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Takamatsu K, Shike T, Kaneda Y, Bhandari D, Sawano T, Ozaki A, Tsubokura M, Kawaguchi H. Physical and psychological effects of a long-term supervised self-exercise program during hemodialysis in elderly dialysis patients: A single-site pilot study in a Japanese community setting. Medicine (Baltimore) 2024; 103:e38963. [PMID: 39029065 DOI: 10.1097/md.0000000000038963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/21/2024] Open
Abstract
Self-exercise during hemodialysis reportedly prevents functional decline. This study aimed to assess the effects of exercise on physical function during hemodialysis. From September 2014 to March 2018, 35 elderly dialysis patients participated in an exercise program 3 times a week for 24 weeks during hemodialysis under staff supervision. The Short Physical Performance Battery and muscle strength test were used to measure physical function, and the Short Form Version 2 and Self-Rating Questionnaire for Depression were used to measure psychological function. For Short Physical Performance Battery, walking speed and standing time improved significantly. Other significant improvements were observed in both knee extension muscle strength and right side of grip strength. There was also an improving trend in both Short Form Version 2 and Self-Rating Questionnaire for Depression after the intervention compared with the baseline. A long-term supervised self-exercise program during dialysis led to maintenance and improvement of physical and psychological functioning in elderly dialysis patients.
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Affiliation(s)
- Katsumori Takamatsu
- Department of Rehabilitation, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Takuya Shike
- Department of Sports and Medical fitness Re-birth, Iwaki, Fukushima, Japan
| | - Yudai Kaneda
- School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Divya Bhandari
- Breast and Thyroid Center, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Toyoaki Sawano
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Akihiko Ozaki
- Breast and Thyroid Center, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Masaharu Tsubokura
- Department of Radiation Health Management, Fukushima Medical University, Fukushima, Japan
| | - Hiroshi Kawaguchi
- Department of Nephrology, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
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Kontos P, Grigorovich A, Dupuis SL, Colobong R, Gray J, Jonas-Simpson C, Serota A. Projecting a Critique of Stigma Associated With Dementia on Screen: The Impact of a Canadian Film on the Importance of Relational Caring in the Community. THE GERONTOLOGIST 2024; 64:gnad045. [PMID: 37067944 DOI: 10.1093/geront/gnad045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Indexed: 04/18/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Relational caring has the capacity to reduce stigma associated with dementia by shifting the focus from dysfunction and behavior management, to attending to the interdependencies and reciprocities that underpin caring relationships, and making explicit the centrality of relationships to quality care, growth, and quality of life. Education, particularly arts-based approaches, has been identified as a key strategy to decrease stigma. Yet rarely are the arts utilized in educational initiatives, and particularly so in community care settings. With an interest in redressing this, our team evaluated the impact of a Canadian filmed research-based drama-Cracked: new light on dementia-about stigma associated with people living with dementia and their families. RESEARCH DESIGN AND METHODS We conducted interviews with family carers of people living with dementia and formal care providers affiliated with community-based dementia care, and also the general public at 3 and 8 months postscreening. RESULTS Our analysis of participants' perceptions/experiences illustrates the effectiveness of Cracked in reducing stigma by demonstrating changes in the understanding of dementia and changes in practice. Our analysis also includes attention to how the film, as a form of cultural production, deepened engagement and facilitated transformation. DISCUSSION AND IMPLICATIONS Our evaluation of Cracked demonstrates that it is an effective strategy for decreasing the stigma associated with dementia by promoting relational caring. It also importantly contributes to the theoretical literature that supports film-based approaches to stigma reduction.
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Affiliation(s)
- Pia Kontos
- KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Alisa Grigorovich
- Department of Recreation and Leisure Studies, Recreation and Leisure Studies, Brock University, St. Catharines, Ontario, Canada
| | - Sherry L Dupuis
- Department of Recreation and Leisure Studies, Recreation and Leisure Studies, University of Waterloo, Waterloo, Ontario, Canada
| | - Romeo Colobong
- KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada
| | - Julia Gray
- Department of Health and Society, University of Toronto-Scarborough, Scarborough, Ontario, Canada
| | | | - Alexine Serota
- Schlegel-UW Research Institute for Aging, Waterloo, Ontario, Canada
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Zhao Y. Comparison of the effect of hemodialysis and peritoneal dialysis in the treatment of end-stage renal disease. Pak J Med Sci 2023; 39:1562-1567. [PMID: 37936738 PMCID: PMC10626077 DOI: 10.12669/pjms.39.6.8056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 04/25/2023] [Accepted: 08/05/2023] [Indexed: 11/09/2023] Open
Abstract
Objective To compare the clinical effects of hemodialysis (HD) and peritoneal dialysis (PD) in the treatment of end-stage renal disease (ESRD) patients. Methods Clinical data of ESRD patients who received HD (n=74) and PD (n=77) for more than 12 months in the First People's Hospital of Tonglu County from October 2020 to November 2021 were retrospectively selected. Renal function indexes, blood pressure, and complication rates in the two groups before the first dialysis and at the end of the observation period were compared. Results After the dialysis, the urea nitrogen (BUN) levels decreased in both groups, and were significantly lower in the PD group compared to the HD group. Urea clearance index (Kt/V) increased, and were significantly higher in the PD group compared to the HD group (P<0.05). After the dialysis, albumin (ALB) and cardiac ejection fraction (EF) levels significantly increased, and ALB levels were significantly higher in the HD group while EF levels were significantly higher in the PD group (P<0.05). Levels of whole parathyroid hormone (iPTH), systolic blood pressure, and diastolic blood pressure indicators in both groups decreased compared to before the dialysis, and were significantly lower in the PD group compared to the HD group of patients (P<0.05). PD was associated with significantly lower total incidence of complications compared to HD (P<0.05). Conclusions Peritoneal dialysis is more effective in maintaining the hemodynamic stability for ESRD patients, reducing blood pressure level, improving the clearance rate of molecular substances, and protecting the renal function of patients compared to hemodialysis.
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Affiliation(s)
- Yuan Zhao
- Yuan Zhao Department of Nephrology, The First People’s Hospital of Tonglu County, Tonglu, Hangzhou City 311500, Zhejiang Province, P.R. China
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Castillo G, Presseau J, Wilson M, Cook C, Field B, Garg AX, McIntyre C, Molnar AO, Hogeterp B, Thornley M, Thompson S, MacRae JM, Bohm C. Addressing feasibility challenges to delivering intradialytic exercise interventions: A theory-informed qualitative study. Nephrol Dial Transplant 2021; 37:558-574. [PMID: 34415351 DOI: 10.1093/ndt/gfab228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Intradialytic exercise (IDE) may improve physical function and health-related quality of life. However, incorporating IDE into standard hemodialysis care has been slow due to feasibility challenges. We conducted a multicenter qualitative feasibility study to identify potential barriers and enablers to IDE and generate potential solutions to these factors. METHODS We conducted 43 semi-structured interviews with healthcare providers and patients across twelve hospitals in Ontario, Canada. We used the Theoretical Domains Framework and directed content analysis to analyze the data. RESULTS We identified eight relevant domains (knowledge, skills, beliefs about consequences, beliefs about capabilities, environmental context and resources, goals, social/professional role and identity, and social influences) represented by three overarching categories: 1) Knowledge, skills and expectations: lack of staff expertise to oversee exercise, uncertainty regarding exercise risks, benefits, and patient interest, lack of knowledge regarding exercise eligibility; 2) Human, material and logistical resources: staff concerns regarding workload, perception that exercise professionals should supervise IDE; space, equipment, and scheduling conflict concerns; 3) Social dynamics of the unit: local champions and patient stories contribute to IDE sustainability.We developed a list of actionable solutions by mapping barriers and enablers to behavior change techniques. We also developed a feasibility checklist of 47 questions identifying key factors to address prior to IDE launch. CONCLUSIONS Evidence-based solutions to identified barriers and enablers to IDE and a feasibility checklist may help recruit and support units, staff, and patients and address key challenges to the delivery of IDE in diverse clinical and research settings.
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Affiliation(s)
- Gisell Castillo
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario
| | - Justin Presseau
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario
| | - Mackenzie Wilson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario
| | - Charles Cook
- Transplant Ambassador Program, Grand River Hospital, Kitchener, Ontario
| | - Bonnie Field
- Patient and Family Advisory Committee, London Health Sciences Centre, London, Ontario
| | - Amit X Garg
- Schulich School of Medicine and Dentistry, Division of Nephrology, Western University, London, Ontario
| | - Christopher McIntyre
- Schulich School of Medicine and Dentistry, Division of Nephrology, Western University, London, Ontario
| | - Amber O Molnar
- Department of Medicine, Division of Nephrology, McMaster University, Hamilton, Ontario
| | - Betty Hogeterp
- Department of Medicine, Division of Nephrology, Lakeridge Health, Oshawa, Ontario
| | - Michelle Thornley
- Department of Medicine, Division of Nephrology, Lakeridge Health, Oshawa, Ontario
| | - Stephanie Thompson
- Department of Medicine, Division of Nephrology, University of Alberta, Edmonton, Alberta
| | - Jennifer M MacRae
- Cumming School of Medicine, Division of Nephrology, University of Calgary, Calgary, Alberta
| | - Clara Bohm
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba
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Ghafourifard M, Mehrizade B, Hassankhani H, Heidari M. Hemodialysis patients perceived exercise benefits and barriers: the association with health-related quality of life. BMC Nephrol 2021; 22:94. [PMID: 33726689 PMCID: PMC7962390 DOI: 10.1186/s12882-021-02292-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 03/02/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Patients on hemodialysis have less exercise capacity and lower health-related quality of life than healthy individuals without chronic kidney disease (CKD). One of the factors that may influence exercise behavior among these patients is their perception of exercise benefits and barriers. The present study aimed to assess the perception of hemodialysis patients about exercise benefits and barriers and its association with patients' health-related quality of life. METHODS In this cross-sectional study, 227 patients undergoing hemodialysis were randomly selected from two dialysis centers. Data collection was carried out using dialysis patient-perceived exercise benefits and barriers scale (DPEBBS) and kidney disease quality of life short form (KDQOL-SF). Data were analyzed using SPSS software ver. 21. RESULTS The mean score of DPEBBS was 68.2 ± 7.4 (range: 24 to 96) and the mean KDQOL score was 48.9 ± 23.3 (range: 0 to 100). Data analysis by Pearson correlation coefficient showed a positive and significant relationship between the mean scores of DPEBBS and the total score of KDQOL (r = 0.55, p < 0.001). Moreover, there was a positive relationship between the mean scores of DPEBBS and the mean score of all domains of KDQOL. CONCLUSION Although most of the patients undergoing hemodialysis had a positive perception of the exercise, the majority of them do not engage in exercise; it could be contributed to the barriers of exercise such as tiredness, muscle fatigue, and fear of arteriovenous fistula injury. Providing exercise facilities, encouraging the patients by the health care provider to engage in exercise programs, and incorporation of exercise professionals into hemodialysis centers could help the patients to engage in regular exercise.
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Affiliation(s)
- Mansour Ghafourifard
- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Shariati-jonubi St., Tabriz, 4515789589, Iran
| | - Banafshe Mehrizade
- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Shariati-jonubi St., Tabriz, 4515789589, Iran.
| | - Hadi Hassankhani
- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Shariati-jonubi St., Tabriz, 4515789589, Iran
| | - Mohammad Heidari
- Community-Oriented Nursing Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
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Kontos P, Colobong R, Grigorovich A, Palma Lazgare LI, Binns M, Alibhai S, Parsons T, Nesrallah G, Jassal SV, Thomas A, Naglie G. Fit for Dialysis: a prospective 2-site parallel intervention trial of a filmed research-based drama to increase exercise amongst older hemodialysis patients. Int Urol Nephrol 2021; 53:1223-1230. [PMID: 33387220 DOI: 10.1007/s11255-020-02745-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 12/03/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE The present study aimed to evaluate the impact of a filmed research-based drama-Fit for Dialysis-and an exercise program on patients' physical activity and fitness outcomes. METHODS Nineteen (10 at the intervention site, 9 at the control site) older patients with a medical diagnosis of hemodialysis-dependent end-stage renal disease were recruited from two acute care hospitals in urban central Canada where they were receiving out-patient hemodialysis care. Participants at the intervention site viewed Fit for Dialysis prior to participating in a 16-week exercise program. Participants at the control site participated only in the 16-week exercise program. Physical activity, measured by total intradialytic exercise time (TIDE), and physical fitness, measured by the Two-Minute Walk Test (2MWT). Secondary measures included: Timed Up and Go (TUG), Grip Strength, Duke Activity Status Index (DASI), Godin Leisure-Time Exerciser Questionnaire (GLTEQ), and pedometer step count. RESULTS TIDE, TUG, and GLTEQ were better at the intervention site compared to the control site at all time points measured. However, the change over time was not different between the sites. The 2MWT improved over time at the intervention site for those who exercised consistently. No significant differences between sites, or over time were found for any of the other measures. CONCLUSIONS Further research is needed to determine the effectiveness of this intervention to facilitate the incorporation of exercise into the care and treatment of HD patients.
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Affiliation(s)
- Pia Kontos
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada. .,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
| | - Romeo Colobong
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Alisa Grigorovich
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Luis Ivan Palma Lazgare
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Data and Analytic Services, ICES Central, Toronto, ON, Canada
| | - Malcolm Binns
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
| | - Shabbir Alibhai
- Department of Medicine, University of Toronto, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, Toronto, ON, Canada.,Department of Medicine, University Health Network, Toronto, ON, Canada
| | - Trisha Parsons
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | - Gihad Nesrallah
- Department of Nephrology, Humber River Hospital, Toronto, ON, Canada
| | - Sarbjit Vanita Jassal
- Department of Medicine, University of Toronto, Toronto, ON, Canada.,Division of Nephrology, University Health Network, Toronto, ON, Canada
| | - Alison Thomas
- St. Michael's Hospital, Toronto, ON, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Gary Naglie
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Department of Medicine, University of Toronto, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, Toronto, ON, Canada.,Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada.,Department of Medicine, Baycrest Health Sciences, Toronto, ON, Canada
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Jacobson J, Ju A, Baumgart A, Unruh M, O’Donoghue D, Obrador G, Craig JC, Dapueto JM, Dew MA, Germain M, Fluck R, Davison SN, Jassal SV, Manera K, Smith AC, Tong A. Patient Perspectives on the Meaning and Impact of Fatigue in Hemodialysis: A Systematic Review and Thematic Analysis of Qualitative Studies. Am J Kidney Dis 2019; 74:179-192. [DOI: 10.1053/j.ajkd.2019.01.034] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 01/30/2019] [Indexed: 11/11/2022]
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