Background
Methods
Participant recruitment
Interviews
Data analysis
Results
Patients (n = 16) | Dialysis staff (n = 14)a | Nephrologists (n = 6) | |
---|---|---|---|
Age, yrs [Mean (SD)] | 60.1 (17.0) | 48.0 (13.2) | 47.8 (11.0) |
Age ≥50 years, % | 12 (75.0%) | 7 (50.0%) | 2 (33.3%) |
Males | 8 (50.0%) | 1 (7.1%) | 3 (50.0%) |
Dialysis vintage (yrs) [Median (range)] | 3.9 (0.3, 11.1) | - | - |
Race | |||
White | 6 (37.5%) | 13 (92.9%) | 2 (33.3%) |
Black | 10 (62.5%) | 1 (7.1%) | 0 |
Other | 0 | 0 | 3 (50.0%) |
Education | - | - | |
High school degree or less | 4 (25.0%) | ||
More than high school degree | 12 (75.0%) | ||
Academic practice | 3 (50%) |
Major themes and subthemes
Theme 1: Knowledge and perceived benefits of exercise: patients and staff view exercise as beneficial: “It gives me more energy…”
“Probably couldn’t be no more than maybe twice a week” [Interview 10, F, 54yo, Black]
Overall perceived health and well-being | |
Patients | • Making you feel better and just making you able to do more things I guess. [Interview 6, F, 64 yo, White] • I wouldn’t be doing quite as well as I am doing now if I wasn’t doing some form of exercise. [Interview 8, M, 65 yo, Black] |
Staff | • I just think it might change their whole attitude, like to a more healthier, more compliant attitude, if they start exercising. [Interview 27, 46 yo, Nurse] |
Physicians | • Helps release endorphins and makes people feel better overall [Interview 34, M, 42 yo, academic] |
Physical Health benefits | |
Cardiovascular | |
Patients | • Was on three blood pressure pills, now I don’t take any [after exercising regularly] [Interview 4, M, 64 yo, Black] |
Staff | • [Exercise during HD would] bring their blood pressure up while they were on the machines, and actually it would hopefully help them lose a little bit more water-weight, if they broke out a little sweat while they were on the machines. [Interview 25, 46 yo, Nurse] • Improved cardiac health, improved cardiac output. For some of our diabetic patients and patients with vascular disease I would think that even some simple exercises would help to improve their vascular health. [Interview 29, 58 yo, Administrator] • mobilization of edema would be another benefit. [Interview 29, 58 yo, Administrator] |
Physicians | • One of the biggest morbidities of dialysis is cardio-vascular so improving cardiovascular health……when patients have very low blood pressure [during HD treatment] sometimes it [exercise during HD] helps keep the pressure up [Interview 34, M, 42 yo, academic] |
Energy | |
Patients | • It gives me more energy. And the more energy I have, the more I feel like doing things. [Interview 12, M, 75 yo, White] • I can go longer than I would be able to go if I wasn’t doing exercise at all. [Interview 8, M, 65 yo, Black] |
Staff | • they will have a lot of energy, more energy. That would be a major benefit, [Interview 27, 46 yo, Nurse] |
Physicians | • Exercise is very good for helping people to deal with energy level…. [Interview 34, M, 42 yo, academic] |
Muscular strength and balance | |
Patients | • I don’t have the tightness in my knees [Interview 4, M, 64 yo, Black] • exercise can …….. help with balance…because that’s where your balance comes from [leg and thigh strengthening] [Interview 16, M, 81 yo, Black] |
Staff | • I like to keep people moving, the more you move, the more the muscle grows back, the less likely it is for you to have atrophy problems and then its gonna eventually impact your ADLs [activities of daily living]. [Interview 25, 46 yo, Nurse] |
Physicians | • Help strength and balance and help them recover if they were ever in a situation where they would fall.[Interview 32, F, 43 yo, private practice] • May allow them to remain independent longer [Interview 31, F, 66 yo, academic] |
Miscellaneous | |
Patients | • It gives me a better appetite. [Interview 4, M, 64 yo, Black] • I have COPD and exercise can help me breathe better [Interview 16, M, 81 yo, Black] |
Staff | • Improving the metabolism …… I think that an improved metabolism could actually help with their nutritional status. [Interview 25, 46 yo, Nurse] |
Physicians | • Sometimes it can help relieve muscle cramps because a lot of these patients have cramps [Interview 33, F, 39 yo, private practice] • It helps keep the weight down because a lot of the dialysis patients you know they’re diabetic they could be obese so that helps a lot. [Interview 33, F, 39 yo, private practice] • In some ways I think you would be better off [exercising during HD], because the thing I worry about with exercise is are you releasing potassium into the blood because of the exercises. [Interview 36, M, 39 yo, private practice] |
Mental Health benefits | |
Patients | • Exercising keeps you on a [reduced] stress level [Interview 10, F, 54 yo, Black] |
Staff | • I think it would help as far as depression goes, you know, I think exercise has definitely been shown to lift the mood, elevate your mood.[Interview 17, 67 yo, Nurse] • Maybe a mental health benefit that they’re doing something productive rather than just whiling away time in the dialysis chair. [Interview 29, 58 yo, Administrator] • Maybe improve mental health as they’re accomplishing simple exercise goals, and the satisfaction and accomplishment that comes along with that. [Interview 30, 54 yo, Administrator] |
Physicians | • Improved sense of well-being, improved mood, and I think that would be a big quality of life improvement for dialysis patients. [Interview 36, M, 39 yo, private practice] • A lot of these patients they have very sedentary lifestyles and won’t leave home and a large portion of them I would think for them just coming to dialysis is their only you know trip of the outside world, know give them a sense of participating in something [exercise during HD] [Interview 33, F, 39 yo, private practice] |
Theme 2: Reported barriers to exercise: dialysis makes exercise challenging: “When I come home from dialysis, I’m a little bit wiped out”
Dialysis-related Fatigue | |
Patients | • And usually when I come from dialysis I’m a little bit wiped out and then Yeah, I’d be kind of drained after dialysis [Interview 8, M, 65 yo, Black] • I was very active at one time and now I’m very tired. You can’t make your body do what you want it to do either all the time because you’re tired [Interview 14, F, 68 yo, Black] |
Staff | • I know the machine makes them tired, dialysis in general is just you know it’s a tiring disease [Interview 19, 35 yo, Dietitian] |
Physicians | • People get really fatigue while on Dialysis and some of them complain of feeling terribly tired. [Interview 32, F, 43 yo, private practice] |
Dialysis access | |
Patients | • You can’t do weights anymore when you’re on dialysis…[because of fistula] [Interview 5, M, 25 yo, Black] • I have Band-Aids on the sites that were where the needles had been and I don’t want to do anything that would cause them to bust or start bleeding again. So those days I don’t do any exercise. [Interview 8, M, 65 yo, Black] • I was always worried about my fistula if I would fall or something. [Interview 6, F, 64 yo, White] • Based on the fact that I now have a catheter and the fistula, it’s prohibited of me from going back to that [water pool exercise class][Interview 11, F, 65 yo, White] |
Non-specific dialysis related factors | |
Patients | • I think the dialysis itself takes enough out of them. I know it does for me; when I go home I have such a headache, I lay down and sleep for a couple of hours [Interview 11, F, 65 yo, White] |
Time constraints due to dialysis | |
Patients | • I usually can only exercise on the days that I don’t go to dialysis, so that really only allows me 2 days a week,[Interview 8, M, 65 yo, Black] • As a result of the dialysis, I have to cram six days of living into three, and so I live alone, so I have to do everything myself [Interview 13, F, 72 yo, White] • Because with my schedule right now I’m trying to get a kidney and I have so many appointments to go to and I have so much going on [Interview 14, F, 68 yo, Black] |
Staff | • It’s also about finding what kind of exercises they might like or could fit into their day, just because dialysis already takes up so much time. [Interview 22, 28 yo, Dietitian] |
Comorbidities | |
Patients | • I have severe arthritis ….. in my knees and in my shoulders [Interview 12, M, 75 yo, White] • Not too many of us are walking without wheelchairs and canes [Interview 15, F, 76 yo, White] • [Other patients] have a lot of other disabilities. One of them has diabetes, he’s blind. Another guy has a double amputation. [Interview 12, M, 75 yo, White] • I’m not sure we have the stamina to continue with exercising for any length of time……, I know what I should be doing but once again what I should be doing and what I can do are 2 different things. There are people of course that are and can only do certain things [Interview 11, F, 65 yo, White] |
Staff | • Because of their age and maybe their health too. Some are sicker than others. [Interview 17, 67 yo, Nurse] |
Physicians | • A lot of our patients they have Diabetes and they’re old and they can’t see very well and can’t hear very well. They can’t feel their feet very well because they have Neuropathy [Interview 32, F, 43 yo, 1302 academic] |
Lack of motivation | |
Patients | • There are days you know where you just don’t feel like doing a whole lot so you just don’t do it. Between being tired and having other physical problems too, it’s tough to get somebody motivated enough to want to try to do it. [Interview 12, M, 75 yo, White] • I’d stop exercising and then you know when you stop something you get lazy about it and no motivation [Interview 1, M, 46 yo, Black] |
Staff | • The tough part of putting in exercise regularly you know is more of a mental challenge than it is physical [Interview 22, 28 yo, Dietitian] • A lot of our patients are there because they really didn’t take care of their diabetes, hypertension, not very many are interested but some of them are interested in changing their ways and being healthier, but some are just like “Oh well”.[Interview 27, 46 yo, Nurse] • The nature of a chronic illness I think has a set of mental challenges and obstacles all by itself simply because it’s a chronic disease[Interview 30, 54 yo, Administrator] |
Physicians | • So yeah there is a fear component and there is a lazy component too. [Interview 32, F, 43 yo, private practice] |
Fear of side effects or complications | |
Patients | • I have fallen several times because I wasn’t paying attention to what I was doing and I have been lucky so far [Interview 12, M, 75 yo, White] |
Physicians | • I have a patient who has Osteoporosis and she’s fallen and broken a hip and now she’s not in to any exercises. …so yeah there is a fear component [Interview 32, F, 43 yo, private practice] |
Logistic barriers for exercise | |
Patients | • When it’s cold outside, I don’t have as much [exercise/walking][Interview 4, M, 64 yo, Black] |
Lack of Staff confidence for counseling | |
Staff | • I think I would [be more comfortable with counseling] if I had a guideline to follow or something, I think a little training, in-service training, would be good [Interview 17, 67 yo, Nurse] |
Theme 3: Reported barriers to intra-dialytic exercise: intra-dialytic exercise should be safe without disrupting usual care: “None of us want to stay there any longer than we have to”
Safety-related limitations of Exercise | |
Patients | • It might make your blood pressure go up [Interview 2, M, 80 yo, White] • Can’t move that arm, you’re locked into that position for however how long your treatment is. …also on your other free arm you have a blood pressure cuff. So you’re really kind of locked on both sides. Any movement in either one of those arms is gonna cause the machine’s alarm to go off. [Interview 8, M, 65 yo, Black] |
Staff | • They could dislodge a needle possibly …. it would also cause them pain, and it could really cause some large damage to their access…the biggest barrier that I could see…. Just moving around too much and cause an infiltrate [Interview 17, 67 yo, Nurse] • If they do too much movement they won’t get a good treatment because they will constantly alarm. [Interview 18, 35 yo, Technician] • Sometimes just moving around causes cramping in a patient [Interview 24, 28 yo, Technician] • When people put their feet down you know blood pressure drops so it would definitely make it a little more challenging as far as making sure that the vitals are staying stabilized. [Interview 24, 28 yo, Technician] |
Physicians | • How do you interpret high blood pressures when you’re exercising? I don’t think you can. So it does create some issues that would have to be [addressed] [Interview 36, M, 39 yo, private practice] • People passed out on Dialysis. If they are doing something else that’s directing blood flow elsewhere again it’s just sort of not an ideal combination. If someone’s inclined because they tend to drop their blood pressure, if you’re going to make them exercise you’re going to exacerbate [hypotension] [Interview 32, F, 43 yo, private practice] • They’re almost like sort of tied up to the machine. one hand is immobile so that pretty much you know they just have the use of one hand and we don’t like the patients to be really moving their arm too much because then the needles would move and there is chances of them infiltrating [Interview 33, F, 39 yo, academic] |
Limitation related to Type of Exercise and Exercise Equipment | |
Patients | • Getting it [stationary bike] up to the chair would be a challenge. It would probably be too big and clunky of a device to put in there [Interview 4, M, 64 yo, Black] • I found that [stationary bike that he used in a past research study] to be very boring, I didn’t like it……….. And I don’t think anybody did because I don’t see anybody doing it now” [Interview 8, M, 65yo, Black] |
Staff | • Buying equipment so we would need to get permission with [the administrator] with the budget. I don’t know if we’re going to want to spend all this money on some sort of equipment and have half the patients not use it [Interview 19, 35 yo, Dietitian] • Some kind of equipment becomes cumbersome for patients.[Interview 23, 60 yo, Social worker] • Depending on the exercise, you have space limitations[Interview 28, 58 yo, Nurse] • Some of them used it [stationary bike] for a short time and then they lost interest in it [Interview 29, 58 yo, Administrator] |
Physicians | • It would be a little bit expensive because I guess it would involve some sort of equipment. [Interview 31, F, 66 yo, academic] |
Lack of privacy during exercising | |
Patients | • I don’t like to be what I think is doing performing in front of people because I don’t think I would do it well. [Interview 12, M, 75 yo, White] |
Staff | • I think for some people it could be a self-conscious thing and maybe they you know some people don’t like to go to the gym because they don’t want others to see them. [Interview 19, 35 yo, Dietitian] |
Impact on staff workload | |
Patients | • Yes it would [impact workload] and guarantee they wouldn’t have time to add that to their load. They’re extremely busy the whole time. …so adding one more responsibility to them I don’t think is realistic [Interview 11, F, 65 yo, White] |
Staff | • As far as the staff goes I don’t think we would have the time to do any really one-on-one [exercise]. [Interview 18, 35 yo, Technician] • It would have to be very minimal. As our staffing doesn’t provide for helping them exercise. I mean just setting them up for it is you know is extra work. we don’t always have the staff and we don’t always have the time.[Interview 21, 52 yo, Nurse] • With the bicycle[stationary bike]…that did add to our work load and not that it was a bad thing but you know it was a good thing for the patients but….I really don’t have a minute to spare” Interview 28,58 yo, Nurse] |
Physicians | • Nurses and techs, they’re on their toes all the time, they are busy and there’s the machines are alarming, someone you know needs attention all the time, and they are not like over-staffed, they are under-staffed so this would be something extra [Interview 33, F, 39 yo, private practice] • There are so many patients per nurse, how attentive can they be when there's another variable in play. [Interview 36, M, 39 yo, private practice] |
Resistance to changing dialysis routine | |
Patients | • If you did it [exercise in dialysis unit prior to starting HD] none of us want to stay there any longer than we have to….you just don’t want to be there. It’s a mental thing, you just want to get out. [Interview 10, F, 54 yo, Black] • I go [to dialysis] early in the morning so I ain’t gonna be doing no exercise early in the morning I like to sleep during the dialysis mostly [Interview 3, M, 54 yo, Black] |
Staff | • The exercising…..we try to encourage them as much as … some people can be very….strong-willed [in adopting changes to their HD routine]. [Interview 18, 35 yo, Technician] • I just don’t see them being willing to, ….. they want to get on the machine, they want to either go to sleep or they want to sit there and do nothing and watch TV.. [Interview 21, 52 yo, Nurse] |
Physicians | • It not really part of the culture of during Dialysis….. some of them have been on Dialysis for a long time and they’re used to their routine and they come in and they do whatever they do and ….. I’m not sure that would be completely easy to change…its going to be an uphill battle to get them to exercise right now … they have their routine [Interview 31, F, 66 yo, academic] • A lot of the patients are not receptive to new ideas …..it’s going to be a big change[Interview 33, F, 39 yo, private practice] |
Theme 4: Motivators and facilitators for exercise: motivation for exercise comes from within and from the encouragement of others: “I’m 100% for exercise, I know first-hand that it is beneficial”
Self-motivation/self-awareness of need to exercise | |
Patients | • At one time I wasn’t sure that [exercise] is what I wanted to do, I realized later that’s what I needed to be doing. I’m 100% for exercise, I know first-hand that it is beneficial … anything is better than nothing…. it’s not so much of trying to be the best in the gym or the best in the place just the fact that you’re there. [Interview 8, M, 65 yo, Black] • I hate to use the word but you just suck it up and that’s about it. So the worst thing to do is to just sit around and mope so you don’t do that. ….I feel really guilty when I come home on these cold days and I can’t go out. I feel guilty about that. [Interview 12, M, 75 yo, White] • Every day, every chance and all day we should do something. Even though you’re tired you try to do what you can. You benefit by being able to do a little bit more. It’s a battle and you know you just can’t sit there because that’s not doing you any good [Interview 14, F, 68 yo, Black] • Well I should be doing a lot more, if I could. And I mean mentally, it bothers me that I can’t run up the steps anymore like I used to or it takes me longer to get from the car inside the house. [Interview 4, M, 64 yo, Black] |
Staff | • Maybe the end goal of improving their energy, improving how they feel after dialysis, any beneficial factors….like I said energy or stress [Interview 22, 28 yo, Dietitian] • Some of our patients are motivated by health goals, it doesn’t just have to be transplant, if they wrestle with something else health wise and they’re on a path for improvement their own health for some can be motivating as well. [Interview 30, 54 yo, Administrator] |
Doctors’ advice | |
Patients | • [Doctors advised] that I had to exercise, to lose weight, whatever it was that I could do that would cause me to shed those pounds, that’s what I did [Interview 4, M, 64 yo, Black] • My doctor, the one that I deal with at clinic, I’d do anything he tells me to do. [Interview 12, M, 75 yo, White] |
Staff | • The support from the medical practitioners would be critical, I mean these are the same people interacting with them about all aspects of their life and their goals [Interview 30, 54 yo, Administrator] |
Staff encouragement | |
Patients | • And I have a crew down there at the dialysis clinic that don’t let you do that [sit and mope around]. They encourage it [exercise]. … it’s just a good environment [Interview 12, M, 75 yo, White] |
Staff | • I’m a huge proponent [of exercise], if you’re able, I wanna encourage patients to do whatever that I believe and they state is their ability level. [Interview 25, 46 yo, Nurse] • I believe in the use it or lose it mentality. You know whether it’s tough for them to workout sometimes, it’s almost like you have to kinda push through it to reap the benefits… I think there may be …. some form of exercise that almost everyone can do. I definitely think that exercise is important in any way they can fit it in [Interview 22, 28 yo, dietitian] |
Physicians | • If the whole team sort of supported them trying it then I think some of them would do that [Interview 31, F, 66 yo, academic] |
Support person (family, friend, other dialysis patients) | |
Patients | • You gotta have somebody that when you work out, you gotta have somebody to get you motivated, Somebody to push you! [Interview 3, M, 54 yo, Black] • I have friends that I walk with, I have a son that’s 26 and he goes to a gym 3 times a week and he’s always telling me I should exercise [Interview 6, F, 64 yo, White] |
Staff | • Yeah that’s usually how our patients are motivated is by lobby discussion [in dialysis unit waiting room] with each other. Yeah usually they’re more receptive to hearing it from another patient [Interview 29, 58 yo, Administrator] • Most have a spouse or a sibling or child or parent that’s working with them in part of their lives. That person’s buy in could be motivating [Interview 30, 54 yo, Administrator] |
Type of exercise program | |
Patients | • It has to be interesting for you, for you to want to do it. …… If you can find something that you like to do that occupies your mind then you might want to keep it up.[Interview 8, M, 65 yo, Black] |
Staff | • Finding what they enjoy you know would be number one [Interview 22, 28 yo, Dietitian] |
Theme 5: Recommendations for intra-dialytic exercise: “It would be good for us mentally to have something else to do there while we are sitting in those chairs”
“it was well tolerated, it was well accepted … was extremely positive from patients. The anecdotal patients’ feedback was overwhelming, not just one or two, essentially all patients seemed to very much appreciate the attention, the diversion…. the patient response one after another after another totally was “This is fun, I like it, I love the person, I look forward to it”. From our measurements of patient perception, participation, and their feedback, it was a wonderful success.” [Interview 30, 54 yo, Administrator]
WHY intra-dialytic exercise might work? – Provide time distraction and convenience | |
Patients | • If you could do it [exercise during dialysis] that would be great. It’s kind of torture sitting in a chair for 3 h. I’ve always questioned why there wasn’t something for us to do there besides sit there. It would be good for us mentally to have something else to do there while we are sitting in those chairs [Interview 10, F, 54 yo, Black] |
Staff | • The convenience too, if they were here for 3–4 h, you know, some people get pretty bored…..but if they were able to do some exercise, that would be a way to spend the time. [Interview 17, 67 yo, Nurse] • They would see how much fun other people were having doing it, and if the staff gets into it, just walking around and doing their work, they’ll be playing around with it, and it just makes for a very light and fun afternoon, time will go fast. [Interview 23, 60 yo, Social worker] • You’re not doing it outside of dialysis which is precious time to our patients….. trying something new in a very routine and monotonous process that they live with every week. It may end up that something like that is motivating because it’s different.[Interview 30, 54 yo, Administrator] |
Physicians | • There is such a time thing for dialysis itself, it would be nice to somehow turn that time into productivity. I think accessibility would be good… you might have more compliance because you’re stuck there for four hours [Interview 36, M, 39 yo, private practice] |
HOW intra-dialytic exercise might work? – Build “Exercise culture” in dialysis unit | |
Patients | • I’m the kind of person says that if you can do it, I can do it [if you saw someone else exercise, could that be motivating?] [Interview 12, M, 75 yo, White] |
Staff | • It’s that mentality if you see someone else trying to improve themselves and then you kind of like feel bad about yourself …….. And then maybe if they are seeing their friends across the aisle doing it, then that might motivate them to do it as well. [Interview 19, 35 yo, Dietitian] • I would think that it[exercise during dialysis] would hopefully kind of be a chain reaction sort of thing – somebody saw someone doing it, you know, while they were on the machine, and then maybe they can get a couple [of other patients] to follow suit. [Interview 25, 46 yo, Nurse] • If they saw somebody that was on dialysis for many, many years, kind of embracing this new philosophy…..That could possibly light the fire for others. [Interview 25, 46 yo, Nurse] • Most of the staff I think would encourage the patients and have fun with it and help the patient have fun with it. [Interview 26, 41 yo, Nurse] |
Physicians | • It’s a social environment and what one person is doing it going to possibly influence another and that can be positive results so other people who see that person exercising may want to do it. If the whole team sort of supported them trying it then I think some of them would do that[Interview 31, F, 66 yo, academic] |
WHAT type of intra-dialytic exercise might work? – Individualized, engaging, group activity | |
Patients | • I think before the exercise is implemented they should give an example to see how the exercise is, if they would be able to do them and how far they should go because we’re not in that position to do all that they might want us to do [Interview 14, F, 68 yo, Black] • Yeah more flexible type because I can choose the intensities because when I get tired or when I’ve had enough, I’m going to stop. [Interview 4, M, 64 yo, Black] |
Staff | • Have a spirited person to try to engage them, and just kind of make it fun. Group activities where you see other people enjoying it and you feel like you want to participate. [Interview 23, 60 yo, Social worker] • Being involved in group activities not necessarily them being pin-pointed you know all by themselves? [Interview 24, 28 yo, Technician] |
Physicians | • I can even imagine having different regimens at higher and lower levels where you have the fitter or more stable patients do something that’s more like high level and maybe the less fit do sort of the leg lifts or other exercises. [Interview 36, M, 39 yo, private practice] |
WHAT components to include? – Education about exercise | |
Patients | • They should put something like that [information on exercise] on the wall [in dialysis unit][Interview 7, F, 43 yo, Black] |
Staff | • I think what would be best initially is just to do some pretty heavy education on the benefits. You know especially kind of hitting home the role of exercise with giving them energy… you need to get stronger so you can live on your own again leave the nursing home, get back to home and this is something that can help you reach those goals. [Interview 19, 35 yo, Dietitian] |
HOW to motivate? - Incentive to exercise | |
Patients | • You have to find some kind of a benefit from what you’re doing or you’re not going to do it and when I do it, I feel good. I feel good about myself. I feel good because I’ve done it. And that’s the only payment you can get from it. [Interview 12, M, 75 yo, White] |
Staff | • Maybe testimonials [from patients about benefits of exercise] ….if they could see that [Interview 28, 58 yo, Nurse] • It would be every few months, do some sort of contest or raffle or something they could earn if they do their exercise,[like we did for fluid gains][Interview 19, 35 yo, Dietitian] • I’m sure that [gift cards] would be incentive but that’s costly. Everybody likes money! [Interview 26, 41 yo, Nurse] |
Physicians | • Maybe in the beginning offering some sort of encouragement or incentive chance whether it’s you know they can have TV or something …. maybe a raffle or … a prize or something. That’d be key to get them motivated to want to do it. [Interview 34, M, 42 yo, academic] |
Theme 6: Dialysis staff attitude towards promoting exercise: “I know it can be done and that it can be tolerated”
“There’s clearly a significant population of patients who could participate in some kind of planned exercise during a dialysis treatment, I know that to be possible. I know it can be done and that it can be tolerated” [Interview 30, 54 yo, Administrator]
“I don’t see it [encouraging exercising] being a huge issue …. monthly education with them on that [exercise] like I do with the diet and you know adding a little bit of work but I don’t think it would cumbersome.” [Interview 19, 35 yo, dietitian]“I don’t know if that would, you know, interfere with us making sure that they’re okay ‘cause we do every half hour check-ups basically we’re making our rounds to every patient, making sure that they’re okay, checking all of their vitals.…….. I wouldn’t see it [exercise during dialysis] being that much of a hassle.” [Interview 24, 28 yo, technician]