Efektifitas Pemberian Self Help Group dengan Acceptance and Commitment Therapy terhadap Interdialytic Weight Gain

Keywords Self Help Group Acceptance and Commitment Therapy Chronic Kidney Disease Interdialytic Weight Gain Hemodialysis

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June 12, 2019

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ABSTRAK

Pendahuluan: permasalahan yang sering terjadi pada klien yang menjalani hemodialisis (HD) adalah terjadinya  penambahan berat badan atau Interdialytic Weight Gain (IDWG) karena  ketidak patuhan klien dalam pembatasan cairan. Untuk itu diterapkan Self help Group (SHG) dan Acceptance and Commitment Therapy (ACT).Tujuan penelitian adalah mengetahui perbedaan efektifitas pemberian Self Help Group dengan Acceptance and Commitment Therapy terhadap penurunan IDWG klirn yang menjalani HD.

Metode: desain penelitian quasy experimental the pretest-posttest one control group disgn. Jumlah responden 57 orang dengan menggunakan purposive sampling. Variabel independen adalah SHG dan ACT, sedangkan variabel dependen IDWG. Untuk variabel independen menggunakana instrumen Satuan Acara Kegiatan,  sedangkan untuk variabel dependen menggunakan instrumen timbangan BB dan lembar observasi IDGW. Uji statistik untuk SHG dan pembanding  menggunakan Wilcoxon Signed­_Rank Test dengan tingkat kemaknaan p≤0,005, untuk ACT menggunakan  Paired T Test dengan tingkat kemaknaan p≤0,005 dan untuk perbandingan antara  SHG, ACT dan Pembanding menggunakan Mann Withney dengan tingkat kemaknaan p ≤ 0,005.

Hasil: Wilcoxon Signed Rank Test  kelompok SHG p=0,002, hasil Paired T Test kelompok ACT p= 0,000, hasil Wilcoxon Signed Rank Test   kelompok pembanding p= 0,224. Hasil statistik Mann Whithney antara SHG- ACT didapatkan nilai p= 0,838, uji Mann Whithney SHG-pembanding p= 0,044 uji Mann Whithney ACT-pembanding p=0,015. Hasil uji statistik ini menunjukan bahwa antara SHG dan ACT keduanya efektif terhadap penurunan IDWG namun pemberian ACT lebih efektif terhadap IDWG dengan p=0,015.

Diskusi: Penerapan SHG dan ACT efektif terhadap penurunan IDWG pada klien yang menjalani HD, sehingga diharapkan SHG dan ACT dapat diterapkan untuk mengantisipasi IDWG yang berlebihan pada klien yang menjalani HD.

 

Kata Kunci: Self Help Group, Acceptance and Commitment Therapy, Penyakit Ginjal Kronis, Interdialytic Weight Gain , Hemodialisis  

 

   

 

 

ABSTRACT

Introduction: Problem  that often occurs in hemodialysis clients is the occurrence of Interdialytic Weight Gain (IDWG) due to client's nonadherence in fluid restrictions. For this reason, Self Help Group (SHG) and Acceptance and Commitment Therapy (ACT) are applied. The purpose of the study is to determine the differences in the effectiveness of SHG with ACT towards the decrease of IDWGs in clients hemodialysis

 Method: the study used the quasi-experimental method with the pretest-posttest one control group design. The number of respondents is 57 people who were determined by using purposive sampling. The independent variables are SHG and ACT, while IDWG is the dependent variable. The instrument used for independent variables is activity event unit, while weight scale and IDGW observation sheets were used for the dependent variable. Statistical test using Wilcoxon Signed_Rank Test with significance level p≤ 0.005 to compare between SHG and the comparator, Paired T Test with significance level p≤ 0.005 for ACT, and Mann Withney with significance level p ≤ 0.005 to compare between SHG, ACT, and the comparator.

Result: Wilcoxon Signed Rank Test of SHG's group obtained p = 0.002, Paired T Test of ACT's group obtained p = 0.000, Wilcoxon Signed Rank Test of comparator's group obtained p = 0.224. Statistical test using Mann Whithney between SHG-ACT obtained p = 0.838, Mann Whithney test between SHG-comparator obtained p = 0.044, while Mann Whithney test between ACT-comparator obtained p = 0.015. The results of these statistical tests show that both SHG and ACT are effective against the decline of IDWG, but ACT is more effective than SHG with p= 0.015

Discussion: the application of SHG and ACT is effective against the decrease of IDWG in clients Hemodialysis, therefore it is expected that both SHG dan ACT can be applied to anticipate excessive IDWG in clients who undergo HD.