Intervensi Motivational Interviewing terhadap Kepatuhan Manajemen Hemodialisis pada Pasien Penyakit Ginjal Kronik dengan Kehamilan: Studi Kasus

https://doi.org/10.22146/jkkk.108299

Aisyah Iffah Ulayya(1), Yayu Nidaul Fithriyyah(2*), Tatik Dwi Wahyuni(3)

(1) Program Studi Ilmu Keperawatan, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada
(2) Departemen Keperawatan Medikal Bedah, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada
(3) Instalasi Hemodialisis RSUP dr. Sardjito
(*) Corresponding Author

Abstract


Background: Pregnancy in women with Chronic Kidney Disease (CKD) undergoing hemodialysis is a rare and high-risk condition, particularly when there is nonadherence to hemodialysis regimens. Unlike other chronic diseases, evidence on the effectiveness of Motivational Interviewing (MI) in improving adherence among pregnant CKD patients remains very limited.
Objective: To evaluate the impact of MI on adherence to hemodialysis management in a pregnant with patient CKD.
Case report: There was a 23-year-old woman on hemodialysis for four years at 24 weeks' gestation. The patient was non-adherent to dialysis, medication, and antenatal care (ANC). MI was delivered in five sessions (lasting 30-45 minutes) for four weeks, using a logbook as reading materials.
Results: MI improved patient awareness and communication with healthcare providers. However, it was not fully effective in ensuring adherence with hemodialysis management, medication consumption, ANC visits, and long-term contraceptive choices in this pregnant patient with CKD. Key barriers included financial issues, childcare responsibilities, and unplanned pregnancy.
Conclusion: MI is recommended in nursing practice to build patient trust and understanding. Formal training and family involvement are needed to enhance MI effectiveness.

INTISARI

Latar belakang: Kehamilan pada wanita dengan Penyakit Ginjal Kronik (PGK) yang menjalani hemodialisis merupakan kondisi langka dengan risiko tinggi, terutama bila terdapat ketidakpatuhan terhadap regimen hemodialisis. Berbeda dengan penyakit kronik lain, bukti mengenai efektivitas motivational interviewing (MI) untuk meningkatkan kepatuhan pada pasien PGK dengan kehamilan, masih sangat terbatas.
Tujuan: Mengevaluasi dampak MI terhadap kepatuhan manajemen hemodialisis pada pasien PGK dengan kehamilan.
Laporan kasus: Perempuan 23 tahun, menjalani hemodialisis selama 4 tahun, usia kehamilan 24 minggu. Pasien tidak patuh dalam hemodialisis, konsumsi obat, dan kunjungan antenatal care (ANC). Intervensi MI dilakukan sebanyak 5 sesi (30-45 menit) selama 4 minggu menggunakan logbook sebagai materi.
Hasil: Intervensi MI meningkatkan kesadaran dan komunikasi pasien dengan tenaga kesehatan, namun belum sepenuhnya efektif dalam meningkatkan kepatuhan manajemen hemodialisis, konsumsi obat, kunjungan ANC, dan pemilihan kontrasepsi jangka panjang pada pasien PGK dengan kehamilan. Hambatan utama meliputi faktor ekonomi, tanggung jawab mengasuh anak, dan kehamilan yang tidak direncanakan.
Simpulan: Intervensi MI direkomendasikan untuk praktik keperawatan karena dapat membangun kepercayaan dan pemahaman pasien. Pelatihan formal dan keterlibatan keluarga diperlukan untuk meningkatkan efektivitas MI.


Keywords


penyakit ginjal kronik, kehamilan, hemodialisis, motivational interviewing, kepatuhan pasien

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DOI: https://doi.org/10.22146/jkkk.108299

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