Patient-led identification and prioritization of exercise interventions for fatigue on dialysis: a workshop report.
clinical trials
dialysis
exercise
fatigue
patient perspectives
Journal
Clinical kidney journal
ISSN: 2048-8505
Titre abrégé: Clin Kidney J
Pays: England
ID NLM: 101579321
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
06
11
2019
accepted:
19
12
2019
entrez:
29
11
2021
pubmed:
4
2
2020
medline:
4
2
2020
Statut:
epublish
Résumé
Fatigue is one of the most important symptoms among patients receiving dialysis and is nominated as a core outcome to be reported in all clinical trials in this setting. However, few trials of interventions targeting fatigue have been conducted. Patients historically have rarely been involved in the design of interventions, which can limit acceptability and uptake. When asked, they have indicated a preference for lifestyle interventions, such as exercise, to improve fatigue. While some research has focussed on intradialytic exercise for patients receiving haemodialysis, patients have also indicated a preference for a convenient method of exercising with guidance, but on their own time outside of dialysis hours. In response to this, a mobile phone application was proposed as the method of delivery for a home-based exercise intervention targeting fatigue. We convened a workshop with five breakout group sessions in Australia, with 24 patients on dialysis (16 haemodialysis and 8 peritoneal dialysis) and 8 caregivers to identify, prioritize and discuss exercise interventions for fatigue in patients receiving dialysis and the delivery of this through a mobile application. Of the 21 types of exercise identified, the top-ranked were walking outdoors, walking on a treadmill and cardio and resistance training. Six themes were identified: (i) 'an expectation of tangible gains from exercise', including strengthening and protecting against bodily deterioration related to dialysis; (ii) 'overcoming physical limitations', meaning that comorbidities, baseline fatigue and fluctuating health needed to be addressed to engage in exercise; (iii) 'fear of risks', which reinforced the importance of safety and compatibility of exercise with dialysis; (iv) 'realistic and achievable' exercise, which would ensure initial readiness for uptake; (v) 'enhancing motivation and interest' , which expected to support sustained use of the exercise intervention and (vi) 'ensuring usability of the mobile application' , which would require simplicity, convenience and comprehensibility. Exercise interventions that are expected by patients to improve health outcomes and that are safe, realistic and easy to adopt may be more acceptable to patients on dialysis.
Sections du résumé
BACKGROUND
BACKGROUND
Fatigue is one of the most important symptoms among patients receiving dialysis and is nominated as a core outcome to be reported in all clinical trials in this setting. However, few trials of interventions targeting fatigue have been conducted. Patients historically have rarely been involved in the design of interventions, which can limit acceptability and uptake. When asked, they have indicated a preference for lifestyle interventions, such as exercise, to improve fatigue. While some research has focussed on intradialytic exercise for patients receiving haemodialysis, patients have also indicated a preference for a convenient method of exercising with guidance, but on their own time outside of dialysis hours. In response to this, a mobile phone application was proposed as the method of delivery for a home-based exercise intervention targeting fatigue.
METHODS
METHODS
We convened a workshop with five breakout group sessions in Australia, with 24 patients on dialysis (16 haemodialysis and 8 peritoneal dialysis) and 8 caregivers to identify, prioritize and discuss exercise interventions for fatigue in patients receiving dialysis and the delivery of this through a mobile application.
RESULTS
RESULTS
Of the 21 types of exercise identified, the top-ranked were walking outdoors, walking on a treadmill and cardio and resistance training. Six themes were identified: (i) 'an expectation of tangible gains from exercise', including strengthening and protecting against bodily deterioration related to dialysis; (ii) 'overcoming physical limitations', meaning that comorbidities, baseline fatigue and fluctuating health needed to be addressed to engage in exercise; (iii) 'fear of risks', which reinforced the importance of safety and compatibility of exercise with dialysis; (iv) 'realistic and achievable' exercise, which would ensure initial readiness for uptake; (v) 'enhancing motivation and interest' , which expected to support sustained use of the exercise intervention and (vi) 'ensuring usability of the mobile application' , which would require simplicity, convenience and comprehensibility.
CONCLUSION
CONCLUSIONS
Exercise interventions that are expected by patients to improve health outcomes and that are safe, realistic and easy to adopt may be more acceptable to patients on dialysis.
Identifiants
pubmed: 34840732
doi: 10.1093/ckj/sfz200
pii: sfz200
pmc: PMC8612136
doi:
Types de publication
Journal Article
Langues
eng
Pagination
831-839Informations de copyright
© The Author(s) 2020. Published by Oxford University Press on behalf of ERA-EDTA.
Références
Indian J Nephrol. 2010 Oct;20(4):185-9
pubmed: 21206679
Am J Nephrol. 2011;33(6):515-23
pubmed: 21555875
Clin J Am Soc Nephrol. 2014 Oct 7;9(10):1813-21
pubmed: 24832095
Semin Dial. 2019 Jul;32(4):281-282
pubmed: 31264290
Health Expect. 2008 Mar;11(1):63-71
pubmed: 18275403
Nephron. 2015;130(2):113-8
pubmed: 26021737
Clin Nephrol. 2004 May;61 Suppl 1:S31-8
pubmed: 15233245
Am J Kidney Dis. 2016 Sep;68(3):444-54
pubmed: 26968042
Am J Kidney Dis. 2019 Aug;74(2):179-192
pubmed: 30955947
Trials. 2017 Aug 14;18(1):378
pubmed: 28807006
Clin J Am Soc Nephrol. 2019 Jan 7;14(1):74-83
pubmed: 30573659
Am J Kidney Dis. 2017 Oct;70(4):464-475
pubmed: 28238554
Int J Behav Nutr Phys Act. 2017 Jun 24;14(1):83
pubmed: 28646889
Am J Kidney Dis. 2008 Aug;52(2):353-65
pubmed: 18572290
BMJ Open. 2019 Jan 21;9(1):e020633
pubmed: 30670499
Health Aff (Millwood). 2013 Feb;32(2):223-31
pubmed: 23381514
Am J Kidney Dis. 2017 Jan;69(1):97-107
pubmed: 27497527
Clin J Am Soc Nephrol. 2009 Nov;4(11):1779-86
pubmed: 19808226
Nephrol Nurs J. 2001 Aug;28(4):385-92; discussion 393-4
pubmed: 12143460
Support Care Cancer. 2018 Mar;26(3):685-700
pubmed: 29185105
Am J Kidney Dis. 2015 Aug;66(2):212-22
pubmed: 25943716
J Pain Symptom Manage. 2012 Nov;44(5):715-24
pubmed: 22743156
Int Urol Nephrol. 2010 Dec;42(4):1125-30
pubmed: 20213292
Hemodial Int. 2019 Oct;23(4):486-493
pubmed: 31100199
JMIR Mhealth Uhealth. 2016 Aug 02;4(3):e93
pubmed: 27485822
Front Physiol. 2018 Jul 05;9:844
pubmed: 30026703
Kidney Int. 2019 Sep;96(3):699-710
pubmed: 31200941
Clin Med Res. 2014 Sep;12(1-2):10-20
pubmed: 24415748
JAMA. 2002 Nov 20;288(19):2469-75
pubmed: 12435261
Clin J Am Soc Nephrol. 2019 Feb 7;14(2):268-276
pubmed: 30696660
Lancet. 2009 Jul 4;374(9683):86-9
pubmed: 19525005
Cochrane Database Syst Rev. 2019 Aug 06;8:CD012379
pubmed: 31425608
J Physiother. 2019 Jan;65(1):4-15
pubmed: 30581137
Cochrane Database Syst Rev. 2011 Oct 05;(10):CD003236
pubmed: 21975737
JMIR Mhealth Uhealth. 2015 Feb 26;3(1):e20
pubmed: 25803705
PLoS Med. 2013;10(1):e1001362
pubmed: 23349621
Int Urol Nephrol. 2003;35(4):535-41
pubmed: 15198163
Patient Prefer Adherence. 2016 Apr 27;10:631-40
pubmed: 27175063
Am J Kidney Dis. 2018 Jul;72(1):104-112
pubmed: 29551585