Perceived Benefits and Barriers to Exercise and Physical Activity Status Among Patients Undergoing Hemodialysis at Kenyatta National Hospital in Kenya

Abstract

Background: Physical inactivity is a common challenge among patients on hemodialysis. This is despite growing evidence about the benefits of physical activity and exercise in these patients. This may be due to uncertainty and lack of appropriate guidance about physical exercise, or driven by the barriers and benefits of exercise that they perceive. Understanding these perceptions may inform interventions aimed to increase their participation in physical exercise. Objective: To determine perceived benefits and barriers to exercise and physical activity status among patients undergoing hemodialysis at Kenyatta National Hospital in Kenya. Methods: This was a descriptive cross-sectional study. It was conducted among 91 adult patients undergoing hemodialysis at Kenyatta National Hospital’s renal unit. The study tools included a self-created questionnaire on respondents’ demographic information, the Dialysis Patient-perceived Exercise Benefits and Barriers Scale (DPEBBS) to assess perceived benefits and barriers to exercise and the General Practice Physical Activity Questionnaire (GPPAQ) to assess the respondents’ physical activity status, all of which were interviewer-administered. The study data was analyzed through descriptive statistics that included percentages and frequencies as well as means and standard deviation using the Statistical Package for Social Sciences (SPSS, version 25). Association between study variables was evaluated using chisquare test at 95% CI. Results were presented in tables and figures. Results: Patients undergoing hemodialysis at KNH renal unit had low physical activity status as only 20.3% (n = 16) were assessed as being moderately active with the remaining assessed as being moderately inactive or inactive. The perceived exercise benefits identified to be associated with the respondents’ physical activity status were prevention of muscular atrophy (Chi square p = .005), achieving a manageable body weight (Chi square p = .005), improved immunity (Chi square p = .015), enhanced self-care abilities (Chi square p = .000) and improved quality of life (Chi square p = .000). The perceived exercise barriers identified to be associated with the respondents’ physical activity status were regular tiredness (Chi square p = .000), fear of falls during exercise (Chi square p = <.000), body pain (Chi square p = .003), frequent lower-extremity muscle fatigue (Chi square p = .005); lacking awareness of how they should exercise (Chi square p = .012), fear of thirst (Chi square p = .009), concerns over their medical condition (Chi square p = .039) and having comorbidities (Chi square p = .000). Conclusions: Patients undergoing hemodialysis at KNH renal unit had low physical activity status. Patients undergoing hemodialysis at KNH renal unit had a wide range of perceived benefits and barriers to exercise. Recommendations: There is need for renal unit healthcare team to create awareness among patients undergoing hemodialysis at KNH’s renal unit on the significance of physical exercises as a critical component of their treatment and management.