Leicester Kidney Lifestyle Team, Department of Health Sciences, University of Leicester, Leicester, LE17RH, UK.
Leicester NIHR Biomedical Research Centre, Leicester, UK.
J Nephrol. 2021 Dec;34(6):1961-1971. doi: 10.1007/s40620-021-01024-y. Epub 2021 Mar 26.
Despite growing evidence about the benefits of physical activity and exercise in patients receiving dialysis, physical inactivity is highly prevalent. This may be due to uncertainty and lack of appropriate guidance about exercise, or driven by the relative barriers and benefits that patients perceive. Understanding these perceptions in dialysis patients may inform interventions aimed to increase exercise participation.
Perceived benefits and barriers to exercise were measured by the 'Dialysis Patient-perceived Exercise Benefits and Barriers Scale' (DPEBBS). Self-reported physical activity status was assessed by the 'General Practice Physical Activity Questionnaire'. Barriers and benefits to exercise were classed as binary variables (i.e. yes and no). Frequency analyses and chi-squared tests were conducted to compare the differences perceived by people on haemodialysis (HD) and peritoneal dialysis (PD). Binominal logistical regression was performed to determine which perceived barriers and benefits had the biggest impact on physical activity status.
One thousand twenty-two HD and 124 PD patients completed the DPEBBS. A greater proportion of HD than PD patients reported 'reduces body pain' (P = 0.013), 'delays decline in body function' (P = 0.01), and 'improves quality of life' (P = 0.033) as benefits of exercise. No differences in barriers were observed. Tiredness was the most reported barrier to exercise. Patients who perceived 'other comorbidities' (OR 3.389, P < 0.001) or 'burden of family' (OR 3.168, P < 0.001) as barriers were 3 times more likely to be inactive.
Dialysis patients perceive several barriers which may prevent them from engaging in physical activity. Addressing these barriers may be key to increasing participation in physical activity and exercise.
尽管越来越多的证据表明身体活动和运动对接受透析的患者有益，但身体活动不足的情况仍非常普遍。这可能是由于对运动的不确定性和缺乏适当的指导，或者是由于患者感知到的相对障碍和益处。了解透析患者的这些看法可能会为旨在增加运动参与度的干预措施提供信息。
通过“透析患者感知运动益处和障碍量表”（DPEBBS）测量患者对运动的感知益处和障碍。通过“一般实践身体活动问卷”评估自我报告的身体活动状况。将运动的障碍和益处归类为二分类变量（即“是”和“否”）。进行频率分析和卡方检验，比较血液透析（HD）和腹膜透析（PD）患者感知的差异。进行二项逻辑回归，以确定对身体活动状况影响最大的感知障碍和益处。
共有 1022 名 HD 和 124 名 PD 患者完成了 DPEBBS。与 PD 患者相比，HD 患者报告“减轻身体疼痛”（P=0.013）、“延缓身体功能下降”（P=0.01）和“提高生活质量”（P=0.033）的益处的比例更高。未观察到运动障碍方面的差异。疲劳是最常被报告的运动障碍。认为“其他合并症”（OR 3.389，P<0.001）或“家庭负担”（OR 3.168，P<0.001）为障碍的患者，其不活动的可能性增加 3 倍。
透析患者感知到一些可能阻止他们进行身体活动的障碍。解决这些障碍可能是增加身体活动和运动参与度的关键。
