Pengelolaan Asuhan Keperawatan dengan Pemberian Terapi Musik untuk Menurunkan Kecemasan pada Pasien CKD on HD Regular di Ruang Hemodialisa RSUP H. Adam Malik Medan

Abstract

Chronic Kidney Disease (CKD) is one of the major global public health problems, and its prevalence is projected to continue increasing. CKD results in the body’s inability to maintain normal metabolism and fluid-electrolyte balance. Instrumental music therapy is an organized auditory stimulus composed of melody, rhythm, harmony, timbre, form, and style. It possesses the potential to serve as a healing modality. When applied as a therapeutic intervention, instrumental music can enhance, restore, and maintain an individual's physical, mental, emotional, social, and spiritual well-being. The aim of this senior practicum is to implement nursing care management through the use of music therapy to reduce anxiety in patients with CKD undergoing regular hemodialysis at the Hemodialysis Unit of H. Adam Malik General Hospital, Medan. The methodology employed is a case study approach involving three clients diagnosed with Chronic Kidney Disease (CKD) on hemodialysis. The nursing care management was carried out over a two-week period, from June 11 to 21, 2025, which included assessment, nursing diagnosis, intervention planning, implementation of music therapy, and evaluation. The implementation was conducted twice a week, with each session lasting 30 minutes using instrumental music as the medium. Based on the three case studies conducted, the results indicated a significant reduction in anxiety scores (measured using the Hamilton Anxiety Rating Scale/HARS) following several sessions of instrumental music therapy. These findings suggest that music therapy has strong potential to be integrated as a non-pharmacological nursing intervention in clinical practice, particularly for patients with chronic illnesses such as CKD, who often experience prolonged anxiety. The success of music therapy as an innovative, non-pharmacological approach that is easy to apply in reducing anxiety highlights the importance of a holistic approach in nursing care, especially by addressing the psychological aspects of patients undergoing long-term treatment like hemodialysis.