Prehabilitation: Care Challenges and Technological Opportunities

Zhu, Haining; Moffa, Zachary J.; Gui, Xinning; Carroll, John M.

doi:10.1145/3313831.3376594

Cited by 6 publications

(5 citation statements)

References 52 publications

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“…Interventions produced a moderate effect on anxiety. This is in line with research trends, which indicate a positive effect of prehabilitation on anxiety 25 . Similar to functional capacity and exercise, anxiety measures were only represented within the unimodal psychological interventions.…”

Section: Discussionsupporting

confidence: 87%

“…This is in line with research trends, which indicate a positive effect of prehabilitation on anxiety. 25 Similar to functional capacity and exercise, anxiety measures were only represented within the unimodal psychological interventions. It is interesting to note that only one exercise intervention 47 employed a measure of anxiety, as that previous literature indicates that exercise can aid in alleviating preoperative anxiety 68 and therefore would been expected as an included outcome.…”

Section: Discussionmentioning

confidence: 99%

“… 23 Evidence suggests that even short forms of psychological interventions are effective at reducing depression and fatigue post‐surgery, compared to care as usual. 24 Psychological benefits can include increased resilience against anxiety, depression and cancer‐related cognitive impairment, 25 , 26 , 27 , 28 as well as an increase in HrQoL. 29 Evidence suggests that the combination of two or more interventions, either bimodal or multimodal prehabilitation, increases efficacy.…”

mentioning

confidence: 99%

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The impact of prehabilitation interventions on affective and functional outcomes for young to midlife adult cancer patients: A systematic review

et al. 2022

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Objective: Cancer remains one of the most enduring health crises of the modern world. Prehabilitation is a relatively new intervention aimed at preparing individuals for the stresses associated with treatment from diagnosis. Prehabilitation can include exercise, psychological and nutrition-based interventions. The present systematic review aimed to assess the efficacy of prehabilitation on affective and functional outcomes for young to midlife adult cancer patients (18-55 years). Outcomes of interest included prehabilitation programme composition, duration, mode of delivery and measures used to determine impact on affective and functional outcomes. Methods: The following databases were searched with controlled and free text vocabulary; Psychological Information database (PsychINFO), Culmunated Index to Nursing and Allied Health Literature (CINAHL), Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica Database (EMBASE) andPublic MEDLINE (PubMed). Abstract and full-text screening was conducted with a secondary reviewer and final texts were subject to risk of bias analysis.Results: Thirteen texts were included at full-text. These included data of 797 prehabilitation participants (mean age 53 years) and a large representation of female participants (71% average). Evidence was found for the efficacy of psychological prehabilitation for anxiety reduction. Prehabilitation did not significantly affect health related quality of life. Findings moderately supported the therapeutic validity of exercise prehabilitation for functional outcomes, both in terms of clinical and experimental improvement with respect to the quality of evidence. Variation between all prehabilitation types was observed. There was insufficient evidence to support the efficacy of psychological prehabilitation on stress, distress or depression. Conclusion:Implications for future research are highlighted and then discussed with respect to this young to midlife age group.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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The impact of prehabilitation interventions on affective and functional outcomes for young to midlife adult cancer patients: A systematic review

et al. 2022

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“…The information gathered in this study will support the development and guidance of future preoperative online applications for patients undergoing cancer surgery. Evidence suggests that adherence to unsupervised programs that are delivered at home is poor when compared to face-to-face programs [37]. This has detrimental effects on patients' well-being and clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

Consumer Perspectives on the Adoption of a Prehabilitation Multimodal Online Program for Patients Undergoing Cancer Surgery

Steffens,

Denehy,

Solomon

et al. 2023

Cancers

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This study aimed to explore patients’ perspectives on the adoption of a prehabilitation multimodal online program. Patients recovering from gastrointestinal cancer surgery at a tertiary hospital between October 2021 and November 2022 were invited to participate. An e-Health program including intensity exercises, nutrition and psychological counselling was used. Patients were instructed to navigate the e-Health program over 24 h using an iPad and then complete the study survey. Patients’ characteristics, use of technology, views and minimal expected outcomes from a preoperative online program were collected. Of the 30 patients included, most were female, most reported confidence in the use of technology, most considered the online program safe and most agreed it would be beneficial for their health. “Poor preoperative health” and “lack of motivation and encouragement” were identified as the main barriers to the uptake of a preoperative online program, while program ‘simplicity’ and perceived ‘benefits’ were the main facilitators. Significant improvement in postoperative outcomes is perceived to influence patients’ willingness to participate in a preoperative multimodal e-Health program. Gastrointestinal cancer patients perceived the adoption of a preoperative multimodal e-Health application as safe to be performed at home and of potential benefit to their health. A range of patient’s characteristics, barriers and facilitators to the uptake of an online program were identified. These should be considered in future preoperative multimodal online programs to enhance patient experience, adherence and efficacy. The safety and efficacy of the online prehabilitation program will need to be determined in a larger randomized controlled trial.

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“…HCPs need more support, tools, and incentives from upper management to integrate PGHD into clinical care practices. HCPs feel that although activity monitoring tools could help to streamline means of collecting data, "current activity monitoring tools are insufficient to address program specific prehabilitation assessment needs; to exacerbate this challenge, stakeholder tailored tools do not currently exist" [40]. Regarding clinical workflow, HCPs feel that PGHD could be beneficial in allowing them to review PATs' conduct to prepare for consultations beforehand, leading to better consultations.…”

Section: Organizational Factorsmentioning

confidence: 99%

Barriers and Enablers in Integrating Patient-Generated Health Data for Shared Decision-Making Between Healthcare Professionals and Patients: A Scoping Review (Preprint)

V S Pakianathan,

Kumar,

Jayatissa

et al. 2024

Preprint

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BACKGROUND Advancements in technologies and increased adoption of wearables and smartphones by individuals have led to an abundance of patient-generated healthcare data. These data, when used effectively, could help to further augment the process of shared decision-making to enable patient-centred care. However, the possible utilization of patient-generated (health) data (PGHD) introduces complexities and challenges which warrant considering both health care professional and patient perspectives. OBJECTIVE Summarize the relevant works in the past 10 years from the perspectives of the key stakeholders – healthcare professionals (HCPs) and patients (PATs) - on potential barriers and enablers to the integration of PGHD for shared decision-making. By looking at both perspectives, we are able to identify the key challenges and opportunities with PGHD throughout the patient’s journey. METHODS Electronic searches were done 3 databases – PubMed, ACM Digital Library and IEEE. Enablers and barriers mentioned by the stakeholders in included papers were extracted. Thematic analysis was performed using a qualitative analysis software, MaxQDA. The six-stage workflow model initially proposed by West at al was used as a reference for deductive coding. Subsequently, considering barriers and enablers faced by both the HCPs and PATs uncovered various tensions and alignments of perspectives which could be addressed in future work and can inform concepts, designs and development in the area of PGHD for shared decision-making. RESULTS Fifty-three publications were included in the scoping review. Six main overarching themes for barriers and enablers were identified: 1) Patient-Provider Relationship, 2) Patient Characteristics, 3) Organizational Factors, 4) Medical Ethics and Law, 5) Data-driven workflow and 6) Design and Technology. The six-stage workflow was further expanded based on the new findings.to include four additional stages which include contextual considerations outside of traditional clinical environments. In addition to partially corroborating previously established barriers in the six-stage workflow model, several new barriers and enablers were identified throughout all stages. This model helps to further align needs of HCPs and PATs beyond the clinical setting and could benefit system designers who plan to integrate DHTs involving PGHD for shared decision making. CONCLUSIONS This scoping review demonstrates that there are several factors to consider for effectively integrating PGHD in health-related shared decision-making. Notably, such factors extend outside the boundaries of traditional clinical settings. Although there is agreement between HCPs and PATs on certain factors, there are also tensions to be addressed. Our findings suggest that apart from lifting the barriers to the integration of PGHD, there can be a role for digital health technologies in mediating alignment between HCPs and PATs on effectively using PGHD for SDM.

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Prehabilitation: Care Challenges and Technological Opportunities

Cited by 6 publications

References 52 publications

The impact of prehabilitation interventions on affective and functional outcomes for young to midlife adult cancer patients: A systematic review

The impact of prehabilitation interventions on affective and functional outcomes for young to midlife adult cancer patients: A systematic review

Consumer Perspectives on the Adoption of a Prehabilitation Multimodal Online Program for Patients Undergoing Cancer Surgery

Barriers and Enablers in Integrating Patient-Generated Health Data for Shared Decision-Making Between Healthcare Professionals and Patients: A Scoping Review (Preprint)

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