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Hubungan Pengetahuan dengan Kepatuhan Penggunaan Insulin dada Pasien DM Tipe 2 Rangga, Alfrida; Najihah, Najihah; Wijayanti, Dewi; Tukan, Ramdya Akbar; Lesmana, Hendy; Iskandar, Ayuk Cucuk
MAHESA : Malahayati Health Student Journal Vol 4, No 12 (2024): Volume 4 Nomor 12 (2024)
Publisher : Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/mahesa.v4i12.15241

Abstract

ABSTRACT Diabetes is a chronic disease in the form of a metabolic disorder characterized by blood sugar levels that exceed normal limits. Type II diabetes mellitus is a disease caused by an increase in blood sugar due to a decrease in low insulin secretion by the pancreas gland. The therapy that is often used in type II diabetes patients is using insulin therapy. Insulin is a safe and effective drug in maintaining blood glucose levels within normal limits. To determine the relationship between knowledge and compliance with insulin use in Type 2 DM patients. Using a cross sectional study research method. Sampling used the Incidental Sampling technique with a sample size of 51 people. The results of the analysis from the Chi square test showed that the sig value was <0.0001 (P < 0.05), so it was said that there was a relationship between knowledge and compliance with insulin use in Type 2 DM patients. Respondents' knowledge about insulin use was related to compliance with insulin use. It is hoped that nurses can pay more attention to nursing care for patients in treating type 2 diabetes mellitus patients  Keywords: Diabetes Mellitus Type 2, Insulin, Compliance, Knowledge  ABSTRAK Diabetes adalah penyakit menahun (kronis) berupa gangguan metabolik yang ditandai dengan kadar gula darah yang melebihi batas normal. Diabetes melitus tipe II merupakan penyakit yang disebabkan kenaikan gula darah karena penurunan sekresi insulin yang rendah oleh kelenjar pancreas Terapi yang banyak dilakukan pada pasien diabetes tipe II ini yaitu menggunakan terapi insulin. Insulin merupakan obat yang aman dan efektif dalam menjaga kadar glukosa darah dalam ambang normal. Untuk mengetahui hubungan pengetahuan dengan kepatuhan penggunaan insulin pada pasien DM Tipe 2. Metode Penelitian dengan menggunakan metode penelitian cross sectional study. Pengambilan sampel menggunakan teknik Sampling Incidental dengan jumlah sampel sebanyak 51 orang. Hasil analisis dari Chi square test didapatkan tetap nilai sig sebesar <0.0001 (P < 0.05) sehingga dikatakan ada hubungan pengetahuan dengan kepatuhan penggunaan insulin pada pasien DM Tipe 2. Pengetahuan responden tentang penggunaan insulin berhubungan dengan kepatuhan dalam penggunaan insulin. Diharapkan perawat dapat lebih memperhatikan asuhan keperawatan pada pasien dalam penanganan pasien diabetes melitus tipe 2 Kata Kunci: Diabetes Melitus Tipe 2, Insulin, Kepatuhan, Pengetahuan
Analisis Faktor yang Mempengaruhi Kualitas Hidup Pasien Gagal Ginjal Kronik yang Menjalani Hemodialisa Yunita, Yunita; Najihah, Najihah; Wijayanti, Dewi; Lesmana, Hendy
MAHESA : Malahayati Health Student Journal Vol 4, No 11 (2024): Volume 4 Nomor 11 (2024)
Publisher : Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/mahesa.v4i11.15137

Abstract

ABSTRACT Chronic Kidney Failure occurs due to irreversible deterioration in kidney function that occurs over several months or years. This situation results in an inability to maintain the balance of body substances or an accumulation of fluid and waste products which requires kidney replacement or dialysis therapy. Hemodialysis therapy is a replacement therapy to remove metabolic waste from the human blood circulation which will affect the quality of life. The aim of this study was to identify factors associated with quality of life in chronic kidney failure patients undergoing hemodialysis at RSUD dr. H. Jusuf SK North Kalimantan. This research is a descriptive study with a cross sectional study design. Sampling used purposive sampling. The samples in this study were patients undergoing hemodialysis therapy at RSUD dr. H. JUSUF SK North Kalimantan, totaling 100 respondents. Data were collected using a questionnaire from WHOQoL. The results of the study showed that there was no relationship between age and employment with a p value of 0.369 and 0.398, whereas gender, education, duration of HD, frequency of HD were found to have a relationship with each p value of 0.036; 0.011; 0.034 and 0.008. It can be concluded that there is a significant relationship between gender, education, duration of hemodialysis and frequency of hemodialysis and the quality of life of patients undergoing hemodialysis at RSUD dr. H. Jusuf SK. Therefore, it is hoped that nurses and other health workers will provide education regarding the importance of HD and increase family participation as a support system to improve the patient's quality of life. Keywords: Quality of Life, Chronic Renal Failure, Hemodialysis  ABSTRAK Gagal Ginjal Kronik terjadi karena kemunduran fungsi dari ginjal ireversibel yang terjadi beberapa bulan atau tahun. Keadaan ini mengakibatkan ketidakmampuan dalam mempertahankan keseimbangan substansi tubuh atau akumulasi cairan dan produk sisa yang memerlukan penggantian ginjal atau terapi dialysis. Terapi hemodialisis merupakan terapi pengganti untuk mengeluarkan sisa-sisa metabolisme dari peredaran darah manusia yang akan mempengaruhi kualitas hidup. Tujuan penelitian ini untuk mengidentifikasi faktor yang berhubungan dengan kualitas hidup pada pasien gagal ginjal kronik yang menjalani hemodialisa di RSUD dr. H. Jusuf SK Kalimantan Utara. Penelitian ini merupakan penelitian deskritif dengan desain cross sectional study. Pengambilan sampel menggunakan purposive sampling. Sampel dalam penelitian ini adalah pasien yang menjalani terapi hemodialisis di RSUD dr. H. JUSUF SK Kalimantan Utara yang berjumlah 100 responden. Pengambilan data menggunakan kuesioner dari WHOQoL. Hasil penelitian menunjukkan bahwa tidak ada hubungan antara usia dan pekerjaan dengan p value 0,369 dan 0,398 sedangkan dengan jenis kelamin, pendidikan, lama HD, frekuensi HD ditemukan ada hubungan dengan masing-masing p value 0,036 ; 0,011; 0,034 dan 0,008. Dapat disimpulkan ada hubungan yang bermakna antara jenis kelamin, pendidikan, lama hemodialisa dan frekuensi hemodialisa dengan kualitas hidup pasien yang menjalani hemodialisa di RSUD dr. H. Jusuf SK. Oleh karena itu, diharapkan agar perawat dan tenaga kesehatan lainnya memberikan edukasi terkait pentingnya HD serta meningkatkan peran serta keluarga sebagai support sistem untuk meningkatkan kualitas hidup pasien. Kata Kunci: Kualitas Hidup, Gagal Ginjal Kronik, Hemodialisa
Analisis Faktor yang Berhubungan dengan Hipotermi Pasca General Anestesi di Instalasi Bedah Sentral Hadariah, Hadariah; Najihah, Najihah; Ose, Maria Imaculata; Wijayanti, Dewi; Pujianto, Ahmat
MAHESA : Malahayati Health Student Journal Vol 4, No 11 (2024): Volume 4 Nomor 11 (2024)
Publisher : Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/mahesa.v4i11.15229

Abstract

ABSTRACT More than 80% of operations use general anesthesia techniques. and it was found that 2.5% of patients experienced complications after undergoing anesthesia. Nearly 30% of post-anesthesia patients experience hypothermia. The negative impacts of hypothermia on patients include increased risk of bleeding, myocardial ischemia, longer recovery after anesthesia, impaired wound healing, and increased risk of infection. The aim of this study was to analyze factors associated with hypothermia after general anesthesia at IBS RSUD dr. H. Jusuf SK Tarakan. This research is a quantitative research with 60 respondents. Respondents in this study were post-general anesthesia patients using consecutive sampling technique. The statistical test used is the Chi-Square test. The results of the study showed that factors associated with hypothermia after general anesthesia were age, BMI, gender, type of operation and duration of operation in a central surgical installation. So it can be concluded that there is a relationship between the factors age, BMI, gender, length of operation and type of operation with hypothermia after general anesthesia at IBS RSUD dr. H. Jusuf SK. Therefore, it is hoped that the hospital can create an SOP regarding the management of preventing hypothermia in post-surgical patients. Keywords: Factor, Hypothermia, General Anesthesia  ABSTRAK Lebih dari 80% operasi menggunakan teknik general anastesi. dan ditemukan 2,5% pasien mengalami komplikasi setelah menjalani anestesi. Pasien pasca anestesi hampir 30% mengalami kejadian hipotermi. Dampak negatif hipotermi terhadap pasien, antara lain risiko perdarahan meningkat, iskemia miokardium, pemulihan pasca anestesi yang lebih lama, gangguan penyembuhan luka, serta meningkatnya risiko infeksi.  Tujuan penelitian ini untuk menganalisis faktor yang berhubungan dengan hipotermi pasca general anestesi di IBS RSUD dr. H. Jusuf SK Tarakan. Penelitian ini merupakan penelitian kuantitatif dengan 60 responden. Responden dalam penelitian ini merupakan pesien pasca general anestesi dengan teknik pengambilan sample consecutive sampling. Uji statistik yang digunakan adalah uji Chi-Square. Hasil penelitian menunjukkan bahwa faktor yang berhubungan dengan hipotermi pasca general anestesi adalah usia, IMT, jenis kelamin, jenis operasi dan lama operasi di instalasi bedah sentral. Sehingga dapat disimpulkan bahwa terdapat hubungan antara faktor usia, IMT, jenis kelamin, lama operasi dan jenis operasi dengan hipotermi pasca general anestesi di IBS RSUD dr. H. Jusuf SK. Oleh karena itu, diharapkan pihak rumah sakit dapat membuat SOP terkait manajemen pencegahan hipotermi pada pasien pasca bedah Kata Kunci: Faktor, Hipotermi, General Anastesi
Peningkatan Kualitas Tidur Pada Pasien Nyeri Akut dengan Relaksasi Benson Madda, Hasmidah; Paridah, Paridah; Tukan, Ramdya Akbar; Ose, Maria Imaculata; Najihah, Najihah; Alfianur, Alfianur; lesmana, Hendy
MAHESA : Malahayati Health Student Journal Vol 4, No 7 (2024): Volume 4 Nomor 7 (2024)
Publisher : Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/mahesa.v4i7.14714

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ABSTRACT Pain is a sensory and emotional experience accompanied by a sense of discomfort due to actual and potential damage to body tissues Pain or soreness is the most frequent major complaint, leading individuals to seek help at health facilities Pain has been identified as the cause of poor sleep quality Therefore, pharmacological and non-pharmacological interventions were needed to overcome the problem Benson relaxation can be used as a non-pharmacological intervention to reduce pain and improve sleep quality. The purpose of this study was to identify the effectiveness of Benson relaxation intervention on improving sleep quality in acute pain patients. This research used a quasi-experimental method with a One-group pretest-posttest design. The sampling used Purposive Sampling (Judgmental Sampling) with a total sample of 47 respondents who were treated in Anggrek A room of RSUD dr. H Jusuf SK. The results of a statistical test using the Wilcoxon Signed Rank test obtained a value of p-0.001 It showed that there was a significant difference between respondents' sleep quality and acute pain before and after Benson relaxation intervention The conclusion of the study showed that Benson relaxation which was given 20 minutes for 3 days was effective for improving sleep quality in acute pain patients. Keywords: Acute Pain, Benson Relaxation Therapy, Insomnia, Sleep Quality  ABSTRAK Nyeri adalah suatu pengalaman sensorik serta emosional disertai rasa ketidaknyamanan akibat rusaknya jaringan tubuh aktual dan potensial. Rasa sakit atau nyeri merupakan keluhan utama yang paling sering, membuat individu mencari bantuan ke fasilitas kesehatan. Nyeri telah diidentifikasi sebagai penyebab kualitas tidur yang buruk oleh karena itu dibutuhkan intervensi farmakologi dan non farmakologi untuk mengatasi masalah tersebut. Relaksasi Benson dapat digunakan sebagai intervensi non farmakologi untuk mengurangi nyeri dan menaikkan kualitas tidur. Tujuan penelitian ini untuk mengidentifikasi efektifitas intervensi relaksasi Benson terhadap peningkatan kualitas tidur pada pasien nyeri akut. Jenis penelitian ini menggambarkan metode quasi-exsperimen dengan desain One-group pretest-posttest design. Pengambilan sampel mengunakan Purposive Sampling (Judgmental Sampling) dengan jumlah sampel 47 pasien yang dirawat di ruang Anggrek A RSUD dr. H Jusuf SK. Hasil uji statistic menggunakan Wilcoxon Signed Rank Test didapatkan nilai p=0,001, ini menunjukkan bahwa ada perbedaan yang signifikan antara kualitas tidur pasien dengan nyeri akut sebelum dan setelah dilakukan intervensi relaksasi benson. Kesimpulan penelitian adalah relaksasi benson yang diberikan 20 menit selama 3 hari efektif untuk meningkatkan kualitas tidur pada pasien nyeri akut. Kata Kunci:Benson Relaxation Therapy, Insomnia, Kualitas Tidur, Nyeri 
Studi Fenomenologi: Pengalaman Perawat dalam Menegakkan Diagnosis Keperwatan Berdasarkan Standar Diagnosis Keperawatan Indonesia Batu, Yuliana; Hasriana, Hasriana; Damayanti, Ana; Lesmana, Hendy; Zulfia, Rahmatuz; Najihah, Najihah
MAHESA : Malahayati Health Student Journal Vol 4, No 9 (2024): Volume 4 Nomor 9 (2024)
Publisher : Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/mahesa.v4i9.14897

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ABSTRACT Diagnosis enforcement is an important aspect of the practice of nursing. Nursing diagnosis have been applied at a number of hospitals and other health facilities, but the knowledge of nurses regarding diagnostic indicators for diagnostic enforcement, and diagnosis enforcement is not difficult. The SDKI as a guideline for the formulation of nursing diagnosis has been implemented since 2017, but in reality, the implementation of nursing diagnosis based on SDKI is not optimal yet. The purpose of the research is to explore the experiences of nurses in enforcing their nursing diagnosis based on SDKI. Through a qualitative study with a phenomenological approach, using purposive sampling techniques and total of 14 participants. The results of this study led to four themes namely: new challenges, making it easier for nurses, obstacles of SDKI use, form of support for the implementation of SDKI. The result of this study conluded that the use of SDKI makes it easier to the determination of nursing diagnoses. The hospital committee should conduct in-house training on nursing care plans in accordance with the Indonesian Standard of Nursing Diagnosis. Keywords: Experience of Nurse, SDKI, Nursing Diagnosis  ABSTRAK Penegakan diagnosis merupakan aspek penting dalam praktik keperawatan. SDKI sebagai pedoman perumusan diagnosis keperawatan telah diberlakukan sejak tahun 2017, akan tetapi pada kenyataannya saat ini penerapan diagnosis keperawatan berdasarkan SDKI belum optimal. Tujuan dari penelitian ini adalah mengeksplorasi pengalaman perawat dalam menegakkan diagnosis keperawatan berdasarkan SDKI, Melalui studi kualitatif dengan pendekatan fenomenologi, menggunakan tehnik purposive sampling dan jumlah 14 partisipan. Hasil penelitian ini memunculkan empat tema yaitu: tantangan baru, memudahkan perawat, kendala penggunaan SDKI, bentuk dukungan penerapan SDKI. Hasil penelitian ini menyimpulkan bahwa Penggunaan SDKI memudahkan dalam penentuan diagnosis keperawatan. Komite rumah sakit perlu melakukan inhouse training tentang nursing care plan yang disesuaikan dengan Standar Diagnosis Keperawatan Indonesia. Kata Kunci: Diagnosis Keperawatan, Pengalaman Perawat, SDKI 
Pengaruh Massage Punggung Terhadap Penurunan Skala Nyeri dengan Menggunakan Numeric Rating Scale (NRS) pada Pasien Pasca Laparatomi Zakinah, ST; Najihah, Najihah; Zulfia, Rahmatuz; Lesmana, Hendy
Jurnal Berita Kesehatan Vol 17 No 2 (2024): Desember 2024
Publisher : Sekolah Tinggi Ilmu Kesehatan Gunung Sari

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58294/jbk.v17i2.188

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Laparatomi merupakan tindakan pembedahan besar yang di lakukan dengan membuat sayatan besar di perut untuk mendapatkan akses ke rongga peritonium. Komplikasi tindakan laparatomi dapat terjadi secara spesifik dan dapat di pengaruhinoleh faktor faktor pada saat operasi, salah satunya dapat menyebabkan nyeri. Penatalaksanaan penanganan nyeri dapat mengunakan tindakan terapeutik dan tindakan kolaborasi salah satunya adalah massage punggung. Penelitian ini bertujuan untuk mengetahui pengaruh massage punggung terhadap penurunan skala nyeri pada pasien pasca laparatomi di RSUD dr. H. Jusuf SK. Desain penelitian ini menggunakan pre-experimental study one group pretest-post Test design. Jumlah sampel pada penelitian ini adalah 21 responden yang dipilih dengan menggunakan Teknik Purposive Sampling. Pengumpulan data dengan menggunakan kuesioner yang berisi data demografi pasien dan lembar observasi skala nyeri Numeric Rating Scale yang di analisis menggunakan Uji Wilcoxon Singed Rank Test. Sebelum dilakukan massage punggung, yang memiliki skala nyeri sedang lebih banyak dibandingkan respoden yang memiliki skala nyeri berat. Sedangkan, setelah dilakukan massage punggung rata–rata skala nyeri yang dirasakan responden berkurang menjadi skala nyeri sedang dan ringan. Selain itu, penelitian ini juga menunjukkan adanya pengaruh efektivitas massage punggung terhadap skala nyeri dengan nilai p-value 0,001 atau lebih kecil dari 0,05. Kesimpulan penelitian ini yaitu terdapat penurunan skala nyeri yang signifikan setelah dilakukan massage punggung pada pasien pasca laparotomi. Perawat diharapkan bisa menjadikan massage punggung menjadi salah satu tindakan alternatif untuk mengurangi nyeri pada pasien pasca laparatomi.
BUDAYA KESELAMATAN PASIEN DAN INSIDEN KESELAMATAN PASIEN DI RUMAH SAKIT: LITERATURE REVIEW Najihah, Najihah
Journal of Islamic Nursing Vol 3 No 1 (2018): Journal Of Islamic Nursing
Publisher : Universitas Islam Negeri Alauddin Makassar

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (65.319 KB) | DOI: 10.24252/join.v3i1.5469

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Patient safety in health care has gained much attention since the Institute of Medicine (IOM) in 2000 published a report entitled "To Err is Human: Building a Safer Health System" which points to the death rate from KTD in hospitalized patients across America totaling 44,000- 98,000 people per year. By using a lower estimate, more people die from medical errors in a year than road accidents, breast cancer, or AIDS. Therefore, if the hospital wants to reduce the incidence of patient safety incidents then the hospital should implement a patient safety culture. The purpose of this paper is to know the application of patient safety culture related to Evidence Based patient evidence incidents. In the literature search process, used several databases such as Pubmed, PMC, NCBI, PXJ, NJEM and BMJ. Keywords included are keywords relevant to the material, namely "Patient Safety Culture", "Patient Safety Incident" and "Reporting Patient Safety Incident". From various literature findings, 12 research articles were combined and considered relevant to the topic. From various research articles it is concluded that the patient safety culture is closely related to the incidence of patient safety incidents. As the patient's safety culture increases, the incidence of patient safety incidents can be minimized. One effort that can be made to improve the application of a patient safety culture to minimize patient safety incidents is to report patient incident safety, either KNC, KPC, KTC let alone KTD
PENGGUNANAAN COMPRESSION STOCKING TERHADAP PENCEGAHAN DEEP VENOUS THROMBOSIS (DVT): LITERATUR REVIEW Najihah, Najihah
Journal of Islamic Nursing Vol 3 No 2 (2018): Journal Of Islamic Nursing
Publisher : Universitas Islam Negeri Alauddin Makassar

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (441.956 KB) | DOI: 10.24252/join.v3i2.6802

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Deep Venous Thrombosis (DVT) is a condition in which a clot forms in deep vein due to inflammation/ venous wall trauma or due to partial venous obstruction. Most DVT comes from lower extremities. Pulmonary embolism is a significant risk for DVT because the release of thrombus then follows the blood flow and is trapped in the pulmonary artery. Compression stocking is one of the compression therapies that helps prevent blood clots that form in the foot by applying pressure varies on each part of the foot. The purpose of this review literature is to determine the effectiveness of using the Compression stocking for prevention of DVT. The process of searching journal articles uses Google Scholar and several databases, namely Cocrane, Proques and Pubmed. Keywords included are "compression therapy", "compression stocking" and "deep venous thrombosis". Search results in each database based on keywords by reading the research abstract obtained 7 journal articles. The use of Compression stocking for prevention of  DVT has been proven by several studies. This is because compression stocking works by exerting a compression level on the ankle with a gradual compression level. A pressure gradient or compression will ensure that blood flows towards the heart instead of reflux to the foot. But in the use of Compression stocking in the prevention of DVT, patients need to obtain information specifically about how to use it to avoid complications that might arise due to the use of Compression stocking.
KUALITAS HIDUP LANSIA DENGAN HIPERTENSI DI WILAYAH KERJA PUSKESMAS SEGERI KABUPATEN PANGKEP Ramli, Rahmawati; Najihah, Najihah
Journal of Islamic Nursing Vol 4 No 1 (2019): Journal Of Islamic Nursing
Publisher : Universitas Islam Negeri Alauddin Makassar

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (432.613 KB) | DOI: 10.24252/join.v4i1.7806

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Abstract Globally in 2012, of all deaths, non-communicable diseases caused 68% deaths and the majority of premature deaths (82%) because non-communicable diseases occurred in countries with low and middle opinions. And of all non-communicable disease-related deaths, 46% came from cardiovascular disease . Long-term hypertension can cause a decline in cognitive function, which of course will greatly disrupt the quality of life of patients. The aim of the study was to determine the quality of life of elderly people with hypertension in the Work Area of Segeri Health Center, Pangkep Regency. This research method uses qualitative research with a focus on phenomenological approaches. The research instrument is the researcher himself. Determination of samples using purposive sampling technique. The results of this study found the quality of life of the elderly in terms of the physical aspects of the elderly experiencing physical problems that disrupt activities, psychological aspects that consider the disease to be acquired due to the aging process, social aspects namely the elderly have good social relations with neighbors, and environmental aspects that are comfortable and safe. It is expected to provide clear and complete information to elderly hypertensive patients and families about the care of elderly hypertension and how to treat hypertension.\ Keywords: Elderly, Quality of life, hipertension.
Lived Experiences of Patients Undergoing Hemodialysis in Tarakan, Indonesia Iskandar, Ayuk Cucuk; Darni, Darni; Najihah, Najihah
IJNP (Indonesian Journal of Nursing Practices) Vol. 10 No. 1 (2026): June
Publisher : Universitas Muhammadiyah Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/ijnp.v10i1.30395

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Background: Chronic kidney disease (CKD) has a major effect on the well-being of patients, and hemodialysis is a necessary yet challenging treatment that alters an individual's way of life. Patient-centered narratives about the life experiences of patients with CKD undergoing hemodialysis are still greatly needed to provide a deeper understanding. Objective: This study aims to explore the lived experiences of patients with chronic kidney disease undergoing hemodialysis. Methods: A descriptive qualitative design with semi-structured interviews was used in this study, which involved 14 participants. Data were analyzed using thematic analysis following Braun & Clarke's six-step approach. Results: Five themes emerged: (1) Total life disrupted, (2) Cyclical survival with hemodialysis, (3) Self-transformation, (4) Family as a supporting pillar, and (5) Hope dynamics. Conclusion: Hope and family support help patients cope with the physical and emotional consequences associated with chronic kidney disease and hemodialysis treatment as they transition from life disruption to self-transformation. The findings suggest opportunities to support a geographically sensitive, family-centered approach to kidney care in island settings. Nursing care can contribute to this by involving families in home care management and providing continuous emotional support to help patients in their ongoing adjustment.