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Fluid restriction adherence in hemodialysis patients using the ESRD-AQ: A multicenter study Hidayati, Wahyu; Ermawati, Eli; Firdaus, Iftinan Nida; Lestariningsih, Lestariningsih; Kristina, Tri Nur
The Journal of Palembang Nursing Studies Vol. 4 No. 1 (2025): January 2025
Publisher : Palembang MediRose Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55048/jpns155

Abstract

Background: Patients with chronic kidney disease (CKD) undergoing hemodialysis must adhere to fluid intake restrictions to prevent fluid accumulation, which can lead to complications such as edema, hypertension, and cardiovascular events. Excess intravascular and interstitial fluid volume contributes to fluid overload, a major risk factor for morbidity and mortality in this population. Objective: To describe adherence to fluid restriction among CKD patients receiving hemodialysis and identify common barriers to adherence. Methods: This descriptive survey study was conducted from January to June 2021 at two hospitals. A total of 129 CKD patients undergoing hemodialysis were recruited through purposive sampling. Inclusion criteria were age ?18 years, receiving routine hemodialysis for at least 3 months, and ability to communicate verbally. Fluid restriction adherence was assessed using the End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ), previously validated and culturally adapted. Descriptive statistics summarized adherence patterns and patient characteristics. Results: Most participants were male, in late adulthood, had completed college, were unemployed, had been on hemodialysis for approximately 5 years, and underwent treatment twice weekly. Overall, 66% adhered to fluid restrictions, with 36.4% reporting following restrictions all the time. However, 62.8% indicated barriers to adherence, including lack of interest, inability to control fluid intake, and not understanding how to follow the restriction. Conclusion: While most CKD patients complied with fluid restrictions, a substantial proportion faced challenges that could undermine long-term outcomes. Continuous education, motivational support, and individualized counseling are essential to improve adherence. Future research should explore the association between adherence, fluid overload, and clinical outcomes.
Interdialytic weight gain and pre-dialysis mean arterial pressure on patients with chronic hemodialysis Wahyu Hidayati; Elingga Widi Pangestu; Lestariningsih Lestariningsih; Tri Nur Kristina
Jurnal Aisyah : Jurnal Ilmu Kesehatan Vol 8, No 2: June 2023
Publisher : Universitas Aisyah Pringsewu

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (630.212 KB) | DOI: 10.30604/jika.v8i2.2059

Abstract

Patients with chronic kidney disease on hemodialysis (CKD-HD) frequently experience an increase in fluid volume, which is largely shown by interdialytic weight gain (IDWG). An increase in IDWG may cause the mean arterial pressure (MAP) during dialysis to increase. Chronic renal disease patients, it might worsen their condition and implies a change in intravascular. Patients must control their fluid intake, nevertheless, there are still a lot of patients who struggle with this. The aim of this study was to investigate the relationship between IDWG and pre-dialysis MAP in patients with chronic kidney disease. A descriptive correlation method with a cross-sectional approach was used in this study. The instruments were observation sheets to note the weight dan blood pressure, weight scales, and a sphygmomanometer. The purposive sampling method was used to select the respondents in this study. The respondents were 52 CKD-HD patients over the age of 18 who exercise at least twice a week and are not in intensive care. The data was collected at a hemodialysis unit. Statistical analysis used Pearson’s product-moment correlation. The results showed that most of the respondents had IDWG in the adequate category (78.8%) and pre-dialysis MAP in the optimal category (23.1%), p=0.003 (less than 0.05) and r=0,41. This study concluded that there was a relationship with moderate strength between IDWG and pre-dialysis MAP in patients with chronic kidney disease. Nurses are urged to strengthen monitoring of IDWG and pre-dialysis MAP, as well as monitoring of dietary compliance and patient fluid intake limitations, to identify potential issues in patients with chronic renal disease.
Scoping Review of Verbal De-Escalation in Psychiatric Emergency Pragholapati, Andria; Fitrikasari, Alifiati; Handayani, Fitria; Kristina, Tri Nur; Dewi, Nur Setiawati; Winarni, Tri Indah
Indonesian Journal of Global Health Research Vol 6 No 2 (2024): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v6i2.2826

Abstract

This article presents an in-depth literature review on the practices and significance of verbal de-escalation in psychiatric emergency situations. Verbal de-escalation is a communication strategy aimed at reducing tension and conflict in psychiatric patients experiencing crises. The aim of this research is to explore the effectiveness of various training methods in implementing verbal de-escalation techniques in psychiatric emergencies. The research method with scoping review, this article provides an overview of the concept of verbal de-escalation, commonly used techniques, and its positive impact on enhancing safety and intervention effectiveness in psychiatric emergencies. Additionally, the article identifies factors influencing the success of implementing verbal de-escalation and emphasizes the need for training and a holistic approach in managing psychiatric emergencies. The findings of this research can offer insights for practitioners, researchers, and policymakers in improving the quality of psychiatric emergency services through the effective implementation of verbal de-escalation strategies.
Compliance of Nurses in Carrying Out Initial Assessment of Hospital Inpathement Wirananda, Abdi; Kristina, Tri Nur; Dwiantoro, Luky
Indonesian Journal of Global Health Research Vol 6 No S4 (2024): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v6iS4.3975

Abstract

Initial assessment of hospital inpatients is an important component of patient care, ensuring appropriate treatment planning and improving patient outcomes. Nurses' adherence to initial assessment protocols is critical to maintaining the quality and safety of patient care. This study aims to evaluate nurses' compliance in implementing initial assessment of hospital inpatients and to identify factors that influence nurses' compliance with established protocols. Methodology: This research adopts an approach scoping review with the framework developed by Arksey and O'Malley. Research includes searching articles through databases Google Scholar and Scopus with the keyword "Obedience" "Assasment"AND "Nurse". The research uses the PRISMA method with data sources from Google Scholar and Scopus resulting in a total of 92 articles. The articles were then filtered based on the inclusion criteria, namely using English and Indonesian with a range of 2014-2024 nurses' compliance in implementing initial assessments of hospital inpatients which resulted in 7 articles that met the requirements. Research shows nurses' compliance with initial assessment protocols is influenced by several factors, including training, workload, and organizational support. Addressing these factors through targeted interventions may improve adherence rates and, consequently, patient outcomes. Further research is needed to develop and implement effective strategies to improve nurse compliance in various health care settings.
Students' perceptions of the relevance of instructors' assessment items in online community-based interprofessional education Hangujiwat, Puspo Palupi Yekti; Kristina, Tri Nur; Dewi, Dian Puspita; Candra, Aryu; Afifah, Diana Nur; Asmara, Fatikhu Yatuni
Jurnal Ners Vol. 19 No. 2 (2024): MAY 2024
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jn.v19i2.51634

Abstract

Introduction: This study aimed to acquire students' perceptions of the assessment items used by instructors implemented in the community-based Interprofessional Education (IPE) program during the COVID-19 pandemic. The study also compared the students' perceptions of the instructors' assessment items regarding student characteristics. Motivation for joining the IPE program and a comparison between motivation and gender and disciplines were also identified in this study. Methods: The research method is observational with a cross-sectional approach. Sixth-semester medical, nursing, and nutrition students who had completed the community-based IPE program were involved. Students' perception was measured using a questionnaire on the instructors' assessment items developed based on the IPE competencies. Motivation was measured using a Motivated Strategies for Learning Questionnaire (MSLQ). Results: A majority of students across the three programs agreed or strongly agreed with the assessment items, and there were no significant differences in student perceptions from the variables of gender (p = 0.23) and disciplines (p = 0.68). The correlation between students' motivation and their perception of the instructors' assessment items was significant (r_s = 0.61 with p < 0.01). However, there was a weak and not significant correlation between students' grade point average (GPA) with the perception of assessment items (r_s= 0.1 with p = 0.07). Conclusions: All instructors' assessment items were still perceived as relevant and can be used to assess the students during IPE online learning. Thus, the result of this study can be considered to be used in another setting with a similar situation.
PENERAPAN KOMUNIKASI SBAR UNTUK MENINGKATKAN KEMAMPUAN PERAWAT DALAM BERKOMUNIKASI DENGAN DOKTER Sri Siska Mardiana; Tri Nur Kristina; Madya Sulisno
Jurnal Ilmu Keperawatan dan Kebidanan Vol 10, No 2 (2019): JURNAL ILMU KEPERAWATAN DAN KEBIDANAN
Publisher : Universitas Muhammadiyah Kudus

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26751/jikk.v10i2.487

Abstract

Komunikasi antara perawat dengan dokter merupakan salah satu elemen penting dari praktik kolaborasi dalam pelayanan kesehatan. Komunikasi yang terjalin baik antara dokter dan perawat diharapkan dapat menjadi sarana untuk menyampaikan hal - hal penting, menjalin diskusi, memutuskan secara bersama-sama serta dapat meminimalkan hambatan-hambatan yang ada dalam pemberian perawatan kepada pasien. Model teknik komunikasi SBAR (Situation Background Assessment Recommendation)  membantu perawat untuk mengorganisasi cara berfikir, mengorganisasi informasi, dapat memudahkan penyampaian pesan serta berdiskusi saat berkomunikasi dengan dokter. Penelitian ini bertujuan untuk membuktikan apakah penerapan komunikasi SBAR dapat meningkatkan kemampuan perawat dalam berkomunikasi lisan dengan dokter. Rancangan penelitian yang digunakan adalah quasi experiment dengan pre-post test with control group. Jumlah sampel sebanyak 18 peserta pada kelompok intervensi dan 18 peserta pada kelompok kontrol yang diambil dengan teknik pengambilan sampel purposive sampling. Penelitian ini menemukan bahwa penerapan komunikasi SBAR dapat meningkatkan kemampuan perawat dalam berkomunikasi dengan dokter. 
EXPLORATION OF MEDICAL STUDENTS' PERCEPTION TOWARDS PBL TUTORIAL MODIFIED WITH INDIVIDUAL AND GROUP ASSESSMENT Kristina, Tri Nur; Dinar, Kintania Lutfiah; Fauzia, Lathifa Putry; Dewi, Dian Puspita
Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education Vol 14, No 4 (2025): December
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jpki.106620

Abstract

Background: Problem-based learning (PBL) has been implemented at the Faculty of Medicine, Universitas Diponegoro, since 2001. The model was later modified to enhance student engagement by incorporating individual and group assessment. Students are assessed not only on their knowledge but also on their skills, attitudes, and active participation in discussions, which contribute to their overall block assessment.Aims: This study explores the students’ perceptions of implementing the modified PBL.Methods: We conducted a qualitative study using six focus group discussions (FGD) involving 36 students from the 2021, 2022, and 2023 cohorts.Results: The study identified five opportunity themes and five challenge themes related to the modified PBL implementation, along with several student recommendations for improvement. The opportunities include more structured individual learning, increased active participation, group reports serving as practical and comprehensive learning resources, and the development of collaboration and leadership skills. Meanwhile, the challenges include delays in distributing PBL scenarios, an imbalance in group participation (e.g., overly passive or dominant students), the individual report becoming burdensome during exam periods, and the limited relevance of individual assessments in discussions. Nonetheless, students demonstrated awareness of these challenges and proposed constructive suggestions for improvement.Conclusion: The findings suggest that students benefit from the modified PBL in various ways. However, it can also potentially threaten the internal motivation of a self-directed learner.
Programmatic Assessment in Medical Education: A Bibliometric and Narrative Review of Its Potential Contributions to Health Literacy and Health Promotion Competencies Triastuti, N Juni; Tri Nur Kristina; Titi Savitri Prihatiningsih
Media Publikasi Promosi Kesehatan Indonesia (MPPKI) Vol. 9 No. 2 (2026): February 2026
Publisher : Fakultas Kesehatan Masyarakat, Universitas Muhammadiyah Palu

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56338/mppki.v9i2.8789

Abstract

Introduction: Programmatic assessment (PA) has emerged as a transformative framework in medical education, emphasizing longitudinal evaluation, meaningful feedback, and data-informed decision-making to enhance learner development. Its role extends beyond competency measurement, contributing to broader educational goals such as strengthening health literacy and health promotion competencies—core attributes for future healthcare professionals. This bibliometric and narrative review aimed to map global research trends, influential contributors, and thematic patterns in programmatic assessment while synthesizing evidence on its potential to advance health literacy and health promotion competencies in medical education. Methods: A comprehensive search was conducted in Scopus database for articles published between 1977 and 2025. Inclusion criteria of eligible studies were those addressing programmatic assessment in medical or health professions education—including portfolios, decision processes, or programmatic feedback—and explicitly linking these approaches to health literacy or health promotion competencies. The dataset comprised 822 records and a final sample of 166 publications eligible for bibliometric analysis. Bibliometric indicators were analysed using VOSviewer, including publication trends, author networks, organizational and country contributions, and keyword co-occurrence. Narrative synthesis integrated empirical findings on PA implementation and its educational outcomes. Results: A total of 1092 authors, 502 organizations, and 44 countries contributed to 1737 indexed keywords, of which 167 met inclusion thresholds. Thematic clustering identified four dominant domains: feedback and learning analytics, competency-based assessment, digital and AI-supported assessment, and professional identity formation. Recent literature emphasizes PA’s capacity to cultivate reflective practice, communication skills, and health advocacy—key components of health literacy and promotion. Conclusion: Programmatic assessment represents an integrative and evidence-driven approach that not only enhances learning and assessment quality but also fosters essential competencies in health literacy and promotion, aligning medical education with 21st-century public health priorities.
Co-Authors Adhuri, Iesha Kinanthi Ageng Abdi Putra Agus Santoso Alifiati Fitrikasari Andra Novitasari Andria Pragholapati Anggit Prasetyo Mituhu Anggit Prasetyo Mituhu Anna Annisa Aarts Antari, Arlita Leniseptaria Ari Budi Himawan Ariani, Resti Arief Wahyudi Jadmiko Aris Puji Widodo Aryu Candra Ashaeryanto Ashaeryanto Awal Prasetyo Bakrie, Saekhol Chairunnisa, Andita Devi Nurmalia Dewi, Dian Puspita Dian Puspita Dewi Diana Nur Afifah, Diana Nur Dinar, Kintania Lutfiah Doni Widyandana Dwiantoro, Luky Eli Ermawati Elingga Widi Pangestu Endang Lestari Endang Sri Lestari Erni Suprapti Ethyca Sari Eti Poncorini Pamungkasari Eti Poncorini Pamungkasari Fatikhu Yatuni Asmara Firdaus, Iftinan Nida Firman Fuad Wirakusumah Fitria Handayani Fitriana Hangujiwat, Puspo Palupi Yekti Hardian Hardian Hario Seno, Heri Nugroho Hendro Wahjono Ika Pawitra Miranti Ilham Uddin Job FM Metsemakers Lathifa Putry Fauzia, Lathifa Putry Lestariningsih Lestariningsih Lestariningsih Lestariningsih Luky Dwiantoro M Martono Diel Madya Sulisno Madya Sulisno Madya Sulisno Mardiana, Sri Siska Marloes A van Bokhoven Masfiyah Masfiyah, Masfiyah Mawardi, Fitriana Mochamad Arif Nugroho Mora Claramita Muchlis Achsan Udji Sofro N. Juni Triastuti Nadia Dwi Rahmawati Novyanti, Baiq Mira Nur Patria Tjahjani Nur Setiawati Dewi Nur Wahyu Puspitasari Nuryanto Nuryanto Pratama, Yanuar Surya Purnomo, Luluk R Vivi Meidianawaty Rebriarina Hapsari Renni Yuniati Riski Dwi Utami Saekhol Bakri, Saekhol Saiful Ridlo Sari Sudarmiati Sri Rejeki Sri Wahyudati Subakir Subakir Sudaryanto Sudaryanto Surya Akbar Syaropi Simanjuntak, Victor Jeremia Tissa Octavira Permatasari Titi Savitri Prihatiningsih Tri Hartiti Tri Indah Winarni Tridjoko Hadianto, Tridjoko Tunik Saptawati Udadi Sadhana, Udadi Udin Bahrudin, Udin Untung Sujianto V. Rizke Ciptaningtyas Wahyu Hidayati Wahyu Hidayati Widyandana Widyandana Winarto - Winarto Winarto Winarto Winarto Wirananda, Abdi Yan Wisnu Prajoko Yayi Suryo Prabandari Yoni Syukriani Zulfa Atabaki, Zulfa ‪Arlina Dhian Sulistyowati‬