The Correlation Between Body Mass Index (BMI) and Hemodialysis Adequacy in Hemodialysis Patients

Hemodialysis is the most common renal replacement therapy in patients with chronic kidney disease and has a dose that must be achieved, known as hemodialysis adequacy. In fact, many hemodialysis patients do not reach the hemodialysis adequacy target. There are three main factors affecting hemodialysis adequacy: the solute, the patient, and the dialysis process. Patient factors are important because these factors can be modified, intervened, and anticipated by nurses. One of the interesting patient factors to study is the Body Mass Index (BMI). The purpose of this study was to determine the relationship between BMI and hemodialysis adequacy. This research was conducted in November 2021. This study used a cross-sectional design with a consecutive sampling technique and comprised of 84 samples that met the inclusion and exclusion criteria. The data were collected by using recording data from the medical records of hemodialysis patients. BMI using post-hemodialysis weight parameters and hemodialysis adequacy were assessed by looking at the Kt/V score. The results showed that there was a significant relationship between BMI and hemodialysis adequacy (p=0.001) with moderate strength and negative pattern (r=-0.362); this means that the greater the BMI value, the less hemodialysis adequacy. The results indicated that maintaining a normal BMI can increase hemodialysis adequacy in patients. This can prevent complications, improve quality of life, reduce treatment costs, and reduce the frequency of hospitalization. Keywords: hemodialysis adequacy, body mass index, chronic kidney diseas

Self-management in Asthma Patients: A Systematic Review

Self-management is very important in treating asthma patients. Various selfmanagement support interventions have been developed to facilitate adequate self-management of asthma. This review aims to identify, describe and assess the evidence regarding self-management intervention programs and their effects on self-management outcomes among asthmatic patients. Four databases, Google Scholar, Europe PMC, Science Direct, and PubMed, were searched using a systematic strategy using keywords: Asthma, Chronic disease, eHealth, smartphone, self-management, educational programs, and quality of life. The study eligibility criteria was a Randomized Control Trial study, published between 2016 and 2021, with language restrictions published in English only. The JBI ( Joanna Brings Institute) tool was used to evaluate study quality. 422 studies were screened, and 11 studies that met the criteria were extracted. The review identified two intervention group methods to improve self-management among asthma patients, including digital-based self-management and non-digital-based self-management. Most research shows that self-management programs improve and maintain quality of life so that people with asthma can live normal lives without obstacles in carrying out daily activities. The self-management program for asthma patients provides the ability to manage the disease so that it can improve the quality of life. Keywords: asthma, self-management program, quality of life, mHealt

The Effect of Islamic Music Therapy for Reducing Pain in CKD Patients Undergoing Hemodialysis

When patients with CKD are receiving hemodialysis, cannulation is frequently performed. For hemodialysis patients, recurrent pain during cannulation is a severe issue. Even though there have been many studies on music therapy, there are currently few on Islamic music therapy’s effectiveness in easing cannulation pain. The study aimed to determine the effect of Islamic music therapy in reducing pain in CKD patients undergoing hemodialysis. This study used a pre-experimental design. 61 hemodialysis patients at Wava Husada Hospital were subjects of the study. They were split into two groups: the Islamic music therapy intervention group and the control group. In this study, non-probability sampling was conducted. Inclusion requirements included being Muslim, receiving hemodialysis for CKD, using AV fistula access, and not being in critical condition. Following the intervention, the NRS pain scale was used to assess the level of pain in each respondent. This study discovered that the control and Islamic music therapy intervention groups experienced different levels of discomfort. This study’s P value was 0.001 (0.05) according to the Mann-Whitney statistical test. Based on the findings of this study, it can be said that using Islamic music therapy to treat hemodialysis patients with chronic kidney disease can help them feel less pain. Keywords: Islamic music therapy, Pain, Hemodialysi

Risk Factors of Hypertension in Adolescents: A Literature Review

The increasing prevalence of hypertension in adolescents is a growing public health problem. This study aimed to determine the risk factors for hypertension in adolescents. A literature review was conducted and 20 relevant articles were found by searching in Pubmed (n = 7), Proquest (n = 6), Science Direct (n = 3), and Google Scholar (n = 4). The data search keywords were “risk factor AND hypertension AND adolescents OR teenager OR juvenile”. According to the results, risk factors for hypertension in adolescents include high birth weight, alcohol consumption, smoking, consuming fast food rich in salt, environmental factors, and exposure to particulate matter and air pollution. Most of the risk factors for hypertension in adolescents are related to obesity. Keywords: risk factors, hypertension, adolescents, tenageer, juvenil

The Effectiveness of Spiritual Therapy in Reducing the Anxiety Level of Preoperative Patients

Pre-surgical anxiety is an anticipative response to an experience regarded by clients as a threat to their life and bodily integrity. Spiritual therapy is an alternative treatment used by the religious through prayer and dzikir. This study aims to determine the effectiveness of spiritual therapies on the level of patient anxiety in preoperative patients. This research used a pre-experiment with a post-test-only design. Fifty respondents were taken by total sampling and divided into two groups (intervention and control group); each group consisted of 25 patients. The research was conducted from September to October 2020 at the University of Muhammadiyah Malang hospital. The dependent variable was anxiety level, measured by SAS (Zung self-rating anxiety scale) questionnaire. The data were analyzed with Mann Whitney Test using SPSS software version 23. The intervention group had mild anxiety at 52%, while the control group had 80%. The statistical test obtained a p-value of 0.016 < 0.05 and an effect size of 0.34 (moderate). This means that there is a difference in anxiety levels between the two groups. Spiritual therapies can enhance emotional intelligence, interpret its condition, and be aware of anything in favor of Allah SWT to improve coping and lower the level of anxiety. The nurse may provide spiritual intervention to pre-surgery patients to reduce their level of anxiety. Keywords: anxiety, spiritual therapy, pre-operation, dziki

Adverse Events Following Immunization (AEFI) of COVID-19 Vaccine: A Descriptive Survey in Malang City

Vaccination is used to stop the transmission of COVID-19. However, it can stimulate Adverse Event Following Immunization (AEFI) symptoms, ranging from mild to severe. This study aims to identify the signs and symptoms of AEFI of the COVID-19 vaccine in the Malang City Community. The research design used is a descriptive survey. The sampling technique used was accidental sampling (n=275). The sample criteria were able and willing to fill out the questionnaire by accessing the google form from the researcher. Data were analysed using the Descriptive Statistical Analysis Test. The results of the study indicated that the number of respondents who experienced AEFI after receiving dose 1 vaccine was 97 people (35.2%), with symptoms including fever in 96 people (34.9%), swelling or redness at the injection site in 13 people (4.7%), pain in the injection site in 44 people (16.0%) and 1 person (0.4%) experienced other symptoms that required medical attention. After the second dose of the vaccine, 63 people (22.9%) had a fever, 11 people (4.0%) experienced swelling or redness at the injection site, 18 people (6.5%) experienced pain at the injection site, and 3 people (1.0 %) had other symptoms that required treatment. Signs and symptoms of AEFI of the COVID-19 vaccine most experienced by respondents after vaccine doses 1 and 2 were fever, pain at the injection site, and swelling or redness at the injection site, and there were no severe signs of AEFI were found in this study. Keywords: AEFI, Covid-19 vaccine, signs, symptom

Pengaruh kombinasi lantunan Asma’ul Husna dan slow deep breathing terhadap tingkat kecemasan pada pasien hemodialisis

Background: Patients undergoing hemodialysis usually experience anxiety because they are afraid of there being worse progress of disease and fear of physical changes. Muslims believe that by reciting AL-Asmaul alHusna (Allah's Most Beautiful Names) in the healing process with a soft sound and combining with slow deep breathing that can provide calm and create a relaxed state. Purpose: To determine the effect of the level of anxiety by listening Asmaul Husna (The 99 Allah's Beautiful Names) and slow deep breathing undergoing hemodialysis therapy. Method: This study used a pre-experimental one-group pre and post-test design. Sampling using purposive sampling with a sample of 40 participants, conducted in the Hemodialysis ward at the University of Muhammadiyah Malang Hospital from February to March 2020. The instrument used was the STAI (State-Trait Anxiety Inventory) scale which contained 20 items. Data was analyzed using the Wilcoxon Signed-Ranks Test. Results: The participant’s score of anxiety before the intervention was 76.72 and after the intervention was 51.92. Obtain p value = 0.000. Conclusion: There is an effect of reciting AL-Asmaul al-Husna (Allah's Most Beautiful Names) and slow deep breathing undergoing hemodialysis therapy and is expected as an alternative of the non-pharmacological intervention options to reduce anxiety levels and facilitate patients undergoing hemodialysis to relax

The Effect of Progressive Muscle Relaxation (PMR) Exercise on Blood Pressure Reduction in Hypertensive Clients: A Literature Review

Compliance with taking antihypertensive drugs is low amongst patients with hypertension. Uncontrolled blood pressure causes heart disease, kidney failure, diabetes, and stroke. It is necessary to have alternative support in controlling blood pressure by using progressive muscle relaxation exercises. This study aimed to determine the effect of progressive muscle relaxation on reducing blood pressure in patients with hypertension. The research design used was a literature study with a sample size of 20 journals: Pubmed (n=2), Proquest (n=4), Science Direct (n=8) and Biomed Central (n=6). By using the keyword search data “Progressive Muscle Relaxation AND Blood Pressure AND Hypertension OR Hypertensive” and using analysis techniques with thematic analysis, 95% of the results of the study reported that there was a decrease in systolic and diastolic values in hypertensive patients before and after the progressive muscle relaxation intervention and 5% reported that there was no change. Progressive muscle relaxation is effective for lowering blood pressure in hypertensive patients. Keywords: Progressive Muscle Relaxation, Blood Pressure, Hypertensio

Korelasi Tingkat Spiritualitas Dengan Tingkat Stress Pada Klien Diabetes Tipe 2

Stress in diabetic patients creates a serious issue with disease severity. Stress can significantly impact an individual's physical, psychological, intellectual, social, and spiritual. In addition, stress becomes a threat to the physiological imbalance. By considering the magnitude consequences of stress on diabetic patients, it is necessary to find a way to manage stress. The research aimed to determine the relationship between spirituality and stress levels in diabetic patients. The correlational design was used and conducted at the Dinoyo Public Health Center using an accidental sampling technique. The number of respondents in this study was 150 diabetic patients, and the sample of the study was calculated using the G*Power application. The questionnaires used to collect data were Multidimensional Measure of Religiousness/Spirituality and Perceived Stress Scale-10. The data was statistically tested using Spearman Rho. The results showed a p-value or significant value (0.000) less than α (0.05), which means there was a relationship between spirituality and stress levels in diabetic patients. In conclusion, the diabetes patients showed a high level of spirituality within low-stress levels on average