Main Article Content
Abstract
Hemodialysis is a renal replacement therapy highly dependent on the
availability of medical-grade water, stable electricity, and supporting
technological systems. This dependency makes hemodialysis services
vulnerable to disruption during disasters, particularly in earthquake- and
flood-prone areas. Treatment interruption may increase the risk of serious
complications and threaten patient safety. In this context, families play an
essential role in maintaining therapy continuity; however, their perspectives
in disaster mitigation remain underexplored. This study aimed to explore
family expectations regarding the resilience of hemodialysis services in
disaster situations. A qualitative exploratory approach with thematic analysis
was employed. Primary informants consisted of two family members of
hemodialysis patients, supported by source triangulation through interviews
with one manager, one nurse, and two patients. Data were collected through
in-depth interviews and analyzed using thematic analysis. The findings
identified four main themes: (1) expectations for clear and structured hospital
preparedness systems, (2) the need for technical education and risk
communication, (3) clarity of emergency referral systems and alternative
service networks, and (4) comprehensive protection of patient safety. The
results indicate that families expect a structured mitigation system that is
well-communicated and actively involves them in pre-disaster simulations
and education. This study highlights that the resilience of hemodialysis
services in disaster situations depends not only on infrastructure and hospital
management but also on empowering families as integral components of the
healthcare resilience system. Integrating families into preparedness planning
may strengthen therapy continuity and enhance patients’ sense of security
during crises.
Keywords
Article Details
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References
Depkes RI. Pedoman Pelayanan Hemodialisis di Sarana Pelayanan Kesehatan. DirDepkes RI (2008) Pedoman Pelayanan Hemodialisis di Sarana Pelayanan Kesehatan Direktorat Bina Pelayanan Medik Spesialistik Direktorat Jenderal Bina Pelayanan Medik Departemen Kesehatan Republik Indonesia, 8–9 https://www.pernefri.org/konsensus/PEDO. 2008;8–9 .
Registry IR. Indonesian Renal Registry. 13th Annual Report of Indonesian Renal Registry 2020. Jakarta: IRR; 2020. 2020. https://www.indonesianrenalregistry.org/media/laporan%20IRR%202020.pdf
Wilt T, Ishani A, Rector TS, Slinin Y, Fitzgerald PM, Greer NL, et al. National Kidney Foundation. KDOQI Clinical Practice Guideline for Hemodialysis Adequacy: 2015 Update. New York: National Kidney Foundation; 2015. National Kidney Foundation. 2015. 1–78 p. https://www.kidney.org/sites/default/files/KDOQI-Clinical-Practice-Guideline-Hemodialysis-Update_Public-Review-Draft-FINAL_20150204.pdf
Lempert KD, Kopp JB. Renal Failure Patients in Disasters doi 10.1017/dmp.2018.142. Disaster Med Public Health Prep. 2019;13(4):782–90. doi:10.1017/dmp.2018.142 PubMed PMID: 31057134.
Murakami M, Takebayashi Y, Ono K, Kubota A. International Journal of Disaster Risk Reduction The decision to return home and wellbeing after the Fukushima disaster. International Journal of Disaster Risk Reduction. 2020;47(February):101538. doi:10.1016/j.ijdrr.2020.101538
Frege IA, Befus E, Bih BK, Fawwad M. WorldRiskReport 2024. 2024. 74 p. https://securesustain.org/wp-content/uploads/2024/10/WorldRiskReport_2024.pdf
BNPB. Badan Nasional Penanggulangan Bencana. Indeks Risiko Bencana Indonesia 2024. Jakarta: BNPB; 2024. 2024. https://inarisk.bnpb.go.id/irbi
Pemetaan D, Evaluasi DAN, Bencana R. Badan Penanggulangan Bencana Daerah Provinsi Sumatera Barat. Dokumen Kajian Risiko Bencana Provinsi Sumatera Barat 2022–2026. Padang: BPBD Sumatera Barat; 2022. 2026. https://bpbd.sumbarprov.go.id/home/index-ppid/1
Centers for Medicare and Medicaid Services (CMS). Emergency Preparedness For Dialysis Facilities A Guide for Chronic Dialysis Facilities, 2nd Ed. 2014. https://www.cms.gov/medicare/end-stage-renal-disease/esrdnetworkorganizations/downloads/emergencypreparednessforfacilities2.pdf
Liossatou A, Golland E. Disaster Preparedness and Evacuation plan (DPEP) in Haemodialysis Units: Patients’ Emergency Self-Disconnection Through “Clamp and Cut” Procedure. 2021;(May). https://www.edtnaerca.org/resource/edtna/files/ElectronicLibrary_Managing_5-21%20(2).pdf
Masakane I, Akatsuka T, Yamakawa T, Tsubakihara Y, Ando R, Akizawa T, et al. Survey of dialysis therapy during the Great East Japan Earthquake Disaster and recommendations for dialysis therapy preparation in case of future disasters. Ren Replace Ther. 2016;2(1):1–15. doi:10.1186/s41100-016-0060-0
WHO. “Strengthening Resilience: A Priority Shared by Health 2020 and the Sustainable Development. 2017. https://iris.who.int/server/api/core/bitstreams/ff08d447-788c-4c8f-9d10-6511d7a9ddc4/content
Yuan F, Farahmand H, Blessing R, Brody S, Mostafavi A. Unveiling Vulnerability and Inequality in Disrupted Access to Dialysis Centers During Urban Flooding arXiv:2208.09425v1. 2023;. https://doi.org/10.48550/arXiv.2208.09425
Nations U. Sendai Framework for Disaster Risk Reduction 2015 - 2030. In: Sendai Framework for Disaster Risk Reduction 2015 - 2030. Geneva Switzerland; 2015. p. 37. https://aidmi.org/sendai-framework-for-disaster-risk-reduction-2015-2030/
Markolinda Y, Sawirman S, Ramadani M, Yusya F, Husna N, Azmi F, et al. Indigenous knowledge for disaster mitigation and climate threats in Mentawai, Indonesia. Jamba J Disaster Risk Stud. 2025;17(1):1–10. DOI: https://doi.org/10.4102/jamba.v17i1.1877