THE RELATIONSHIP BETWEEN THE SATISFACTION OF PATIENT FOR HEMODIALYSIS SERVICES IN THE NEPHROLOGY UNIT OF HNGV, DILI, TIMOR-LESTE

In today's era of globalization there are always changes in the needs of patients who always ask to get quality health services according to their wishes. According to the Global Burden of Disease in 2013, showed that the global prevalence of chronic kidney disease caused the death of 965.000 people worldwide. According to (ESRD, 2014), in Europe, it was stated that the number of hemodialysis patient was 79 patients, and according to research results obtained from respondent showed that, there where 45 (57,0%) of patients who were satisfied and 34 (43,0%) of patients who were dissatisfied with hemodialysis services. To know how the relationship between the satisfaction of patient for hemodialysis services in the nephrology unit of HNGV, Dili, Timor-Leste. This study used a quantitative correlation method with a cross sectional approach using non probability sampling techniques and total sampling techniques with a total of 98 respondents. According to the survey results obtained by 98 respondents who were satisfied with the services provided by nurses, the majority with satisfied category of 48 (49%) and minority with dissatisfied category of 10 (10%). Related to the services provided by nurses, the majority with good category of 45 (46%) and the minority with category less than 17 (17%). Based on the Spearman Rank statistic test showed that the result of p value 0.000 < 0.05, with a coefficient r= 0.647 means that there is a relationship between independent and dependent variable that category as a strong relationship. The result of this research demonstrates that there is a strong relationship between independent and dependent variable .


INTRODUCTION.
Generally in the world, chronic kidney failure is currently a big problem because it's categorized as a disease that's difficult to cure.Currently, the therapy for patient with kidney failure is kidney transplant therapy or hemodialysis.Without of renal replacement therapy can be cause the abnormalities of metabolic that may occur spontaneously (Wahyuni et all., 2014).
In today's era of globalization there are always changes in the needs of patients who always ask to get quality health services according to their wishes.As we know that in all existing health services there is always a feeling of comparison by patients about the services who provided by nurses.The good of health services are nurses who can handle patients well and also are good listeners about patient complaints, because of only good service will make patients satisfied, and the satisfaction of patients will be an indicator that will determine the quality of services provided by health workers (Khadijah & Dianasari, 2018).
According to the Global Burden of Disease in 2013, showed that the global prevalence of chronic kidney disease caused the death of 965.000 people worldwide and every year there are 1,2 million people who died by CKD (GBD, 2013., in Istiqomah Maximiliani, 2018).The incidence and prevalence of chronic kidney failure also increased in 2014.Every year there are 200.000people from American countries who undergoing hemodialysis (Widyastuti, 2014).The highest number of patients undergoing hemodialysis are from America +/-350.000,Japan with a population of 300.000 and Indonesia +/-15.000(Pinem et al., 2015).According to the End Stage Renal Disease ,(2014) in Europe, it was stated that the number of hemodialysis patient was 79 patients, and according to research results obtained from respondent showed that, there where 45 (57,0%) of patients who were satisfied and 34 (43,0%) of patients who were dissatisfied with hemodialysis services (Bayoumi Magda et al., 2016).
Based to the data of Indonesian Renal Registry, (2014) from 249 renal unit in 2015 related that the highest chronic kidney failure of the population over the age of 15 with 19% who suffering CKD.Of that number, there where 30.554 people who undergone hemodialysis and from this case there were 1.243 people who died and had undergone hemodialysis therapy for 1-317 months.In Indonesia the total prevalence of chronic kidney failure in 2013 with a total of 2 per mile and compared in 2018 this case increased to 3,8 per mile of population.The prevalence of chronic kidney failure is higher in Kalimantan with 6,4 per mile of population and lower in Sulawesi with a total of 1,8 per mile (Riskedas., 2018, in Pratiwi Novi Dian, 2022).According to the research findings contucted by Maria Esti Rahayu, (2014) in public hospital Indonesia Wates, Kulon Progo, Yogyakarta, showed that the total number of patients undergoing hemodialysis was 25 patients consisting of 16 man and 9 women.And then based on the research results The Relationship Between The Satisfaction Of Patient For Hemodialysis Services In The Nephrology Unit Of Hngv, Dili, Timor-Leste Jurnal Fusion, Vol. 3, No. 11, November 2023 1159 obtained from respondent showed that, there where 21 (84,0%) of patients who were satisfied and 4 (16,0%) of patients who were dissatisfied with the hemodialysis services.
According to the world Health Organization (WHO, 2014) showed that the mortality rate of chronic kidney failure in Timor-leste hospital with a total of 608, and from this number caused the death of 101 people (1,63%) from a total mortality 18,89/100.00population.The mortality rate of chronic kidney failure also incresead in 2020 with a total of 192 (2,72%), (WHO, 2020).
Based on the data that obtained from HNGV, (2023) related that a total number of patients hemodilysis in nephrology unit in 2020 with a total of 89 patients, compared in 2021 with 93 patients and then in 2022-2023 with 98 patients consisting of 48 man and 50 women who is currently undergoing hemodialysis.According to the survey results obtained by 98 respondents in nephrology unit, National Hospital Guido Valadares in 2023, showed that the patients who were satisfied with the services provided by nurses, the majority with a satisfied category of 48 (49%), minority with dissatisfied category of 10 (10%) and the less satisfied category of 40 (41%).

METHOD
This research used a quantitative correlation method with a cross sectional approach, using non probability sampling techniques and total sampling techniques with a total of 98 respondents in the Nephrology Unit, National Hospital Guido Valadares in 2023.Data collection technique uses questionnaire and data analysis using Spearman Rank Correlation.According to the table 1.2 above from 98 respondents showed that the majority patients who are undergoing hemodialysis based on gender is a women with a total frequency of 50 (51%) and minority is a men with a total of 48 (49%).It shows that the percentage of women who are undergoing hemodialysis is higher than men.According to the table 1.2 above from 98 respondents showed that the majority patients who are undergoing hemodialysis in every week is twice a week with a total frequency of 60 (61%) and the minority is three times a week with a total frequency of 38 (39%).4.1 above, it can be showed that the result from Spearman Rank statistic test of pvalue 0.000 < 0.05, with a coefficiest r= 0.647 (0,60 -0,799).This means that there is a positive relationship between independent variable (hemodialysis services ) and dependent variable (satisfaction of patient) that categorized as a strong relationship.

The characteristic of respondents
Basen on the results who has done research about the relationship between satisfaction of patient for hemodialysis service in Nephrology Unit HNGV, Year 2023.
According to the table 1.2 above from 98 respondents showed that the majority patients who are undergoing hemodialysis based on gender is a women with a total frequency of 50 (51%) and minority is a men with a total of 48 (49%).
According to the table 1.3 above from 98 respondents showed that the majority patients who are undergoing hemodialysis based to level education is the level education of illiterate with a total frequency of 34 (35%) and minority with a master's level of education with a frequency of 1 (1.0%).
According to the table 1.4 above from 98 respondents showed that the majority patients who are undergoing hemodialysis in every week is twice a week The Relationship Between The Satisfaction Of Patient For Hemodialysis Services In The Nephrology Unit Of Hngv, Dili, Timor-Leste Jurnal Fusion, Vol. 3, No. 11, November 2023 1163 with a total frequency of 60 (61%) and the minority is three times a week with a total frequency of 38 (39%).

Research result of independent variable
Based on table 1.5 above shows that the hemodialysis services who provided by nurses in Nephrology Unit with largest percentage were good category 45 people (46%), suficient category 36 people (37%) and the less category 17 people (17%).
According to Baradero et all., (2005) said that the hemodialysis services is a health program that is carried out to separates the patient's blood from the body through a dialyser which occurs by diffusion and ultrafiltration, and then the blood will return into the patient's body.

Research result of dependent variable
Based on table 1.6 above shows that from 98 repondents who undergoing hemodialysis ih Nephrology Unit related to hemodialysis services provided by nurses with largest percentage of category satisfied 48 people (49%), less satisfied category 40 people (41%) and dissatisfied category 10 people (10%).
According to Abdullah, (2012) said that the satisfaction of patient is the level of patient feelings about the quality of services provided by nurses and then compared to what was expected.

The results of research about the relationship between satisfaction of patient for
hemodialysis services in Nephrology Unit HNGV, year 2023.
Based on the Correlation Spearman Rank statistic test showed that the result of p value 0.000 < 0.05, with a coefficiest r= 0.647 (0,60 -0,799), it means that there is a relationship between independent and dependent variable that is categorized as a strong relationship.
According to the results of research conducted by Maria Esti Rahayu, (2013) with her thesis topic about "The relationship between hemodialysis services and the levels of patient satisfaction in public hospital Indonesia Wates, Kulon Progo, Yogyakarta, in 2012", this study states that there is a relationship between the satisfaction of patient and hemodialysis services with a p value 0,02 < 0,05, which was obtained from 25 respondents consisting of 16 man and 9 women.From these number showed that the patients who satisfied with this service are 21 (84,0%) and those who dissatisfied with this service are 4 (16,0%).

CONCLUSION
According to the research of results and discussion which said that to know how the relationship between the satisfaction of patient for hemodialysis services in Nephrology Unit HNGV, year 2023.Based on the results of existing research, the researcher wants to make conclusions based on the following results: This research of analysis results showed that the total of hemodialysis patient who became as respondents with a total of 98 respondents related to hemodialysis services who provided by nurses the majority with a good category of 45 (46%), suficient category of 36 (37%) and the less category of 17 (17%).
Based on research results showed that the total of hemodialysis patient who became as respondents with a total of 98 respondents who undergoin hemodialysis the majority with a satisfied category of 48 (49%), less satisfied category of 40 (41%) and dissatisfied category of 10 (10%).From the results obtained by researcher concluded that this study showed that there was a relationship between patient satisfaction and hemodialysis services provided by nurses, using the spearman rank correlation test showed that the result of p value 0,000 < 0,05 with a coefficient r= 0,647 (0,60 -0,799), and categorized as a strong relationship.
The Relationship Between The Satisfaction Of Patient For Hemodialysis Services In The Nephrology Unit Of Hngv, Dili, Timor-Leste

Table 1 .3 The Distribution of frequency based to level education in Nephrology Unit, HNGV in 2023
According to the table 1.2 above from 98 respondents showed that the majority patients who are undergoing hemodialysis based to level education is the level education of illiterate with a total frequency of 34 (35%) and minority with a master's level of education with a frequency of 1 (1.0%).

Table 1 .4 The distribution of frequency based on dialysis frequency in Nephrology Unit, HNGV in 2023 Frequency of Hemodialysis
The Relationship Between The Satisfaction Of Patient For Hemodialysis Services In The Nephrology Unit Of Hngv, Dili, Timor-Leste Jurnal Fusion, Vol. 3, No. 11, November 2023 1161

Table 1 .5 The distribution of respondents about hemodialysis services in Nephrology Unit, HNGV in 2023 Hemodilysis services
Based on table 1.5 above shows that the hemodialysis services who provided by nurses in Nephrology Unit with largest percentage were good category 45 people (46%), suficient category 36 people (37%) and the less category 17 people (17%).

Table 1 .6 The distribution of respondents about the satisfaction of patient in Nephrology Unit, HNGV in 2023 Satisfaction of patient
Source: The result of the correlation Spearman Rank with program SPSS version 20.0 Based on table