Implementation of a nurse-led intra-dialysis physical exercise to improve sleep quality among patients undergoing hemodialysis: A quasi-experimental study

Background and aim: Patients undergoing hemodialysis reported poor sleep quality, including insomnia, short sleep duration, and sleep disturbances due to several physical, psychological, and functional complications of the hemodialysis process. This study aimed to assess the effectiveness of intra-dialysis physical exercises on sleep quality among patients undergoing hemodialysis. Methods: A quasi-experimental pretest–posttest study with a comparison group was conducted among 88 patients undergoing hemodialysis in the largest hospitals in Amman, Jordan. 43 participants in the experimental group received supervised intra-dialysis exercise for 8 weeks, 3 times per week, whereas 45 participants in the comparison group received usual care. The data were collected at two separate time points using self-reported questionnaires that included sociodemographic variables and the Pittsburgh Sleep Quality Index. Results: The descriptive statistics indicated that the mean sleep quality score among all participants was 9.6 (SD±4.1); in the experimental group, it was 9.8 (SD±4.1), while in the control group, it was 9.4 (SD±4.0). The results of the paired-sample t-test showed a significant improvement in sleep quality in the intervention group after the study intervention compared with baseline, t = 9.4, p < .001. The results of an independent sample t-test showed significant improvement in sleep quality levels among the interventional group compared with the control group, t = 3.15, p< .001 Conclusions: Nurse-led intra-dialysis physical exercise is safe, effective, and applicable among patients undergoing hemodialysis and significantly improves sleep quality. Although some limitations were acknowledged, this study has significant implications for renal nursing care.