Relationship between Social Support with Coping Mechanisms

Haemodialysis Patients

Muhammad Rosyidul ‘Ibad

, Tutu April Ariani, and Sari Rachmania

Department of Nursing, Faculty of Health Science, University of Muhammadiyah Malang

Jl. Bendungan Sutami No. 188A Malang, East Java, Indonesia 65145

Keywords: Social Support, Coping Mechanisms, Haemodialysis.

Abstract: Patients with haemodialysis therapy will undergo lifelong therapy to maintain their health while undergoing

therapy; the patient will experience burnout, stress, and feel the side effects of therapy. Coping mechanisms

that occur in haemodialysis patients are not always adaptive, and they also tend to maladaptive coping

mechanisms such as denial, denial, and even avoidance. Social support is needed to change the mechanism of

maladaptive coping into adaptive. The purpose of this study was to identify the relationship of social support

to the ability of coping mechanisms of haemodialysis patients. The study was conducted on 30 HD patients

and analysed using Chi-Square. The result is a significance value of less than alpha of 0.050, which means

that there is a relationship between social support and coping mechanisms at an error rate of 5 percent.

1 INTRODUCTION

Report from (Bandiara et al., 2012) shows the

percentage of primary diagnoses of HD patients with

diagnoses of acute kidney failure in CRF of 4% or 789

patients, diagnoses of acute kidney failure of 7% or

1,504 patients, and chronic kidney failure of 89% or

18,613 patients. According to the Report of Indonesia

(Indonesia, 2014), the number of patients undergoing

haemodialysis in East Java was 73175 patients

undergoing routine haemodialysis therapy, with the

duration of the most HD treatments being 3-4 hours,

this is still below the standard duration of HD

treatment which should be 5 hours (Cal et al., 2015).

Research (Armiyati and Rahayu, 2014)

explained the length of time the patient underwent

haemodialysis was 84 months (4 years), and the

fastest was two months. Based on research conducted

by (Wurara et al., 2013), it was found that most

respondents who had undergone haemodialysis

therapy between 1-12 months were 29 people. Based

on research conducted by (Herman, 2016), it was

found that haemodialysis time in patients undergoing

haemodialysis <6 months was 27%, 6-12 months was

47.3%, and >12 months was 25.7%.

Everyone can experience stress throughout their

lives and try to overcome them. Stress can stimulate

change and growth, and too much stress can result in

poor adjustment, physical illness, and an inability to

cope or coping with problems (Harwood et al., 2009).

Stress is a phenomenon that affects all dimensions of

a person's life (Potter and Perry, 2009). In patients

undergoing haemodialysis therapy also has the

potential for stress because the procedure of therapy,

where they have to come twice a week, have to leave

work (Suhrcke et al., 2006), and take the time to do

therapy, this will continue to recur and trigger stress.

Stressed individuals must have the ability to adapt,

and only everyone has different coping mechanisms

capabilities (Harahap et al., 2015).

Another aspect that influences coping

mechanisms and the quality of life of haemodialysis

patients is the level of perceived social support. The

first category refers to the availability of assistance

from others in the management or resolution of

practical situations or daily operations, such as

material and financial support or help in some daily

activities (Silva et al., 2016). At present, the increase

in life expectancy of people with HD is not the

ultimate goal of treatment, but it is slowly being

recognized that social support is a crucial element to

achieving effective treatment management, defined

social support offering and receiving assistance by

others when a crisis arises or in a state of imbalance

haemostasis (Davaridolatabadi and Abdeyazdan,

2016). Individuals usually get support from family,

friends, or other closest people such as health

’Ibad, M., Ariani, T. and Rachmania, S.

Relationship between Social Support with Coping Mechanisms Haemodialysis Patients.

DOI: 10.5220/0009203402710274

In Proceedings of the 2nd Health Science International Conference (HSIC 2019), pages 271-274

ISBN: 978-989-758-462-6

271

workers, peer groups and others. Social support is

very influential for patients who undergo

haemodialysis to survive, and social support can take

the form of material support, self-esteem, emotional

and informational (Lilympaki et al., 2016).

Based on the results of a preliminary study

conducted in July 2017, the research team conducted

interviews with the head of the HD room and HD

patients at Tk.II Hospital Dr. Soepraoen Malang. The

research team received information that

haemodialysis patients who experience stress around

75%, especially patients who have not recently

undergone haemodialysis every week and use

different coping mechanisms - each patient, patients

undergoing haemodialysis therapy experience

various changes including lifestyle, role disorders,

time spent during therapy, positive beliefs / views,

social support, and material. Some patients show

positive attitudes such as smiling and talking to

researchers, but some other patients show negative

attitudes, such as showing an expressionless face,

furrowing eyebrows, and ignorant. The patient's

family has also accompanied when the process of

haemodialysis is taking place, but more patients are

not accompanied by the family when the therapy

process has taken place; implementing nurses provide

information that the patient is highly recommended to

be accompanied by family or close people during the

therapy process. Based on these problems, the

research team was interested in researching the

Relationship of Social Support to Coping

Mechanisms in Patients with Chronic Diseases at Tk.

II Dr. Soepraoen Hospital.

2 METHODS

Samples that have been included in this study are

patients who have been diagnosed with chronic

kidney failure with haemodialysis therapy at Tk

Hospital. II Dr. Soepraoen Malang, following the

inclusion criteria, were 30 patients (Hidayat, 2007).

The sampling technique that has been used in this

study is Purposive Sampling with inclusion criteria:

Haemodialysis patients starting in 2017 (May-

October), Patients with compos mentis awareness

(GCS 456), haemodialysis twice a week. Researchers

assess social support using the Multidimensional

Scale of Perceived Social Support (MSPSS) and

assess coping mechanisms using the COPE Inventory

(Su et al., 2015). Furthermore, bivariate analysis with

Chi-square using SPSS software for Windows 20.

3 RESULT AND DISCUSSION

Researchers have obtained the characteristics of

haemodialysis patients at Tk.II Hospital, dr.

Soepraoen Malang in October 2017. Respondents

who were involved in this study were haemodialysis

patients in 2017 and did therapy 2 times a week, on

Monday and Thursday, or Tuesday and Friday. The

results can be seen in table 1.

Table 1: Characteristics of Respondents based on HD (month) at Tk Hospital. II Dr. Soepraoen Malang.

Frequency Percent Valid Percent Cumulative Percent

Valid Mei 4 13.3 13.3 13.3

Jun 1 3.3 3.3 16.7

July 4 13.3 13.3 30.0

Augustus 5 16.7 16.7 46.7

September 11 36.7 36.7 83.3

October 5 16.7 16.7 100.0

Total 30 100.0 100.0

N Valid

missing

Table 2: Gender characteristics of HD Respondents at Tk Hospital. II Dr. Soepraoen Malang.

Frequency Percent Valid Percent Cumulative Percent

Valid Woman 15 50.0 50.0 50.0

Man 15 50.0 50.0 100.0

Total 30 100.0 100.0

N Valid

missing

HSIC 2019 - The Health Science International Conference

272

Table 3: Characteristics of Respondents based on Social Support.

Frequency Percent Valid Percent Cumulative Percent

Valid Poor 16 53.3 53.3 53.3

Moderate 11 36.7 36.7 90.0

High 3 10.0 10.0 100.0

Total 30 100.0 100.0

Table 4: Characteristics of Respondents by Coping Mechanism.

Frequency Percent Valid Percent Cumulative Percent

Valid Maladaptive 19 63.3 63.3 63.3

Adaptive 11 36.7 36.7 100.0

Total 30 100.0 100.0

Social Support

Researchers have obtained data on the level of social

support in haemodialysis patients according to the

results of table 3. Based on table 3, it has been

obtained the results of social support to the most

respondents in poor social support 16 people, 11

people moderate social support, and three people high

social support.

Coping Mechanism

Researchers have obtained research data on the

coping mechanism category, which is presented in

table 4. Based on table 4, it has been found that the

most respondents coping mechanism is maladaptive

coping mechanism19 and adaptive coping

mechanism 11 patients HD.

Relationship between Social Support with Coping

Mechanisms

able 5: Relationship between Social Support with

Coping Mechanisms.

Chi-Square Tests

Value df

10.720

12.215 2

10.356 1

2 cells (33.2%) have expected count less than 5. The

minimum expected count is 1.10

There are respondents with poor social support

have adaptive coping mechanisms as many as 5

people (16.6%), but there are respondents with poor

social support have adaptive coping mechanisms as

many as 5 people (16.6%). The test results of the

relationship between social support with coping

mechanisms obtained Chi-square value of 10.720

more than the value of Chi-square table of 5.991 or a

significance value of 0.005 less than alpha of 0.050

which means that there is a relationship between

social support and coping mechanism at an error rate

of 5 percent

Based on the results of research conducted on

haemodialysis patients at Tk.II Hospital Dr.

Soepraoen Malang, it is known that the level of the

respondent's social support is low. According to

(Taylor, 2006), social support is a form of

information that there are people who love and care

for us and consider us as someone valuable. Social

support owned by respondents can influence coping

mechanisms. Respondents who have mild social

support can be interpreted that respondents have

inadequate coping mechanisms. Social support can

reduce the effects of stress, which helps a person to

be able to cope with events caused by stressors,

reducing the possibility of distress, which can worsen

health conditions (Harahap et al., 2015).

From the results of research that has been done it

is known that the existence of a form of support from

the environment, especially from someone close to

the patient, will help someone grow a good coping, if

support tends to be less will result in someone unable

to solve the problem they are experiencing, in the

long run, can result in distress. Shown in this study,

the most significant percentage of respondents who

have poor social support have maladaptive coping

mechanisms of 11 people. Social support is part of the

source of coping, and if someone uses it, it will affect

adaptive coping; men and women usually have

deference coping mechanisms to reduce their stressor

(Wilsey and Lyke, 2015).

Social support is the main thing in this study, it is

expected that haemodialysis sufferers have someone

who is trusted to convey complaints (anger, sadness,

despair, and anxiety) (Valcanti et al., 2012), so that

Relationship between Social Support with Coping Mechanisms Haemodialysis Patients

273

sufferers feel that their existence is valuable to others,

that there is someone who loves them, there is

someone who pays attention to it, it can lead to

confidence, self-esteem haemodialysis sufferers and

be able to foster a good coping mechanism, and

reduce the possibility of stress.

4 CONCLUSIONS

Most haemodialysis patients have low levels of social

support and maladaptive coping mechanisms, and

there is a relationship between social support and

coping mechanisms. As a nurse, we should pay

attention to aspects of support from the closest person

of the patient and be sensitive to coping mechanisms

that are shown by patients both verbally and

nonverbally, because if the patient has an adaptive

coping mechanism it will avoid the problem of

neurosis that can directly affect their lives.

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