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PENGARUH PENGATURAN SUHU DIALISAT TERHADAP STABILITAS TEKANAN DARAH INTRADIALITIK PASIEN HEMODIALISIS DENGAN SINDROM KARDIORENAL Wahidi, Kemala Desy; Nursanti, Irna; Irawati, Diana; Jumaiyah, Wati; Yuniarsih, Winda
Jurnal Perawat Indonesia Vol. 6 No. 2 (2022): August 2022
Publisher : Persatuan Perawat Nasional Indonesia (PPNI) Jawa Tengah.

Sindrom Kardiorenal adalah penyakit multi-organ, meliputi jantung, ginjal dan disfungsi sistem vaskular dimana gangguan ginjal sering disertai dengan gagal jantung dan disfungsi jantung menyebabkan Acute Kidney Injury (AKI) atau Cronic Kidney Disease, yang berujung kepada kebutuhan akan tindakan hemodialisis. Tindakan hemodialisis dapat menimbulkan berbagai komplikasi. Komplikasi yang paling sering adalah hipotensi intradialitik. Salah satu upaya untuk mencegah gangguan stabilitas tekanan darah adalah dengan mengatur suhu dialisat. Tujuan penelitian ini untuk melihat pengaruh suhu dialisat terhadap stabilitas tekanan darah. Penelitian ini menggunakan jenis penelitian kuantitatif quasi experiment, pre and post test dimana peneliti akan memberikan intervensi pada subyek penelitian, kemudian membandingkan efek sebelum dan sesudah intervensi. Penelitian ini dilakukan pada 18 pasien dengan pre test dan post test dalam satu kelompok. Pasien dinilai selama dua sesi dialisis; satu sesi dengan suhu dialisat normal (37ºC) dan di sesi lain, suhu dialisat rendah (35,5ºC). Hasil penelitian ini menunjukkan adanya peningkatan tekanan darah sistolik, diastolik dan Mean Arterial Pressure (MAP) secara signifikan dengan nilai p = 0,001. Dialisat suhu rendah sangat bermanfaat untuk meningkatkan toleransi terhadap dialisis pada pasien sindrom kardiorenal yang cenderung hipotensi dan menjaga stabilitas hemodinamik selama dan setelah dialisis. Kata kunci: Dialisat dingin, hemodialisis, tekanan darah

Effectiveness of Implementing Modified Mindfulness Based Stress Reduction (MBSR) on Stress and Fatigue in Hemodialysis Patients Irawan, Aprianto Guntur; Natashia, Dhea; Gayatri, Dewi; Jumaiyah, Wati; Yuniarsih, Winda
Jurnal Ners Vol. 9 No. 2 (2025): APRIL 2025
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/jn.v9i2.43554

Stress and fatigue are common complaints among hemodialysis patients, significantly affecting their quality of life during long-term therapy. This study aimed to evaluate the effectiveness of a modified Mindfulness-Based Stress Reduction (MBSR) intervention on stress and fatigue in patients undergoing hemodialysis. The study adopted a quasi-experimental pretest-posttest control group design and employed simple random sampling. A total of 32 respondents participated, with 16 in each group. Stress was measured using the Perceived Stress Scale (PSS-10) and fatigue using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F 40). The modified MBSR intervention was conducted for 30 minutes per session. Data were analyzed using paired t-tests and independent t-tests. The results showed significant differences in stress (MD = -13.12, t = -4.748, p < 0.001) and fatigue levels (MD = 7.34, t = -3.865, p = 0.001) between the intervention and control groups. These findings indicate that the modified MBSR therapy was effective in reducing stress and fatigue, with a p-value < 0.05 indicating statistical significance. Therefore, this modified MBSR therapy is a promising non-pharmacological nursing intervention that can be integrated into nursing care for chronic kidney failure patients experiencing stress and fatigue during hemodialysis.

The Effectiveness of Digital Virtual Reality-Based Therapy in Reducing Anxiety Among Patients Undergoing Gastrointestinal Endoscopy Sismanto, Bayu Aji; Gayatri, Dewi; Natashia, Dhea; Jumaiyah, Wati; Yuniarsih, Winda
Jurnal Ners Vol. 9 No. 3 (2025): JULI 2025
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/jn.v9i3.45021

Psychological responses such as anxiety often arise from negative perceptions in situations perceived as threatening, even when they should not induce fear. These anxiety-induced responses can lead to increased hemodynamic parameters such as elevated blood pressure, heart rate, and respiratory rate—particularly prior to medical procedures. This study aimed to evaluate the effectiveness of a digital virtual reality (VR)-based therapeutic intervention in reducing patient anxiety before undergoing gastrointestinal endoscopy. A quasi-experimental design was employed, involving both an experimental group and a control group using a pretest-posttest control group approach. Anxiety levels were measured using the State-Trait Anxiety Inventory (STAI). The intervention consisted of a 6-minute immersive VR video featuring calming mountain and beach scenery. A total of 50 respondents participated, with 25 in each group. Data were analyzed using paired and independent t-tests. Results showed no statistically significant difference in mean anxiety scores between the intervention and control groups (MD = 0.23, df = 48, t = 0.59, 95% CI: -0.56 to 1.03, p > 0.001). These findings suggest that the digital VR-based therapy was not statistically effective in reducing pre-endoscopy anxiety. Future interventions may require more immersive and interactive VR experiences—such as 360-degree simulations of endoscopic procedures—to achieve more substantial effects.

Early Mobilization with Digital-Based Isometric Exercise Intervention: Impact on Pain and Muscle Strength Post-ORIF Upper Extremity Febryandy, Valentino; Gayatri, Dewi; Natashia, Dhea; Jumaiyah, Wati; Yuniarsih, Winda
Jurnal Ners Vol. 9 No. 3 (2025): JULI 2025
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/jn.v9i3.47270

Background Fracture is a condition of partial or complete bone discontinuity. Upper extremity fractures can be caused by direct trauma (such as accidents) or indirect trauma (such as excessive pressure). Fracture management is performed through surgery such as Open Reduction Internal Fixation (ORIF), which can cause pain and muscle stiffness. Early mobilization with isometric exercises is needed to prevent these problems. Objective This study aims to determine the effect of digital-based Isometric Exercise on pain levels and muscle strength in patients post-ORIF upper extremity fracture. Methods The study used a Quasi-Experimental design with a Pretest-Posttest Control Group approach, involving 34 respondents divided into two groups. Muscle strength was measured using a Hand Grip Dynamometer, while pain was measured using the Brief Pain Inventory Short Form (BPI-SF). Isometric exercise intervention was performed 24 hours after surgery, twice daily with a duration of 35 minutes per intervention. Results The study showed a more significant increase in muscle strength in the intervention group compared to the control group with a Mean difference increasing to 4.23 (95% CI: 3.28-5.18), t=9.062, df=32, p=0.000. Pain levels also decreased more in the intervention group with a Mean difference of 1.81 (SD=0.866), 95% CI: 1.51-2.11, t=12.2, df=33, p=0.000. Conclusion: Isometric exercise is effective as early mobilization to reduce pain and increase muscle strength in ORIF upper extremity fracture patients. Keywords: Digital Intervention, Upper Extremity Fracture, Isometric Exercise, Muscle Strength, Pain

Effectiveness of Digital Application-Based Foot Care Education and Training Programmes in Improving Self-Efficacy and Foot Care Behaviour in Patients with Type 2 Diabetes Mellitus Feriadianto, Feriadianto; Natashia, Dhea; Gayatri, Dewi; Jumaiyah, Wati; Yuniarsih, Winda
Jurnal Ners Vol. 9 No. 4 (2025): OKTOBER 2025
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/jn.v9i4.49962

Background: Type 2 diabetic mellitus with low self-efficacy, which affects how they take care of their feet. This can lead to reduced foot sensitivity and increase the risk of serious complications like ulcers and infections. Objective: To determine the effectiveness of of the Diabetic Educare digital application foot care education and exercise program on self-efficacy, foot care behaviour and foot sensitivity in patients with type 2 diabetic mellitus. Methods: Quasy experiment research design with two groups, namely the intervention group (n=27) and the control group (n=27). Data collection was using Diabetic Management Self Efficacy Scale, Notthingham Assessment Foot Care Behavior and 10gram monofilament test measurements. Demographic characteristics analysis using univariate tests, bivariate analysis with paired t-test and independent t-test. Results: There was a significant effect on the intervention group to increase self-efficacy p-value =0.011 (p< 0.005) and foot care behavior p-value =0.032 (p< 0.005). Based on the independent t-test, it was shown that the intervention had no effect on the increase in foot sensitivity p-value = 0.141 (p< 0.005). Recommendation: Educare diabetic education and exercise program has an effect on improving self-efficacy and foot care behavior. The Diabetic Educare education and training program is expected to be a modality in the preparation of foot care education and exercise programs as part of a holistic nursing intervention, in patients with type 2 diabetic mellitus. Keywords: type 2 diabetic mellitus; Self-efficacy;Foot care behavior; Sensitivity; Digital Application-Based Foot Care Education and Training Program

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