ABSTRACT
ABSTRACT: The transtheoretical model (TTM) is a promising approach to the promotion of behavior change, but it remains to be established whether there is an association between the TTM approach and intradialytic exercise among patients on hemodialysis (HD) with low motivation to exercise in a real-world setting.This retrospective cohort study, conducted in a regional hospital in Japan, included adult outpatients receiving HD 3 times per week who had never participated in intradialytic pedaling exercise despite the encouragement of the HD personnel. Patients were divided into 2 groups according to HD weekday. Patients undergoing HD on Tuesday, Thursday, and Saturday were encouraged by the HD unit team to exercise during HD based on the TTM (exposure group) and those receiving HD on Monday, Wednesday, and Friday were encouraged to exercise as usual (control group). The primary outcome was sustained intradialytic exercise using a leg ergometer, defined as a total of 72 sessions of 30-minute pedaling exercise (duration of at least 6âmonths).Overall, 85 patients were included in the analysis (mean age: 67.1â±â11.9âyears, 22% female). Of 33 patients in the exposure group, 10 (30%) maintained intradialytic exercise, compared with 2 of 52 patients (4%) in the control group. Log-binomial regression models with stabilized inverse probability of treatment weighting showed a significant association between the TTM approach and sustained intradialytic exercise (adjusted risk ratio 9.23 [95% confidence interval 2.13-40.00]). There were no exercise-related cardiovascular events.Among patients with low motivation to exercise during HD, use of the TTM approach in clinical practice was associated with sustained intradialytic exercise compared with usual care.
Subject(s)
Bicycling/physiology , Counseling/methods , Kidney Failure, Chronic/therapy , Renal Dialysis/methods , Transtheoretical Model , Aged , Aged, 80 and over , Bicycling/psychology , Female , Health Knowledge, Attitudes, Practice , Healthy Lifestyle , Humans , Japan , Kidney Failure, Chronic/psychology , Male , Middle Aged , Motivation , Retrospective StudiesABSTRACT
In dental hygienist education, many skills are taught that cannot be acquired without repeated training. To make this training more efficient, we need to measure the students' skills and show correction points in real-time. In this research, we focus on hand scaling work, which is one of the most important tasks of dental hygienists. We developed a measurement system to measure both the motion and force exerted during hand scaling work. This measured data can be used to quantitatively evaluate students' skills. In the experiment, we measured the hand scaling motion of several participants with different levels of job experience, including dental hygienist teachers, dental hygienists, and dental hygienist students. We showed that it is possible to extract from the measured results a quantitative index for discriminating different individual skills.
