan, Canada. International Journal for Equity in Health, 14(1), pp. 1–8. doi: 10.1186/s1293901502370.

Chandra AP, Ani L (2013). Gambaran Riwayat Diabetes Mellitus Keluarga, Indeks Massa Tubuh Dan Aktivitas Fisik pada Penderita Diabetes Mellitus Tipe 2 di Wilayah Kerja Puskesmas Manggis 1 Tahun 2013. Universitas Udayana.

Cloostermans L, Wendelvos W, Doornbos G, Howard B, Craig CL, Kivimaki M, Tabak AG, et al. (2015). Independent and combined effects of physical activity and body mass index on the development of Type 2 Diabetesa metaanalysis of 9 prospective cohort studies, International Journal of Behavioral Nutrition and Physical Activity. doi: 10.1186/s1296601503043.

Da silva A, Gomes R, Carvalho LA, Mayra A, Silva L, Luísa A, Santos B, Maria T, Moreira M (2015). Association of body mass index and physical activity with the risk of developing type 2 diabetes mellitus in the next decade. Diabetology & Metabolic Syndrome. doi: 10.1186/175859967S1A155.

Dinas Kesehatan Profinsi Jawa Tengah (2015). Profil Kesehatan Provinsi Jawa Tengah. Semarang: Dinas Kesehatan.

Dinas Kesehatan (2016). Buku Saku Kesehatan Kesehatan Triwulan Dua Tahun 2016. Semarang: Dinas Kesehatan.

Dunning T (2013). Care of People with Diabetes A Manual of Nursing Practice Fourth Edition. UK: Wiley Blackwell.

Egan B, Yumin Z, Walter Ab (2013) Epidemiology Of Hypertension In Diabetes. Editor: Samy I. Mcfarlane. Brooklyn , Ny, USA.

Ell K, Katon W, Lee PJ, Guterman J, Wu S (2015). Demographic, Clinical And Psychosocial Factors Identify A HighRisk Group for Depression Screening Among Predominantly Hispanic Patients With Type 2 Diabetes In Safety Net Care. General Hospital Psychiatry, 37: 414-419. doi: 10.1016/j.genhosppsych. 2015.05.010.

FaridahIN, Dewintasari V (2016). Hubungan Usia dan Penyakit Penyerta terhadap Kualitas Hidup Pasien Diabetes Mellitus Tipe 2 di Puskesmas Kotagede 1 Yogyakarta. Prosiding Rakernas dan Pertemuan Ilmiah Tahunan, pp. 123–126.

Frankilawati (2013). Hubungan Antara Pola Makan, Genetic Dan Kebiasaan Olahraga Terhadap Kejadian Dm Tipe 2 Di Wilayah Kerja Puskesmas Nusukan Surakarta. Fakultas Ilmu Keseatan Universitas Muhammadiyah Surakarta.

Habtewold TD, Islam A, Radie YT, Tegegne BS (2016). Comorbidity of Depression and Diabetes: an Application of Biopsychosocial Model, International Journal of Mental Health Systems. BioMed Central, 1–9. doi: 10.1186/s1303301601062.

Hellen C, Alves R, Aparecida S, Souza FD, Caroline N, Azevedo VD (2015). Comparing the Level of Physical Activity in Women With Type 2 Diabetes. Diabetology & Metabolic Syndrome. doi: 10.1186/175859967-S1A236.

Heryana OA (2006). Faktor Risiko Diabetes Melitus tipe 2. Universitas Esa Unggul.

Hutama FA, Rochmawatii I (2015). Hubungan Antara Faktor Demografi Dengan Depresi Pada Penderita Diabetes Melitus Di Kabupaten Gunungkidul DIY. Universitas Muhammadiyah Yogyakarta 2015.

International Diabetes Federation (2015). IDF Diabetes Atlas Seventh Edition 2015. UK: International Diabetes Federation.

Isworo A (2008). Hubungan Depresi Dan Dukungan Keluarga Terhadap Kadar Gula Darah Pada Pasien Diabetes Mellitus Tipe 2 Di RSUD Sragen. Universitas Indonesia, Depok.

Isworo A, Saryono (2010). Hubungan Depresi dan Dukungan Keluarga Terhadap Kadar Gula Darah pada Pasien Diabetes Mellitus Tipe 2 di Rsud Sragen. Jurnal Keperawatan Soedirman, 5:1.

Januszewska AG, Lindström J, Tuomilehto J, SolskaBP, Mądry RT, Szybinski Z, Peltonen M, Schwarz PEH, Windak A,Dydejczyk AH (2017). Sustained Diabetes Risk Reduction After Real Life And Primary Health Care Setting Implementation Of The Diabetes In Europe Prevention Using Lifestyle, Physical Activity And Nutritional Intervention (DEPLAN) Project. BMC Public Health, 17:198, doi: 10.1186/s1288901741043.

Khanam PA, Hoque S, Begum T, Habib SH, Latif ZA (2017). Microvascular Complications and Their Associated Risk Factors in Type 2 Diabetes Mellitus, Diabetes & Metabolic Syndrome: Clinical Research & Reviews. Diabetes India, 11: S577–S581. doi: 10.1016/j.dsx.2017.04.007.

Leong, A, Rahme E, Dasgupta K (2014). Spousal Diabetes As A Diabetes Risk Factor: A Systematic Review and Meta Analysis. BMC Medicine, 12:12.

Lukacs A, Toth EK, Csordas A, Sasvari P, and Barkai L (2017). Screening Risk Factors For Type 2 Diabetes in Overweight and Obese Adolescents in School Settings of Hungary: A Population Based Study. Journal of King Saud University–Science, 10183647. doi: org/10.1016/j.jksus. 2017.01.006.

Matias S (2012). Kemiskinan dan Solusi. Medan: Grasindo.

Mirghani HO, Elbadawi AS (2016). Depression, Anxiety, and Daytime Sleepiness Among Type 2 Diabetic Patients and Their Correlation With the Diabetes Control : A Case Control Study. Journal of Taibah University Medical Sciences, Elsevier Ltd, 11(4) :374-379.doi:10.1016/j.jtumed. 2016 .05.009.

Mommersteeg PMC, Herr R, Zijlstra WP, Schneider S, Pouwer F (2012). Higher Levels of Psychological Distress Are Associated with a Higher Risk of Incident Diabetes During 18 Year FollowUp: Results from The British Household Panel Survey. BMC Public Health, 12:1109. doi: 10.1186/14712458121109.

Mongisidi G (2014). Hubungan Antara Status Sosio Ekonomi dengan Kejadian Diabetes Mellitus Tipe 2 di Poliklinik Interna Blu RSUP Prof. Dr. R. D. Kandou Manado. FKM Sam Ratulangi.

Muflikhatin SK, Fahrudin. (2013). Hubungan Antara Usia, Riwayat Ketu-runan dan Pola Makan Dengan Kejadian Diabetes Mellitus Tipe 2 Di Ruang Flamboyan RSUD Abdul Wahab Sjahranie Samarinda. Samarinda.

Nur A, Fitria E, Zulhaida A, Hanum S (2016). Hubungan Pola Konsumsi Dengan Diabetes Melitus Tipe 2 pada Pasien Rawat Jalan di RSUD Dr. Fauziah Bireuen Provinsi Aceh. Media Litbangkes, 26: 3: 145-150.

Palimbunga TM, Ratag BT, Kaunang PJ (2016). Faktor-Faktor Yang Berhubungan dengan Kejadian Diabetes Melitus Tipe 2 di RSU Gmim Pancaran Kasih Manado. Universitas Sam Ratulangi Manado.

Profil Kesehatan Kota Surakarta (2014). Profil Kesehatan Kota Surakarta Tahun 2014. Surakarta: Jawa Tengah.

Rahayu P, Utomo M, Setiawan R (2011). Hubungan Antara Faktor Karakteristik, Hipertensi Dan Obesitas Dengan Kejadian Diabetes Mellitus Di Rumah Sakit Umum Daerah Dr. H. Soewondo Kendal. Universitas Muhammadiyah Semarang.

Ramadhan N, Marissa N (2015). Karakteristik Penderita Diabetes Mellitus Tipe 2 Berdasarkan Kadar Hba1c Di Puskesmas Jayabaru Kota Banda Aceh. Media of Health Research and Development, 2(2): 49-56.

Raymond K, Lovell GP (2016). Journal of Diabetes and its Complications Food addiction Associations with Psychological Distress among People with Type 2 Diabetes. Journal of Diabetes and Its Complications. Elsevier Inc, 30(4): 651–656. doi: 10.1016/j.jdiacomp.2016.01.020.

Riset Kesehatan Dasar (2013). Hasil Riskesdas 2013. Jakarta: Riset Kesehatan Dasar .

Riyadi S, Sukarmin (2013). Asuhan Keperawatan pada Pasien dengan Gangguan Eksokrin dan Endokrin Pada Pankreas. Yogyakarta: Graha Ilmu.

Rondonuwu RG, Rompas S, Bataha Y (2016). Hubungan Antara Perilaku Olahraga Dengan Kadar Gula Darah Penderita Diabetes Mellitus di Wilayah Kerja Puskesmas Wolaang Kecamatan Langowan Timur. Ejournal Keperawatan, 4:1.

RSUD Dr. Moewardi (2016). Laporan Kinerja RSUD Dr. Moewardi. Surakarta.

Setyani T (2012). Hubungan Tingkat Depresi Dengan Kadar Gula Darah Pada Penderita Diabetes Melitus Tipe 2 Di Rumah Sakit Umum Daerah Karanganyar. Universitas Muhammadiyah Surakarta.

Setyaningrum DE, Sugiyanto Z (2015). Faktor Risiko yang Berhubungan Dengan Kejadian Diabetes Melitus Tipe II pada Usia Kurang Dari 45 Tahun di RSUD Tugurejo Semarang. Universitas Dian Nuswantoro.

Spurr S, Bally J, Bullin C, Trinder K (2017). Type 2 Diabetes in Canadian Aboriginal Adolescents: Risk Factors and Prevalence. Journal of Pediatric Nursing. Elsevier Inc, 36: 111–117.

Sukmaningsih W (2016). Faktor Risiko Kejadian Diabetes Mellitus Tipe IIdi Wilayah Kerja Puskesmas Purwodiningratan Surakarta. Fakultas Ilmu Kesehatan Universitas Muhammadiyah, Surakarta.

Tripathy JP, Thakur JS, Jeet G, Jain S (2017). Prevalence and Determinants of Comorbid Diabetes and Hypertension: Evidence from Non Communicable Disease Risk Factor STEPS survey, India, Diabetes and Metabolic Syndrome: Clinical Research and Reviews. 11: S459–S465.doi: 10.1016/j.dsx.2017.03.036.

Trisnawati SK, Setyorogo S (2013). Faktor Risiko Kejadian Diabetes Melitus Tipe II di Puskesmas Kecamatan Cengkareng Jakarta Barat Tahun 2012. Jurnal Ilmiah Kesehatan 5(1): 6–11.

Vidal PC, Lucha LMO, Lucha LAC, Tricas MJM, Miguel E, Bernues VL (2014). A Descriptive Study of Health Status And Health Related Quality of Life In Selected Outpatients With Type 2 Diabetes, Pathological Body Mass Index And Cardiovascular Risk In Spain. Journal of Diabetology & Metabolic Syndrome, 6:35.

Wielgosz A, Dai S, Walsh P, McCrea LJ, Celebican E (2016) Comorbid Conditions in Canadians Hospitalized Because of Diabetes, Canadian Journal of Diabetes. Elsevier Inc, 1–6. doi: 10.1016/j.jcjd.2017.03.004.

World Health Organization (2011). World Health Statistic 2011. Switzerland: WHO press.

World Health Organization (2016). Global Report On Diabetes. Switzerland: World Health Organization.

Refbacks

  • There are currently no refbacks.