Current status and influencing factors of exercise adherence among peritoneal dialysis patients: a multicenter...

Physical inactivity is a significant yet modifiable risk factor for all-cause mortality and falls among peritoneal dialysis (PD) patients; however, their inadequate exercise adherence remains poorly understood. This study aimed to characterize current patterns of exercise adherence in PD patients and identify key determinants influencing adherence behaviors.

A multicenter cross-sectional survey was conducted from July 2024 to July 2025 across four tertiary hospitals in Shenzhen, enrolling 207 eligible PD patients. Data were collected using demographic questionnaires, the Exercise Adherence Rating Scale, the Tampa Scale for Kinesiophobia, the Self-Efficacy for Managing Chronic Disease Scale, and the Functional Assessment of Chronic Illness Therapy-Fatigue Scale. Statistical analyses included multiple linear regression and mediation analysis.

The mean exercise adherence score was 32.06 ±8.28, indicating moderate adherence. Multiple linear regression identified receipt of structured exercise guidance (β= 4.124, p < 0.001), higher self-efficacy (β= 1.392, p < 0.001), and lower kinesiophobia (β= -0.282, p = 0.033) as significant predictors of exercise adherence. Mediation analysis showed indirect associations via self-efficacy [β= 0.136, 95% CI (0.064, 0.220)] and kinesiophobia [β= 0.120, 95% CI (0.046, 0.202)], accounting for 76.2% of the total association.

Exercise adherence in PD patients is influenced by multiple factors, with exercise guidance, self-efficacy, and kinesiophobia emerging as critical determinants. Fatigue was indirectly associated with adherence through self-efficacy and kinesiophobia in exploratory analyses. Clinicians may consider prioritizing early identification of at-risk patients and develop and implement theory-driven, multifaceted interventions to enhance adherence.