Page 86 - Physical activity in recipients of solid organ transplantation - Edwin J. van Adrichem

Chapter 5
Measurements
Participant characteristics regarding gender, marital status, education level (low, lower
vocational and primary; medium, intermediate vocational and secondary; high, high
vocational and university), date of transplantation and comorbidities were collected by a
self-report questionnaire. Comorbidities were classi
Comorbidity Index (CCI): a di
erent weight is assigned to speci
13

ed according to the Charlson

c conditions and weights
are subsequently summed to get a total CCI.

e barriers and motivators questionnaire

e Barriers and Motivators Questionnaire was originally developed (Boston, MA) in
order to obtain insight into the most salient barriers to and motivators of physical activity in hemodialysis patients12 and was previously used in kidney transplant recipients.14 e
items were derived from literature on barriers to and motivators of physical activity in
several populations and from feedback of patients, an exercise physiologist, director of
nursing, a social worker, and psychologists. Expert feedback indicated that the types of
barriers and motivators indicated were appropriate and comprehensive.

e questionnaire
contains 32 items on barriers and 23 items on motivators. Participants were asked to
indicate to which extent they experienced the stated item as a barrier or motivator to being
physically active or to exercise.

ereby they selected one out of four answer options for
each item (‘not at all’ = 0, ‘slightly’ = 1, ‘moderately’ = 2, or ‘very much’ = 3). A sum score for
frequency was separately calculated for barriers and motivators by summing all items
endorsed as at least ‘slightly’. A second sum score was calculated for barrier intensity and
motivator intensity by summing the corresponding increasing numbers for the weight of
the barriers and motivators that were endorsed. A higher intensity score indicated a
stronger experienced in

uence.
In this study, one item of the original questionnaire was removed following expert
review, i.e., ‘My kidney disease is a barrier to being physically active’, as it was considered
unsuitable for recipients of solid organ transplantation.

e remaining items were judged as
being applicable to the current population and being comprehensive by an expert panel
existing of physical therapists, human movement scientists, specialized nurses and a
rehabilitation physician.
Data analyses

a native speaker after which
e questionnaire items are presented in the results section (Table
1 and 2). All items were forward translated into Dutch by a healthcare professional familiar
with the terminology in the research area. Conceptual translation was emphasized rather
than literal translation. After expert review (physical therapists, human movement
scientists, and rehabilitation physician) the questionnaire was translated back to English by

nal modi

cations were made. Pilot testing of the
questionnaire did not yield further point of improvement.
Data were analyzed using the IBM statistical software package SPSS (version 23, IBM
SPSS Inc., Chicago, IL) and the statistical programming language R (version 3.2.0). Only
participants with complete data on the Barriers and Motivators Questionnaire were
84.