Putri Wahyuningsih, Hamudi Prasestiyo

Laporan Kasus Dengan Masalah Gangguan Pola Tidur Pada Pasien Chronic Kidney Desease Di Ruang Dahlia Rsud Wates

Introduction

Laporan kasus dengan masalah gangguan pola tidur pada pasien chronic kidney desease di ruang dahlia rsud wates. Laporan kasus gangguan pola tidur pada pasien Penyakit Ginjal Kronis (CKD) di RSUD Wates. Temukan efektivitas intervensi dzikir dalam meningkatkan kualitas tidur pasien CKD.

Abstract

Latar Belakang: Penyakit ginjal kronis (Chronnic Kidney Disease) merupakan penyakit gagal ginjal dimana terdapat penurunan fungsi ginjal yang ditandai dengan penurunan glomerulus filtration rate (GFR).Terapi yang sering dilakukan oleh penderita CKD adalah dengan cara hemodialisis dan peritonealialisa. Tujuan : memberikan gambaran penerapan intervensi dzikir pada pasien CKD dengan diagnosis keperawatan gangguan pola tidur di ruang Dahlia RSUD Wates. Metode: penelitian ini adalah penelitian studi kasus observasional yang mengeksplorasi masalah keperawatan terutama gangguan pola tidur. Teknik pengumpulan data yang digunakan berupa wawancara, dan observasi. Hasil: Pengkajian Pada penapisan paliatif diperoleh skor 5 yaitu pasien tersebut perlu intervensi palliative. Dalam Edmonton Symptom Assessment System (ESAS) pasien mengalami tidak bisa tidur, pasien dengan depresi sedang. Didalam aktivitas fisik pada pasien terdapat skor karnofsky 50 % yaitu sering memerlukan bantuan, sering memerlukan perawatan medis. Dalam kebutuhan spiritualnya pasien CKD adalah 76 dimana merupakan spiritual sedang. Kesimpulan: pasien mengalami peningkatan kualitas tidur menggunakan Instrumen yang digunakan adalah Pittsburgh Sleep Quality Index (PSQI). setelah dilakukan intervensi dzikir yang ditandai dengan penurunan skor PSQI dari 17 menjadi 12 atau dari kategori berat menjadi kategori ringan kemudian pasien mampu tidur lebih cepat yang biasanya lebih dari jam 12 malam, setelah dilakukan intervensi dzikir pasien mampu tidur kurang dari jam 10 malam.

Review

This case report, titled "Laporan Kasus Dengan Masalah Gangguan Pola Tidur Pada Pasien Chronic Kidney Desease Di Ruang Dahlia Rsud Wates," presents a compelling initial exploration into the application of *dzikir* as an intervention for sleep pattern disturbances in a patient with Chronic Kidney Disease (CKD). The abstract clearly outlines a pertinent clinical problem, as sleep disruption is a common and distressing symptom for individuals undergoing dialysis, significantly impacting their quality of life. The study's aim to describe the implementation of a spiritual intervention, *dzikir*, is commendable, offering a potentially culturally sensitive and non-pharmacological approach to symptom management. The reported decrease in the Pittsburgh Sleep Quality Index (PSQI) score from 17 to 12, indicating a shift from severe to mild sleep disturbance and faster sleep onset, suggests a promising initial outcome. However, the methodology, an observational single-case study, inherently limits the generalizability and conclusive power of the findings. While valuable for hypothesis generation, a single case report with no control for confounding variables makes it challenging to attribute the observed improvement solely to the *dzikir* intervention. The abstract briefly mentions other assessments like ESAS, Karnofsky score, and spiritual needs, but their specific interrelation with the intervention and outcome is not fully elucidated. Furthermore, the description of the *dzikir* intervention itself is sparse, making it difficult for others to replicate or understand the specific components that might have contributed to the improvement. The lack of a robust methodological framework, such as a time-series design within the single case or comparison to a baseline without intervention, prevents stronger claims of efficacy. Despite these limitations, this case report serves as an important preliminary step, highlighting a potential area for further research. Future studies should aim for more rigorous designs, such as pilot randomized controlled trials with larger sample sizes, to validate these encouraging preliminary results. It would be beneficial to standardize the *dzikir* intervention, detail its components, and consider objective measures of sleep quality alongside subjective reports. Exploring the mechanisms through which spiritual practices might influence sleep in CKD patients, perhaps by reducing anxiety or promoting relaxation, would also add significant value. This initial case report, therefore, lays a foundational brick for a much-needed investigation into holistic and culturally appropriate interventions for a challenging symptom in chronic illness.

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