A Study On The Current Status Of Physical Activity And The Influencing Factors In Patients With Chronic Kidney Disease Stage 3~4 Without Dialysis

Objective This study aims to investigate the current situation of patients' physical activity,who suffers from the3?4 stage of chronic kidney disease without dialysis.At the same time,this study also tries to analysis the influencing factors during this period and try to provide basis and reference for the clinical health education and intervention on the physical activity.Methods This study is combined with a quantitative research and a qualitative research.In the quantitative research,200 patients visiting the department of nephrology in Long Hua hospital during 2018.6 to 2018.12 were invited to take part in this study.The patients were struggling with 3?4 stage of chronic kidney disease but without dialysis.In this part,the researcher use the Global Physical Activity Questionnaire to evaluate the current situation of physical activity,at the same time,patients' grip,sitting and up times in 30 seconds and body composition was measured.the general information questionnaire,overall health perception,MFI-20,behavioral stage,activity pleasure questionnaire,disease awareness questionnaire,chronic disease self-efficacy energy scale and social support rating scale to evaluate the influencing factors.In the qualitative research,the researcher interview 8 patients and using the Colaizzi method to code the result of the interview to analysis and get the conclusion.Results1.According to the result of the Global Physical Activity Questionnaire,11(5.5%)patients belong to the active level,89(44.5%)patients belong to the adequate level and100(50%)patients belong to inadequate level,even 36(18%)patients were completely meditation.The median time spend on physical activity for each patient's weekly work,transportation and entertainment was 0,0 and 90 minutes.On average,one patient spends33.2 minutes taking part in activities every day,most are the entertaining ones.Every person spends 6.8hours just sitting.2.Taking the total amount of physical activity per week as the dependent variable,the results of univariate analysis shows that patients' feeling of fatigue(p=0.001),overall health perception(p=0.038),activity pleasure(OR=0.612,p=0.00),self-efficacy(OR=0.41,p=0.00)have an impact on the amount of physical activity.Using the multiple linear regression to take further exploration,we find that factors having a greater impact on the amount of physical activity are activity pleasure(SE=0.39,p=0.00),prealbumin(SE=0.23,p=0.01),self-efficacy(SE=0.22,p=0.04)and so on.3.Taking the weekly activity rate as the dependent variable,results of the chi-square test shows that hemoglobin(p=0.029)and fatigue(p=0.01)are closely related to the rate of physical activity compliance.Using the logistic regression to take further exploration,we find these factors have an impact on the activity rate: times of sitting and standing up in 30 seconds(OR=0.148,p=0.01),albumin(OR=-0.136,p=0.01)and activity pleasure(OR=0.086,p=0.00).4.Explore the characteristics of different groups of people,we find out that patients with qualified amount of physical activity can do more sitting and standing in 30seconds(p=0.00),have more activity pleasure(p=0.00),less fatigue(p=0.00),higher self-efficacy(p=0.00)and serum total iron binding rate(p=0.03).Patients taking part in physical activities can do more sitting and standing in 30 seconds(p=0.00),have more social support(p=0.04),more activity pleasure(p=0.00)and less fatigue(p=0.00).5.According to the result of the interview,the factors are distinguished into the positive ones and negative ones which both delivered into tendency,contributed and strengthen ones.Strong sense of activity benefits can strengthen patients' activity habit and lack of relevant knowledge and guidance is a major obstacle to patients' lack of physical activity.ConclusionsThe current situation of patients' physical activity is not ideal and medical staff should pay more attention on them,while interventions are also necessary.Medical staff may try to improve their albumin,prealbumin,serum total iron binding,grip,sitting and up times in 30 seconds,overall health perception,self-efficacy energy and social support,which may contribute to the change in their health situation,strengthen their understanding of disease and physical activity,make their experience better,firm their confidence and reinforce the social support and health education.The researcher suggest that different health strategy should provided to patients in different behavior stage,so that the education can be more scientific and targeted to help patients develop activity habits.