A Qualitative Study of Exercise Participation Intentions Among Patients Undergoing Maintenance Hemodialysis

Abstract

Introduction. Exercise improves physical function and quality of life in patients undergoing maintenance hemodialysis (MHD). 
However, exercise participation remains suboptimal in this population. This study explored factors influencing exercise 
participation intentions among patients undergoing MHD to provide evidence for developing targeted interventions.
Methods. A qualitative study was conducted using purposive sampling to recruit 16 patients undergoing MHD. Data were 
collected through semi-structured interviews and analyzed using Colaizzi’s phenomenological method. Themes were identified 
based on the Capability, Opportunity, Motivation–Behavior (COM-B) model.
Results. Three major themes and 12 subthemes were identified. Capability included insufficient exercise-related knowledge, limited self-management skills, and poor perceived physical condition. Opportunity comprised the need for individualized exercise prescriptions and professional guidance, limited opportunities for exercise, positive social support, and social isolation. Motivation encompassed fear of exercise, recognition of the value of exercise, previous exercise habits and experiences, expectations of exercise benefits, and strengthened role identity. These factors collectively influenced patients’ willingness to participate in exercise.
Conclusions. Exercise participation intentions among patients undergoing MHD are shaped by multiple capability-, opportunity-, and motivation-related factors. Healthcare professionals should strengthen exercise education, provide individualized exercise 
prescriptions and professional guidance, enhance social support, offer timely feedback on exercise outcomes, and implement 
multidimensional strategies to improve patients’ self-efficacy and motivation, thereby promoting greater participation in 
regular exercise.