Perceptions of healthcare providers on benefits, risks and barriers regarding intradialytic exercise among haemodialysis patients

. 2024 Dec ; 19 (1) : 2287597. [epub] 20231206

Jazyk angličtina Země Spojené státy americké Médium print-electronic

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/pmid38055756

PURPOSE: Clinical guidelines call for the inclusion of exercise interventions in every patient's dialysis session, but these recommendations are rarely adopted. Healthcare providers play a key role in this. Therefore, the aim of this study was to explore how healthcare providers perceive the benefits, risks and barriers of intradialytic exercise (IDE). METHODS: We conducted 21 individual, semi-structured interviews with 11 nurses, 5 nephrologists, 3 training assistants and 2 managers from two dialysis centres in Slovakia. Verbatim transcripts of digitally recorded interviews were thematically analysed using MAXQDA®. RESULTS: Participants reported the benefits of IDE as improvements in patients' physical and psychosocial functioning, independence and self-efficacy, clinical profile and quality of therapy. As risks of IDE, they most frequently reported exercise-related damage to vascular access, insufficient individualization of training and musculoskeletal injuries. The presence of psychological problems among patients was reported as a major barrier for initiating and maintaining patients' exercise. Other reported barriers included limitations in financial and personnel resources of haemodialysis care. CONCLUSIONS: Safe and sustainable implementation of IDE, which might improve a patient's well-being, need to be prescribed in alignment with the patient's clinical profile, be delivered individually according to the patient's characteristics and requires adjustments in the available resources.

Zobrazit více v PubMed

Arazi, H., Mohabbat, M., Saidie, P., Falahati, A., & Suzuki, K. (2022). Effects of different types of exercise on kidney diseases. PubMed DOI PMC

Baker, L. A., March, D. S., Wilkinson, T. J., Billany, R. E., Bishop, N. C., Castle, E. M., Chilcot, J., Davies, M. D., Graham-Brown, M. P. M., Greenwood, S. A., Junglee, N. A., Kanavaki, A. M., Lightfoot, C. J., Macdonald, J. H., Rossetti, G. M. K., Smith, A. C., & Burton, J. O. (2022). Clinical practice guideline exercise and lifestyle in chronic kidney disease. PubMed DOI PMC

Bikbov, B., Purcell, C. A., Levey, A. S., Smith, M., Abdoli, A., Abebe, M., Adebayo, O. M., Afarideh, M., Agarwal, S. K., Agudelo-Botero, M., Ahmadian, E., Al-Aly, Z., Alipour, V., Almasi-Hashiani, A., Al-Raddadi, R. M., Alvis-Guzman, N., Amini, S., Andrei, T. … GBD Chronic Kidney Disease Collaboration . (2020). Global, regional, and national burden of chronic kidney disease, 1990–2017: A systematic analysis for the Global burden of disease study 2017. PubMed DOI PMC

Bogataj, Š., Pajek, M., Pajek, J., Buturović Ponikvar, J., & Paravlic, A. (2019). Exercise-based interventions in hemodialysis patients: A systematic review with a meta-analysis of randomized controlled trials. PubMed DOI PMC

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. DOI

Bündchen, D. C., Sousa, H., Afreixo, V., Frontini, R., Ribeiro, O., Figueiredo, D., & Costa, E. (2021). Intradialytic exercise in end-stage renal disease: An umbrella review of systematic reviews and/or meta-analytical studies. PubMed DOI

Capitanini, A., Lange, S., D’Alessandro, C., Salotti, E., Tavolaro, A., Baronti, M. E., Giannese, D., & Cupisti, A. (2014). Dialysis exercise team: The way to sustain exercise programs in hemodialysis patients. PubMed DOI

Carrero, J. J., Johansen, K. L., Lindholm, B., Stenvinkel, P., Cuppari, L., & Avesani, C. M. (2016). Screening for muscle wasting and dysfunction in patients with chronic kidney disease. PubMed DOI

Carswell, C., Reid, J., Walsh, I., Johnston, W., McAneney, H., Mullan, R., Lee, J. B., Nelson, H., Matthews, M., Weatherup, E., Spencer, A., Michelo, J., Quail, A., Kielty, G., Mackenzie, A., Elliott, J., Arbuckle, N., Wilson, A., & Noble, H. (2020). A mixed-methods feasibility study of an arts-based intervention for patients receiving maintenance haemodialysis. PubMed DOI PMC

Clarke, A. L., Young, H. M., Hull, K. L., Hudson, N., Burton, J. O., & Smith, A. C. (2015). Motivations and barriers to exercise in chronic kidney disease: A qualitative study. PubMed DOI

Clyne, N., & Anding-Rost, K. (2021). Exercise training in chronic kidney disease-effects, expectations and adherence. PubMed DOI PMC

Darvishi, A., Hemami, M. R., Shafiee, G., Daroudi, R., Mohseni, M., Shekarabi, F. H., & Heshmat, R. (2021). Sarcopenia screening strategies in older people: A cost effectiveness analysis in Iran. PubMed DOI PMC

DeJonckheere, M., & Vaughn, L. M. (2019). Semistructured interviewing in primary care research: A balance of relationship and rigour. PubMed DOI PMC

Deligiannis, A., D’Alessandro, C., & Cupisti, A. (2021). Exercise training in dialysis patients: Impact on cardiovascular and skeletal muscle health. PubMed DOI PMC

Ghafourifard, M., Mehrizade, B., Hassankhani, H., & Heidari, M. (2021). Hemodialysis patients perceived exercise benefits and barriers: The association with health-related quality of life. PubMed DOI PMC

Giglio, J., Kamimura, M. A., Lamarca, F., Rodrigues, J., Santin, F., & Avesani, C. M. (2018). Association of sarcopenia with nutritional parameters, quality of life, hospitalization, and mortality rates of elderly patients on hemodialysis. PubMed DOI

Golestaneh, L., Alvarez, P. J., Reaven, N. L., Funk, S. E., McGaughey, K. J., Romero, A., Brenner, M. S., & Onuigbo, M. (2017). All-cause costs increase exponentially with increased chronic kidney disease stage. PubMed

Griva, K., Lam, K. F. Y., Nandakumar, M., Ng, J. H., McBain, H., & Newman, S. P. (2018). The effect of brief self-management intervention for hemodialysis patients (HED-SMART) on trajectories of depressive and anxious symptoms. PubMed DOI

Gullick, J., Monaro, S., & Stewart, G. (2017). Compartmentalising time and space: A phenomenological interpretation of the temporal experience of commencing haemodialysis. PubMed DOI

Hall, R. K., Cary, M. P., Washington, T. R., & Colón-Emeric, C. S. (2020). Quality of life in older adults receiving hemodialysis: A qualitative study. PubMed DOI PMC

Hannan, M., & Bronas, U. G. (2017). Barriers to exercise for patients with renal disease: An integrative review. PubMed DOI PMC

Hargrove, N., El Tobgy, N., Zhou, O., Pinder, M., Plant, B., Askin, N., Bieber, L., Collister, D., Whitlock, R., Tangri, N., & Bohm, C. (2021). Effect of aerobic exercise on dialysis-related symptoms in individuals undergoing maintenance hemodialysis: A systematic review and meta-analysis of clinical trials. PubMed DOI PMC

Hatef, M., Mousavinasab, N., Esmaeili, R., Kamali, M., Madani, Z., Spahbodi, F., & Shafipour, V. (2020). The effects of exercise training on physical performance and self-efficacy in hemodialysis patients: A randomized controlled clinical trial. PubMed DOI PMC

Heiwe, S., & Tollin, H. (2012). Patients’ perspectives on the implementation of intra-dialytic cycling—a phenomenographic study. PubMed DOI PMC

Hill, C. E., Knox, S., Thompson, B. J., Williams, E. N., Hess, S. A., & Ladany, N. (2005). Consensual qualitative research: An update. DOI

Hu, H., Liu, X., Chau, P. H., & Choi, E. P. H. (2022). Effects of intradialytic exercise on health-related quality of life in patients undergoing maintenance haemodialysis: A systematic review and meta-analysis. PubMed DOI

Hull, K. L., Quann, N., Glover, S., Wimbury, C., Churchward, D. R., Pickering, W. P., Preston, R., Baines, R., Graham-Brown, M. P. M., & Burton, J. O. (2021). Evaluating the clinical experience of a regional in-center nocturnal hemodialysis program: The patient and staff perspective hemodialysis international. PubMed DOI

Intiso, D. (2014). The rehabilitation role in chronic kidney and end stage renal disease. PubMed DOI

Isoyama, N., Qureshi, A. R., Avesani, C. M., Lindholm, B., Bàràny, P., Heimbürger, O., Cederholm, T., Stenvinkel, P., & Carrero, J. J. (2014). Comparative associations of muscle mass and muscle strength with mortality in dialysis patients. PubMed DOI PMC

Jamshed, S. (2014). Qualitative research method-interviewing and observation. PubMed DOI PMC

Janssen, I., Shepard, D. S., Katzmarzyk, P. T., & Roubenoff, R. (2004). The healthcare costs of sarcopenia in the United States. PubMed DOI

Jayaseelan, G., Bennett, P. N., Bradshaw, W., Wang, W., & Rawson, H. (2018). Exercise benefits and barriers: The perceptions of people receiving hemodialysis. PubMed

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. PubMed DOI PMC

Johansen, K. L., Sakkas, G. K., Doyle, J., Shubert, T., & Dudley, R. A. (2003). Exercise counseling practices among nephrologists caring for patients on dialysis. PubMed DOI

Kang, S. H., Do, J. Y., Jeong, H. Y., Lee, S. Y., & Kim, J. C. (2017). The clinical significance of physical activity in maintenance dialysis patients. PubMed DOI

Kendrick, J., Ritchie, M., & Andrews, E. (2019). Exercise in individuals with CKD: A focus group study exploring patient attitudes, motivations, and barriers to exercise. PubMed DOI PMC

Kirkman, D. L., Scott, M., Kidd, J., & Macdonald, J. H. (2019). The effects of intradialytic exercise on hemodialysis adequacy: A systematic review. PubMed DOI

Kontos, P. C., Miller, K. L., Brooks, D., Jassal, S. V., Spanjevic, L., Devins, G. M., De Souza, M. J., Heck, C., Laprade, J., & Naglie, G. (2007). Factors influencing exercise participation by older adults requiring chronic hemodialysis: A qualitative study. PubMed DOI

Kouidi, E. J. (2001). Central and peripheral adaptations to physical training in patients with end-stage renal disease. PubMed DOI

Lambert, K., Lightfoot, C. J., Jegatheesan, D. K., Gabrys, I., Bennett, P. N., & Delanaye, P. (2022). Physical activity and exercise recommendations for people receiving dialysis: A scoping review. PubMed DOI PMC

Lee, I. M., Shiroma, E. J., Lobelo, F., Puska, P., Blair, S. N., Katzmarzyk, P. T., & Lancet Physical Activity Series Working Group . (2012). Effect of physical inactivity on major non-communicable diseases worldwide: An analysis of burden of disease and life expectancy. PubMed PMC

Levesque, J. F., Harris, M. F., & Russell, G. (2013). Patient-centred access to health care: Conceptualising access at the interface of health systems and populations. PubMed DOI PMC

Li, P. K., Chan, G. C., Chen, J., Chen, H. C., Cheng, Y. L., Fan, S. L., He, J. C., Hu, W., Lim, W. H., Pei, Y., Teo, B. W., Zhang, P., Yu, X., & Liu, Z. H. (2021). Tackling dialysis burden around the world: A global challenge. PubMed DOI PMC

Lightfoot, C. J., Wilkinson, T. J., Song, Y., Burton, J. O., & Smith, A. C. (2021). Perceptions of exercise benefits and barriers: The influence on physical activity behaviour in individuals undergoing haemodialysis and peritoneal dialysis. PubMed DOI PMC

Lopes, L. C. C., Mota, J. F., Prestes, J., Schincaglia, R. M., Silva, D. M., Queiroz, N. P., Freitas, A. T. V. S., Lira, F. S., & Peixoto, M. D. R. G. (2019). Intradialytic resistance training improves functional capacity and lean mass gain in individuals on hemodialysis: A randomized pilot trial. PubMed DOI

Luyckx, V. A., Tuttle, K. R., Garcia-Garcia, G., Gharbi, M. B., Heerspink, H. J. L., Johnson, D. W., Liu, Z. H., Massy, Z. A., Moe, O., Nelson, R. G., Sola, L., Wheeler, D. C., & White, S. L. (2017). Reducing major risk factors for chronic kidney disease. PubMed DOI PMC

Ma, Q., Gao, Y., Lu, J., Liu, X., Wang, R., Shi, Y., Liu, J., & Su, H. (2022). The effect of regular aerobic exercise on renal function in patients with CKD: A systematic review and meta-analysis. PubMed DOI PMC

Malini, H., Forwaty, E., Cleary, M., Visentin, D., Oktarina, E., & Lenggogeni, D. P. (2022). The effect of intradialytic range of motion exercise on dialysis adequacy and fatigue in hemodialysis patients. PubMed DOI

March, D. S., Wilkinson, T. J., Burnell, T., Billany, R. E., Jackson, K., Baker, L. A., Thomas, A., Robinson, K. A., Watson, E. L., Graham-Brown, M. P. M., Jones, A. W., & Burton, J. O. (2022). The Effect of non-pharmacological and pharmacological interventions on measures associated with sarcopenia in end-stage kidney disease: A systematic review and meta-analysis. PubMed DOI PMC

Mayes, J., Young, H. M. L., Blacklock, R. M., Lightfoot, C. J., Chilcot, J., & Nixon, A. C. (2022). Targeted non-pharmacological interventions for people living with frailty and chronic kidney disease. DOI

McGrath, C., Palmgren, P. J., & Liljedahl, M. (2019). Twelve tips for conducting qualitative research interviews. PubMed DOI

Molsted, S., Bennett, P. N., Wilund, K., Bruun, K., Pakpour, A. H., Liljehult, J. M., & Brandi, L. (2022). Nurses’ and medical doctors’ attitudes towards exercise for people with chronic kidney disease in Denmark. PubMed DOI

Moorman, D., Suri, R., Hiremath, S., Jegatheswaran, J., Kumar, T., Bugeja, A., & Zimmerman, D. (2019). Benefits and barriers to and desired outcomes with exercise in patients with ESKD. PubMed DOI PMC

Painter, P., & Johansen, K. L. (2006). Improving physical functioning: Time to be a part of routine care. PubMed DOI

Parker, K. (2016). Intradialytic exercise is medicine for hemodialysis patients. PubMed DOI

Rabajdova, M., Spakova, I., Zelko, A., Rosenberger, J., Kolarcik, P., Sobolova, V., Pella, D., Marekova, M., & Madarasova Geckova, A. (2021). The role of physical activity and miRnas in the vascular aging and cardiac health of dialysis patients. PubMed DOI PMC

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., DiIorio, B. R., Conti, P., & Fiaccadori, E. (2018). Gruppo di Studio “esercizio fisico nel paziente con insufficienza renale cronica” of the Società Italiana di Nefrologia. PubMed DOI PMC

Roshanravan, B., Gamboa, J., & Wilund, K. (2017). Exercise and CKD: Skeletal muscle dysfunction and practical application of exercise to prevent and treat physical impairments in CKD. PubMed DOI PMC

Russ, A. J., Shim, J. K., & Kaufman, S. R. (2005). “Is there life on dialysis?: Time and aging in a clinically sustained existence.” PubMed DOI PMC

Saitoh, M., Ogawa, M., Dos Santos, M. R., Kondo, H., Suga, K., Itoh, H., & Tabata, Y. (2016). Effects of intradialytic resistance exercise on protein energy wasting, physical performance and physical activity in ambulatory patients on dialysis: A single-center preliminary study in a Japanese dialysis facility. PubMed DOI

Saunders, B., Sim, J., Kingstone, T., Baker, S., Waterfield, J., Bartlam, B., Burroughs, H., & Jinks, C. (2018). Saturation in qualitative research: Exploring its conceptualization and operationalization. PubMed DOI PMC

Shahgholian, N., & Yousefi, H. (2015). Supporting hemodialysis patients: A phenomenological study. PubMed DOI PMC

Shlipak, M. G., Sheshadri, A., Hsu, F. C., Chen, S. H., Jotwani, V., Tranah, G., Fielding, R. A., Liu, C. K., Ix, J., Coca, S. G., Pahor, M., Guralnik, J. M., Leeuwenburgh, C., Caudle, C., Crump, L., Holmes, L., Leeuwenburgh, J., Lu, C.-J. … LIFE Investigators . (2022). Effect of structured, moderate exercise on kidney function decline in sedentary older adults: An ancillary analysis of the LIFE study randomized clinical trial. PubMed DOI PMC

Song, Y., Wang, J., Chen, X., Guo, Y., Wang, X., & Liang, W. (2019). Facilitators and barriers to exercise influenced by traditional Chinese culture: A qualitative study of Chinese patients undergoing hemodialysis. PubMed DOI

Sutherland, S., Penfold, R., Doherty, A., Milne, Z., Dawes, H., Pugh, C., Boulton, M., & Newton, J. L. (2021). A cross-sectional study exploring levels of physical activity and motivators and barriers towards physical activity in haemodialysis patients to inform intervention development. PubMed DOI

Thiel, A., Sudeck, G., Gropper, H., Maturana, F. M., Schubert, T., Srismith, D., Widmann, M., Behrens, S., Martus, P., Munz, B., Giel, K., Zipfel, S., Nieß, A. M., & iReAct Team . (2019). The iReact study - a biopsychosocial analysis of the individual response to physical activity. PubMed DOI PMC

Thompson, S., Tonelli, M., Klarenbach, S., & Molzahn, A. (2016). A qualitative study to explore patient and staff perceptions of intradialytic exercise. PubMed DOI PMC

Thurlow, J. S., Joshi, M., Yan, G., Norris, K. C., Agodoa, L. Y., Yuan, C. M., & Nee, R. (2021). Global epidemiology of end-stage kidney disease and disparities in kidney replacement therapy. PubMed DOI PMC

Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. PubMed DOI

Wang, X. X., Lin, Z. H., Wang, Y., Xu, M. C., Kang, Z. M., Zeng, W., & Ma, Y. C. (2020). Motivators for and barriers to exercise rehabilitation in hemodialysis centers: A multicenter cross-sectional survey. PubMed DOI

Wilkinson, T. J., Clarke, A. L., Nixon, D. G. D., Hull, K. L., Song, Y., Burton, J. O., Yates, T., & Smith, A. C. (2021). Prevalence and correlates of physical activity across kidney disease stages: An observational multicentre study. PubMed DOI

Wilund, K. R., Thompson, S., Viana, J. L., & Wang, A. Y. (2021). Physical activity and health in chronic kidney disease. PubMed DOI

Wilund, K. R., Viana, J. L., & Perez, L. M. (2020). A critical review of exercise training in hemodialysis patients: Personalized activity prescriptions are needed. PubMed DOI PMC

Wodskou, P. M., Reinhardt, S. M., Andersen, M. B., Molsted, S., & Schou, L. H. (2021). Motivation, barriers, and suggestions for intradialytic exercise-A qualitative study among patients and nurses. PubMed DOI PMC

Wu, X. L., Ji, B., Yao, S. D., Wang, L. L., & Jiang, Z. Y. (2021). Effect of music intervention during hemodialysis: A comprehensive meta-analysis. PubMed DOI

Ye, C., Zheng, X., Aihemaitijiang, S., Wang, R., Halimulati, M., Huang, X., & Zhang, Z. (2022). Sarcopenia and catastrophic health expenditure by socio-economic groups in China: An analysis of household-based panel data. PubMed DOI PMC

Young, H. M., Hudson, N., Clarke, A. L., Dungey, M., Feehally, J., Burton, J. O., Smith, A. C., & Aguilera, A. I. (2015). Patient and staff perceptions of intradialytic exercise before and after implementation: A qualitative study. PubMed DOI PMC

Zelko, A., Rosenberger, J., Skoumalova, I., Kolarcik, P., Madarasova Geckova, A., van Dijk, J. P., & Reijneveld, S. A. (2022). The effects of an intradialytic resistance training on lower extremity muscle functions. PubMed DOI

Zhang, F., Bai, Y., Zhao, X., Huang, L., Wang, W., Zhou, W., & Zhang, H. (2022). Therapeutic effects of exercise interventions for patients with chronic kidney disease: An umbrella review of systematic reviews and meta-analyses. PubMed DOI PMC

Zhou, L., Shi, D., Zhang, L., Wang, Q., Chen, L., & Chen, H. (2023). Does intradialytic group exercise programme influence patient-reported outcomes, laboratory parameters, and anthropometric parameters in maintenance hemodialysis patients? A single-group repeated-measures trial. PubMed DOI PMC

Najít záznam

Citační ukazatele

Pouze přihlášení uživatelé

Možnosti archivace

Nahrávání dat ...