Aims: Health care professionals (HCPs) play a vital role in the effectiveness of a prehabilitation program, but information is limited about what assists HCP deliver an effective service. This study evaluated allied health clinicians’, nurses’ and haematologists’ perceptions of enablers and barriers to two behaviours: referral for, and delivery of, multidisciplinary prehabilitation prior to autologous stem cell transplant.
Methods: Based on the Theoretical Domains Framework (TDF) of behaviour change, we conducted semi-structured interviews, purposively sampling 14 participants at a tertiary cancer centre. Discipline-specific topic guides were designed based on the TDF and the behaviours appropriate to each discipline. Interviews were audio-recorded, transcribed verbatim, anonymised, analysed by content analysis (grouping, then labelling, thematically similar responses) and classified into theoretical domains. Structured rules were used to classify themes as high, medium or low priority.
Results: Fifty enablers and 31 barriers were identified; with 26 and 16 classified as high priority, respectively. Four domains had the most frequent high-priority enablers: Social professional role and identity (e.g., multidisciplinary teamwork); Beliefs about consequences (e.g., patients will benefit from prehabilitation); Memory, attention and decision processes (e.g., refer as early as possible); and Environmental context and resources (e.g., electronic medical records are beneficial). High-priority barriers were most prevalent in four domains: Memory, attention and decision processes (e.g., conflicting views about who should be referred); Environmental context and resources (e.g., lack of time); Social influences (e.g., families); and Emotions (e.g., patients’ emotions).
Conclusion: Participants reported more enablers to prehabilitation referral and delivery than barriers. These findings can support delivery of prehabilitation programs in hospital settings where uptake remains low. Future prehabilitation services should include interventions targeted at high-priority enabler domains: Social professional role and identity; Beliefs about consequences; Memory, attention and decision processes; and Environmental context and resources.