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

This study aimed to reveal information that can be used for composing a prehabilitation program tailored to elderly gynecological oncological patients and is applicable to healthcare professionals. We investigated possible content and indications for prehabilitation, and what potential barriers might exist.
Because of the primary exploratory study aim, inductive thematic template analysis on semi-structured interviews with gynecologic oncological patients aged ≥60 years and healthcare professionals were used.
16 patients and 20 healthcare professionals were interviewed. Three themes important for prehabilitation were found: (1) “Motivation,” (2) “Practical issues and facilitators,” and (3) “Patient-related factors.” A short time interval between diagnosis and surgery was reported as a potential barrier for prehabilitation. Given components for a tailor-made prehabilitation program are: (1) The first contact with a nurse who screens the patients, gives tailor-made advice on prehabilitation and keeps patients motivated and supports them mentally; (2) If patients are referred to a more extensive/supervised program, this should preferably be arranged close to a patients’ home.
Based on our findings, an outline of a patient-tailored prehabilitation program was developed. The main important themes for prehabilitation were “Motivation,” “Practical issues and facilitators,” and “Patient-related factors.”IMPLICATIONS FOR REHABILITATION
Patients and healthcare professionals are positive about prehabilitation.
Main themes for designing a prehabilitation program are “Motivation,” “Practical issues and facilitators,” and “Patient-related factors.”
Nursing staff can play a key role in prehabilitation.
It is important to screen patients for specific impairments to obtain a tailor-made prehabilitation program.
For some patients, general advice on prehabilitation might be sufficient, while others may need more supervision.
The time interval between diagnosis and surgery is often short and is perceived as a potentially significant barrier for an effective prehabilitation program.

Patients and healthcare professionals are positive about prehabilitation.
Main themes for designing a prehabilitation program are “Motivation,” “Practical issues and facilitators,” and “Patient-related factors.”
Nursing staff can play a key role in prehabilitation.
It is important to screen patients for specific impairments to obtain a tailor-made prehabilitation program.
For some patients, general advice on prehabilitation might be sufficient, while others may need more supervision.
The time interval between diagnosis and surgery is often short and is perceived as a potentially significant barrier for an effective prehabilitation program.