PENERAPAN EDUKASI TERSTRUKTUR MENINGKATKAN SELF EFFICACY DAN MENURUNKAN IDWG PASIEN HEMODIALISA DI RSUD INDRAMAYU

Abstract

ABSTRAK

Jumlah kasus chronic kidney disease yang harus menjalani terapi hemodialisa sejumlah 400 pasien dari 1.000.000 penduduk di Indonesia (Situmorang, 2013). Pemantauan keberhasilan hemodialisa diukur dari Inter Dialilytic Weight Gain (IDWG) yang tidak lebih dari 4 % berat kering. Nilai IDWG yang melebihi dari normal menimbulkan gejala edema, sesak nafas, dan rasa tidak nyaman. Salah satu kepatuhan pasien dalam mempertahankan IDWG adalah self efficacy. Penelitian ini bertujuan untuk menganalisa pengaruh edukasi terstruktur terhadap self efficacy dan IDWG pada pasien hemodialisa. Desain penelitian quasi experimen, dengan pendekatan pretest-posttest with control group. Pemilihan sampel menggunakan purposive sampling. Jumlah sampel 38 pasien hemodialisa dibagi dua kelompok 22 kelompok intervensi dan 16 kelompok kontrol. Edukasi diberikan dengan gambar dan video dalam media LCD proyektor dan leaflet. IDWG diukur dengan observasi berat badan sedangkan self efficacy menggunakan kuesioner. Uji statistik menggunakan uji t-dependen dan t-independen. Hasil penelitian menunjukkan pemberian edukasi terstruktur pada kelompok intervensi meningkatkan self efficaccy untuk mengontrol intake cairan antar waktu dialysis (p=0,000, α=0,05), dan menurunkan IDWG (p=0,04, α=0,05). Sedangkan pada kelompok kontrol penerapan edukasi meningkatkan self efficacy (p=0,03, α=0,05), namun tidak menurnkan IDWG (p=0,053, α=0,05). Hasil analisis lanjut menggunakan uji t-independen pada kedua kelompok ditemukan tidak ada perbedaan yang bermakna dalam self efficacy dan IDWG (p > 0,05). Edukasi terstruktur berpengaruh dalam meningkatkan self efficacy dan menurunkan IDWG.

Kata kunci : self efficacy, IDWG, edukasi terstruktur

ABSTRACT

The number of chronic kidney disease with hemodialysis therapy was 400 patients of 1,000,000 population in Indonesia (Situmorang, 2013). The success hemodialysis was monitored by Inter Dialilytic Weight Gain (IDWG) and the criteria was not more than 4 % of dry weight. An excess of IDWG value would cause the symptoms of edema, shortness of breath, and discomfort. Self efficacy was one of patient compliance in maintaining IDWG. The aim of this study was to analyze the effect of a structured education on self-efficacy and IDWG in hemodialysis patients. The study used quasi experimental design, with pretest-posttest control group approach. The sample was selected by purposive sampling technique. The sample was 38 patients, divided into intervention group (22 patients) and control group (16 patients). The intervention of structured education was use pictures and videos by LCD projector and leaflets. IDWG was measured by weight observation, while self-efficacy by questionnaire. The statistical test used t-dependent and t-independent. The result showed that structured education increased self efficaccy to control fluid intake on inter dialysis time (p = 0.000, α = 0.05) and decreased IDWG value (p = 0.04, α = 0.05) in the intervention group. While the intervention increased self efficaccy to control fluid intake on inter dialysis  time (p = 0.03, α = 0.05) and decreased IDWG value (p=0,053, α=0,05) in the control group. The results of further analysis used an independent t-test, showed that there were not a significant differences in self-efficacy and IDWG (p> 0.05) between intervention and control group. The structured education caused an increasing of self-efficacy and a decreasing of IDWG value.

Keyword : self efficacy, IDWG, structured education