Engaged mindsets, adaptive coping skills benefit patients on hemodialysis
Compared with patients on hemodialysis with a disengaged mindset, those with an engaged mindset exhibited more adaptive coping skills, moved more and had a normal body weight habitus, according to data published in Kidney Medicine.
Further, researchers suggested that adaptive coping skills can assist this population with carrying out daily life activities and overcoming challenges with being physically active.
“Prior qualitative studies investigating this topic have identified common themes of functional disability or impairment, psychological distress, loss of control and the importance of a social support network; however, more research is warranted,” Pamela Rothpletz-Puglia, EdD, RDN, from the department of interdisciplinary studies at Rutgers University in Newark, New Jersey, and colleagues wrote. “Therefore, to learn more about supporting people who require dialysis to do more or remain independent, this research aimed to understand in more depth their physical activity and the barriers and facilitators for maintaining and improving their level of desired activity.”
In a mixed methods study, researchers evaluated a purposive sample of 15 patients (median age was 58 years; 83% were African American; 67% were men) receiving maintenance hemodialysis from seven dialysis centers in Newark, New Jersey. All patients were adults, had stage 5 chronic kidney disease and were on maintenance hemodialysis for at least 3 months prior to the study.
At baseline, patients provided clinical measurements, took a physical exam and a comprehensive functional status assessment. Between July and October 2018, a researcher conducted semi-structured interviews with each patient at Rutgers. All interviews were recorded, transcribed and uploaded into NVivo 12 software program for thematic analysis.
Researchers then sorted patients into the sub-theme characteristics created from the thematic analysis.
The overarching theme was revealed to be patients’ mindset regarding physical activity as a routine daily activity as opposed to a structured exercise. Similarly, patients with an engaged mindset showed more adaptive coping skills, moved more, wanted to help others and had a normal weight body habitus. Those with a disengaged mindset showed maladaptive coping skills, infrequent activity and obesity.
“These findings provide preliminary support for identifying and characterizing the mindset and levels of engagement in activity for people requiring maintenance hemodialysis and have implications for future research in assessing coping skills,” Rothpletz-Puglia and colleagues wrote. “Since coping skills are modifiable, the findings may also provide preliminary evidence for programming for people requiring maintenance hemodialysis to include volunteering opportunities and mindset interventions, such as coping and resilience training.”
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