The Impact of Digital Psycho-Religious Therapy on Stress Reduction and Quality of Life in Patients with Diabetes Mellitus in Indonesia

Authors

  • Rosliana Dewi Department of Nursing, Sekolah Tinggi Ilmu Kesehatan Sukabumi, Kota Sukabumi, Jawa Barat 43122, Indonesia
  • Johan Budhiana Department of Nursing, Sekolah Tinggi Ilmu Kesehatan Sukabumi, Kota Sukabumi, Jawa Barat 43122, Indonesia
  • Iwan Permana Department of Nursing, Sekolah Tinggi Ilmu Kesehatan Sukabumi, Kota Sukabumi, Jawa Barat 43122, Indonesia

DOI:

https://doi.org/10.31674/mjn.2025.v16isupp2.007

Abstract

Background: Diabetes mellitus (DM) is a chronic disease that imposes significant stress and reduces quality of life (QoL), complicating glycaemic control and increasing complications. Leveraging digital platforms offers a scalable and efficient solution, especially in resource-constrained settings such as Indonesia. Objective: This study evaluates the efficacy of a digital psycho-religious therapy program in alleviating stress and enhancing QoL among type 2 DM patients in Indonesia. Methods: A quasi-experimental pretest-post-test control group design was employed with 300 patients diagnosed with type 2 DM in West Java, Indonesia. Stress levels were measured using the Perceived Stress Scale (PSS), while QoL was assessed with the WHOQOL-BREF questionnaire, both at baseline and after the intervention. Statistical analyses, including descriptive and regression were conducted to evaluate outcomes. Results: The intervention group experienced a significant reduction in stress (scores decreased from 25.6 ± 4.2 to 16.4 ± 3.5, p < 0.001) and a marked improvement in QoL (scores increased from 58.7 ± 6.5 to 72.4 ± 5.8, p < 0.001). Regression analysis revealed that group allocation, baseline scores, and age were significant predictors of outcomes, whereas a longer duration of diabetes was associated with reduced improvements. Conclusion: Digital psycho-religious therapy is a promising intervention for stress reduction and QoL improvement in type 2 DM patients, with potential applicability in other low-resource settings. Future research should investigate the long-term effects and broader applicability of this intervention.

Keywords:

Diabetes Mellitus, Digital Health Intervention, Psycho-Religious Therapy, Quality of Life, Stress Reduction

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References

Abbas, J. (2024). Utilizing faith-based mind body intervention to improve stress level in women 18 years and older (doctoral dissertation, University of Massachusetts Global). Retrieved from: https://www.proquest.com/openview/713709026439eaad301ae0c9b8c6e5d6/1?pq-origsite=gscholar&cbl=18750&diss=y. Accessed on 28th March 2024.

Abdelwahab, S. I., Taha, M. M. E., Farasani, A., Abdullah, S. M., Moshi, J. M., Khamjan, N. A., ... & Hassan, W. (2025). Teaching spirituality in nursing: Additional evidence for developing a bibliometric analysis. Journal of Religion and Health, 1-41. https://doi.org/10.1007/s10943-024-02203-4

Alam, M. Z., Hoque, M. R., Hu, W., & Barua, Z. (2020). Factors influencing the adoption of mHealth services in a developing country: A patient-centric study. International Journal of Information Management, 50, 128-143. https://doi.org/10.1016/j.ijinfomgt.2019.04.016

Awoke, A., & Cosendey, B. N. (2025). Investigate the ethnomedical practices of different indigenous communities: A literature review. International Journal of Ethnoscience and Technology in Education, 2(1), 64-89. https://doi.org/10.33394/ijete.v2i1.13903

Belachew, E. A., Getachew, D., Netere, A. K., Gizachew, E., & Sendekie, A. K. (2023). Perception, willingness, and practices of telemedicine in patients with chronic diseases: Implication of digital health in patients' perspective at a tertiary care hospital in Ethiopia. Frontiers in Public Health, 11. https://doi.org/10.3389/fpubh.2023.1234436

Bouwhuis-Van Keulen, A. J., Koelen, J., Eurelings-Bontekoe, L., Hoekstra-Oomen, C., & Glas, G. (2024). The evaluation of religious and spirituality-based therapy compared to standard treatment in mental health care: A multi-level meta-analysis of randomized controlled trials. Psychotherapy Research, 34(3), 339-352. https://doi.org/10.1080/10503307.2023.2241626

Chew, B. H., Mohd-Sidik, S., & Shariff-Ghazali, S. (2015). Negative effects of diabetes–related distress on health-related quality of life: an evaluation among the adult patients with type 2 diabetes mellitus in three primary healthcare clinics in Malaysia. Health and Quality of Life Outcomes, 13, 1-16. https://doi.org/10.1186/s12955-015-0384-4

Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385–396. https://doi.org/10.2307/2136404

Conversano, C., Orrù, G., Pozza, A., Miccoli, M., Ciacchini, R., Marchi, L., & Gemignani, A. (2021). Is mindfulness-based stress reduction effective for people with hypertension? A systematic review and meta-analysis of 30 years of evidence. International Journal of Environmental Research and Public Health, 18(6). https://doi.org/10.3390/ijerph18062882

Haseldine, C., Pallin, J. A., Kearney, P. M., Mc Hugh, S. M., Riordan, F., Cotterill, S., & O’Donoghue, G. (2025). Healthcare workers’ perspectives on barriers and facilitators to referral to type 2 diabetes prevention programmes: A systematic review. BMJ Open, 15(3). https://doi.org/10.1136/bmjopen-2024-090105

International Council of Nurses. (2021). Nurses: A voice to lead – A vision for future healthcare. Retrieved from: https://www.icn.ch/resources/publications-and-reports/nurses-voice-lead-vision-future-healthcare. Accessed on 28th March 2024.

Karki, S., Gajurel, B., & Chalise, S. (2025). The role of nurses in managing chronic diseases: A focus on diabetes care in Finland. Retrieved from: https://urn.fi/URN:NBN:fi:amk-2025052315487. Accessed on 12th March 2024.

Koenig, H. G. (2012). Religion, spirituality, and health: The research and clinical implications. International Scholarly Research Notices, 2012(1). https://doi.org/10.5402/2012/278730

Kong, L., Ren, J., Fang, S., He, T., Zhou, X., & Fang, M. (2022). Effects of traditional Chinese mind-body exercise-Baduanjin for type 2 diabetes on psychological well-being: A systematic review and meta-analysis. Frontiers in Public Health, 10. https://doi.org/10.3389/fpubh.2022.923411

Lazor, P., Weiner, J., Lawton, A., Schreiber, J., Muehlhausen, B. L., & Fitchett, G. (2025). Evaluation of spiritual care services at Cedars Sinai hospitals: employees’ views. Journal of Health Care Chaplaincy, 1-20. https://doi.org/10.1080/08854726.2025.2506919

Li, M., Liu, S., Yu, B., Li, N., Lyu, A., Yang, H., ... & Gao, R. (2025). Assessing the effectiveness of digital health behavior strategies on type 2 diabetes management: Systematic review and network meta-analysis. Journal of Medical Internet Research, 27. https://doi.org/10.2196/63209

Lucchetti, G., Koenig, H. G., & Lucchetti, A. L. G. (2021). Spirituality, religiousness, and mental health: A review of the current scientific evidence. World journal of clinical cases, 9(26), 7620–7631. https://doi.org/10.12998/wjcc.v9.i26.7620

Lucchetti, G., Lucchetti, A. L. G., Vitorino, L. M., Martin, E. Z., de Araujo Almeida, P. O., Damiano, B. B. F., ... & Damiano, R. F. (2024). Quantitative and qualitative research in the field of ‘Spirituality and Health’: An introductory how-to-guide from a Brazilian perspective. Journal of Religion and Health, 63(5), 3906-3925. https://doi.org/10.1007/s10943-024-02086-5

Pargament, K. I., & Exline, J. J. (2021). Working with spiritual struggles in psychotherapy: From research to practice. Guilford Publications, NY, USA.

Puchalski, C. (2021). Spiritual care in health care: Guideline, models, spiritual assessment and the use of the© FICA Spiritual History Tool. In Spiritual Needs in Research and Practice: The Spiritual Needs Questionnaire as a Global Resource for Health and Social Care (pp. 27-45). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-030-70139-0_3

Peng, R., Li, X., Guo, Y., Ning, H., Huang, J., Jiang, D., ... & Liu, Q. (2024). Barriers and facilitators to acceptance and implementation of eMental-health intervention among older adults: a qualitative systematic review. Digital Health, 10. https://doi.org/10.1177/20552076241234628 .

Pong, C., Tseng, R. M. W. W., Tham, Y. C., & Lum, E. (2024). Current implementation of digital health in chronic disease management: Scoping review. Journal of Medical Internet Research, 26. https://doi.org/10.2196/53576

Rosmarin, D., Pandya, A. G., Lebwohl, M., Grimes, P., Hamzavi, I., Gottlieb, A. B., ... & Harris, J. E. (2020). Ruxolitinib cream for treatment of vitiligo: a randomised, controlled, phase 2 trial. The Lancet, 396(10244), 110-120. https://doi.org/10.1016/S0140-6736(20)30609-7

Saeedi, P., Petersohn, I., Salpea, P., Malanda, B., Karuranga, S., Unwin, N., ... & IDF Diabetes Atlas Committee. (2019). Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas. Diabetes Research and Clinical Practice, 157, 107843. https://doi.org/10.1016/j.diabres.2019.107843

Smati, S., Mahot, P., Bourdiol, A., Ploteau, S., Hadjadj, S., & Cariou, B. (2020). Euglycaemic ketoacidosis during gestational diabetes with concomitant COVID-19 infection. Diabetes & Metabolism, 47(2). https://doi.org/10.1016/j.diabet.2020.07.008

Asif, M., & Gaur, P. (2025). The impact of digital health technologies on chronic disease management. Telehealth and Medicine Today, 10(1). https://doi.org/10.30953/thmt.v10.556

Valente, T., & Arbex, A. K. (2021). Glycemic variability, oxidative stress, and impact on complications related to type 2 diabetes mellitus. Current Diabetes Reviews, 17(7), 1-11. https://doi.org/10.2174/1573399816666200716201550

World Health Organization (WHO). (1996). WHOQOL-BREF: Introduction, administration, scoring and generic version of the assessment: field trial version, December 1996. Retrieved from: https://www.who.int/publications/i/item/WHOQOL-BREF. Accessed on 18th August 2024.

World Health Organization (WHO). (2022). Global strategy on digital health 2020–2025. Retrieved from: https://www.who.int/docs/default-source/documents/gs4dhdaa2a9f352b0445bafbc79ca799dce4d.pdf. Accessed on 9th July 2024.

Published

25-06-2025

How to Cite

Dewi, R. ., Budhiana, J. ., & Permana, I. . (2025). The Impact of Digital Psycho-Religious Therapy on Stress Reduction and Quality of Life in Patients with Diabetes Mellitus in Indonesia. The Malaysian Journal of Nursing (MJN), 16(Supplementary 2), 57-66. https://doi.org/10.31674/mjn.2025.v16isupp2.007

Issue

Section

SI 2025: Sustainable Health Information System (HIS) & e-healthcare in Nursing

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