Effects of Modification of Self-Freedom (Self-Submission) Excercise on Sleep Quality Indicators Pittsburgh Sleep Quality Index (PSQI) Approach in Hemodialysis Patients

Sleep disorders occur to patients with chronic kidney disease (CKD), especially clients with end-stage renal disease (ESRD). Hemodialysis patients teated by Cognitive Behavior Therapy (CBT) can significantly improve sleep quality, fatigue, depression, and anxiety. Self-help exercise (LPD) is part of Complementary and Alternative Medicine (CAM) that combines relaxation and dhikir. This study aims to find out the effect of modification of selfabsorption exercise on sleep quality of patients with chronic kidney disease undergoing hemodialysis. This research type is Quasy-Experiment research with a pre-post test design control group design study. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used for pre-post test in this study. The independent variables of the study were modification of self-absorption exercise given for 18 days and done 2 times per day. The dependent variable was sleep quality, with sub variable of subjective sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbance, daytime dysfunction. The population of the study was PGK clients undergoing hemodialysis at Gambiran Hospital Kediri and met the criteria of the sample at the time of the research with purposive sampling technique which was divided into 11 treatment groups and 11 control groups. Mann Whitney test results obtained p = 0.004. The result showed that there was difference of sleep quality between those of the treatment groups and those of the control groups after LPD treatment, while Mann Whitney test result on sub variable of sleep quality only on subjective sleep quality showed there was difference between groups with p = 0,024. Based on the results of the study, the hospital, especially nurse staff, began to identify the problem of sleep disorders in clients with CKD with PSQI questionnaires and provide appropriate education issues of sleep disorders experienced by clients, and it can be suggested that the use of modification of self-freedom (self-submission) exercise as a companion therapy was effective to improve patient sleep quality CKD.