Factors influencing exercise participation by older adults requiring chronic hemodialysis: a qualitative study
Factors influencing exercise participation by older adults requiring chronic hemodialysis: a qualitative study
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DOI：
10.1007/s11255-007-9265-z
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发表时间：
2007-12-01
影响因子：
2
通讯作者：
Naglie, Gary
中科院分区：
文献类型：
--
作者：
Kontos, Pia C.;Miller, Karen-Lee;Naglie, Gary
尽管运动对患有终末期肾病(ESRD)的老年人具有公认的健康和心理社会益处，但运动参与度仍然很低。之前的研究将低水平的锻炼归因于与患者相关的因素，如缺乏动力和对不良后果的恐惧。这项定性研究包括与血液透析患者、肾病护士和家庭护理提供者的焦点小组讨论，探讨了需要血液透析的老年人参与运动的特定动机和障碍。护士参与者被选为卫生保健提供者焦点小组，因为他们在透析治疗期间与血液透析患者长时间和持续的接触使他们能够很好地鼓励和促进锻炼。锻炼的动机包括患者对锻炼的渴望和他们从锻炼中获得改善的经历，以及将锻炼正式纳入整体透析治疗计划。锻炼的障碍包括护士缺乏锻炼的鼓励，交通问题，以及使用锻炼器材，使患者在透析期间倾斜不能参与，并由于担心器材相关的伤害而阻止护士锻炼。这些发现支持需要更广泛地认识到可能阻碍需要血液透析的老年人参与运动的系统性因素。ESRD治疗计划的文化需要向健康的角度转变，其中包括对锻炼的期望、医疗保健团队的鼓励和患者的参与。
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.