Motivation, barriers, and suggestions for intradialytic exercise—A qualitative study among patients and nurses

Pernille Maria Wodskou*, Sasha Maria Reinhardt, Marie Borring Andersen, Stig Molsted, Lone Helle Schou

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review


Background: Intradialytic exercise is an effective intervention to reduce morbidity and mortality and increase quality of life among patients with chronic kidney disease undergoing dialysis. However, implementing and sustaining it in clinical practice has proved challenging. To identify how to best design an effective and sustainable intervention in clinical practice, we aimed to explore hemodialysis patients’ and nurses’ attitudes towards intradialytic exercise, including their motivation, anticipated barriers, and suggestions for the design of a proposed exercise program. Methods: Data were collected through qualitative semistructured interviews with patients and focus group interviews with nurses and analyzed inductively with content analysis. Results: Overall, patients’ and nurses’ attitudes towards intradialytic exercise were positive. Patients were motivated by their expectations about perceived benefits, such as improved quality of life and reduced musculoskeletal pain. Their main concern was triggering dialysis machine alarms and disturbing nurses. Nurses were more skeptical of intradialytic exercise and concerned about patient safety. Patients and nurses had several ideas on how to design a safe and motivating intradialytic exercise intervention. Conclusion: The analysis of patients’ and nurses’ experiences and attitudes generated recommendations for an intradialytic exercise program. Recommendations include individually tailored programs that are safe and that patients can do independently, continuous collaboration between patients, nurses, physicians, and physiotherapists, and educating nurses about the benefits and safety of intradialytic exercise.

Original languageEnglish
Article number10494
JournalInternational Journal of Environmental Research and Public Health
Issue number19
Publication statusPublished - 1. Oct 2021

Bibliographical note

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.


  • Barriers
  • Chronic kidney disease
  • Hemodialysis
  • Intradialytic exercise
  • Motivation
  • Nurses’ perspective
  • Patient involvement
  • Patient perspective
  • Qualitative study


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