透析患者运动参与的障碍。
Barriers to exercise participation among dialysis patients.
机构信息
Division of Nephrology, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
出版信息
Nephrol Dial Transplant. 2012 Mar;27(3):1152-7. doi: 10.1093/ndt/gfr404. Epub 2011 Jul 26.
BACKGROUND
Physical inactivity is a strong predictor of mortality in patients with end-stage renal disease and is associated with poor physical functioning. Patients with end-stage renal disease are inactive even compared to sedentary individuals without kidney disease. We sought to identify patient barriers to physical activity.
METHODS
Adult patients on hemodialysis in the San Francisco Bay Area were recruited and asked to complete a study survey composed of questions about self-reported level of physical functioning, physical activity participation, patient physical activity preference and barriers to physical activity. Univariate and multivariable linear regression analyses were performed to study the association between barriers to physical activity and participation in physical activity.
RESULTS
A total of 100 patients participated in the study, the majority of whom were male (73%), with a mean age of 60 ± 15 years. Twenty-seven percent identified themselves as white, 30% black and 21% Hispanic. The majority of participants strongly agreed that a sedentary lifestyle was a health risk (98%) and that increasing exercise was a benefit (98%). However, 92% of participants reported at least one barrier to physical activity. The most commonly reported barriers were fatigue on dialysis days and non-dialysis days (67 and 40%, respectively) and shortness of breath (48%). In multivariate analysis, a greater number of reported barriers was associated with lower levels of physical activity (P < 0.02). Post-dialysis fatigue was not associated with differences in activity level in multivariate analysis. Lack of motivation was associated with less physical activity. Endorsement of too many medical problems and not having enough time on dialysis days were also associated with less activity in adjusted analysis.
CONCLUSION
We have identified a number of barriers to physical activity that can be addressed in studies aimed at increasing levels of physical activity. Inconsistent with nephrologists' reported assumptions, dialysis patients were interested in physical activity.
背景
身体活动不足是终末期肾病患者死亡的强有力预测因素，并且与身体机能下降有关。与没有肾脏疾病的久坐个体相比，终末期肾病患者的活动量更少。我们试图确定患者进行身体活动的障碍。
方法
招募了旧金山湾区的血液透析成年患者，并要求他们完成一项研究调查，该调查由关于自我报告的身体机能水平、身体活动参与情况、患者对身体活动的偏好以及身体活动障碍的问题组成。采用单变量和多变量线性回归分析来研究身体活动障碍与身体活动参与之间的关系。
结果
共有 100 名患者参加了这项研究，其中大多数为男性（73%），平均年龄为 60±15 岁。27%的患者自认为是白人，30%是黑人，21%是西班牙裔。大多数参与者强烈认为久坐的生活方式是健康风险（98%），增加运动是有益的（98%）。然而，92%的参与者报告至少有一个身体活动障碍。最常报告的障碍是透析日和非透析日的疲劳（分别为 67%和 40%）和呼吸急促（48%）。在多变量分析中，报告的障碍越多，身体活动水平越低（P<0.02）。透析后疲劳在多变量分析中与活动水平的差异无关。缺乏动力与身体活动减少有关。认可过多的医疗问题和在透析日没有足够的时间也与调整后的活动量减少有关。
结论
我们已经确定了一些身体活动的障碍，可以在旨在增加身体活动水平的研究中加以解决。与肾病医生报告的假设不一致的是，透析患者对身体活动感兴趣。
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