View of Self-Efficacy Weight Management and Family Support on Risk Factors of Prediabetes Patient

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Journal of Nursing Science Update

Vol. 11, No. 2, November 2023 e-ISSN: 2829-0003 DOI : http://dx.doi.org/10.21776/ub.jik.2023.011.02.07 p-ISSN: 2829-7075 Website : http://www.jik.ub.ac.id

@JNSU. This is an open access article under the CC BY-NC 4.0 license

161 Original Research

Self-Efficacy Weight Management and Family Support on Risk Factors of Prediabetes Patient

Krisna Rina Martines¹, Dewi Prabawati²*, Sudibyo Supardi³

1,2Sekolah Tinggi Ilmu Kesehatan Sint Carolus Jakarta, Keperawatan

3Universitas Indonesia

*Corresponding author:

Dewi Prabawati STIKES Sint Carolus

Jl. Salemba Raya No. 41 RT 03/RW 05, Paseban, Senin, Kota Jakarta Pusat, Telp: 021-3924094 Email: [email protected]

How to cite this article: Martines, K. R., Prabawati, D., & Supardi, S. (2023). Self-Efficacy Weight Management and Family Support on Risk Factors of Prediabetes Patient . Journal of Nursing Science Update, 11(2), 161–168.

Article Info ABSTRACT

Article History:

Received 25 Januari 2023 Revised 18 Oktober 2023 Accepted 28 November 2023

The shift in the pattern of non-communicable diseases to a younger age makes prediabetes undetected and tends to be ignored.

Monitoring weight is an essential behavior for individuals to reduce the risk of obesity as a predictor of prediabetes. In addition, family support plays a crucial role in maintaining each individual's health in deciding his lifestyle. This study aimed to determine the relationship between self-efficacy weight management (SEWM) and family support on risk factors for prediabetes at the Community Health Center, Batam. The research design is a descriptive correlation with the cross-sectional approach. Fifty respondents were chosen using a purposive sampling technique based on the inclusion and exclusion criteria. Instrument of INA-PRISC questionnaire, Weight Efficacy Lifestyle Short Form Questionnaire, and Perceived Social Support from Family (PSS- Fa) utilized in this study. Based on univariate results, the majority of respondents aged 26-35 years (30%), female (68%), higher education background (78%), obesity (>25) (80%), had a family history of DM (60%), not smoking (70%), physical activity <150 minutes/week (94%), hypertension >160/100 mmHg (44%), moderate risk of prediabetes (48%), low SEWM (70%), and good family support (38%). A bivariate statistical test using Kendall's Tau B revealed there was a significant relationship between SEWM (<

0.05) and family support for risk factors for prediabetes (< 0.05). It is suggested that respondents increase self-awareness in the early detection of prediabetes risk and the family's active role in assisting family members in starting an active and healthy lifestyle.

Keywords:

Family Support Prediabetes Self Efficacy

Weight Management

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Self-Efficacy Weight Management …

162 Introduction

The shift from infectious to non- communicable diseases is the primary cause of health issues that affect society nowadays.

Changes in lifestyle, especially diet and decreased physical activity, make cases of Diabetes Mellitus (DM) growing rapidly.

The prevalence of Global Diabetes Mellitus Cases, according to the International Diabetes Federation (IDF, 2019), estimates that around 463 million people in the age range of 20-79 years or around 9.3% of the total population. With 10.7 million total diabetes mellitus patients, Indonesia is the only Southeast Asian nation on the list, holding the seventh- highest position (Ministry of Health of the Republic of Indonesia, 2020).

The high number of DM sufferers in Indonesia requires appropriate interventions to reduce the prevalence. However, not many know that the condition of diabetes Mellitus is always preceded by Prediabetes (Dany et al., 2017). The prevalence of prediabetes cases globally in 2014 was 314 million people with prediabetes, and this figure will continue to grow to 418 million in 2025 (Kusumaningrum et al., 2020). In Indonesia, cases of prediabetes, especially in the adult population, significantly increased from 10.2% in 2007 to 36.6% in 2013 (Fujiati et al., 2017).

The shift in the pattern of non- communicable diseases to a younger age makes prediabetes sometimes go undetected and tend to be ignored. Efforts that can be made in controlling prediabetes are that the community understand the risk factors for prediabetes itself. The US Diabetes Prevention Program (DPP) found that lifestyle change interventions that start with increasing physical activity and targeting weight loss can reduce the risk of developing DM by 58%

(Cioffi et al., 2018).

Self-Efficacy Weight Management refers to an individual's belief in his ability to achieve what he wants, especially in controlling and managing his weight. Self- Efficacy Weight Management is essential in controlling obesity because it focuses on controlling overeating behavior in individuals (Bandura, 1997 in Schulz & Mcdonald, 2011).

Another factor that supports the success of Weight Management is Family Social Support. Family support significantly influences individuals in terms of physical and

mental health, where it will be easier for individuals to accept and change their behavior in a healthier direction. With the family support provided, a person is expected to be able to control the risk factors for prediabetes (Retnowati & Satyabakti, 2015).

In 2022, in May, DM cases at the Sei Pancur Health Center reached 148 people and were ranked No. 2 most after hypertension. In 2019, the achievement of the prevalence indicator for obesity cases in the age group >

18 years was 28.1%; this figure is the reported obesity proportion (Riau Islands Health Office, 2019). The high number of DM cases that occur makes the Riau Islands Provincial Health Office try to reduce the number of PTM through early detection of risk factors, especially in the productive age group.

However, the current obstacle is the need for more community participation for early detection and low logistical support, especially blood glucose strip tests, compared to the target population who took part in screening (Dinas Kesehatan Kepulauan Riau, 2019).

Most individuals already know how to prevent prediabetes, but only a few individuals can implement these actions because it is influenced by several factors, such as lack of self-efficacy and low family support in recognizing and controlling risk factors for prediabetes. Low individual confidence (self-efficacy) and family support in maintaining their health make it difficult to control and detect this disease early, so the role through PTM Posbindu activities is expected to increase self-awareness attitudes so that prediabetes can be prevented as early as possible. This study aimed to analyze the relationship between Self-Efficacy, Weight Management, and Family Support on Risk Factors for Prediabetes Patients at the Sei Pancur Health Center Batam.

Method

The study design is correlational research with a cross-sectional approach. The sampling technique used non-probability and purposive sampling (Masturoh & T Anggita, 2018). Respondents involved in this study had one of the following inclusion criteria:

overweight, smoker, family history of diabetes mellitus, hypertension. The total sample of this research is 50 respondents.

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163 The research location is at the Sei Pancur Health Center in Batam City in the general poly and PTM Posbindu. The procedure for collecting data in this study was filling out a questionnaire related to age, gender, education level, family history of diabetes mellitus, activity level, and smoking habits. Next, take weight and height measurements to determine Body Mass Index (BMI) and blood pressure measurements.

This research was carried out directly, and health protocols and facilitated chairs that were given a distance between respondents, measured temperature with a gun/standing thermometer; each respondent was required to wear a mask, and both researchers and respondents had to wash their hands before and after the interview, was in the environment open with ventilation with free

air. The respondent is also required to have been vaccinated at least 1x.

The instruments used were the Indonesia Prediabetes Risk Score (INA-PRISC) Questionnaire, Weight Efficacy Lifestyle Questionnaire Short Form Questionnaire (WEL), and Perceived Social Support-Family (PPS-FA) Questionnaire.

The statistical test in this study is Kendal's Tau B correlation test, which tests the closeness of a relationship between X and Y variables. The data is ordinal and does not have to be normally distributed. Conclusion If p-value < 0.05, there is a relationship between the two variables; if p > 0.05, there is no relationship.

This research was approved to pass the ethical test with letter number 098/KEPPKSTIKSC/XII/2021 on December 14, 2021.

Results and Discussion

Table 1. Distribution of Components in the INAPRISCH questionnaire in the Work Area of the Sei Pancur Health Center Batam City in 2022

Components in the INAPRISCH questionnaire n %

Age (years)

26-35 15 30.0

36-45 12 24.0

46-55 14 28.0

<55 9 18.0

Gender

Female 34 68.0

Male 16 32.0

Education level

Uneducated 4 8.0

Low education 7 14.0

High education 39 78.0

Diabetes history in first-degree

Yes 30 60.0

No / unknown 20 40.0

Smoking habit

Yes 15 30.0

No 35 70.0

Physical activity

No or <150 min/week 47 94.0

Yes or >150 min/week 3 6.0

BMI >25 (obese) 27 54.0

23-24.9 (overweight) 18 36.0

18.5-22.9 (normal) 5 10.0

Hypertension

SBP ≥160 mmHg or DBP ≥100 mmHg 22 44.0

SBP 140-159 mmHg or DBP 90-99 mmHg 13 26.0

SBP 120-139 mmHg or DBP 80-89 mmHg 15 30.0

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Table 2. Distribution of Prediabetes Levels (INAPRISCH) of Respondents in the Work Area of the Batam Sei Pancur HealthCenter in 2022

INAPRISCH n %

Low risk 18 36.0

Medium risk 24 48.0

High risk 8 16.0

Table 3. Frequency Distribution Weight Efficacy Lifestyle in the Work Area of the Sei Pancur Health Center Batam City in 2022

Table 4. Frequency Distribution of Respondents' Family Support in the Work Area of Sei Pancur Health Center Batam in 2022

Family Support n %

Poor (20-33) 15 30.0

Fair (34-37) 16 32.0

Good (48-60) 19 38.0

Table 5. The Relationship of Weight Efficacy Lifestyle to Risk Factors of Prediabetes in the Work Area of the Sei Pancur Health Center Batam City in 2022

Weight Efficacy

Lifestyle Prediabetes

Low Risk Medium Risk High Risk P-values

n % n % n %

.000

High WEL ≥40 15 100 0 0.0 0 0.0

Low WEL ≤40 3 8.4 24 68.6 8 22.8

Table 6. Relationship Of Family Support To Risk Factors For Prediabetes In The Work Area of the Sei Pancur Health Center Batam City in 2022

Based on table 1, the most significant percentage of respondents aged 26-35 years (30%) and 46-55 years (28%), Female gender (68%), Higher Education (78%), had a history

of DM in the family

(Grandfather/Grandmother/Father/Mother) (60%), not smoking (70%), physical activity

<150 minutes/week (94%), obesity >25 (80%), and hypertension (44%). Based on INAPRISCH in measuring the risk of prediabetes, the majority of respondents were in the moderate risk category 48%, followed by very high risk (16%). Based on Table 2 INAPRISCH in measuring the risk of

prediabetes, the average respondent is in the moderate risk category as many as 24 respondents 48% followed by very high risk as many as eight respondents (16%). Table 3 shows the study's results on the distribution of Self-Efficacy Weight Management Lifestyle (WEL- SF) showed that the majority of respondents at the Sei Pancur Health Center had a low WEL as many as 35 respondents (70%).

Table 4 reveals that family support at the Sei Pancur Health Center Batam City, on average, had respondents with Good support 19 respondents (38%). Table 5 shows that

WEL n %

Low WEL ≤ 40 35 70.0

High WEL ≥ 40 15 30.0

Family Support Prediabetes

Low Risk Medium Risk High Risk P-values

n % n % n % .000

Good (48-60) 13 68.4 6 31.6 0 0

Fair (34-37) 3 18.8 12 75 1 6.2

Poor (20-33) 2 13.3 6 40 7 46.7

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165 respondents with a high Weight Efficacy Lifestyle Management had a low risk of prediabetes (100%). Meanwhile, respondents who have Weight Efficacy Management have a moderate risk (68.6%) of prediabetes. Based on the results of statistical tests using Kendall's Tau B, it was found that there were significant results between self-efficacy weight management and prediabetes risk factors with p-value .000 < 0.05, meaning Ha was accepted.

As seen in Table 6, the results of the study found that respondents with good family support had a low risk of prediabetes (68.4%).

Respondents who have sufficient family support have a moderate risk of the incidence of prediabetes (75%). Furthermore, respondents who have less family support have a very high risk of prediabetes (46.7%). Based on the statistical test results of Kendall's Tau B, there were significant results between family support and risk factors for prediabetes .000 <

0.05, meaning that Ha was accepted.

Factors of age, BMI, family history, physical activity and hypertension mainly caused prediabetes in this study. This aligns with research (Gujral et al., 2020) that shows that prediabetes into DM is most rapidly influenced by central obesity, family history, and low physical activity. Prediabetes conditions can increase the risk of DM within 5-10 years if not treated (Alim Nur, 2017). The risk of Impaired Glucose Tolerance (IGT) or Impaired Glucose Tolerance to develop into DM is more significant than Impaired Fasting Glucose (IFG). Complications of DM cause macrovascular and microvascular disorders (Hurst, 2016).

The results of the Indonesian Prediabetes Risk Score (INA-PRISC) Questionnaire showed that the respondents had moderate risk. This can be linked to other Prediabetes questionnaires such as FINDRISC.

Based on the FINDRISC questionnaire, it was found that the progression of moderate risk of prediabetes will develop into DM, 1 in 6 will develop into DM, or about 2.2% will develop into T2DM (Vandersmissen & Godderis, 2015).

Low Weight Management refers to the individual's low confidence in maintaining weight. This shows that the lower the Weight Management, the higher the risk of having prediabetes. Some respondents also said they were so busy with their work that they did not have time to diet. The type of individual work

that sits in front of a computer screen for 6-8 hours every day has an irregular eating and sleeping schedule, triggers a hormonal imbalance that regulates the balance of eating and energy expenditure so that this triggers an increase in risk factors for prediabetes (Arania et al., 2021). This is in line with research conducted by (Dwi & Ambarita, 2022), that many respondents have a sedentary activity sedentary lifestyle and the incidence of prediabetes p-value 0.027.

Based on the theory of eating behaviour according to (Van Strein et al., 1986), there are two aspects of eating behaviour, one of which is Emotional eating; eating is a temporary response that expresses anger such as fear, depression, anxiety, and so on by ignoring hunger signals from the body. Individuals will tend to consume foods with high calories or other saturated fats. This is also related to the function of the effective self-efficacy process when individual feelings and emotions affect the self-efficacy process. Individuals who can manage stress and control emotions tend to have high self-efficacy, so they are able not to overeat when experiencing depression (Lenz &

Shortridge-Baggett, (2002). Research conducted (Sirait et al., 2015) found that the variable central obesity (RR = 3,98; Cl 95%:

1,86-8,55) was the most critical factor in the incidence of prediabetes (18.4%). This is due to the lack of knowledge in managing a balanced diet, family or environmental support and low self-efficacy in the individual (Yanuar et al., 2020). A similar study by Ratih & Prabawati (2022) found that there was a relationship between self-awareness of eating patterns and the incidence of prediabetes (p <0.05).

Family support influences diet's regularity and adequacy (Wijayanti, 2015).

What is consumed by the family is not much different from that of other family members;

families who often get used to family members snacking randomly, have low awareness of health, unbalanced nutrition supply, and low physical activity, it will be very risky for prediabetes (Cioffi et al., 2018). The results of this study are in line with research (Salan et al., 2017) that there is a relationship between family support and nutritional status (Body Mass Index) p-value 0.000 < 0.01. A similar study by (Sastrika et al., 2018) showed that family support affected decreasing blood sugar levels in the elderly with a p-value of 0.005. Full

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166 support from the family will help individuals overcome and improve the health status of each family member. This theory (Friedman, 1998 in Simbolon, 2017) suggests one type of family support: informational support. Support from the family is handy in the formation of healthy living behaviour so that it can avoid prediabetes conditions through appropriate weight management (Sari & Suryaputri, 2019;

Wijayanti, 2015; Yanto & Setyawati, 2017).

Another critical factor in controlling prediabetes is maintaining a lifestyle such as regular exercise for 30 minutes, eating a balanced diet and managing stress. Research by Ratih & Prabawati (2022) on self-awareness of eating patterns found that individuals with high self-awareness tend to have a low risk of prediabetes because they can manage and choose food to eat. It has been found that low awareness of diabetes mellitus (DM) can negatively impact the outcome of the disease. A study conducted in Slovakia by Magurová compared two groups of patients, one that received diabetes education and one that did not. The results showed that patients who received diabetes education had a significantly higher awareness of the disease (p < 0.001) (Sami, 2017). The study shows that knowing diabetes can dramatically improve the quality of life for patients and reduce the burden on their families (Kakuma et al., 2020).

Another study conducted in India by Dussa assessed the level of diabetes awareness among patients and the general population.

The study found that the level of diabetes awareness was low. Similarly, a study conducted by Shah in India reported that 63%

of T2DM patients were unaware of what DM is, and the majority were unaware of its complications.

Another Research from (Dwi &

Ambarita, 2022) found that a sedentary lifestyle will increase the risk of prediabetes.

Physical activity helps regulate blood sugar levels, because the glucose stored in the muscles will be converted into energy when doing activities that trigger muscle contractions. Low physical activity will trigger disruption of insulin release and increase the occurrence of hyperglycemia.

Conclusion

Based on INAPRISCH in measuring the risk of prediabetes, most respondents were in

the moderate risk category. This study found a significant relationship between weight management self-efficacy and family support to the risk of prediabetes in the work area of the Batam Sei Pancur Health Center.

Respondents can increase self-awareness in the early detection of prediabetes risk and the family's active role in assisting family members in starting an active and healthy lifestyle.

Limitation of the Study

The study was conducted only in one area of community health care; therefore, the result of the study cannot be generalized to a broad population. Aside from that, research assistance is also needed to collect the data because of community limitations, especially elderly/old age, in understanding and filling out the questionnaire; thus, it will shorten the research duration in data collection.

Acknowledgement

Researchers would like to express gratitude to Puskesmas Sei Pancur Batam for all the facilities and support that have been given throughout the data collection.

Conflict of Interest

All authors declare that they have no conflict of interest.

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