Surrender : The influence of religion, culture and access to health care on diabetes self-care for Javanese Muslim in Yogyakarta

Abstract

Self-care, capability in performing certain activity in maintaining well-being in daily life, is regarded important especially among people with long-term condition such as diabetes. Locus of control and religion are regarded as important factors in influencing such particular activity in day to day basis. Indeed, among Javanese people the lingering culture cannot be separated from religion, influencing how they perceive any factors that might play into role in managing any ill-health condition. Utilizing a mixed methods study design, with the deployment of two screening tools for further semi-structured interviews (the Summary of Diabetes Self-care Activity and the Muslim Piety questionnaires), this study was aimed to explore further into the perceptions and experiences of Javanese Muslim with diabetes in utilizing religion with embedded cultural aspects, in managing their daily self-care activity. Subsequent to this, the study sought further into barriers and opportunities in performing self-care. A convenient sample of 100 participants has filled the questionnaires, and 24 participants from various gender and age groups were purposively collected to gain a richer perspective for further interviews. The study identified the moderate self-care practices as a separate notion, instead of an integrated and comprehensive concept. The study has also found that the act of surrendering or nerimo ing pandum among Javanese people, as a representation of external locus of control, is paramount in maintaining self-care. The state of surrendering has been shown in the belief in Allah as the determinative factor in managing self-care, and in how they were surrendering to the lacking of adequate access to healthcare services. Social support can be served as a hindrance in self-care, as well as supporting factor. The later notion has been shown in the role of Pengajian, a social religious activity, and Persadia, a peer support group, which have been performing more of a social hub in supporting not only in enhancing capability, but also psychological support. \nThe role of external locus of control and the lack of healthcare access have been served as an opportunity in conducting an individualized approach in educating the Javanese Muslim in enhancing the capability and capacity in self-caring themselves, with collaborative work between the healthcare professional and the Muslim cleric.