Improving Exercise Intentions for People Diagnosed with End-Stage-Renal Disease: The Importance of Brief In-Patient Social Cognitive-based Approaches

Low-levels of physical activity (PA) are ubiquitous among End-Stage-Renal Disease (ESRD) patients and sustaining PA in this population is challenging. Given the absence of theoretically-supported approaches of research in this area and the high costs of such interventions, case-study methods are needed. The purpose of this study was to examine the effectiveness of an in-patient social cognitive theory (SCT)-tailored intervention to improve PA antecedents of an ESRD patient. Methods: During a brief in-patient session in a hospital-based dialysis unit, a physical therapist tailored discussion about PA with the participant using SCT constructs, while the participant completed two intradialytic exercise (IDE) bouts using a leg ergometer to improve self-efficacy, PA skills, and reduce fear (15-minutes of continuous activity, 15-minutes of rest, 15-minutes of continuous activity). Self-report pre/post-surveys were completed, including PA self-efficacy, chronic disease self-efficacy, outcome expectations, intention to exercise, and fear-avoidance. Results: Positive changes in scores occurred with intention to exercise in the next three months (D=250%), intention to exercise next month (D=75%), fear-avoidance (D=40%), intention to exercise next week (D=20%), chronic disease self-efficacy (D=20%), general PA self-efficacy (D=5.7%), and PA outcome expectations (D=5.6%). Conclusions: Participation in a SCT-tailored intervention incorporating IDE led to improvements in self-efficacy, outcome expectations, and intention to engage in PA. This case study supports further examination of brief in-patient SCT-tailored interventions with IDE to increase PA among those diagnosed with ESRD. Exposure to brief exercise bouts may lead to increased levels of self-efficacy, intention, and subsequently PA for people diagnosed with ESRD post in-patient care.