afebba4f32836cdc9e164ad1678cd2ba jcm-13-03732.pdf 800204f045aeee2e3450606a7514c614d5f20f87 jcm-13-03732.pdf da64f636a652b53cf1553a12d79a4cd3eadf290d06863de3e4b5a0171b78aa3c jcm-13-03732.pdf Title: Experiences of Patients with Breast Cancer Participating in a Prehabilitation Program: A Qualitative Study Subject: Background: Breast cancer (BC) is the most prevalent cancer diagnosis among women worldwide. Several randomized controlled trials and systematic reviews have shown the benefits of exercise before, during, and after cancer treatment to manage side effects related to cancer and its therapies. However, these are poorly implemented across the disease-span, specifically, during the preoperative setting. Methods: Patients diagnosed with BC and participating in a randomized controlled trial on the effects of a prehabilitation program based on Nordic walking, muscle strengthening, and therapeutic education were invited to participate in this qualitative substudy. Two groups of eight patients each were recorded, transcript and analyzed using a specialized software (Atlas-Ti®, version 24). Results: During the axial codification phase, 22 unique codes and 6 main themes were identified related to their experience with the program, namely, (1) information received prior to participating; (2) motivation to participate; (3) barriers; (4) facilitators; (5) perceived degree of support from healthcare workers as well as peers; and (6) satisfaction with the characteristics of the prehabilitation program. Conclusions: Patients interviewed showed great interest in prehabilitation as a way to prepare both physically and mentally for surgery. In order to implement these interventions, healthcare systems need to acknowledge barriers and facilitators as well as the need for these programs to be supervised and monitored to avoid adverse events. Keywords: prehabilitation; breast cancer; qualitative research; barriers; facilitators; peer-support; multidisciplinary care Author: Anabel Casanovas-Álvarez, Raquel Sebio-Garcia, Jaume Masià and Ester Mateo-Aguilar Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Wed Jun 26 14:20:06 2024 CEST ModDate: Wed Jun 26 14:30:22 2024 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 19 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 509643 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- BXCBNI+VnURWPalladioL-Bold Type 1 Custom yes yes yes 10 0 UVANMX+URWPalladioL-Bold Type 1 Custom yes yes yes 16 0 QDOFRT+URWPalladioL-Roma Type 1 Custom yes yes yes 22 0 QIWAXH+URWPalladioL-Ital Type 1 Custom yes yes yes 27 0 OHKNFJ+VnURWPalladioL Type 1 Custom yes yes yes 32 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 48 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 51 0 WABLSD+SFRM1000 Type 1 Custom yes yes yes 71 0 YRFEEX+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 86 0 WJCNXB+PalatinoLinotype-Italic TrueType WinAnsi yes yes yes 94 0 VHTROD+PalatinoLinotype-Bold TrueType WinAnsi yes yes yes 98 0 UYFGAF+PalatinoLinotype-Roman TrueType WinAnsi yes yes yes 102 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2025-03-28 02:42:58 CET RepresentationInformation: jcm-13-03732.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2025-03-27 16:49:24 CET Size: 509643 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 345 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Design Destination: subsection.2.1 Item: Title: Context and Participants Destination: subsection.2.2 Item: Title: Prehabilitation Program Destination: subsection.2.3 Item: Title: Data Collection Destination: subsection.2.4 Item: Title: Data Analysis Destination: subsection.2.5 Item: Title: Results Destination: section.3 Children: Item: Title: Information Prior to the Prehabilitation Study Destination: subsection.3.1 Children: Item: Title: Lack of Information from the Medical Team Destination: subsubsection.3.1.1 Item: Title: Lack of Information from the Case Manager Destination: subsubsection.3.1.2 Item: Title: Information Received from the Physical Therapist Destination: subsubsection.3.1.3 Item: Title: Motivation for Adherence to the Prehabilitation Program and Positive Value of the Choice to Participate Destination: subsection.3.2 Children: Item: Title: Motivation for Adherence to the Prehabilitation Program Destination: subsubsection.3.2.1 Item: Title: Positive Value of the Choice to Participate Destination: subsubsection.3.2.2 Item: Title: Barriers to Participation and Adherence to the Prehabilitation Program Destination: subsection.3.3 Children: Item: Title: Side Effects of Chemotherapy Destination: subsubsection.3.3.1 Item: Title: Lack of Information and Prescription for Prehabilitation Destination: subsubsection.3.3.2 Item: Title: Adverse Weather Conditions Destination: subsubsection.3.3.3 Item: Title: Facilitators for Participation and Adherence to the Prehabilitation Program Destination: subsection.3.4 Children: Item: Title: Professionalism and Follow-Up of the Physiotherapist Destination: subsubsection.3.4.1 Item: Title: Adaptation of Exercises Destination: subsubsection.3.4.2 Item: Title: Safety of the Exercise Intervention Destination: subsubsection.3.4.3 Item: Title: Benefits of the Intervention Destination: subsubsection.3.4.4 Item: Title: Facilities Destination: subsubsection.3.4.5 Item: Title: Availability of the Participants Destination: subsubsection.3.4.6 Item: Title: Peer-Support Destination: subsubsection.3.4.7 Item: Title: Satisfaction with the Prehabilitation Program Destination: subsection.3.5 Children: Item: Title: Location of the Program Destination: subsubsection.3.5.1 Item: Title: Materials Used during Prehabilitation Destination: subsubsection.3.5.2 Item: Title: Dosage of Prehabilitation Sessions Destination: subsubsection.3.5.3 Item: Title: Guidance by the Multidisciplinary Team during Breast Cancer Treatment Destination: subsection.3.6 Children: Item: Title: Guidance by the Multidisciplinary Team Destination: subsubsection.3.6.1 Item: Title: Lack of Guidance by the Multidisciplinary Team Destination: subsubsection.3.6.2 Item: Title: Insufficient Information on Side Effects Destination: subsubsection.3.6.3 Item: Title: Discussion Destination: section.4 Item: Title: Limitations and Strengths of the Study Destination: section.5 Item: Title: Conclusions Destination: section.6 Item: Title: References Destination: appendix.A. Info: Title: Experiences of Patients with Breast Cancer Participating in a Prehabilitation Program: A Qualitative Study Author: Anabel Casanovas-Álvarez, Raquel Sebio-Garcia, Jaume Masià and Ester Mateo-Aguilar Subject: Background: Breast cancer (BC) is the most prevalent cancer diagnosis among women worldwide. Several randomized controlled trials and systematic reviews have shown the benefits of exercise before, during, and after cancer treatment to manage side effects related to cancer and its therapies. However, these are poorly implemented across the disease-span, specifically, during the preoperative setting. Methods: Patients diagnosed with BC and participating in a randomized controlled trial on the effects of a prehabilitation program based on Nordic walking, muscle strengthening, and therapeutic education were invited to participate in this qualitative substudy. Two groups of eight patients each were recorded, transcript and analyzed using a specialized software (Atlas-Ti®, version 24). Results: During the axial codification phase, 22 unique codes and 6 main themes were identified related to their experience with the program, namely, (1) information received prior to participating; (2) motivation to participate; (3) barriers; (4) facilitators; (5) perceived degree of support from healthcare workers as well as peers; and (6) satisfaction with the characteristics of the prehabilitation program. Conclusions: Patients interviewed showed great interest in prehabilitation as a way to prepare both physically and mentally for surgery. In order to implement these interventions, healthcare systems need to acknowledge barriers and facilitators as well as the need for these programs to be supervised and monitored to avoid adverse events. Keywords: prehabilitation; breast cancer; qualitative research; barriers; facilitators; peer-support; multidisciplinary care Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Wed Jun 26 14:20:06 CEST 2024 ModDate: Wed Jun 26 14:30:22 CEST 2024 ID: 0x2f701317747af427e759bf7fa28933ab, 0x2f701317747af427e759bf7fa28933ab Filters: FilterPipeline: FlateDecode Fonts: Type1: Font: BaseFont: OHKNFJ+VnURWPalladioL FontSubset: true FirstChar: 129 LastChar: 226 FontDescriptor: FontName: OHKNFJ+VnURWPalladioL Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: UVANMX+URWPalladioL-Bold FontSubset: true FirstChar: 3 LastChar: 122 FontDescriptor: FontName: UVANMX+URWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: QDOFRT+URWPalladioL-Roma FontSubset: true FirstChar: 2 LastChar: 248 FontDescriptor: FontName: QDOFRT+URWPalladioL-Roma Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: WABLSD+SFRM1000 FontSubset: true FirstChar: 180 LastChar: 180 FontDescriptor: FontName: WABLSD+SFRM1000 Flags: Symbolic FontBBox: -189, -321, 1456, 937 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: BXCBNI+VnURWPalladioL-Bold FontSubset: true FirstChar: 129 LastChar: 160 FontDescriptor: FontName: BXCBNI+VnURWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: QIWAXH+URWPalladioL-Ital FontSubset: true FirstChar: 2 LastChar: 148 FontDescriptor: FontName: QIWAXH+URWPalladioL-Ital Flags: Symbolic FontBBox: -170, -305, 1010, 941 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Pages: Page: Sequence: 1 Annotations: Annotation: Subtype: Link Rect: 99, 304, 152, 313 Annotation: Subtype: Link Rect: 34, 292, 102, 301 Annotation: Subtype: Link Rect: 34, 164, 96, 186 Annotation: Subtype: Link Rect: 125, 90, 154, 99 Annotation: Subtype: Link Rect: 34, 78, 149, 87 Annotation: Subtype: Link Rect: 34, 756, 176, 792 Annotation: Subtype: Link Rect: 515, 756, 560, 792 Annotation: Subtype: Link Rect: 177, 660, 188, 674 Annotation: Subtype: Link Rect: 369, 660, 380, 674 Annotation: Subtype: Link Rect: 506, 660, 517, 674 Annotation: Subtype: Link Rect: 216, 207, 223, 216 ActionDest: 138 Annotation: Subtype: Link Rect: 219, 182, 226, 191 ActionDest: 138 Annotation: Subtype: Link Rect: 549, 157, 556, 166 ActionDest: 141 Annotation: Subtype: Link Rect: 330, 132, 337, 141 ActionDest: 141 Annotation: Subtype: Link Rect: 369, 107, 376, 116 ActionDest: 141 Annotation: Subtype: Link Rect: 130, 17, 267, 28 Annotation: Subtype: Link Rect: 424, 17, 560, 28 Annotation: Subtype: Link Rect: 34, 390, 87, 409 Page: Sequence: 2 Annotations: Annotation: Subtype: Link Rect: 243, 743, 250, 752 ActionDest: 141 Annotation: Subtype: Link Rect: 253, 743, 260, 752 ActionDest: 141 Annotation: Subtype: Link Rect: 440, 731, 447, 740 ActionDest: 141 Annotation: Subtype: Link Rect: 213, 693, 220, 702 ActionDest: 141 Annotation: Subtype: Link Rect: 544, 681, 556, 690 ActionDest: 141 Annotation: Subtype: Link Rect: 215, 593, 226, 602 ActionDest: 141 Annotation: Subtype: Link Rect: 227, 593, 239, 602 ActionDest: 141 Annotation: Subtype: Link Rect: 240, 568, 252, 577 ActionDest: 141 Annotation: Subtype: Link Rect: 224, 555, 236, 564 ActionDest: 141 Annotation: Subtype: Link Rect: 228, 530, 240, 539 ActionDest: 141 Annotation: Subtype: Link Rect: 396, 517, 408, 526 ActionDest: 141 Annotation: Subtype: Link Rect: 350, 492, 362, 501 ActionDest: 141 Annotation: Subtype: Link Rect: 363, 492, 375, 501 ActionDest: 141 Annotation: Subtype: Link Rect: 375, 492, 387, 501 ActionDest: 141 Annotation: Subtype: Link Rect: 356, 417, 368, 426 ActionDest: 141 Annotation: Subtype: Link Rect: 410, 379, 422, 388 ActionDest: 141 Annotation: Subtype: Link Rect: 545, 354, 557, 363 ActionDest: 141 Annotation: Subtype: Link Rect: 390, 265, 402, 274 ActionDest: 141 Annotation: Subtype: Link Rect: 499, 127, 511, 136 ActionDest: 141 Page: Sequence: 3 Annotations: Annotation: Subtype: Link Rect: 453, 530, 465, 539 ActionDest: 141 Annotation: Subtype: Link Rect: 395, 404, 407, 413 ActionDest: 141 Annotation: Subtype: Link Rect: 417, 115, 429, 124 ActionDest: 141 Page: Sequence: 4 Annotations: Annotation: Subtype: Link Rect: 346, 351, 353, 363 ActionDest: 80 Page: Sequence: 5 Page: Sequence: 6 Page: Sequence: 7 Page: Sequence: 8 Page: Sequence: 9 Page: Sequence: 10 Page: Sequence: 11 Page: Sequence: 12 Page: Sequence: 13 Annotations: Annotation: Subtype: Link Rect: 231, 155, 243, 164 ActionDest: 141 Annotation: Subtype: Link Rect: 245, 155, 257, 164 ActionDest: 144 Page: Sequence: 14 Annotations: Annotation: Subtype: Link Rect: 386, 718, 398, 727 ActionDest: 144 Annotation: Subtype: Link Rect: 317, 706, 329, 715 ActionDest: 144 Annotation: Subtype: Link Rect: 544, 593, 556, 602 ActionDest: 144 Annotation: Subtype: Link Rect: 312, 555, 324, 564 ActionDest: 141 Annotation: Subtype: Link Rect: 214, 492, 226, 501 ActionDest: 144 Annotation: Subtype: Link Rect: 229, 492, 241, 501 ActionDest: 144 Annotation: Subtype: Link Rect: 440, 492, 452, 501 ActionDest: 144 Annotation: Subtype: Link Rect: 325, 392, 337, 401 ActionDest: 144 Annotation: Subtype: Link Rect: 249, 367, 261, 376 ActionDest: 144 Annotation: Subtype: Link Rect: 348, 279, 360, 288 ActionDest: 144 Annotation: Subtype: Link Rect: 360, 279, 372, 288 ActionDest: 144 Annotation: Subtype: Link Rect: 493, 204, 505, 213 ActionDest: 141 Annotation: Subtype: Link Rect: 512, 204, 524, 213 ActionDest: 144 Annotation: Subtype: Link Rect: 200, 166, 212, 175 ActionDest: 144 Annotation: Subtype: Link Rect: 483, 116, 495, 125 ActionDest: 144 Page: Sequence: 15 Annotations: Annotation: Subtype: Link Rect: 311, 743, 323, 752 ActionDest: 144 Annotation: Subtype: Link Rect: 323, 744, 335, 752 ActionDest: 144 Annotation: Subtype: Link Rect: 249, 655, 261, 665 ActionDest: 144 Annotation: Subtype: Link Rect: 216, 618, 228, 627 ActionDest: 144 Annotation: Subtype: Link Rect: 229, 618, 241, 627 ActionDest: 144 Annotation: Subtype: Link Rect: 407, 580, 419, 589 ActionDest: 144 Annotation: Subtype: Link Rect: 216, 530, 228, 539 ActionDest: 144 Annotation: Subtype: Link Rect: 409, 505, 421, 514 ActionDest: 144 Annotation: Subtype: Link Rect: 519, 430, 531, 439 ActionDest: 141 Annotation: Subtype: Link Rect: 313, 342, 325, 351 ActionDest: 144 Annotation: Subtype: Link Rect: 326, 342, 338, 351 ActionDest: 144 Annotation: Subtype: Link Rect: 198, 204, 210, 213 ActionDest: 147 Annotation: Subtype: Link Rect: 211, 204, 223, 213 ActionDest: 147 Page: Sequence: 16 Annotations: Annotation: Subtype: Link Rect: 526, 453, 560, 464 Annotation: Subtype: Link Rect: 165, 441, 363, 452 Annotation: Subtype: Link Rect: 210, 94, 248, 104 Annotation: Subtype: Link Rect: 225, 71, 262, 81 Page: Sequence: 17 Annotations: Annotation: Subtype: Link Rect: 200, 730, 237, 741 Annotation: Subtype: Link Rect: 243, 730, 279, 741 Annotation: Subtype: Link Rect: 197, 707, 234, 718 Annotation: Subtype: Link Rect: 240, 707, 276, 718 Annotation: Subtype: Link Rect: 232, 684, 270, 694 Annotation: Subtype: Link Rect: 136, 661, 174, 671 Annotation: Subtype: Link Rect: 484, 637, 522, 648 Annotation: Subtype: Link Rect: 59, 604, 96, 614 Annotation: Subtype: Link Rect: 59, 569, 96, 579 Annotation: Subtype: Link Rect: 102, 569, 138, 579 Annotation: Subtype: Link Rect: 86, 522, 211, 533 Annotation: Subtype: Link Rect: 318, 522, 356, 533 Annotation: Subtype: Link Rect: 59, 489, 96, 499 Annotation: Subtype: Link Rect: 102, 489, 138, 499 Annotation: Subtype: Link Rect: 59, 454, 96, 464 Annotation: Subtype: Link Rect: 102, 454, 138, 464 Annotation: Subtype: Link Rect: 457, 430, 494, 441 Annotation: Subtype: Link Rect: 500, 430, 536, 441 Annotation: Subtype: Link Rect: 145, 397, 183, 407 Annotation: Subtype: Link Rect: 189, 397, 225, 407 Annotation: Subtype: Link Rect: 251, 373, 289, 384 Annotation: Subtype: Link Rect: 237, 338, 275, 349 Annotation: Subtype: Link Rect: 281, 338, 317, 349 Annotation: Subtype: Link Rect: 194, 305, 231, 315 Annotation: Subtype: Link Rect: 238, 305, 274, 315 Annotation: Subtype: Link Rect: 432, 281, 469, 292 Annotation: Subtype: Link Rect: 475, 281, 511, 292 Annotation: Subtype: Link Rect: 378, 258, 415, 269 Annotation: Subtype: Link Rect: 59, 224, 96, 234 Annotation: Subtype: Link Rect: 137, 177, 175, 188 Annotation: Subtype: Link Rect: 181, 177, 217, 188 Annotation: Subtype: Link Rect: 414, 167, 452, 177 Annotation: Subtype: Link Rect: 341, 143, 379, 154 Annotation: Subtype: Link Rect: 385, 143, 421, 154 Annotation: Subtype: Link Rect: 413, 120, 451, 131 Annotation: Subtype: Link Rect: 434, 108, 472, 119 Annotation: Subtype: Link Rect: 302, 85, 339, 96 Annotation: Subtype: Link Rect: 346, 85, 382, 96 Page: Sequence: 18 Annotations: Annotation: Subtype: Link Rect: 95, 730, 132, 741 Annotation: Subtype: Link Rect: 138, 730, 174, 741 Annotation: Subtype: Link Rect: 305, 695, 342, 706 Annotation: Subtype: Link Rect: 349, 695, 385, 706 Annotation: Subtype: Link Rect: 443, 672, 480, 683 Annotation: Subtype: Link Rect: 95, 638, 132, 648 Annotation: Subtype: Link Rect: 519, 626, 557, 637 Annotation: Subtype: Link Rect: 59, 615, 95, 625 Annotation: Subtype: Link Rect: 351, 591, 389, 602 Annotation: Subtype: Link Rect: 242, 557, 279, 568 Annotation: Subtype: Link Rect: 285, 557, 322, 568 Annotation: Subtype: Link Rect: 509, 534, 547, 545 Annotation: Subtype: Link Rect: 496, 499, 533, 510 Annotation: Subtype: Link Rect: 216, 465, 254, 476 Annotation: Subtype: Link Rect: 260, 465, 296, 476 Annotation: Subtype: Link Rect: 460, 442, 498, 453 Annotation: Subtype: Link Rect: 484, 419, 522, 430 Annotation: Subtype: Link Rect: 302, 384, 339, 395 Annotation: Subtype: Link Rect: 135, 351, 173, 361 Annotation: Subtype: Link Rect: 318, 327, 355, 338 Annotation: Subtype: Link Rect: 303, 292, 341, 303 Annotation: Subtype: Link Rect: 347, 292, 383, 303 Annotation: Subtype: Link Rect: 519, 269, 557, 280 Annotation: Subtype: Link Rect: 59, 259, 95, 269 Annotation: Subtype: Link Rect: 519, 235, 557, 246 Annotation: Subtype: Link Rect: 59, 224, 95, 234 Annotation: Subtype: Link Rect: 256, 200, 294, 211 Annotation: Subtype: Link Rect: 300, 200, 336, 211 Annotation: Subtype: Link Rect: 205, 166, 243, 177 Annotation: Subtype: Link Rect: 249, 166, 285, 177 Annotation: Subtype: Link Rect: 266, 143, 304, 154 Annotation: Subtype: Link Rect: 310, 143, 346, 154 Annotation: Subtype: Link Rect: 317, 108, 354, 119 Annotation: Subtype: Link Rect: 361, 108, 397, 119 Annotation: Subtype: Link Rect: 259, 85, 296, 96 Page: Sequence: 19 Annotations: Annotation: Subtype: Link Rect: 261, 719, 299, 729 Annotation: Subtype: Link Rect: 59, 684, 96, 694 Checksum: cc950b68 Type: CRC32 Checksum: afebba4f32836cdc9e164ad1678cd2ba Type: MD5 Checksum: 800204f045aeee2e3450606a7514c614d5f20f87 Type: SHA-1 Checksum: da64f636a652b53cf1553a12d79a4cd3eadf290d06863de3e4b5a0171b78aa3c Type: SHA-256