Mobility in Older Adults Receiving Maintenance Hemodialysis: A Qualitative Study.
Mobility in Older Adults Receiving Maintenance Hemodialysis: A Qualitative Study.
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DOI：
10.1053/j.ajkd.2021.07.010
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发表时间：
2022-04
期刊：
影响因子：
--
通讯作者：
Weiner DE
中科院分区：
文献类型：
--
作者：
Liu CK;Seo J;Lee D;Wright K;Tamura MK;Moye JA;Bean JF;Weiner DE
对于老年人来说，保持行动能力是一个主要的优先事项，特别是对于那些患有慢性疾病的人，如肾衰竭。然而，我们对影响接受维持性血液透析的老年人活动能力的因素的了解是有限的。描述性定性研究。采用目的抽样，我们招募了1）年龄≥ 60岁接受维持性血液透析的患者和2）为接受血液透析的老年人提供定期支持的护理伙伴（≥ 18岁）。在一次单独的家庭访视中，我们使用短体力活动成套测验（SPPB）评估了活动能力，并就与活动能力相关的重要个人因素进行了单独的一对一访谈。人口统计学和SPPB数据采用描述性统计。根据国际职能分类流动框架，对成绩单进行了专题编码。我们使用概念内容分析归纳提取主题和次主题。我们招募了31名接受血液透析的老年人（42%女性，68%黑人），平均年龄为73 ± 8岁，平均透析持续时间为4.6 ± 3.5年;平均SPPB为3.6 ± 2.8分。在12名护理伙伴（75%女性，33%黑人）中，平均年龄为54 ± 16岁，平均SPPB为10.1 ± 2.4分。摘录的主要主题有：1）流动性代表独立性; 2）流动性是不稳定的; 3）流动性的限制导致痛苦; 4）鼓励和动机的来源是关键; 5）适应性是关键。来自单一地理区域的适度样本。对于接受血液透析的老年人来说，活动能力严重受限，而且往往不稳定，造成痛苦。接受血液透析的老年人及其护理伙伴已经确定了鼓励和流动性的动力来源，并认为适应性思维方式很重要。未来的研究应将流动性概念化为一个可变条件，并建立在这种观点的适应性发展的干预措施。流动性，从一个地方移动到另一个地方的能力，使独立和支持福祉。然而，许多接受血液透析的老年人需要帮助行走，我们不知道所有的原因。我们采访了31名接受血液透析的老年人和12名他们的护理伙伴，询问他们在行动能力丧失方面的经历。他们说，流动性以不可预测的方式变化，这是情绪上令人不安。为了应对，老年人求助于他们的教会、亲人和他们自己的内心意愿，并对他们能做的事情保持灵活的期望。当我们开发改善接受血液透析的老年人活动能力的方法时，我们应该考虑到活动能力的频繁变化，并纳入这种适应性的观点。
For older adults, maintaining mobility is a major priority, especially for those with advanced chronic diseases like kidney failure. However, our understanding of the factors affecting mobility in older adults receiving maintenance hemodialysis is limited. Descriptive qualitative study. Using purposive sampling, we recruited 1) persons aged ≥ 60 years receiving maintenance hemodialysis and 2) care partners (≥ 18 years) providing regular support to an older adult receiving hemodialysis. During a single in-person home visit, we assessed mobility using the Short Physical Performance Battery (SPPB) and conducted individual one-on-one interviews regarding important personal factors related to mobility. Descriptive statistics were used for demographic and SPPB data. Transcripts underwent thematic coding, informed by the International Classification of Function framework of mobility. We used conceptual content analysis to inductively extract themes and subthemes. We enrolled 31 older adults receiving hemodialysis (42% female, 68% Black) with mean age of 73±8 years and mean dialysis duration of 4.6±3.5 years; mean SPPB was 3.6±2.8 points. Among 12 care partners (75% female, 33% Black), mean age was 54±16 years and mean SPPB was 10.1±2.4 points. Major themes extracted were: 1) mobility represents independence; 2) mobility is precarious; 3) limitations in mobility cause distress; 4) sources of encouragement and motivation are critical; and 5) adaptability is key. Modest sample from single geographic area. For older adults receiving hemodialysis, mobility is severely limited and is often precarious in nature, causing distress. Older adults receiving hemodialysis and their care partners have identified sources of encouragement and motivation for mobility, and cite an adaptable mindset as important. Future studies should conceptualize mobility as a variable condition, and build upon this outlook of adaptability in the development of interventions. Mobility, the ability to move from one place to another, enables independence and supports well-being. Yet many older adults receiving hemodialysis need help with walking and we don’t know all the reasons why. We interviewed 31 older adults receiving hemodialysis and 12 of their care partners to ask about their experiences with losses in mobility. They said that mobility changes in unpredictable ways, which is emotionally upsetting. To cope, the older adults turn to their church, loved ones, and their own inner will, and stay flexible in their expectations of what they can do. As we develop ways to improve the mobility of older adults receiving hemodialysis, we should consider that mobility changes frequently and incorporate this outlook of adaptability.
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影响因子：
2
作者：
Kontos, Pia C.;Miller, Karen-Lee;Naglie, Gary
通讯作者：
Naglie, Gary
DOI：
10.1053/j.ajkd.2015.01.024
发表时间：
2015-08
期刊：
American journal of kidney diseases : the official journal of the National Kidney Foundation
影响因子：
--
作者：
Kutner NG;Zhang R;Huang Y;Painter P
通讯作者：
Painter P
影响因子：
1.9
作者：
Bossola, Maurizio;Di Stasio, Enrico;Marzetti, Emanuele
通讯作者：
Marzetti, Emanuele
影响因子：
13.2
作者：
Painter, Patricia;Clark, Lauren;Olausson, Jill
通讯作者：
Olausson, Jill
影响因子：
19.6
作者：
Cook, W. L.;Jassal, S. V.
通讯作者：
Jassal, S. V.