DOI: https://doi.org/10.14710/nmjn.v14i1.56812

Development of a Holistic Nursing Model Based on Transcultural Nursing to Improve the Quality of Life of Patients with Type-2 Diabetes Mellitus

Ni Wayan Suniyadewi orcid scopus  -  Faculty of Nursing, Universitas Airlangga, Indonesia
*Yuni Sufyanti Arief  -  Faculty of Nursing, Universitas Airlangga, Indonesia
Ninuk Dian Kurniawati  -  Faculty of Nursing, Universitas Airlangga, Indonesia
I Dewa Ayu Rismayanti  -  Nursing Program, Sekolah Tinggi Ilmu Kesehatan (STIKES) Buleleng Bali, Indonesia
Ni Wayan Trisnadewi  -  Nursing Program, Sekolah Tinggi Ilmu Kesehatan (STIKES) Wira Medika Bali, Indonesia
Iswatun Iswatun  -  Nursing Department, Faculty of Vocational Studies, Universitas Airlangga, Indonesia
Open Access Copyright (c) 2024 by the Authors, Published by Department of Nursing, Faculty of Medicine, Universitas Diponegoro
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Citation Format:
Abstract

Background: The management of type 2 diabetes mellitus (T2DM) primarily emphasizes physical care, yet the quality of life (QoL) remains suboptimal. The management of diabetes often neglects psychological, socio-cultural, and spiritual aspects, which are essential components of transcultural nursing. Developing a holistic nursing model rooted in transcultural nursing, which has never been broadly investigated, is imperative to enhance QoL in individuals with T2DM.

Purpose: This study aimed to develop a nursing model based on transcultural nursing to enhance the QoL of individuals with T2DM.

Methods: This study employed a quantitative research design with a cross-sectional approach. A sample of 145 individuals with T2DM was recruited using a simple random sampling technique. A self-developed questionnaire was used, incorporating factors from Dossey’s holistic nursing model, Leininger’s transcultural nursing model, and a QoL questionnaire. Inferential statistics using smart PLS-structural equation modeling (SEM) were employed for data analysis.

Results: The findings revealed that the holistic nursing model based on transcultural nursing in individuals with T2DM was influenced directly by respondent characteristics (t=3.313, p=0.001), religious and life philosophy (t=2.836, p=0.005), social and kinship (t=2.579, p=0.010), cultural and lifestyle (t=2.833, p=0.005), biological (t=2.718, p=0.007), and psychological (t=2.497, p=0.013) factors. However, the technological factor was not significantly (t=0.802, p=0.423) associated with the model. The holistic nursing model based on transcultural nursing had a direct influence on the quality of life (t=9.124 and p=0.000).

Conclusion: The holistic nursing model based on transcultural nursing encompasses six variables: respondent characteristics, religious and life philosophy, social and kinship, cultural and lifestyle, and biological and psychological factors. The model can serve as a guideline for managing type 2 DM patients to enhance the QoL.
Fulltext View|Download
Keywords: Development; holistic nursing; transcultural nursing; T2DM; quality of life

Article Metrics:

Article Info
Section: Articles
Language : EN
Recent articles
Stressors and Coping Strategies as Perceived among Nursing Students during Related Learning Experience (RLE) Effectiveness of Self-Management Training, “EDUDARA”, on Psychological Wellbeing and Cortisol Levels in Breast Cancer Patients during the COVID-19 Pandemic The Association of Nurse Burnout with Patient Satisfaction from Nurse Perspective Mediated by Nurse Job Satisfaction and Caring Behavior More recent articles
Most cited articles
Nausea, Vomiting and Retching of Patients with Cervical Cancer undergoing Chemotherapy in Bali, Indonesia Attitudes, Belief, and Barriers of Indonesian Oncology Nurses on Providing Assistance to Overcome Sexuality Problem Concept Analysis of Perceived Control Providing Basic Needs and Encouragement as Strategies in Managing Aggression in Dementia Clients Case Study: Evidence-Based Interventions Enhancing Diabetic Foot Care Behaviors among Hospitalized DM Patients More cited articles
  1. Ade, M. S., Kulkarni, J., & Ade, S. S. (2011). Healthcare technologies and telehealth emergency (THE) system telehealth [paper presentation]. The 2nd International Conference on Wireless Communication, Vehicular Technology, Information Theory and Aerospace & Electronic Systems Technology (Wireless VITAE), Chennai, India, 1–4. https://doi.org/10.1109/WIRELESSVITAE.2011.5940870
  2. Albougami, A. S., Pounds, K. G., & Alotaibi, J. S. (2016). Nursing and health care comparison of four cultural competence models in transcultural nursing : A discussion paper. International Archives of Nursing and Health Care, 2(4), 1–5. https://doi.org/10.23937/2469-5823/1510053
  3. Álvarez-Najar, J., Sanabria, R., & Pena-Pita, A. (2020). Beliefs and practices in diabetes care. Duazary, 17(1), 74–86. https://doi.org/10.21676/2389783X.3218
  4. Amelia, R., Lelo, A., Lindarto, D., Mutiara, E. (2018). Quality of life and glycemic profile of type 2 diabetes mellitus patients of Indonesian: A descriptive study. IOP Conference Series: Earth and Environmental Science, 125(1), 012171. https://doi.org/10.1088/1755-1315/125/1/012171
  5. American Diabetes Association. (2019). 5. Lifestyle management: Standards of medical care in diabetes-2019. Diabetes Care, 42(Suppl1), S46–S60. https://doi.org/10.2337/dc19-S005
  6. Ameyaw, K., Dyson, S., & Anthony, D. (2022). Experiences and cultural beliefs of patients with diabetes: Lessons for nursing practice, education, and policy. International Journal of Africa Nursing Sciences, 16(10), 100392. https://doi.org/10.1016/j.ijans.2021.100392
  7. Bahtiar, B., Sahar, J., & Wiarsih, W. (2020). Meaning of life among elderly individuals with chronic diseases living with family: A qualitative study. Makara Journal of Health Research, 24(1), 35–40. https://doi.org/10.7454/msk.v24i1.1161
  8. Baig, A. A., Benitez, A., Quinn, M. T., & Burnet, D. L. (2016). Family interventions to improve diabetes outcomes for adults. HHS Public Access, 1353(1), 89–112. https://doi.org/10.1111/nyas.12844.Family
  9. Bali Provincial Health Office [Dinas Kesehatan Provinsi Bali]. (2017). Profil kesehatan provinsi Bali 2017 [Health profile of Bali province]. https://www.diskes.baliprov.go.id/download/profil-kesehatan-provinsi-bali-tahun-2017/
  10. Betancourt, D. A. B. (2016). Madeleine Leininger and the transcultural theory of nursing. The Downtown Review, 2(1), 1-7
  11. Bloom, D. E., Chatterji, S., Kowal, P., Lloyd-Sherlock, P., McKee, M., Rechel, B., Rosenberg, L., & Smith, J. P. (2015). Macroeconomic implications of population ageing and selected policy responses. The Lancet, 385(9968), 649–657. https://doi.org/10.1016/S0140-6736(14)61464-1
  12. Brata, I. (2019). Menyama braya: Refleksi multikulturalisme memperkuat identitas nasional [Menyama braya: Reflection of multiculturalism to strengthen national identity]. Media Bina Ilmiah, 13(1978), 1493–1500. https://doi.org/10.33758/mbi.v13i8.227
  13. Casagrande, S. S., & Cowie, C. C. (2018). Health insurance and diabetes. In C. C. Cowie et al. (Eds.), Diabetes in America (3rd ed.). National Institute of Diabetes and Digestive and Kidney Diseases (US)
  14. CDC. (2022). Diabetes and women. https://www.cdc.gov/diabetes/library/features/diabetes-and-women.html
  15. Cholil, A. R., Lindarto, D., Pemayun, T. G. D., Wisnu, W., Kumala, P., & Puteri, H. H. S. (2019). DiabCare Asia 2012: Diabetes management, control, and complications in patients with type 2 diabetes in Indonesia. Medical Journal of Indonesia, 28(1), 47-56. https://doi.org/10.13181/mji.v28i1.2931
  16. Darvyri, P., Christodoulakis, S., Galanakis, M., Avgoustidis, A. G., Thanopoulou, A., & Chrousos, G. P. (2018). On the role of spirituality and religiosity in type 2 diabetes mellitus management-A systematic review. Psychology, 9, 728–744. https://doi.org/10.4236/psych.2018.94046
  17. Deng, F., Zhang, A., & Chan, C. B. (2013). Acculturation, dietary acceptability, and diabetes management among Chinese in North America. Frontier in Endocrinology, 4, 108. https://doi.org/10.3389/fendo.2013.00108
  18. de Oliveira, C. M., Viater Tureck, L., Alvares, D., Liu, C., Horimoto, A. R. V. R., Balcells, M., de Oliveira Alvim, R., Krieger, J. E., & Pereira, A. C. (2020). Relationship between marital status and incidence of type 2 diabetes mellitus in a Brazilian rural population: The Baependi Heart Study. PloS one, 15(8), e0236869. https://doi.org/10.1371/journal.pone.0236869
  19. Diabetes UK. (2023). What is diabetes distress and burnout?. https://www.diabetes.org.uk/guide-to-diabetes/emotions/diabetes-burnout
  20. Dobrowolska, B., Whelan, J., & Timmins, F. (2022). Managing holistic nursing practice: The need for spiritual care competence in health care practice. Journal of Nursing Management, 30(5), 1083–1086. https://doi.org/10.1111/jonm.13538
  21. Dossey, B. M., Keegan, L., & Guzetta. (2005). Holistic nursing: A handbook for practice (4th ed.). Jones and Bartlett
  22. Duke, N. (2021). Type 2 diabetes self-management: Spirituality, coping and responsibility. Journal of Research in Nursing, 26(8), 743–760. https://doi.org/10.1177/17449871211026958
  23. Elizabeth, Y., Gunawan, S., Christina, M., Sukartiningsih, E., & Namuwali, D. (2022). Cultural, belief, and lifeway factors in diabetes patients: An ethnonursing study. Malaysian Journal of Medicine and Health Sciences, 18(8), 148–157. https://doi.org/10.47836/mjmhs18.6.21
  24. Fisher, L., Glasgow, R. E., Mullan, J. T., Skaff, M. M., & Polonsky, W. H. (2008). Development of a brief diabetes distress screening instrument. Annals of Family Medicine, 6(3), 246–252. https://doi.org/10.1370/afm.842
  25. Franz M. J. (2017). Weight management: Obesity to diabetes. Diabetes Spectrum, 30(3), 149–153. https://doi.org/10.2337/ds17-0011
  26. Ghozali, I., & Latan, H. (2020). Partial least squares: Concepts, techniques, and applications to use 3.0 SmartPLS program [Partial least squares: Konsep, teknik, dan aplikasi menggunakan program smartPLS 3.0] (2nd ed.). Undip Press
  27. Hair, J. F., Ringle, C. M., Gudergan, S. P., Fischer, A., Nitzl, C., & Menictas, C. (2019). Partial least squares structural equation modeling-based discrete choice modeling: An illustration in modeling retailer choice. Business Research, 12, 115–142. https://doi.org/10.1007/s40685-018-0072-4
  28. Hess, T. M., Strough, J., & Löckenhoff, C. (2015). Aging and decision making: Empirical and applied perspectives. Elsevier Academic Press
  29. IDF. (2018). IDF diabetes atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Research and Clinical Practice, 138, 271–281. https://doi.org/10.1016/j.diabres.2018.02.023
  30. International Diabetes Federation. (2019). IDF diabetes atlas (9th ed.). International Diabetes Federation. https://www.diabetesatlas.org/en/resources/
  31. Ismail, S., Dwidiyanti, M., Wiguna, R. I., Yusuf, N. A. R., Riani, S., Adisty, P., Sari, I. W., Dewi, T., Kurniawati, E., & Lisnawati, L (2019). Keperawatan holistik dan aplikasi intervensi komplementer [Holistic care and the applications of complementary interventions]. S. Ismail (Ed.). LPPM STikes Kendal
  32. Juanamasta, I. G., Aungsuroch, Y., Gunawan, J., Suniyadewi, N. W., & Nopita Wati, N. M. (2021). Holistic care management of diabetes mellitus: An integrative review. International Journal of Preventive Medicine, 12, 69. https://doi.org/10.4103/ijpvm.IJPVM_402_20
  33. Jones, J. E. D. (2014). Is marital status a determinant of self-monitoring of blood glucose ? [Theses, University of Mississippi). Electronic Theses and Dissertations. https://egrove.olemiss.edu/etd/593/
  34. Kalra, S., Jena, B. N., & Yeravdekar, R. (2018). Emotional and psychological needs of people with diabetes. Indian Journal of Endocrinology and Metabolism, 22(5), 696–704. https://doi.org/10.4103/ijem.IJEM_579_17
  35. Kalra, S., Verma, K., & Singh Balhara, Y. P. (2017). Management of diabetes distress. The Journal of the Pakistan Medical Association, 67(10), 1625–1627
  36. Koelmeyer, R. L., Dharmage, S. C., & English, D. R. (2016). Diabetes in young adult men: Social and health-related correlates. BMC Public Health, 16, 1061. https://doi.org/10.1186/s12889-016-3704-7
  37. Kumari, G., Singh, V., Chhajer, B., & Jhingan, A. K. (2021). Effect of lifestyle intervention holistic approach on blood glucose levels, health-related quality of life and medical treatment cost in type 2 diabetes mellitus patients. Acta Scientiarum. Health Sciences, (2017), 1–19. https://doi.org/10.4025/actascihealthsci.v43i1.53729
  38. Lagisetty, P. A., Priyadarshini, S., Terrell, S., Hamati, M., Landgraf, J., Chopra, V., & Heisler, M. (2017). Culturally targeted strategies for diabetes prevention in minority population. The Diabetes Educator, 43(1), 54–77. https://doi.org/10.1177/0145721716683811
  39. Laochai, W., Salab, R., Pipatsombat, P., Tejangkura, L., Chinpinkleaw, P., & Kearmalai, N. (2021). Holistic nursing for diabetics with complications: A case study. Vajira Nursing Journal, 23(1), 84–97
  40. Leininger, M. (2002). Culture care theory: A major contribution to advance transcultural nursing knowledge and practices. Journal of Transcultural Nursing, 13(3), 189–192. https://doi.org/10.1177/10459602013003005
  41. Mamo, Y., Bekele, F., Nigussie, T., & Zewudie, A. (2019). Determinants of poor glycemic control among adult patients with type 2 diabetes mellitus in Jimma University Medical Center, Jimma zone, South West Ethiopia: A case-control study. BMC Endocrine Disorders, 19(1), 91. https://doi.org/10.1186/s12902-019-0421-0
  42. Ministry of Health Republic of Indonesia. (2023). Terapi nutrisi medis pada diabetes melitus tipe 2 [Medical nutrition therapy in type 2 diabetes mellitus]. https://yankes.kemkes.go.id/view_artikel/2112/terapi-nutrisi-medis-pada-diabetes melitus-tipe-2-series-3
  43. Mora, N., & Golden, S. H. (2017). Understanding cultural influences on dietary habits in Asian, Middle Eastern, and Latino patients with type 2 diabetes: A review of current literature and future directions. Current Diabetes Reports, 17(12), 126. https://doi.org/10.1007/s11892-017-0952-6
  44. Mphasha, M. H., Mothiba, T. M., & Skaal, L. (2022). Family support in the management of diabetes patients ’ perspectives from Limpopo province in South Africa. BMC Public Health, 22, 2421. https://doi.org/10.1186/s12889-022-14903-1
  45. Ofori, S. N., & Unachukwu, C. N. (2014). Holistic approach to prevention and management of type 2 diabetes mellitus in a family setting. Diabetes, Metabolic Syndrome and Obesity, 7, 159–168. https://doi.org/10.2147/DMSO.S62320
  46. Ofori, S. N., & Unachukwu, C. N. (2022). Holistic approach to prevention and management of type 2 diabetes mellitus in a family setting Holistic approach to prevention and management of type 2 diabetes mellitus in a family setting. Diabetes, Metabolic Syndrome and Obesity, 2014(7), 159–168. https://doi.org/10.2147/DMSO.S62320
  47. Onyango, J. T., Namatovu, J. F., Besigye, I. K., & Kaddumukasa, M. (2022). The relationship between perceived social support from family and diabetes self-management among patients in Uganda. PanAfrican Medical Journal, 41, 279. https://doi.org/10.11604/pamj.2022.41.279.33723
  48. Onyishi, C. N., Eseadi, C., Ilechukwu, L. C., Okoro, K. N., Okolie, C. N., Egbule, E., & Asogwa, E. (2022). Potential influences of religiosity and religious coping strategies on people with diabetes. World Journal of Clinical Cases, 10(25), 8816–8826. https://doi.org/10.12998/wjcc.v10.i25.8816
  49. Reach, G., Pellan, M., Crine, A., Touboul, C., Ciocca, A., & Djoudi, Y. (2018). Holistic psychosocial determinants of adherence to medication in people with type 2 diabetes. Diabetes and Metabolism, 44(6), 500–507. https://doi.org/10.1016/j.diabet.2018.06.001
  50. Rebolledo, J. A., & Arellano, R. (2016). Cultural differences and considerations when initiating insulin. Diabetes Spectrum, 29(3), 185–190. https://doi.org/10.2337/diaspect.29.3.185
  51. Rhee, T. G., Westberg, S. M., & Harris, I. M. (2018). Complementary and alternative medicine in US adults with diabetes: Reasons for use and perceived benefits. Journal of Diabetes, 10(4), 310-319. https://doi.org/10.1111/1753-0407.12607
  52. Roglic, G. (2016). WHO Global report on diabetes: A summary. International Journal of Noncommunicable Diseases, 1(1), 3-8. https://doi.org/10.4103/2468-8827.184853
  53. Roohafza, H. R., Afshar, H., Keshteli, A. H., Mohammadi, N., Feizi, A., Taslimi, M., & Adibi, P. (2014). What's the role of perceived social support and coping styles in depression and anxiety? Journal of Research in Medical Sciences, 19(10), 944–949
  54. Sachdeva, S., Khalique, N., Ansari, M. A., Khan, Z., Mishra, S.K., & Sharma, G. (2015). Cultural determinants: Addressing barriers to holistic diabetes care. Journal of Social Health and Diabetes, 03(01), 033–038. https://doi.org/10.4103/2321-0656.140885
  55. Seiglie, J. A., Marcus, M. E., Ebert, C., Prodromidis, N., Geldsetzer, P., Theilmann, M., Agoudavi, K., Andall-Brereton, G., Aryal, K. K., Bicaba, B. W., Bovet, P., Brian, G., Dorobantu, M., Gathecha, G., Gurung, M. S., Guwatudde, D., Msaidié, M., Houehanou, C., Houinato, D., … Manne-Goehler, J. (2020). Diabetes prevalence and its relationship with education, wealth, and BMI in 29 low- and middle-income countries. Diabetes Care, 43(4), 767–775. https://doi.org/10.2337/dc19-1782
  56. Shahzad, A., Ahmad, M. M., Anwer, I., Ijaz, N., Shahzad, M., Usman, M. (2018). Gender-specific knowledge of diabetes and its management among patients visiting outpatient clinics in Faisalabad, Pakistan. Cureus, 10(8), e3119. https://doi.org/10.7759/cureus.3119
  57. Shwe, H., Oo, W., Nau, K., & Mar, K. (2020). The cultural practices of Bamar diabetic patients: An ethnographic study. Heliyon, 6(2), e03267. https://doi.org/10.1016/j.heliyon.2020.e03267
  58. Siddiqui, M. A., Khan, M. F., & Carline, T. E. (2013). Gender differences in living with diabetes mellitus. Materia Socio Medica 25(2), 140–142. https://doi.org/10.5455/msm.2013.25.140-142
  59. Sitawa, M. & Muhati, C. (2016). Socio-cultural dynamics influencing diabetes control: A case study of Vihiga district hospital, Kenya. International Journal of Scientific Research and Innovative Technology, 3(2), 140–158
  60. Soelistijo, S. A., Lindarto, D., Decroli, E., Permana, H., Sucipto, K. W., Kusnadi, Y., Budiman, B., Ikhsan, R., Sasiarini, L., & Sanusi H. (2019). Pedoman pengelolaan dan pencegahan diabetes melitus tipe 2 dewasa di Indonesia 2019 (The guideline of adult type 2 diabetes mellitus management and prevention in Indonesia 2019]. Perkumpulan Endokrinologi Indonesia. https://pbperkeni.or.id/wp-content/uploads/2020/07/Pedoman-Pengelolaan-DM-Tipe-2-Dewasa-di-Indonesia-eBook-PDF-1.pdf
  61. Steele, C. J., Schöttker, B., Marshall, A. H., Kouvonen, A., O'Doherty, M. G., Mons, U., Saum, K. U., Boffetta, P., Trichopoulou, A., Brenner, H., & Kee, F. (2017). Education achievement and type 2 diabetes-what mediates the relationship in older adults? Data from the ESTHER study: A population-based cohort study. BMJ Open, 7(4), e013569. https://doi.org/10.1136/bmjopen-2016-013569
  62. Sukarno, A., & Pamungkas, R. A. (2020). Religiousness associated with type 2 diabetes care management: A concept analysis. International Journal of Nursing and Health Services (IJNHS), 3(3), 462–470. https://doi.org/10.35654/ijnhs.v3i3.324
  63. Tang, T. S., Halani, K., Sohal, P., Bains, P., & Khan, N. (2020). Do cultural and psychosocial factors contribute to type 2 diabetes risk ? A look into Vancouver’s South Asian community. Canadian Journal of Diabetes, 44(1), 14–21. https://doi.org/10.1016/j.jcjd.2019.04.015
  64. Thulasi, A., Kumar, V., Jagannathan, A., Angadi, P., Umamaheswar, K., & Raghuram, N. (2019). Development and validation of yoga program for patients with type 2 diabetes mellitus (T2DM). Journal of Religion and Health, 61(4), 1-17. https://doi.org/10.1007/s10943-019-00859-x
  65. Tiwari , I., & Negi , C. S. . (2019). The relevance of yoga in developing holistic health and holistic community. Environment Conservation Journal, 20(SE), 83–88. https://doi.org/10.36953/ECJSE.2019.02016
  66. Tolossa, T., Mengist, B., Mulisa, D., Fetensa, G., Turi, E., & Abajobir, A. (2020). Prevalence and associated factors of foot ulcer among diabetic patients in Ethiopia: A systematic review and meta-analysis. BMC Public Health, 20(1), 41. https://doi.org/10.1186/s12889-019-8133-y
  67. Tondok, S. B., Rachman, N., Hanafi, W., & Susanto, A. (2022). Correlation between family support and adherence to routine controlling treatment in patients with type 1 diabetes mellitus in Merauke. International Journal of Nursing and Midwifery Science (IJNMS), 6(3), 235-242. https://doi.org/10.29082/IJNMS/2022/Vol6/Iss3/414
  68. Tran, A. H. T., & Tran, N. N. (2022). Holistic self-management behavior among urban patients with type 2 diabetes. International Journal of Public Health Science, 11(3), 846–851. https://doi.org/10.11591/ijphs.v11i3.21707
  69. Ventegodt, S., Kandel, I., Ervin, D. A., & Merrick, J. (2016). Concepts of holistic care. In I.L Rubin et al. (eds.), Health care for people with intellectual and developmental disabilities across the lifespan (pp. 1935-1941). Springer International Publishing. https://doi.org/10.1007/978-3-319-18096-0_148
  70. Watkins, Y.J., Quinn, L.T., Ruggiero, L., Quinn, M.T. and Choi, Y.K. (2013) Spiritual and religious beliefs and practices and social support’s relationship to diabetes self-care activities in African Americans. Diabetes Education, 39(2), 231-239. http://doi.org/10.1177/0145721713475843
  71. Wibisono et al. (2021). Petunjuk Praktis Terapi Insulin pada Pasien Diabetes Mellitus 2021 [Practical guideline for insulin therapy on diabetes mellitus patients 2021]. Perkeni. https://pbperkeni.or.id/wp-content/uploads/2021/11/22-10-21-_-Website-Pedoman-Petunjuk-Praktis-Terapi-Insulin-Pada-Pasien-Diabetes-Melitus-Ebook.pdf
  72. Wijaya, A. (2019). Metode penelitian menggunakan smart PLS 03 [Research methods using 3.0 smartPLS]. Innosain
  73. Wilding, J. P. H. (2014). The importance of weight management in type 2 diabetes mellitus. The International Journal of Clinical Practice, 68(6), 682–691. https://doi.org/10.1111/ijcp.12384
  74. Wulandari, I., Kusnanto, K., Wibisono, S., & Haryani, A. (2021). Family support in caring for diabetes mellitus patient: Patient's perspective. Macedonian Journal of Medical Sciences, 9, 199–205. https://doi.org/10.3889/oamjms.2021.5778
  75. Zamanzadeh, V., Jasemi, M., Valizadeh, L., & Keogh, B. (2015). Effective factors in providing holistic care: A qualitative study. Indian Journal of Palliative Care, 21(2), 214–224. https://doi.org/10.4103/0973-1075.156506
  76. Zhou, J., Wang, Q., Xiang, Z., Tong, Q., Pan, J., Wan, L., & Chen, J. (2019). Network pharmacology analysis of traditional Chinese medicine formula xiao ke yin shui treating type 2 diabetes mellitus. Evidence-based Complementary and Alternative medicine: eCAM, 2019, 4202563. https://doi.org/10.1155/2019/4202563

Last update:

No citation recorded.

Last update: 2024-11-02 00:20:40

No citation recorded.