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Journal : Holistik Jurnal Kesehatan

Evidence based nursing in practice penerapan breating relaxation exercise untuk mengurangi nyeri selama pemasangan chest tube dan thoracotomy Tampubolon, Briefman; Rayasari, Fitrian; Yuniarti, Niknik; Nugraha, Rizki; Anggraini, Dewi
Holistik Jurnal Kesehatan Vol. 19 No. 8 (2025): Volume 19 Nomor 8
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i8.1670

Abstract

Background: Chest tube placement in post-thoracostomy patients often causes pain, which impacts the healing process. Pharmacological therapies such as analgesics are commonly used but have limitations. Therefore, non-pharmacological interventions such as Breathing Relaxation Exercise (BRE) are needed to help reduce pain. Purpose: To determine the effect of breathing relaxation exercises on pain reduction during chest tube placement and thoracotomy. Method: A pre-experimental one-group pretest-posttest design with a sample size of 13 participants determined using the G*Power calculation. The pain measurement instrument used was the Visual Analogue Scale (VAS). Data analysis was performed using the Shapiro-Wilk normality test and a paired sample t-test. Results: Before BRE, most patients experienced severe pain (69.2%). After the intervention, the pain scale decreased to moderate (38.5%) and mild (46.2%) pain categories. The paired sample t-test results showed a significant difference (p<0.05), with an average pain reduction of 1.615. Conclusion: There was a significant decrease in the pain scale before BRE was implemented.   Keywords: Breathing Relaxation Exercise; Chest Tube; Evidence Based Nursing In Practice; Painful; Thoracotomy.   Pendahuluan: Pemasangan chest tube pada pasien pasca torakostomi sering menimbulkan nyeri yang berdampak pada proses penyembuhan. Terapi farmakologis seperti analgetik umum digunakan, namun memiliki keterbatasan. Oleh karena itu, diperlukan intervensi nonfarmakologis seperti Breathing Relaxation Exercise (BRE) untuk membantu menurunkan nyeri. Tujuan: Mengetahui pengaruh penerapan breating relaxation exercise untuk mengurangi nyeri selama pemasangan chest tube dan thoracotomy. Metode: Desain pre-eksperimental one group pretest-posttest dengan jumlah sampel 13 partisipan yang ditentukan melalui perhitungan G*Power. Instrumen pengukuran nyeri menggunakan Visual Analogue Scale (VAS). Analisis data dilakukan dengan uji normalitas Shapiro-Wilk dan uji Paired Sample t-Test. Hasil: Sebelum diberikan BRE, sebagian besar pasien mengalami nyeri berat (69.2%). Setelah intervensi, skala nyeri menurun menjadi kategori nyeri sedang (38.5%) dan ringan (46.2%). Hasil uji Paired Sample t-Test menunjukkan terdapat perbedaan bermakna (p<0.05), dengan rata-rata penurunan nyeri sebesar 1.615. Simpulan: Adanya penurunan signifikan skala nyeri sebelum dilakukan dilakukan penerapan BRE.   Kata Kunci: Breating Relaxation Exercise; Evidence Based Nursing In Practice; Chest Tube; Nyeri; Thoracotomy.
Penerapan evidence-based practice nursing program intradialytic flexsibility exercise range of mation terhadap fatigue pada pasien chronic kidney disease yang menjalani hemodialisa Ukur, Sada; Nugraha, Rizki; Setiawantari , Rani; Siswandi, Iyar; Sofiani, Yani; Jumaiyah , Wati
Holistik Jurnal Kesehatan Vol. 19 No. 8 (2025): Volume 19 Nomor 8
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i8.1671

Abstract

Background: Chronic Kidney Disease (CKD) is one of the leading causes of global morbidity and mortality. Patients undergoing hemodialysis often experience fatigue, which significantly affects their quality of life, productivity, and psychological well-being. One of the non-pharmacological interventions that can be applied is intradialytic flexibility exercise in the form of range of motion (ROM). Purpose: To determine the effect of intradialytic flexibility exercise range of motion on fatigue levels among CKD patients undergoing hemodialysis. Method: A quasi-experimental study using a one-group pre-post test design was conducted from May to July 2025 at Al Ihsan Regional General Hospital, West Bandung. Purposive sampling was used to select 18 participants. The independent variable in this study was the Intradialytic Flexibility Exercise Range of Motion Program, while the dependent variable was the level of fatigue. Data analysis was performed using univariate analysis in the form of frequency distribution and bivariate analysis using the Cochran test. Translated with DeepL.com (free version) Results: Before the intervention, 77.8% of participants experienced severe fatigue. After 8 weeks of intervention, all participants (100%) showed a decrease in fatigue to a mild category. Statistical analysis indicated a significant difference in fatigue levels before and after the intervention (p < 0.05). Conclusion: Intradialytic flexibility exercise range of motion is effective in reducing fatigue levels among CKD patients undergoing hemodialysis. This intervention can be considered a non-pharmacological nursing strategy to improve patients’ quality of life.   Keywords: Chronic Kidney Disease; Fatigue; Hemodialysis; Intradialytic Exercise; Range of Motion.   Pendahuluan: Penyakit ginjal kronis (CKD) merupakan salah satu penyebab utama morbiditas dan mortalitas global. Pasien CKD yang menjalani hemodialisis sering mengalami kelelahan (fatigue) yang berdampak pada kualitas hidup, produktivitas, dan kesehatan mental. Salah satu intervensi non-farmakologis yang dapat diterapkan adalah intradialytic flexibility exercise berupa range of motion (ROM). Tujuan: Untuk mengetahui pengaruh penerapan intradialytic flexibility exercise range of motion terhadap tingkat kelelahan pada pasien CKD yang menjalani hemodialisa. Metode: Penelitian quasi experimental dengan metode one group pre-posttest design, dilaksanakan pada Mei-Juli 2025 di RSUD Al Ihsan, Bandung Barat. Teknik pengambilan sampel menggunakan purposivel sampling dengan jumlah sampel yang digunakan sebanyak 18 partisipan. Variabel independen dalam penelitian ini adalah Program Intradialytic Flexibility Exercise Range of Motion, sedangkan variabel dependen ialah tingkat kelelahan. Analisis data yang digunakan univariate dalam bentuk distribusi frekuensi dan bivariate menggunakan uji Cochran. Hasil: Sebelum intervensi, 77.8% partisipan mengalami fatigue berat. Setelah 8 minggu intervensi, seluruh partisipan (100%) mengalami penurunan tingkat fatigue menjadi kategori ringan. Hasil uji statistik menunjukkan adanya perbedaan signifikan tingkat fatigue sebelum dan sesudah intervensi (p < 0.05). Simpulan: Penerapan intradialytic flexibility exercise range of motion efektif menurunkan tingkat kelelahan pada pasien CKD yang menjalani hemodialisa.   Kata Kunci: Chronic Kidney Disease; Fatigue; Hemodialisa; Intradialytic Exercise; Range of Motion.