Barriers and facilitators to participation in exercise prehabilitation before cancer surgery for older adults with frailty: a qualitative study.
Barriers and facilitators to participation in exercise prehabilitation before cancer surgery for older adults with frailty: a qualitative study.
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DOI：
10.1186/s12877-023-03990-3
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发表时间：
2023-06-06
期刊：
影响因子：
4.1
通讯作者：
McIsaac, Daniel I.
中科院分区：
文献类型：
--
作者：
Barnes, Keely;Hladkowicz, Emily;Dorrance, Kristin;Bryson, Gregory L.;Forster, Alan J.;Gagne, Sylvain;Huang, Allen;Lalu, Manoj M.;Lavallee, Luke T.;Saunders, Chelsey;Moloo, Hussein;Nantel, Julie;Power, Barbara;Scheede-Bergdahl, Celena;Taljaard, Monica;van Walraven, Carl;McCartney, Colin J. L.;McIsaac, Daniel I.
体弱的老年人手术后不良后果的风险增加。术前锻炼（运动康复）可以减少不良事件，提高术后恢复。然而，运动疗法的坚持度通常很低，尤其是在老年人中。本研究的目的是从参与随机试验干预组的虚弱老年人的角度定性评估参与运动康复的障碍和促进因素。这是一项经伦理批准的、嵌套的描述性定性研究，在一项随机对照试验中，对接受选择性癌症手术且身体虚弱（临床虚弱量表≥4）的老年患者（≥60岁）进行以家庭为基础的运动康复与标准治疗的对比。干预是在手术前至少3周的以家庭为基础的康复计划，包括有氧运动、力量和拉伸以及营养建议。在完成康复计划后，参与者被要求参加一个由理论领域框架（TDF）通知的半结构化访谈。定性分析以TDF为指导。完成了15次定性访谈。促进因素包括：1)该方案易于管理，适合身体虚弱的老年人；2)有足够的资源支持参与；3)来自他人的支持；4)控制感、内在价值、注意到进展和改善健康结果；5)该方案令人愉快，并受到以往经验的促进。障碍包括：1)已有的疾病，疲劳和基线健康，2)天气，以及3)无法锻炼时的内疚和沮丧。与会者提出了个性化和多样化的需要，因此认为这既是障碍也是促进因素。以家庭为基础的运动康复对准备接受癌症手术的老年人来说是可行和可接受的。参与者认为，以家庭为基础的项目是可管理的，易于遵循的有用资源，包括来自研究团队的宝贵支持，他们报告了自我感知的健康益处和对自己健康的控制感。未来的研究和实施应考虑基于健康和健身、社会心理支持和对有氧运动的修改以应对恶劣天气条件的个性化。在线版本包含补充材料，可在10.1186/s12877-023-03990-3获得。
Older adults with frailty are at an increased risk of adverse outcomes after surgery. Exercise before surgery (exercise prehabilitation) may reduce adverse events and improve recovery after surgery. However, adherence with exercise therapy is often low, especially in older populations. The purpose of this study was to qualitatively assess the barriers and facilitators to participating in exercise prehabilitation from the perspective of older people with frailty participating in the intervention arm of a randomized trial. This was a research ethics approved, nested descriptive qualitative study within a randomized controlled trial of home-based exercise prehabilitation vs. standard care with older patients (≥ 60 years) having elective cancer surgery, and who were living with frailty (Clinical Frailty Scale ≥ 4). The intervention was a home-based prehabilitation program for at least 3 weeks before surgery that involved aerobic activity, strength and stretching, and nutritional advice. After completing the prehabilitation program, participants were asked to partake in a semi-structured interview informed by the Theoretical Domains Framework (TDF). Qualitative analysis was guided by the TDF. Fifteen qualitative interviews were completed. Facilitators included: 1) the program being manageable and suitable to older adults with frailty, 2) adequate resources to support engagement, 3) support from others, 4) a sense of control, intrinsic value, noticing progress and improving health outcomes and 5) the program was enjoyable and facilitated by previous experience. Barriers included: 1) pre-existing conditions, fatigue and baseline fitness, 2) weather, and 3) guilt and frustration when unable to exercise. A need for individualization and variety was offered as a suggestion by participants and was therefore described as both a barrier and facilitator. Home-based exercise prehabilitation is feasible and acceptable to older people with frailty preparing for cancer surgery. Participants identified that a home-based program was manageable, easy to follow with helpful resources, included valuable support from the research team, and they reported self-perceived health benefits and a sense of control over their health. Future studies and implementation should consider increased personalization based on health and fitness, psychosocial support and modifications to aerobic exercises in response to adverse weather conditions. The online version contains supplementary material available at 10.1186/s12877-023-03990-3.
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影响因子：
3.2
作者：
Hsieh, HF;Shannon, SE
通讯作者：
Shannon, SE
影响因子：
2.9
作者：
Gillis C;Gill M;Marlett N;MacKean G;GermAnn K;Gilmour L;Nelson G;Wasylak T;Nguyen S;Araujo E;Zelinsky S;Gramlich L
通讯作者：
Gramlich L
DOI：
10.1186/s13012-017-0605-9
发表时间：
2017-06-21
期刊：
Implementation science : IS
影响因子：
--
作者：
Atkins L;Francis J;Islam R;O'Connor D;Patey A;Ivers N;Foy R;Duncan EM;Colquhoun H;Grimshaw JM;Lawton R;Michie S
通讯作者：
Michie S
影响因子：
4.6
作者：
McIsaac, D. I.;Beaule, P. E.;Van Walraven, C.
通讯作者：
Van Walraven, C.
影响因子：
9
作者：
McIsaac, Daniel I.;Taljaard, Monica;Forster, Alan J.
通讯作者：
Forster, Alan J.