Kebijakan medik pada pasien gagal ginjal kronik dengan hemodialisis di rs Hasan Sadikin bandung
Date
2014
Journal Title
Journal ISSN
Volume Title
Publisher
Pusat Kebijakan dan Manajemen Kesehatan, Universitas Gadjah Mada, Yogyakarta, ID
Abstract
Background: Prevalence of Chronic Kidney Disease in
dialysis’s patients in Indonesia has increased. Some of them
occurred with malnutrition inflammation complex syndrome and
lead to death. This study aims to determine the intake of protein
and energy, and determine factors that cause the low intake
of nutritions.
Methods: Design of the study was mixed methods using
embedded conccurent strategy. Research paradigm was
constructivism whereas qualitative research conducted indepth
interviews and observations. Quantitative research has
been done with a descriptive approach, observational, using
secondary data and perform 24 Hour Recall and Food
Frequency Questionnaire (FFQ). The study was conducted at
Hemodialysis Unit, Hasan Sadikin Hospital from June to
September 2013, with a total sampling. Qualitative and
quantitative data analysis has been done, followed by analysis
of policy and analysis for policy for establishing a medical
policy for chronic kidney disease patients receiving medical
hemodialysis.
Result: The average protein intake of the patients was 1.32 g/
kg/day. Interval of protein intake of 0.5 g/kg /day (lowest) untill
2.8 g/kg/day (highest). 24% of patients had protein intake
under 1 g /kg BW/day and 22.8% was above 1.5 g/kg BW/day.
Average energy intake was 2001 kcal patient/day (930 kcal/
day - 3196.9 kcal/day). Qualitative analysis resulted in seven
themes which causes nutrient low intake. The themes were
underlying diseases (such as diabetes mellitus and
hypertension), length of dialysis, frequency and number of
dialysis, effects of dialysis, body’s response, cost factor,
counseling and education. Most of respondens felt suffer from
anemia and complined of nausea and vomiting. Body responses
varied widely among them.
Conclusion: Protein intake of dialysis patients as recomendded
by K/DOQI, but not accordance to energy intake. Protein and
energy intake of Jamkesmas’s holder patients were lower
than recommendation of K/DOQI. The cause of lower intake of
nutrients due to the underlying disease, length of dialysis,
frequency and number of dialysis, effects of dialysis, body
responses, cost factors and lack of counseling and education.
Counseling and education of the patients hospital is needed.
Government should be encourage medical policy in the
management of patients with chronic kidney failure are
comprehensive, in primary care, secondary and tertiary.
Government must provide competent personnel, facilities and
supporting infrastructure, service standards and standard
operating procedures are required for each level of service.
Description
item.page.type
Journal Article (peer-reviewed)
item.page.format
Text
Keywords
MALNUTRITION, KIDNEY DISEASES, DIALYSIS, MORBIDITY, PROTEIN DEFICIENCY, CARE STANDARDS, POLICY MONITORING
Citation
Marhaeni Diah Herawati, D., & Fuji Ariyanto, E. (2014). Kebijakan medik pada pasien gagal ginjal kronik dengan hemodialisis di rs Hasan Sadikin bandung. Jurnal Kebijakan Kesehatan Indonesia, 3(2): 66-74.