title: Factors influencing exercise participation by older adults requiring chronic hemodialysis: a qualitative study.
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.
authors: Toronto Rehabilitation Institute, 11035-550 University Ave, Toronto, ON, Canada, M5G 2A2. kontos.pia@torontorehab.on.ca
authors: Pia C
authors: PC
authors: Kontos
authors: Karen-Lee
authors: KL
authors: Miller
authors: Dina
authors: D
authors: Brooks
authors: Sarbjit Vanita
authors: SV
authors: Jassal
authors: Lily
authors: L
authors: Spanjevic
authors: Gerald Michael
authors: GM
authors: Devins
authors: Mary Jane
authors: MJ
authors: De Souza
authors: Carol
authors: C
authors: Heck
authors: Judith
authors: J
authors: Laprade
authors: Gary
authors: G
authors: Naglie
mesh_terms: D000368:Aged; D001294:Attitude to Health; D015444:Exercise; D005260:Female; D017144:Focus Groups; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000534:rehabilitation*; D008297:Male; D009864:Ontario / Q000453:epidemiology; D010358:Patient Participation; D006435:Renal Dialysis