Patients’ perspectives on the implementation of intra-dialytic cycling—a phenomenographic study

Implementation Science

Helena Tollin²  Susanne Heiwe¹ 

[1] Department of Medicine & Department of Clinical Sciences, Division of Nephrology, Karolinska Institutet, Stockholm, Sweden;Department of Renal Medicine, Haemodialysis Unit, Karolinska University Hospital, Stockholm, Sweden

关键词: Behavioural change;    Renal replacement therapy;    Health behaviour;    Exercise;    Chronic kidney disease;   

Others  :  814748
DOI  :  10.1186/1748-5908-7-68

 received in 2011-07-30, accepted in 2012-06-27,  发布年份 2012

【 摘 要 】

Background

Adults undergoing haemodialysis have significantly reduced physical capacity and run a high risk of developing cardiovascular complications. Research has shown that intra-dialytic cycling has many evidence-based health effects, but implementation is rare within renal clinical practice. This may be due to several causes, and this study focuses on the patients’ perspective. This perspective has seldom been taken into account when aiming to assess and improve the implementation of clinical research. The aim of this study was to describe how adults undergoing in-centre haemodialysis treatment experienced an implementation process of intra-dialytic cycling. It aimed to identify potential motivators and barriers to the implementation process from a patient perspective.

Methods

Maximum-variation purposive sampling was used. Data were collected until saturation, through semistructured interviews, which were analysed using phenomenography.

Results

The implementation of intra-dialytic cycling was experienced as positive, as it had beneficial effects on physical and psychological well-being. It was easy to perform and did not intrude on patients’ spare time. These factors increased the acceptance of the implementation and supported the maintenance of intra-dialytic cycling as an evidence-based routine within their haemodialysis care. The patients did, however, experience some barriers to accepting the implementation of intra-dialytic cycling. These barriers were sometimes so strong that they outweighed the participants’ knowledge of the advantages of intra-dialytic cycling and the research evidence of its benefits. The barriers sometimes also outweighed the participants’ own wish to cycle. The barriers that we identified concerned not only the patients but also the work situation of the haemodialysis nurses.

Conclusions

Consideration of the motivators and barriers that we have identified can be used in direct care to improve the implementation of intra-dialytic cycling.

【 授权许可】

   
2012 Heiwe and Tollin; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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