Empowering Recovery: A Co-Designed Intervention to Transform Care for Operable Lung Cancer

IF 3 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Health Expectations Pub Date : 2025-04-05 DOI:10.1111/hex.70196

Georgina A. Whish-Wilson, Lara Edbrooke, Vinicius Cavalheri, Zoe T. Calulo Rivera, Madeline Cavallaro, Daniel R. Seller, Catherine L. Granger, Selina M. Parry

{"title":"Empowering Recovery: A Co-Designed Intervention to Transform Care for Operable Lung Cancer","authors":"Georgina A. Whish-Wilson, Lara Edbrooke, Vinicius Cavalheri, Zoe T. Calulo Rivera, Madeline Cavallaro, Daniel R. Seller, Catherine L. Granger, Selina M. Parry","doi":"10.1111/hex.70196","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Patients undergoing surgery for lung cancer experience significant symptom burden and physical impairments. Exercise rehabilitation programmes have been shown to improve symptoms and aid recovery, however, implementation into routine practice has proven challenging.</p>\n </section>\n \n <section>\n \n <h3> Objective</h3>\n \n <p>To develop a robust understanding of the key design requirements of an exercise-based pre- and post-operative rehabilitation prototype intervention designed to support patients with operable lung cancer prepare for and recover from thoracic surgery, and co-design an acceptable intervention prototype with key stakeholders.</p>\n </section>\n \n <section>\n \n <h3> Design, Setting and Participants</h3>\n \n <p>An experience-based co-design (EBCD) study involving patients, caregivers, clinicians, consumer advocates and researchers from across Australia. Two rounds of EBCD workshops were held between November 2023 and May 2024. Workshops were underpinned by the COM-B Model and Theoretical Domains Framework. Qualitative data were thematically analysed by two independent researchers. Identified barriers and facilitators were mapped to the Behaviour Change Wheel, and used to develop the final intervention prototype, which was presented using the Template for Intervention Description and Replication (TIDieR) guide.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Eleven patients (55% female, mean age 66.4 (±9.3) years), one caregiver, and 16 professionals (physiotherapists, nurses, respiratory physicians, a thoracic surgeon, consumer advocates and researchers) participated. Retention between workshop rounds was high (86%). Nineteen major themes were developed, including unmet education needs; the link between mental health and recovery; and the influence of unexpected, persistent symptoms and functional decline. Core intervention principles included flexibility, individualisation and continuity. Essential components included screening/assessment, education, exercise, behaviour change, and mental health support. The intervention prototype was refined in the second workshop round.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>This EBCD study successfully identified key experiences and barriers in preparing for and recovering from lung cancer surgery and engaged stakeholders in complex intervention design, culminating in the development of a flexible, multi-modal pre- and post-operative rehabilitation programme prototype. Future projects will evaluate the prototype acceptability and feasibility.</p>\n </section>\n \n <section>\n \n <h3> Patient or Public Contribution</h3>\n \n <p>Past patients and their caregivers with lived experience of undergoing/caring for someone undergoing lung cancer surgery, and multidisciplinary professionals, participated in co-design workshops to develop and refine the exercise-based rehabilitation intervention goals, priorities, and prototype.</p>\n </section>\n </div>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 2","pages":""},"PeriodicalIF":3.0000,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70196","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health Expectations","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/hex.70196","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Patients undergoing surgery for lung cancer experience significant symptom burden and physical impairments. Exercise rehabilitation programmes have been shown to improve symptoms and aid recovery, however, implementation into routine practice has proven challenging.

Objective

To develop a robust understanding of the key design requirements of an exercise-based pre- and post-operative rehabilitation prototype intervention designed to support patients with operable lung cancer prepare for and recover from thoracic surgery, and co-design an acceptable intervention prototype with key stakeholders.

Design, Setting and Participants

An experience-based co-design (EBCD) study involving patients, caregivers, clinicians, consumer advocates and researchers from across Australia. Two rounds of EBCD workshops were held between November 2023 and May 2024. Workshops were underpinned by the COM-B Model and Theoretical Domains Framework. Qualitative data were thematically analysed by two independent researchers. Identified barriers and facilitators were mapped to the Behaviour Change Wheel, and used to develop the final intervention prototype, which was presented using the Template for Intervention Description and Replication (TIDieR) guide.

Results

Eleven patients (55% female, mean age 66.4 (±9.3) years), one caregiver, and 16 professionals (physiotherapists, nurses, respiratory physicians, a thoracic surgeon, consumer advocates and researchers) participated. Retention between workshop rounds was high (86%). Nineteen major themes were developed, including unmet education needs; the link between mental health and recovery; and the influence of unexpected, persistent symptoms and functional decline. Core intervention principles included flexibility, individualisation and continuity. Essential components included screening/assessment, education, exercise, behaviour change, and mental health support. The intervention prototype was refined in the second workshop round.

Conclusions

This EBCD study successfully identified key experiences and barriers in preparing for and recovering from lung cancer surgery and engaged stakeholders in complex intervention design, culminating in the development of a flexible, multi-modal pre- and post-operative rehabilitation programme prototype. Future projects will evaluate the prototype acceptability and feasibility.

Patient or Public Contribution

Past patients and their caregivers with lived experience of undergoing/caring for someone undergoing lung cancer surgery, and multidisciplinary professionals, participated in co-design workshops to develop and refine the exercise-based rehabilitation intervention goals, priorities, and prototype.

Abstract Image

查看原文本刊更多论文

授权恢复：一个共同设计的干预措施，以改变可手术肺癌的护理

背景肺癌手术患者有明显的症状负担和身体损伤。运动康复方案已被证明可以改善症状并帮助康复，然而，将其付诸日常实践已被证明具有挑战性。目的了解基于运动的可手术肺癌患者术前和术后康复原型干预的关键设计要求，并与关键利益相关者共同设计可接受的干预原型。设计、设置和参与者一项基于经验的共同设计（EBCD）研究，涉及来自澳大利亚各地的患者、护理人员、临床医生、消费者倡导者和研究人员。两轮EBCD工作坊于2023年11月至2024年5月期间举行。研讨会以COM-B模型和理论领域框架为基础。定性数据由两位独立研究人员进行主题分析。已确定的障碍和促进因素被映射到行为改变轮，并用于开发最终的干预原型，该原型使用干预描述和复制模板（TIDieR）指南提出。结果11名患者（55%为女性，平均年龄66.4（±9.3）岁），1名护理人员，16名专业人员（物理治疗师，护士，呼吸内科医生，胸外科医生，消费者权益倡导者和研究人员）参与。工作坊之间的保留率很高（86%）。制定了19个主要主题，包括未满足的教育需求；心理健康与康复之间的联系；以及意外的、持续的症状和功能下降的影响。核心干预原则包括灵活性、个性化和连续性。基本组成部分包括筛查/评估、教育、锻炼、行为改变和心理健康支持。干预原型在第二轮研讨会中得到完善。这项EBCD研究成功地确定了肺癌手术准备和术后恢复的关键经验和障碍，并让利益相关者参与复杂的干预设计，最终开发了一个灵活的、多模式的术前和术后康复方案原型。未来的项目将评估原型的可接受性和可行性。患者或公众贡献有过肺癌手术经历的患者及其护理人员，以及多学科专业人员，参与了共同设计研讨会，以制定和完善基于运动的康复干预目标、优先事项和原型。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Health Expectations 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.20

自引率

9.40%

发文量

251

审稿时长

>12 weeks

期刊介绍： Health Expectations promotes critical thinking and informed debate about all aspects of patient and public involvement and engagement (PPIE) in health and social care, health policy and health services research including: • Person-centred care and quality improvement • Patients'' participation in decisions about disease prevention and management • Public perceptions of health services • Citizen involvement in health care policy making and priority-setting • Methods for monitoring and evaluating participation • Empowerment and consumerism • Patients'' role in safety and quality • Patient and public role in health services research • Co-production (researchers working with patients and the public) of research, health care and policy Health Expectations is a quarterly, peer-reviewed journal publishing original research, review articles and critical commentaries. It includes papers which clarify concepts, develop theories, and critically analyse and evaluate specific policies and practices. The Journal provides an inter-disciplinary and international forum in which researchers (including PPIE researchers) from a range of backgrounds and expertise can present their work to other researchers, policy-makers, health care professionals, managers, patients and consumer advocates.