Feasibility of Intradialytic Cycling Program in a Remote Community Hemodialysis Unit: Mixed-Methods Analysis of Implementation

Background: There is growing evidence demonstrating the benefits of intradialytic cycling. However, there are relatively few centers where this practice has been adopted with no reports from hemodialysis units in rural, remote, and northern locations. Maintaining mobility and quality of life for pat...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Malgorzata E. Kaminska, Robin K. Roots, Anurag Singh
Formato:	article
Lenguaje:	EN
Publicado:	SAGE Publishing 2021
Materias:	Diseases of the genitourinary system. Urology RC870-923
Acceso en línea:	https://doaj.org/article/13bb466c55c248b69dc1811bf36b35cd
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:13bb466c55c248b69dc1811bf36b35cd
record_format	dspace
spelling	oai:doaj.org-article:13bb466c55c248b69dc1811bf36b35cd2021-11-10T23:03:43ZFeasibility of Intradialytic Cycling Program in a Remote Community Hemodialysis Unit: Mixed-Methods Analysis of Implementation2054-358110.1177/20543581211056233https://doaj.org/article/13bb466c55c248b69dc1811bf36b35cd2021-11-01T00:00:00Zhttps://doi.org/10.1177/20543581211056233https://doaj.org/toc/2054-3581Background: There is growing evidence demonstrating the benefits of intradialytic cycling. However, there are relatively few centers where this practice has been adopted with no reports from hemodialysis units in rural, remote, and northern locations. Maintaining mobility and quality of life for patients on kidney replacement therapy living in remote northern communities is inhibited by inclement weather and lack of access to resources and infrastructure that support physical activity. The integration of intradialytic cycling during hemodialysis offers patients a form of safe physical activity year-round. Objective: This study focuses on better understanding the feasibility and acceptability of implementing intradialytic cycling in a remote northern geographical context. Design: A feasibility study using a mixed-methods explanatory design was adopted for this study. Setting: The research is conducted in Prince George, British Columbia. Participants: The participants are patients attending a community-based dialysis unit in remote northern British Columbia and health professionals working in the same facility. Methods: Quantitative measures were captured through cycling logbooks and quality of life measure, and qualitative data were obtained through semi-structured interviews and analyzed using thematic analysis. Results: Six (43%) eligible patients used leg ergometers more than once for a median of 2.5 (interquartile range: 1-4) months and 87% of hemodialysis sessions. Participants cycled for a median of 65 (interquartile range: 39-76) minutes per session, with frequent variability noted between participants and different hemodialysis sessions for the same participant. Nine patients completed the European Quality of Life Health Questionnaire prestudy, with 5 (56%) also completing it poststudy. Interviews with 9 patients, 4 nurses, and 1 physiotherapist led to the identification of themes instrumental to implementation: a supportive community dialysis unit, shared responsibility, knowledge of patients/providers, and benefits associated with engagement. Themes that were identified as being key to acceptability in this remote dialysis unit were trust, connection, and engagement through common values. Limitations: Due to dialysis unit size, we had a small number of participants. Conclusions: This study demonstrates the feasibility of implementing best practice in a remote community and provides insight into the elements of context and participation that contribute to acceptability in the implementation of intradialytic cycling.Malgorzata E. KaminskaRobin K. RootsAnurag SinghSAGE PublishingarticleDiseases of the genitourinary system. UrologyRC870-923ENCanadian Journal of Kidney Health and Disease, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the genitourinary system. Urology RC870-923
spellingShingle	Diseases of the genitourinary system. Urology RC870-923 Malgorzata E. Kaminska Robin K. Roots Anurag Singh Feasibility of Intradialytic Cycling Program in a Remote Community Hemodialysis Unit: Mixed-Methods Analysis of Implementation
description	Background: There is growing evidence demonstrating the benefits of intradialytic cycling. However, there are relatively few centers where this practice has been adopted with no reports from hemodialysis units in rural, remote, and northern locations. Maintaining mobility and quality of life for patients on kidney replacement therapy living in remote northern communities is inhibited by inclement weather and lack of access to resources and infrastructure that support physical activity. The integration of intradialytic cycling during hemodialysis offers patients a form of safe physical activity year-round. Objective: This study focuses on better understanding the feasibility and acceptability of implementing intradialytic cycling in a remote northern geographical context. Design: A feasibility study using a mixed-methods explanatory design was adopted for this study. Setting: The research is conducted in Prince George, British Columbia. Participants: The participants are patients attending a community-based dialysis unit in remote northern British Columbia and health professionals working in the same facility. Methods: Quantitative measures were captured through cycling logbooks and quality of life measure, and qualitative data were obtained through semi-structured interviews and analyzed using thematic analysis. Results: Six (43%) eligible patients used leg ergometers more than once for a median of 2.5 (interquartile range: 1-4) months and 87% of hemodialysis sessions. Participants cycled for a median of 65 (interquartile range: 39-76) minutes per session, with frequent variability noted between participants and different hemodialysis sessions for the same participant. Nine patients completed the European Quality of Life Health Questionnaire prestudy, with 5 (56%) also completing it poststudy. Interviews with 9 patients, 4 nurses, and 1 physiotherapist led to the identification of themes instrumental to implementation: a supportive community dialysis unit, shared responsibility, knowledge of patients/providers, and benefits associated with engagement. Themes that were identified as being key to acceptability in this remote dialysis unit were trust, connection, and engagement through common values. Limitations: Due to dialysis unit size, we had a small number of participants. Conclusions: This study demonstrates the feasibility of implementing best practice in a remote community and provides insight into the elements of context and participation that contribute to acceptability in the implementation of intradialytic cycling.
format	article
author	Malgorzata E. Kaminska Robin K. Roots Anurag Singh
author_facet	Malgorzata E. Kaminska Robin K. Roots Anurag Singh
author_sort	Malgorzata E. Kaminska
title	Feasibility of Intradialytic Cycling Program in a Remote Community Hemodialysis Unit: Mixed-Methods Analysis of Implementation
title_short	Feasibility of Intradialytic Cycling Program in a Remote Community Hemodialysis Unit: Mixed-Methods Analysis of Implementation
title_full	Feasibility of Intradialytic Cycling Program in a Remote Community Hemodialysis Unit: Mixed-Methods Analysis of Implementation
title_fullStr	Feasibility of Intradialytic Cycling Program in a Remote Community Hemodialysis Unit: Mixed-Methods Analysis of Implementation
title_full_unstemmed	Feasibility of Intradialytic Cycling Program in a Remote Community Hemodialysis Unit: Mixed-Methods Analysis of Implementation
title_sort	feasibility of intradialytic cycling program in a remote community hemodialysis unit: mixed-methods analysis of implementation
publisher	SAGE Publishing
publishDate	2021
url	https://doaj.org/article/13bb466c55c248b69dc1811bf36b35cd
work_keys_str_mv	AT malgorzataekaminska feasibilityofintradialyticcyclingprograminaremotecommunityhemodialysisunitmixedmethodsanalysisofimplementation AT robinkroots feasibilityofintradialyticcyclingprograminaremotecommunityhemodialysisunitmixedmethodsanalysisofimplementation AT anuragsingh feasibilityofintradialyticcyclingprograminaremotecommunityhemodialysisunitmixedmethodsanalysisofimplementation
_version_	1718439649462976512

Feasibility of Intradialytic Cycling Program in a Remote Community Hemodialysis Unit: Mixed-Methods Analysis of Implementation

Ejemplares similares