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

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


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.

Keywords: clinical indicators, hemodialysis, insomnia and nursing diagnosis.


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