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88 535 1 PB PDF
88 535 1 PB PDF
2017 August;3(4):383-389
Accepted: 19 June 2017
http://belitungraya.org/BRP/index.php/bnj/
*Correspondence:
Ary Astuti
Faculty of Medicine, Diponegoro University, Semarang, Indonesia.
E-mail : nersary83@yahoo.com
ABSTRACT
Background: Patients with chronic kidney disease undergoing hemodialysis suffer changes in lifestyle, which
cause physical and psychosocial problems, particularly anxiety. Progressive Muscular Relaxation is considered
as an intervention to reduce anxiety.
Objective: This study aims to examine the effect of progressive muscular relaxation in in reducing anxiety in
patients with chronic kidney disease undergoing hemodialysis.
Methods: This study used a quasi-experimental design involved 78 respondents, with 38 randomly assigned in
the intervention and control group. The progressive muscular relaxation was performed on 14 muscle groups for
4-week period. Hamilton Anxiety Rating Scale was used to measure anxiety. Univariate, bivariate and
multivariate analyses were performed for data analyses.
Results: The results showed a statistically significant difference in anxiety values between the intervention and
control group with p-value 0.000 (<0.05).
Conclusion: There was a significant effect of progressive muscular relaxation in reducing anxiety in patients
with chronic kidney disease undergoing hemodialysis. The results of this study is expected to be one reference
in making the progressive muscular relaxation as a nursing intervention in reducing anxiety in patients
undergoing hemodialysis.
Key words: Anxiety, progressive muscular relaxation, hemodialysis, chronic kidney disease
INTRODUCTION
Chronic Kidney Disease (CKD) is an minute / 1.73 m2, and needs to initiate
abnormality of renal structure or function hemodialysis or renal transplant.1 Patients
for more than 3 months progressive to undergoing hemodialysis experience
terminal renal failure with Glomerular lifestyle changes in the family. The
filtration rate (GFR) less than 15 ml / patients will experience a sense of loss
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Belitung Nursing Journal , Volume 3, Issue 4, July-August 2017
General Hospital of Tugurejo amounted to symptoms. Each symptom group was
234 people. There were 78 samples assigned a score of 0-4, which means that
selected using simple random sampling, 0 means no symptoms, 1 mild symptom, 2
with 39 assigned in the intervention and moderate symptoms, 3 hemorrhagic
control group. The sample size was symptoms, and 4 very severe symptoms.
calculated using the average formula of Each score of the 14 symptom groups is
two independent populations,14 with drop summed to know the degree of anxiety of
out anticipation 10%. The researchers a person as a total score, consisting of:
determined that patients receiving <14 no anxiety, 14-20 mild anxiety, 21-27
hemodialysis therapy in morning shif moderate anxiety, 28-41 severe anxiety,
were the treatment group, and the patients and 42-56 very severe anxiety. The
in the afternoon shif were the control instrument has been translated in
group. Respondents in both groups were Indonesian language with the permission
patients in the same hospital. The of the instrument developer. The HARS
inclusion criteria of the sample were scale has been proven to have validity and
patients with hemodialysis therapy twice a reliability to measure anxiety with alpha
week, aged 18-65 years, able to read and cronbach 0.93.
write, patients with HARS> 14 score and
full consciousness, good hearing function, Data Analysis
able to read and write, no infection or Data were analyzed by univariate,
inflammation, trauma, severe and acute bivariate and multivariate. In univariate
heart disease, and with AV-shunt and analysis, data were presented in terms of
double lumen access. mean, median, standard deviation,
minimum, and maximum in the form of
Intervention frequency distribution and percentage of
Progressive Muscular Relaxation is a each variable. While bivariate analysis
procedure to get relaxation on the muscles used t-test and multivariate analysis used
in two steps: 1) to give a tension to a multiple linear regression test.
muscle group, and 2) to stop the tension
and focusing on how the muscles relax, Ethical Consideration
amd feeling the sensation. This This research was approved by the Health
intervention was performed on 14 muscle Research Ethics Committee (KEPK) of
groups in 8 times for 4-week period with a Faculty of Medicine, Diponegoro
duration of 15 minutes per session. While University and the Hospotal of Dr.
the control group received deep breathing Kariadi Semarang with No.106 / EC / FK-
relaxation techniques as a Standard RSDK / III / 2017. The researchers
Operational Procedure (SOP) at the confirmed that each respondent has
General Hospital of Tugurejo Semarang. obtained an appropriate informed consent.
Instrument
Anxiety levels were measured using the RESULTS
Hamilton Anxiety Rating Scale (HR This study was conducted on 78 patients
Anxiety Rating Scale), adopted from with chronic kidney disease who
previous study in Indonesian language.15 underwent hemodialysis, with 39 assigned
The scale consisted of 14 symptom groups in the intervention and control group.
in which each group has more specific
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Belitung Nursing Journal , Volume 3, Issue 4, July-August 2017
Table 2 shows that there was a and in the control group with p-value
significant difference in anxiety value in 0.0463
the intervention group with p-value 0.000
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Belitung Nursing Journal , Volume 3, Issue 4, July-August 2017
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16. Rustina. GAMBARAN TINGKAT
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