NURSE AND PATIENT PERCEPTION IN SELF-MONITORING OF DAWN EFFECT TO ENHANCE SELF-MANAGEMENT IN DIABETES MELLITUS PATIENT’S: A QUALITATIVE CASE STUDY

Ratna Kurniawati; Suhartini Ismail

doi:10.55681/armada.v1i4.462

Authors

Ratna Kurniawati Akademi Keperawatan Alkautsar
Suhartini Ismail Universitas Diponegoro

DOI:

https://doi.org/10.55681/armada.v1i4.462

Keywords:

Dawn Effect, Diabetes Mellitus, Self-Management, Self-Monitoring

Abstract

Background: A phenomenon in diabetes mellitus patients is called dawn effect, the condition of hyperglycemia suddenly increasing insulin requirement in the morning caused by nonattendance of nighttime hypoglycemia. Self-monitoring can be minimizing the impacts of dawn effect. Self-management can be actualized to oversee the blood glucose levels fluctuation in diabetes mellitus patients. Objective: to gain self-monitoring influencing factors of dawn effect phenomenon, and increase self-management in diabetic patient and nurse knowledge in Temanggung, Central Java Methods: A qualitative study design was used in this research with semi-structured interviews and open-ended questions. Participants were selected using purposive sampling technique from primary healthcare and secondary healthcare of both nurse and patient. Twelve participants consisted of senior nurse (n=5), patients with type 2 diabetes mellitus (n=7). Information of psychometric diabetes self-management scale and blood glucose monitoring were day by day collected within the morning. Result: Nurses' perception of the dawn effect is still relatively low due to a lack of knowledge and competence in self-management of diabetes patients. They followed the doctor's advice. In addition, the patient's perspective of blood glucose monitoring was taken into account, despite the fact that they did not have a glucometer from a mobile device (lack of self-management and dawn effect). Furthermore, all participants (n=7) increase in blood glucose level in the morning. Invasive glucometer has a high accuracy, but inducing finger discomfort, uncomfortable, and increase risk of infection when it checked daily. Conclusion: Perceptions of nurse and patient about self-monitoring can improve patient self-management and prevent the occurrence of dawn effects.

Downloads

Download data is not yet available.

References

M. S. Al-Keilani, B. A. Almomani, N. A. Al-Sawalha, and B. A. Shhabat, “Self-monitoring of blood glucose among patients with diabetes in Jordan: Perception, adherence, and influential factors,” Diabetes Res. Clin. Pract, vol. 126, pp. 79–85, Apr. 2017.

M. I. Yacoub, W. M. Demeh, M. W. Darawad, J. L. Barr, A. M. Saleh, and M. Y. Saleh, “An assessment of diabetes-related knowledge among registered nurses working in hospitals in Jordan,” Int. Nurs. Rev., vol. 61, no. 2, pp. 255–262, 2014.

M. I. Schmidt, A. Hadji-Georgopoulos, M. Rendell, S. Margolis, and A. Kowarski, “The dawn phenomenon, an early morning glucose rise: Implications for diabetic intraday blood glucose variation,” Diabetes Care, vol. 4, no. 6, pp. 579–585, 1981.

L. Monnier, C. Colette, S. Dejager, and D. Owens, “Magnitude of the dawn phenomenon and its impact on the overall glucose exposure in type 2 diabetes: Is this of concern?,” Diabetes Care, vol. 36, no. 12, pp. 4057–4062, 2013.

M. Brijesh, “Diabetes & Metabolism Somogyi Effect in a Patient of Type 2 Diabetes Mellitus,” vol. 6, no. 2, 2015.

L. Monnier, C. Colette, S. Dejager, and D. Owens, “The dawn phenomenon in type 2 diabetes : How to assess it in clinical practice ?,” Diabetes Metab., vol. 41, no. 2, pp. 132–137, 2015.

M. Rybicka, R. Krysiak, and B. Okopień, “The dawn phenomenon and the Somogyi effect - Two phenomena of morning hyperglycaemia,” Endokrynol. Pol., vol. 62, no. 3, pp. 276–283, 2011.

H. Yuxin, W. Haidong, L. Yuan, T. Xiaoming, and S. Jiao, “Poor Sleep Quality is Associated with Dawn Phenomenon and Impaired Circadian Clock Gene Expression in Subjects with Type 2 Diabetes Mellitus,” vol. 2017, pp. 1–20, 2017.

P. Holt, “Blood glucose monitoring in diabetes,” Diabetes Technol. Ther., vol. 17, no. 27, p. S3, 2015.

B. Riegel, T. Jaarsma, and A. Strömberg, “A Middle-Range Theory of Self-Care of Chronic Illness,” no. 35, pp. 194–204, 2012.

D. Guo, D. Zhang, L. Zhang, and G. Lu, “Sensors and Actuators B : Chemical Non-invasive blood glucose monitoring for diabetics by means of breath signal analysis,” Sensors Actuators B. Chem., vol. 173, pp. 106–113, 2012.

J. Yadav, A. Rani, V. Singh, and B. Mohan Murari, “Investigations on Multisensor-Based Noninvasive Blood Glucose Measurement System,” J. Med. Device., vol. 11, no. 3, p. 31006, 2017.

J. Yadav, A. Rani, V. Singh, and B. M. Murari, “Prospects and limitations of non-invasive blood glucose monitoring using near-infrared spectroscopy,” Biomed. Signal Process. Control, vol. 18, pp. 214–227, 2015.

M. Mitchell, W. Chaboyer, E. Burmeister, and M. Foster, “Positive Effects of a Nursing Intervention on Family-centered Care in Adult Critical Care,” Am. J. Crit. Care, vol. 18, no. 6, pp. 543–552, 2009.

J. J. Chamberlain, A. S. Rhinehart, C. F. Shaefer, and A. Neuman, “Diagnosis and management of diabetes: Synopsis of the 2016 American diabetes association standards of medical care in diabetes,” Ann. Intern. Med., vol. 164, no. 8, pp. 542–552, 2016.

S. Suh and J. H. Kim, “Glycemic variability: How do we measure it and why is it important?,” Diabetes Metab. J., vol. 39, no. 4, pp. 273–282, 2015.

A. Tura, J. Farngren, A. Schweizer, J. E. Foley, G. Pacini, and B. Ahren, “Four-Point Preprandial Self-Monitoring of Blood Glucose for the Assessment of Glycemic Control and Variability in Patients with Type 2 Diabetes Treated with Insulin and Vildagliptin,” Int. J. Endocrinol. Print, vol. 2015, p. 484231, 2015.

M. S. D’Souza, S. N. Karkada, K. Parahoo, R. Venkatesaperumal, S. Achora, and A. R. R. Cayaban, “Self-efficacy and self-care behaviours among adults with type 2 diabetes,” Appl. Nurs. Res., vol. 36, pp. 25–32, 2017.

B. Gharaibeh, A. M. Al-Smadi, and D. Boyle, “Psychometric properties and characteristics of the Diabetes Self Management Scale,” Int. J. Nurs. Sci., vol. 4, no. 3, pp. 252–259, 2017.

S. I. Factor et al., “SOMOGYI EFFECT IN TYPE 2 DIABETES MELLITUS : A CASE REPORT,” vol. 2, no. 2, pp. 32–33, 2016.

R. Abolghasemi and M. Sedaghat, “The Patient’s Attitude Toward Type 2 Diabetes Mellitus, a Qualitative Study,” J. Relig. Health, vol. 54, no. 4, pp. 1191–1205, 2015.

NICE National Institute for Health and Care Excellence, “Managing blood glucose in adults with type 2 diabetes,” pp. 1–24, 2016.

N. Akmal, B. Abd, W. Hidayat, Z. B. Manap, and F. Salehuddin, “The Evolution of Non-invasive Blood Glucose Monitoring System for Personal Application,” J. Telecommun. Electron. Comput. Eng., vol. 8, no. 1, pp. 59–65, 2016.

B. M. Scirica, “Use of Biomarkers in Predicting the Onset, Monitoring the Progression, and Risk Stratification for Patients with Type 2 Diabetes Mellitus,” Clin. Chem., vol. 63, no. 1, pp. 186–195, 2017.

M. Goodarzi, S. Sharma, H. Ramon, and W. Saeys, “Trends in Analytical Chemistry Multivariate calibration of NIR spectroscopic sensors for continuous glucose monitoring,” Trends Anal. Chem., vol. 67, pp. 147–158, 2015.

R. Pandey, N. Chari, and N. Spegazzini, “Trends in Analytical Chemistry Emerging trends in optical sensing of glycemic markers for diabetes monitoring,” Trends Anal. Chem., vol. 64, pp. 100–108, 2015.

M. S. Wróbel, “Non-invasive blood glucose monitoring with Raman spectroscopy: Prospects for device miniaturization,” IOP Conf. Ser. Mater. Sci. Eng., vol. 104, no. 1, 2016.

A. D. Association, “Standards of Medical care in diabetes - 2017,” J. Clin. Appl. Res. Educ., vol. 40, no. January, pp. 1–142, 2017.

G. Bano, S. A. Ali, M. Mawani, and S. A. Ali, “Burden of Diabetes Mellitus and Role of Telemedicine in its Management : Narrative Review,” Ann. Clin. Lab. Res., vol. 4, no. 3(113), pp. 1–8, 2016.

S. Sapkota, J. A. E. Brien, and P. Aslani, “Blood glucose monitoring in type 2 diabetes - Nepalese patients’ opinions and experiences,” Glob. Health Action, vol. 10, no. 1, 2017.