Physical Activity and Health-Related Quality of Life of Patients on Hemodialysis with Comorbidities: A Cross-Sectional Study

Wu, Yu-Hui; Hsu, Yu‐Juei; Tzeng, Wen‐Chii

doi:10.3390/ijerph19020811

Cited by 25 publications

(17 citation statements)

References 43 publications

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“…Exercise intervention is recommended in addition to pharmacological and nutritional interventions, with clinical benefits such as improved health-related quality of life and delayed muscle wasting in patients with CKD [ 133 , 134 ].…”

Section: Therapeutic Strategies For Muscle Wastingmentioning

confidence: 99%

Muscle Wasting in Chronic Kidney Disease: Mechanism and Clinical Implications—A Narrative Review

Cheng

Huang

Kao

et al. 2022

IJMS

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Muscle wasting, known to develop in patients with chronic kidney disease (CKD), is a deleterious consequence of numerous complications associated with deteriorated renal function. Muscle wasting in CKD mainly involves dysregulated muscle protein metabolism and impaired muscle cell regeneration. In this narrative review, we discuss the cardinal role of the insulin-like growth factor 1 and myostatin signaling pathways, which have been extensively investigated using animal and human studies, as well as the emerging concepts in microRNA- and gut microbiota-mediated regulation of muscle mass and myogenesis. To ameliorate muscle loss, therapeutic strategies, including nutritional support, exercise programs, pharmacological interventions, and physical modalities, are being increasingly developed based on advances in understanding its underlying pathophysiology.

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Section: Therapeutic Strategies For Muscle Wastingmentioning

confidence: 99%

Muscle Wasting in Chronic Kidney Disease: Mechanism and Clinical Implications—A Narrative Review

Cheng

Huang

Kao

et al. 2022

IJMS

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“…In total, dialysis related healthcare comprises 8.7-9.3% of Taiwan annual national healthcare budget ($1.78 billion) [5]. Due to the characteristics and progression of dialysis, patients undergoing treatment are likely to experience other chronic comorbidities, including hypertension, diabetes, and cardiovascular disease [6], anxiety and depression [7], frequent hospitalization, and higher mortality rates compared to patients with prostate, colorectal, or breast cancer and heart failure [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

The explorations of the awareness, contemplation, self-Efficacy, and readiness of advance care planning, and its predictors in Taiwanese patients while receiving hemodialysis treatment

Chen

et al. 2022

BMC Palliat Care

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Background End-stage renal disease (ESRD) is a major chronic illness worldwide, and Taiwan reports one of the highest incidence rates of ESRD with 529 cases per million population (pmp). A number of patients with ESRD patients might require lifelong hemodialysis (HD) or peritoneal dialyses (PD). Due to the progression of dialysis, patients are likely to experience other chronic comorbidities, anxiety and depression, frequent hospitalizations, and higher rates of mortality compared to patients with other types of chronic illnesses. As a result, dialysis patients are prone to experience advance care planning (ACP) needs, such as whether they withdraw from receiving dialysis while approaching their end-of-life (EOL). Yet, existing studies have shown that dialysis patients seldom receive timely consultation regarding ACP and there are limited studies examining ACP amongst Taiwan HD patients. Purpose The purpose of this study was to examine ACP awareness, contemplation, self-efficacy and readiness; and factors influencing ACP readiness. Design This cross-sectional descriptive study with convenience sampling was conducted in the out-patient HD unit at a regional teaching hospital in southern Taiwan. A total of 143 ESRD patients undergoing HD treatments were recruited. A 55-item ACP engagement survey containing the subscales of awareness, contemplation, self-efficacy, and readiness was employed. The data were analyzed with t-tests, one-way ANOVAs, Pearson’s correlations and multiple regressions. Results The results of our investigation revealed that approximately half of the participants (n = 67, 46.9%) were not informed of ACP. Although they reported considering their EOL, medical decisions and desired care, they demonstrated significantly low self-efficacy in discussing ACP (t= -5.272, p < 0.001). HD duration influenced all four ACP subscales; religious beliefs significantly influenced ACP-self-efficacy and readiness; and marital status, education, and primary decision-maker status significantly influenced ACP-readiness. The predictors of ACP-readiness were high self-efficacy and being the primary decision-maker (Adjusted R2 61%). Conclusion Most of the HD patients in this study had low ACP-awareness, contemplation, self-efficacy, and readiness, and most had not completed any ACP-related advance directives (AD). Healthcare professionals should proactively provide HD patients with ACP-related information and answer patients’ and medical decision-makers’ questions in a timely manner, thereby improving the quality of EOL care.

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“…Regular physical activity reduces the risk of chronic diseases (e.g., cardiovascular diseases and diabetes), enhances physical function and prevents them from deteriorating with age, and provides overall health benefits [ 26 ]. A study that examined patients on hemodialysis after they performed moderate-intensity physical activities reported that those with comorbidities scored less on quality of life than those without comorbidities [ 27 ]. Studies have indicated that the mortality rate of patients on hemodialysis with higher levels of physical activity is 52% less than that of patients on hemodialysis with lower levels of physical activity [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

Correlation between Physical Activity and Psychological Distress in Patients Receiving Hemodialysis with Comorbidities: A Cross-Sectional Study

Hsu

Tzeng

2022

IJERPH

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Comorbidities cause psychological distress to patients on hemodialysis and cause their physical function to deteriorate. This study aims to examine whether physical patterns are associated with anxiety, depression and fatigue among patients with and without comorbidities who are on hemodialysis. To this end, a cross-sectional survey was administered to 120 patients on hemodialysis. Data were collected using the International Physical Activity Questionnaire—Short Form, Beck Depression Inventory—Second Edition, Beck Anxiety Inventory, and Brief Fatigue Inventory—Taiwan Version. An independent sample t test and generalized linear model analyses were conducted. The results revealed that patients with comorbidities exhibited more severe levels of depression (p < 0.001), anxiety (p < 0.001), and fatigue (p = 0.010) than patients without comorbidities. Additionally, patients on hemodialysis with a high physical activity level (≥600 metabolic equivalent of task per min/week) exhibited less depression (B = −4.03; p < 0.001; 95% confidence interval [CI] = −6.04, −2.03) and anxiety (B = −2.64; p = 0.002; 95% CI = −4.27, −1.00) severity than those with a low physical activity level; those who engaged in weekly physical activities exhibited less fatigue severity (B = −1.17; p = 0.001; 95% CI = −1.84, −0.49) and fatigue interference (B = −0.61; p = 0.015; 95% CI = −1.10, −0.12). For patients on hemodialysis, having comorbidities was correlated with more severe levels of depression, anxiety, and fatigue. Weekly moderate-intensity physical activities were revealed to be correlated with less severity levels of depression, anxiety, and fatigue. The study findings aid the development of interventions for promoting physical activity among patients on hemodialysis to prevent the exacerbation of complications caused by comorbidities and psychological distress.

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Physical Activity and Health-Related Quality of Life of Patients on Hemodialysis with Comorbidities: A Cross-Sectional Study

Cited by 25 publications

References 43 publications

Muscle Wasting in Chronic Kidney Disease: Mechanism and Clinical Implications—A Narrative Review

Muscle Wasting in Chronic Kidney Disease: Mechanism and Clinical Implications—A Narrative Review

The explorations of the awareness, contemplation, self-Efficacy, and readiness of advance care planning, and its predictors in Taiwanese patients while receiving hemodialysis treatment

Correlation between Physical Activity and Psychological Distress in Patients Receiving Hemodialysis with Comorbidities: A Cross-Sectional Study

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