Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK.
Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK.
BMC Cancer. 2023 Aug 11;23(1):744. doi: 10.1186/s12885-023-10986-0.
'Prehabilitation' interventions aim to enhance individuals' physical fitness prior to cancer treatment, typically involve exercise training as a key component, and may continue to support physical activity, strength, and fitness during or after treatment. However, uptake of prehabilitation is variable. This study investigated how patients from diverse socio-economic status groups perceived an exemplar prehabilitation and recovery programme, aiming to understand factors impacting acceptability, engagement and referral.
This research was conducted in the context of the Prehab4Cancer and Recovery Programme, a prehabilitation and recovery programme available across Greater Manchester, UK. Qualitative, semi-structured phone/video-call interviews were conducted with 18 adult patient participants referred to the programme (16 'engagers', 2 'non-engagers'; half the sample lived in localities with low socio-economic status scores). An online questionnaire with free-response and categorical-response questions was completed by 24 'clinician' participants involved in referral (nurses, doctors and other staff roles). An inductive, multi-perspective, thematic analysis was performed, structured using the Framework approach.
Discussing and referring patients to prehabilitation can be challenging due to large quantities of information for staff to cover, and for patients to absorb, around the time of diagnosis. The programme was highly valued by both participant groups; the belief that participation would improve recovery seemed a major motivator for engagement, and some 'clinicians' felt that prehabilitation should be treated as a routine part of treatment, or extended to support other patient groups. Engagers seemed to appreciate a supportive approach where they did not feel forced to do any activity and tailoring of the programme to meet individual needs and abilities was appreciated. Initial engagement could be daunting, but gaining experience with the programme seemed to increase confidence.
The prehabilitation programme was highly valued by engagers. Introducing prehabilitation at a challenging time means that personalised approaches might be needed to support engagement, or participation could be encouraged at a later time. Strategies to support individuals lacking in confidence, such as buddying, may be valuable.
The study protocol was uploaded onto the Open Science Framework 24 September 2020 ( https://osf.io/347qj/ ).
“预康复”干预旨在提高癌症治疗前个体的身体健康水平，通常将运动训练作为关键组成部分，并且可能在治疗期间或之后继续支持身体活动、力量和健康。然而，预康复的采用情况各不相同。本研究调查了来自不同社会经济地位群体的患者如何看待一个典范的预康复和恢复计划，旨在了解影响可接受性、参与度和转诊的因素。
本研究是在 Prehab4Cancer 和 Recovery 计划的背景下进行的，该计划在英国大曼彻斯特地区提供预康复和恢复计划。对 18 名被转介到该计划的成年患者参与者（16 名“参与者”，2 名“非参与者”；一半的样本居住在社会经济地位得分较低的地区）进行了定性、半结构式电话/视频通话访谈。24 名参与转诊的“临床医生”参与者（护士、医生和其他工作人员角色）填写了一份在线问卷，其中包含自由回答和类别回答问题。使用框架方法进行了归纳、多视角、主题分析。
由于在诊断时，工作人员需要涵盖大量信息，而患者需要吸收大量信息，因此讨论和向患者转介预康复可能具有挑战性。该计划受到两组参与者的高度重视；参与可以提高恢复的信念似乎是参与的主要动力，一些“临床医生”认为预康复应该被视为治疗的常规部分，或扩展到支持其他患者群体。参与者似乎很欣赏一种支持性的方法，在这种方法中，他们不会被迫进行任何活动，并且对该计划进行个性化定制以满足个人需求和能力是值得赞赏的。最初的参与可能令人生畏，但随着对该计划经验的增加，信心似乎会增强。
参与者高度重视预康复计划。在具有挑战性的时期引入预康复意味着可能需要个性化的方法来支持参与，或者可以鼓励在以后的时间参与。支持缺乏信心的个人的策略，如交友，可能是有价值的。
研究方案于 2020 年 9 月 24 日上传至开放科学框架（https://osf.io/347qj/）。
