EFEKTIFITAS KOMBINASI FAMILY-CENTERED EDUCATION DENGAN COGNITIVE BEHAVIOR THERAPY TERHADAP INTERDIALYTIC WEIGHT GAIN (IDWG) PASIEN HEMODIALISA
Abstract
Abstract
Adherence to fluid restriction program is the greatest stressor for hemodialysis patients. Non adherence to the program may lead to physical problems and psychological changes. Therefore, a multi-intervention approach such as psycho-education involving families as a support system for patients is very strategic. This study aims to determine the effectiveness of a combination of family-focused education (FCE) with Cognitive Behavior Therapy (CBT) on Interdialytic Weight Gain (IDWG) of hemodialysis patients in Dr. Soedarso Pontianak. This study used quasi experimental design, with one group pre test and post test without control group approach. Data were collected from 12 respondents who IDWG more than 5%. The study was conducted in 2 phases, FCE and combination FCE intervention CBT. The time have given intervention to evaluation almost 8 week. The results showed no significant difference of IDWG mean between before and after given FCE (p value 0,684) and there was no significant difference of mean of IDWG between before and after given combination of FCE with CBT (p value 0,097). It is concluded that both interventions are long-term behavioral investment. Suggestions for nurses to undertake assessment of the structure, roles and functions of the family, so that interventions are targeted to families directly involved in patient care, modification of educational media and CBT implementation techniques in hemodialysis units.
Keywords : Family support, IDWG compliance, fluid restriction
Abstrak
Kepatuhan pada program restriksi cairan merupakan stressor terbesar bagi pasien hemodialisa. Ketidakpatuhan terhadap program tersebut dapat mengakibatkan masalah fisik dan perubahan psikologis. Oleh karena itu, pendekatan multi intervensi seperti psiko-edukasi dengan melibatkan keluarga sebagai sistem pendukung pasien sangat strategis. Penelitian ini bertujuan untuk mengetahui efektivitas kombinasi pendidikan berfokus keluarga (Family Centered Education, FCE) dengan Cognitive Behavior Therapy (CBT) terhadap Interdialytic Weight Gain (IDWG) pasien hemodialisa di RSUD Dr. Soedarso Pontianak. Penelitian ini menggunakan desain quasi experimental, dengan pendekatan one group pre test dan post test without control group. Data dikumpulkan dari responden dengan IDWG lebih dari 5 % sebanyak 12 orang. Penilain IDWG dilakukan dalam 2 tahap, yaitu FCE dan kombinasi intervensi FCE dengan CBT. Total waktu intervensi hingga evaluasi adalah 8 minggu. Hasil penelitian menununjukkan tidak terdapat perbedaan signifikan mean IDWG antara sebelum dan sesudah diberikan FCE (p value 0,684) dan tidak terdapat perbedaan signifikan mean IDWG antara sebelum dan sesudah diberikan kombinasi FCE dengan CBT (p value 0,097). Disimpulkan bahwa kedua intervensi merupakan behavioral investment jangka panjang. Saran bagi perawat untuk melakukan pengakajian struktur, peran dan fungsi keluarga, sehingga intervensi diberikan tepat sasaran pada keluarga yang terlibat langsung dalam perawatan pasien, modifikasi media edukasi dan tehnis pelaksaan CBT di unit hemodialisa
Kata Kunci : Dukungan keluarga, IDWG, kepatuhan, restriksi cairan
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