Dropping out or Moving on? A Systematic Review With Meta-Aggregation of the Experience of Prehabilitation Among Patients With Cancer.

[BACKGROUND] The effect of prehabilitation on reducing the level of postoperative stress and facilitating recovery has been proven to be controversial in previous studies involving patients with cancer. This review contributes to the improvement of an intervention programme by qualitatively integrating the prehabilitation experiences of patients with cancer.

[OBJECTIVE] This review aimed to integrate the individual experiences of patients with cancer who had received prehabilitation interventions to identify the barriers and facilitators to implementation, which can be used to understand patients' adherence behaviours.

[DESIGN] This was a qualitative evidence synthesis review.

[METHODS] Articles were systematically searched from inception to February 18, 2025, using four English databases and three Chinese databases. Keywords and Medical Subject Headings were used to identify potential studies written in both Chinese and English. This study was performed using the Joanna Briggs Institute qualitative systematic review methodology.

[RESULTS] Twenty-five articles were included in this review. Guided by the Theoretical Domains Framework (TDF), eight synthesised findings were extracted, focusing on the representation of factors influencing the adherence of patients with cancer to prehabilitation, including the domains of knowledge (two facilitators), reinforcement (two facilitators), beliefs about consequences (two facilitators), beliefs about capabilities (two barriers), environmental context and resources (two barriers, one intervention preference factor), social influence (one facilitator, one intervention preference factor), emotion (one barrier, one facilitator) and behavioural regulation (one facilitators, two intervention preference factors).

[CONCLUSION] Our findings indicate that the adherence to prehabilitation among patients with cancer is shaped by a dynamic interplay of determinants. Structured assessments, self-monitoring, tailored interventions and tele-prehabilitation can improve patients' self-efficacy, perceived benefits and access to resources, which in turn can facilitate their completion of prehabilitation.

[IMPACT] This study deepens our understanding of behaviours related to adherence to prehabilitation among patients with cancer and provides valuable guidance for the formulation and optimisation of subsequent prehabilitation intervention programmes.

[REPORTING] ENTREQ.

[PATIENT OR PUBLIC CONTRIBUTION] No patient or public contributions.

[TRIAL REGISTRATION] PROSPERO CRD: 42024553972.