Data from: Patient and staff perceptions of intradialytic exercise before and after implementation: a qualitative study

Introduction: Despite guidance and evidence for the beneficial effects of
intradialytic exercise (IDE), such programmes are rarely adopted within
practice and little is known about how they may best be sustained. The
Theoretical Domains Framework (TDF) was used to guide the understanding of
the barriers and facilitators to initial and ongoing IDE participation and
to understand how these are influential at each stage. Materials and
Methods: Focus groups explored patient (n=24) and staff (n=9) perceptions
of IDE prior to the introduction of a programme and, six months later,
face to face semi-structured interviews captured exercising patients
(n=11) and staffs’ (n=8) actual experiences. Data were collected at
private and NHS haemodialysis units within the UK. All data were
audio-recorded, translated where necessary, transcribed verbatim and
subject to framework analysis. Results: IDE initiation can be facilitated
by addressing the pre-existing beliefs about IDE through the influence of
peers (for patients) and training (for staff). Participation was sustained
through the observation of positive outcomes and through social influences
such as teamwork and collaboration. Despite this, environment and resource
limitations remained the greatest barrier perceived by both groups.
Conclusions: Novel methods of staff training and patient education should
enhance engagement. Programmes that clearly highlight the benefits of IDE
should be more successful in the longer term. The barrier of staff
workload needs to be addressed through specific guidance that includes
recommendations on staffing levels, roles, training and skill mix.