Zhang Rui, Wu Mei, Cheng Yun, Zhao Liting, Xu Yamin, Xia Lu
Faculty of Health Services, Naval Medical University, Shanghai, China.
Department of Nursing, Huadong Hospital, Fudan University, Shanghai, China.
BMC Nurs. 2025 May 12;24(1):517. doi: 10.1186/s12912-025-03153-2.
Understanding the barriers and facilitators of prehabilitation in elderly patients with early-stage lung cancer is of significant importance. This study aimed to elucidate these barriers and facilitators from the perspectives of different clinical professionals.
A qualitative descriptive study was undertaken. Semi-structured interviews with clinical professionals, using purposive sampling and content analysis were conducted in March to May 2023 to summarize and refine the key themes.
From the perspective of clinical professionals, the facilitators of prehabilitation have been categorized into five major themes. These include the recognized importance of prehabilitation, the positive attitude of clinical professionals, the support of leadership, the willingness of the majority of patients to accept prehabilitation, and the initial implementation of an enhanced recovery after surgery - multidisciplinary team (ERAS-MDT) approach. Conversely, clinical professionals identify several barriers to prehabilitation, which are grouped into seven themes. These impediments encompass a lack of knowledge regarding clinical practice, insufficient preoperative preparation time, the absence of an aging-friendly clinical practice scheme, an immature multidisciplinary cooperation mechanism, a lack of explicit regulations, inadequate emergency safeguards, and a shortage of specialized professionals. Practice strategies for promoting prehabilitation in elderly patients with early lung cancer include development of evidence summaries, develop healthcare training materials, develop patient health education brochures, clarify the division of labor of ERAS-MDT, improve patient safety and monitoring measures, optimize practice flow and obtain funding support.
To enhance the feasibility and clinical relevance of prehabilitation, clinical professionals should consider establishing a multidisciplinary information consulting team, developing a comprehensive prehabilitation program, and reinforcing the support system prior to surgery.
了解老年早期肺癌患者术前康复的障碍和促进因素具有重要意义。本研究旨在从不同临床专业人员的角度阐明这些障碍和促进因素。
进行了一项定性描述性研究。2023年3月至5月，采用目的抽样和内容分析法对临床专业人员进行了半结构化访谈，以总结和提炼关键主题。
从临床专业人员的角度来看，术前康复的促进因素可分为五个主要主题。这些包括对术前康复公认的重要性、临床专业人员的积极态度、领导的支持、大多数患者接受术前康复的意愿以及术后加速康复——多学科团队（ERAS-MDT）方法的初步实施。相反，临床专业人员确定了术前康复的几个障碍，这些障碍分为七个主题。这些障碍包括临床实践知识不足、术前准备时间不足、缺乏适合老年人的临床实践方案、多学科合作机制不成熟、缺乏明确规定、应急保障不足以及专业人员短缺。促进老年早期肺癌患者术前康复的实践策略包括制定证据摘要、开发医疗培训材料、编写患者健康教育手册、明确ERAS-MDT的分工、改善患者安全和监测措施、优化实践流程并获得资金支持。
为提高术前康复的可行性和临床相关性，临床专业人员应考虑建立多学科信息咨询团队，制定全面的术前康复计划，并在手术前加强支持系统。
