The Role of Behavioral Science in Personalized Multimodal Prehabilitation in Cancer

Frontiers in Psychology

Meeke Hoedjes¹  Camille E. Short²  Judit Varkonyi-Sepp³  Imogen Fecher-Jones⁴  Chloe Grimmett⁵  Katherine Bradbury⁶  Suzanne O. Dalton⁷ 

[1] Department of Medical and Clinical Psychology, CoRPS—Center of Research on Psychological and Somatic Disorders, Tilburg University, Tilburg, Netherlands;Faculty of Medicine, Dentistry, and Health Sciences, Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia;Faculty of Medicine, Dentistry, and Health Sciences, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, VIC, Australia;NIHR Southampton Biomedical Research Center, University Hospital Southampton, Southampton, United Kingdom;Perioperative Medicine, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom;School of Health Sciences, University of Southampton, Southampton, United Kingdom;School of Psychology, University of Southampton, Southampton, United Kingdom;Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark;Department of Clinical Oncology and Palliative Services, Zealand University Hospital, Næstved, Denmark;

关键词: prehabilitaion;    behavior change;    behavioral science;    co-design;    interventions;    oncology;    cancer;   

DOI  :  10.3389/fpsyg.2021.634223

来源: Frontiers

【 摘 要 】

Multimodal prehabilitation is increasingly recognized as an important component of the pre-operative pathway in oncology. It aims to optimize physical and psychological health through delivery of a series of tailored interventions including exercise, nutrition, and psychological support. At the core of this prescription is a need for considerable health behavior change, to ensure that patients are engaged with and adhere to these interventions and experience the associated benefits. To date the prehabilitation literature has focused on testing the efficacy of devised exercise and nutritional interventions with a primary focus on physiological and mechanistic outcomes with little consideration for the role of behavioral science, supporting individual behavior change or optimizing patient engagement. Changing health behavior is complex and to maximize success, prehabilitation programs should draw on latest insights from the field of behavioral science. Behavioral science offers extensive knowledge on theories and models of health behavior change to further advance intervention effectiveness. Similarly, interventions developed with a person-centered approach, taking into consideration individual needs and preferences will increase engagement. In this article, we will provide an overview of the extent to which the existing prehabilitation literature incorporates behavioral science, as well as studies that have explored patient's attitudes toward prehabilitation. We will go on to describe and critique ongoing trials in a variety of contexts within oncology prehabilitation and discuss how current scientific knowledge may be enhanced from a behavioral science perspective. We will also consider the role of “surgery schools” and detail practical recommendations that can be embedded in existing or emerging clinical settings.

【 授权许可】

CC BY