臺灣博碩士論文加值系統

ABSTRACT

Background: Knowledge is fundamental for diabetes patients to practice foot care. However, increasing knowledge itself is not sufficient to improve foot care behavior among Diabetes Mellitus patients. Illness perception may contribute towards foot care behavior, with diabetes patients in Indonesia having different beliefs influencing their foot care behavior. There is limited information about the relationship between illness perception and foot care behavior among patients with Diabetes Mellitus in Indonesia.
Objectives: The purpose of the study was to understand the relationships between illness perception and foot care behavior among patients with type II diabetes in Indonesia. This study aims to (1) describe and to (2) determine the relationships between foot care knowledge, illness perception, local beliefs and foot care behavior among patients with diabetes in Indonesia.
Method: This cross-sectional study uses convenience sampling technique, recruited 200 patients with type II diabetes in the outpatient department of Islamic Hospital of Klaten. They were invited to complete the Foot Care Knowledge Questionnaire, B-IPQ, Local Beliefs Questionnaire and DFSBS.
Result: The level of foot care knowledge among patients with type II diabetes (71.5%) is categorized as good. The domain of illness perception most perceived by patients was timeline (mean= 7.8), and the lowest was identity (mean= 5.1). They also had acceptable foot care behavior with a mean score of 27.45. The hierarchical regression result showed that foot care knowledge, illness perception, and local beliefs explained 68.2% of foot care behavior. Foot care knowledge itself explained 39.7% of the variance and illness perception such as consequences, personal control, and treatment control explained 13.5% of foot care behavior. Meanwhile, local beliefs explained 2% of foot care behavior. Having families or friends with diabetic foot ulcer (DFU), foot care knowledge, consequences, and treatment control were the significant predictors of foot care behavior (p〈0.001). Local beliefs also became the significant predictor of illness perception (p〈0.05).
Conclusion ＆ Implication: Knowledge of foot care is important to predict foot care behavior, but illness perception also needs to be considered. Therefore, changing the patients’ illness perception especially decreasing the consequence domain and increasing treatment control domain is important to improve foot care behavior among patients with diabetes in Indonesia.

Keywords: illness perception, knowledge, and foot care behavior.

TABLE OF CONTENTS
ABSTRACT i
ACKNOWLEDGEMENTS ii
TABLE OF CONTENTS iii
LIST OF TABLES vi
LIST OF FIGURES vii
LIST OF APPENDICES viii
CHAPTER ONE: INTRODUCTION 1
1.1. Research Background 1
1.2. Research Purpose 5
1.3. Research Framework 5
CHAPTER TWO: LITERATURE REVIEW 6
2.1. Diabetes Mellitus 6
2.1.1. Diabetic Foot Ulcer 7
2.1.2. Impact of Diabetic Foot Ulcer 9
2.1.3. Foot Care 11
2.2. Illness Perception 13
2.2.1. Illness Perception Concept 13
2.2.2. Illness Perception in DM Treatment 15
2.2.3. Illness Perception of Indonesian Patients 16
CHAPTER THREE: RESEARCH METHOD 18
3.1. Study Design 18
3.2. Sample 18
3.3. Research Instruments 19
3.3.1. The Demographic and Clinical Factors Questionnaire 19
3.3.2. The Foot Care Knowledge Questionnaire 19
3.3.3. The Brief Illness Perception Questionnaire 21
3.3.4. The Diabetic Foot Self-Care Behavior Scale 23
3.3.5. The Local Beliefs Questionnaire 23
3.4. Data Collection 24
3.5. Data Analysis 24
CHAPTER FOUR: RESEARCH RESULTS 26
4.1. Demographics and Clinical Factors 27
4.2. Foot Care Knowledge 28
4.3. Illness Perception 29
4.4. Foot Care Behavior 30
4.5. Bivariate Analysis between Demographic and Clinical Factors, Illness
Perception and Foot Care Behavior 31
4.6. Multivariate Analysis between Demographic and Clinical Factors, Illness
Perception and Foot Care Behavior 39
CHAPTER FIVE: DISCUSSION AND CONCLUSION 45
5.1. Discussion 45
5.1.1. Foot Care Knowledge 45
5.1.2. Illness Perception 47
5.1.3. Foot Care Behavior 49
5.1.4. Demographic, Clinical Factors, Foot Care Knowledge and Foot Care
Behavior 52
5.1.5. Illness Perception and Foot Care Behavior 55
5.1.6. Local Beliefs and Foot Care Behavior 56
5.1.7. Predictors of Foot Care Behavior 58
5.2. Limitation and Strength of Study 60
5.3. Implication in Nursing Field 63
5.4. Conclusion 64
5.5. Future Research 64
REFERENCES 65
APPENDICES 73
 
LIST OF TABLES

Table 4-1. Demographic and Clinical Factors of the Respondents 27
Table 4-2. Foot Care Knowledge 28
Table 4-3. Items Rank of Foot Care Knowledge 29
Table 4-4. Illness Perception and Patients' Local Beliefs 30
Table 4-5. Foot Care Behavior 30
Tabel 4-6. Relationship between Demographics, Foot Care Knowledge and Foot
Care Behavior 32
Tabel 4-7. Relationship between Clinical Factors, Foot Care Knowledge and Foot
Care Behavior 33
Tabel 4-8. Relationship between Illness Perception, Foot Care Knowledge and Foot
Care Behavior 34
Tabel 4-9. Relationship between Local Beliefs, Foot Care Knowledge and Foot Care
Behavior 34
Tabel 4-10. Relationship between Demographics Data and Illness Perception 37
Tabel 4-11. Relationship between Clinical Factors, Foot Care Knowledge, and Illness
Perception 38
Table 4-12. Hierarchical Regression Analysis Illness Perception and Foot Care
Behavior 40
Table 4-13. Hierarchical Regression Analysis Local Beliefs and Foot Care Behavior 42
Table 4-14. Hierarchical Regression Analysis Illness Perception, Local Beliefs and
Foot Care Behavior 44



LIST OF FIGURES

Figure 1-1. Research Framework 5
Figure 4-1. Histogram and Q-Q Plot of Foot Care Behavior Distribution 26
Figure 4-2. Normal Probability Plots of Regression Standardized Residual 41

 
LIST OF APPENDICES

Appendix 1: Demographic and Clinical Factors Questionnaire 73
Appendix 2: Foot Care Knowledge Questionnaire 75
Appendix 3: The Brief Illness Perception Questionnaire 76
Appendix 4: Diabetes Foot Self-Care Behavior Scale 78
Appendix 5: Consent to Participate in Research 79
Appendix 6: Inform Consent Form 80
Appendix 7: Instruction of the BIPQ 81
Appendix 8: Instruction of the DFSCBS 82
Appendix 9: Permission Letter from the Author of Foot Care Knowledge Questionnaire 83
Appendix 10: Permission Letter from the Author of the Brief Illness Perception Questionnaire 84
Appendix 11: Permission Letter from the Author of the Diabetes Foot Self-Care
Behavior Scale 85
Appendix 12: Demographic and Clinical Factors Questionnaire - Indonesian Version 86
Appendix 13: Foot Care Knowledge Questionnaire - Indonesian Version 88
Appendix 14: The Brief Illness Perception Questionnaire - Indonesian Version 89
Appendix 15: Diabetes Foot Self-Care Behavior Scale - Indonesian Version 91
Appendix 16: Research Permission Approval Document 92

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