Phenomenological Study of Hemodialysis Therapy Compliance in Chronic Renal Failure Patients at El Syifa Hospital

The problem of kidney failure patients in El Syifa Hospital (Fresenius Kidney Care) In Kuningan, West Java continues to increase year on year and in 2019 by 140. By 2020 it will increase to 155 sufferers. The data of patients undergoing hemodialysis therapy. The purpose of knowing the cause of the phenomenon of renal failure and along with factors that affect the non-compliance of kidney failure patients to perform hemodialysis therapy El Syifa Hospital (Fresenius Kidney Care) Kuningan West Java. The research design method used is descriptive with purpusive sampling. Research instruments in the form of interviews, data in Analysis by Colaizzi method, the results of the study data on the type of kemalin men 60% and women 40% Due to the habits of smoking, drinking fizzy drinks, and alcoholic beverages. The result data was obtained, irregular participants (70%), and the tertur (30%) irregularities include economic factors (44%), health (4%), support (10%), employment (4%). No symptoms (6%), personal agitation (2%), duration 5 hours, and with a duration of 2 x in 1 week.


Introduction
The incidence of kidney failure in Indonesia is increasing, according to the Indonesian Nephrology Association with the overall number of chronic kidney failure diseases as many as 30.7 million people. And for the area of West Java itself as one of the provinces in Indonesia has a considerable contribution of chronic kidney failure sufferers. The number of patients undergoing hemodialysis in West Java in 2009 was recorded at 2,003 patients. And in 2010 it increased to 2,412, and in 2011 it was recorded at 3,038.
The problem of kidney failure patients at El Syifa Hospital (Fresenius Kidney Care) of Kuningan Regency of West Java continues to increase year on year from 140 in 2019 to 155 in 2020

Research Method Instruments
In the data retrieval for this study, the tool used is a data collection sheet, a recording device (Mp 4), to record information provided by participants, a portable computer.

Data Processing
In data retrieval using the interview method by surveying participants with purposive sampling, the data analysis in this study used the Colaizzi method (Data validity consists of 4 criteria, namely: level of trust, dependence, certainty, and reliability). Equipped with triangulation of data among others (medical record data, interviews, observations).

Results and Discussion
The characteristic of the respondents is presented in Table 1. Researchers have confirmed from 8 themes questions and criteria participants undergo hemodialysis therapy 2x in 1 week with a duration of therapy 4 hours, and get the results of the study based on the experience of participants. The confirmed theme was analyzed collaizi method based on interviews with participants. From the results of this study provides an overview of hemodialysis therapy compliance and an early picture of the causes of participants affected by renal failure, among which are the impacts, Early history of kidney failure disease, Insights, gender and work before kidney failure disease, changes and biological impacts, adherence to hemodialysis therapy, drug adherence, support in hemodialysis therapy, spiritual changes due to hemodialysis therapy, food, and beverage intake patterns.

Early History of Kidney Failure
According to the data of the results of a live interview with pasrtisipan that concluded there were several sources of participants affected by kidney failure. Among them participants consumed fizzy drinks, instant drinks, using drugs in the long term, comorbid disease (neprotoxic, hypertension, diabetes mellitus, CHF, anemia).

Insights, Gender, and Occupation before Exposure to Hemodialysis Disease
According to the data results can be accommodated that a variety of educational backgrounds last where elementary (15) people, junior high school (10) people, high school / vocational school (17) people, S1 (8) People. Education can influence in the study by participants with higher education more quickly understand the early condition of kidney failure And according to the data of the type of kemalin men 60% and women 40% according to research type dark men more than women. Because of the habits of smoking, drinking fizzy drinks, and drinking alcohol. So that the kidneys work harder, alcohol carcinogens that are ecrewed out of the body through the kidneys change DNA and damage kidney cells so that the possibility of damage to the kidneys is greater this study Tuesday with research (Doni S, 2019). Various jobs are done by participants, but there are several types of work that will affect the volume and spread of disease, including minimal office work, movement activity and stress proneness that can cause the collapse of the ureteric ducts in the kidneys, and in addition to heavy work office work that causes a lot of sweating causing severe dehydration, thus causing severe dehydration and forcing the kidneys to work harder, this reason is in line with research (Doni S, 2019).  Vol.18 No. 02 Desember 2021: 470-475 And shop stewards, thus forcing someone to keep up for the night, and needing so good conditions that participants need drinks, or supplements to support their work in order to continue to be primed and not cause sleepiness throughout the night. This is likely to be a contributor to an increase in chronic kidney failure.

Biological Impact
Physical changes in hemodialysis patients were so significant, which based on the results of interviews with participants, participants often experienced weakness, dizziness and cramps in the legs due to nutrients not entering the body perfectly, in cramps in the legs of doctors provide therapy to participants who experience cramps with frequent frequency (sumbara, 2015) this is in line with research conducted (Sullivan, 2009) where participants experience fatigue after undergoing hemodialysis therapy.

Adherence to Taking Medication
According to the interview data (58%) participants are obedient in taking drugs, (42%) participants do not obediently take drugs, the behavior of compliance with taking drugs participants are obedient to all diseasesupporting drugs experienced by participants according to the results of the interview of drug compliance is strongly influenced by several factors including. Insight factors, support from family.
And for participants who feel bored taking drugs, is the fruit of the length of the treatment process so that this participant no longer has more hope for his recovery, and participants do not feel the drugs consumed reacting to trigger bored participants in taking drugs.

Support in Hemodialysis Therapy
According to the results of interviews with prtisipan, did not get the support of (5) participants. for participants is not uncommon when the participants are male, only get support from parents, relatives only. Because for hemodialysis participants this is a disease that is not received by the partner so as to cause mental exposure of participants.

Spiritual Changes due to Hemodialysis Therapy
For spiritual changes hemodialysis patients sorted the data of the interview results of the average participants subject to accepting the disease in the end, to pray. Participants do not necessarily become diligent or not, because prayer, study, has been used since before suffering from the disease so as not necessarily lead diligent worship in the disease. This has become a habit and a squal up to his god.

Food and Beverage Intake Patterns
For participants chronic kidney disorders are very important in maintaining food, especially on fruits in participants not infrequently many violations to regulate eating fruits especially whereas according to Eka Fauziah research, 2017 written consuming bananas, watermelon and processed from nuts. Basically, participants know less about the restriction of potassium intake in participants with chronic kidney disorders. Because potassium in food, especially in fruits, because potassium in the blood is high can cause dysrrhythmia or cardiac arrest