Talk Show Good Life Healthy Solutions: The Role of the Family in Chronic Disease Management

The Role of the Family in Chronic Disease Management

Together: dr. Yayuk Fathonah, MSc.

Efforts to achieve health development priorities in the Healthy Indonesia Program are carried out by utilizing all existing potential, both from the central, provincial, district/city governments, and the community. Health development starts from the smallest unit of society, namely the family.

The family is the focus in the approach to implementing the Healthy Indonesia program because according to Friedman (1998), there are five functions of the family, namely:

  1. Affective function (The Affective Function) is the main function of the family to teach everything to prepare family members to relate to other people. This function is needed for the individual and psychosocial development of family members.
  2. The function of socialization is the process of development and change that individuals go through which results in social interaction and learning to play a role in their social environment. Socialization begins at birth. This function is useful for fostering socialization in children, forming behavioral norms according to the child's developmental level and and continuing family cultural values.
  3. The reproductive function is a function to maintain generations and maintain family continuity.
  4. Economic function (The Economic Function), namely the function of the family to meet the needs of the family economically and a place to develop individual abilities to increase income to meet family needs.
  5. The function of health care or maintenance (The Health Care Function) is to maintain the health condition of family members in order to maintain high productivity. This function was developed into a family task in the health sector. While the duties of the family in health care are:
  6. Recognize health development disorders of each family member,
  7. Make decisions for appropriate health actions,
  8. Providing care to sick family members
  9. Maintaining a home atmosphere favorable to the health and personality development of family members,
  10. Maintaining mutual relations between families and health facilities

One of the non-communicable diseases that is quite important in the Family Approach is hypertension (high blood pressure). The prevalence of hypertension in adults according to Riskesdas in 2013 was 25,8% and in 2018 it reached 34,1%. Of that number, only 36,8% had contact with health workers, while the remaining 2/3 did not know that they had hypertension. This shows that if the family approach is not used, 2/3 of the hypertension sufferers will not be treated. This shows that a family approach is absolutely necessary if we want to control hypertension successfully.

Based on Riskesdas data for 2018, of all hypertension sufferers in Indonesia who regularly take medication:

  1. Routine :54,4%
  2. Not routine: 32,27%
  3. Do not take medication: 13,33%

Reasons for not taking medication as directed:

  1. Often forget
  2. Medication not available
  3. Take traditional medicine
  4. Can't stand the side effects of the drug
  5. Can't afford regular medicine
  6. Not routinely taking medication (31.3%)
  7. Feeling healthy (most = 59,8%)

The proportion of people who routinely measure blood pressure in Indonesia:

  1. Routine : 12%
  2. Sometimes : 47%
  3. No : 41%

The second disease that is also important to note is diabetes mellitus. The prevalence of DM in Indonesia based on Riskesdas in 2013 was 6,9% and in 2018 it was 8,5%. Compliance with drinking or routine drug injections was 90,56%.

Reasons for not taking medication as directed:

  1. Often forget
  2. Medicines are not available at the health facility
  3. Taking traditional medicine (25,29%)
  4. Can't stand the side effects of the drug
  5. Can't afford regular medicine
  6. Not routinely taking medication (30,24%)
  7. Feeling healthy (most = 50,40%)

DM control type:

  1. Meal arrangement : 80,2%
  2. Exercise : 48,1%
  3. Herbal medicine : 35,7%

The proportion of routine blood sugar checks in the Indonesian population:

  1. Routine : 1,8 %
  2. Sometimes : 12,8 %
  3. Never : 85,5 %

 

Diabetes mellitus and hypertension are the biggest public health problems and a challenge in the health system. Diabetes mellitus and hypertension reduce the quality of life and increase the mortality rate due to the various complications they cause. The chronic diseases above require long-term care so that it has an impact on the emergence of large treatment costs. This burden becomes a consideration for policy makers to create a sustainable care system.

 

Self-management is the most important element in the management of chronic disease to maintain good control of blood pressure and blood sugar levels. Patients must be empowered to do so self-management so that the disease is always under control, preventing complications and having an optimal quality of life. There are four factors that influence the success of self-management, namely the character of the patient, the patient's family, doctors and health systems, and the patient community. Characteristics of the patient's family is the main social context of chronic disease management that has not been explored much. Interventions involving family members are used to design chronic disease treatment strategies, because the family has a very important role in the effort self-management chronic disease patients in primary care units.