P18
EXERCISE IN END STAGE RENAL FAILURE: PATIENT PERCEIVED BARRIERS
AND MOTIVATORS
Young, H1, Dungey, M2, Watson, E3, Baines, R1, Burton, J1,3, Smith, A1,3
1
John Walls Renal Unit, Leicester General Hospital, 2School of Sport, Exercise and Health
Science, Loughborough University, 3Department of Infection, Immunity and
Inflammation, University of Leicester
BACKGROUND: The benefits of regular exercise for the end stage renal disease (ESRD)
population undergoing haemodialysis are now well established. Exercise is recommended in
national guidelines but uptake into the routine clinical service has been slow and effective
strategies to enable its incorporation into clinical practice are required. The ESRD population
encounter significant physical, psychological and social barriers to exercise participation, and an
understanding of patient perceptions will be essential to underpin the design of feasible, patient
centred physical activity interventions.
AIMS: We aimed to ascertain the common barriers and motivators to exercise participation in
a unit-based haemodialyisis patient population.
METHODS: With the permission of the authors, we employed the Dialysis Patient Perceived
Exercise Barriers and Benefits Scale1 (DPEBBS). This validated questionnaire scores the
importance of 24 potential barriers to and benefits of exercise participation, and also includes a
free text section for explanation of any other factors the patient wishes to mention. The
DPEBBS was completed by patients undergoing routine haemodialysis on a satellite unit as part
of a service evaluation exercise. The questionnaire was distributed during routine dialysis
sessions to all patients deemed clinically suitable for exercise participation, and consent was
implied if participants filled out the questionnaire and returned it to the staff.
RESULTS: 58 patients completed the DPEBBS. Commonly identified barriers were general
tiredness (69%), muscular fatigue (60%), the burden upon family members (53%), and body
pain (45%). Although many patients understood the benefits of exercise (70%) a lack of
knowledge about how to exercise (41%) remained a significant barrier. Commonly identified
exercise benefits were preventing functional decline (94%), improving quality of life (89%),
preventing muscle atrophy (89%) and keeping body weight at a steady level (89%). >80%
agreed that exercise improved their optimism, self care abilities, mood and appetite. Thematic
analysis of the free text comments revealed the wish to increase general fitness and sense of
wellbeing, and a strong desire to exercise to increase positivity about life and self-perception,
which was linked to feeling ‘normal’, weight loss and body image. Additional barriers included
worries that exercise might induce other health problems or worsen ESRD/dialysis-associated
symptoms.
CONCLUSIONS: This survey provides a valuable insight into the perspectives of
haemodialysis patients around exercise. Exercise was widely perceived to be beneficial, and the
motivators identified can be utilised for physical activity promotion. Barriers to be addressed
include fatigue management, lack of understanding of how to undertake exercise, and safety
concerns.
Reference: 1Zheng J et al Int J Nurs Stud 47:166-80,2010