Caturia Sasti Sulistyana
Akademi Keperawatan Adi Husada Surabaya

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MODEL PERENCANAAN PERAWATAN AKHIR HAYAT (PPAH) BERBASIS PSIKONEUROIMUNOLOGI (PNI) TERHADAP KECEMASAN KLIEN CKD YANG MENJALANI HEMODIALISIS Caturia Sasti Sulistyana
Adi Husada Nursing Journal Vol 3 No 1 (2017): Adi Husada Nursing Journal
Publisher : STIKes Adi Husada

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Abstract

Kecemasan sering ditemukan terjadi pada klien Chronic Kidney Disease (CKD) yang menjalani hemodialisis. Kecemasan berlebih akan menurunkan mood dan motivasi menjalankan hemodialisis, meningkatkan kesakitan, dan kematian lebih dini. Kondisi ini membutuhkan perawatan lanjut dengan pendekatan psikoedukatif-supportif untuk mengubah persepsi negatif terhadap hemodialisis. oleh karena itu dikembangkan sebuag model berbasis Psikoneuroimunologi (PNI) yang terinspirasi dari intervensi Advance Care Planning (ACP), yaitu Model Perencanaan Perawatan Akhir Hayat (PPAH). Model PPAH disintesis dari konsep spiritualitas, model pemberdayaan keluarga, komunikasi terapeutik, serta teori keperawatan caring Jean Watson, dan peaceful end of life Ruland & Moore. Penelitian ini menggunakan desain quasi eksperimen pre and post test with control group. Hasil Wilcoxon tes (2 tailed) pada kelompok intervensi adalah P value 0,000, artinya ada perbedaan tingkat kecemasan antara kelompok pre dan post intervensi. Hasil Mann-Whitney (1 tailed) adalah P value 0,005, artinya ada perbedaan tingkat kecemasan antara kelompok intervensi dan kontrol. Umumnya, kecemasan dirasakan oleh klien yang baru menjalani hemodialisis karena pemahamannya yang masih kurang mengenai prognosis penyakit sehingga memiliki persepsi negatif terhadap hemodialisis. Persepsi negatif menyebabkan koping melemah, menurunkan personal kontrol, dan meningkatkan respon emosional. Kesimpulan penelitian ini adalah intervensi PPAH berbasis PNI diberikan untuk mengubah persepsi negatif sehingga mampu meningkatkan mekanisme koping klien dalam mengatasi kecemasan. Saran untuk penelitian selanjutnya adalah ada pengembangan alat ukur secara objektif untuk menilai tingkat kecemasan klien melalu pemeriksaan biologis agar hasil lebih tepat. Kata kunci: Kecemasan, Model Perencanaan Perawatan Akhir Hayat (PPAH) Model, CKD yang menjalani hemodialisis ABSTRACT Anxiety is often found to occur on Chronic Kidney Disease (CKD) clients who are undergoing hemodialysis. The excess anxiety will lower the mood and motivation undergoing hemodialysis, increase the morbidity and premature mortality. This condition needs treatment with psychoeducative-supportive approach to change negative perception toward hemodialysis. Therefore developed a model based Psychoneuroimmunology (PNI), inspired by Advance Care Planning (ACP) intervention, namely Perencanaan Perawatan Akhir Hayat (PPAH) model. PPAH model was synthesized from the concept of spirituality, family empowerment model, therapeutic communication, caring by Watson and peaceful end of life by Ruland & Moore’s nursing theory. This study using quasy experimental with pre and post test control group design. The Wilcoxon’s result (2 tailed) in intervention group is P value 0,000, it means there are the difference in the anxiety level between pre and post group. The Mann-Whitney’s result (1 tailed) is P value 0,005, it means there are the difference in the anxiety level between intervention and control group. Generally, anxiety perceived by new clients undergoing hemodialysis because their insight were lacking about prognosis and then they have negative perception to hemodialysis. A negative perception causes coping weakened, lowering personal control, and increase an emotional response. The conclusion of this research is PPAH’s intervention based PNI given to change the perception negative that can improve clients’s mechanism coping within overcome anxiety. The suggestion for the next research is the development of the tool measuring objectively to clients’s anxiety with biological test that more results right. Keywords: Anxiety, Perencanaan Perawatan Akhir Hayat (PPAH) Model, CKD undergoing hemodialysis DAFTAR PUSTAKA Alligood, M.R. 2014. Nursing theorists and their work Eighth edition. Elsevier Mosby. United States of America. Berton, T.C. 2015. Increasing comfort with end-of-life discussions. University of Nevada. Las Vegas Bristowe, Horsley, Shepherd, Brown, Carey, Mattews, O’Donoghue, Vinen, Murtagh, 2015. Thinking ahead – the need for early Advance Care Planning for people on haemodialysis : A qualitative interview study, 28(8), pp.1000-1025. Clarke, Yates, Smith, Chilcot. 2016. Patient’s perceptions of chronic kidney disease and their association with psychosocial and clinical outcomes:a narrative review, pp.1–9 Fradeloz, Tzavella, Koukia, Papathanasiou, Alikari, Stathoulis, Panoutsopoulos, Zyga. Integrating Chronic Kidney Disease Patient’s Spirituality in Their Care: Health Benefits and Research Perspectives. Mater Sociomed, 27(5), pp.354-358. 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The effects of advance care planning on end-of-life-care: A systematic review. Palliative Medicinne, 28(8), pp.1000-1025. 2009. Penyakit Ginjal Kronis: Buku Ajar Ilmu Penyakit Dalam. Departemen llmu Penyakit Dalam FK Universitas Indonesia, Jakarta. Hal 571-573. Taylor, F & Combes, G. 2014. Supporting the emotional and psychological needs of end- stage renal disease patients Study Report Appendix 6 : Literature Review Authors : Acknowledgements, pp.1–66. 2012. Pendekatan Kognitif-Perilaku untuk Mengurangi Kecemasan pada Pasien Gagal Ginjal Terminal. Tesis. Universitas Indonesia, Jakarta. Zahrofi. 2013. Publikasi Skripsi. Pengaruh Pemberian Terapi Murottal Alquran terhadap Tingkat Kecemasan pada Pasien Hemodialisa di RS PKU Muhammadiyah Surakarta. Fakutas Ilmu Kesehatan Universitas Muhammadiyah Surakarta, Surakarta DOWNLOAD FULL TEXT PDF
PENGALAMAN KLIEN CHRONIC KIDNEY DISEASE (CKD) MENJALANI HEMODIALISIS DI RUMAH SAKIT UMUM (RSU) HAJI SURABAYA Caturia Sasti Sulistyana
Adi Husada Nursing Journal Vol 4 No 1 (2018): Adi Husada Nursing Journal
Publisher : STIKes Adi Husada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (115.006 KB)

Abstract

ABSTRACT Chronic Kidney Disease (CKD) is one of serious health problems in main accesing morbidity and mortality in the world, and caused of which weakens illness. Clients who undergoing hemodialysis had been relying on an dialysis engine for life, which made their negative perception to their prognosis of the illness. The aim of this research to explore their experiences when undergoing hemodialysis as caused their anxiety. This research used explorative descriptive design with quality approach to explore, understand, explan of their comprehension, assumption, felt, source of informations, coping mechanism, sosial support about their illness. The results of this research were they had bad knowledge and negative perception of their illness and hemodialysis, and felt of shock, afraid, sad, despair, and denial when the first time diagnosed by doctor to undergoing hemodialysis. They were not acceptance on their conditions, which to made on opposed of the therapy and spirituality distress. They deems hemodialysis is so terrible and causes death. The conclusion of this research is negative perception occurs on CKD clients undergoing hemodialysis. The negative perception to made their felt so bad and axiety. The suggestion on the next research used critical review to develop a nursing intervention according the results. Keywords: Experience, CKD clients undergoing hemodialysis