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

IF 2.1 4区 医学 Q2 NURSING International Journal of Qualitative Studies on Health and Well-Being Pub Date : 2024-12-01 Epub Date: 2023-12-06 DOI:10.1080/17482631.2023.2287597
Aurel Zelko, Ivana Skoumalova, Denisa Kravcova, Zuzana Dankulincova Veselska, Jaroslav Rosenberger, Andrea Madarasova Geckova, Jitse P van Dijk, Sijmen A Reijneveld
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Abstract

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.

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医疗保健提供者对血液透析患者透析内运动的益处、风险和障碍的看法。
目的:临床指南要求在每个患者的透析疗程中纳入运动干预,但这些建议很少被采纳。医疗保健提供者在这方面发挥着关键作用。因此,本研究的目的是探讨医疗保健提供者如何看待分析内运动(IDE)的益处、风险和障碍。方法:我们对斯洛伐克两家透析中心的11名护士、5名肾病学家、3名培训助理和2名管理人员进行了21次单独的半结构化访谈。使用MAXQDA®对数字记录访谈的逐字记录进行主题分析。结果:参与者报告了IDE的益处,包括患者身体和心理社会功能、独立性和自我效能、临床概况和治疗质量的改善。作为IDE的风险,他们最常报告与运动相关的血管通路损伤、训练的个体化不足和肌肉骨骼损伤。据报道,患者心理问题的存在是患者开始和维持运动的主要障碍。其他报道的障碍包括血液透析护理的财政和人力资源的限制。结论:安全、可持续地实施IDE可能会改善患者的健康状况,需要根据患者的临床情况开具处方,根据患者的特点单独提供,并需要调整现有资源。
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来源期刊
CiteScore
3.20
自引率
5.60%
发文量
99
审稿时长
14 weeks
期刊介绍: International Journal of Qualitative Studies on Health and Well-being acknowledges the international and interdisciplinary nature of health-related issues. It intends to provide a meeting-point for studies using rigorous qualitative methodology of significance for issues related to human health and well-being. The aim of the International Journal of Qualitative Studies on Health and Well-being is to support and to shape the emerging field of qualitative studies and to encourage a better understanding of all aspects of human health and well-being.
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