Ners Profesion Health National Seminar STIKESAl-Irsyad Al-Islamiyyah Cilacap 2017

Management Communication In Health Team Collaboration

Of Giving High Alert For Patient Safety

Description on Spiritual Needs Level of the Kidney Failure Patients that are going
through Hemodialysis on RSUD Cilacap’s Hemodialisa Room

M. Muniruzzaman1, Yuni Sapto Edi R2, Agus Prasetyo3

1,2,3STIKES Al-Irsyad Al-Islamiyyah Cilacap

e-mail: prasetyoagus163@gmail.com

Abstrack
Suffering from end-stage renal failure often makes the individual needs spiritual fulfillment.
Efforts to improve nursing care on the patient's spiritual dimension, one of them is through
the study of spiritual needs. This study aims to identify the spiritual needs of patients with
chronic renal failure who undergo hemodialysis. This quantitative descriptive study involved
65 patients with chronic renal failure who underwent hemodialysis in RSUD Cilacap taken by
accidental sampling. Data were collected using the Spiritual Needs Questionaire (SPNQ 2.1)
instrument that covered aspects of religion, peace and self-existence and giving needs. Data
analysis of spirituality needs using frequency distribution and percentage. The results showed
that on the religious aspect, as many as (90.8%), the dimension of peace was (55.4%), the
dimension of existence as much as (20%), whereas in the giving dimension there were
(86.2%) patients at need level. In general the level of spiritual needs of respondents is
(49.2%) at the level of need rather and (50.8%) at the need level.

Keywords: Chronic Kidney Failure, Hemodialysis, Spiritual Needs

 Ners Profesion Health National Seminar STIKESAl-Irsyad Al-Islamiyyah Cilacap 2017
Management Communication In Health Team Collaboration
A. INTRODUCTION
Human being are build up
from physical, emotional,
intelectual, sosial and spiritual
dimensions, in which each
dimension's needs has to be fulfilled.
Client's problems that are frequently
exist when they got some health
issues (for example physical illness)
are the cause of their psychososial
and sosial problems. When clients
are suffering from an illness, their
spiritual power can help them to
cure themselves and they can reach
their goal with or through the
spiritual needs fulfillment. (Asmadi,
2008)
According to Bussing et al
(2010), spiritual needs has 4
dimension which are; religious,
inner peace, self existency and an
active giving. Each person has these
needs but they have different aspect
and their level of needs, therefore it
is important to do a reseach on
determining the patients need
beforehand.
Dunning (2003) said that
spirituality is an invisible essential part
of an individu which gives life
meaning and goal, and also the
relationship with God, the supreme
power. Spirituality is different from
religion, spirituality is a much broader
concept that is universal and personal.
While, religion is a part of spirituality
and related to culture and society.
The most common problem on
the failure of fulfilling the spiritual
needs will gives impact to a more
serious problem wich is spiritual
distress
The most common problem on
the failure of fulfilling the spiritual
needs will gives impact to a more
serious problem wich is spiritual
distress. It is a situation when an
individual or a group of people had a
Of Giving High Alert For Patient Safety
risk on having issue on their believe or
a system that can give them
power,hopes and life meaning. It begins
with a calling for spiritual help from the
patient, showing doubt in their believe,
excessive doubt on their life-meaning,
showing their interest on death and the
after-life, makes decisions, and refusing
a ritual ceremony. These are supported
by the action of crying, pulling
themselves from the society, anxiety
isues, anger, and also physical changes
such as eating disorders, insomnia and
increasing blood pressure. (Hidayat,
2006)
In a health service area, the
medical staffs have a important roles
on fulfilling spiritual needs. The
staffs are required to give an extra
fulfillment when the patient are
going to have an operation, critical
patient and the patients with low rate
life chances. Therefore, the
relationship between faith and health
service can be found. An aspect of
spiritual needs and biological needs
can be provided on the health service
area. Spiritual aspect is capable of
encouraging patients on their healing
process.
According to Hawari (1997),
the importance of spiritual aspect in
supporting other healing aspects is
not negotiable, as some current
researches proves that spiritual
impact is an essential part of the
patient’s health and healing process.
This is acceptable as the hospital’s
patients especially inpatients, not
only they are suffering from physical
illness. but also suffering from many
kinds of pressure and mental spiritual
illness. Both from the light to the
severe one as a result from their
illness. (Priyanto, 2009)
The realization of the above is
not accurate as it is stated. On some
Local Hospital (RSUD) that are
operated both by the government and
 Ners Profesion Health National Seminar STIKESAl-Irsyad Al-Islamiyyah Cilacap 2017
Management Communication In Health Team Collaboration
Of Giving High Alert For Patient Safety

private institution, spiritual service Hemodialysis on RSUD Cilacap’s

for the inpatients is not a habitual Hemodialisa Room.”
process both individualy and
colaboratively with the nursing care. RESEARCH METHODS
Therefore, compared to other nursing
This research is using a
care, especially mdical nursing care,
simple quantitative descriptive
inpatient’s spiritual needs are not
design with the survey method on a
noticed.
group of objects. This design was
The initial study had been done
chosen because the writer would like
by the researcher on June 17, 2016
to show the description on spiritual
towards 10 kidney failure patients that
needs of chronical kidney failure
are going through Hemodialysis in
patients that are going through
RSUD Cilacap. The result of the study
Hemodialysis on RSUD Cilacap’s
shows that 8 of the kidney failure
Hemodialisa room.
patients pray more than before,
readings religious book, and accepting
POPULATION AND SAMPLE
their situation. 2 of the patients feel
The subject of this research are
tired of the Hemodialysis treatment 120 kidney failure patients that are
and feel like it is useless, they closing going though Hemodialysis in RSUD
themselves from the society, and they Cilacap. Finding the amount of the
show no interest on communication to research sample is done with the
people around them including the Slovin calculation which resulting in
health care staffs. 65 respondent.
Based on the explanation
above on the spiritual needs, the
RESEARCH RESULT
writer is interested to do the research
The result of the analysis on
about “Description on Spiritual
the 65 respondents can be seen on this
Needs Level of the Kidney Failure
explanation :
Patients that are going through

A. Religious Dimension

Tabel.1 Distribution of Religious Dimension Need Level on Sppiritual Needs of

Chronical Kidney Failure Patients That Are Going Through Hemodialysis.

Not at all Somewhat Strong Very Strong

Question
N % N % N % N %
To pray with someone? 4 6,2 16 24,6 8 12,3 37 56,9

That someone prays for you? - - - - 28 43,1 37 56,9

To pray for yourself? - - - - 10 15,4 55 84,6

To participate at a religious 1 1,5 19 29,3 33 50,8 12 18,5
ceremony (i.e. service)?
To read religious / spiritual 3 4,6 12 18,5 34 52,3 16 24,6
books?
To turn to a higher presence
(i.e.,God, Allah)?
- - - - 6 9,2 59 90,8
 Ners Profesion Health National Seminar STIKESAl-Irsyad Al-Islamiyyah Cilacap 2017
Management Communication In Health Team Collaboration
Of Giving High Alert For Patient Safety

B. Peace Dimension

Tabel 2 Distribution of Peace Dimension Need Level on Sppiritual Needs of

Chronical Kidney Failure Patients That Are Going Through Hemodialysis.

Not at all Somewhat Very

Strong Strong
Question
N % N % N % N %
To plunge into beauty of nature? 1 1,5 21 32,3 25 38,5 18 27,7
To dwell at a place of quietness - - 4 6,2 28 43,1 33 50,6
and peace?

To find inner peace? - - 15 23,1 30 46,2 20 30,8

To give away something from
yourself? 5 7,7 17 26,2 14 21,5 29 44,6
For being complete and safe?
21 32,3 13 20,0 14 21,5 17 26,2

C. Existential Dimension

Tabel 3 Distribution of Existential Dimension Need Level on Spiritual Needs of Chronical

Kidney Failure Patients That Are Going Through Hemodialysis.

Very
Not at all Somewhat Strong
Question Strong
N % N % N % N %
To talk with others about your
fears and worries? 27 41,5 11 16,9 27 41,5 - -

To reflect your previous life? - - 22 33,8 33 50,8 10 15,4

To dissolve open aspects of your
life? 46 70,8 7 10,8 10 15,4 2 3,1
To find meaning in illness 1 1,5 13 20,0 20 30,8 31 47,7
and/or suffering?
To talk with someone about the 5 7,7 11 16,9 35 53,6 14 21,5
question of meaning in life?
To talk with someone about the 36 55,4 12 18,5 16 24,6 1 1,5
possibility of life after death?
To forgive someone from a - - 8 12,3 34 52,3 23 35,4
distinct period of your life?
To be forgiven? - - 39 60,0 - - 26 40,0
 Ners Profesion Health National Seminar STIKESAl-Irsyad Al-Islamiyyah Cilacap 2017
Management Communication In Health Team Collaboration
Of Giving High Alert For Patient Safety

D. Active Giving Dimension

Tabel 4 Description of Active Giving Dimension Need Level on Active Giving of Chronical
Kidney Failure Patients That Are Going Through Hemodialysis.
Very
Not at all Somewhat Strong
Question Strong
N % N % N % N %
That someone of your
religious community (i.e. 5 7,7 5 7,7 19 29,2 36 55,4
pastor) cares for you?
To turn to someone in a loving
attitude? - - 8 12,3 34 52,3 23 35,4

To solace someone?
34 52,3 13 20,0 17 26,2 1 1,5

To feel connected with family? - - 2 3,1 11 16,9 52 80

To pass own life experiences to 1 1,5 24 36,9 35 53,8 5 7,7
others?
To be assured that your life - - 1 1,5 36 55,4 28 43,1
was meaningful and of value?
To be assured that your life 6 9,2 34 52,3 25 38,5
was meaningful and of value?
To be assured that your life - - - - 5 7,7 60 92,3
was meaningful and of value?

E. Description on Spiritual Needs Level

Tabel 5 Description of Spiritual Needs DISCUSSION

Level on Active Giving of Chronical The research shows that
Kidney Failure Patients That Are Going religious aspect is most needed by
Through Hemodialysis. the respondents. Najlah Naqiyah
(Naqiyah,2005) stated that religion
Rather Needed Highly
Spiritual
Needed Needed is needed by human beings to
Needs
N % N % N % construct a meaning of their life
Religion 6 9,2 59 90,8 - - experience, as with the presence of
Peace 28 43,1 31 47,7 6 9,2
Existence 52 80,0 13 20,0 - -
self confidence to give an
Giving 14 21,5 51 78,5 - - extraordinary meaning to the reality,
Spiritual religion is capable to guide a person
Needs Level 32 49,2 33 50,8 - -
to have acceptance on their
problems. While literature shows
Table 5 shows the result of spiritual
that a person rather sees God and
needs level on the religion
their congregation as a source of
dimension of 6 respondents (9,2%)
love and support and not as a source
whose spiritual needs are on the
of pain and punishment. (e.g., Croog
“rather needed” level and 59
and Levina 1972; Bearon and
respondents (90,8%) whose spiritual
Koenig 1990; Pargament, 1998).
needs are on the “needed” level.
 Ners Profesion Health National Seminar STIKESAl-Irsyad Al-Islamiyyah Cilacap 2017
Management Communication In Health Team Collaboration
The next spiritual needs is the
desire to give. Regarding to Bussing
et al (2010), the desire to give
consists of : conciously active on
comforting others, sharing life
experience, and ensuring others that
their life has a purpose and meaning.
Walton (2002) stated that spirituality
is a balance thing, after a person gets
help when they were having a crisis,
they will have a desire to give or
being useful so that they can gain
balance. In a process to becomes
healthy, participants feel that they are
fragile and they are dependent on
others. After they gain their health,
participants have a desire to give
their help back to the people in need.
The desire to give or being useful to
others in need is a strong part of
spirituality. One of the patient’s
spirituality meaning in Indonesia is to
share the help to the other (Nuraeni,
2012.)
Peace Dimension is a
spiritual needs that is required by the
respondents comparing to the other
dimension, this can be proven by the
result of the research that shows that
all of the respondents need this
spiritual need. Chao, Chen dan Yen
(2002) stated that self peace is a
spiritual thing that comes out from
self reconsilitaion, as a result of
negotiation on the existing conflict.
Nuraeni’s research (2012) shows that
self peace might come out as a form
of acceptance on the problems
(disease) that is seen as a warning or
trials on their life. This acceptance
can guide them into a better life.
Self existential need is the
least needed spiritual aspect. Bussing et
al (2010) said that existential need
Of Giving High Alert For Patient Safety
covers ; self reflection, discussing about
the life’s meaning and goal to their
relatives, discussing about fear and
after-life to relatives. Frankl (on
Guillory et al, 1997) stated that the point
of human’s existence can be seen
through the searching of life meaning
and goal. Furthermore, Buchardt and
Nagai-Jacobson defines spirituality as
an essential part of human’s existence,
raise awareness on self identity, life goal
and human’s spiritual source.
REFFERENCE
Arifin, Z. (2013). Evaluasi
Pembelajaran, Prinsip, Teknik,
Prosedur. Bandung: PT
Remaja Rosdakarya.
Asmadi. (2008). Konsep Dasar
Keperawatan, Jakarta: EGC.
Burkhardt, M.A. & Nagai
Jacobson,
M.G. (2005). Spirituality and
Health. In Holistic Nursing A
Hand Book For Practice
(Fourth Ed). Massachussetts:
Jones And Ba rlett Publisher.
Bussing, A., Balzat, H., & Heusser, P.
(2010). Spiritual needs of
patients with chronic pain
diseases and cancer - validation
of the spiritual needs
questionnaire. Eur J Med Res
15, 266–273.
Co-Shi Chantal Chao / Ching-Huey
Chen / Miaofen Yen. (2002).
The essence of spirituality of
terminally ill patient J Nurs
Research, 10. 237 – 244.
Dunning, T. (2003). Care of people
with diabetes a manual
nursing practice. Melbourne:
Blackwell Publishing.
Guillory, J. A., Sowell, R.,
Moneyham, L., & Seals,
B.(1997).An
exploration of the meaning
and use of spirituality among
 Ners Profesion Health National Seminar STIKESAl-Irsyad Al-Islamiyyah Cilacap 2017
Management Communication In Health Team Collaboration
Of Giving High Alert For Patient Safety

women with HIV/AIDS.

Alternative Therapy Health
Medicine, 3(5), 55–60.
Hawari, D. (2002). Dimensi Religi
dalam Praktek Psikiatri dan
Psikologi. Jakarta: Gaya Baru.
Hidayat, A. A. (2006). Pengantar
Kebutuhan Dasar Manusia 1:
Aplikasi Konsep dan Proses
Keperawatan. Jakarta:
Salemba Medika.
Naqiyah, Najlatun (2012), Hubungan
Interaksi Sosial
dan
Keharmonisan Keluarga
Dengan Perilaku Agresif
Pada Siswa Kelas X SMK
Negeri 1 Baureno
Bojonegoro. Jurnal BK
UNESA. Volume 04
Nomor 01, 375–382
Nuraeni Setyaningrum, (2012). Upaya
Peningkatan Pelayanan Sosial
Bagi Lansia Melalui Home
Care Service di Panti Sosial
Tresna Werdha (PSTW)
YOGYA KARTA Unit Budi
Luhur. Universitas Negeri
Yogya karta.
Priyanto, A. (2009). Komunikasi dan
Konseling, Aplikasi dalam
Sarana Pelayanan Kesehatan
untuk Perawat dan Bidan,
Salemba Medika, Jakarta.
Walton, R.E & M. Torabinejad.
(2002). Principles and
Practice of Endodontics. 3rd
ed. Philadelphia:W.B.Saunders