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The Relationship between Length of Hospitalization and the Level of Anxiety of the Families
of Patients Treated in the High Care Unit (HCU) of Tk Hospital. III Dr. Reksodiwiryo
Padang City in 2023

Pramita Dewi1, Rebbi Permata Sari2, Willady Rasyid3

Alifah Padang College of Health Sciences Jl. Khatib Sulaiman No. 52 B

e-mail : Pramitadewi729@gmail.com rebbi.permatasari@gmail.com rasyidwillady@gmail.com

Abstract

Treatment in the intensive care unit with the patient in a coma can cause worry which will cause discomfort
so that the family experiences anxiety. With the presence of good caring nurses, the anxiety felt by the family
can be reduced. Health problems are often faced by the community and are the cause of death now. These are
usually chronic diseases. Patients with chronic disease conditions require care and treatment with a
multifactorial and comprehensive approach. The aim of this research is to determine the relationship between
length of stay and the anxiety level of the patient's family in the High Care Unit (HCU) of Dr. Reksodiwiryo
Hospital Padang in 2023. This type of research is quantitative with a cross sectional approach, This research
was conducted from January - August 2023. The population was 110 with a sample of 43 respondents,
purposive sampling technique, data collection using the HARS questionnaire, analyzed univariately and
bivariately. Based on the research results, it was found that the majority of respondents had a length of stay of
≥ 5 days (51.2%) and their families experienced moderate anxiety (41.9%). After carrying out the Pearson
Chi-Square statistical test, the P value was 0.034 (p value ≤0.05). This research can be concluded that there is
a relationship between length of stay and the level of anxiety of families treated in the high care unit (HCU) of
Dr. Reksodiwiryo Hospital, Padang. analyzed univariately and bivariately. Based on the research results, it
was found that the majority of respondents had a length of stay of ≥ 5 days (51.2%) and their families
experienced moderate anxiety (41.9%). After carrying out the Pearson Chi-Square statistical test, the P value
was 0.034 (p value ≤0.05). This research can be concluded that there is a relationship between length of stay
and the level of anxiety of families treated in the high care unit (HCU) of Dr. Reksodiwiryo Hospital, Padang.
analyzed univariately and bivariately. Based on the research results, it was found that the majority of
respondents had a length of stay of ≥ 5 days (51.2%) and their families experienced moderate anxiety (41.9%).
After carrying out the Pearson Chi-Square statistical test, the P value was 0.034 (p value ≤0.05). This
research can be concluded that there is a relationship between length of stay and the level of anxiety of
families treated in the high care unit (HCU) of Dr. Reksodiwiryo Hospital, Padang.

Keywords :HCU, Family Anxiety, Length of Hospitalization.

Address : Jl. Khatib Sulaiman No. 52 B

E-mail :Pramitadewi729@gmail.com

The health problems that people often face

INTRODUCTIO and are the causes of death today are usually
chronic diseases. Most chronic diseases do not

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2 The Relationship between Length of Hospitalization and the Level of Anxiety of the Families of
Patients Treated in the High Care Unit (HCU) of Tk Hospital. III Dr. Reksodiwiryo Padang City in
cause death directly, but result in patients feeling
very sick for a long time (Widiyanti, 2020). Patients
with chronic disease conditions require care and
treatment with a multifactorial approach and carried
out comprehensively (Hariyono, 2021).
During critical nursing, care in an intensive
care unit with the patient in a coma can cause
anxiety which will cause discomfort so that the
family experiences anxiety, the patient and family
members have different emotional mental burdens.
The fast-paced atmosphere and busy HCU activities
cause families to have difficulty communicating
with patients, nurses and other staff, so that the
patient's condition is not easily known by the
family. Situations like this make families
experience anxiety (Sudarsih, 2022).
Anxiety is a subjective feeling of mental
calmness that is disturbing as a general reaction to
the inability to overcome a problem or a lack of
feeling safe. These uncertain feelings are generally
unpleasant which will later lead to physiological
and psychological changes. The emotional
reactions commonly experienced by patient
families in the intensive care unit are anxiety, anger,
grief, hope, love, depression, helplessness,
loneliness or loyalty (Kristiani & Dini, 2017).
According to Carpenito in Mubarrok et al
(2021), anxiety that occurs in the patient's family
can also be influenced by the length of time a
person is treated. Patients treated in the HCU arrive
suddenly and unplanned, the illness is critical and
the severity of the disease causes long treatment
which is associated with worry and anxiety. The
length of treatment required for a patient to undergo
treatment at the hospital is calculated from the time
they are admitted to the hospital until they are
discharged from the hospital, whether they recover
or die.
Length of Stay (LOS) or length of stay is
the number of days a patient is treated in hospital,
from the day of admission to the day of discharge
or going home and LOS is used by hospitals as an
indicator of service. LOS shows how many days a
patient is hospitalized during one treatment period
(Hosizah & Maryati, 2018).
The length of stay for patients treated in the
intensive care unit generally comes as planned or
not. The severity of the disease and the critical
condition of the patient means that patient care in
the intensive care unit requires a long time which is
associated with anxiety. The length of treatment
days will have an influence on the family that is
caring for it, such as it can cause feelings of anxiety
AHoJ : Allied Health of Journal Vol X No X
in the family that is being treated, which means that
the longer the patient is treated, the more anxiety
the patient's family members will increase (Saragih,
& Suparmi, 2017).
The condition of the patient being treated in
the intensive care unit will affect the length of the
patient's treatment period. The length of treatment
for patients in the intensive care unit varies greatly.
Based on the Barber-Johnson chart (International
Standard), the average length of stay for clients is 5
days (Amelia et al, 2020). Based on the standard
length of stay for patients in the HCU Room at TK
Hospital. III Dr. Reksodiwiryo Padang average 4.69
days or 5 days, (TK. III Hospital Dr. Reksodiwiryo
Padang, 2023).
Based on a preliminary study conducted by
researchers on December 29 2022, by interviewing
10 families of patients treated in the High Care Unit
(HCU) of TK Hospital. III Dr. Reksodiwiryo
Padang. It was found that 8 patients' families said
they were anxious, of which 2 people said they felt
tense, tired and anxious, 2 people felt afraid and
uneasy in the hospital, 2 people felt they didn't get
enough rest and couldn't get enough sleep, 2 people
also said they were anxious, no calm/often paces
around, and is afraid of what will be done to the
family being cared for. Of the 10 patient families
interviewed, 4 of the patient's families said their
family had been treated for 5 days. 2 of the patient's
families said they had been treated for > 7 days. 3
patients' families said they were treated < 5 days,
Based on the background above,
researchers are interested in examining the
relationship between length of stay and the anxiety
level of the families of patients treated in the High
Care Unit (HCU) of TK Hospital. III Dr.
Reksodiwiryo Padang in 2023.
RESEARCH METHODS
This type of research is quantitative with a
cross sectional approach. This research was
conducted in the High Care Unit (HCU) of the Tk
hospital. III Dr. Reksodiwiryo Padang City in 2023,
the population in this research were all families of
patients treated in the High Care Unit (HCU) in the
last 3 months, namely 110 people. Sampling in this
study used purposive sampling, the population was
calculated using the Slovin formula, the number of
respondents was 43 respondents.Dataobtained
directly from the respondent by giving a
questionnaire directly to the respondent which
includes the variables studied (length of stay and
3 The Relationship between Length of Hospitalization and the Level of Anxiety of the Families of
Patients Treated in the High Care Unit (HCU) of Tk Hospital. III Dr. Reksodiwiryo Padang City in
anxiety level of the patient's family) using the the length of treatment varies from 1 day to 34
HARS questionnaire.Then the data was processed days, but generally more than 7 days (85.2%).
using univariate analysis and bivariate analysis DayTreatment is the time required for a
using the chi-square statistical test which showed a patient to undergo treatment in hospital which is
value (p value <0.05). calculated from the time they are admitted to the
hospital until they are discharged from the
RESEARCH RESULTS AND hospital, whether they recover or die, with an
DISCUSSION average of 5 days of treatment (Keliat et al,
A. Respondent Characteristics 2009).
Characteristics of respondents in this study Research by Saragih & Suparmi 2017,
included age, gender and length of time shows that the patient's long length of stay is
undergoing hemodialysis.
caused by chronic disease, complications and
Table 1.Frequency Distribution of Respondents
Based on Characteristics. cost factors. A long length of stay indicates that
the disease tends to get worse or that there are
Respondent Characteristics f % complications or other comorbidities. Patients
Gender
Man 11 25.4%
with a short length of stay can indicate several
Woman 32 44.4% factors, namely that the patient's condition can
Last education improve within 24 hours or, on the contrary, die.
elementary school 22 51.2%
JUNIOR HIGH SCHOOL 14 32.6% According to assumptionsResearchers say
SENIOR HIGH SCHOOL 7 16.3% that the longer the length of stay, the disease
Work
Doesn't work 1 2.3% tends to be worse or there are other
IRT 32 74.4% complications. This is influenced by the
Self-employed 8 18.6%
Private 2 4.7%
condition of the patient. The longer the patient is
treated in the HCU, this means that the patient is
Based on Table 1, it can be seen that Of the 43 not yet stable and requires special treatment and
respondents, the results showed that more than complete equipment so that the patient cannot be
half were female, namely 32 respondents transferred to normal room
(74.4%). More than half of the 22 respondents
(51.2%) had at least elementary school 2. Family Anxiety
education. Meanwhile, more than half of the Table 3.Frequency Distribution based on the
32 (74.4%) are housewives. level of anxiety of the patient's family in the
High Care Unit (HCU)
B. Univariate Analysis
Anxiety Level f %
1. Length of Hospitalization
Severe Anxiety 12 27.9%
Table 2. Frequency Distribution based on Moderate Anxiety 18 41.9%
Length of Stay in the High Care Unit (HCU) Mild Anxiety 13 30.2%
Length of ƒ % Total 43 100%
Hospitalization Based on Table 3. it can be seen fromFrom
≥ 5 days 22 51.2% 43 respondents, more than half of the results
< 5 days 21 48.8% were obtained, namely (41.9%) of families
Total 43 100%
experiencing moderate anxiety in the High Care
Based on the table above, from 43
Unit (“HCU) of TK Hospital. III Dr.
respondents, the results showed that more than
Reksodiwiryo Padang in 2023.
half of the 22 respondents (51.2%) had a length
MatterThis is in line with the results of
of stay of ≥ 5 days in the High Care Unit (HCU)
Waruwu's research (2019), the level of family
at TK Hospital. III Dr. Reksodiwiryo Padang in
anxiety in the inpatient room (Santa Theresia
2023.
room) Santa Elisabeth Hospital Medan. In 2019,
This research is not in line with the results
the results showed that as many as 57 families
of Hardisman's (2018) research which shows
experienced severe anxiety with a percentage of
that

AHoJ : Allied Health of Journal Vol X No X

4 The Relationship between Length of Hospitalization and the Level of Anxiety of the Families of
Patients Treated in the High Care Unit (HCU) of Tk Hospital. III Dr. Reksodiwiryo Padang City in
(73.1%), mild anxiety as much as 5 people
(6.4%), 8 people were moderately anxious
(10.3%), 5 people were very anxious (6.4%),
while only 3 people did not experience anxiety
with a percentage (3.8%).
According toKristen & Dini 2017, that
Anxiety is a subjective feeling of mental
calmness that is disturbing as a general
reaction to the inability to overcome a
problem or the lack of a sense of security.
These uncertain feelings are generally
unpleasant which will later lead to
physiological and psychological changes.
Emotional reactions commonly experienced
by patient families in the intensive care unit
are anxiety, anger, grief, hope, love,
depression, helplessness, loneliness or
loyalty.
According to researchers'
assumptions,that family anxiety can also be
caused by several factors, such as the illness
suffered by the patient, where this has an
impact on the patient's healing process,
especially family members being treated in
the HCU room in critical condition, causing
excessive anxiety for the patient's family.
C. Bivariate Analysis
Relationship between length of stay and anxiety
level of families of patients treated in the High
Care Unit (HCU)
Table 4.Relationship between length of stay and
anxiety level of families of patients treated in the
High Care Unit (HCU)
Table. 4showed that the length of stay for
most patients was in the category ≥ 5 days as
many as 22 respondents (45.5%). Meanwhile,
CONCLUSION
<5 days were 21 respondents (14.3%).
stay for 43 respondents was more than half that of
AHoJ : Allied Health of Journal Vol X No X
The Chi-Square Test results obtained a p-
value of 0.034 (p-value ≤0.05), namely there
isThe relationship between the length of
hospital stay and the level of anxiety of the
families of patients treated in the HCU
ward at Dr. Reksodieiryo Hospital, Padang
in 2023.
This research is not in line with the theory
put forward by Carpenito in Mubarrok et al
(2021), the anxiety that occurs in the patient's
family can also be influenced by the length of
time a person is treated. Patients treated in the
HCU arrive suddenly and unplanned, the
illness is critical and the severity of the disease
causes long treatment which is associated with
worry and anxiety. The length of treatment
required for a patient to undergo treatment at
the hospital is calculated from the time they
are admitted to the hospital until they are
discharged from the hospital, whether they
recover or die.
The results of research conducted by Siti
(2019), factors such as age, education, socio-
economic level, physical appearance of the
room, relationships between personnel,
equipment noise and interaction restrictions
are factors that influence the anxiety level of
patient families in the HCU room. Waruwu
(2019), in his research on coping and family
social support, stated that nurses have an
important role and function in helping parents
cope during hospitalization. Andi (2019),
researched emotional support and information
for families when children are sick, especially
parents whose children have received
treatment for a long time. The results of this
research are that families really want to be
listened to by nurses. In this research,
According to researchers'
assumptionsthat it was proven that there was
a relationship between length of stay in
hospital and the level of anxiety of the patient's
family in the HCU room at Tk.III Dr.
Reksodiwiryo Hospital, Padang, with a P value
of 0.034. The longer the patient is treated does
not necessarily determine the family's anxiety,
because family anxiety occurs due to several
factors, one of which is cost, there is no
experience of waiting, the family's anxiety will
increase.
Based on the research results, the length of
5 The Relationship between Length of Hospitalization and the Level of Anxiety of the Families of
Patients Treated in the High Care Unit (HCU) of Tk Hospital. III Dr. Reksodiwiryo Padang City in
22 respondents (51.2%) with a length of stay of ≥ 5 Rumah Sakit TK. III Dr. Reksodiwiryo Padang.
days in the High Care Unit (HCU) at TK Hospital. 2023. Angka Kejadian Penyakit di
III Dr. Reksodiwiryo Padang in 2023. The results of ruangan HCU dan ICU Rumah Sakit
research on anxiety levels from 43 respondents TK. III Dr. Reksodiwiryo Padang
showed that more than half (41.9%) of families Tahun 2022
experienced moderate anxiety in the High Care Saragih dan Suparmi. (2017). Faktor-Faktor yang
Unit (“HCU) room at TK Hospital. III Dr.
Mempengaruhi Tingkat Kecemasan
Reksodiwiryo Padang in 2023.
Pasien yang Dirawat di Ruang
There is a relationship between the length of ICU/ICCU RS Husada Jakarta.
hospital stay and the level of anxiety of the families KOSALA, 5(1), 61-69.
of patients treated in the HCU room at the https://doi.org/10.37831/jik.v5i1.119
Kindergarten hospital. III Dr. Reksodiwiryo Padang Siti, N. (2019). Hubungan Lama Rawat dan Status
City in 2023 with p-value = 0.034 (p-value ≤0.05). Pasien Kritis dengan Koping
Keluarga Di Ruang ICU RSUD Sele
ACKNOWLEDGMENTS Be Solu Kota Sorong. Jurnal Inovasi
On this occasion the researcher would like Kesehatan, 1(1), 44-49.
to thank STIKes Alifah Padang who has helped in https://doi.org/10.37063/antaraperawat.
carrying out this research and the researcher also v1i1.57
thanks the Tk hospital. III Dr. Rekodiwiryo Padang Sudarsih. (2022). Hubungan Pemberian
who has provided support and permission Informasi Penyakit Jantung
toresearchers to conduct research so that this Terhadap
research runs smoothly. The researcher also thanks Kecemasan Keluarga Pasien di
the supervisor Mrs. Ns. Rebbi Permata Sari, M.Kep Ruang ICU Rumah Sakit Mardi
and Mr. Ns. Willady Rasyid, M.Kep, Sp. Kep MB Rahayu Kudus. Journal of
for taking the time to guide and provide direction TSCS1Kep,7(1), 23-36.
and input so that researchers can complete this http://ejournal.annurpurwodadi.ac.id/i
research. ndex.php/TSCS1Kep
Waruwu, I. C. (2019). Hubungan lama hospitalisasi
anak Dengan tingkat kecemasan
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