Alisa Grigorovich is a health services researcher and a critical gerontologist. her research focuses on evaluating health services and policies to identify structural barriers to equity and access in the context of rehabilitation and long-term care for adults with multiple and complex health conditions. Her postdoctoral research is focused on aggression and sexuality in long-term residential dementia care.
Using research-based film to foster exercise for wellness in hemodialysis care for older adults
Although, exercise can improve the functional outcomes and quality of life of older patients with end-stage renal disease undergoing hemodialysis, it has yet to be promoted as part of routine care. Health care providers and informal carers rarely provide encouragement for patients to exercise, and the majority of older patients remain largely inactive. There is thus the need for a shift in the culture of hemodialysis care towards the promotion of exercise for wellness, including expectations of exercise participation by older patients, and encouragement of exercise by health care providers and informal carers. While film-based educational initiatives hold promise to effect cultures of best practice, they have yet to be utilized with this population. We developed a research-based film, Fit for Dialysis, to promote exercise for wellness in hemodialysis care. To determine in what ways and why this film influences knowledge/attitudes regarding exercise for patients undergoing hemodialysis, we conducted qualitative interviews with 10 patients, 10 health care providers, and 10 informal carers. Data were analyzed using thematic analysis. We found that the film was effective in increasing patients’, informal carers’ and health care providers’ understanding of the importance of exercise and its benefits, motivating patients to exercise, and in increasing encouragement by informal carers and health care providers of patient exercise. Realism (e.g. character identification) and aesthetic qualities of the film (e.g. dialogue) were identified as central to triggering change. Fit for Dialysis is well-positioned to optimize the health and wellbeing of older adults undergoing hemodialysis.