Prehabilitation in cancer care: Patients’ ability to prepare for major abdominal surgery

Background:Patients’ perspectives on standardised, multi-modal prehabilitation programmes showed barriers toadherence. Further investigation of patients’ ability toprepare is needed.Aim:To investigate what patients with cancer who weredue to undergo major abdominal surgeryactually wereable to dowhen provided with preoperative, home-based, multimodal recommendations presented in aleaflet.Methods:Patients from the colorectal- or ovarian cancercentre, who were scheduled for major abdominal sur-gery, received a leaflet with preoperative recommenda-tions. On a daily basis, the patients filled in what theyhad completed in relation to these recommendations, sothat adherence could be investigated. Additionally, face-to-face interviews were conducted to evaluate patients’experiences of using the leaflet. Malterud’s principles ofsystematic text condensation were used to analyse theinterviews. A convergent design was used to merge thequantitative and qualitative data into a combined inter-pretation presented in the discussion.Results:A total of 53 patients returned a completed leaf-let, and five patients were interviewed. In the combinedinterpretation, patients’ ability to prepare was presentedthrough four major domains. The domains wereadherenceand the importance of support, manageable actions leading tochange, preparation in a broader perspective and impedimentsto preparation and to symptom relief.Conclusions:Patients prepared themselves in various ways,which were not limited to recommendations inspired bymultimodal prehabilitation. Patients from the ovariancancer centre increased their weekly exercise during thepreoperative period, which indicates that the leaflet notonly functioned as a data collection tool, but also moti-vated and supported the patients in prehabilitation-re-lated actions. Patients’ perspectives on prehabilitationneed to be taken into account, when aiming to enhancepatient-centredness and adherence