Effectiveness Of Bibliotherapy And Spiritual Guidance Therapy On The Quality Of Life Of Diabetes Mellitus Patients At Muhammadiyah Metro General Hospital

Hestia  Devi; Arena  Lestari; Sri  Yulia

Hestia Devi Universitas Muhammadiyah Pringsewu
Arena Lestari Universitas Muhammadiyah Pringsewu
Sri Yulia Universitas Muhammadiyah Pringsewu

Keywords: Bibliotherapy, Spiritual Therapy, Quality of Life, Diabetes Mellitus

Abstract

Purpose: This study aimed to evaluate the effectiveness of bibliotherapy, spiritual therapy in the form of pastoral guidance, and a combination of both interventions in improving the quality of life of patients with diabetes mellitus. Literature Review: Diabetes mellitus is a chronic disease that negatively affects patients' physical, psychological, social, and spiritual well-being, leading to a decline in quality of life. Previous studies have shown that bibliotherapy and spiritual therapy may improve psychological adaptation and coping, but evidence regarding their combined effectiveness remains limited. Methodology: This study employed a quasi-experimental pretest–posttest design with three intervention groups, each consisting of 15 patients (total n = 45), conducted at Muhammadiyah Metro General Hospital. Quality of life was assessed using the World Health Organization Quality of Life (WHOQoL) instrument. Data were analyzed using paired t-tests, mixed ANCOVA, and Bonferroni post hoc tests. Results: Significant improvements in quality of life were observed in all groups (p < 0.001). The combined intervention demonstrated the greatest improvement, with a mean score increasing from 63.53 to 76.60, and was significantly more effective than bibliotherapy alone (mean difference = 6.345; p < 0.001) and spiritual therapy alone (mean difference = 2.752; p = 0.037). Conclusions: The combination of bibliotherapy and spiritual therapy was the most effective intervention for improving the quality of life of patients with diabetes mellitus. Recommendations: Healthcare professionals should consider integrating both interventions into holistic nursing care for patients with diabetes mellitus, while future multicenter studies with larger samples are recommended. Additional Data: The combined intervention is non-pharmacological, low-cost, easy to implement, and supports holistic patient-centered care by addressing psychosocial and spiritual needs.

References

Aarthy, R., Mikocka-Walus, A., Pradeepa, R., Anjana, R.M., Mohan, V. and Aston-Mourney, K. (2021). Quality of life and diabetes in India: A scoping review. Indian Journal of Endocrinology and Metabolism, 25(5), 365–380. https://doi.org/10.4103/ijem.ijem_336_21.
Abualhommos, A.K., Alturaifi, A.H., Hamdhah, A.M.A.B., Al-Ramadhan, H.H., Al Ali, Z.A. and Al Nasser, H.J. (2022). The health-related quality of life of patients with type 2 diabetes in Saudi Arabia. Patient Preference and Adherence, 16, 1233–1245. https://doi.org/10.2147/PPA.S353525.
Afrasiabifar, A., Mosavi, A., Jahromi, A.T. and Hosseini, N. (2021). Randomized controlled trial study of the impact of a spiritual intervention on hope and spiritual well-being of persons with cancer. Investigacion y Educacion en Enfermeria, 39(3), e08. https://doi.org/10.17533/UDEA.IEE.V39N3E08.
Andini, M. and Kartinah. (2025). Kualitas hidup lansia dengan diabetes melitus dan distribusi domainnya berdasarkan WHOQoL-BRIEF: Studi cross sectional di Puskesmas Kartasura. Jurnal Promotif Preventif, 8(6), 1704–1712. https://doi.org/10.47650/jpp.v8i6.2429.
Azami-Aghdash, S., Nouri, M., Rahimi, F., Amuzadeh-Araei, S., Abass, K.S., Aghababaeian, H., Koupaei, S.Y., Karami, S. and Rostampour, M. (2025). Effectiveness of spiritual health-based interventions in improving health indicators of patients in Iran: A systematic review and meta-analysis. BMC Psychology, 13(1), 938. https://doi.org/10.1186/s40359-025-03275-X.

Faul, F., Erdfelder, E., Lang, A.-G. and Buchner, A. (2020). GPOWER: A general power analysis program. Behavior Research Methods, 39(2), 175–191. http://www.gpower.hhu.de/.
Gupta, J., Kapoor, D. and Sood, V. (2021). Quality of life and its determinants in patients with diabetes melitus from two health institutions of sub-himalayan region of India. Indian Journal of Endocrinology and Metabolism, 25(3), 211–219. https://doi.org/10.4103/ijem.IJEM_246_21.

Herlina. (2021). Bibliotherapy (terapi melalui buku). Edulib, 2(2), 1–14. https://doi.org/10.17509/edulib.v2i2.10044.
IDF. (2022). IDF Diabetes Atlas 2021 10th edition. In Diabetes Research and Clinical Practice (Vol. 102, No. 2). International Diabetes Federation (IDF). https://doi.org/10.1016/j.diabres.2013.10.013.

Isworo, A. (2021). Improvement of self efficacy through bibliotherapy in diabetes patient. International Journal of Research in Medical Sciences, 6(12), 3954. https://doi.org/10.18203/2320-6012.ijrms20184889.
Kemenkes RI. (2024). Survei Kesehatan Indonesia Tahun 2023 (SKI) Dalam Angka. Badan Kebijakan Pembangunan Kesehatan.

Kirupa and Bhat, S. (2021). Effectiveness of bibliotherapy on quality of life, distress and depression among chronic leg and foot ulcer. International Journal of Health Sciences and Research, 11(4), 93–101. https://doi.org/10.52403/ijhsr.20210412.

Lotfi, M.H., Ahmadi Faraz, M.M., Namiranian, N., Arab, R., Dashtabadi, M. and Khormizi, H.Z. (2024). A review about the role of spiritual health in type 2 diabetes melitus people. Iranian Journal of Diabetes and Obesity, 16(1). https://doi.org/10.18502/ijdo.v16i1.15243.

Magharei, M., Tabatabaei, H.S. and Momennasab, M. (2023). The effect of spiritual care on spiritual well-being and quality of life in diabetic patients: A clinical trial. Family Medicine and Primary Care Review, 25(4), 413–419. https://doi.org/10.5114/fmpcr.2021.110358.

Monroy-Fraustro, D., Maldonado-Castellanos, I., Aboites-Molina, M., Rodríguez, S., Sueiras, P., Altamirano-Bustamante, N.F., de Hoyos-Bermea, A. and Altamirano-Bustamante, M.M. (2021). Bibliotherapy as a non-pharmaceutical intervention to enhance mental health in response to the COVID-19 pandemic: A mixed-methods systematic review and bioethical meta-analysis. Frontiers in Public Health, 9, 629872. https://doi.org/10.3389/FPUBH.2021.629872.
Moodi, V., Arian, A., Moodi, J.R. and Dastjerdi, R. (2020). Effectiveness of spiritual therapy on depression, anxiety, and stress in hemodialysis patients. Modern Care Journal, 17(4), 24–26. https://doi.org/10.5812/modernc.108879.
Noor, J. (2021). Metodologi penelitian: skripsi, tesis, disertasi dan karya ilmiah. Edisi 1. Prenada Media Group.
Notoatmodjo, S. (2018). Metodologi Penelitian Kesehatan. Edisi Revisi. PT Rineka Cipta.
Onyishi, C.N., Ilechukwu, L.C., Victor-Aigbodion, V. and Eseadi, C. (2021). Impact of spiritual beliefs and faith-based interventions on diabetes management. World Journal of Diabetes, 12(5), 630–641. https://doi.org/10.4239/wjd.v12.i5.630.
Panahi, N., Ahmadi, M., Hosseinpour, M., Sedokani, A., Sanjari, M., Khalagi, K., Mansourzadeh, M.J., Farhadi, A., Nabipour, I., Larijani, B., Fahimfar, N. and Ostovar, A. (2024). The association between quality of life and diabetes: The Bushehr Elderly Health Program. BMC Geriatrics, 24(1), 1–10. https://doi.org/10.1186/s12877-024-04878-6.