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All Journal Nurse Media Journal of Nursing Jurnal Keperawatan Padjadjaran Jurnal Kesehatan Holistic Jurnal Ilmiah Ilmu Keperawatan Indonesia (Indonesian Nursing Scientific Journal) Jurnal Kreativitas PKM Human Care Journal Jurnal Ners Indonesian Journal of Global Health research Lentera Perawat Jurnal Kesehatan Kartika Holistik Jurnal Kesehatan Indonesian Journal of Global Health Research
Rizki Nugraha Agung
Universitas Muhammadiyah Jakarta
Education Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Medicine & Pharmacology Neuroscience Nursing Public Health Veterinary

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Terapi musik efektif menurunkan kecemasan pada pasien penyakit ginjal kronis yang menjalani pemasangan akses vena Apri Budianto; Rizki Nugraha Agung; Iyar Siswandi; Yani Sofiani; Sandra Andini
Hik Vol. 19 No. 12 (2026): Volume 19 Nomor 12
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i12.2417

Abstract

Background: Anxiety in patients with chronic kidney disease (CKD) is not only a psychological problem but also a serious clinical threat because it triggers hemodynamic instability. When patients experience intense anxiety before an invasive procedure such as double-lumen catheter (DLU) placement, the sympathetic nervous system is activated, increasing blood catecholamine levels, leading to spikes in blood pressure and tachycardia. This condition is particularly risky for CKD patients who already have cardiovascular complications. Several factors can trigger anxiety and depression in hemodialysis patients, including frequent comorbidities, frequent hospitalizations, new experiences with invasive procedures, chronic pain, sleep disturbances, chronic inflammation, increased fatigue, decreased sexual function, uremia, and lack of family support in daily life. Purpose: To determine the effectiveness of music therapy in reducing anxiety in patients with chronic kidney disease undergoing venous access placement. Method: This study used an evidence-based nursing practice (EBNP) approach with a quasi-experimental pre-post-test design, conducted on 14 participants selected through purposive sampling based on inclusion criteria. Music therapy was administered during the venous access/CDL surgical procedure for 30 minutes. Anxiety was measured using the HARS and VAS questionnaires. Data were analyzed using univariate and bivariate tests, including paired t-tests and Wilcoxon tests. Results: The prevalence of anxiety decreased from 60% to 40%, with HARS and VAS measurements decreasing from 48% to 43% after the intervention. The paired t-test and Wilcoxon test showed p-values ​​of 0.01 and 0.00, respectively. Conclusion: Music therapy can reduce anxiety in hemodialysis participants. Applied systematically and supported by scientific evidence, music therapy has a positive effect on anxiety in patients with chronic kidney disease (CKD) undergoing venous access. Suggestion: Further exploration of the physiological and psychological mechanisms of music therapy is needed, as well as consideration of other factors, such as pain, sleep quality, depression levels, and medication adherence, which may influence anxiety levels in hemodialysis patients undergoing first-time venous access.   Keywords: Anxiety; Chronic Kidney Disease Patients; Music Therapy; Venous Access Insertion.   Pendahuluan: Kecemasan pada pasien Penyakit Ginjal Kronis (PGK) bukan sekadar masalah psikologis, melainkan ancaman klinis yang serius karena memicu instabilitas hemodinamik. Saat pasien mengalami kecemasan hebat menjelang tindakan invasif seperti pemasangan catheter dual lumen (CDL), sistem saraf simpatis akan teraktivasi, meningkatkan kadar katekolamin dalam darah yang berujung pada lonjakan tekanan darah dan takikardia. Kondisi ini sangat berisiko bagi pasien PGK yang sudah memiliki komplikasi kardiovaskular. Beberapa faktor yang bisa memicu kecemasan dan depresi pada pasien hemodialisis, antara lain penyakit penyerta yang sering timbul, seringnya dirawat di rumah sakit, pengalaman baru terhadap tindakan invasif, nyeri kronik, gangguan tidur, peradangan kronik, peningkatan kelelahan, penurunan fungsi seksual, uremia, dan kegagalan dukungan keluarga dalam kehidupan sehari-hari. Tujuan: Untuk menerapkan terapi musik efektif menurunkan kecemasan pada pasien penyakit ginjal kronis yang menjalani pemasangan akses vena. Metode: Penelitian ini menggunakan pendekatan evidence-based nursing practice (EBNP) dengan desain quasi-experiment pre-posttest, dilakukan pada 14 partisipan terpilih berdasarkan purposive sampling sesuai kriteria inklusi. Terapi musik diberikan selama proses operasi pemasangan akses vena/CDL selama 30 menit, kecemasan diukur menggunakan kuesioner HARS dan VAS. Data dianalisis menggunakan uji univariat dan bivariat dengan uji paired t-test dan uji Wilcoxon. Hasil: Prevelansi tingkat kecemasan 60% menurun menjadi 40% dengan pengukuran HARS dan VAS 48% menurun menjadi 43% setelah intervensi. Uji paired t-test dan Uji wilcoxon menunjukkan nilai p=0.01 dan p=0.00. Simpulan: Terapi musik dapat menurunkan kecemasan pada partisapan hemodialisis, diaplikasikan secara sistematis dan didukung oleh bukti ilmiah untuk menurunkan kecemasan terapi musik memiliki efek positif terhadap kecemasan pasien penyakit ginjal kronis yang menjalani pemasangan akses vena. Saran: Perlu mengeksplorasi lebih jauh mekanisme fisiologis maupun psikologis dari penerapan terapi musik, serta mempertimbangkan faktor-faktor lain, seperti nyeri, kualitas tidur, tingkat depresi, dan kepatuhan terhadap pengobatan yang mungkin berpengaruh terhadap tingkat kecemasan pada pasien hemodialis yang akan menjalani pemasangan akses vena pertama kali.   Kata Kunci: Kecemasan; Pasien Penyakit Ginjal Kronis; Pemasangan Akses Vena; Terapi Musik.
Door-to-Balloon Time and Quality of Life after Primary PCI in STEMI Supriyadi Supriyadi; Yani Sofiani; Rizki Nugraha Agung; Wati Jumaiyah
Indonesian Journal of Global Health Research Vol. 8 No. 6 (2026): Indonesian Journal of Global Health Research: December 2026
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v8i6.2791

Abstract

ST-elevation myocardial infarction (STEMI) requires rapid reperfusion to limit myocardial injury. Primary percutaneous coronary intervention (PPCI) is the preferred reperfusion strategy when it can be delivered within the recommended time, and door-to-balloon (DTB) time is an important indicator of emergency cardiac care performance. Quality of life after PPCI is also an important patient-centred outcome. This study examined the relationship between DTB time and quality of life in patients with STEMI after PPCI and identified clinical factors associated with quality of life. A quantitative observational analytic study with a cross-sectional design was conducted among 142 patients with STEMI who underwent PPCI at the National Cardiovascular Center Harapan Kita Hospital, Jakarta. Participants were selected purposively and comprised 71 patients in the on-time group and 71 in the delayed group. Quality of life was assessed using the Indonesian version of the Seattle Angina Questionnaire-7 (SAQ-7), a validated instrument with good construct validity and test–retest reliability (ICC ≥0.78). Univariate and bivariate analyses were followed by binary logistic regression. Statistical significance was set at p<0.05. The mean DTB time was 73.85 minutes in the on-time group and 142.54 minutes in the delayed group. Overall, 93 participants (65.5%) had good quality of life. The proportion with good quality of life was 78.9% in the on-time group and 52.1% in the delayed group (p=0.001). Bivariate analysis also showed significant associations for comorbidity burden (p=0.023), left ventricular ejection fraction (LVEF) (p=0.020), physical limitation (p<0.001), and angina frequency (p<0.001). In the final multivariable model, DTB (OR=2.794; 95% CI: 1.215–6.426; p=0.016), LVEF (OR=2.342; 95% CI: 1.064–5.154; p=0.034), and length of stay (OR=1.213; 95% CI: 1.030–1.429; p=0.021) were significantly associated with quality of life. Quality of life after STEMI and PPCI was associated with timely reperfusion, ventricular systolic function, and length of hospital stay. Strengthening rapid STEMI pathways and monitoring functional recovery may support better patient-reported outcomes.
Application of A Progressive Individualized Rehabilitation Program to Improve Mobility in A Patient with Guillain–Barré Syndrome: A Case Report Adria Verantika; Elis Rahmawati; Rifan Setyadi; Rizki Nugraha Agung
Indonesian Journal of Global Health Research Vol. 8 No. 6 (2026): Indonesian Journal of Global Health Research: December 2026
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v8i6.2830

Abstract

Guillain–Barré syndrome (GBS) is an acute immune-mediated peripheral neuropathy that can cause rapidly progressive muscle weakness, sensory disturbance, respiratory dysfunction, and substantial functional limitation. Recovery of motor function may continue after the acute phase and requires rehabilitation tailored to clinical stability and functional capacity. Objective to describe the implementation and clinical outcomes of a progressive individualized rehabilitation program for impaired mobility in a hospitalized patient with GBS. A descriptive case study was conducted in one 27-year-old woman with GBS who was hospitalized from 1 to 10 July 2026. The rehabilitation program consisted of readiness assessment, passive and active-assisted range-of-motion (ROM) exercises, rolling, sitting training, monitoring of muscle strength using the Medical Research Council (MRC) scale, activity tolerance monitoring, and patient/family education. Rehabilitation was progressed according to clinical status and functional readiness. During nine days of implementation, the patient demonstrated gradual improvement in motor and functional performance. Shoulder strength increased to MRC grade 5, toe and hip strength improved to grade 3 during the progression of bed mobility, and knee and hip strength subsequently improved. The patient progressed from requiring assistance for repositioning to rolling right and left with minimal assistance and sitting for 10, 20, and finally 30 minutes. The program was temporarily withheld when the patient developed melena and severe anemia (hemoglobin 6.9 g/dL) requiring packed red blood cell transfusion. Dangling, standing, and walking were not achieved during hospitalization because lower-extremity strength and postural control remained insufficient and the inpatient rehabilitation period was limited. A progressive individualized rehabilitation program supported gradual improvement in muscle strength, bed mobility, and sitting tolerance while maintaining patient safety.
Co-Authors Abdu Rahim Kamil Adria Verantika Apri Budianto Ari Yulistianingsih Asep Novi Taufiq Firdaus Dewi Anggraini Dhea Natashia Dian Noviati Kurniasih Dian Noviati Kurniasih Dian Noviati Kurniasih Elis Rahmawati Erwan Setiyono Fakhrudin Nasrul Sani Fenny Maryani Ganjar Kundi Prasetya Giri Widakdo Hadi, Muhammad Irma Puspita Arisanty Iyar Siswandi Jumaiyah, Wati Junaidin Junaidin Juwi Athia Rahmini Laela Nur Adzmi M. Khalid Fredy Saputra Melati Fajarini MG Enny Mulyatsih Muhammad Hadi Naryati Naryati Naryati Naryati Neneng Kurwiyah Nia Ayu Puspitasari Ninik Yunitri Nuraeni Nuraeni Rayasari, Fitrian Retno Dyah Wahyuningsih Rifan Setyadi Safruddin Safruddin Saharuddin Saharuddin Sandra Andini Saqiraz Miftahayatun Putryana Siti Aisyah Afifah Siti Nafisah Supriyadi Supriyadi Suryani Suryani Wati Jumaiyah Yana Adharani Yani Sofiani Yani Sofiani Yeni Astuty Yeni Karlina Yohanes Andy Rias Yundari, Yundari Zainab Zainab