MODEL PERENCANAAN PERAWATAN AKHIR HAYAT (PPAH) BERBASIS PSIKONEUROIMUNOLOGI (PNI) TERHADAP KECEMASAN KLIEN CKD YANG MENJALANI HEMODIALISIS - Caturia Sasti Sulistyana (STIKes Adi Husada, 2017)
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. 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