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Published in: International Urology and Nephrology 4/2007

01-12-2007 | Original Article

Factors influencing exercise participation by older adults requiring chronic hemodialysis: a qualitative study

Authors: Pia C. Kontos, Karen-Lee Miller, Dina Brooks, Sarbjit Vanita Jassal, Lily Spanjevic, Gerald Michael Devins, Mary Jane De Souza, Carol Heck, Judith Laprade, Gary Naglie

Published in: International Urology and Nephrology | Issue 4/2007

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Abstract

Despite the recognized health and psychosocial benefits of exercise for older adults with end-stage renal disease (ESRD), exercise participation remains poor. Previous research has attributed low levels of exercise to patient-related factors such as lack of motivation and fear of adverse consequences. This qualitative study involving focus group discussions with hemodialysis patients, nephrology nurses, and family care providers explored specific motivators and barriers to exercise participation in older adults requiring hemodialysis. Nurse participants were chosen for the health care provider focus groups because their prolonged and sustained contact with hemodialysis patients during the dialysis treatment sessions positions them well to encourage and promote exercise. Motivators to exercise included patient aspirations to exercise and their experiences of improvements from exercising, as well as the formal incorporation of exercise into the overall dialysis treatment plan. Barriers to exercise included nurses’ lack of encouragement to exercise, transportation issues, and the use of exercise equipment that precludes participation by patients who recline during dialysis and inhibits exercise encouragement by nurses due to concerns of equipment-related injury. These findings support the need for a broader recognition of the systemic factors that may impede exercise participation by older adults requiring hemodialysis. A shift is required in the culture of ESRD treatment programs towards a wellness perspective that includes expectations of exercise encouragement by the health care team and participation by patients.
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Literature
1.
go back to reference Colangelo RM, Stillman MJ, Kessler-Fogil D, Kessler-Hartnett D (1997) The role of exercise in rehabilitation patients with end-stage renal disease. Rehabil Nurs 22(6):288–292PubMed Colangelo RM, Stillman MJ, Kessler-Fogil D, Kessler-Hartnett D (1997) The role of exercise in rehabilitation patients with end-stage renal disease. Rehabil Nurs 22(6):288–292PubMed
2.
go back to reference Kouidi EJ (2001) Central and peripheral adaptations to physical training in patients with end-stage renal disease. Sports Med 31(9):651–655PubMedCrossRef Kouidi EJ (2001) Central and peripheral adaptations to physical training in patients with end-stage renal disease. Sports Med 31(9):651–655PubMedCrossRef
3.
go back to reference Pianta TF, Kutner NG (1999) Improving physical functioning in the elderly dialysis patient: relevance of physical therapy. ANNA J 26(1):11–21PubMed Pianta TF, Kutner NG (1999) Improving physical functioning in the elderly dialysis patient: relevance of physical therapy. ANNA J 26(1):11–21PubMed
4.
go back to reference Lysaght MJ (2002) Maintenance dialysis population dynamics: current trends and long-term implications. J Am Soc Nephrol 13:S37–S40PubMedCrossRef Lysaght MJ (2002) Maintenance dialysis population dynamics: current trends and long-term implications. J Am Soc Nephrol 13:S37–S40PubMedCrossRef
5.
go back to reference Sioson ER, Kerfoot S, Ziat LM (1993) Rehabilitation outcome of older patients with end stage renal disease and lower extremity amputation. J Am Geriatr Soc 41:667–668PubMed Sioson ER, Kerfoot S, Ziat LM (1993) Rehabilitation outcome of older patients with end stage renal disease and lower extremity amputation. J Am Geriatr Soc 41:667–668PubMed
6.
go back to reference Painter P, Carlson L, Carey S, Paul SM, Myll J (2000) Physical functioning and health-related quality-of-life changes with exercise training in hemodialysis patients. Am J Kidney Dis 35(3):482–492PubMed Painter P, Carlson L, Carey S, Paul SM, Myll J (2000) Physical functioning and health-related quality-of-life changes with exercise training in hemodialysis patients. Am J Kidney Dis 35(3):482–492PubMed
7.
go back to reference Painter P, Carlson L, Carey S, Paul SM, Myll J (2000) Low-functioning hemodialysis patients improve with exercise training. Am J Kidney Dis 36:600–608PubMed Painter P, Carlson L, Carey S, Paul SM, Myll J (2000) Low-functioning hemodialysis patients improve with exercise training. Am J Kidney Dis 36:600–608PubMed
8.
go back to reference Mercer T, Crawford C, Gleeson NP, Naish PF (2002) Low-volume exercise rehabilitation improves functional capacity and self-reported functional status of dialysis patients. Am J Phys Med Rehabil 81(3):162–167PubMedCrossRef Mercer T, Crawford C, Gleeson NP, Naish PF (2002) Low-volume exercise rehabilitation improves functional capacity and self-reported functional status of dialysis patients. Am J Phys Med Rehabil 81(3):162–167PubMedCrossRef
9.
go back to reference Kong CH, Tattersall JE, Greenwood RN, Farrington K (1999) The effect of exercise during haemodialysis on solute removal. Nephrol Dial Transplant 14:2927–2931PubMedCrossRef Kong CH, Tattersall JE, Greenwood RN, Farrington K (1999) The effect of exercise during haemodialysis on solute removal. Nephrol Dial Transplant 14:2927–2931PubMedCrossRef
10.
go back to reference Stenvinkel P, Elinder C, Bárány P (2000) Physical activity promotes health also among dialysis patients. Int J Cardiol 72:299–300PubMedCrossRef Stenvinkel P, Elinder C, Bárány P (2000) Physical activity promotes health also among dialysis patients. Int J Cardiol 72:299–300PubMedCrossRef
11.
go back to reference Johansen KL, Kaysen G, Young B, Hung A, da Silva M (2002) Longitudinal study of nutritional status, body composition, and physical function in hemodialysis patients. Am J Clin Nutr 77(4):842–846 Johansen KL, Kaysen G, Young B, Hung A, da Silva M (2002) Longitudinal study of nutritional status, body composition, and physical function in hemodialysis patients. Am J Clin Nutr 77(4):842–846
12.
go back to reference Kouidi E, Grekas D, Deligiannis A, Tourkantonis A (2004) Outcomes of long-term exercise training in dialysis patients: comparison of two training programs. Clin Nephrol 61:S31–S38PubMed Kouidi E, Grekas D, Deligiannis A, Tourkantonis A (2004) Outcomes of long-term exercise training in dialysis patients: comparison of two training programs. Clin Nephrol 61:S31–S38PubMed
13.
go back to reference Goodman ED, Ballou MB (2004) Perceived barriers and motivators to exercise in hemodialysis patients. Nephrol Nurs J 31(1):23–29PubMed Goodman ED, Ballou MB (2004) Perceived barriers and motivators to exercise in hemodialysis patients. Nephrol Nurs J 31(1):23–29PubMed
14.
go back to reference Johansen KL, Sakkas GK, Doyle J, Shubert T, Dudley RA (2003) Exercise counseling practices among nephrologists caring for patients on dialysis. Am J Kidney Dis 41(1):171–178PubMedCrossRef Johansen KL, Sakkas GK, Doyle J, Shubert T, Dudley RA (2003) Exercise counseling practices among nephrologists caring for patients on dialysis. Am J Kidney Dis 41(1):171–178PubMedCrossRef
15.
go back to reference Painter P, Carlson L, Carey S, Myll J, Paul S (2004) Determinants of exercise encouragement practices in hemodialysis staff. Nephrol Nurs J 31(1):67–74PubMed Painter P, Carlson L, Carey S, Myll J, Paul S (2004) Determinants of exercise encouragement practices in hemodialysis staff. Nephrol Nurs J 31(1):67–74PubMed
16.
go back to reference Mays N, Pope C (1995) Qualitative research: rigour and qualitative research. BMJ 311:109–112PubMed Mays N, Pope C (1995) Qualitative research: rigour and qualitative research. BMJ 311:109–112PubMed
17.
go back to reference Rowan M, Huston P (1997) Qualitative research articles: information for authors and peer reviewers. CMAJ 157:1442–1446PubMed Rowan M, Huston P (1997) Qualitative research articles: information for authors and peer reviewers. CMAJ 157:1442–1446PubMed
18.
go back to reference Morse J (1995) Designing funded qualitative research. In: Denzin NK, Lincoln YS (eds) Handbook of qualitative research. Sage, Thousand Oaks, CA, pp 220–235 Morse J (1995) Designing funded qualitative research. In: Denzin NK, Lincoln YS (eds) Handbook of qualitative research. Sage, Thousand Oaks, CA, pp 220–235
19.
go back to reference Denzin NK, Lincoln YS (1998) Collecting and interpreting qualitative materials. Sage, Thousand Oaks, CA Denzin NK, Lincoln YS (1998) Collecting and interpreting qualitative materials. Sage, Thousand Oaks, CA
20.
go back to reference Glesne C, Peshkin A (1992) Becoming qualitative researchers: an introduction. Longman, White Plains, NY Glesne C, Peshkin A (1992) Becoming qualitative researchers: an introduction. Longman, White Plains, NY
21.
go back to reference Kuckartz U (1995) Case-oriented quantification. In: Kelle U (ed) Computer-aided qualitative data analysis. Sage, London, pp 158–166 Kuckartz U (1995) Case-oriented quantification. In: Kelle U (ed) Computer-aided qualitative data analysis. Sage, London, pp 158–166
22.
go back to reference Barbour RS (2001) Checklists for improving rigour in qualitative research: a case of the tail wagging the dog? BMJ 322:1115–1117PubMedCrossRef Barbour RS (2001) Checklists for improving rigour in qualitative research: a case of the tail wagging the dog? BMJ 322:1115–1117PubMedCrossRef
23.
go back to reference Naglie G, Jassal V, Tomlinson G, Richardson R (2002) Frailty in elderly hemodialysis patients at a large university hospital dialysis center. Gerontol 42(special issue 1):239–240 Naglie G, Jassal V, Tomlinson G, Richardson R (2002) Frailty in elderly hemodialysis patients at a large university hospital dialysis center. Gerontol 42(special issue 1):239–240
24.
go back to reference Curtin RB, Lowrie EG, DeOreo PB (1999) Self-reported functional status: an important predictor of health outcomes among end-stage renal disease patients. Adv Ren Replace Ther 6(2):133–139PubMed Curtin RB, Lowrie EG, DeOreo PB (1999) Self-reported functional status: an important predictor of health outcomes among end-stage renal disease patients. Adv Ren Replace Ther 6(2):133–139PubMed
25.
go back to reference K/DOQI Workgroup (2005) K/DOQI clinical practice guidelines for cardiovascular disease in dialysis patients. Am J Kidney Dis 45(4 suppl 3):S1–S153 K/DOQI Workgroup (2005) K/DOQI clinical practice guidelines for cardiovascular disease in dialysis patients. Am J Kidney Dis 45(4 suppl 3):S1–S153
26.
go back to reference Mendelssohn DC, Chery A (1994) Dialysis utilisation in the Toronto region from 1981 to 1992. Can Med Assoc J 150(7):1099–1105 Mendelssohn DC, Chery A (1994) Dialysis utilisation in the Toronto region from 1981 to 1992. Can Med Assoc J 150(7):1099–1105
27.
go back to reference Rocco M, Burkart J (1993) Prevalence of missed treatments and early sign-offs in hemodialysis patients. J Am Soc Nephrol 4(5):1178–1183PubMed Rocco M, Burkart J (1993) Prevalence of missed treatments and early sign-offs in hemodialysis patients. J Am Soc Nephrol 4(5):1178–1183PubMed
28.
go back to reference Painter PL, Nelson-Worel JN, Hill MM, Thornbery DR, Shelp WR, Harrington AR et al (1986) Effects of exercise training during hemodialysis. Nephron 43(2):87–97PubMedCrossRef Painter PL, Nelson-Worel JN, Hill MM, Thornbery DR, Shelp WR, Harrington AR et al (1986) Effects of exercise training during hemodialysis. Nephron 43(2):87–97PubMedCrossRef
29.
go back to reference Williams A, Stephens R, McKnight T, Dodd S (1991) Factors affecting adherence of end-stage renal disease patients to an exercise programme. BJSM 25(2):90–93 Williams A, Stephens R, McKnight T, Dodd S (1991) Factors affecting adherence of end-stage renal disease patients to an exercise programme. BJSM 25(2):90–93
30.
go back to reference Konstantinidou E, Koukouvou G, Kouidi E, Deligiannis A, Tourkantonis A (2001) Exercise renal rehabilitation: comparison of three exercise programs. J Rehabil Med 34:40–45CrossRef Konstantinidou E, Koukouvou G, Kouidi E, Deligiannis A, Tourkantonis A (2001) Exercise renal rehabilitation: comparison of three exercise programs. J Rehabil Med 34:40–45CrossRef
31.
go back to reference Moug SJ, Grant S, Creed G, Boulton JM (2004) Exercise during haemodialysis: West of Scotland pilot study. Scott Med J 49:14–17PubMed Moug SJ, Grant S, Creed G, Boulton JM (2004) Exercise during haemodialysis: West of Scotland pilot study. Scott Med J 49:14–17PubMed
32.
go back to reference Ridley J, Hoey K, Ballagh-Howes N (1999) The exercise-during-hemodialysis program: report on a pilot study. CANNT 9:20–26PubMed Ridley J, Hoey K, Ballagh-Howes N (1999) The exercise-during-hemodialysis program: report on a pilot study. CANNT 9:20–26PubMed
33.
go back to reference Rimmer JH, Riley B, Wang E, Rauworth A, Jurkowski J (2004) Physical activity participation among persons with disabilities. Am J Prev Med 26(5):419–425PubMedCrossRef Rimmer JH, Riley B, Wang E, Rauworth A, Jurkowski J (2004) Physical activity participation among persons with disabilities. Am J Prev Med 26(5):419–425PubMedCrossRef
Metadata
Title
Factors influencing exercise participation by older adults requiring chronic hemodialysis: a qualitative study
Authors
Pia C. Kontos
Karen-Lee Miller
Dina Brooks
Sarbjit Vanita Jassal
Lily Spanjevic
Gerald Michael Devins
Mary Jane De Souza
Carol Heck
Judith Laprade
Gary Naglie
Publication date
01-12-2007
Publisher
Springer Netherlands
Published in
International Urology and Nephrology / Issue 4/2007
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-007-9265-z

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