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            <depositor_name></depositor_name>
            <email_address></email_address>
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        <registrant>Kıbrıs Ruh Sağlığı Enstitüsü</registrant>
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            <journal>
            <journal_metadata language="tr">
                <full_title>Cyprus Turkish Journal of Psychiatry and Psychology</full_title>
                                    <abbrev_title>KTPP Dergisi</abbrev_title>
                                                    <issn media_type="print">1302-7840</issn>
                            </journal_metadata>
                            <journal_issue>
                    <publication_date media_type="online">
                        <month>03</month>
                        <day>28</day>
                        <year>2026</year>
                    </publication_date>
                                            <journal_volume>
                            <volume>8</volume>
                        </journal_volume>
                                                                <issue>1</issue>
                                    </journal_issue>
                        <journal_article publication_type="full_text">
                                    <titles>
                        <title>Improving Illness Acceptance and Reducing Stress in Patients with Chronic Kidney Disease Receiving Hemodialysis</title>
                    </titles>
                
                                    <contributors>
                                                    <person_name contributor_role="author"
                                         sequence="first">
                                <given_name>Muhamad Salis</given_name>
                                <surname>Yuniardi</surname>
                                                                    <affiliations>
                                        <institution>
                                            <institution_name>University of Muhammadiyah Malang</institution_name>
                                        </institution>
                                    </affiliations>
                                                                                                    <ORCID>https://orcid.org/0000-0001-5787-8314</ORCID>
                                                            </person_name>
                                                    <person_name contributor_role="author"
                                         sequence="additional">
                                <given_name>Khairil Ashran</given_name>
                                <surname>Triana</surname>
                                                                    <affiliations>
                                        <institution>
                                            <institution_name>University of Muhammadiyah Malang</institution_name>
                                        </institution>
                                    </affiliations>
                                                                                                    <ORCID>https://orcid.org/0009-0006-7772-0905</ORCID>
                                                            </person_name>
                                                    <person_name contributor_role="author"
                                         sequence="additional">
                                <given_name>Nurul</given_name>
                                <surname>Husna</surname>
                                                                    <affiliations>
                                        <institution>
                                            <institution_name>University of Muhammadiyah Malang</institution_name>
                                        </institution>
                                    </affiliations>
                                                                                                    <ORCID>https://orcid.org/0009-0004-6322-2425</ORCID>
                                                            </person_name>
                                            </contributors>
                
                                    <jats:abstract>
                        <jats:p xml:lang="en">Suffering from kidney failure and subsequently adapting to a new routine of hemodialysis therapy can lead to stress. Stress conditions can worsen the illness and the mental health of patients. Illness acceptance is known to reduce stress. The Gestalt approach helps clients recognize and accept themselves. Illness acceptance is considered part of self-acceptance. Group therapy provides social support from fellow patients, which is believed to accelerate the self-acceptance process. This experiment tested the effectiveness of Gestalt group therapy in improving illness acceptance and reducing stress among chronic kidney disease patients undergoing hemodialysis. A pre-test post-test control group design was employed, involving 4 participants in the experimental group who received treatment and 4 participants in the control group who did not receive treatment. The research instruments included the Chronic Illness Acceptance Questionnaire with a reliability of 0.861 and the Perceived Stress Scale with a reliability of 0.814. The Wilcoxon test results found that Gestalt group therapy significantly improved illness acceptance (p = 0.046) and reduced stress levels (p = 0.046). These findings recommend that Gestalt group therapy can be used to improve illness acceptance while simultaneously reducing stress among chronic kidney disease patients undergoing hemodialysis. They become aware of their current condition and are also collectively aware of the potential of each member of the experimental group. Consequently, their daily activities become more enjoyable and take more pleasure.</jats:p>
                    </jats:abstract>
                
                <publication_date media_type="online">
                    <month>03</month>
                    <day>28</day>
                    <year>2026</year>
                </publication_date>

                                    <acceptance_date media_type="online">
                        <month>12</month>
                        <day>26</day>
                        <year>2025</year>
                    </acceptance_date>
                
                                    <pages>
                                                    <first_page>28</first_page>
                                                                            <last_page>33</last_page>
                                            </pages>
                
                
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                        <doi>10.35365/ctjpp.26.1.04</doi>
                        <resource>https://dergipark.org.tr/en/doi/10.35365/ctjpp.26.1.04</resource>
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                                    <citation_list>
                                                    <citation key="ref1">
                                                                    <unstructured_citation>Abbott, K. C., Glanton, C. W., Trespalacios, F. C., Oliver, D. K., Ortiz, M. I., Agodoa, L. Y., Cruess, D. F., &amp; Kimmel, P. L. (2004). Body mass index, dialysis modality, and survival: Analysis of the United States Renal Data System Dialysis Morbidity and Mortality Wave II Study. Kidney International, 65(2), 597–605. https://doi.org/10.1111/j.1523-1755.2004.00385.x</unstructured_citation>
                                                            </citation>
                                                    <citation key="ref2">
                                                                    <unstructured_citation>Abd Alrazaq, A. A. A., Fadhil, A. A., Hameed, N. M., Alsaadi, A. A., Hussein, S. F., &amp; Kadhum, N. A. D. (2022). Comparing the effectiveness of positive psychology and gestalt therapy on psychological well-being of patients with lung cancer. International Journal of Body, Mind and Culture, 9(Special Issue), 22–33. https://doi.org/10.22122/IJBMC.V9ISP.411</unstructured_citation>
                                                            </citation>
                                                    <citation key="ref3">
                                                                    <unstructured_citation>Ali, N., &amp; Cerkez, Y. (2020). The effects of group counseling with gestalt therapy in reducing depression, anxiety and stress among traumatized people. Revista de Cercetare Si Interventie Sociala, 71, 343–359. https://doi.org/10.33788/RCIS.71.21</unstructured_citation>
                                                            </citation>
                                                    <citation key="ref4">
                                                                    <unstructured_citation>Austin, J., &amp; Austin, J. A. (2022). Gestalt applications to group work. Revista de Psicoterapia, 33(121), 123–138. https://doi.org/10.33898/RDP.V33I121.1126</unstructured_citation>
                                                            </citation>
                                                    <citation key="ref5">
                                                                    <unstructured_citation>Basirun. (2015). Peran dukungan keluarga terhadap manajemen stres pada pasien gagal ginjal di Yogyakarta. Jurnal Spirits, 5(2), 15–22. https://doi.org/10.30738/spirits.v5i2.1061</unstructured_citation>
                                                            </citation>
                                                    <citation key="ref6">
                                                                    <unstructured_citation>Beacham, A. O., Linfield, K., Kinman, C. R., &amp; Payne-Murphy, J. (2015). The chronic illness acceptance questionnaire: Confirmatory factor analysis and prediction of perceived disability in an online chronic illness support group sample. Journal of Contextual Behavioral Science, 4(2), 96–102. https://doi.org/10.1016/J.JCBS.2015.03.001</unstructured_citation>
                                                            </citation>
                                                    <citation key="ref7">
                                                                    <unstructured_citation>Cluley, V., Burton, J. O., Quann, N., Hull, K. L., &amp; Eborall, H. (2023). Biographical dialectics: The ongoing and creative problem solving required to negotiate the biographical disruption of chronic illness. Social Science &amp; Medicine, 325, 115900. https://doi.org/10.1016/J.SOCSCIMED.2023.115900</unstructured_citation>
                                                            </citation>
                                                    <citation key="ref8">
                                                                    <unstructured_citation>Cohen, S., Kamarck, T., &amp; Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385–396. https://doi.org/10.2307/2136404</unstructured_citation>
                                                            </citation>
                                                    <citation key="ref9">
                                                                    <unstructured_citation>Erbildim, E., &amp; Nweke, G. E. (2024). The mediator role of experiential avoidance in the relationship between perceived stress and somatic symptoms. Cyprus Turkish Journal of Psychiatry &amp; Psychology, 6(3), 255–261. 
https://doi.org/10.35365/ctjpp.24.3.07</unstructured_citation>
                                                            </citation>
                                                    <citation key="ref10">
                                                                    <unstructured_citation>Frediani, F., &amp; Bussone, G. (2019). When does the brain choose pain? Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 40(Suppl 1), S27–S29. 
https://doi.org/10.1007/S10072-019-03849-9</unstructured_citation>
                                                            </citation>
                                                    <citation key="ref11">
                                                                    <unstructured_citation>Ghimire, S., Castelino, R. L., Jose, M. D., &amp; Zaidi, S. T. R. (2017). Medication adherence perspectives in haemodialysis patients: a qualitative study. BMC Nephrology, 18(1), 167-. https://doi.org/10.1186/s12882-017-0583-9</unstructured_citation>
                                                            </citation>
                                                    <citation key="ref12">
                                                                    <unstructured_citation>Hopko, D. R., McIndoo, C. C., Gawrysiak, M., &amp; Grassetti, S. (2014). Psychosocial Interventions for Depressed Breast Cancer Patients. Oxford University Press..  https://doi.org/10.1093/OXFORDHB/9780199797004.013.004</unstructured_citation>
                                                            </citation>
                                                    <citation key="ref13">
                                                                    <unstructured_citation>Indonesian Ministry of Health. (2022). Profil Kesehatan Indonesia 2021. https://kemkes.go.id/id/profil-kesehatan-indonesia-2021</unstructured_citation>
                                                            </citation>
                                                    <citation key="ref14">
                                                                    <unstructured_citation>Jacobs, E. D. E., Masson, R. L., Harvill, R. L., &amp; Schimmel, C. J. (2012). Group Counseling: Strategies and Skills (7th ed.). Brooks/Cole Cengage Learning. San Franscisco, United States of America. ISBN-13: 978-0840033932.</unstructured_citation>
                                                            </citation>
                                                    <citation key="ref15">
                                                                    <unstructured_citation>Kapadi, R., Elander, J., Burton, A. E., Taylor, J., Coyne, E., Selby, N. M., Taal, M. W., Mitchell, K., &amp; Stalker, C. (2023). An exploration of successful psychosocial adjustment to long-term in-centre haemodialysis. Psychology &amp; Health, 40(3), 394–409. https://doi.org/10.1080/08870446.2023.2231007</unstructured_citation>
                                                            </citation>
                                                    <citation key="ref16">
                                                                    <unstructured_citation>Konghoiro, I., Kartasasmita, S., &amp; Subroto, U. (2017). Penerapan group gestalt therapy bagi warga binaan lapas narkotika x yang mengalami kecemasan menjelang bebas. Jurnal Muara Ilmu Sosial, Humaniora, Dan Seni, 1(2), 430–438. https://doi.org/10.24912/JMISHUMSEN.V1I2.921</unstructured_citation>
                                                            </citation>
                                                    <citation key="ref17">
                                                                    <unstructured_citation>Kübler-Ross, E., &amp; Kessler, D. (2005). On grief and grieving : finding the meaning of grief through the five stages of loss. Scribner. New York, United States of America. ISBN-13: 978-1476775555.</unstructured_citation>
                                                            </citation>
                                                    <citation key="ref18">
                                                                    <unstructured_citation>Kurpas, D., Mroczek, B., &amp; Bielska, D. (2013). The correlation between quality of life, acceptance of illness and health behaviors of advanced age patients. Archives of Gerontology and Geriatrics, 56(3), 448–456. 
https://doi.org/10.1016/J.ARCHGER.2012.12.010</unstructured_citation>
                                                            </citation>
                                                    <citation key="ref19">
                                                                    <unstructured_citation>Nurrezki, S., &amp; Irawan, R. (2020). Hubungan stres, cemas, dan depresi dengan kejadian migrain pada mahasiswa kedokteran di Jakarta. Damianus: Journal of Medicine, 19(1), 1–7. https://doi.org/10.25170/djm.v19i1.1200</unstructured_citation>
                                                            </citation>
                                                    <citation key="ref20">
                                                                    <unstructured_citation>Paramita, R., &amp; Margaretha. (2013). Pengaruh penerimaan diri terhadap penyesuaian diri penderita lupus. Jurnal Psikologi, 12(1), 1–8. https://doi.org/10.14710/JPU.12.1.1-8</unstructured_citation>
                                                            </citation>
                                                    <citation key="ref21">
                                                                    <unstructured_citation>Pompey, C. S., Ridwan, M. N., Zahra, A. N., &amp; Yona, S. (2019). Illness acceptance and quality of life among end state renal disease patients undergoing hemodialysis. Enfermería Clínica, 29, 128–133. https://doi.org/10.1016/J.ENFCLI.2019.04.020</unstructured_citation>
                                                            </citation>
                                                    <citation key="ref22">
                                                                    <unstructured_citation>Rahayu, R. H., Munawaroh, S., &amp; Mashudi, S. (2019). Respon stres pasien gagal ginjal kronik yang menjalani hemodialisa. Health Sciences Journal, 3(1), 78.  https://doi.org/10.24269/hsj.v3i1.222</unstructured_citation>
                                                            </citation>
                                                    <citation key="ref23">
                                                                    <unstructured_citation>Rohaeti, S., Ibrahim, K., Hartati Pratiwi, S. (2021). Hubungan Terapi Komplementer dengan Psychological Well Being pada Pasien Penyakit Ginjal Kronis Stadium 5. The Indonesian Journal of Health Science, 13(1), 12–24. 
https://doi.org/10.32528/IJHS.V13I1.4004</unstructured_citation>
                                                            </citation>
                                                    <citation key="ref24">
                                                                    <unstructured_citation>Ryff, C. D. (2014). Psychological well-being revisited: Advances in the science and practice of eudaimonia. Psychotherapy and Psychosomatics, 83(1), 10–28.  https://doi.org/10.1159/000353263</unstructured_citation>
                                                            </citation>
                                                    <citation key="ref25">
                                                                    <unstructured_citation>Siwi, A. S. (2021). Kualitas hidup pasien gagal ginjal kronik yang menjalani terapi hemodialisa. Jurnal Keperawatan Muhammadiyah Bengkulu, 9(2), 1–9. https://doi.org/10.36085/JKMB.V9I2.1711</unstructured_citation>
                                                            </citation>
                                                    <citation key="ref26">
                                                                    <unstructured_citation>Sompie, E. M., Kaunang, T. M. D., &amp; Munayang, H. (2015). Hubungan antara lama menjalani hemodialisis dengan depresi pada pasien dengan penyakit ginjal kronik di rsup. Prof. Dr. R. D. Kandou manado. E-CliniC, 3(1). 
https://doi.org/10.35790/ecl.3.1.2015.6834</unstructured_citation>
                                                            </citation>
                                                    <citation key="ref27">
                                                                    <unstructured_citation>Sopha, R. F., &amp; Wardhani, I. Y. (2016). Stres dan tingkat kecemasan saat ditetapkan perlu hemodialisis berhubungan dengan karakteristik pasien. Jurnal Keperawatan Indonesia, 19(1), 55–61. https://doi.org/10.7454/JKI.V19I1.431</unstructured_citation>
                                                            </citation>
                                                    <citation key="ref28">
                                                                    <unstructured_citation>Srianti, N. M., Sukmandari, N. M. A., Putu, S., Ayu, A., Dewi, P., Mangusada Badung, R., Studi, P., Ners, P., Bina, S., &amp; Bali, U. (2021). A difference in intradialytic  blood pressure in chronic renal failure patients with interdialytic weight gains&gt; 5% and &lt;5% in the hemodialysis room at RSD Mangusada, Badung regency. Nursing Update : Jurnal Ilmiah Ilmu Keperawatan, 12(2), 24–32. https://doi.org/10.36089/NU.V12I2.313</unstructured_citation>
                                                            </citation>
                                                    <citation key="ref29">
                                                                    <unstructured_citation>Syahri, L. M. (2021). Group counseling services with a gestalt approach to coping with quarter life crisis. Counseling and Humanities Review, 1(2), 39–43.  https://doi.org/10.24036/00614kons2023</unstructured_citation>
                                                            </citation>
                                                    <citation key="ref30">
                                                                    <unstructured_citation>Syahrizal, T., Kharisna, D., &amp; Putri, V. D. (2020). Analisis tingkat stres  pada pasien hemodialisa di rsud arifin  achmad provinsi riau di masa pandemi COVID-19. Health Care: Jurnal Kesehatan, 9(2), 61–67. https://doi.org/10.36763/HEALTHCARE.V9I2.84</unstructured_citation>
                                                            </citation>
                                                    <citation key="ref31">
                                                                    <unstructured_citation>Tang, S. T., Chang, W. C., Chen, J. S., Chou, W. C., Hsieh, C. H., &amp; Chen, C. H. (2016). Associations of prognostic awareness/acceptance with psychological distress, existential suffering, and quality of life in terminally ill cancer patients’ last year of life. Psycho-Oncology, 25(4), 455–462. https://doi.org/10.1002/PON.3943</unstructured_citation>
                                                            </citation>
                                                    <citation key="ref32">
                                                                    <unstructured_citation>Ulhaq, S. D. (2022). Efektivitas konseling gestalt untuk meningkatkan self esteem pada remaja korban bullying : literature review. Realita : Jurnal Bimbingan Dan Konseling, 7(2), 1642–1650. https://doi.org/10.33394/REALITA.V7I2.5545</unstructured_citation>
                                                            </citation>
                                                    <citation key="ref33">
                                                                    <unstructured_citation>Widiana, I. G. R., Kandarini, Y., Suardana, I. K., &amp; Suka, N. (2017). Terapi Dialisis: Buku Pegangan untuk Dokter dan Perawat Dialisistle. Udayana University Press. Denpasar, Indonesia. ISBN:978-602-294-333-4.</unstructured_citation>
                                                            </citation>
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