[Influencing Factors of Adherence to Exercise Prehabilitation in Older Patients With Colorectal Cancer: A Qualitative Study]

Overview

Journal Sichuan Da Xue Xue Bao Yi Xue Ban

Specialty General Medicine

Date 2023 Aug 7

PMID 37545079

Authors

Xiayun Wang

Xiaoping Zhu

Qian Wu

Affiliations

Soon will be listed here.

Abstract

Objective: To investigate the influencing factors of adherence to exercise prehabilitation in older patients with colorectal cancer.

Methods: Based on the capacity, opportunity, and motivation of behavior change (COM-B) model, 12 older colorectal tumors patients undergoing elective surgeries at a tertiary-care hospital in Shanghai between August 2022 and December 2022 were enrolled for the study through purposive sampling. The respondents were involved in semi-structured interviews. Directed content analysis of their data was conducted to extract themes.

Results: A total of 3 themes and 8 sub-themes were deduced from the analysis, including capacity (physical ability to tolerate exercise intensity and psychological experience of worrying about exercise risks), opportunity (adequate information support and professional guidance and simple and feasible exercise prescriptions and prehabilitation conditions), motivation (the intrinsic drive to identify with the prehabilitation values, the positive drive of inherent exercise habits, the continuous drive of exercise benefits, and the dual inspiration of team spirit and family support). These themes and subthemes were identified as influencing factors of adherence to exercise prehabilitation in older patients with colorectal cancer.

Conclusion: Prehabilitation in older patients with colorectal cancer is influenced by multiple factors. Healthcare professionals should enhance education, develop individualized prehabilitation programs, and improve the diversified social support system to enhance patients' adherence to prehabilitation exercise and maximize the benefits of prehabilitation.

References

Kerr C, Nixon A, Wild D . Assessing and demonstrating data saturation in qualitative inquiry supporting patient-reported outcomes research. Expert Rev Pharmacoecon Outcomes Res. 2010; 10(3):269-81. DOI: 10.1586/erp.10.30. View

Li Z, Lu S, Kong C, Sun W, Wang P, Zhang S . Impact of Compliance with an Enhanced Recovery After Surgery Program on the Outcomes Among Elderly Patients Undergoing Lumbar Fusion Surgery. Clin Interv Aging. 2020; 15:2423-2430. PMC: 7769084. DOI: 10.2147/CIA.S286007. View

Perry R, Herbert G, Atkinson C, England C, Northstone K, Baos S . Pre-admission interventions (prehabilitation) to improve outcome after major elective surgery: a systematic review and meta-analysis. BMJ Open. 2021; 11(9):e050806. PMC: 8487197. DOI: 10.1136/bmjopen-2021-050806. View

Hsieh H, Shannon S . Three approaches to qualitative content analysis. Qual Health Res. 2005; 15(9):1277-88. DOI: 10.1177/1049732305276687. View

Smeuninx B, Elhassan Y, Manolopoulos K, Sapey E, Rushton A, Edwards S . The effect of short-term exercise prehabilitation on skeletal muscle protein synthesis and atrophy during bed rest in older men. J Cachexia Sarcopenia Muscle. 2020; 12(1):52-69. PMC: 7890266. DOI: 10.1002/jcsm.12661. View

Warehime S, Dinkel D, Alonso W, Pozehl B . Long-term exercise adherence in patients with heart failure: A qualitative study. Heart Lung. 2020; 49(6):696-701. PMC: 7669664. DOI: 10.1016/j.hrtlng.2020.08.016. View

Ferreira V, Agnihotram R, Bergdahl A, van Rooijen S, Awasthi R, Carli F . Maximizing patient adherence to prehabilitation: what do the patients say?. Support Care Cancer. 2018; 26(8):2717-2723. DOI: 10.1007/s00520-018-4109-1. View

Beck A, Thaysen H, Hasselholt Soegaard C, Blaakaer J, Seibaek L . What matters to you? An investigation of patients' perspectives on and acceptability of prehabilitation in major cancer surgery. Eur J Cancer Care (Engl). 2021; 30(6):e13475. DOI: 10.1111/ecc.13475. View

Bojesen R, Jorgensen L, Grube C, Skou S, Johansen C, Dalton S . Fit for Surgery-feasibility of short-course multimodal individualized prehabilitation in high-risk frail colon cancer patients prior to surgery. Pilot Feasibility Stud. 2022; 8(1):11. PMC: 8781359. DOI: 10.1186/s40814-022-00967-8. View

10.

Michie S, van Stralen M, West R . The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci. 2011; 6:42. PMC: 3096582. DOI: 10.1186/1748-5908-6-42. View

11.

Carli F, Bousquet-Dion G, Awasthi R, Elsherbini N, Liberman S, Boutros M . Effect of Multimodal Prehabilitation vs Postoperative Rehabilitation on 30-Day Postoperative Complications for Frail Patients Undergoing Resection of Colorectal Cancer: A Randomized Clinical Trial. JAMA Surg. 2020; 155(3):233-242. PMC: 6990653. DOI: 10.1001/jamasurg.2019.5474. View

12.

Karlsson E, Dahl O, Rydwik E, Nygren-Bonnier M, Bergenmar M . Older patients' attitudes towards, and perceptions of, preoperative physical activity and exercise prior to colorectal cancer surgery-a gap between awareness and action. Support Care Cancer. 2019; 28(8):3945-3953. PMC: 7316666. DOI: 10.1007/s00520-019-05237-7. View

13.

Zhou Y . [Prehabilitation for gastrointestinal cancer patients]. Zhonghua Wei Chang Wai Ke Za Zhi. 2021; 24(2):122-127. DOI: 10.3760/cma.j.cn.441530-20200318-00152. View

14.

Fracol M, Teven C, Selimos B, Wier S, Stockslager C, Schoenfeldt J . Pushing the DIEP Envelope with ERAS: 24 Hour Discharge is Safe in Appropriately Selected Patients. Plast Reconstr Surg Glob Open. 2023; 11(6):e5070. PMC: 10313246. DOI: 10.1097/GOX.0000000000005070. View

15.

Thomas G, Tahir M, Bongers B, Kallen V, Slooter G, van Meeteren N . Prehabilitation before major intra-abdominal cancer surgery: A systematic review of randomised controlled trials. Eur J Anaesthesiol. 2019; 36(12):933-945. PMC: 6855314. DOI: 10.1097/EJA.0000000000001030. View

16.

Garcia-Botello S, Martin-Arevalo J, Cozar-Lozano C, Benitez-Riesco A, Moro-Valdezate D, Pla-Marti V . Does delaying curative surgery for colorectal cancer influence long-term disease-free survival? A cohort study. Langenbecks Arch Surg. 2021; 406(7):2383-2390. PMC: 8272683. DOI: 10.1007/s00423-021-02251-4. View

17.

Li C, Carli F, Lee L, Charlebois P, Stein B, Liberman A . Impact of a trimodal prehabilitation program on functional recovery after colorectal cancer surgery: a pilot study. Surg Endosc. 2012; 27(4):1072-82. DOI: 10.1007/s00464-012-2560-5. View

18.

Britton-Jones C . Prehabilitation. Br J Hosp Med (Lond). 2017; 78(12):729. DOI: 10.12968/hmed.2017.78.12.729. View

19.

Kimura C, Bidwell S, Shankar K, Shelton E, Shelton A, Kin C . Adherence to a Home-Based Prehabilitation Program for Patients Undergoing Colorectal Surgery. J Gastrointest Surg. 2022; 27(3):565-567. DOI: 10.1007/s11605-022-05446-2. View

20.

Latrille M, Buchs N, Ris F, Koessler T . Physical activity programmes for patients undergoing neo-adjuvant chemoradiotherapy for rectal cancer: A systematic review and meta-analysis. Medicine (Baltimore). 2021; 100(51):e27754. PMC: 8702187. DOI: 10.1097/MD.0000000000027754. View