Abstract
Chronic noncommunicable diseases (NCDs), particularly hypertension and type 2 diabetes mellitus, are increasing in Indonesia’s coastal communities including the Bajo population in Southeast Sulawesi. Limited healthcare access, cultural barriers, and low preventive health engagement exacerbate the disease burden in these communities. Culturally tailored interventions are needed to enhance self-awareness and improve chronic disease management. This study aimed to develop and validate a culturally sensitive care model for chronic disease management in the Bajo coastal community. A three-round modified Delphi method was used with 26 panelists representing health professionals, community leaders, policymakers, and family members recruited through community health centers and community health worker networks. The first round gathered qualitative input on cultural values, traditional practices, barriers, and care model components. The second and third rounds quantitatively assessed proposed components for consensus, defined as ≥75% agreement with ratings ≥4 on a 5-point Likert scale. Eleven of the twelve proposed components achieved full consensus. Highpriority elements included integration of traditional and biomedical care, family and community involvement, culturally relevant health education, flexible service schedules, and routine free health checks. The panel emphasized communication in the local language, engagement of trusted local figures, and employment of culturally competent health workers. One component, the use of local broadcasting media, was rejected because it was perceived as having low feasibility. This study presents a culturally sensitive care framework that operationalizes cultural integration through traditional–biomedical collaboration, family engagement, culturally adapted education, and community-based screening in Indigenous and remote settings. Future studies should prioritize pilot implementation of this framework and evaluation of its feasibility, acceptability, and health outcomes in coastal settings.
Bahasa Abstract
Pengembangan Model Perawatan Berbasis Budaya untuk Pengelolaan Penyakit Kronis pada Komunitas Pesisir: Studi Modified Delphi. Penyakit tidak menular, khususnya hipertensi dan diabetes melitus tipe 2, semakin meluas di masyarakat pesisir Indonesia, termasuk masyarakat Bajo di Sulawesi Tenggara. Keterbatasan akses layanan kesehatan, hambatan budaya, dan rendahnya upaya pencegahan menjadi faktor meningkatya angka penderita di komunitas tersebut. Oleh karena itu, intervensi yang peka dengan budaya setempat diperlukan untuk meningkatkan kesadaran masyarakat dan meningkatkan kualitas pengelolaan penyakit kronis. Penelitian ini bertujuan untuk mengembangkan dan memvalidasi model keperawatan peka budaya dalam pengelolaan penyakit kronis pada komunitas pesisir di Sulawesi Tenggara. Metode modified Delphi tiga putaran digunakan dengan melibatkan 26 panelis yang terdiri dari tenaga kesehatan, tokoh masyarakat, pembuat kebijakan, dan anggota keluarga yang direkrut melalui puskesmas dan jejaring tenaga kesehatan masyarakat. Putaran pertama adalah mengumpulkan masukan kualitatif terkait nilai budaya, praktik tradisional, hambatan, dan komponen model keperawatan. Putaran kedua dan ketiga adalah menilai komponen yang diusulkan secara kuantitatif untuk mencapai konsensus, menghasilkan ≥75% kesepakatan dengan skor ≥4 pada skala Likert 5 poin. Sebanyak sebelas dari dua belas komponen yang diusulkan mencapai konsensus penuh. Komponen prioritas meliputi integrasi perawatan tradisional dan biomedis, keterlibatan keluarga dan komunitas, edukasi kesehatan yang relevan secara budaya, jadwal layanan yang fleksibel, serta pemeriksaan kesehatan rutin gratis. Panelis juga menekankan pentingnya komunikasi dalam bahasa lokal, keterlibatan tokoh yang dipercaya, serta tenaga kesehatan yang memiliki kompetensi budaya. Satu komponen, yaitu penggunaan media penyiaran lokal, tidak disepakati karena dinilai memiliki tingkat kelayakan yang rendah. Penelitian ini menghasilkan kerangka perawatan sensitif budaya yang mengoperasionalkan integrasi budaya melalui kolaborasi tradisional-biomedis, keterlibatan keluarga, edukasi yang disesuaikan secara budaya, serta skrining berbasis komunitas pada konteks masyarakat adat dan wilayah terpencil. Penelitian selanjutnya perlu memprioritaskan uji implementasi awal serta evaluasi kelayakan, penerimaan, dan luaran kesehatan dari model ini di wilayah pesisir.
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Recommended Citation
Saltar, Laode; Heltty, Heltty; and Kaimuddin, Sitti Mikarna
(2026)
"Development of a Culturally Tailored Care Model for Chronic Disease Management in The Coastal Community: A Modified Delphi Study,"
Jurnal Keperawatan Indonesia: Vol. 29:
No.
2, Article 2.
DOI: 10.7454/jki.v29i2.1946
Available at:
https://scholarhub.ui.ac.id/jki/vol29/iss2/2
