communication barriers; clinical training; emotional strain; nursing education; qualitative study

Dublin Core

Title

communication barriers; clinical training; emotional strain; nursing education; qualitative study

Subject

decision-making; diabetes mellitus type 2; family support;
hemoglobin; glycemic control; self-management

Description

Background: Effective management of type 2 diabetes mellitus (T2DM)
requires structured self-care education supported by family and cultural
context. In Bali, health-related decisions are often influenced by patrilineal
households where male family members act as primary decision-makers.
Purpose: This study evaluated a self-care education program based on
Balinese local wisdom to improve glycemic control and self-efficacy among
T2DM patients.
Methods: A quasi-experimental design with pre- and post-tests and a
control group was conducted at Community Health Center in Bali, Indonesia
from June to September 2024. .Seventy patients with T2DM living in
patrilineal households were purposively recruited and randomly allocated
into intervention (n=35) and control (n=35) groups.. The intervention
consisted of twelve weekly sessions of culturally tailored self-care education
covering diet, physical activity, monitoring, medication, and foot care, with
active involvement of male household decision-makers. Outcome measures
included self-efficacy (Diabetes Management Self-Efficacy Scale), HbA1C,
and systolic/diastolic blood pressure, analyzed using t-tests.
Results: After 12 weeks, the intervention group demonstrated significant
improvements compared to controls: self-efficacy (mean difference: 8.37,
p<0.001), systolic blood pressure (-4.51 mmHg, p<0.001), diastolic blood
pressure (-2.74 mmHg, p<0.001), and HbA1C (-0.61%, p<0.001). Although
the HbA1C reduction was modest, it indicates a meaningful step toward
better glycemic control.
Conclusion: A 12-week culturally tailored self-care education program
involving patrilineal family members improved self-efficacy and glycemic
control in T2DM patients. These findings highlight the importance of
integrating local wisdom and family involvement into diabetes education to
enhance patient empowerment and adherence.

Creator

I Dewa Putu Gede Putra Yasa1

* , I Wayan Surasta1 , Iga Ari Rasdini1
,
Abdulkareem S. Iblasi2 , Rapin Polsook3 , I Gede Juanamasta4

Source

http://jkp.fkep.unpad.ac.id/index.
php/jkp

Date

: December 20, 2025

Contributor

peri irawan

Format

pdf

Language

english

Type

text

Files

Citation

I Dewa Putu Gede Putra Yasa1 * , I Wayan Surasta1 , Iga Ari Rasdini1 , Abdulkareem S. Iblasi2 , Rapin Polsook3 , I Gede Juanamasta4, “communication barriers; clinical training; emotional strain; nursing education; qualitative study,” Repository Horizon University Indonesia, accessed February 12, 2026, https://repository.horizon.ac.id/items/show/10828.