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Mobility in Older Adults Receiving Maintenance Hemodialysis: A Qualitative Study
American Journal of Kidney Diseases ( IF 13.2 ) Pub Date : 2021-08-20 , DOI: 10.1053/j.ajkd.2021.07.010
Christine K Liu 1 , Janet Seo 2 , Dayeun Lee 3 , Kristen Wright 4 , Manjula Kurella Tamura 5 , Jennifer A Moye 6 , Jonathan F Bean 7 , Daniel E Weiner 8
Affiliation  

Rationale & Objective

For older adults, maintaining mobility is a major priority, especially for those with advanced chronic diseases like kidney failure. However, our understanding of the factors affecting mobility in older adults receiving maintenance hemodialysis is limited.

Study Design

Descriptive qualitative study.

Setting & Participants

Using purposive sampling, we recruited (1) persons aged  60 years receiving maintenance hemodialysis; and (2) care partners (≥18 years) providing regular support to an older adult receiving hemodialysis. During a single in-person home visit, we assessed mobility using the Short Physical Performance Battery (SPPB) and conducted individual one-on-one interviews regarding important personal factors related to mobility.

Analytical Approach

Descriptive statistics were used for demographic and SPPB data. Transcripts underwent thematic coding, informed by the International Classification of Function framework of mobility. We used conceptual content analysis to inductively extract themes and subthemes.

Results

We enrolled 31 older adults receiving hemodialysis (42% female, 68% Black) with a mean age of 73 ± 8 years and mean dialysis vintage of 4.6 ± 3.5 years; their mean SPPB score was 3.6 ± 2.8 points. Among 12 care partners (75% female, 33% Black), the mean age was 54 ± 16 years and mean SPPB score was 10.1 ± 2.4 points. Major themes extracted were (1) mobility represents independence; (2) mobility is precarious; (3) limitations in mobility cause distress; (4) sources of encouragement and motivation are critical; and (5) adaptability is key.

Limitations

Modest sample from single geographic area.

Conclusions

For older adults receiving hemodialysis, mobility is severely limited and is often precarious in nature, causing distress. Older adults receiving hemodialysis and their care partners have identified sources of encouragement and motivation for mobility, and cite an adaptable mindset as important. Future studies should conceptualize mobility as a variable condition and build on this outlook of adaptability in the development of interventions.



中文翻译:

接受维持性血液透析的老年人的流动性:一项定性研究

理由和目标

对于老年人来说,保持活动能力是重中之重,尤其是对于那些患有肾衰竭等晚期慢性疾病的人。然而,我们对影响接受维持性血液透析的老年人活动能力的因素的了解是有限的。

学习规划

描述性定性研究。

设置和参与者

使用有目的的抽样,我们招募了(1)接受维持性血液透析的  60 岁的人;(2) 为接受血液透析的老年人提供定期支持的护理伙伴(≥18 岁)。在一次面对面的家访中,我们使用短期体力测试 (SPPB) 评估了行动能力,并就与行动能力相关的重要个人因素进行了一对一的单独访谈。

分析方法

描述性统计用于人口统计和 SPPB 数据。转录本经过主题编码,由国际流动性功能分类框架提供信息。我们使用概念内容分析来归纳提取主题和子主题。

结果

我们招募了 31 名接受血液透析的老年人(42% 为女性,68% 为黑人),平均年龄为 73  ±  8 岁,平均透析时间为 4.6  ±  3.5 年;他们的平均 SPPB 得分为 3.6  ±  2.8 分。在 12 名护理伙伴(75% 女性,33% 黑人)中,平均年龄为 54  ±  16 岁,平均 SPPB 评分为 10.1  ±  2.4 分。提取的主要主题是(1)流动性代表独立性;(2) 流动性不稳定;(3) 行动不便造成困扰;(4) 鼓励和激励的来源至关重要;(5)适应性是关键。

限制

来自单一地理区域的适度样本。

结论

对于接受血液透析的老年人来说,活动能力受到严重限制,而且在本质上往往不稳定,造成痛苦。接受血液透析的老年人及其护理伙伴已经确定了鼓励和行动动力的来源,并认为适应性思维很重要。未来的研究应该将流动性概念化为一个可变条件,并在干预措施的发展中建立在这种适应性的观点之上。

更新日期:2021-08-20
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