PENGARUH SUPPORTIVE EDUCATIVE NURSING INTERVENTION (SENI) TERHADAP SELF-EFFICACY DAN NILAI INTERDIALYTIC WEIGHT GAIN (IDWG) PASIEN PENYAKIT GINJAL KRONIK YANG MENJALANI HEMODIALISA

BARDAH WASALAMAH, dr. Widyandana, MHPE., Ph.D., Sp.M.; Syahirul Alim, S.Kp., M.Sc., Ph.D

2018 | Tesis | MAGISTER KEPERAWATAN

Latar Belakang : Pembatasan cairan merupakan regimen paling sulit diikuti oleh pasien hemodialiasa, sehingga menyebabkan peningkatan Interdialytic Weight Gain (IDWG) dengan berbagai komplikasi. Supportive Educative Nursing Intervention (SENI) Orems theory adalah suatu metode inovatif yang bertujuan untuk meningkatkan self-efficacy pasien HD dalam pembatasan cairan, sehingga berdampak positif pada pengontrolan IDWG sebagai marker objektif kepatuhan restriksi cairan. Tujuan penelitian ini adalah untuk mengetahui pengaruh SENI terhadap self-efficacy dan nilai IDWG pada pasien PGK yang menjalani hemodialisa. Metode : Desain penelitian ini adalah quasi-experimental, pre and post test with control group. Penelitian ini dilakukan di RSUD. Dr. M Yunus Bengkulu, Indonesia dengan melibatkan 80 pasien hemodialisa. Self-efficacy diukur menggunakan Indonesian Fluid Intake Appraisal Inventory (I-FIAI) dan nilai IDWG diukur berdasarkan pengukuran berat badan sebelum dan setelah hemodialisa. Pengukuran outcome dilakukan 3 kali yakni sebelum intervensi, satu minggu setelah intervensi, dan dua minggu setelah intervensi. Analisa data menggunakan Repeated ANOVA dan Independent sample t-test. Hasil : Hasil uji Repeated ANOVA menunjukkan terdapat perbedaan yang signifikan rata-rata self-efficacy dan nilai IDWG masing-masing kelompok setelah intervensi dengan nilai p=0.000. Rata-rata peningkatan self-effiacy pada kelompok yang mendapatkan SENI lebih tinggi dibandingkan dengan kelompok kontrol (p<0.05). Terdapat perbedaan yang signifikan penurunan IDWG setelah 2 minggu intervensi dengan penurunan lebih tinggi pada kelompok intervensi (p=0.013). Kesimpulan : Supportive Educative Nursing Intervention (SENI) Orems theory efektif meningkatkan self-efficacy pasien hemodialisa dalam pembatasan asupan cairan dan meningkatkan kepatuhan pembatasan cairan yang ditunjukkan dengan penurunan nilai IDWG.

Background : Fluid restriction is the hardest regimen to follow in chronic kidney disease patients receiving hemodialysis, leading to an increase of Interdialytic Weight Gain (IDWG) with several complications. Supportive Educative Nursing Intervention (SENI) Orem's theory is innovative method with the goal of enhancing fluid restriction self-efficacy, and thus have a positive impact on controlling IDWG as an objective marker of fluid restriction adherence. This study aimed to determine the effect of Supportive Educative Nursing Intervention (SENI) on self-efficacy and Interdialytic Weight Gain (IDWG) of CKD patients receiving hemodialysis. Method : This study adopted a quasi-experimental, pre and post test with control group. This study was conducted at the RSUD. Dr. M Yunus Bengkulu, Indonesia involving 80 hemodialysis patients. Self-efficacy was measured using the Indonesian Fluid Intake Appraisal Inventory (I-FIAI) and IDWG was measured by weight measurement before and after HD. Outcomes were measured before intervention, 1 and 2 weeks after intervention. Data analysis were carried out using Repeated ANOVA, and Independent sample t-test. Results : Repeated ANOVA test showed a statistically significant difference in mean score self-efficacy and IDWG of each group after intervention (p=0.000). An increase mean score self-efficacy of intervention group was higher than control group (p<0.05). There was significant difference IDWG after 2 weeks of intervention with greater decline in intervention group compared to the control group (p=0.013). Conclusions : Supportive Educative Nursing Intervention (SENI) Orem's theory increases self-efficacy of hemodialysis patients in fluid restriction and improves self-care behavior as indicated by IDWG.

Kata Kunci : Penyakit Ginjal Kronik (PGK), Hemodialisa, Supportive Educative Nursing Intervention (SENI), Self-efficacy, Interdialytic Weight Gain (IDWG), Chronic Kidney Disease (CKD), Hemodialysis, Supportive Educative Nursing Intervention (SENI), Self-efficacy