Path Analysis of the Factors Affecting the Quality of Life of Chronic Kidney Failure Patients Receiving Hemodialysis
Patients undergoing hemodialysis for chronic kidney failure will experience physical and psychosocial changes that affect their physical, psychological, social, and economic quality of life. Several factors can affect the quality of life of patients with chronic kidney failure, including self-management, self-efficacy, and religiosity. This study aimed to determine the effects of religiosity, self-efficacy, and self-management on the quality of life of hemodialysis patients with chronic kidney failure. This research is a correlational study. The sample size was 71, and the sampling strategy was total sampling. The instrument employs the KDQoL to assess the quality of life, the general self-efficacy (GSE) questionnaire to assess self-efficacy, the hemodialysis self-management instrument (HDSMI) to assess self-management, and the Duke University Religion Index to assess religious affiliation (DUREL). Utilizing path analysis for statistical analysis. Results indicated that the mean and standard deviation of quality of life was 62.76 (8.36), self-management was 51.56 (5.64), self-efficacy was 71.11 (8.44), and religiosity was 21.02. (2.78). Self-management (b = 0.280, p = 0.006), self-efficacy (b = 0.270, p = 0.013), and religiosity (b = 0.425, p = 0.000) have a direct influence on the quality of life. Religiosity indirectly influences the quality of life via self-efficacy and self-management. Through self-management, self-efficacy has an indirect effect on the quality of life. The conclusion is that religiosity, self-efficacy, and self-management can enhance the quality of life for patients with chronic kidney failure. In order for the hospital to improve the patient’s quality of life, intensive education concerning the three variables is therefore anticipated.
Keywords: quality of life, religiosity, self-management, self-ef
 Shofiyah R, Komarayanti S. Socialization of management of chronic diseases and stunting by consuming organic embryo rice and their processes in UMKM in Sukorambi Village, Jember Regency. August. 2020;1(2):93–101.
 WHO. Classification of diabetes mellitus 2019, Edisi 2019. Geneva; 2019.
 Manalu N V. Family support on the quality of life of chronic kidney failure patients undergoing therapy at Adventist Hospital in Bandar Lampung. Angew Chemie Int Ed. 2021;6(11):951–952.
 Smeltzer, Bare. Textbook of Brunner & Suddart Medical Surgical Nursing (Agwal Waluyo Translation).Jakarta: EGC; 2010.
 Sembiring F, Nasution SS, Ariani Y. Description of uremic pruritus in patients with chronic kidney failure in the hemodialysis unit of Adam Malik Haji Center General Hospital Medan.J Perawat Indones. 2020;4(1):1–7.
 WHO. Global report on diabetes. France: World Health Organization; 2016.
 Jawak EF, Novizar R, Girsang R. The relationship between psychological intervention and improving the quality of life in patients with chronic kidney failure undergoing hemodialysis therapy. J Nurs Research Med. 2021;3(1):44–51.
 Lina LF, Wahyu H, Weti, Oktarianita. Experience of nurses in handling patients with chronic kidney failure hemodialysis and confirmed Covid-19. J Nurs. 2021;13(4).
 Sitanggang TW, Anggraini D, Utami UW. The relationship between compliance of patients undergoing hemodialysis therapy with quality of life of patients with chronic renal failure in the hemodialysis room of hospital. BSD Medical Year 2020. Med (Media Inf Kesehatan). 2021;8(1):129.
 Mailani F, Setiawan, Cholina. Spiritual experience of chronic renal failure patient undergoing hemodialysis. J Keperawatan Padjadjaran. 2015;3(1):11–7.
 Georgianni S, Babatsikou F, Gerogianni G, Grapsa E, Vasilopoulos G, Zyga S, et al. Concerns of patients on dialysis: A research study. Heal Sci J. 2014;8(4):423–437.
 Pratama AS, Pragholapati A, Nurrohman I. Coping mechanisms in chronic kidney failure patients undergoing hemodialysis at the Bandung Hospital Hemodialysis Unit.J Smart Keperawatan. 2020;7(1).
 Siagian, Sondang P. Human resource management. Jakarta: Bumi Aksara; 2012.
 Putri ST, Fitriana LA, Ningrum A. Comparative study: Quality of life for elderly living with families and institutions. J Indo Nurs Educator. 2015;1(1).
 Dewi R, Anugrah IH, Permana I, Budhiana J, Melinda F. The relationship between coping mechanisms and quality of life in patients with Type 2 diabetes mellitus. J Kesehat Indra Husada. 2021;9(1):1–9.
 Solikin, Heriyadi. The relationship between self management and the quality of life of diabetes mellitus patients. Faculty of Nursing and Health Sciences: Muhammadiyah University Banjarmasin. J Midwifery Nurs. 2020;11(1).
 Wakhid A, Linda Wijayanti E, Liyanovitasari L. Correlation between self-efficacy and quality of life in chronic kidney failure patients undergoing hemodialysis. J Holist Nurs Sci. 2018;5(2):56–63.
 Baharun H et al. Self-Efficacy as a Media for Increasing Teacher Professionalism in Madrasas’, Risâlah, J Islam Educ Studies. J Educator and Islamic Studies. 2020;6(2):344–57.
 Griva K, Mooppil N, Seet P, Krishnan DSP, James H, Newman SP. The NKFNUS hemodialysis trial protocol-a randomized controlled trial to determine the effectiveness of a self management intervention for hemodialysis patients. BMC Nephrol. 2011;12(1):1–11.
 Luthfa I, Fadhilah N. Self management determines the quality of life of diabetes mellitus patients. J Endur Kaji Ilm Probl Kesehat. 2019;4(2):397–405.
 Pratiwi SH, Sari EA, Kurniawan T. Nurse empowerment in developing booklet-based educational media for hemodialysis patients. Media Karya Kesehat. 2019;2(1):365– 374.
 Shamsalinia A, Pourghaznein T, Parsa M. The relationship between hope and religious coping among patients with type 2 diabetes. Glob J Health Sci. 2016;8(1):208.
 Dewi R, Panduragan SL, Umar NS, Melinda F, Budhiana J. The effect of religion, self-care, and coping mechanisms on quality of life in diabetes mellitus patients. J Keperawatan Padjadjaran. 2022;10(1):58–65.
 Azizah A. Relationship of religiosity with hypertension incidence in Type II diabetes mellitus patients at Prolanis Clinic. Indonesian Islamic University; 2018.
 Widiana N. The relationship between religiosity levels and mental health (Study on Students of the 6th Semester Pai Study Program, Stain Salatiga, 2013). Salatiga State Islamic College; 2013.
 Mulyadi M, Almaini A. The relationship between regiousity and family support with meaningfulness of life of chronic kidney failure’s clients in Curup Hospital. J Sains Kesehat. 2018;25(2):31–8.
 Koenig HG, McCullough ME, Larson DB. Handbook of religion and health. Oxford University Press; 2001.
 Hidayat A. Relationship between religiosity and quality of life of breast cancer patients in the surgery clinic of Panembahan Senopati Hospital, Bantul.STIKes Jendral Achmad Yani Yogyakarta. 2016;(1–37).
 Satrianegara M. The effect of religiosity on the level of depression, anxiety, stress, and the quality of life of patients with chronic diseases in Makassar City. J Progr Stud Kesehat Masy. 2014;7(1).
 Najjini S. Relation between religiosity and quality of life of patients with chronic kidney failure at the Hospital of Yogyakarta City. Yogyakarta: University of ’Aisyiyah Yogyakarta; 2017.
 Mulyadi E, Basri B. Relationship of family knowledge with patient compliance in running a Type II DM Diet at Sekarwangi Hospital, Sukabumi Regency. J Ilm Mandala Educ. 2021;7:237–245.
 Najjini, Sudyasih T. Relation between religiosity and quality of life of patients with chronic kidney failure at Yogyakarta City Hospital.Naskah Publ Univ ’Aisyiyah. 2017.
 Ardian I. The concept of spirituality and religiosity (spiritual and religion) in the context of nursing Type 2 Diabetes Mellitus Patients. Nurscope J Nurs Sci. 2016;2(5):1–9.
 Kusumastuti H. Correlation between self-efficacy in independent health care with quality of life of patients with chronic kidney disease undergoing hemodialysis at Tugurejo Hospital, Semarang. Diponegoro: Diponegoro University; 2016.
 Anasulfalah H. The relationship between self efficacy and quality of life in patients with chronic kidney disease undergoing hemodialysis at Dr. Moewardi. Surakarta: Faculty of Health Sciences, Muhammadiyah University of Surakarta; 2018.
 Putri A, Rinanda V, Chaidir R. The relationship between self-efficacy and the quality of life of colorectal cancer patients at Dr. Achmad Mochtar Bukittinggi Hospital in 2019. Afiyah. 2022;1(1).
 Wakhid A, Wijayanti EL, Liyanovitasari. Correlation between self-efficacy and quality of life in chronic kidney failure patients undergoing hemodialysis. J Holist Nurs Sci. 2018;5(2).
 Mardhatillah M, Arsin A, Syafar M, Hardianti A. Survival of patients with chronic kidney disease undergoing hemodialysis at Dr. Wahidin Sudirohusodo Makassar. JKMM. 2020;3(1).
 Ummah, A K, Hartanti, R D. The relationship between self efficacy and the quality of life of hemodialysis patients at Kraton Hospital, Pekalongan Regency. Pekajangan Muhammadiyah University; 2019.
 Asnaniar WOS, Bakhtiar SZ, Safruddin. Correlation between self-efficacy and quality of life in chronic kidney failure patients undergoing hemodialysis. J Holist Nurs Sci. 2020;5(2):56–63.
 Xu S, Zhang Z, Wang A, Zhu J, Tang H, Zhu X. Effect of self- efficacy intervention on quality of life of patients with intestinal stoma. Gastroenterol Nurs. 2018;41(4):341.
 Omran S, McMillan S. Symptom severity, anxiety, depression, self- efficacy and quality of life in patients with cancer. Asian Pac J Cancer Prev. 2018;19(2):365–374.
 Yuliana S, Junaidin. The effectiveness of family based diabetes self-management education on self-care and quality of life of diabetes mellitus patients. J Mental Nurs Indo Natl Nurses Assoc. 2021;9(4):879–886.
 Hidayat S. The relationship between self management and the quality of life of poststroke patients at the neurology polyclinic at Dr. Tk.Ii Hospital. Soepraoen Malang. Faculty of Medicine, University of Brawijaya; 2019.
 Wijayanti D, Dinarwiyata, Tumini. Self care management of hemodialysis patients in view of family support at Dr. Soetomo Hospital, Surabaya. J Health Sci. 2017;6(1).
 Barlow JH, Wright CC, Sheasby JE, Turner AP, Hainsworth J. Self-management approaches for people with chronic conditions: A review. Patient Educ Couns. 2002;48(2):177–187.
 Yonlafado E, Simanjuntak B, Lombu, T K. Self management related to quality of life of chronic kidney failure patients undergoing hemodialysis. J Comm Health Environ. 2018.