Exploring factors that influence participation in intradialytic physical exercise for haemodialysis users: A phenomenological qualitative study
Keywords:
Exercise, Renal dialysis, Perception, Patient participationAbstract
Background: Most of haemodialyzed users are sedentary, because of these the practice of intradialytic physical exercise is fundamental. Programs of physical exercise have been implemented on several dialysis units, but there is still low participation, so it is necessary to find the factors that are influencing participant decisions. Objective: Exploring factors that influence haemodialysis users participation in intradialytic physical exercise. Materials and methods: A phenomenological qualitative study was carried out applying semi-structured interviews to 24 people among patients, family members and health care team. The Colaizzi method was used for data analysis. Results: Three main themes appeared, facilitators, positive impacts, and barriers. Among the facilitators, a favourable social environment, an assertive physical therapy treatment, effective communication and self-care awareness were identified. On the positive impacts, physical impact and quality of life were perceived and, finally, participation barriers included physical and psychosocial factors, and haemodialysis treatment barriers. Conclusions: The present study shows that both facilitators and positive impacts perceived by the users, encourage participation in intradialytic physical exercise, and the barriers decrease it. It seems that to raise participation in intradialytic physical exercise programs, it is necessary to find the local factors influencing participation, enhance facilitators and decrease the existing barriers.
Funding
Physiotherapy department at Universidad Austral de Chile, Patricia Aguilera, head nurse at Dialysis Unit-Valdivia's Hospital, Dr. Mauricio BarriaDownloads
References
Clarke, A. L., Young, H. M. L., Hull, K. L., Hudson, N., Burton, J. O., & Smith, A. C. (2015). Motivations and barriers to exercise in chronic kidney disease: A qualitative study. Nephrology Dialysis Transplantation, 30(11), 1885-1892. https://doi.org/10.1093/ndt/gfv208
Delgado, C., & Johansen, K. L. (2012). Barriers to exercise participation among dialysis patients. Nephrology Dialysis Transplantation, 27(3), 1152-1157. https://doi.org/10.1093/ndt/gfr404
Dorcas, T. M., Youth, T. B., Atuhaire, C., Priebe, G., & Cumber, S. N. (2018). Physiological and psychosocial stressors among hemodialysis patients in the Buea Regional Hospital, Cameroon. Pan African Medical Journal, 30, 30-49. https://doi.org/10.11604/pamj.2018.30.49.15180
Fiaccadori, E., Sabatino, A., Schito, F., Angella, F., Malagoli, M., Tucci, M., Cupisti, A., Capitanini, A., & Regolisti, G. (2014). Barriers to physical activity in chronic hemodialysis patients: A single-center pilot study in an Italian dialysis facility. Kidney & Blood Pressure Research, 39(2-3), 169-175. https://doi.org/10.1159/000355793
Heiwe, S., & Jacobson, S. H. (2011). Exercise training for adults with chronic kidney disease. Cochrane Database of Systematic Reviews, 10. https://doi.org/10.1002/14651858.cd003236.pub2
Heiwe, S., & Tollin, H. (2012). Patients' perspectives on the implementation of intra-dialytic cycling a phenomenographic study. Implementation Science, 7(1), 7-68. https://doi.org/10.1186/1748-5908-7-68
Jhamb, M., McNulty, M. L., Ingalsbe, G., Childers, J. W., Schell, J., Conroy, M. B., Forman, D. E., Hergenroeder, A., & Dew, M. A. (2016). Knowledge, barriers and facilitators of exercise in dialysis patients: a qualitative study of patients, staff and nephrologists. BMC Nephrology, 17(1), 17. https://doi.org/10.1186/s12882-016-0399-z
Johansen, K. L., & Painter, P. (2012). Exercise in individuals with CKD. American journal of kidney diseases: the official journal of the National Kidney Foundation, 59(1), 126–134. https://doi.org/10.1053/j.ajkd.2011.10.008
Kendrick, J., Ritchie, M., & Andrews, E. (2019). Exercise in Individuals With CKD: A Focus Group Study Exploring Patient Attitudes, Motivations, and Barriers to Exercise. Kidney Medicine, 1(3), 131-138. https://doi.org/10.1016/j.xkme.2019.03.004
Moorman, D., Suri R., Hiremath S., Jegatheswaran J., Kumar T., Bugeja A., & Zimmerman T. (2019). Benefits and Barriers to and Desired Outcomes with Exercise in Patients with ESKD | American Society of Nephrology. (s. f.).14 (2) 268-276; https://doi.org/10.2215/CJN.09700818
Regolisti, G., Maggiore, U., Sabatino, A., Gandolfini, I., Pioli, S., Torino, C., Aucella, F., Cupisti, A., Pistolesi, V., Capitanini, A., Caloro, G., Gregorini, M., Battaglia, Y., Mandreoli, M., Dani, L., Mosconi, G., Bellizzi, V., Di Iorio, B. R., Conti, P., & Fiaccadori, E. (2018). Interaction of healthcare staff's attitude with barriers to physical activity in hemodialysis patients: A quantitative assessment. PLOS ONE, 13(4), e0196313. https://doi.org/10.1371/journal.pone.0196313
Smart, N., & Steele, M. (2011b). Exercise Training in Hemodialysis Patients: A Systematic Review and Meta-Analysis. Nephrology, 16(7), 626-632. https://doi.org/10.1111/j.1440-1797.2011.01471.x
Thompson, S., Tonelli, M., Klarenbach, S., & Molzahn, A. (2016). A Qualitative Study to Explore Patient and Staff Perceptions of Intradialytic Exercise. Clinical Journal of the American Society of Nephrology, 11(6), 1024-1033. https://doi.org/10.2215/cjn.11981115
Young, H. M. L., Hudson, N., Clarke, A. L., Dungey, M., Feehally, J., Burton, J. O., & Smith, A. C. (2015). Patient and Staff Perceptions of Intradialytic Exercise before and after Implementation: A Qualitative Study. PLOS ONE, 10(6), e0128995. https://doi.org/10.1371/journal.pone.0128995
Zhu, F.-X., Zhang, X.-Y., Ding, X.-K., & Han, B. (2017). Protective effect of regular physical activity on major depressive episodes in patients with early stages of chronic kidney disease. Renal Failure, 39(1), 602-606. https://doi.org/10.1080/0886022x.2017.1361833
Published
How to Cite
Issue
Section
License
Copyright (c) 2020 Journal of Human Sport and Exercise
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Each author warrants that his or her submission to the Work is original and that he or she has full power to enter into this agreement. Neither this Work nor a similar work has been published elsewhere in any language nor shall be submitted for publication elsewhere while under consideration by JHSE. Each author also accepts that the JHSE will not be held legally responsible for any claims of compensation.
Authors wishing to include figures or text passages that have already been published elsewhere are required to obtain permission from the copyright holder(s) and to include evidence that such permission has been granted when submitting their papers. Any material received without such evidence will be assumed to originate from the authors.
Please include at the end of the acknowledgements a declaration that the experiments comply with the current laws of the country in which they were performed. The editors reserve the right to reject manuscripts that do not comply with the abovementioned requirements. The author(s) will be held responsible for false statements or failure to fulfill the above-mentioned requirements.
This title is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International license (CC BY-NC-ND 4.0).
You are free to share, copy and redistribute the material in any medium or format. The licensor cannot revoke these freedoms as long as you follow the license terms under the following terms:
Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
NonCommercial — You may not use the material for commercial purposes.
NoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation.
No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.
Transfer of Copyright
In consideration of JHSE’s publication of the Work, the authors hereby transfer, assign, and otherwise convey all copyright ownership worldwide, in all languages, and in all forms of media now or hereafter known, including electronic media such as CD-ROM, Internet, and Intranet, to JHSE. If JHSE should decide for any reason not to publish an author’s submission to the Work, JHSE shall give prompt notice of its decision to the corresponding author, this agreement shall terminate, and neither the author nor JHSE shall be under any further liability or obligation.
Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article, except as disclosed on a separate attachment. All funding sources supporting the Work and all institutional or corporate affiliations of the authors are acknowledged in a footnote in the Work.
Each author certifies that his or her institution has approved the protocol for any investigation involving humans or animals and that all experimentation was conducted in conformity with ethical and humane principles of research.
Competing Interests
Biomedical journals typically require authors and reviewers to declare if they have any competing interests with regard to their research.
JHSE require authors to agree to Copyright Notice as part of the submission process.
