Ying Chai, Qingping Gu, Lijuan Fan,* Ying Lu* 

Hemodialysis Center, Shanghai General Hospital, Shanghai, 200080, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Ying Chai, Hemodialysis Center, Shanghai General Hospital, Shanghai, 200080, People’s Republic of China, Tel +86-13916253453, Email 735203805@qq.com

Background: Exercise therapy could improve physical and psychological health in patients with chronic kidney disease (CKD). This study aimed to investigate knowledge, attitudes and practices (KAP) towards exercise therapy among patients with CKD stage 5 on regular hemodialysis.
Methods: The cross-sectional study was conducted between August 1st and 30th, 2023; KAP and demographic characteristics of CKD-5 patients were assessed with self-distributed questionnaire and analyzed using logistic regression and structural equation modeling (SEM). A higher score represented better knowledge, more positive attitude, and more proactive practice.
Results: In 513 collected questionnaires, mean scores for knowledge, attitudes, and practices were 9.5 ± 4.1 (possible range: 0– 13), 31.9 ± 5.0 (possible range: 9– 45), and 21.7 ± 9.3 (possible range: 9– 45). Multivariate logistic regression analysis showed that education (OR = 1.8, 95% CI: 1.1– 3.0, P = 0.02), income (OR = 1.7, 95% CI: 1.1– 2.6, P = 0.02), and family support (OR = 3.8, 95% CI: 2.0– 7.1, P < 0.001) were independently associated with higher knowledge scores. Knowledge score (OR = 5.1, 95% CI: 1.7– 15.1, P < 0.001) and attitude score (OR = 7.3, 95% CI: 3.7– 14.2, P < 0.001) were independently associated with higher practice scores. According to SEM, knowledge directly influenced attitude (β=1.3, P < 0.001), while attitude influenced practice (β=0.8, P < 0.001).
Conclusion: Patients with CKD-5 who underwent regular hemodialysis demonstrated insufficient knowledge, passive attitude and inactive practices towards exercise therapy. Improving knowledge and attitude through educational interventions might result in better practice.

Keywords: renal insufficiency, chronic, renal dialysis, exercise therapy, health knowledge, attitudes, practice, surveys and questionnaires