Dr Brett Tarca1, Prof Shilpanjali Jesudason2,3, Ms Alison Burford1, Prof Paul Bennett1,4
1Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, Adelaide University, Adelaide, Australia, 2Faculty of Health and Medical Sciences, Adelaide University, Adelaide, Australia, 3Central and Northern Adelaide Renal and Transplantation Service Clinical Research Group, Royal Adelaide Hospital, Adelaide , Australia, 4School of Nursing & Midwifery, Griffith University, Brisbane, Australia
Biography:
Brett is an exercise physiologist and lecturer within the Clinical Exercise Physiology undergraduate program at Adelaide University. His research focus involves the role of exercise therapy in end stage kidney disease with his current focus exploring the effectiveness of early movement-based interventions on high priority patient outcomes for people commencing peritoneal dialysis.
Abstract:
Background: People receiving peritoneal dialysis often experience physical function decline associated with kidney failure and its treatment. Prehabilitation improves the functional capacity of an individual prior to a treatment or procedure. The perceptions and attitudes of clinicians towards prehabilitation programs for people commencing peritoneal dialysis remain undefined.
Aim: Explore the perceptions and attitudes of kidney care clinicians towards prehabilitation programs for peritoneal dialysis.
Method: Semi-structured interviews were conducted with nephrologists, nurses and allied health professionals involved in either pre- and/or post-catheter insertion care of individuals commencing peritoneal dialysis. Data were analysed thematically using an inductive approach to identify key themes.
Results: Nineteen clinicians from Australia, United Kingdom, Canada and Portugal completed interviews. Four high-level themes were identified, 1) recognised clinical value, 2) empowering safe and personalised exercise participation, 3) limited patient engagement and support and, 4) integration into clinical care through advocacy and cultural change. Clinicians generally spoke positively towards prehabilitation with key enablers to program effectiveness included embedding exercise expertise within care teams, fostering advocacy and engagement and, integrating professionally guided patient-centred exercise programs into routine home dialysis care pathways. Barriers included limited clinician exercise literacy and patient burden during this transitional period, however, all clinicians still believed that when appropriately integrated, prehabilitation could play an important role in the patient journey.
Conclusion: Clinicians support the concept of prehabilitation programs for people commencing peritoneal dialysis. Despite identifying potential challenges, they support these exercise programs as a strategy to optimise peritoneal dialysis and overall health for people commencing treatment.