Effect sofCombi nat i onTherapy
Benson' sAndWarm Wat erFootTowardFat i que I nChr oni cKi dneyFai l urePat i ent si nt heHemodi al ysi sRoom
EMelastuti1*
1NursingstudyProgram,UniversitasIslam SultanAgung,Semarang, Indonesia,E-mail:erna@unissula.ac.id
YFatmawati2
2NursingStudyProgram,Unissula,Semarang,Indonesia ISWahyuningsih3
3NursingStudyProgram,Unissula,Semarang,Indonesia
Abstract:Kidneyisanimportantorganthatfunctionstomaintainbloodcomposition bypreventingtheaccumulationofwasteandcontrollingfluidbalanceinthebody.
Hemodialysisisareplacementtherapyusedonthekidneysthatisperformed2-3 timesaweekforadurationof4-5hours,withtheaim ofremovingthewaste productsofproteinmetabolism,correctingfluidandelectrolytebalancedisorders.
Thelength oftimeundergoing hemodialysistherapyisgenerally:itwillcause physicalstress,thepatientwillfeelfatigue,headachesandcoldsweatdueto decreasedbloodpressure,duetotheeffectsofhemodialysis.Fatigueisoneofthe mostcommonsymptomsexperiencedwhendoinghemodialysistherapyandcan interfere with a person's activities,therefore itrequires non-pharmacological treatment,namelywarm waterfootsoakandbensontherapy.Bensonrelaxationis thedevelopmentofarelaxationrespondentmethodthatinvolvespatientbelief factors,whichcancreateaninternalenvironmentsothatitcanhelppatientsachieve higherhealthandwell-being. Objectives:Thisresearchisa quantitativetypewithaquasiexperimentaldesignusingapretest-postestdesign withoutcontrolgroup.Samplingusing purposivesamplingwiththenumberof respondents17people.UsingtheWilxocontestforwarm andBensonfootbath therapy.
Result:CombinationTherapyBensonWarm WaterFootSoak(ρvalue0.000)
Conclusion:Thereisasignificanteffectonthetherapyoffootbathinwarm water andbensononreducingfatigue.Sothatitcanbeappliedasoneofthenursing interventions for fatigue therapy in patients undergoing hemodialysis.
Keywords:CKD,Hemodialysis,Fatigue,Warm WaterFoot,Benson Bibliography:(2009-2019)
I.INTRODUCTION
Thekidneysareimportantorgansthatfunctiontomaintainblood composition.Chronickidneydisease(CKD)isapublichealthproblem (Hill etal.,2016).AccordingtoWHOdatain2017,theglobalincidenceofkidney failureismorethan500millionpeopleand1.5millionpeoplewhohaveto livedependentondialysis(hemodialysis).Chronickidneyfailureranks ninthofthe15leadingcausesofdeathintheUnitedStatesin2015 (Murphy,Kochanek,Curtin,&Aries,2017).Basedondatafrom theCenters
forDiseaseControlandPrevention(CDC)in2017,itisestimatedthat15%
ofadultsintheUnitedStateshavechronickidneyfailure,whichisabout30 millionpeople.AccordingtothedatacenteroftheIndonesianMinistryof Health,thenumberbasedonIRRdatafrom 249renalunitsthatreported, therewere30,554activepatientsundergoingdialysis(KemenkesRI,2018).
InCentralJava,patientswithkidneyfailureranknumberthreewith2,192 patients(Infodatin,2017).
Fatigueisacommonsymptom thatoccursinpatientsundergoing hemodialysis(Sri,Siti,Cronic,& Disease,2018).Severalstudieshave shownthat71.0%to92.2%ofpatientsexperiencefatigueandthatfatigue isthemostimportantconditiontobeobservedinpatientswithchronic kidneydisease(Murphyetal.,2017).Non-pharmacologicaltreatmentcan bedonebychangingahealthierlifestyleanddoingfootsoaktherapyusing warm waterthatcanbedoneanytime.Theeffectoffootsoakinginwarm wateristhesameaswalkingwithbarefeetfor30minutes(Sulaiman, 2015).
Benson relaxation is the developmentofa relaxation respondent methodthatinvolvespatientbelieffactors,whichcancreateaninternal environmentsothatitcanhelppatientsachievehigherhealthandwell- being.(Hulfa,2015)TheBensonrelaxationtechniqueisanaturalhealing techniqueandispartofaholisticself-carestrategytodealwithvarious complaintssuchasfatigue,pain,sleepdisturbances,stressandanxiety.
(Yustina,2016)TheresultsofapreliminarystudyconductedattheSultan AgungIslamicHospitalinSemarangobtaineddataon120patients.Based ontheresultsofinterviewsfrom 20patients,5ofthem experienced fatigue.Patientswhoexperiencedtheirfatiguecopewithdeepbreathsand someofthem letandmadesleep.
II.METHOD
Thedesignofthisstudyusedaquasiexperimentdesignpre-posttest inonegroup(0ne-grouppre-posttest).Thepopulationinthisstudywere chronickidneyfailurepatientsattheSultanAgungIslamicHospitalin Semarang.Thesampleofthisstudywas15peopleaccordingtothe minimum experimentalcriteria (Demsey,2002,and anticipation of droppingoutof2peoplesothatthetotalsamplewas17people.using nonprobabilitysampling(purposivesampling)withinclusioncriteria1) Renalfailurepatientsundergoinghemodialysistherapy.2)Patientswho arewillingtobecomerespondentsbysigningtheinformedconsetand exclusioncriteria1)Respondentswhoarepregnantinthethirdtrimester.2) Respondentswhohavelegulcers.3)Respondentswhohavephysical weakness.
ThisresearchwasconductedinDecember2019-January2020where
the research was conducted atthe Sultan Agung Islamic Hospital Semarang.ThestudyusedanFSS(FatigueSavertyScale)instrumentthat hadbeentestedforreliabilityandvaliditywiththeresultvalue,Crobach alpha0.841byNasekhah,(2016),univariateanalysisincludedrespondent characteristics:age,gender,education and duration ofhemodialysis therapy,fatiguebeforeandAftertheBensontherapygroupandwarm waterfootsoak,bivariateanalysiswascarriedoutbyconductingnormality testswithSapiroWilk,andWilcoxontestingtodeterminefatiguebefore andaftertheinterventionwasgiven.
III.RESULTS
a.Characteristicsofrespondentswiththetablebelow:
karasteristikrespondendengantabeldibawahini:
Variable Frequency Prosentation
Age
26-35 4 23,5%
36-45 4 23,5%
46-55 5 29,4%
56-65 4 23,5%
>65 4 23,5%
Gender
Female 5 29,4%
Male 12 70,6%
Pendidikan
SD 5 29,4%
SMP 7 41,2%
SMA 3 17,6%
S1 2 11,8%
TheLengthOfTime Hemodialysis
<2Years 3 17,6%
>2Years 14 82,4%
Total 17 100%
Theresultsshowedthattheaverageagewas46-5yearsasmanyas6 respondentsor29.4%ofallrespondents.11respondentsor73.3%ofall respondents.Theaverageeducationlevelofjuniorhighschoolwas6 respondents or40.0% ofthe totalrespondents who had undergone hemodialysistherapyonaverage82.4%orasmanyas14peopleover2 yearsfrom17respondentsor100%ofthetotalrespondents.
b.Normalitytest
Intervention Ρ-Value N
Before 0,029 17
After 0,029 17
combinationtherapyofwarm waterfootsoakandbensonbeforeandafter givenshowedabnormalresults.basedonthetestdata,thisdataistested usingtheWilxocontest.
c.TestanalysisoftheeffectofBensoncombinationtherapyandwarm waterfootbathsandbeforeandaftertheintervention
TheresultsshowedthatBensononfatiguewiththeresultpvalue=0.000
(<0.05)meansthatthereisasignificanteffectofcombinationtherapywith bensonandwarmwaterfootsoakingonfatigue.
IV.DISCUSSION
Theresultsshowedthattheaverageagewas46-5yearsasmanyas6 respondentsor29.4% ofallrespondents.along withincreasing age resultedindecreasedorganfunctionfollowedbypathologyorChronic KidneyDisease(CKD)whichresultedinphysicalsufferers.From the results ofgender,itwas found thatmale respondents were 11 respondentsor73.3% ofallrespondents.Whenviewedfrom genderto theleveloffatigueitwasfoundthatthelevelofwomen'sfatiguewas higherthanthatofmen.Thisisbecausewomenoftentalkaboutthe diseasesandproblemstheyexperiencesotheyeasilyexperiencefatigue ((Jhambetal.,2008).Theaveragejuniorhighschooleducationlevelis6
N Median
(Minimum-maximum)
Mean±s.b Ρ
BeforeIntervention 17 1,51(1,48-1,54) 1,5148±0,02387
AfterIntervention 17 1,56(1,56-1,59) 1,5709±0,00968 0,000
respondentsor40.0%ofthetotalrespondents.ningsih(2016)Knowledge isaveryimportantdomaininshapingaperson'sactions.Thehighera person'seducationlevel,hewilltendtobehavepositivelybecausethe education obtained can lay the foundations for understanding (understanding)andbehaviorinaperson.Theaveragelengthoftime undergoinghemodialysistherapywas17respondentsor100% ofthe totalrespondents.Thedecreaseinfatiguelevelscanalsobeseenfrom patientcharacteristicssuchaslengthoftimeundergoinghemodialysis.
Significancecomparedtothelengthofhemodialysisinthesusceptible years,thedecreasewasnotsosignificant.Sherwood(2018).Basedon theresearchconducted,itwasfoundthattheeffectofcombination therapyoffootbathinwarm waterandBensononfatigueinpatientswith kidneyfailureinthehemodialysisroom.Thistherapyaimstoincrease blood flow to the feet.Hydrotherapy orwarm waterfootsoak is scientificallywarm waterhasaphysiologicalimpactonthebody.Firstly, warm watermakesbloodcirculationsmooth.Soakingyourfeetinhot watercanheatthewholebody,increasebloodcirculationtotheupper partandsuppresscirculation.
V.CONCLUSION
Ingeneral,theresultsofthisstudyfoundthattherewasaneffectof BensonRelaxationonthefatiguelevelofHDpatientswithchangesin fatiguescoresafterthefifthtreatment.BensonRelaxationisprovensafe, withoutsideeffects,andeasytodo.
VI.CONFLICTOFINTEREST
Noconflictsofinteresthavebeendeclared.
VII.ACKNOWLEDGMENT
TheauthorofthisstudywouldliketothankSultanAgungIslamic Hospital,Faculty ofNursing,Sultan Agung Islamic University for supportingthisresearch
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