Körperliche Aktivität bei chronischen Hämodialysepatienten

Dyck, Marcus van (2019): Körperliche Aktivität bei chronischen Hämodialysepatienten: Querschnittsstudie zur Erhebung des Aktivitätsniveaus und psychologischer Einflussfaktoren auf das Bewegungsprofil. Dissertation, LMU München: Medizinische Fakultät

Abstract

Background and objective: Besides kidney failure haemodialysis patients (HDP) often suffer from comorbidities like fatigue, depression, pain, and stress. Physical activity (PA) is associated with higher exercise capacity and has a positive influence on these comorbidities. However, HDP are barley physically active. Data on the activity level in Germany is still missing to deduce appropriate prevention approaches. The purpose of this study was to determine the current level of PA and identify potential related factors influencing PA in HDP. Methods: In this cross-sectional study participated 240 HDP and 230 non-renal disease general practice patients (GPP) were recruited from the area of Munich and Upper Franconia. A standardized questionnaire was used to analyze PA (European Health Interview Survey Physical Activity Questionnaire), comorbidities (Self-Administered Comorbidity Questionnaire), depression (Hospital Anxiety and Depression Scale), quality of life (CDC-HRQOL-4), stress (Perceived Stress Scale-4), sedentary time (Marshall Sitting Questionnaire), pain (Patient Health Questionnaire), fatigue (Fatigue Severity Scale), everyday disabilities (WHO Disability Assessment Schedule 2.0), sport specific self-efficacy (Self-Efficacy Scale for Physical Activity) and optimism (Life Orientation Test-Revised). Differences were calculated using t-tests, respectively Mann-Whitney-U-Test (significance level p<.05). For correlation analysis we used Pearson`s correlation coefficient and univariate as well as multivariate logistic regression analysis. Results: The mean age of HDP was 64,19 years ±13,57 (GPP: 55.73 ±10.43 years) and 70.8 % of the patients were men (GPP: 41.7 %). Mean number of months of dialysis was 55,63 ±61,76. HDP reported 76,13 ±124,02 min. of moderate PA per week which was about 175 min. less than GPP (p<.01). HDP that were more active assessed their subjective health condition on a higher level, reported fewer physical limitations and less depressive symptoms than inactive HDP. Male HDP were less active and showed significantly more depressive symptoms than female HDP (p<.05). Depression, stress and age showed a negative association, sport specific self-efficacy a positive association with PA (p<.05). Multivariate logistic regression revealed that sport specific self-efficacy increased the chance of becoming physically active while depression reduced the chance of achieving 150 Min. PA. No association was found between optimism and PA in HDP. However, in GPP multivariate logistic regression optimism revealed an increased chance of becoming active. Discussion and conclusion: HDP were barely physically active. The results display the necessity to further promote PA in HDP. Physicians should be aware of patients’ self-efficacy as well as depressive symptoms and develop concepts that strengthen the self-efficacy and promote the positive effects of PA on health. The potential link between optimism and PA should be further investigated.

• Dokumententyp: Dissertationen (Dissertation, LMU München)
• Keywords: physical activity; bewegung; dialysis; psychology; movement; prevention
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften ; 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• Fakultäten: Medizinische Fakultät
• Sprache der Hochschulschrift: Deutsch
• Datum der mündlichen Prüfung: 7. Mai 2019
• 1. Bericht­erstatter:in: Schelling, Jörg