Evidence-based practice of exercise during dialysis in maintenance hemodialysis patients.

Abstract

Objective: To develop a standardized evidence-based practice plan for exercise during dialysis in maintenance hemodialysis patients based on the best evidence.

Methods: Based on the Johns Hopkins evidence-based nursing practice model as theoretical guidance, the evidence of exercise during dialysis in maintenance hemodialysis patients was systematically retrieved, evaluated and summarized, and an evidence-based practice plan was formed and applied in clinical practice. 35 patients and 19 nurses were reviewed before and after the application of evidence, and the obstacle factors and improvement measures were discussed and analyzed. The effect and significance of the evidence application were analyzed by comparing the patients' grip strength, 30-s sit-to-stand test, quality of life score, self-efficacy, and dialysis adequacy.

Results: Extracted 28 pieces of evidence from 35 best evidence sources and 8 review indicators were formulated. Following the implementation of evidence-based practices, the adherence rates for the eight indicators showed significant improvement (P < 0.05). The analysis identified 12 barriers and 12 facilitators, leading to the development of 16 change strategies. Before and 1 month, 2 months and 3 months after the application of evidence, the patients' grip strength, 30-s sit-to-stand test and quality of life score were compared, and the differences were statistically significant (P < 0.05). There was no significant difference in self-efficacy and dialysis adequacy (P > 0.05).

Conclusions: Evidence-based practice of intradialytic exercise in maintenance hemodialysis patients can standardize intradialytic exercise rehabilitation. It can improve the muscle strength of upper and lower limbs and the quality of life of patients. However, its effect on self-efficacy and dialysis adequacy is limited.