Grimmett Chloe, Bradbury Katherine, Dalton Suzanne O, Fecher-Jones Imogen, Hoedjes Meeke, Varkonyi-Sepp Judit, Short Camille E
School of Health Sciences, University of Southampton, Southampton, United Kingdom.
School of Psychology, University of Southampton, Southampton, United Kingdom.
Front Psychol. 2021 Feb 16;12:634223. doi: 10.3389/fpsyg.2021.634223. eCollection 2021.
Multimodal prehabilitation is increasingly recognized as an important component of the pre-operative pathway in oncology. It aims to optimize physical and psychological health through delivery of a series of tailored interventions including exercise, nutrition, and psychological support. At the core of this prescription is a need for considerable health behavior change, to ensure that patients are engaged with and adhere to these interventions and experience the associated benefits. To date the prehabilitation literature has focused on testing the efficacy of devised exercise and nutritional interventions with a primary focus on physiological and mechanistic outcomes with little consideration for the role of behavioral science, supporting individual behavior change or optimizing patient engagement. Changing health behavior is complex and to maximize success, prehabilitation programs should draw on latest insights from the field of behavioral science. Behavioral science offers extensive knowledge on theories and models of health behavior change to further advance intervention effectiveness. Similarly, interventions developed with a person-centered approach, taking into consideration individual needs and preferences will increase engagement. In this article, we will provide an overview of the extent to which the existing prehabilitation literature incorporates behavioral science, as well as studies that have explored patient's attitudes toward prehabilitation. We will go on to describe and critique ongoing trials in a variety of contexts within oncology prehabilitation and discuss how current scientific knowledge may be enhanced from a behavioral science perspective. We will also consider the role of "surgery schools" and detail practical recommendations that can be embedded in existing or emerging clinical settings.
多模式术前康复越来越被认为是肿瘤学术前路径的一个重要组成部分。它旨在通过提供一系列量身定制的干预措施，包括运动、营养和心理支持，来优化身体和心理健康。这种方案的核心是需要患者在健康行为上有相当大的改变，以确保患者参与并坚持这些干预措施，并体验到相关益处。迄今为止，术前康复文献主要集中在测试既定运动和营养干预措施的效果，主要关注生理和机制方面的结果，很少考虑行为科学的作用、支持个体行为改变或优化患者参与度。改变健康行为是复杂的，为了最大限度地取得成功，术前康复计划应借鉴行为科学领域的最新见解。行为科学提供了关于健康行为改变的理论和模型的广泛知识，以进一步提高干预效果。同样，以患者为中心的方法制定的干预措施，考虑到个体需求和偏好，将提高参与度。在本文中，我们将概述现有术前康复文献纳入行为科学的程度，以及探索患者对术前康复态度的研究。我们将继续描述和批评肿瘤学术前康复各种背景下正在进行的试验，并讨论如何从行为科学角度加强当前的科学知识。我们还将考虑“手术学校”的作用，并详细说明可以融入现有或新兴临床环境的实用建议。
