Physical Function and Physical Activity Assessment and Promotion in the Hemodialysis Clinic: A Qualitative Study

Painter, Patricia; Clark, Lauren; Olausson, Jill

doi:10.1053/j.ajkd.2014.01.433

Cited by 40 publications

(76 citation statements)

References 27 publications

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“…First, there was a perceived lack of support from management-expressed as a lack of adequate staffing. Second, consistent with findings from other studies on IDE (15,17), staff frequently mentioned that there was no time to assist with IDE. Given the high value placed on busyness in acute care nursing (34), the assumption that staff could accommodate IDE in their workflow may have negatively influenced its acceptability.…”

Section: Discussionsupporting

confidence: 79%

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A Qualitative Study to Explore Patient and Staff Perceptions of Intradialytic Exercise

Thompson

Klarenbach

Molzahn

2016

CJASN

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Background and objectives Randomized, controlled trials show that regular exercise is beneficial for patients on hemodialysis. Intradialytic exercise may have additional benefits, such as amelioration of treatment-related symptoms. However, the factors that influence the implementation of intradialytic exercise are largely unknown.Design, setting, participants, & measurements Individual semistructured interviews were conducted with a purposive sample of patients on hemodialysis who had participated in a pilot randomized, controlled trial on intradialytic exercise and dialysis staff that worked in the unit during the trial. The trial took place from July to December of 2014 and enrolled 31 patients. Interviews were conducted from April to December of 2014. Interview coding followed an inductive and broad-based approach. Thematic analysis was used to group codes into common themes, first individually and then, across staff and patient interviews.Results Twenty-five patients and 11 staff were interviewed. Three themes common to both groups emerged: support, norms (expected practices) within the dialysis unit, and the role of the dialysis nurse. The support of the kinesiologist enhanced patients' confidence and sense of capability and was a key component of implementation. However, the practice of initiating exercise at the start of the shift was a barrier to staff participation. Staff focused on the technical aspects of their role in intradialytic exercise, whereas patients viewed encouragement and assistance with intradialytic exercise as the staff's role. An additional theme of no time (for staff to participate in intradialytic exercise) was influenced by its low priority in their workflow and the demands of the unit. The staff's emphasis on patients setting up their own equipment and enhanced social interaction among participants were additional themes that conveyed the unintended consequences of the intervention. ConclusionsThe kinesiologist-patient interactions and staff readiness for intradialytic exercise were important factors in the implementation of intradialytic exercise. Understanding how unit workflow and the personal values of staff can influence implementation may improve the design of intradialytic exercise interventions.

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Section: Discussionsupporting

confidence: 79%

“…However, few studies have explored the perspectives of dialysis staff (15,16) or the contextual factors that influence IDE uptake (17). Understanding the perspectives of both those delivering and receiving IDE can improve the design and implementation of interventions (18).…”

Section: Introductionmentioning

confidence: 99%

A Qualitative Study to Explore Patient and Staff Perceptions of Intradialytic Exercise

Thompson

Klarenbach

Molzahn

2016

CJASN

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“…In clinical practice guidelines for chronic kidney disease, it was stated that all hemodialysis patients should be advised and encouraged by a nephrologist and hemodialysis ward staff so as to increase their physical activities (28). Despite strong evidence which shows low physical activity in hemodialysis patients (29,30) and despite many reports which indicate the benefits of regular exercise for these patients, the medical team did not still advise the patients to exercise (31,32). In a study on 505 nephrologists, 97% of the researchers found that the physical activity was important and essential in the care of hemodialysis patients; however, only 38% of them advised their patients to exercise regularly (33).…”

Section: Discussionmentioning

confidence: 99%

Effect of home-based exercise on functional ability of hemodialysis patients: a systematic review and meta-analysis

et al. 2017

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Background and purpose: Hemodialysis patients suffer from impaired functional ability. Several pilot studies have been conducted concerning the effect of home-based exercise on functional ability of hemodialysis patients; however, there have been observed some contradictions between the results of these studies. The aim of this study was, therefore, to determine the effects of home-based exercise on functional ability of hemodialysis patients using meta-analysis. Methods:In this review study, for the purpose of finding studies published electronically form 2000 to 2016, the papers published in journals indexed in the databases of "PubMed, Science Direct, Google Scholar" were used. Also, to analyze the full text of these articles, Stata Software Version 11 was used. Heterogeneity index between the studies was determined using Cochran (Q) c and I2 tests. Since heterogeneity was observed between the studies, a random effect model was used to estimate the mean score of the standardized difference of a 6-minute walk test in order to measure the functional ability of hemodialysis patients in two experimental and comparison groups. Results: Four articles were finally selected in this meta-analysis. 68 patients were in the experimental group and 65 were in the control group. After the intervention, the mean score of the standardized difference of a 6-minute walk test in the experimental group with a confidence interval of 95% was 0.21 (-0.15, 0.57) units more than before the intervention, which was statistically not significant. Conclusion:The results of the meta-analysis showed that home-based exercise increased the functional ability of hemodialysis patients although this effect was not significant.

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“…This is due to our measurement technique, PDPAR, a self-report recall tool for assessment of DPA in children (24,25). Although, its validity and reliability have been qualified with a pedometer and an accelerometer (18), yet in most studies researchers tend to assess children's PA with PD-PAR at the same time as a pedometer or other validated measure (26)(27)(28)(29).…”

Section: Discussionmentioning

confidence: 99%

“…We almost found no study in contrast with this finding. Although the recommended level of PA for boys is more than girls (28,(30)(31)(32)(33), some social inequalities and social barriers may be the common cause for such differences (34).…”

Section: Discussionmentioning

confidence: 99%

Encouragement to be More Physically Active or to Lessen Sedentary Behavior; Are These Two as the Same?

Hosseinzadeh¹,

Niknami

Hidarnia³

2015

Biotech Health Sci

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Background: There are a considerable number of published studies that strongly support the benefits of physical activity in children, and to achieve such benefits, guidelines recommend children to participate in at least 60 minutes of physical activity every day. There is a vicious cycle between low physical activity and increased body mass index. Objectives: The aim of this study was to assess daily physical activity and sedentary behavior in overweight and obese children. Patients and Methods:In this descriptive analytical study, 300 overweight and obese children were recruited to assess their daily physical activity, energy expenditure and screen times with standard techniques. Distribution of these variables was examined according to their demographic characteristics. Using Pearson's correlation test and linear regression the predictor effect between these variables was discovered. Results: There was a significant difference between physical activity and screen time according to Relative Body Mass Index (RBMI), gender and grade (P ≤ 0.001). Pearson's correlation test discovered a positive association between Weekly Screen Time (WST) and Daily Physical Activity (DPA) (r ≈ 0.37, P ≤ 0.001). In the regression model, children's screen time explained only about 13% of change in body mass index. Conclusions: Overweight and obese children may consume more energy according to the international recommendations. In parallel with this, they experience more sedentary behavior, as well. In this situation, planning to decrease their sedentary behavior is at greater priority.

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Physical Function and Physical Activity Assessment and Promotion in the Hemodialysis Clinic: A Qualitative Study

Cited by 40 publications

References 27 publications

A Qualitative Study to Explore Patient and Staff Perceptions of Intradialytic Exercise

A Qualitative Study to Explore Patient and Staff Perceptions of Intradialytic Exercise

Effect of home-based exercise on functional ability of hemodialysis patients: a systematic review and meta-analysis

Encouragement to be More Physically Active or to Lessen Sedentary Behavior; Are These Two as the Same?

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