Table 5 Motivators/Facilitators to Exercise

Patients

• At one time I wasn’t sure that [exercise] is what I wanted to do, I realized later that’s what I needed to be doing. I’m 100% for exercise, I know first-hand that it is beneficial … anything is better than nothing…. it’s not so much of trying to be the best in the gym or the best in the place just the fact that you’re there. [Interview 8, M, 65 yo, Black]

• I hate to use the word but you just suck it up and that’s about it. So the worst thing to do is to just sit around and mope so you don’t do that. ….I feel really guilty when I come home on these cold days and I can’t go out. I feel guilty about that. [Interview 12, M, 75 yo, White]

• Every day, every chance and all day we should do something. Even though you’re tired you try to do what you can. You benefit by being able to do a little bit more. It’s a battle and you know you just can’t sit there because that’s not doing you any good [Interview 14, F, 68 yo, Black]

• Well I should be doing a lot more, if I could. And I mean mentally, it bothers me that I can’t run up the steps anymore like I used to or it takes me longer to get from the car inside the house. [Interview 4, M, 64 yo, Black]

Staff

• Maybe the end goal of improving their energy, improving how they feel after dialysis, any beneficial factors….like I said energy or stress [Interview 22, 28 yo, Dietitian]

• Some of our patients are motivated by health goals, it doesn’t just have to be transplant, if they wrestle with something else health wise and they’re on a path for improvement their own health for some can be motivating as well. [Interview 30, 54 yo, Administrator]

Patients

• [Doctors advised] that I had to exercise, to lose weight, whatever it was that I could do that would cause me to shed those pounds, that’s what I did [Interview 4, M, 64 yo, Black]

• My doctor, the one that I deal with at clinic, I’d do anything he tells me to do. [Interview 12, M, 75 yo, White]

Staff

• The support from the medical practitioners would be critical, I mean these are the same people interacting with them about all aspects of their life and their goals [Interview 30, 54 yo, Administrator]

Patients

• And I have a crew down there at the dialysis clinic that don’t let you do that [sit and mope around]. They encourage it [exercise]. … it’s just a good environment [Interview 12, M, 75 yo, White]

Staff

• I’m a huge proponent [of exercise], if you’re able, I wanna encourage patients to do whatever that I believe and they state is their ability level. [Interview 25, 46 yo, Nurse]

• I believe in the use it or lose it mentality. You know whether it’s tough for them to workout sometimes, it’s almost like you have to kinda push through it to reap the benefits… I think there may be …. some form of exercise that almost everyone can do. I definitely think that exercise is important in any way they can fit it in [Interview 22, 28 yo, dietitian]

Physicians

• If the whole team sort of supported them trying it then I think some of them would do that [Interview 31, F, 66 yo, academic]

Patients

• You gotta have somebody that when you work out, you gotta have somebody to get you motivated, Somebody to push you! [Interview 3, M, 54 yo, Black]

• I have friends that I walk with, I have a son that’s 26 and he goes to a gym 3 times a week and he’s always telling me I should exercise [Interview 6, F, 64 yo, White]

Staff

• Yeah that’s usually how our patients are motivated is by lobby discussion [in dialysis unit waiting room] with each other. Yeah usually they’re more receptive to hearing it from another patient [Interview 29, 58 yo, Administrator]

• Most have a spouse or a sibling or child or parent that’s working with them in part of their lives. That person’s buy in could be motivating [Interview 30, 54 yo, Administrator]

Patients

• It has to be interesting for you, for you to want to do it. …… If you can find something that you like to do that occupies your mind then you might want to keep it up.[Interview 8, M, 65 yo, Black]

Staff

• Finding what they enjoy you know would be number one [Interview 22, 28 yo, Dietitian]