Prehabilitation in Ovarian Cancer: Patients' Experiences and Views
Research type
Research Study
Full title
A qualitative exploration of views, experiences, facilitators and barriers surrounding prehabilitation in a diverse cohort of advanced ovarian cancer patients.
IRAS ID
304833
Contact name
Mary Wells
Contact email
Sponsor organisation
Imperial College London
Duration of Study in the UK
0 years, 5 months, 28 days
Research summary
Research Summary
Prehabilitation is a process of preparing patients for cancer treatment by supporting them to improve their emotional and physical health and wellbeing before surgery, chemotherapy or radiotherapy. Research has shown that prehabilitation programmes can successfully improve patient outcomes following surgery for certain cancers, including shorter length of stay in hospital, reduced post-operative complications and therefore cost-saving for the NHS. However, little is known about the most appropriate prehabilitation strategies for ovarian cancer patients, who usually require a large abdominal operation and other treatments, with potentially life-long impacts.
Several research teams have set out to explore the thoughts and opinions of cancer patients around prehabilitation but very few have asked an ethnically diverse group of patients with ovarian cancer. This study plans to fill that research gap by gaining in-depth insights from women with advanced ovarian cancer, who represent a diverse population.
Women of different ages, demographics and ethnicities with advanced ovarian cancer (Stage 3 or 4) at Imperial College Healthcare NHS Trust will be identified and approached either before or after their major surgery. Another group of patients who are taking part in a prehabilitation programme called the "Marsden Mile" at the Royal Marsden Hospital, will also be approached.
Following informed consent, participants will be interviewed using a semi-structured topic guide either face-face, virtually (using Microsoft Teams) or over the telephone. They will be asked questions about how they prepared for surgery and what might have helped them to improve their health, fitness and wellbeing during the period before surgery. They will also be asked for their views on prehabilitation and what might support or discourage them to participate in a prehabilitation programme.
Audio recordings of the interviews will be transcribed and analysed for key themes, which can help inform a patient-centred model for ovarian cancer prehabilitation.Summary of Results
A qualitative interview study was undertaken with 21 women who had advanced ovarian cancer. Women were interviewed about their experiences and/or thoughts and views of prehabilitation (defined as 'preparing the body and mind for treatment'), so that these insights could be used to help design the most appropriate prehabilitation programme for use in the NHS. Nine women were due to have surgery for their cancer and twelve had completed surgery. Nine women had taken part in a prehabilitation programme, which consisted of exercise, dietary and psychological advice. Twelve women had not had any experience of prehabilitation.
Those interviewed included women aged between 46 and 72, eight of whom were from minority ethnic groups.
Interviews were recorded and transcribed, then analysed using a technique called 'thematic analysis', whereby women's views and experiences were looked at in detail and sorted into the most important and common aspects that need to be considered in the design of a prehabilitation programme for women with ovarian cancer. The four 'themes' were:
(1) Mindset; (2) Actual preparation; (3) Support system; and (4) Delivery of prehabilitation. The first theme - Mindset - showed that most women wanted to be as healthy as possible before their treatment and welcomed the idea of a prehabilitation programme, provided it was explained properly and took into consideration their own goals for recovery from treatment. The second theme - Actual preparation - showed that many women already tried to improve their fitness and diet in the lead up to surgery. Not all were sure that they would benefit from specific psychological preparation, but felt that it should be provided quickly if it was needed. Many expressed a need to prepare for surgery by sorting out aspects of life that were not related to exercise, diet or their own mental health, for example writing wills, financial issues, family needs. The third theme - Support system - showed how valuable women found it to have support from family and friends as well as health care professionals in the lead up to surgery. Many also talked about the role of faith in helping them prepare for treatment. The final theme - Delivery of prehabilitation - showed that women differed in their views of what they would find most useful. For example, some preferred the idea of attending prehabilitation in person rather than online (via internet, video or phone). Although many thought written information was helpful, most felt the need for personal contact with health care professionals as well. The results of our study show that women with ovarian cancer feel positive about prehabilitation, but that any programme needs to take into consideration the needs, beliefs, goals and mindsets of individuals.REC name
North East - Newcastle & North Tyneside 2 Research Ethics Committee
REC reference
21/NE/0231
Date of REC Opinion
21 Dec 2021
REC opinion
Further Information Favourable Opinion