The Acceptability and Experiences of Participating in a Preoperative Intentional Weight-Loss Programme From Diagnosis to Surgery for Colorectal Cancer.

IF 3.4 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Health Expectations Pub Date : 2026-10-01 DOI:10.1111/hex.70896

Amelia Talbot, Claire Foster, Susan A Jebb, Pete Wheatstone, Simon Buczacki, Dimitrios A Koutoukidis

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引用次数: 0

Abstract

Introduction: Colorectal cancer surgery has a higher risk of complications for patients carrying excess weight. Preoperative weight loss might reduce this risk. However, it is unclear how patients perceive engagement with an intensive weight-loss programme in the short window between diagnosis and surgery. This qualitative study, embedded within the CARE randomised controlled trial, aimed to understand the acceptability and experiences of following an intensive weight-loss programme with dietetic support as prehabilitation before colorectal cancer surgery.

Methods: Thirty-one participants (65% male, mean (SD) BMI 36.0 (5.5) kg/m², 65 (7) years) took part in a semi-structured interview based on the Theoretical Framework of Acceptability after following the programme for an average of 24 (12) days and 12 (7) days before surgery. Data were thematically analysed using the four constructs of Normalisation Process Theory (NPT).

Results: Participants understood, via interactions with healthcare professionals, that the programme could potentially make their operation technically easier and expedite hospital discharge (coherence). Continued adherence was supported by the dietitians (cognitive participation), and improvements in health markers and rapid weight loss helped to reframe some participants' views that their bodies were failing due to cancer (reflexive monitoring). However, some families' distrust of the programme's safety, social eating occasions, and side effects prevented full acceptability and total adherence (collective action). This highlighted how collective action sometimes overrode the consistently strong coherence, cognitive participation, and reflexive monitoring components of NPT.

Conclusion: The weight-loss programme was mostly acceptable to people who had already joined the intervention. Addressing challenges with collective action may support more patients to adhere.

Clinical trial registration: ISRCTN39207707, Registration date 13/03/2023.

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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.