Department of Biobehavioral Health Science (M/C 802), College of Nursing, University of Illinois at Chicago, 845 S. Damen Avenue, Chicago, IL, 60612-7350, USA.
J Nephrol. 2017 Dec;30(6):729-741. doi: 10.1007/s40620-017-0420-z. Epub 2017 Jul 8.
Renal disease is a common health condition that leads to loss of physical function, frailty, and premature loss of independence in addition to other severe comorbidities and increased mortality. Increased levels of physical activity and initiation of exercise training is recommended in the current guidelines for all patients with renal disease, but participation and adherence rates are low. The barriers to exercise and physical activity in patients with renal disease are not well defined and currently based on patient provider perception and opinion. There have been no published reviews that have synthesized published findings on patient reported barriers to exercise. This integrative literature review therefore aimed to identify the current understanding of patient reported barriers to regular exercise. This integrative review found that patient perceived barriers to exercise are not consistent with the barriers that have been identified by renal disease specialists and healthcare providers, which were disinterest, lack of motivation, and being incapable of exercise. The patient reported barriers identified through this review were complex and diverse, and the most frequently reported patient perceived barrier to exercise was low energy levels and fatigue. It is clear that additional research to identify patient perceived barriers to exercise is needed and that patient directed interventions to address these barriers should be developed. This integrative review provides information to the interdisciplinary nephrology team that can be used to tailor their assessment of barriers to exercise and provide exercise education for patients with renal disease.
肾脏疾病是一种常见的健康问题，除了其他严重的合并症和增加的死亡率外，还会导致身体功能丧失、虚弱和过早失去独立性。目前的指南建议所有肾脏疾病患者增加身体活动水平并开始运动训练，但参与率和坚持率都很低。肾脏疾病患者运动和身体活动的障碍尚未得到很好的定义，目前基于患者和提供者的感知和意见。目前还没有发表的综述综合了关于患者报告的运动障碍的发现。因此，本次综合文献综述旨在确定目前对患者报告的定期运动障碍的理解。这项综合审查发现，患者感知到的运动障碍与肾脏病专家和医疗保健提供者确定的障碍不一致，这些障碍是缺乏兴趣、缺乏动力和无法运动。通过本次审查确定的患者报告的障碍复杂多样，最常报告的患者运动障碍是能量水平低和疲劳。显然，需要进一步研究以确定患者感知到的运动障碍，并应开发针对这些障碍的以患者为导向的干预措施。本综合综述为跨学科肾脏病团队提供了信息，可用于调整他们对运动障碍的评估，并为肾脏疾病患者提供运动教育。
