Advanced ovarian cancer patients identify opportunities for prehabilitation: A qualitative study

PREsurgery thoughts – thoughts on prehabilitation in oncologic gynecologic surgery, a qualitative template analysis in older adults and their healthcare professionals

“…The involvement of the gynecologist was said to be important, to inform and motivate patients. The importance of empowerment by a physician as a facilitator for prehabilitation was also mentioned in other qualitative studies in abdominal cancer patients [29,37,38]. But the major role suggested by our participants is for the oncology nurses and paramedics.…”

“…They were able to increase their weekly exercise significantly [31]. However, not feeling well or being in bad physical and/or psychological shape was a limitation for following the advice, which was also mentioned as a potential barrier in our study and by Polen-De et al [29,30]. It is expected that for more frail patients, who are often also sedentary, general advice will not be enough to prehabilitate, whereas they probably belong to the group who will benefit the most from prehabilitation [32][33][34].…”

“…Since the preoperative period can be stressful for patients, which can make it harder to follow an extensive program, it seems desirable to organize prehabilitation close to a patient's home and make the program easily accessible. The importance of easy access and the preference for a home-based or close-tohome program was also found in other qualitative studies with cancer patients and healthcare professionals [29,30,37,39]. They also stated the importance of a tailor-made approach [30,37,39].…”

“…Healthcare professionals can play a role in motivating patients, as suggested by our participants. In a recent qualitative study by Polen-De et al, most women with advanced ovarian cancer (mean age 64 years old) did not exercise, but demonstrated high motivation and willingness to exercise during chemotherapy, particularly if it would have been recommended by their healthcare professionals and if they believe there will be a benefit on their treatment options or cancer cure [29]. In line with our study, women in the study of Polen-De et al also stated that the ability to contribute to their own health and distraction from negative thoughts was encouraging them [29].…”

Considerations for multimodal prehabilitation in women with gynaecological cancers: A realist scoping review

“…The 24 articles included nine registered protocols for randomised controlled trials of prehabilitation interventions (23)(24)(25)(26)(27)(28)(29)(30)(31), six observational studies (of which four were abstracts only) (32)(33)(34)(35)(36)(37), three mixed-methods studies (38)(39)(40), two qualitative studies (41,42), two cross-sectional surveys (43,44), one costeffectiveness analysis (45) and one review (46) (Table 2). 'Last chance to live normally'.…”