维持性血液透析患者透析中运动依从性的影响因素及干预策略研究进展
Research Progress on Influencing Factors and Intervention Strategies of Intradialytic Exercise Adherence in Maintenance Hemodialysis Patients
摘要: 透析中运动对维持性血液透析患者生理功能、透析充分性及生活质量的改善作用已得到广泛证实，但患者运动依从性普遍低下成为临床转化的主要瓶颈。本研究对患者透析中运动依从性现状、影响因素及干预策略3个方面进行综述。以期为临床提供针对性干预措施，提升维持性血液透析患者透析中运动的长期依从性，改善患者预后。
Abstract: The beneficial effects of intradialytic exercise on physical function, dialysis adequacy, and quality of life in maintenance hemodialysis patients have been widely confirmed. However, poor exercise adherence among patients remains a major bottleneck for clinical translation. This study reviews three aspects: the current status of intradialytic exercise adherence, its influencing factors, and intervention strategies. The aim is to provide targeted intervention measures for clinical practice, improve long-term adherence to intradialytic exercise in maintenance hemodialysis patients, and enhance patient outcomes.
文章引用：陈功, 刘少邦, 赵黎, 周津娇, 付培虎. 维持性血液透析患者透析中运动依从性的影响因素及干预策略研究进展[J]. 护理学, 2026, 15(6): 220-226. https://doi.org/10.12677/ns.2026.156197

参考文献

[1] 郝文娟, 赵丹, 丁梓峻, 等. 单中心维持性血液透析患者现况调查及预后影响因素分析[J]. 临床医学研究与实践, 2025, 10(33): 22-26.
[2] Zhang, L., Zou, L. and Zhou, L. (2024) Effectiveness of Psychoeducational Interventions on Psychological Distress and Health-Related Quality of Life among Patients with Maintenance Hemodialysis: A Systematic Review and Meta-Analysis. Renal Failure, 46, Article ID: 2331613. [Google Scholar] [CrossRef] [PubMed]
[3] 张帆, 王蔚琼, 张华春. 慢性肾脏病的运动康复临床实践指南及专家共识解读[J]. 中国血液净化, 2022, 21(2): 111-114.
[4] 叶丹, 郑拿, 赵凌雨, 等. 有氧运动的延续护理对维持性血液透析患者睡眠质量和症状的影响[J]. 海军医学杂志, 2022, 43(6): 607-610.
[5] 翁晓羽, 徐姝娟, 陶明芬, 等. 影响血液透析患者居家运动强度、频率、时间相关因素分析[J]. 华北理工大学学报(医学版), 2019, 21(5): 384-390.
[6] Bernier-Jean, A., Wong, G., Saglimbene, V., Ruospo, M., Palmer, S.C., Natale, P., et al. (2021) Self-Reported Physical Activity and Survival in Adults Treated with Hemodialysis: A DIET-HD Cohort Study. Kidney International Reports, 6, 3014-3025. [Google Scholar] [CrossRef] [PubMed]
[7] Zhao, S., Zhong, G., Lv, A., Tao, Y., Liu, H., Lv, H., et al. (2025) Intradialytic Exercise Interventions to Enhance Physical Activity Levels in Hemodialysis Patients: A Systematic Review and Meta-Analysis. American Journal of Nephrology. [Google Scholar] [CrossRef] 
[8] 蒋婕, 张颖君, 薛贵方. 维持性血液透析患者运动自我效能与运动知识及水平的相关性研究[J]. 护士进修杂志, 2019, 34(8): 678-680.
[9] 蒋广慧, 许明月, 代雯莉, 等. 动力取向干预联合量化运动指导在老年尿毒症维持性血液透析患者中的应用[J]. 齐鲁护理杂志, 2024, 30(5): 30-34.
[10] Johansen, K.L., Painter, P., Kent-Braun, J.A., Ng, A.V., Carey, S., Da Silva, M., et al. (2001) Validation of Questionnaires to Estimate Physical Activity and Functioning in End-Stage Renal Disease. Kidney International, 59, 1121-1127. [Google Scholar] [CrossRef] 
[11] Zheng, J., You, L., Lou, T., Chen, N., Lai, D., Liang, Y., et al. (2010) Development and Psychometric Evaluation of the Dialysis Patient-Perceived Exercise Benefits and Barriers Scale. International Journal of Nursing Studies, 47, 166-180. [Google Scholar] [CrossRef] [PubMed]
[12] Bogataj, Š., Pajek, M., Pajek, J., Buturović Ponikvar, J. and Paravlic, A.H. (2019) Exercise-based Interventions in Hemodialysis Patients: A Systematic Review with a Meta-Analysis of Randomized Controlled Trials. Journal of Clinical Medicine, 9, Article 43. [Google Scholar] [CrossRef] [PubMed]
[13] Bogataj, Š., Pajek, M., Buturović Ponikvar, J. and Pajek, J. (2020) Outcome Expectations for Exercise and Decisional Balance Questionnaires Predict Adherence and Efficacy of Exercise Programs in Dialysis Patients. International Journal of Environmental Research and Public Health, 17, Article 3175. [Google Scholar] [CrossRef] [PubMed]
[14] Martins, M.A., Ghisi, G.L.M., da Silva, K.B., Leopoldino, G., Pakosh, M. and Bundchen, D.C. (2024) Psychometrically Validated Questionnaires to Measure the Effects and Benefits/Barriers to Physical Exercise in Hemodialysis Patients: A Systematic Review. Disability and Rehabilitation, 46, 1459-1470. [Google Scholar] [CrossRef] [PubMed]
[15] 香舒, 陈娴, 曹海红, 等. 维持性血液透析患者自我调节疲劳及医学应对方式的潜在类别分析[J]. 中国护理管理, 2025, 25(7): 1011-1017.
[16] 叶丽钦, 张海林, 周莹. 血液透析患者衰弱的相关研究进展[J]. 中华护理杂志, 2018, 53(1): 99-104.
[17] 闫晓伟, 李梦婷, 潘梦娇, 等. 老年维持性血液透析病人内在能力现状及影响因素分析[J]. 实用老年医学, 2024, 38(6): 541-544.
[18] 刘玉玲, 邱慧鑫, 李燕. 分阶段康复训练对老年慢性肾脏病维持性血液透析患者心功能及透析耐受性的影响分析[J]. 中国现代药物应用, 2026, 20(6): 154-157.
[19] 葸英博, 路婷婷, 张莲荷, 等. 基于多理论模型的维持性血液透析病人口渴预防管理方案的构建与应用[J]. 循证护理, 2025, 11(23): 4895-4902.
[20] 陶颖, 吉小静, 于新涛, 等. 维持性血液透析患者运动恐惧现况及影响因素研究[J]. 护理管理杂志, 2024, 24(1): 50-54.
[21] 于新涛, 常燕, 倪停停, 等. 维持性血液透析患者运动体验质性研究的Meta整合[J]. 中华护理杂志, 2024, 59(14): 1769-1776.
[22] Hu, S., Yang, Q., Qi, S., Li, J., Wang, L., Ma, L., et al. (2025) Maintenance Hemodialysis Patients Participate in a Virtual Reality Rehabilitation Training Experience: A Qualitative Study. Disability and Rehabilitation, 47, 3151-3156. [Google Scholar] [CrossRef] [PubMed]
[23] 苑振浩, 马磊, 朱友超, 等. 维持性血液透析患者运动康复体验质性研究的Meta整合[J]. 当代护士(中旬刊), 2025, 32(12): 44-49.
[24] 熊敏. 个体化运动方案对维持血液透析患者预后和社会回归的影响[J]. 当代护士(中旬刊), 2020, 27(12): 75-77.
[25] Buchanan, H., Newton, J.T., Baker, S.R. and Asimakopoulou, K. (2021) Adopting the COM‐B Model and TDF Framework in Oral and Dental Research: A Narrative Review. Community Dentistry and Oral Epidemiology, 49, 385-393. [Google Scholar] [CrossRef] [PubMed]
[26] 凌敏. 基于BCW理论的奥塔戈运动在维持性血液透析衰弱前期患者中的应用[D]: [硕士学位论文]. 湖州: 湖州师范学院, 2024.
[27] Heijnen, S., Sleutels, J. and de Kleijn, R. (2024) Model Virtues in Computational Cognitive Neuroscience. Journal of Cognitive Neuroscience, 36, 1683-1694. [Google Scholar] [CrossRef] [PubMed]
[28] 许雅静. 个体化运动疗法护理对维持性血液透析患者睡眠质量及负性情绪的影响[J]. 世界睡眠医学杂志, 2019, 6(7): 964-965.
[29] 解欣怡. 基于BCW理论的健康教育对老年轻度认知障碍血液透析患者认知功能管理依从性的影响[D]: [硕士学位论文]. 郑州: 河南大学, 2024.
[30] 孙佳佳, 顾勤, 薛冬群, 等. 维持性血液透析患者透析中运动锻炼的最佳证据总结[J]. 护理学杂志, 2022, 37(13): 9-12.
[31] 何恩晓, 宋蓉蓉, 李娜娜. 医院-社区-家庭三元联动护理模式在尿毒症维持性血液透析患者中的应用[J]. 青岛医药卫生, 2022, 54(4): 307-310.
[32] Rao, H., Guo, Y., Qiu, L. and Ren, X. (2025) Exploring Health Challenges and Coping Strategies in Young Patients Undergoing Maintenance Hemodialysis: A Qualitative Study. BMC Nephrology, 26, Article No. 378. [Google Scholar] [CrossRef] [PubMed]

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