JKEP (Jurnal Keperawata.
Vol 9.
No.
May 2024 ISSN: 2354-6042 (Prin.
ISSN: 2354-6050 .
Stressful Conditions Increase Fatigue during Undergoing Hemodialysis Rumentalia Sulistini*.
Yudha Pratama.
Indra Febriani.
Eva Susanti.
Imelda Erman Poltekkes Kemenkes Palembang.
Indonesia *email: rumentalia@poltekkespalembang.
Article history Posted.
Apr 25th, 2024 Reviewed.
May 20th, 2024 Received.
May 31th, 2024 Copyright A 2024 Authors This work is licensed under a Creative Commons Attribution-ShareAlike 4.
International License.
ABSTRACT
Hemodialysis is a therapy given to replace kidney function.
This therapy has various physical and psychological impacts on the sufferers.
This study aims to analyze stress conditions with fatigue in patients undergoing hemodialysis.
Analytic observation research design with a cross-sectional approach.
Population of chronic renal failure patients undergoing The sample was 54 patients, with a non-random sampling technique, with inclusion criteria, namely routine hemodialysis 2 times/week, full consciousness, communication well, and not experiencing complications during dialysis.
Analysis using the Independent T-test and Pearson Correlation Test.
The instruments used were the Depression Anxiety Stress Scale questionnaire and the fatigue questionnaire.
The analysis results obtained the youngest age .
, more women than men, most of them have higher education and most of them undergo hemodialysis for more than 11 months.
The average patient undergoing hemodialysis experienced mild stress and was in a state of severe fatigue.
There was a significant relationship between stress and fatigue .
-value 0.
, with a prediction model that increasing one stress score will increase the fatigue score by 0.
Therefore, psychological aspects must be an important concern in providing nursing care to patients undergoing hemodialysis in the hemodialysis unit.
Keywords: Fatigue.
Psychological .
Stress
ABSTRAK
Hemodialisa merupakan terapi yang diberikan sebagai penganti fungsi ginjal.
Terapi ini memberikan berbagai dampak fisik dan psikologis pada penderitanya.
Penelitian ini bertujuan menganalisis kondisi stres dengan fatigue pada penderita yang menjalani hemodialisis.
Desain penelitian observasi analitik dengan pendekatan cross sectional.
Populasi penderita gagal ginjal kronik yang menjalani hemodialisis.
Sampel berjumlah 54 pasien, dengan teknik non random sampling, dengan kriteria inklusi yaitu rutin hemodialisis 2 kali/ minggu, kesadaran penuh, dapat berkomunikasi dengan baik, tidak mengalami komplikasi saat dialisis.
Analisis menggunakan uji T Independen dan Uji Korelasi Pearson.
Instrumen yang digunakan kuesioner JKEP (Jurnal Keperawata.
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Hasil analisis didapatkan usia termuda .
, perempuan lebih banyak dibandingkan laki-laki, sebagian besar berpendidikan tinggi dan sebagian besar menjalani hemodalisis lebih dari 11 bulan.
Rata rata penderita yang menjalani hemodialisis mengalami stres ringan dan berada pada kondisi fatigue berat.
Ada hubungan yang signifikan antara stres dan fatigue ( p value 0,.
, dengan model prediksi peningkatan satu skor stres akan meningkatkan skor fatigue sebesar 0,237.
Oleh karena itu aspek psikologis perlu menjadi perhatian penting dalam memberikan Asuhan keperawatan pada Pasien yang menjalani Hemodialisis di unit Hemodialisis.
Kata Kunci : Fatigue.
Psikologi.
Stress
INTRODUCTION
Fatigue is weakness and decreased energy Progressive kidney damage that occurs in that is felt subjectively and unpleasant.
This patients with chronic kidney disease, can condition will eventually affect the quality result in death because the body is unable to of life of patients with CKD, therefore appropriate interventions are needed to overcome fatigue in sufferers.
Patients (Diyono and Mulyanti, 2.
Patients with chronic kidney failure (CKD) who received hemodialysis therapy in 2020 in Indonesia problems including depression, anxiety, and amounted to 130,931, while in South (Bezerra.
Silva and Elias, 2018.
Sumatra, there were 715 people in 2017.
Ghaffari et al.
, 2.
serve hemodialysis in Indonesia, there are up to 475 dialysis machines with 338 nurses (Perhimpunan Nefrologi Indonesia, 2.
Hemodialysis Stress in patients with hemodialysis can be caused by changes in life because patients must depend on dialysis machines, undergo routine dialysis processes, changes in health replacement therapies for patients with chronic kidney damage.
Dialysis is a These changes are stressors for treatment that is carried out for a long time kidney failure patients undergoing dialysis as a temporary treatment before undergoing (Gerogianni and Babatsikou, 2014.
Canaud (Indonesian et al.
, 2.
The condition of chronic renal failure itself has a wide range of effects Hemodialysis has various effects on patients including dialysis therapy, complications in with CKD who undergo it, and usually, up the heart, blood vessels, reproduction, skin, to 80% of patients undergoing hemodialysis anemia, and musculoskeletal, and almost the experience fatigue (Artom et al.
, 2014.
entire system has changed.
This condition Picariello et al.
, 2017.
Bossola et al.
, 2.
has also given me a feeling of anxiety and Nephrology Association.
JKEP (Jurnal Keperawata.
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1 Mei 2024 hlm 109-115 stress in dealing with the reality of chronic and signed informed consent.
Exclusion renal failure (Bezerra.
Silva and Elias, 2.
The role of nurses is crucial in managing and hemodialysis therapy by paying attention to all aspects of physical, psychological, social, and cultural factors (Loenggogeni.
Suriani.
Neherta, and Sari, 2.
Therefore, in this study, we examine the extent of the relationship between the two stress variables and fatigue.
Data The research instrument used the FACIT- Fatigue Scale to measure fatigue scores, with high validity (Cronbach alpha .
and reliability (ICC 0.
(Tennant, 2.
and the Indonesian version of the Depression Anxiety Stress Scale (DASS .
, with satisfactory reliability .
(Muttaqin and Ripa, 2.
The data in this The design used was analytic observational with a cross-sectional approach.
Palembang .
for the measurement of stress scores METHOD City Data a hospital in study were analyzed using the Independent T-test and the Pearson Correlation test.
RESULTS AND DISCUSSION
The results of the analysis are presented in the form of descriptions of age, gender.
Sampling was done using non-random education, length of hemodialysis, stress, sampling, with inclusion criteria, being and fatigue.
Table 1 shows that 68.
5% of patients with CKD who have undergone patients are aged 45 or older, and 53.
7% are hemodialysis at least twice .
, with More respondents had high school dialysis frequency of twice a week, full or college education .
5%), and most consciousness, ability to communicate well, undergone dialysis for more than 11 years.
Table.
Characteristics of Patients Undergoing Hemodialysis (N=.
Variable Age Young (<45 yr.
Old (>45 yr.
Gender Male Female Education Low .
lementary school & junior high schoo.
JKEP (Jurnal Keperawata.
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Duration of Hemodialysis Not long (<11 month.
Long(>11 month.
Patients who underwent hemodialysis were high level of education, namely high school predominantly aged 45 years or older or college.
Most patients have been .
5%) and female .
7%).
Of the patients undergoing hemodialysis for a long time who underwent hemodialysis, 64.
8% had a .
1%), which is 11 months or more.
Table.
Average Stress and Fatigue scores of Patients undergoing Hemodialysis (N=.
Variable Stress
Fatigue Mean
Median Min - Max
0 - 27
9 - 34
95% CI
26 Ae 14.
82 Ae 22.
Table 2 explains that the average stress also describes that patients have average score is 12.
96, indicating that the average fatigue of 21.
31, indicating that the average patient undergoing hemodialysis is at a mild patient experiences severe fatigue (Score < stress level.
However, the variation in stress undergoing hemodialysis vary from a score hemodialysis ranges from a stress score of Fatigue 9 to a high of 34.
zero to a severe stress score of 27.
Table 2 Table 3.
Correlation between Stress and Fatigue (N .
Variable Stress Line equation P Value Fatigue=18.
237*Stress Table 3.
illustrates that only 7.
3% of the The line equation model obtained fatigue variable can be explained by the in Table 3 can be used to predict the level stress variable.
This means that this model of fatigue, namely every increase of 1 stress has a weak predictive ability, and to score will increase the fatigue score 0.
improve it, additional variables and/or a Hemodialysis is a kidney replacement more complex analysis approach are therapy used for acute patients and patients JKEP (Jurnal Keperawata.
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1 Mei 2024 hlm 109-115 with terminal-stage kidney disease, ot those loss of self-esteem, uncertainty about the who have reached stage V (Nurchayati, future, and feelings of guilt towards the This condition has many physical (Kang and Chae, 2.
Another and psychological impacts including stress.
parallel study by Sari .
states that From the results in Table 3, it is found that patients undergoing dialysis can experience there is a significant relationship between severe stress, reaching 25%, and shows a This relationship between fatigue and stress in relationship is weak .
=0.
and positive, patients undergoing hemodialysis therapy.
meaning that an increase in stress scores (Kocalevent et al.
, 2.
=0.
will increase fatigue scores.
Therefore, researcher assumes that as the Fatigue describes the subjective feelings that individuals have, and this is influenced undergoing hemodialysis, the fatigue score by other factors, one of which is also increases.
Patients who experience psychological factors including depression, stress during hemodialysis therapy cause anxiety, and stress (Prastiwi.
Wihastuti and fatigue, even though the results of the Ismail, 2.
dan stress (Picariello et al.
= 0.
show that the relationship between the two variables is However, there is an opinion that Stress conditions are associated with fatigue in patients with CKD who undergo hemodialysis (Garcya-Llana et al.
, 2014.
Picariello et al.
, 2017.
Sulistni.
Damanik and Lukman, 2.
Stress can affect The causing changes in blood circulation, heart rate, and blood pressure.
This condition drains the body's energy resulting in (Harrington, 2.
Stress in patients undergoing hemodialysis is usually due to daily restrictions, tension from dependence on hemodialysis machines, stress and fatigue form a mutually reinforcing cycle.
Stress causes a person to experience fatigue, which leads to a decrease in work productivity, further increasing stress.
Comprehensive physical and psychological care is needed in treating patients undergoing hemodialysis.
In the Hemodialysis Unit, nurses performing interventions and provide psychological support (Parvan et al.
, 2.
, and develop techniques (Sultan et al.
, 2.
JKEP (Jurnal Keperawata.
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CONCLUSION
There is a significant relationship between stress and fatigue in patients undergoing hemodialysis in the hemodialysis unit .
An increase of one stress score can increase the fatigue score by 0.
Therefore, the psychological aspects of patients undergoing hemodialysis need special attention from families, nurses, and other health workers in the Hemodialysis Unit.
ACKNOWLEDGMENT
Thank you to the patients, families, and health workers who were actively involved.
REFERENCE