Investigating the experiences, thoughts, and feelings underlying and influencing prehabilitation among cancer patients: a qualitative perspective on the what, when, where, who, and why

Abstract

To investigate the experiences, thoughts, and feelings that underlie and influence prehabilitation among cancer patients due to undergo major abdominal surgery. Materials and methodsPrior to their surgery, sixteen patients with peritoneal carcinomatosis of colorectal or ovarian origin due to undergo major surgery received oral information and a leaflet with preoperative recommendations. They subsequently participated in individual, semi-structured interviews.Malterud's principles of systematic text condensation were used to analyse the interviews, and the concept of action competence inspired and framed the discussion. ResultsAlthough the patients found themselves in an unpredictable and uncontrollable situation, they nevertheless knew what was important to them. These factors were contextualised in five themes that reflected the experiences, thoughts, and feelings that underlay and influenced their actions: 'Perception of preparation', 'The two-sided preoperative period', 'Home or facility-based prehabilitation', 'Stakeholders in prehabilitation', and 'Reasons for taking action'. Conclusions 2The patients demonstrated action competence in relation to their preoperative preparation.However, in relation to the kind of prehabilitation that required lifestyle changes, their action competence needed to be developed and supported. To do so, it is necessary to ask questions that cover the patients' perspectives of the what, when, where, who, and why of prehabilitation.

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

“…Patients stated that it was important for them to have a patient-centered program and that they can do what suits their individual situation. This was also found in another qualitative study on prehabilitation among abdominal cancer patients [30] and corresponds to the concept of a biopsychosocial health care model in which psychological, social, and medical issues interact [18].…”

“…This statement is supported by a qualitative study among patients who were scheduled for major abdominal surgery (including for ovarian cancer). In that study, all patients received a leaflet with preoperative recommendations about preparation for surgery (among others about exercising, nutrition, relaxation, intoxications) [30]. Patients actually did put an extra effort into preparing themselves, as they became aware of the small actions they could do that could be beneficial.…”

Current Landscape of Nutrition Within Prehabilitation Oncology Research: A Scoping Review

“…Only 37 of the 110 studies of prehabilitation had a nutrition treatment component. The study designs were as follows: 27% (n = 10) were protocols (18-27), 14% (n = 5) were pilot studies (8, 28-31), 5% (n = 2) were descriptions of prehabilitation programs (32, 33), 3% (n = 1) were case reports (34), 3% (n = 1) were feasibility studies (35), and 3% were qualitative studies (36). Of these 37 studies, 30% (n = 11) were cohort studies (37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47) and 16% (n = 6) were RCTs (48)(49)(50)(51)(52)(53).…”

“…Seventy-eight percent (n = 29) of the 37 identified studies included a statement regarding the conduct of nutritional assessment [n = 8 studies did not include a nutritional assessment statement (20,26,32,36,39,43,45,47)]; however, the application of assessment was inconsistent across studies. Eight percent (n = 3) of studies stated that an assessment was conducted without providing details of the method or tool used (21,25,42).…”

Living habits affecting subsequent gastrointestinal cancer surgery: An interpretative phenomenological interview study

“…Studies on patient adherence to prehabilitation have shown the need to make the programs patientcentred by taking personal thoughts, needs and abilities into account [14][15][16], and practical barriers and facilitators should be considered [14,17]. Patients with depressive symptoms have been shown to bene t from prehabilitation interventions [18].…”