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

The aim was to explore patients' reflections related to their choice of participating or not in a multimodal prehabilitation randomised controlled trial (RCT) in relation to minor surgery.

A qualitative study with 22 semi-structured in-depth interviews on patients awaiting ventral hernia repair was conducted between March and May 2024 and reported according to the COREQ guideline. All were eligible to participate in a prehabilitation RCT; twelve had accepted, and ten had declined. The interviews were analysed using Kirsti Malterud's method of systematic text condensation, resulting in themes.

Five global themes were identified: "time commitment", "research participation for the general good", "personal benefits of RCT participation", "ambivalence of own health and lifestyle", and "complications after surgery". All participants found the RCT and its prehabilitation programme a positive initiative. Those who had accepted to participate in the RCT emphasised personal benefits and contributing to research, while those who had declined expressed more ambivalence regarding lifestyle change, the extent of personal advantage, and prioritising of time.

Those who declined RCT participation generally had more elaborate and ambivalent reflections than those who had accepted. Addressing ambivalence regarding lifestyle change, personal benefits, and prioritising time might be a relevant focus point for increasing inclusion rates in prehabilitation RCTs and in clinical practice to increase patients' readiness for lifestyle change.