Accepted for/Published in: JMIR Rehabilitation and Assistive Technologies
Date Submitted: Jul 5, 2026
Date Accepted: Oct 5, 2026
Game on or Game over: A qualitative SWOT analysis of healthcare providers’ attitudes and expectations on intradialytic exergaming
ABSTRACT
Background:
Physical inactivity significantly contributes to the rapid decline in clinical and health-related outcomes among patients undergoing haemodialysis. Exergaming may offer a safe, effective, and sustainable solution for maintaining adequate physical activity levels in these patients.
Objective:
To support its clinical applicability, our aim was to examine the attitudes and expectations of healthcare providers regarding intradialytic exergaming (IEG).
Methods:
We conducted 21 individual, in-person, semi-structured interviews with healthcare providers. Using purposive sampling, we included training assistants, nurses, nephrologists, and managers from two dialysis centres in Slovakia. The verbatim transcripts of interviews were qualitatively analysed using an inductive thematic analysis approach. The identified codes and themes were further deductively categorised into the strengths, weaknesses, opportunities, and/or threats quadrants of the SWOT framework.
Results:
We identified two strengths, two weaknesses, three opportunities, and three threats of IEG. Strengths included healthcare providers’ enthusiasm and belief in the safety of IEG. Weaknesses involved concerns about the complexity of IEG and low digital literacy among patients and providers, potentially affecting its effectiveness and sustainability. Opportunities were seen in improving information availability and specificity, adjusting clinical culture, and tailoring exercises. Threats included scepticism about availability of financial resources for IEG, resistance to changes in clinical practice, and issues related to patient behaviour and privacy.
Conclusions:
Healthcare providers perceived IEG as a safe and appropriate intervention for clinical practice. To ensure high effectiveness and sustainability, it is important to consider specific expectations regarding resource availability, as well as the technological and organizational aspects of IEG. Clinical Trial: ClinicalTrials.gov NCT03511924; https://clinicaltrials.gov/study/NCT03511924
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