ArticlePloS one2018
Interaction of healthcare staff's attitude with barriers to physical activity in hemodialysis patients: A quantitative assessment.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 40 papers, 2 of them syntheses that pooled it.
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Who cites it
40 citing papers in PubMed, 2 syntheses or guidelines pooled it, 63 citations in OpenAlex.
- Systematic review of the best evidence for resistance exercise in maintenance hemodialysis patients.PloS one · 2024Pooled it
- The optimal exercise modality and intensity for hemodialysis patients incorporating Bayesian network meta-analysis and systematic review.Frontiers in physiology · 2022Pooled it
- Effects of electrical muscle stimulation during hemodialysis in older patients with frailty: a crossover randomized controlled trial.Journal of nephrology · 2025Trial
- Trial
- Perceptions of Exercise Benefits and Barriers and Physical Activity Status Among Patients Undergoing Hemodialysis in Saudi Arabia.Healthcare (Basel, Switzerland) · 2026Article
- Characteristics, Attitudes and Preferences of an End-Stage Kidney Disease Population at the Beginning of an Exercise Program: A Pragmatic Multicenter Trial.Journal of clinical medicine · 2026Article
- Using behavioural theory to explore barriers and facilitators to physical activity in haemodialysis patients: an updated systematic review of qualitative evidence.Health psychology and behavioral medicine · 2026Review
- Participation of physical therapists in medical fee-based dialysis-prevention interventions: a nationwide survey in Japan.Clinical and experimental nephrology · 2026Article
- Physical activity in kidney disease: evidence and implementation.Nature reviews. Nephrology · 2025Review
- Lack of physiotherapy resources restricts exercise prescription for patients with chronic kidney disease-the EUropean SUrvey on REnal EXercise (EUSUREX).Clinical kidney journal · 2025Article
- Nephrologists' Insights on Exercise in Renal Health.Kidney & blood pressure research · 2025Article
- Perceptions of healthcare providers on benefits, risks and barriers regarding intradialytic exercise among haemodialysis patients.International journal of qualitative studies on health and well-being · 2024Article
- Review of Exercise Interventions to Improve Clinical Outcomes in Nondialysis CKD.Kidney international reports · 2024Review
- The Association Between the Perception of Exercise Benefits and Barriers and Exercise Self-Efficacy During the Induction Phase of Dialysis in Patients with End-Stage Kidney Disease: A Cross-Sectional Study.Journal of clinical medicine · 2024Article
- Physical activity and exercise in chronic kidney disease: consensus statements from the Physical Exercise Working Group of the Italian Society of Nephrology.Journal of nephrology · 2024Article
- Physical activity and exercise programs for kidney patients: an Italian survey of nephrology centres.Journal of nephrology · 2024Article
- Nutritional Strategies to Prevent Muscle Loss and Sarcopenia in Chronic Kidney Disease: What Do We Currently Know?Nutrients · 2023Review
- How is exercise being prescribed for patients on hemodialysis? A scoping review.Journal of nephrology · 2023Article
- Influence of sex differences in maintenance-hemodialysis participants on motivation of exercise therapy implementation: a multicenter cross-sectional study.Journal of nephrology · 2022Article
- Relationship between Nutrition-Related Problems and Falls in Hemodialysis Patients: A Narrative Review.Nutrients · 2022Review
Corrections and comments
- Erratum issued
Authors and funding
21 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and aim of the studyIn hemodialysis patients, sedentarism is a potentially modifiable mortality risk factor. We explored whether healthcare staff's attitude towards exercise interacts with patient-perceived barriers in modifying the level of physical activity in this population.
methodsIn this prospective, cross-sectional, multicenter study we recruited 608 adult patients and 330 members of the healthcare staff in 16 hemodialysis units in Italy. We assessed patient-perceived barriers to, and healthcare staff's attitude towards, exercise by specific questionnaires. We fitted multilevel linear models to analyze the relationships of either barriers or staff's attitude, and their interaction, with a measure of patient self-reported physical activity (the Human Activity Profile-Adjusted Activity Score [HAP-AAS]), adjusting for multiple confounders. We also employed latent class analysis to dichotomize patients into those endorsing or not endorsing barriers.
resultsMost barriers were negatively associated with the HAP-AAS (adjusted change attributable to a given barrier ranging between -5.1 ["Feeling too old", 95% Confidence Interval: -9.4 to -0.8] and -15.6 ["Ulcers on legs and feet", 95%CI: -24.8 to -6.5]. We found a significant interaction between staff's attitude and barriers (adjusted P values ranging between 0.03 ["I do not believe that it is physician's or nurse's role providing advice on exercise to patients on dialysis"] and 0.001 ["I do not often ask patients about exercise"]). A beneficial effect of a proactive staff's attitude was evident only in patients not endorsing barriers.
conclusionsBarriers and non-proactive staff's attitude reduce physical activity in hemodialysis patients. Patients not endorsing barriers benefit the most from a proactive staff's attitude.
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