Outcomes of a Nurse-Led Case Management Program on Home Exercise Training for Hemodialysis Patients

2.50
Hdl Handle:
http://hdl.handle.net/10755/335616
Category:
Abstract
Type:
Presentation
Title:
Outcomes of a Nurse-Led Case Management Program on Home Exercise Training for Hemodialysis Patients
Author(s):
Tao, Xingjuan; Wong, Frances Kam Yuet; Chow, Susan Ka Yee
Lead Author STTI Affiliation:
Pi lota
Author Details:
Xingjuan Tao, MSc, RN, tao.xingjuan@connect.polyu.hk; Frances Kam Yuet Wong, RN, BSc, MA, PhD; Susan Ka Yee Chow, RN, BN, MPHC, PhD
Abstract:
Session presented on Sunday, July 27, 2014: Purpose: The purpose of this study was to examine the effects of a 12-week nurse-led case management program on home exercise training for maintenance hemodialysis patients. The interventions aimed at increasing physical function, improving patients’ perceived exercise benefits, removing perceived exercise barriers, enhancing health-related quality of life, and relieving depressive symptom for the patients. Methods: The study was a two group randomized, controlled trial.  Ninety participants were recruited from the hemodialysis units of two tertiary hospitals in Nanjing, China in 2013.  They were randomly assigned to either study group (n = 45) or comparison group (n = 45).  Participants in both groups received the in-center exercise training (20 minutes) before hemodialysis sessions weekly for 6 weeks and were instructed to perform exercise at home. The in-center training was conducted by the researcher with a group of four-to six participants focusing on flexibility and strengthening exercise only. Patients were encouraged to have cardiovascular exercises at home which will improve their cardiovascular conditions and endurance. The list of cardiovascular exercise included brisk walking, bicycling, jogging. Participants in the study group were instructed to start walking or brisk walking at low duration and gradually progress to a maximum of 30 minutes daily per week. To facilitate exercise progression, the nurse case managers discussed exercise benefits, explored exercise barriers and developed mutual goals with patients. The nurse will motivate them and check the exercise behaviors to ensure adherence to the recommended exercise regime. The nurse case managers interviewed the study group patients weekly for six weeks and biweekly for another six weeks. Participants in the comparison group only participated in the in-center exercise training.  The control group patients received usual care from the nurse without the interviews and mutual goals developed. Gait speed (both normal gait speed and fast gait speed), 10-repetition sit-to-stand (10-STS), health-related quality of life, perceived exercise benefits and barriers, and depressive symptom were measured at baseline, 6- and 12-week.  Data were analyzed by the two-way repeated-measures ANOVA with an intention-to-treat analysis.  Missing values were replaced by the last observed values from the same participants.  Results: For fast gait speed test, repeated-measures ANOVA showed a significant difference between groups across the three time points (F=4.79, p=0.031). For 10-STS performance, significant within-group effect (F=21.91, p=0.000) was observed for both groups.  For health-related quality of life, a significant difference was found between the groups in the subscale for Symptoms of Kidney Disease (F=5.60, p=0.020), and significant within-group differences were noted from the study group in the subscale for Burden of Kidney Disease (F=3.51, p=0.041) and Mental Component Summary (F=3.37, p=0.037).  There were significant within-group differences in the perceived benefits and perceived barriers scores (F=15.55, p=0.000; F=13.79, p=0.000, respectively), and both the study group and comparison groups seemed to improve over time; while no significant difference for the between-group effects.  The scores for Depressive symptom decreased for both groups, there were no significant differences for between and within group effects.  No injuries were observed during the program.  Conclusion: The findings reinforce the notion that exercise is safe and beneficial for hemodialysis patients.  The structured 12-week nurse-led case management program on home exercise training is practical and effective to improve the physical function and health-related quality of life of the patients.
Keywords:
Hemodialysis; Nursing; Exercise
Repository Posting Date:
17-Nov-2014
Date of Publication:
17-Nov-2014
Conference Date:
2014
Conference Name:
25th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Hong Kong
Description:
International Nursing Research Congress, 2014 Theme: Engaging Colleagues: Improving Global Health Outcomes. Held at the Hong Kong Convention and Exhibition Centre, Wanchai, Hong Kong
Note:
This is an abstract-only submission. If the author has submitted a full-text item related to this abstract, you may find it by browsing the repository by author. If author contact information is availabe in this abstract, please feel free to contact him or her with your queries regarding this submission.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleOutcomes of a Nurse-Led Case Management Program on Home Exercise Training for Hemodialysis Patientsen_GB
dc.contributor.authorTao, Xingjuanen_GB
dc.contributor.authorWong, Frances Kam Yueten_GB
dc.contributor.authorChow, Susan Ka Yeeen_GB
dc.contributor.departmentPi lotaen_GB
dc.author.detailsXingjuan Tao, MSc, RN, tao.xingjuan@connect.polyu.hk; Frances Kam Yuet Wong, RN, BSc, MA, PhD; Susan Ka Yee Chow, RN, BN, MPHC, PhDen_GB
dc.identifier.urihttp://hdl.handle.net/10755/335616-
dc.description.abstractSession presented on Sunday, July 27, 2014: Purpose: The purpose of this study was to examine the effects of a 12-week nurse-led case management program on home exercise training for maintenance hemodialysis patients. The interventions aimed at increasing physical function, improving patients’ perceived exercise benefits, removing perceived exercise barriers, enhancing health-related quality of life, and relieving depressive symptom for the patients. Methods: The study was a two group randomized, controlled trial.  Ninety participants were recruited from the hemodialysis units of two tertiary hospitals in Nanjing, China in 2013.  They were randomly assigned to either study group (n = 45) or comparison group (n = 45).  Participants in both groups received the in-center exercise training (20 minutes) before hemodialysis sessions weekly for 6 weeks and were instructed to perform exercise at home. The in-center training was conducted by the researcher with a group of four-to six participants focusing on flexibility and strengthening exercise only. Patients were encouraged to have cardiovascular exercises at home which will improve their cardiovascular conditions and endurance. The list of cardiovascular exercise included brisk walking, bicycling, jogging. Participants in the study group were instructed to start walking or brisk walking at low duration and gradually progress to a maximum of 30 minutes daily per week. To facilitate exercise progression, the nurse case managers discussed exercise benefits, explored exercise barriers and developed mutual goals with patients. The nurse will motivate them and check the exercise behaviors to ensure adherence to the recommended exercise regime. The nurse case managers interviewed the study group patients weekly for six weeks and biweekly for another six weeks. Participants in the comparison group only participated in the in-center exercise training.  The control group patients received usual care from the nurse without the interviews and mutual goals developed. Gait speed (both normal gait speed and fast gait speed), 10-repetition sit-to-stand (10-STS), health-related quality of life, perceived exercise benefits and barriers, and depressive symptom were measured at baseline, 6- and 12-week.  Data were analyzed by the two-way repeated-measures ANOVA with an intention-to-treat analysis.  Missing values were replaced by the last observed values from the same participants.  Results: For fast gait speed test, repeated-measures ANOVA showed a significant difference between groups across the three time points (F=4.79, p=0.031). For 10-STS performance, significant within-group effect (F=21.91, p=0.000) was observed for both groups.  For health-related quality of life, a significant difference was found between the groups in the subscale for Symptoms of Kidney Disease (F=5.60, p=0.020), and significant within-group differences were noted from the study group in the subscale for Burden of Kidney Disease (F=3.51, p=0.041) and Mental Component Summary (F=3.37, p=0.037).  There were significant within-group differences in the perceived benefits and perceived barriers scores (F=15.55, p=0.000; F=13.79, p=0.000, respectively), and both the study group and comparison groups seemed to improve over time; while no significant difference for the between-group effects.  The scores for Depressive symptom decreased for both groups, there were no significant differences for between and within group effects.  No injuries were observed during the program.  Conclusion: The findings reinforce the notion that exercise is safe and beneficial for hemodialysis patients.  The structured 12-week nurse-led case management program on home exercise training is practical and effective to improve the physical function and health-related quality of life of the patients.en_GB
dc.subjectHemodialysisen_GB
dc.subjectNursingen_GB
dc.subjectExerciseen_GB
dc.date.available2014-11-17T13:55:55Z-
dc.date.issued2014-11-17-
dc.date.accessioned2014-11-17T13:55:55Z-
dc.conference.date2014en_GB
dc.conference.name25th International Nursing Research Congressen_GB
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen_GB
dc.conference.locationHong Kongen_GB
dc.descriptionInternational Nursing Research Congress, 2014 Theme: Engaging Colleagues: Improving Global Health Outcomes. Held at the Hong Kong Convention and Exhibition Centre, Wanchai, Hong Kongen_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item related to this abstract, you may find it by browsing the repository by author. If author contact information is availabe in this abstract, please feel free to contact him or her with your queries regarding this submission.en_GB
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