Analysis Of Nursing Care In Chronic Kidney Disease Patients With Anxiety Through Combination Of General Therapy With Mindfulness Therapy In Pku Muhammadiyah Gombong Hospital

Abstract

Chronic kidney disease (CKD) is a condition where there is progressive and irreversible
renal function impairment. The main psychological problem that often occurs in patients
with kidney failure undergoing hemodialysis is anxiety. The aim of this study was
to describe the results of nursing care for chronic kidney disease (CKD) patients with
anxiety nursing problems through combination generalist therapy with mindfulness
therapy in PKU Muhammadiyah Gombong hospital.
The method of this research was descriptive with a case study approach in the form of
nursing care for 5 chronic kidney disease patients who experience anxiety with a duration
of approximately 20 minutes at each meeting, starting from assessment, diagnosis,
intervention, implementation, and evaluation. The instruments used are psychosocial
mental nursing care format, observation sheet, sign and symptom format, and standard
operating procedures for mental nursing actions and HADS (Hospital Anxiety and
Depression Scale). The results of this case study showed that before the nursing
implementation, all patients (5 patients) had experienced signs and symptoms of anxiety.
After being given a combination of generalist therapy (deep breath relaxation technique,
five finger hypnosis and spiritual technique) with mindfulness therapy, all patients
experienced a decrease in signs and symptoms of anxiety as well as an increase in the
patient's ability to control anxiety. The most significant decrease in signs and symptoms
of anxiety in the fourth patient was a decrease of 6 signs and symptoms (62%). The results
of the measurement with the HARS instrument, the patient's level of anxiety before the
intervention was given the majority of patients experienced moderate anxiety (60%), while
after the intervention, the majority of patients experienced mild anxiety (60%). Meanwhile,
the ability of the five patients to reduce anxiety increased from a score of 7 (60%) to a score
of 21 (100%). Individual therapy using generalist therapy combined with mindfulness
therapy is recommended to be applied by nurses in providing psychosocial psychiatric
nursing care