Patient Reflections on Participation in a Randomised Controlled Multimodal Prehabilitation Trial Before Ventral...

Area of Science:

• Surgical patient experience
• Health services research
• Qualitative research methodology

Background:

• Investigating patient perspectives on participating in a multimodal prehabilitation randomized controlled trial (RCT) for minor surgery.
• Understanding patient decision-making processes regarding prehabilitation interventions.

Purpose of the Study:

• To explore patient reflections on their choices to participate or decline a prehabilitation RCT.
• To identify factors influencing patient recruitment into prehabilitation trials.

Main Methods:

• Qualitative study involving 22 semi-structured interviews with patients undergoing ventral hernia repair.
• Interviews analyzed using systematic text condensation (Kirsti Malterud's method).
• Participants included those who accepted (n=12) and declined (n=10) prehabilitation RCT participation.

Main Results:

• Five themes emerged: time commitment, research for general good, personal benefits, health/lifestyle ambivalence, and surgical complications.
• Participants viewed the prehabilitation program positively.
• Those declining expressed more ambivalence regarding lifestyle changes, personal benefits, and time prioritization.

Conclusions:

• Patients declining RCT participation showed more complex and ambivalent reflections than those who accepted.
• Addressing patient ambivalence about lifestyle changes, personal benefits, and time is crucial for improving prehabilitation RCT recruitment.
• Enhancing patient readiness for lifestyle changes can be supported by focusing on these ambivalent factors in clinical practice.