The Audiovisual-Based Health Education as a Therapeutic Modality for Managing Anxiety in CKD Patients Facing Fluid Intake Limitations

  • Giovanni Iga Firmanda Nursing Study Program, Faculty of Health, Institut Ilmu Kesehatan Bhakti Wiyata Kediri
  • Aries Wahyuningsih S1 Hospital Administration Study Program, STIKES RS Baptis

Abstract

Chronic Kidney Disease (CKD) patients undergoing hemodialysis often experience heightened levels of anxiety due to complex treatment regimens and strict fluid intake restrictions. This study aimed to evaluate the effectiveness of an audiovisual intervention in reducing anxiety levels among CKD patients. A pre-experimental one-group pretest-posttest design was employed, involving 60 CKD patients selected through purposive sampling. The intervention consisted of a five-minute audiovisual presentation combining fluid restriction education and relaxation techniques. The independent variable was the audiovisual intervention, while the dependent variable was the patients' anxiety levels. Anxiety was assessed using the standardized Generalized Anxiety Disorder-7 (GAD-7) questionnaire, administered both before and after the intervention. Data analysis was conducted using paired t-tests to compare mean anxiety scores, with a significance threshold set at p < 0,05. Prior to the intervention, the majority of participants (56.6%) experienced moderate anxiety, while 41,6% had mild anxiety, and 1.8% had severe anxiety. After the intervention, a notable shift occurred: 91,6% of patients reported mild anxiety, and only 8,4% experienced moderate anxiety, with no cases of severe anxiety. The average anxiety score significantly decreased from 11,03 to 7,57, resulting in a mean difference of 2,466 and a p-value of 0,000, indicating a statistically significant improvement. These findings suggest that audiovisual media are effective in reducing anxiety in hemodialysis patients by improving their understanding of fluid management and promoting relaxation. The engaging and accessible nature of the intervention empowered patients and helped alleviate emotional distress, supporting its use in clinical settings as a complementary therapeutic tool.

References

Akpan Ekong Effiong, Isaac, U. A. A., Umoh Odudu Idongesit, & Victor, U. A. (2025). Prevalence of Anxiety and Depression among Chronic Kidney Disease Patients in a Nigerian Tertiary Institution: A Comparison of Pre-dialysis and Hemodialysis Patients. Asian Journal of Medicine and Helath, 23(4), 42–53. https://doi.org/https://doi.org/10.9734/ajmah/2025/v23i41203
Danche, D. N., Sukartini, T., Nastiti, A. A., & Suarilah, I. (2024). Effect of digital health education towards anxiety among pre-operative patients: A systematic review. Indonesian Journal of Global Health Research, 6(6). https://doi.org/https://doi.org/10.37287/ijghr.v6i6.3772
Deshpande, N., Wu, M., Kelly, C., Woodrick, N., Warner, D. A., Volerman, A., & Press, V. G. (2023). Video-Based Educational Interventions for Patients With Chronic Illnesses: Systematic Review. Journal of Medical Internet Research, 25. https://doi.org/https://doi.org/10.2196/41092
Djuwardi, A. S. Al, Rekawati, E., & Kurnia, D. A. (2025). The Influence of Music Therapy and Mindfulness Meditation in Reducing Anxiety in Elderly Individuals Undergoing Hemodialysis: A Systemic Review. Indonesian Journal of Global Health Research, 7(2). https://doi.org/https://doi.org/10.37287/ijghr.v7i2.5729
Jeon, J.-Y., Kim, D.-H., & Kang, K. (2023). Effect of audiovisual media-based nursing information on environmental stress, anxiety, and uncertainty in patients undergoing open-heart surgery. Medicine, 102(8). https://doi.org/https://doi.org/10.1097/md.0000000000033001
Kemenkes RI. (2023). Profil Kesehatan Indonesia 2023.
Khan, A., Amin, S., Ahmad, S., Khan, M. S. A., Ahmed, W., & Bano, R. (2022). Prevalence of Depression and Anxiety in Chronic Kidney Disease Patients on Hemodialysis. PJMHS, 16(9), 403–405. https://doi.org/https://doi.org/10.53350/pjmhs22169403
Kusumawardani, S. (2021). Perbandingan Efektivitas Media Audiovisual dan Leaflet terhadap Kepatuhan Pembatasan Cairan Pasien Gagal Ginjal Kronik. Jurnal Ilmiah Kesehatan Media Husada, 10(2), 160–168. https://doi.org/https://doi.org/10.33475/jikmh.v10i2.278
Luitel, K., Pandey, A., Sah, B. K., & KC, T. (2020). Therapeutic Adherence among Chronic Kidney Disease Patients under Hemodialysis in Selected Hospitals of Kathmandu Valley. Journal of Health and Allied Sciences, 10(2), 55–62. https://doi.org/10.37107/jhas.164
Mailani, F., Muthia, R., Herien, Y., Huriani, E., Chan, C. M., & Abdullah, K. L. (2021). The Fluid Management Experience in Patients with Chronic Kidney Disease Undergoing Hemodialysis in Indonesia: A Qualitative Study. Nurse Media Journal of Nursing, 11(3), 390–402. https://doi.org/https://doi.org/10.14710/nmjn.v11i3.38838
Manalu, L. O., Latifah, N. N., & Arifin, A. (2021). Efektivitas Pemberian Edukasi Kesehatan Terhadap Tingkat Kecemasan Pasien Gagal Ginjal Kronis yang dihemodialisa di RSKG Ny. Ra Habibie Bandung. Risenologi, 6(1a). https://doi.org/https://doi.org/10.47028/j.risenologi.2021.61a.215
Mosleh, H., Alenezi, M., Johani, S. Al, Alsani, A., Fairaq, G., & Bedaiwi, R. (2020). Prevalence and Factors of Anxiety and Depression in Chronic Kidney Disease Patients Undergoing Hemodialysis: A Cross-sectional Single-Center Study in Saudi Arabia. Cureus, 15(12). https://doi.org/https://doi.org/10.7759/cureus.6668
Mushtaque, I., Awais-E-Yazdan, M., Zahra, R., & Anas, M. (2024). Quality of Life and Illness Acceptance among End-Stage Renal Disease (ESRD) Patients on Hemodialysis: The Moderating Effect of Death Anxiety during COVID-19 pandemic. Omega (United States), 89(2), 567–586. https://doi.org/10.1177/00302228221075202
Powathil, G. G., & KR, A. (2023). The Experience of Living with a Chronic Illness: A Qualitative Study among End-Stage Renal Disease Patients. Journal of Social Work in End of Life & Palliative Care, 19(3), 109–208. https://doi.org/https://doi.org/10.1080/15524256.2023.2229034
Shor, J., Miyatani, Y., Arita, E., Chen, P., Ito, Y., Kayama, H., Reiter, J., Kobayashi, K., & Kobayashi, T. (2023). Reducing Health Anxiety in Patients With Inflammatory Bowel Disease Using Video Testimonials: Pilot Assessment of a Video Intervention. JMIR Formative Research, 7. https://doi.org/10.2196/39945
Weidmann, A. E., Sonneitner-Heglmeir, A., & C.Dartsch, D. (2023). Effect of patient education videos on modifying medication-related health behaviours: A systematic review using the behaviour intervention functions. Patient Education and Counseling, 117. https://doi.org/https://doi.org/10.1016/j.pec.2023.107992
Widyaningsih, S., & Chandra, S. D. (2024). Uji Efektifitas Aplikasi Digital Edukasi Managemen (Emala-Lisa). Jurnal Kesehatan Tambusai, 5(2), 3369–3378.
Wong, S. S. Y., Cheung, H. H. Ti., Ng, F. F., Yau, D. K. W., Wong, M. K. H., Lau, V. N. M., Leung, W. W., Mak, T. W. C., & Lee, A. (2022). Effect of a patient education video and prehabilitation on the quality of preoperative person-centred coordinated care experience: protocol for a randomised controlled trial. BMJ Open, 12(9), 1–6. https://doi.org/10.1136/bmjopen-2022-063583
Xing, J., Gong, C., Wu, B., Li, Y., Liu, L., Yang, P., Wang, T., Hei, Z., Zhou, S., & Chen, C. (2023). Effect of an educational video about ERAS on reducing preoperative anxiety and promoting recovery. Heliyon, 29(9). https://doi.org/https://doi.org/10.1016/j.heliyon.2023.e20536
Yang, Y., Li, Y., Zhang, H., Xu, Y., & Wang, B. (2021). The efficacy of computer-assisted cognitive behavioral therapy (cCBT) on psychobiological responses and perioperative outcomes in patients undergoing functional endoscopic sinus surgery: a randomized controlled trial. Perioperative Medicine, 10(1), 1–10. https://doi.org/10.1186/s13741-021-00195-3
Ye, W., Wang, L., Wang, Y., Wang, C., & Zeng, J. (2022). Depression and anxiety symptoms among patients receiving maintenance hemodialysis: a single center cross-sectional study. BMC Nephrology, 23(1), 1–8. https://doi.org/10.1186/s12882-022-03051-8
Published
2025-05-27
How to Cite
FIRMANDA, Giovanni Iga; WAHYUNINGSIH, Aries. The Audiovisual-Based Health Education as a Therapeutic Modality for Managing Anxiety in CKD Patients Facing Fluid Intake Limitations. Adi Husada Nursing Journal, [S.l.], v. 11, n. 1, p. 10-16, may 2025. ISSN 2502-2083. Available at: <https://www.adihusada.ac.id/jurnal/index.php/AHNJ/article/view/619>. Date accessed: 18 sep. 2025. doi: https://doi.org/10.37036/ahnj.v11i1.619.

Keywords

Audiovisual Health Education, Anxiety Management, Fluid Restriction