PERSPECTIVES OF KIDNEY TRANSPLANT RECIPIENTS REGARDING THE BARRIERS AND ENABLERS TO EXERCISE

Abstract

BACKGROUND Kidney transplant is a second chance at life for people with kidney failure. However, the post-transplant journey is difficult with high rates of complications such as new onset diabetes, steroid induced weight gain and cardiovascular disease. While exercise has the potential to improve quality of life and reduce the susceptibility these complications, kidney transplant recipients (KTRs) report lower levels of exercise and physical activity compared to the general population. Our qualitative study aimed to explore the barriers and enablers to exercise in KTRs. METHODS People with a stable kidney transplant treated in the Illawarra Shoalhaven Local Health District were invited to participate in the study. Interviews were conducted with n=11 KTRs with an age of 25-74 years, transplant duration of 1-19 years, and comorbidities included hypertension (n=9), cancer (n=4), diabetes (n=3) and dyslipidemia (n=4). Interviews were transcribed then inductively coded and deductively categorised according to the Theoretical Domains Framework and the Capability, Opportunity, and Motivation Model of Behaviour. RESULTS KTRs expressed a desire to exercise though barriers specific to transplant were identified. Barriers included a lack of knowledge and specific guidance, physical limitations (e.g. fatigue, illness related to medications or comorbidities, injury or pain), and fear of harming the kidney (e.g. herniation, pain/pulling at surgical site, dehydration, immunocompromised state). Enablers to exercise included already living an active lifestyle, perceived mental benefits, exercise preferences and social support. CONCLUSIONS A key finding of this research was a preference from KTRs specific exercise information and guidance after kidney transplant. The findings of this study can be used to inform the development of exercise resources and interventions for KTRs and their health care professionals within the local community and at a greater level.