Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.
John Walls Renal Unit, University Hospitals of Leicester NHS Trust, Leicester, UK.
Health Expect. 2022 Apr;25(2):764-774. doi: 10.1111/hex.13423. Epub 2022 Jan 10.
Exercise has the potential to attenuate the high levels of cardiovascular morbidity and mortality present in kidney transplant recipients (KTRs). Despite this, activity levels in KTRs remain low. The aim of this qualitative study was to explore the barriers and facilitators of exercise in KTRs.
Thirteen KTRs (eight males; mean ± SD; age 53 ± 13 years; estimated glomerular filtration rate 53 ± 21 ml/min/1.73 m ) were recruited and completed semistructured one-to-one interviews at University Hospitals of Leicester NHS Trust. All KTRs were eligible if their kidney transplant was completed >12 weeks before interview and their consultant considered them to have no major contraindications to exercise. All interviews were audio recorded, transcribed verbatim and subject to framework analysis to identify and report themes.
Themes were organized into personal, behavioural and environmental factors based on social cognitive theory. Facilitators of exercise were largely internal: enjoyment, exercise for general health and health of the transplanted kidney and desire to maintain normality. Social interaction, support and guidance of healthcare professionals and goal setting were perceived as motivational. Harming the kidney, a lack of guidance, self-motivation and accessibility were barriers to exercise.
These results provide detailed insight into the development of interventions designed to increase physical activity in KTRs. They provide strong evidence that specific exercise guidelines are required for this population and that the healthcare system could have a key role in supporting KTRs to become more physically active. Interventions need to be multifaceted to appeal to the differing levels of support desired by KTRs.
KTRs were involved in the development of the interview topic guide to ensure all relevant topics were explored.
运动有可能减轻肾移植受者（KTR）存在的心血管发病率和死亡率高的问题。尽管如此，KTR 的活动水平仍然很低。本定性研究的目的是探讨 KTR 运动的障碍和促进因素。
在莱斯特大学医院 NHS 信托基金会，招募了 13 名 KTR（8 名男性；平均年龄 53 ± 13 岁；估算肾小球滤过率 53 ± 21 ml/min/1.73 m ），并完成了半结构化的一对一访谈。所有 KTR 都符合条件，如果他们的肾移植在访谈前完成了 >12 周，并且他们的顾问认为他们没有运动的主要禁忌症。所有访谈均进行录音、逐字转录，并进行框架分析，以识别和报告主题。
根据社会认知理论，主题被组织成个人、行为和环境因素。运动的促进因素主要是内在的：享受、运动对一般健康和移植肾健康的益处，以及保持正常生活的愿望。社会互动、医疗保健专业人员的支持和指导以及目标设定被认为是激励因素。损害肾脏、缺乏指导、自我激励和可及性是运动的障碍。
这些结果深入了解了旨在增加 KTR 身体活动的干预措施的发展。它们有力地证明了该人群需要特定的运动指南，并且医疗保健系统可以在支持 KTR 变得更加活跃方面发挥关键作用。干预措施需要多方面的，以吸引 KTR 所需的不同水平的支持。
KTR 参与了访谈主题指南的制定，以确保探讨了所有相关主题。
