Pelatihan Pengkajian Komprehensif Perubahan Fisik, Psikososial, dan Frailty Bagi Perawat dalam Meningkatkan Kualitas Pelayanan Pasien Hemodialisis

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ABSTRAK

Penyakit Ginjal Kronis (PGK) adalah kondisi medis yang cukup kompleks. Kejadian PGK cukup tinggi di Indonesia, sehingga diperlukan intervensi jangka panjang. Pengobatan hemodialisis jangka panjang ini berdampak signifikan pada pasien secara fisik, psikologis, dan sosial. Selain itu, prevalensi frailty juga tinggi di antara pasien yang menjalani HD. Frailty pada pasien dengan penyakit ginjal kronis (PGK) dapat memperburuk perkembangan penyakit dari aspek fisik dan psikologis, meningkatkan kematian, dan menurunkan kualitas hidup. Saat ini, para perawat menghadapi tantangan dalam melakukan pengkajian komprehensif terhadap pasien akibat pengetahuan terbatas tentang prosedur dan format pengkajian. Program pelatihan perawat dikembangkan untuk meningkatkan kemampuan mereka dalam mengkaji perubahan fisik, psikososial, dan status frailty yang dapat berdampak terhadap kualitas hidup pasien. Kegiatan Pengabdian kepada Masyarakat (PkM) ini bertujuan untuk memberikan pelatihan pengkajian komprehensif kepada 18 perawat di ruang hemodialysis rumah sakit islam Jakarta cempaka putih. Kegiatan PkM ini menggunakan pendekatan intervensi keperawatan berbasis edukasi (educative-based nursing intervention) yang terdiri dari beberapa sesi yaitu sesi edukasi, role-play dan bedside teaching praktik dan sesi diskusi. Analisa data dilakukan menggunakan metode analisis kuantitatif one group pre-post-test design dengan menggunakan paired t-test.  Hasil PkM ini menunjukan peningkatan pengetahuan dan keterampilan peserta terhadap pengkajian komprehensif pada pasien penyakit ginjal kronik yang menjalani Hemodialisa. Peningkatan signifikan dalam pengetahuan dan keterampilan peserta menunjukkan keberhasilan pendekatan intervensi keperawatan berbasis edukasi dalam pengabdian masyarakat untuk pengaplikasian dalam praktik klinis.

Kata Kunci: Hemodialisis, Gejala Fisik, Perubahan Psikologis, Kelemahan, Pengkajian

ABSTRACT

Chronic Kidney Disease (CKD) is an advanced medical condition. The incidence of CKD is significantly high in Indonesia, necessitating long-term interventions. This prolonged haemodialysis treatment significantly impacts patients physically, psychologically, socially, with various signs and symptoms emerging during the process. Besides, the incidence of frailty is also high among patients undergoing HD. Frailty in patients with chronic kidney disease (CKD) may worsen disease progression, increase mortality, and decrease quality of life. Nurses currently face challenges in conducting comprehensive patient assessments due to limited knowledge of assessment procedures and formats. To address this issue, nurse training programs are being developed to improve their skills in assessing physical, psychosocial, and quality-of-life changes. Enhanced assessment proficiency will aid in identifying patient issues and implementing targeted interventions, ultimately improving patient care and quality of life. Community Service Activity (CSA) activities aim to provide comprehensive assessment training to 18 nurses in the haemodialysis unit of Jakarta Islamic Hospital Cempaka Putih. This CSA activity employs an educative-based nursing intervention approach, consisting of several sessions, including education sessions, role-play, bedside teaching practices, and discussion sessions. Data analysis is conducted using the quantitative analysis method with a one-group pre-post-test design, utilising paired t-tests. The results of CSA show an improvement in participants' knowledge and skills in conducting comprehensive assessments on chronic kidney disease patients undergoing Haemodialysis. The results show the positive impact of Community Service Activity (CSA) activities in strengthening the competencies of HD nurses in comprehensive patient assessment, not just routine tasks. The significant improvement in participants' knowledge and skills after the community service activity is a positive outcome. This indicates that the nursing based educational approach applied in community service has successfully enhanced the participants' competencies for application in clinical practice routine.

Keywords: Haemodialysis, Physical Symptoms, Psychological Changes, Frailty, Assessment