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Table 3 Reported Barriers to Exercise

From: Knowledge, barriers and facilitators of exercise in dialysis patients: a qualitative study of patients, staff and nephrologists

Dialysis-related Fatigue
Patients • And usually when I come from dialysis I’m a little bit wiped out and then Yeah, I’d be kind of drained after dialysis [Interview 8, M, 65 yo, Black]
• I was very active at one time and now I’m very tired. You can’t make your body do what you want it to do either all the time because you’re tired [Interview 14, F, 68 yo, Black]
Staff • I know the machine makes them tired, dialysis in general is just you know it’s a tiring disease [Interview 19, 35 yo, Dietitian]
Physicians • People get really fatigue while on Dialysis and some of them complain of feeling terribly tired. [Interview 32, F, 43 yo, private practice]
Dialysis access
Patients • You can’t do weights anymore when you’re on dialysis…[because of fistula] [Interview 5, M, 25 yo, Black]
• I have Band-Aids on the sites that were where the needles had been and I don’t want to do anything that would cause them to bust or start bleeding again. So those days I don’t do any exercise. [Interview 8, M, 65 yo, Black]
• I was always worried about my fistula if I would fall or something. [Interview 6, F, 64 yo, White]
• Based on the fact that I now have a catheter and the fistula, it’s prohibited of me from going back to that [water pool exercise class][Interview 11, F, 65 yo, White]
Non-specific dialysis related factors
Patients • I think the dialysis itself takes enough out of them. I know it does for me; when I go home I have such a headache, I lay down and sleep for a couple of hours [Interview 11, F, 65 yo, White]
Time constraints due to dialysis
Patients • I usually can only exercise on the days that I don’t go to dialysis, so that really only allows me 2 days a week,[Interview 8, M, 65 yo, Black]
• As a result of the dialysis, I have to cram six days of living into three, and so I live alone, so I have to do everything myself [Interview 13, F, 72 yo, White]
• Because with my schedule right now I’m trying to get a kidney and I have so many appointments to go to and I have so much going on [Interview 14, F, 68 yo, Black]
Staff • It’s also about finding what kind of exercises they might like or could fit into their day, just because dialysis already takes up so much time. [Interview 22, 28 yo, Dietitian]
Comorbidities
Patients • I have severe arthritis ….. in my knees and in my shoulders [Interview 12, M, 75 yo, White]
• Not too many of us are walking without wheelchairs and canes [Interview 15, F, 76 yo, White]
• [Other patients] have a lot of other disabilities. One of them has diabetes, he’s blind. Another guy has a double amputation. [Interview 12, M, 75 yo, White]
• I’m not sure we have the stamina to continue with exercising for any length of time……, I know what I should be doing but once again what I should be doing and what I can do are 2 different things. There are people of course that are and can only do certain things [Interview 11, F, 65 yo, White]
Staff • Because of their age and maybe their health too. Some are sicker than others. [Interview 17, 67 yo, Nurse]
Physicians • A lot of our patients they have Diabetes and they’re old and they can’t see very well and can’t hear very well. They can’t feel their feet very well because they have Neuropathy [Interview 32, F, 43 yo, 1302 academic]
Lack of motivation
Patients • There are days you know where you just don’t feel like doing a whole lot so you just don’t do it. Between being tired and having other physical problems too, it’s tough to get somebody motivated enough to want to try to do it. [Interview 12, M, 75 yo, White]
• I’d stop exercising and then you know when you stop something you get lazy about it and no motivation [Interview 1, M, 46 yo, Black]
Staff • The tough part of putting in exercise regularly you know is more of a mental challenge than it is physical [Interview 22, 28 yo, Dietitian]
• A lot of our patients are there because they really didn’t take care of their diabetes, hypertension, not very many are interested but some of them are interested in changing their ways and being healthier, but some are just like “Oh well”.[Interview 27, 46 yo, Nurse]
• The nature of a chronic illness I think has a set of mental challenges and obstacles all by itself simply because it’s a chronic disease[Interview 30, 54 yo, Administrator]
Physicians • So yeah there is a fear component and there is a lazy component too. [Interview 32, F, 43 yo, private practice]
Fear of side effects or complications
Patients • I have fallen several times because I wasn’t paying attention to what I was doing and I have been lucky so far [Interview 12, M, 75 yo, White]
Physicians • I have a patient who has Osteoporosis and she’s fallen and broken a hip and now she’s not in to any exercises. …so yeah there is a fear component [Interview 32, F, 43 yo, private practice]
Logistic barriers for exercise
Patients • When it’s cold outside, I don’t have as much [exercise/walking][Interview 4, M, 64 yo, Black]
Lack of Staff confidence for counseling
Staff • I think I would [be more comfortable with counseling] if I had a guideline to follow or something, I think a little training, in-service training, would be good [Interview 17, 67 yo, Nurse]
  1. Abbreviation. yo years old