Increasing the uptake of exercise programs in the dialysis unit: A protocol for a realist synthesis

被引：4

作者：

Thompson S. ^{[1
]}

Clark A. ^{[2
]}

Molzahn A. ^{[2
]}

Klarenbach S. ^{[3
]}

Tonelli M. ^{[4
]}

机构：

[1] University of Alberta, 3064-8308 114 Street, Edmonton, T6G 2V2, AB

[2] University of Alberta, Faculty of Nursing, Level 3, Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, T6G 1C9, AB

[3] University of Alberta, Division of Nephrology, 11-107 CSB, Edmonton, T6G 2C3, AB

[4] University of Calgary, Division of Nephrology, TRW Building, 7th Floor, 3280 Hospital Drive NW, 7D12, Calgary, T2N 4Z6, AB

来源：

Systematic Reviews | / 5卷 / 1期

关键词：

Contextual factors; Exercise; Hemodialysis; Intradialytic exercise; Realist synthesis;

D O I：

10.1186/s13643-016-0224-6

中图分类号：

学科分类号：

摘要：

Background: For people with end-stage kidney disease on hemodialysis, exercise during the dialysis treatment (intradialytic exercise) may promote exercise adherence and enhance aspects of the dialysis treatment. However, intradialytic exercise programs are complex and how to adapt program components to local context so that the program is more likely to attain its intended health outcomes have not been well described. To increase the uptake of exercise in clinical practice, more evidence is needed on how contextual factors influence the program's impact. Methods: Using the realist approach, we aim to understand how the processes and structures of intradialytic exercise programs work to influence patient participation according to different contextual factors. The focus of a realist review is explanatory and aims to develop and test theory on how contextual factors trigger specific processes or behaviors (or "mechanisms") to produce outcomes. Using the realist context-mechanism-outcome configuration of theory development, we will use a range of sources to develop initial candidate theories: a scoping review of published papers and the gray literature, and discussion with stakeholders. To provide a theoretical basis for how contextual factors could work to influence patient participation in intradialytic exercise (IDE), several of our preliminary theories will be based on dominant theories of exercise adherence and behavior change. To support or refute these initial theories, we will synthesize data from a systematic literature review and semi-structured interviews with intradialytic exercise program stakeholders, sampled from a range of programs worldwide. Discussion: The complexity of intradialytic exercise programs poses challenges to their implementation. Using the "context, mechanism, outcome" approach, the knowledge gained from this study will be used to develop general recommendations for renal care providers and administration on how to adapt components of an intradialytic exercise programs according to different contextual factors in order to promote patient participation. Systematic review registration: PROSPERO CRD42016033335 © 2016 Thompson et al.

引用

共 23 条

[21]

Greenwood S.A., Koufaki P., Rush R., Macdougall I.C., Mercer T.H., Exercise counselling practices for patients with chronic kidney disease in the UK: a renal multidisciplinary team perspective, Nephron Clin Pract, 128, 1-2, pp. 67-72, (2014)

[22]

Young H.M.L., Hudson N., Clarke A.L., Dungey M., Feehally J., Burton J.O., Et al., Patient and staff perceptions of intradialytic exercise before and after implementation: a qualitative study, PLoS One, 10, 6, (2015)

[23]

Kontos P.C., Miller K.L., Brooks D., Jassal S.V., Spanjevic L., Devins G.M., Et al., Factors influencing exercise participation by older adults requiring chronic hemodialysis: a qualitative study, Int Urol Nephrol, 39, 4, pp. 1303-1311, (2007)

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