Department of Medicine, Division of Nephrology, University of California, San Francisco, CA, USA.
Department of Medicine, Division of Nephrology, San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA.
Nephrol Dial Transplant. 2020 Aug 1;35(8):1405-1411. doi: 10.1093/ndt/gfaa047.
A randomized trial of a pedometer-based intervention with weekly activity goals led to increased walking among dialysis patients. However, the association of participant-expressed motivations and barriers to participation and performance in such an intervention has not been determined.
Thirty dialysis patients were randomized to a 12-week pedometer-based intervention with weekly step goals. Participants were asked about motivations and barriers to the increasing activity via weekly semi-scripted telephone interviews. We examined the association of these motivations and barriers with achieving weekly goals, reaching overall targets and increasing steps through multivariable linear and logistic regression analyses adjusted for age, sex, body mass index, dialysis modality and baseline steps.
The most common motivations were desire to maintain/improve functional ability (30%) and activity (30%). The most common barriers were health-related (33%). Motivation to maintain/improve functional ability was associated with achieving weekly goals 17.9% more often [95% confidence interval (CI) 1.7-34.2] and with a greater increase in steps (1524 steps; 95% CI 61-2989) than those lacking this motivation. Experiencing a health-related barrier was not associated with the decreased achievement of weekly goals but was associated with lower odds of reaching overall targets (odds ratio = 0.06; 95% CI 0.01-0.53) and a smaller increase in steps (-1640 steps, 95% CI -3244 to -36). No patients who reported weather/environmental barriers or safety concerns reached overall targets.
Participants who express a desire to maintain/improve functional ability may be particularly suited for activity interventions. Health-related setbacks should be met with revised goals. Reporting environmental or safety concerns may merit lowering overall targets.
一项基于计步器的干预措施与每周活动目标的随机试验导致透析患者的步行量增加。然而，参与者表达的参与和完成此类干预的动机和障碍的关联尚未确定。
30 名透析患者被随机分配到基于计步器的 12 周干预组，每周设定目标步数。通过每周半脚本电话访谈，参与者被问及增加活动的动机和障碍。我们通过多变量线性和逻辑回归分析，调整了年龄、性别、体重指数、透析方式和基线步数，来检验这些动机和障碍与实现每周目标、达到总体目标和增加步数之间的关联。
最常见的动机是保持/改善功能能力（30%）和活动能力（30%）的愿望。最常见的障碍是与健康相关的障碍（33%）。保持/改善功能能力的动机与更频繁地实现每周目标相关（多实现 17.9%，95%置信区间为 1.7-34.2），与更大的步数增加相关（增加 1524 步，95%置信区间为 61-2989），而缺乏这种动机的人则没有。体验与健康相关的障碍与未能实现每周目标无关，但与达成总体目标的可能性较低相关（比值比=0.06，95%置信区间为 0.01-0.53），且步数增加较少（减少 1640 步，95%置信区间为-3244 至-36）。没有报告天气/环境障碍或安全问题的患者达到了总体目标。
表达保持/改善功能能力愿望的参与者可能特别适合参加活动干预。应针对健康相关的挫折设定修订后的目标。报告环境或安全问题可能需要降低总体目标。
