362 Jurnal Ners dan Kebidanan, Volume 7, Nomor 3, Desember 2020, hlm. 362–367

Factor Associated with Diabetes Burnout Syndrome Among
Type 2 Diabetes Mellitus

Nian Afrian Nuari
Prodi S1 Keperawatan STIKES Karya Husada Kediri, Indonesia

JURNAL NERS DAN KEBIDANAN
(JOURNAL OF NERS AND MIDWIFERY)
http://jnk.phb.ac.id/index.php/jnk

JNK

History Article:
Received, 12/08/2020
Accepted,11/11/2020
Published, 05/12/2020

Keywords:
Diabetes, burnout, syndrome

Article Information Abstract

Diabetes mellitus is a metabolic disease that is often found in Indonesia and
the number of sufferers is increasing every time. Management of therapy
patients with type 2 diabetes mellitus consists of five steps that require
compliance and discipline to maintain stable blood sugar levels. This condi-
tion causes burnout by diabetes mellitus patients. The purpose of this study
was to identify factors associated with diabetes mellitus among type 2 Dia-
betes mellitus. This study used a correlational design with a cross-sectional
approach with a sample size of 89 respondents who were taken by purposive
sampling.Based on the results of the study it was found that most Diabetes
mellitus patients were 56-60 years old, female, and the education background
was junior high school level. The level of income of majority of the respon-
dents was under 1 million rupiahs and suffered from Diabetes mellitus for 1-
10 years. The result found almost the entire entire patient consumed diabe-
tes drugs. Most of the respondents had a severe category in diabetes burn-
out syndrome. The research found that there was a correlation between age,
gender educational background, level of income, duration suffering DM,
consumption of diabetes drugs with diabetes burnout syndrome among
type 2 Diabetes Mellitus. Health workers must provide education about the
importance of preventing the incidence of burnout syndrome and taking
therapeutic management for patients who already had diabetes burnout syn-
drome.

Correspondence Address:
STIKes Karya Husada Kediri–East Java, Indonesia P-ISSN : 2355-052X
Email: nian.afrian@gmail.com E-ISSN : 2548-3811
DOI: 10.26699/jnk.v7i3.ART.p362–367
This is an Open Access article under the CC BY-SA license (http://creativecommons.org/licenses/by-sa/4.0/)

362

https://crossmark.crossref.org/dialog/?doi=10.26699/jnk.v7i3.ART.p362-367&domain=pdf&date_stamp=2020-12-05
https://doi.org/10.26699/jnk.v7i3.ART.p362-367

363Nuari, Factor Associated with Diabetes Burnout Syndrome Among ...

INTRODUCTION
Diabetes mellitus (DM) is a disease commonly

known as diabetes; this disease can be experienced
by various ages ranging from young to old disease.
Dia betes Mellitus is a meta bolic disea se
cha r a cter ized by high blood suga r levels
(hyper glycemia) caused by impa ir ed insulin
secretion, insulin resistance, or both. Diabetes
Mellitus is also called the Silent Killer because it
does not cause symptoms (asymptomatic) causing
vascular damage before the disease is detected
(Gibney et al., 2009). Insulin resistance and damage
to pancreatic beta cells is a common condition
pathogenesis of diabetes. Patients with prediabetes
are 4-9% changed become diabetic every year
(Bock et al, 2012) The prevalence of diabetes
continues to increase rapidly worldwide and an
estimated > 470 million people will have prediabetes
by 2030 (Tabák et al, 2012).

The World Health Organization (WHO, 2013)
as a world health agency stated that from the results
of a survey, Indonesia currently has 8.4 million
people with DM, and this number is expected to
continue to increase to 21.3 million in 2030. Basic
Health Research (RisKesDas) 2013 shows that in
2013 there were 2.4% of DM cases in Indonesia.
Based on a preliminary study conducted in the
working area of the Puskemas Pare, Kediri district,
data were obtained from 295 people with Diabetes
Mellitus Type II. From the results of preliminary
studies, 7 out of 10 respondents showed symptoms
of diabetes burnout syndrome.

Patients with Diabetes Mellitus have to do a
series of procedures that require high compliance
and discipline regarding medical management.
Adherence in carrying out medical procedures is
the key to maintaining stable blood sugar levels. In
the course of treatment, patients with Type 2
Diabetes Mellitus sometimes feel bored, anxious,
and experience boredom in carrying out the therapy.
Diabetes mellitus patients will experience saturation
during treatment. This is known as Diabetes burnout
syndrome. Patients complain of feeling depressed,
emotional feelings such as anger, anxiety, and
depression (Nuari, 2020). The impact of patients
with diabetes burnout syndrome can affect patients
in the management of diabetes mellitus diseases.

Diabetes patients who experience burnout can
experience stress which can affect their blood sugar
levels and lead to non-compliance with therapy
management (Nuari et al, 2018). This can affect

the stability of blood sugar levels. Based onthe
background, The purpose of this study was to
identify factors associated with diabetes mellitus
among type 2 Diabetes mellitus. among type 2
Diabetes Mellitus.

METHODS
The research design was correlational with a

cross-sectional approach. The research was located
in the working area of Puskesmas Pare, Kediri
District. The population in this study was all 295
patients with dia betes mellitus type 2. The
respondents were taken using purposive sampling
method, with a sample size of 89 respondents. The
instrument in this study was diabetes burnout
syndrome using a modified questionnaire from the
Shirom – Melamed Burnout Questionnaire. The data
analysis was performed on the results of the study
using univariate and bivariate tests. The univariate
test was used to determine the frequency distribution
of the results of the study, while the bivariate test
used the Spearman Rho test and Pearson Test with
a significance level of 0.05.

RESULTS
Based on theresults showed that the frequency

distribution of respondent based on gender, age, level
education, duration of suffering from diabetes
mellitus, level of income, consumption of diabetes
drugs and diabetes burnout syndrome among type
2 Diabetes Mellitus.

Variable f %

Age
46-50 years old 16 18
51-55 years old 15 16,9
56-60 years old 27 30,3
61-65 years old 17 19,1
66-70 years old 14 15,7

Gender
Male 47 52,8
Female 42 47,2

Education Level
Elementery 27 30,3
Yunior High School 34 38,3
Senior High School 19 21,3
Higher education 9 10,3

Table 1 Participant Characteristics (Sosio economic
and demographic)

364 Jurnal Ners dan Kebidanan, Volume 7, Nomor 3, Desember 2020, hlm. 362–367

Level of Income Every Month
Under 1 milion rupiahs 46 51,7
1-2 milion rupiahs 19 21,3
2-3 milion rupiahs 9 10,1
More than 4 milion rupiahs 15 16,9

DurationSuffering DM
0-5 years 40 44,9
6-10 years 40 44,9
11-15 years 9 10,1

Consumption Of Diabetes Drugs
Yes 71 79,8
No 18 20,2

Diabetes Burnout Syndrome
Severe 34 38
Moderate 32 36
Mild 23 25

N=89

Age
Diabetes Burnout Syndrome

Severe Moderate Mild

46-50 years old 9 5 2
51-55 years old 7 6 2
56-60 years old 12 10 5
61-65 years old 5 4 8
66-70 years old 1 7 6
Total 34 32 23

P value: 0,000

Table 2 Correlation between Age And Diabetes Burn-
out Syndrome Among Type 2 Diabetes Mellitus

Based on the results of the statistical test
analysis, it was found that there was a significant
correlation between the age of Diabetes Mellitus
patients and diabetes burnout syndrome among Type
2 Diabetes Mellitus

Table 3 Correlation between Gender And Diabetes
Burnout Syndrome Among Type 2 Diabetes
Mellitus

Age

Male 13 18 16
Female 21 14
Total 34 32 23

P value: 0,017

Based on the results of statistical test analysis,
it was found that there was a significant correlation
between the sex of Diabetes Mellitus patients and
diabetes burnout syndromeAmong Type 2 Diabetes
Mellitus.

Educational Diabetes Burnout Syndrome
Level Severe Moderate Mild

Elementery 13 11 3
Yunior High School 15 13 6
Senior High School 4 8 7
Higher education 2 0 7
Total 34 32 23

P value: 0,001

Table 4 Correlation between Education Level And Dia-
betes Burnout SyndromeAmong Type 2 Diabe-
tes Mellitus

Based on the results of statistical test analysis,
it was found that there was a significant correlation
between education level and diabetes burnout
syndrome among Type 2 Diabetes Mellitus.

Table 5 Correlation between Level of Income Every
Month And Diabetes Burnout SyndromeAmong
Type 2 Diabetes Mellitus

Income Diabetes Burnout Syndrome
Level Severe Moderate Mild

0-1 milion rupiahs 20 17 9
1-2 milion rupiahs 8 9 2
2-3 milion rupiahs 1 5 3
More than 4 milion
rupiahs 5 1 9
Total 34 32 23

P value: 0,044

Based on the results of statistical test analysis,
it was found that there was a significant correlation
between levels of income every month and diabetes
burnout syndrome among Type 2 Diabetes Mellitus.Diabetes Burnout Syndrome

Severe Moderate Mild

365Nuari, Factor Associated with Diabetes Burnout Syndrome Among ...

Based on the results of statistical test analysis,
it was found that there was a significant correlation
between consumption of diabetes drug and diabetes
burnout syndrome among Type 2 Diabetes Mellitus.

DISCUSSION
The Correlation of Age And Diabetes Burn-
out Syndrome Among Type 2 Diabetes Melli-
tus

Based on the results of the study it was found
that the majority of respondents who had burnout
syndrome aged 56-60 years. The results of data
analysis showed that there was a significant
correlation between the age of Diabetes Mellitus

patients and diabetes burnout syndrome among type
2 Diabetes Mellitus.

Patients with diabetes mellitus are mostly found
at an older age than younger patients (Kalyani et
al, 2013). This is in accordance with Noventi’s
research (2019) which states that ages 35 to more
than 65 years will have a risk of developing Diabetes
mellitus. The results of this study showed that
respondents who experience burnout are in the
severe category in 56-60 years, where at that age
the level of experience with the problem has matured
so that there is burnout which is also driven by other
factors such as economic factors, retirement from
work and other external factors can affect the
saturation of diabetes mellitus treatment.

The Correlation of Gender And Diabetes Burn-
out Syndrome Among Type 2 Diabetes Melli-
tus

Based on the results of the study found the
majority of respondents who had burnout in the
severe category was female. The analysis showed
that there was a correlation between gender and
diabetes burnout syndrome among type 2 Diabetes
Mellitus. Many research results showed that the
incidence of DM in women was more than men.
Several risk factors such as obesity, lack of
exercise, age and a history of diabetes during
pregnancy cause a high incidence of diabetes in
women (Nuar i, NA &Kar tika sar i, M, 2015).
According research by Gautam et al, (2009) on a
cross sectional study of the quality of life of type
DM patients 2 in India, most of the respondents are
female.

The Correlation of Education Level And Dia-
betes Burnout Syndrome Among Type 2 Dia-
betes Mellitus

Based on the result, the majority of respondents
who had severe burnout syndrome were had junior
high school education background level. According
to Azwar (2003) in Bangun (2009) argued that the
level of education then someone will behave more
positively. Knowledge is a very important behavioral
practice. If good patient knowledge is expected able
to form positive behavior for avoid burnout of the
diabetes mellitus treatment.

Table 6 Correlation between Duration Suffering Dia-
bete s M e l li tus And Diabe te s Bur nout
SyndromeAmong Type 2 Diabetes Mellitus

Log Suffering Diabetes Burnout Syndrome
DM Severe Moderate Mild

0-5 years 27 11 2
6-10 years 7 21 12
11-15 years 0 0 9
Total 34 32 23

P value: 0,000

Table 7 Correlation between Consumption Of Diabe-
tes Drugs And Diabetes Burnout Syndrome
Among Type 2 Diabetes Mellitus

Diabetes Drag Diabetes Burnout Syndrome
Consumption Severe Moderate Mild

Yes 16 32 23
No 18 0 0
Total 34 32 23

P value: 0,000

Based on the results of statistical test analysis,
it was found that there was a significant correlation
between the suffering duration of Diabetes Mellitus
and diabetes burnout syndrome among Type 2
Diabetes Mellitus.

366 Jurnal Ners dan Kebidanan, Volume 7, Nomor 3, Desember 2020, hlm. 362–367

The Correlation of Level of Income Every
Month And Diabetes Burnout Syndrome
Among Type 2 Diabetes Mellitus

Based on the result, the majority of respondents
who had severe burnout syndrome were in the level
of income under 1 million rupiahs every month.
Diabetes Mellitus patients always control blood
sugar continuously; it required an adequate source
of income so that the therapy could be fulfilled
(Nuari NA, 2018) Selection of activities and drugs
that diabetes patients should do Mellitus must be
adjusted to the source of his income. Diabetes
mellitus patients with a low income cause burnout
in the treatment of diabetes mellitus ( Nuari NA,
2017).

The correlation of Duration Suffering Diabe-
tes Mellitus And Diabetes Burnout Syndrome
Among Type 2 Diabetes Mellitus

Based on the results of the study found that
the majority of duration suffering diabetes mellitus
1-10 years. The results of data analysis showed
there was a significant correlation between duration
suffering Diabetes Mellitus patients and diabetes
burnout syndrome among type 2 Diabetes Mellitus.
The length of time suffering from diabetes affects
the level of adaptation Diabetes Mellitus patients
have in carrying out treatment for their disease
(Nuari, 2016).

Correlation between Consumption Of Diabe-
tes Drug And Diabetes Burnout Syndrome
Among Type 2 Diabetes Mellitus

Based on the results of the study found that
almost all of the respondentsconsumed Diabetes
drugs. The results of the data analysis showed there
was a significant correlation between consumption
of Diabetes drugs and diabetes burnout syndrome
among type 2 Diabetes Mellitus. Patients who
suffered from DM disease for a long time will tend
to experience burnout in taking medication. Burnout
in these patients can be caused by the necessity
and compliance of patients in taking medication and
diet therapy to control their blood sugar levels.

CONCLUSION
Based on the results of the study found that

most of the Diabetes mellitus patients were 56-60
years old, female, had junior high schooleducation
background level. The majority respondent hadthe

level of income under 1 million rupiahs. There were
many patients suffered from Diabetes mellitus for
1-10 years. The result found almost the patient
consumed diabetes drugs. Most of the respondent
had severe category in diabetes burnout syndrome.
The study findings found there was a correlation
between ages, gender educational background, level
of income, duration suffering DM, consumption of
diabetes drugs and diabetes burnout syndrome
among type 2 Diabetes Mellitus.

SUGGESTION
Patients with diabetes burnout syndrome need

support from family and health professionals. Health
wor ker s must pr ovide educa tion a bout the
importance of preventing the incidence of burnout
syndrome and taking therapeutic management for
pa tients who a lr ea dy have diabetes bur nout
syndrome. Families and nurses are expected to
support diabetes mellitus patients to reduce patient
burn out in managing and treating their diseases.

REFERENCES
Bock G, C, M, et al.(2012). Pathogenesis of pre-diabetes:

mechanisms of fasting and postprandialhypergly-
cemia in people with impaired fasting glucose and/
or impaired glucose tolerance. Diabetes Care
55:3536–3549. https://care.diabetesjournals.org/

Gautam,Y,.Sharma, A.K, & Agarwal. (2009). ‘A cross
sectional study of qol of diabetic patient at tertiary
care hospital in delhi’Indian journal of community
medicine, 34 (4), 346-350

Gibney J.M., Margaretts M.B ., Kearney M.J., & Arab L.
(2009). Gizi Kesehatan Masyarakat. Jakarta: Buku
Kedokteran EGC.

Kalyani RR, Egan JM.(2013). Diabetes and altered
glucose metabolism with aging. Endocrinol Metab
Clin North Am. 42(2):333–47.

Nuari, A.N. & Kartikasari, M .(2015). Peningkatan Self
Empowerment dan Kualitas Hidup Pasien Diabetes
Mellitus Tipe II Dengan Pendekatan DEE Berbasis
Health Promotion Model. Jurnal Ners, 10(2).

Nuari, NA.(2016). Pengembangan model peningkatan
pemberdayaan diri dan kualitas hidup pasien
diabetes mellitus tipe 2.Jurnal Lentera. Vol4.
No.2.http://jurnal.wima.ac.id/index.php/NERS/
article/view/878

Nuari, NA. (2017). Metode Self Instructional Training
untuk Menurunkan Kadar Gula Darah Pasien DM
Tipe 2.Jurnal Ners dan Kebidanan STIKES Patria
Husada Blitar. Vol.4, No.1,April 2017.https://
j n k . p h b. a c. i d / i n d ex . p h p/ j n k / a r t i c l e / vi ew/
0157.DOI:10.26699/jnk.v4i1.ART.p006-011

367Nuari, Factor Associated with Diabetes Burnout Syndrome Among ...

Nuari N. A. (2018). Diabetes Burnout Syndrom With Self
Care Agency Diabetes Mellitus Type 2 Patient.
Journal of Health Science and Prevention, 2(2),
78-82. https://doi.org/10.29080/jhsp.v2i2.122

Nuari, NA.(2020).Correlation Of Diabetes Burnout
Syndrome And Quality Of Life In Diabetes Mellitus.
Borneo Nursing Journal. Vol.1, No.1, Januari 2020.

Noventi, Iis, et all. (2019). Prevalensi, Karakteristik dan
Faktor Resiko Prediabetes di Wilayah Pesisir,
Pegunungan dan Perkotaan. Jurnal Ners dan
Kebidanan STIKES Patria Husada Blitar. Vol.6,
No.3,Desem ber 2019. h ttps:// jnk. phb. ac.i d/

index.php/jnk/article/view/478, DOI: 10.26699/
jnk.v6i3.ART.p371-381

RISKESDA. (2013). Riset Kesehatan Dasar. http://
www.riskesdas2013.pdf. Diakses 25 Desember 2019

Tabák, A. G., C. (2012). Prediabetes: a high-risk state for
diabetes development. The Lancet,379(9833), 2279–
2290.

World Health Organization. (2006). Definition, diagnosis
and clasification of diabetus mellitusand its
complications.’Report a WHO Consultation.
WHO,Geneva.