Gambaran Indikator Klinis Diagnosis Keperawatan Insomnia Menggunakan Insomnia Severity Index pada Pasien Hemodialisis

https://doi.org/10.22146/jkkk.56584

Ayu Dwi Silvia Putri(1*), Totok Harjanto(2), Intansari Nurjannah(3)

(1) Rumah Sakit Krakatau Medika, Kotabumi, Kec. Purwakarta, Kota Cilegon, Banten
(2) Departemen Keperawatan Dasar dan Gawat Darurat, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada
(3) Departemen Keperawatan Jiwa dan Komunitas, Fakultas Kedokteran Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada
(*) Corresponding Author

Abstract


Background: End Stage Renal Disease is a condition of chronic kidney disease characterized by decreased renal function that requires hemodialysis therapy. Hemodialysis causes several effects, one of which is insomnia.
Objective: To identify clinical indicator of nursing diagnosis for insomnia using Insomnia Severity Index (ISI) as the measuring instrument.
Methods: This was descriptive research with cross-sectional design. Respondents in this study were patients undergoing hemodialysis which amounting in total to 72 patients. Two instruments, ISI and NANDA-I for Insomnia (an instrument developed from clinical indicators of nursing diagnosis), were used in this research. Then, the most appeared ISI’s clinical indicators at every level of insomnia were analyzed using univariate analysis.
Results: The ISI’s clinical indicators which appear in all severe insomnia patients are: early awakening, difficulty in initiating sleep, difficulty in maintaining sleep, alteration in sleep pattern (sleep quantity and quality change), health status shifting, sleep disturbance with an impact on the next-day, exhausted, decreased quality of life, mood swing, and haggard. Only one ISI’s clinical indicator which appears in all moderate insomnia patients which is alteration in sleep pattern (sleep quality change). On the mild insomnia, there is not any clinical indicator which appear in every patient; however, patients are likely to experience alteration in sleep pattern (sleep quantity and quality change).
Conclusions: Ten clinical indicators of insomnia nursing diagnosis found in patients with severe insomnia need to be considered as the main indicator in patients with insomniac nursing diagnosis.

 

ABSTRAK

Latar belakang: End Stage Renal Disease adalah penyakit ginjal kronis yang ditandai dengan menurunnya fungsi ginjal sehingga membutuhkan terapi hemodialisis. Hemodialisis menimbulkan beberapa dampak, salah satunya adalah insomnia.
Tujuan: Mengetahui gambaran indikator klinis diagnosis keperawatan insomnia yang diukur menggunakan Insomnia Severity Index (ISI).
Metode: Penelitian ini merupakan penelitian deskriptif dengan rancangan cross-sectional. Responden dalam penelitian ini adalah 72 pasien yang menjalani hemodialisis. Pengukuran insomnia pada responden dilakukan menggunakan dua instrumen yaitu ISI dan instrumen yang disusun dari indikator klinis diagnosis keperawatan insomnia berdasarkan NANDA-I. Peneliti menganalisis indikator klinis yang muncul pada setiap tingkatan insomnia berdasarkan ISI.
Hasil: Indikator klinis yang terdapat pada insomnia berat sesuai ISI adalah: bangun terlalu dini, kesulitan memulai tidur, kesulitan mempertahankan tidur, gangguan pola tidur (perubahan kuantitas dan kualitas tidur), perubahan status kesehatan, gangguan tidur yang berdampak pada keesokan hari, tidak berenergi, penurunan kualitas hidup, perubahan suasana hati, dan tidur tidak memuaskan. Indikator klinis yang terdapat pada pasien dengan insomnia sedang sesuai ISI adalah gangguan pola tidur (perubahan kualitas tidur). Pada insomnia ringan, tidak ada indikator klinis yang muncul pada pasien, namun pasien cenderung mengalami gangguan pola tidur (perubahan kuantitas dan kualitas tidur).
Kesimpulan: Sepuluh indikator klinis diagnosis keperawatan insomnia yang terdapat pada pasien dengan insomnia berat perlu dipertimbangkan sebagai indikator utama pada pasien dengan diagnosis keperawatan insomnia.


Keywords


diagnosis keperawatan; hemodialisis; indikator klinis; insomnia

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References

  1. Nahas M.E. and Levin A. Chronic Kidney Disease A Practical Guide to Understanding and Management. UK: Oxford University Press; 2009.
  2. Billings D.M. Lippincott’s Content Review for NCLEX-RN. Philadelphia: Lippincott Williams & Wilkins; 2009.
  3. United States Renal Data System. ESRD in the United States: An Overview of USRDS Annual Data Report Volume 2. Washington: USRDS; 2014.
  4. Perhimpunan Nefrologi Indonesia. 7th Report Of Indonesian Renal Registry. Pernefri, Jakarta. 2014 [diakses pada 26 Maret 2016]. Diakses dari: http:// indonesianrenalregistry.org
  5. Kopple, J.D., Massry, S.G., Zadeh, K.K. Nutritional Management of Renal Disease 3rd Edition. London: Elsevier; 2013.
  6. Bahramnezhad, F., Asgari, P., Zolfaqhari, M., Afshar, P.F. Family-Centered Education and Its Clinical Outcomes in Patients Undergoing Hemodialysis Short Running. Iranian Red Crescent Medical Journal. 2015; 17(6): e20705.
  7. Anand, S., Johansen, K.L., Grimes, B., Kaysen, G.A., Dalrymple. L.S., Kutner, N.G., et al. Physical Activity and Self-Reported Self of Insomnia, Restless Leg Syndrome and Depression: the Comprehensive Dialysis Study. Hemodialysis International. 2013; 17(1):50-58.
  8. Yu, I.C., Tsai, Y.F., Fang, J.T., Yeh, M.M., Fang, J.Y., Liu, C.Y. Effects of Mouthwash Interventions on Xerostomia and Unstimulated Whole Saliva Flow Rate Among Hemodialysis Patients: A Randomized Controlled Study. International Journal of Nursing Studies. 2016; 63: 9-17.
  9. Aribi, L., Masmoudi, R., Ben, H.A., Charfeddine, F., Jarraya, F., Hachicha, J., et al. Sexual Disorder in Hemodialysis Patients. La Tunisie Medicale. 2015; 93(2): 79-84.
  10. American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorder Fifth Edition "DSM-5". Arlington: American Psychiatric Publishing; 2013.
  11. Herdman, H.T. and Kamitsuru, S. Nursing Diagnoses Definitions and Classification 2015-2017. Oxford: Wiley Blackwell; 2014.
  12. Wilkinson, J.M. Buku Saku Diagnosis Keperawatan: Diagnosis NANDA, intervensi NIC, Kriteria Hasil NOC Edisi 19. Jakarta: EGC; 2012.
  13. Pascoal, L.M., Lopes, M.V., Silva, V.M., Beltrão, B.A., Chaves, D.B., Santiago, J.M., Herdman, T.H. Ineffective Breathing Pattern: Defining Characteristics in Children with Acute Respiratory Infection. International Journal of Nursing Knowledge. 2014; 25(1).
  14. Sari, A.P. Hubungan Lama Hemodialisis dengan Insomnia pada Pasien Gagal Ginjal Kronik yang Menjalani Hemodialisa di RST Dr. Asmir Salatiga. [Skripsi]. Ungaran: Sekolah Tinggi Ilmu Kesehatan Ngudi Waluyo; 2016.
  15. World Health Organization (WHO). The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. Geneva: World Health Organization; 1992.
  16. Einollahi, B., Motalebi, M., Rostami, Z., Nemati, E., Salesi, M. Sleep Quality Among Iranian Hemodialysis Patients: A Multicenter Study. Nephrol Urol Mon. 2015; 7(1): e23849.
  17. Roth, T. Insomnia: Definition, Prevalence, Etiology, and Concequences. Journal of Clinical Sleep Medicine. 2007; 23(5).
  18. McHorney, C.A., Katz, D.A. The Relationship between Insomnia and Health-Related Quality of Life in Patients with Chronic Illness. The Journal of Family Practice. 2002; 51(3):229-235.
  19. Wang, L.J. and Chen, C.K. The Psychological Impact of Hemodialysis on Patients with Chronic Renal Failure. Renal Failure - The Facts, Dr. Momir Polenakovic (Ed.). InTech. 2012. ISBN: 978-953-51-0630-2
  20. Taylor, D.J., Mallory, L.J., Lichstein, K.L., Durrence, H.H., Riedel, B.W., Bush, A.J. Comorbidity of Chronic Insomnia with Medical Problems. SLEEP. 2007; 30(2): 213-218.
  21. Schlack, R., Hapke, U., Maske, U., Busch, M., Cohrs, S. Frequency and Distribution of Sleep Problems and Insomnia in the Adult Population in Germany, Result of the German Health Interview and Examination Survey for Adults (DEGS1). Bundesgesundheltsbl. 2013; 256: 740-748.
  22. Al-Jahdali, H.H., Khogeer, H.A., Al- Qadhi, W.A., Baharoon, S., Tamim, H., Al-Hejaili, F.F., et al. Insomnia in Chronic Renal Patients on Dialysis in Saudia Arabia. Journal of Circardian Rythyms. 2010; 8:1-7.
  23. Bonner, A., Wellard, S., Caltabiano, M. The Impact of Fatigue on Daily Activity in People with Chronic Kidney Disease. J Clin Nurs. 2010; 19: 3006-3015.
  24. Baglioni, C., Spiegelhalder, K., Lombardo, C., Riemann, D. Sleep and Emotions: A Focus on Insomnia. Sleep Medicine Reviews. 2010; 14: 227-238.
  25. Davidson, S.N. and Jhangri, G.S. The Impact of Chronic Pain on Depression, Sleep, and the Desire to Withdraw from Dialysis in Hemodialysis Patients. Journal of Pain and Symptom Management. 2005; 20(5): 465-473.



DOI: https://doi.org/10.22146/jkkk.56584

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