Knowledge, Attitudes, and Practices Towards Exercise Therapy Among Patients with Stage 5 Chronic Kidney Disease on Regular Hemodialysis

Overview

Journal Int J Gen Med

Publisher Dove Medical Press

Specialty General Medicine

Date 2024 Dec 16

PMID 39678679

Authors

Ying Chai

Qingping Gu

Lijuan Fan

Ying Lu

Affiliations

Soon will be listed here.

Abstract

Background: Exercise therapy could improve physical and psychological health in patients with chronic kidney disease (CKD). This study aimed to investigate knowledge, attitudes and practices (KAP) towards exercise therapy among patients with CKD stage 5 on regular hemodialysis.

Methods: The cross-sectional study was conducted between August 1st and 30th, 2023; KAP and demographic characteristics of CKD-5 patients were assessed with self-distributed questionnaire and analyzed using logistic regression and structural equation modeling (SEM). A higher score represented better knowledge, more positive attitude, and more proactive practice.

Results: In 513 collected questionnaires, mean scores for knowledge, attitudes, and practices were 9.5 ± 4.1 (possible range: 0-13), 31.9 ± 5.0 (possible range: 9-45), and 21.7 ± 9.3 (possible range: 9-45). Multivariate logistic regression analysis showed that education (OR = 1.8, 95% CI: 1.1-3.0, P = 0.02), income (OR = 1.7, 95% CI: 1.1-2.6, P = 0.02), and family support (OR = 3.8, 95% CI: 2.0-7.1, P < 0.001) were independently associated with higher knowledge scores. Knowledge score (OR = 5.1, 95% CI: 1.7-15.1, P < 0.001) and attitude score (OR = 7.3, 95% CI: 3.7-14.2, P < 0.001) were independently associated with higher practice scores. According to SEM, knowledge directly influenced attitude (β=1.3, P < 0.001), while attitude influenced practice (β=0.8, P < 0.001).

Conclusion: Patients with CKD-5 who underwent regular hemodialysis demonstrated insufficient knowledge, passive attitude and inactive practices towards exercise therapy. Improving knowledge and attitude through educational interventions might result in better practice.

References

Chan C, Blankestijn P, Dember L, Gallieni M, Harris D, Lok C . Dialysis initiation, modality choice, access, and prescription: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney Int. 2019; 96(1):37-47. DOI: 10.1016/j.kint.2019.01.017. View

Uchiyama K, Adachi K, Muraoka K, Nakayama T, Oshida T, Yasuda M . Home-based aerobic exercise and resistance training for severe chronic kidney disease: a randomized controlled trial. J Cachexia Sarcopenia Muscle. 2021; 12(6):1789-1802. PMC: 8718025. DOI: 10.1002/jcsm.12775. View

Greenwood S, Castle E, Lindup H, Mayes J, Waite I, Grant D . Mortality and morbidity following exercise-based renal rehabilitation in patients with chronic kidney disease: the effect of programme completion and change in exercise capacity. Nephrol Dial Transplant. 2018; 34(4):618-625. PMC: 6452180. DOI: 10.1093/ndt/gfy351. View

Mallamaci F, Pisano A, Tripepi G . Physical activity in chronic kidney disease and the EXerCise Introduction To Enhance trial. Nephrol Dial Transplant. 2020; 35(Suppl 2):ii18-ii22. PMC: 7066543. DOI: 10.1093/ndt/gfaa012. View

Weisman D, Thavarajah S, Jaar B . Prime time for chronic kidney disease. BMC Nephrol. 2023; 24(1):295. PMC: 10559593. DOI: 10.1186/s12882-023-03340-w. View

Ke C, Liang J, Liu M, Liu S, Wang C . Burden of chronic kidney disease and its risk-attributable burden in 137 low-and middle-income countries, 1990-2019: results from the global burden of disease study 2019. BMC Nephrol. 2022; 23(1):17. PMC: 8727977. DOI: 10.1186/s12882-021-02597-3. View

Pei G, Tang Y, Tan L, Tan J, Ge L, Qin W . Aerobic exercise in adults with chronic kidney disease (CKD): a meta-analysis. Int Urol Nephrol. 2019; 51(10):1787-1795. DOI: 10.1007/s11255-019-02234-x. View

Wee H, Seng B, Lee J, Chong K, Tyagi P, Vathsala A . Association of anemia and mineral and bone disorder with health-related quality of life in Asian pre-dialysis patients. Health Qual Life Outcomes. 2016; 14:94. PMC: 4919845. DOI: 10.1186/s12955-016-0477-8. View

Ghannadi S, Amouzegar A, Amiri P, Karbalaeifar R, Tahmasebinejad Z, Kazempour-Ardebili S . Evaluating the Effect of Knowledge, Attitude, and Practice on Self-Management in Type 2 Diabetic Patients on Dialysis. J Diabetes Res. 2016; 2016:3730875. PMC: 4958437. DOI: 10.1155/2016/3730875. View

10.

He Q, Wang G, He J, Wang Y, Zhang J, Luo B . Knowledge, attitude and practice regarding occupational protection against COVID-19 among midwives in China: A nationwide cross-sectional study. Int J Disaster Risk Reduct. 2022; 79:103184. PMC: 9283191. DOI: 10.1016/j.ijdrr.2022.103184. View

11.

Andrade C, Menon V, Ameen S, Praharaj S . Designing and Conducting Knowledge, Attitude, and Practice Surveys in Psychiatry: Practical Guidance. Indian J Psychol Med. 2021; 42(5):478-481. PMC: 7750837. DOI: 10.1177/0253717620946111. View

12.

Inkeroinen S, Koskinen J, Karlsson M, Kilpi T, Leino-Kilpi H, Puukka P . Sufficiency of Knowledge Processed in Patient Education in Dialysis Care. Patient Prefer Adherence. 2021; 15:1165-1175. PMC: 8166350. DOI: 10.2147/PPA.S304530. View

13.

Li Y, Ning Y, Shen B, Shi Y, Song N, Fang Y . Temporal trends in prevalence and mortality for chronic kidney disease in China from 1990 to 2019: an analysis of the Global Burden of Disease Study 2019. Clin Kidney J. 2023; 16(2):312-321. PMC: 9900593. DOI: 10.1093/ckj/sfac218. View

14.

Villanego F, Naranjo J, Vigara L, Cazorla J, Montero M, Garcia T . Impact of physical exercise in patients with chronic kidney disease: Sistematic review and meta-analysis. Nefrologia (Engl Ed). 2020; 40(3):237-252. DOI: 10.1016/j.nefro.2020.01.002. View

15.

Barker K, Eickmeyer S . Therapeutic Exercise. Med Clin North Am. 2020; 104(2):189-198. DOI: 10.1016/j.mcna.2019.10.003. View

16.

Seng J, Monteiro A, Kwan Y, Zainudin S, Tan C, Thumboo J . Population segmentation of type 2 diabetes mellitus patients and its clinical applications - a scoping review. BMC Med Res Methodol. 2021; 21(1):49. PMC: 7953703. DOI: 10.1186/s12874-021-01209-w. View

17.

Levey A, Eckardt K, Tsukamoto Y, Levin A, Coresh J, Rossert J . Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int. 2005; 67(6):2089-100. DOI: 10.1111/j.1523-1755.2005.00365.x. View

18.

Yee-Moon Wang A, March D, Burton J . Physical activity and nutrition in chronic kidney disease. Curr Opin Clin Nutr Metab Care. 2023; 26(4):385-392. DOI: 10.1097/MCO.0000000000000947. View

19.

Wolide A, Kumela K, Kerga F, Debalke S, Seboka M, Edilu B . Knowledge, attitude, and practices toward chronic kidney disease among care providers in Jimma town:cross-sectional study. BMC Public Health. 2020; 20(1):1079. PMC: 7346627. DOI: 10.1186/s12889-020-09192-5. View

20.

Klang B, Bjorvell H, Clyne N . Predialysis education helps patients choose dialysis modality and increases disease-specific knowledge. J Adv Nurs. 1999; 29(4):869-76. DOI: 10.1046/j.1365-2648.1999.00957.x. View