Introduction: Uncertainty Diabetes mellitus shows the inability of individuals to determine the meaning of events related to the disease process. Uncertainty Diabetes mellitus causes stress due to uncertainty around the disease, disease process, treatment and side effects. The purpose of this study was to develop a stress adaptation model to the uncertainty of the diabetes mellitus disease process. Method: The design of this research is an explanatory survey with a cross sectional approach.Methods: The sample size of the study was 250 Diabetes mellitus clients who were recruited using simple random sampling technique. The research variables are cognitive, biophysical, social, psychological factors, structure providers, illusions, inferences, uncertainty, psychosocial coping and adaptations. Data were collected by questionnaire and analyzed by SEM-PLS. Results: The results of this study indicate that cognitive, biophysical, psychological factors, structure providers and the illusion of inference have a significant effect on uncertainty. Social factors have no effect on uncertainty. Uncertainty has a significant effect on coping and psychosocial adaptation. Coping has a significant effect on psychosocial adaptation. The test criteria state that if the T-statistics T-table value (1.96) or the P-value <significant alpha 5% or 0.05, it is stated that there is a significant effect of the independent variable on the dependent variable. Conclusions: The finding of the stress adaptation model to the uncertainty of the disease process Diabetes mellitus is associated with that uncertainty is a cognitive condition, indicating the inadequacy of existing cognitive factors to support the interpretation of disease-related events.Then adaptation in the context of uncertainty reflects the continuation of the normal biopsychosocial behavior of Diabetes mellitus clients and is the expected result of coping efforts to reduce uncertainty which is assessed as a danger.

Poor psychological well-being is an important issue that must be addressed in managing Diabetes Mellitus. Uncertainty surrounding health conditions substantially affects psychological outcomes, anxiety characteristics, loss of hope and psychological distress in clients with Diabetes Mellitus. The purpose of this study was to determine the description of the uncertainty of the disease process (Uncertainty in illness) and the psychological status of Diabetes Mellitus clients in the Jember Community Health Center. The design of this study was the explanatory survey with a cross-sectional approach. The study population was all Diabetes Mellitus clients in the Jember Community Health Center. Sample size: 250 Diabetes Mellitus clients were recruited using a simple random sampling technique. The data used in this research is descriptive statistical analysis so that the results will be obtained in the form of a frequency distribution. The results showed that the highest level of client expectations was with a low expected rate of 51.2%. The level of distress of respondents who had the highest Diabetes Mellitus was in the category of distress by 50.4%. The level of anxiety felt by respondents is mostly in the category of disturbance by 47.6% and uncertainty (Uncertainty) is in the less category by 63.2%. Several psychological factors have contributed to affect the emotional and psychological well-being of diabetes mellitus clients, including the Diabetes Mellitus client's acceptance of the uncertainties surrounding health conditions.

Diabetic ulcers are the most feared complications of Diabetes mellitus patients because of reduced blood supply to the tissues, causing tissue death and compounded with bacterial infections that can cause amputations and even have wide impact because they can cause death, morbidity, disability, and decreased quality of life. The purpose of this study was to determine the relationship of diabetic ulcers in patients with diabetes mellitus with body image. The research design used was analytic survey with cross sectional design. The sample in this study proves 40 samples taken Probability of Samples with the type of sampling in a row that was a diabetic ulcer sufferer who performs examinations in the clinic of Jember. This research was conducted by observing the degree of injury for diabetic ulcers and questionnaire sheets for body image. The results of this study were analyzed using the statistical test Spearman rank test. The results of the analysis showed that first-degree injuries were 22 respondents (55%), second-degree injuries were 17 respondents (42.5%), and third-degree injuries were respondent (2.5%). While the body image results in diabetics with 13 respondents (32.5%) had a negative body image, while 27 respondents (67.5%) had a positive body image. The results of the analysis of the two variables obtained by the value of p value Sig. (two tailed) of 0.023 α α (0.05) which shows that there was a relationship between diabetic ulcers in patients with diabetes mellitus with body image. Clients who suffer from diabetes mellitus will affect the appearance of the body, especially will have an impact on body image so it is very important for clients diabetes mellitus to improve adjustment in dealing with the disease process and the consequences of the disease. Keywords: diabetic ulcer; body image ABSTRAK Ulkus diabetikum merupakan komplikasi yang paling ditakuti pasien Diabetes Melitus karena berkurangnya suplay darah ke jaringan tersebut menyebabkan kematian jaringan dan diperparah dengan infeksi bakteri yang dapat menyebabkan amputasi bahkan berdampak luas karena dapat menyebabkan kematian, morbiditas, peningkatan biaya perawatan, dan penurunan kualitas hidup. Tujuan dari penelitian ini adalah untuk mengetahui hubungan ulkus diabetik pada penderita diabetes melitus dengan citra tubuh di Klinik Jember. Desain penelitian yang digunakan yaitu survey analitik dengan rancangan coss sectional. Sampel dalam penelitian ini diambil secara Probability Sample dengan jenis Consecutive Sampling yaitu penderita ulkus diabetik yang melakukan pemeriksaan di klinik jember sebanyak 40 responden Penelitian ini dilakukan dengan cara melihat/observasi derajat luka untuk ulkus diabetik dan lembar kuesioner untuk citra tubuh. Hasil penelitian ini dianalisa menggunakan uji statistic spearman rank test. Hasil analisanya didapatkan bahwa luka derajat 1 sebanyak 22 responden (55%), luka derajat 2 sebanyak 17 responden (42,5%), dan luka derajat 3 sebanyak 1 responden (2,5%). Sedangkan hasil citra tubuh pada penderita diabetes melitus sebanyak 13 responden (32,5%) memiliki citra tubuh negatif , sedangkan 27 responden (67,5%) memiliki citra tubuh positif. Hasil analisa dari kedua variabel didapatkan nilai p value Sig (two tailed) sebesar 0,023 ≤ α (0,05) yang menunjukkan bahwa ada hubungan ulkus diabetik pada penderita diabetes melitus dengan citra tubuh. Klien yang menderita diabetes mellitus akan mempengaruhi penampilan tubuh, terutama akan berdampak pada citra tubuh sehingga sangat penting bagi klien diabetes mellitus untuk meningkatkan penyesuaian dalam menangani proses penyakit dan konsekuensi penyakit. Kata kunci: ulkus diabetic; citra tubuh

Introduction: Dementia is a clinical syndrome of decline in cognitive function. Dementia with various neuropsychiatric symptoms can have a large impact on both clients and caregivers, one of which is wandering behavior. Wandering is a neuropsychiatric symptom that is difficult to control, challenging, at risk of loss, causes various risks of fracture, and even death. Wandering management still uses traditional methods until now. The purpose of this study was to determine the effect of Social Leisure Activity in reducing the risk of wandering. Methods: The design of this study was quasi-experimental with a pre-post test one group. The study population was 47 elderly and a sample of 34 elderly dementia along with their caregivers who were outpatients at the Psychogeriatric Clinic of Dr. RSJ Radjiman Wediodiningrat Lawang. The sampling technique used purposive sampling method. The independent variable in this study was the Social Leisure Activity and the dependent variable was wandering risk. The instrument used  Elopement Screening to assess the risk of wandering, the KATZ Independence Index, and the Caregiver Training questionnaire. The intervention was carried out at home by the caregiver in the form of a series of activities carried out for 4 weeks with a frequency of 3 times a week and 45 minutes per activity. The caregiver was given training as well as a demonstration of wandering and social leisure activity before the research was conducted. Data were analyzed using Paired-Samples T-Test. Results: The results of the analysis showed that there were significant differences (p = 0,000) on the value of the risk of wandering before and after an intervention. Training data on the caregiver gave a result that there was a significant difference (p = 0,000) in the caregiver's knowledge before and after training. Discussion: The risk of wandering in dementia elderly could be reduced by providing regular physical activities that prioritize elements of social interaction. Social Leisure Activity is an effective activity to be developed because it is easy to implement and efficient because it does not require high costs. Conclusions and Suggestions: Social Leisure Activities can help reduce the risk of wandering if done regularly and continuously. Social Leisure Activity can be used as an alternative for caregivers and elderly dementia to keep on doing activities.