EXPLORING THE BARRIERS AND FACILITATORS FOR AN UPPER GASTROINTESTINAL PREHABILITATION SERVICE

Abstract

Background: To establish the barriers and facilitators for key stakeholders in implementing and engaging in a prehabilitation service. Methods: This was an evaluation conducted at a tertiary cancer hospital. Using semi structured interviews, we explored healthcare professionals’ and patient experiences of a pilot prehabilitation program run in 2019 as well as eliciting their overall views of implementing and engaging in prehabilitation. Transcripts were analyzed using thematic analysis. Results: Seven healthcare professionals and four patients participated in interviews. There was one facilitator common to patients and healthcare professionals: knowledge. Ongoing support and appointment type were facilitators for patients, while multidisciplinary working and development opportunities were key to engagement for healthcare professionals. There was one common barrier for both healthcare professionals and patients – the emotional impact of diagnosis. Additional barriers for patients included the impact of neoadjuvant treatment and additional travel, while healthcare professional barriers were staff buy in, setting expectations and capacity. Conclusion: This study concurs with current documented barriers to implementation of prehabilitation. Key facilitators were identified, which had not been previously reported in the literature, particularly for healthcare professionals. These should be considered when implementing prehabilitation as they provide an opportunity to optimize the success of a program.

Keywords

• barriers
• facilitators
• prehabilitation
• patients
• healthcare professionals
• gastrointestinal surgery