ASPEK SPIRITUAL TERHADAP PASIEN PENYAKIT GINJAL CHRONIC DENGAN HEMODIALISIS
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Community of Publishing in Nursing (COPING), ISSN: 2303-1298
ASPEK SPIRITUAL TERHADAP PASIEN PENYAKIT GINJAL CHRONIC DENGAN HEMODIALISIS
Mugihartadi, Wahidin
Akademi Keperawatan Pemerintah Kabupaten Purworejo
Email: gik_kippi@yahoo.com
ABSTRAK
Gagal ginjal kronis adalah salah satu penyakit terminal yang akan mempengaruhi kualitas hidup pasien yang menciptakan ketidakseimbangan biologis, psikologis, sosial dan spiritual. Aspek spiritual dari kesehatan dan perawatan memengaruhi keyakinan dan aspek fisik dan psikososial. Tujuan penulisan ini adalah untuk mengkaji sumber-sumber yang mengidentifikasi berbagai cara pengobatan penyakit ginjal ginjal dengan hemodialisis. Metode penulisan makalah ilmiah ini menggunakan studi tinjauan pustaka. Sumber perpustakaan menggunakan artikel dengan jurnal dan menerbitkan basis data pencarian jurnal periode 2013 hingga 2017. Artikel yang dikumpulkan terkait dengan gagal ginjal kronis, termasuk kualitas hidup, kualitas tidur, kesehatan mental dan ketakutan akan kematian. Pemenuhan kesehatan pada pasien dengan kegagalan kronis, meningkatkan kualitas hidup, kesehatan mental, meningkatkan kepercayaan diri pasien bahkan dalam kondisi kesehatan yang tidak mendukung dan mengurangi kecemasan juga takut akan kematian dengan kegiatan spiritual seperti doa.
Kata kunci: aspek spiritual, penyakit ginjal kronis, hemodialisis
ABSTRACT
Chronic kidney failure is one of the terminal diseases that will affect the quality of life of patients which creates biological, psychological, social and spiritual imbalances. The importance of Spirituality in health. Spiritual aspects must be taken care of in addition to the physical and psychosocial aspects because according to some research results indicate that spiritual beliefs influence health and care. The purpose of this paper is to conduct a literature review of articles that examine aspects of spirituality in patients with chronic renal kidney disease with hemodialysis. This method of writing scientific papers uses the literature review study. The library source uses articles with data base search journal and publishing journal period 2013 until 2017. The themes in the articles collected were related to spiritual aspects in patients with chronic kidney failure, include quality of life, sleep quality, mental health and fear of death. Fulfillment of aspects of spirituality in patients with chronic kidney failure is important as one way to improve meaning and life expectancy, improve quality of life, mental health, increase patient confidence even in health conditions that do not support and reduce anxiety also fear of death with spiritual activities such as prayer.
Keywords: spiritual aspect, chronic kidney disease, hemodialysis
INTRODUCTION
Chronic kidney disease (CKD) affect 10% of the population worldwide (Melamed et al., 2017). In the US, approximately 30 million people or 15% of adults have CKD and 662,000 were living on chronic dialysis or with a kidney transplant to survive (Control & Prevention, 2017). In Malaysia alone, the incidence and prevalence of patient with ESRD has been on an upward trend for the past 20 years. The 22nd report of the Malaysian dialysis and transplant registry in 2013 recorded a total of 32,026 patient of
ESRD receiving dialysis treatment, 29,192 on hemodialysis (91%) and 2,834 on peritoneal dialysis (9%) (Bujang et al., 2017). This disease is characterized by the kidneys cannot filter blood as well as healthy kidneys, resulting excess fluid and waste from the blood remain in the body and may cause other health problems (Control & Prevention, 2017).
Chronic kidney failure is one of the terminal diseases that will affect the quality of life of patients which creates biological, psychological, social and spiritual
imbalances. The importance of Spirituality in health, (Nicholas, Kalantar-Zadeh, & Norris, 2015) states that the aspect of religion (spiritual) is one of the definitions of full health. WHO added the religious dimension as one of the four pillars of complete human health, namely: physical health, psychiatric health, social and spiritual (spiritual / religious). In other words, a whole healthy human being is a religious person and this is in accordance with human nature.
Spiritual aspects must be taken care of in addition to the physical and psychosocial aspects because according to some research results indicate that spiritual beliefs influence health and care, including; Stoll's research states that praying alone or with the closest person is reported as a good / positive coping strategy. Through prayer, people can express their feelings, hopes and beliefs to God.
The purpose of this paper is to conduct a literature review of articles that examine aspects of spirituality in patients with chronic renal kidney disease with hemodialysis.
METHOD
Relevant articles reviewed following of searches of the Google Scholar search engine. Year of search limited in the range of 5 years backward, from 2013 to 2017 to ensure that included articles up to date and we also limited the search to english language articles only. Using the keywords: “Spiritual needs”+“Hemodialysis”, Spiritual AND Hemodialysis, Spiritual need AND Chronic Kidney Disease, Spirituality AND/OR Chronic Kidney Disease. Relationship between mental health and spiritual wellbeing among hemodialysis patients: a correlation study (Martinez & Custodio, 2014).
Relationship between daily spiritual experiences and fear of death in hemodialysis patients (Mahboub, Ghahramani, Shamohammadi, & Parazdeh, 2014). Spiritual well-being and quality of life of older adults in hemodialysis (Pilger, Santos, Lentsck,
Marques, & Kusumota, 2017). Sleep Quality and Spiritual Well-Being in Hemodialysis Patients (Eslami, Rabiei, Khayri, Nooshabadi, & Masoudi, 2014). Relationship between spiritual well-being and quality of life in hemodialysis patients (Ebrahimi, Ashrafi, Eslampanah, & Noruzpur, 2014)
RESULTS
Five potentially journal were identified from database and fulfill our inclusion and exclusion criteria. All of the journal using Cross Sectional design.
Quality of Life
In two journal that included hemodialysis patients, spiritual well-being resulted in improvement of Quality of life. The aspect of Quality of life with most significantly improvement are physical role, Fatigue, mental health, social performance, and general health (p = < 0.05 with ANOVA test) (Pilger et al., 2017). Another cross sectional research shown that score of patient quality of life had a significantly higher in patient with good spiritual well-being (p = <0.05). This research using WHOQOL-BREF and WHOQOL-OLD questionnaire as the instruments (Ebrahimi et al., 2014).
Sleep Quality
A incretion in sleep quality was reported in one cross sectional with hemodialysis patient. In research that conduct of (Eslami et al., 2014), shown that there is a signification relationship between the sleep quality and spiritual well-being (P < 0.04, r = 0,149 with Person correlation test). Also based on the regression analyses of factors that affect to sleep quality, prediction of spiritual wellbeing was more than others (β= 0.209) (Eslami et al., 2014)
Mental Health
One cross-sectional study (Pilger et al., 2017) shown spiritual well being had significant impact towards mental health status (using General Health Questionnaire Scores) with p value 0.001. Poor mental
health and the presence of psychological stress, sleep disturbance and psychosomatic complaints were associated with lower existential and spiritual wellbeing (P < 0.05).
Fear of Death
Another, cross sectional research shown he relationship between fear of death and spiritual dimensions had significantly and strong relationship with p = 0.001, r = -0.22 (by the Pearson Correlation Coefficient). Based on the obtained results in the present study, significant negative correlation was observed between spiritual beliefs and spiritual activity with the fear of death in hemodialysis patients. This means that the high level of religious belief and religious activity, leads to reduce of death fear (Mahboub et al., 2014)
DISCUSSION
The aim of this literature review was conducted to (aim of the literature review). The experience of patients with Chronic Kidney disease or Hemodialysis (HD) process, from diagnosis through treatment, survivorship, and death, encompass many aspects of their life. Studies show that individuals may have increased levels of spiritual distress and clinical depression after diagnosis, and at the end of active treatment when predictable routines end (Puchalski, Vitillo, Hull, & Reller, 2014). Spirituality is defined as a way people find meaning and purpose and how they experience their connectedness to self, others, and significant or God. Religion, one expression of spirituality, is a set of organized belief about God shared within a community of people (Puchalski et al., 2014). Spirituality may help patient to maintain their wellness during treatment process also increasing cope to find meaning and peace (Reig-Ferrer et al., 2012).
This literature review shown that spiritual well-being had positive impact toward Quality of Life (QOL) of hemodialysis patient. Another study that
(Cheawchanwattana, Chunlertrith, Saisunantararom, & Johns, 2015) perform cross-sectional study of 31 hemodialysis patients to find out whether there is a relationship between spiritual well-being and quality of life or not. The result is there is strong relationship with p value <0.001 (Cheawchanwattana et al., 2015). Evidence prove that spiritual and religious experiences also contribute to QOL and important for coping with illness (Bredle, Salsman, Debb, Arnold, & Cella, 2011)
Recent advances in Hemodialysis technology have increased the life expectancy of HD patients, but their quality of life has not changed appreciably. HD patients still experience a number of adverse situations relating to health, survival, limitations in activities of daily living, losses and biopsychosocial changes. These stressful situations result in psychiatric symptoms, especially depression and anxiety (Theofilou, 2012). Our literature review results revealed that poor mental health was associated with lower spiritual wellbeing, and that psychological stress, sleep disturbance and psychosomatic complaints were associated with lower existential and spiritual wellbeing (Eslami et al., 2014). Recently, a crosssectional study (264 participant) from (Loureiro, de Rezende Coelho, Coutinho, Borges, & Lucchetti, 2017) shown that Concerning spiritual well-being (FACIT-Sp 12), the subscale of “Meaning” was associated with lower risk of suicide, depression, and anxiety (p <0.001). The subscale “Peace” was associated with lower depression and anxiety (p <0.001), whereas the subscale “Faith” was associated with lower suicide risk and depression (p,0.01) (Loureiro et al., 2017). There are several limitations in this review, mainly because it does not conduct a critical appraisal of the material that is presented as a systematic review. In addition, this paper only reviews the 5 articles published in English and the
period of 2013-2018 as well as the limitations of the search method.
CONCLUSION
Spiritual well-being can improve the ability of patients to overcome a disease and accelerate recovery as well reduce anxiety and tension of the disease which also affects the quality of the patient's sleep. Fulfillment of aspects of spirituality in patients with chronic kidney failure is important as one way to improve meaning and life expectancy, improve quality of life, mental health, increase patient confidence even in health conditions that do not support and reduce anxiety also fear of death with spiritual activities such as prayer.
REFFERENCES
Bredle, J. M., Salsman, J. M., Debb, S. M.,
Arnold, B. J., & Cella, D. (2011). Spiritual well-being as a component of health-related quality of life: the functional assessment of chronic illness therapy—spiritual well-being scale (FACIT-Sp). Religions, 2(1), 77-94.
Bujang, M. A., Adnan, T. H., Hashim, N. H., Mohan, K., Kim Liong, A., Ahmad, G., . .
. Haniff, J. (2017). Forecasting the incidence and prevalence of patients with end-stage renal disease in Malaysia up to the year 2040. International journal of nephrology, 2017.
Cheawchanwattana, A., Chunlertrith, D., Saisunantararom, W., & Johns, N. (2015). Does the Spiritual Well-Being of Chronic Hemodialysis Patients Differ from that of Pre-dialysis Chronic Kidney Disease Patients? Religions, 6(1), 1423.
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Ebrahimi, H., Ashrafi, Z., Eslampanah, G., & Noruzpur, F. (2014). Relationship between spiritual well-being and quality of life in hemodialysis patients. J Nurs Midwifery Sci, 1(3), 41-48.
Eslami, A. A., Rabiei, L., Khayri, F., Nooshabadi, M. R. R., & Masoudi, R. (2014). Sleep quality and spiritual wellbeing in hemodialysis patients. Iranian Red Crescent Medical Journal, 16(7).
Loureiro, A. C. T., de Rezende Coelho, M. C., Coutinho, F. B., Borges, L. H., & Lucchetti, G. (2017). The influence of spirituality and religiousness on suicide risk and mental health of patients undergoing hemodialysis.
Comprehensive Psychiatry, 80, 39-45.
Mahboub, M., Ghahramani, F., Shamohammadi, Z., & Parazdeh, S. (2014). Relationship between daily spiritual experiences and fear of death in hemodialysis patients. J. Biol. Todays World, 3, 7-11.
Martinez, B. B., & Custodio, R. P. (2014). Relationship between mental health and spiritual wellbeing among hemodialysis patients: a correlation study. Sao Paulo medical journal, 132(1), 23-27.
Melamed, M. L., Chonchol, M., Gutiérrez, O. M., Kalantar-Zadeh, K., Kendrick, J., Norris, K., . . . Thadhani, R. (2017). The role of vitamin D in CKD stages 3 to 4: report of a scientific workshop sponsored by the National Kidney Foundation. American Journal of Kidney Diseases, 72(6), 834-845.
Nicholas, S. B., Kalantar-Zadeh, K., & Norris, K. C. (2015). Socioeconomic disparities in chronic kidney disease. Advances in chronic kidney disease, 22(1), 6-15.
Pilger, C., Santos, R. O. P. d., Lentsck, M. H., Marques, S., & Kusumota, L. (2017). Spiritual well-being and quality of life of older adults in hemodialysis. Revista brasileira de enfermagem, 70(4), 689696.
Puchalski, C. M., Vitillo, R., Hull, S. K., & Reller, N. (2014). Improving the spiritual dimension of whole person care: reaching national and international consensus. Journal of Palliative Medicine, 17(6), 642-656.
Reig-Ferrer, A., Arenas, M. D., Ferrer-Cascales, R., Fernández-Pascual, M. D., Albaladejo-Blázquez, N., Gil, M. T., & de la Fuente, V. (2012). Evaluation of spiritual well-being in haemodialysis patients. Nefrología (English Edition), 32(6), 731-742.
Theofilou, P. (2012). Quality of life and mental health in hemodialysis and peritoneal dialysis patients: the role of health beliefs. International Urology and Nephrology, 44(1), 245-253.
Volume 5, Nomor 3, Desember 2017
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