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Implementing a Virtual Mind-Body Prehabilitation Program for Patients Undergoing Thoracic Surgery – A Quality Improvement Project

Open AccessPublished:March 17, 2023DOI:https://doi.org/10.1016/j.xjon.2023.03.003
Implementing a Virtual Mind-Body Prehabilitation Program for Patients Undergoing Thoracic Surgery – A Quality Improvement Project
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      ABSTRACT

      BACKGROUND

      Prehabilitation (prehab) before thoracic surgery has been found to improve outcomes in patients with cancer, however COVID-19 presented challenges to access on-site programs. We describe the development, implementation, and evaluation of a synchronous, virtual mind-body prehab program developed in response to COVID-19.

      METHODS

      Eligible participants were patients seen at a thoracic oncology surgical department of an academic cancer center, >= 18 years of age with a diagnosis of thoracic cancer and referred at least one week before surgery. The program offered two 45-minute pre-operative mind-body fitness classes each week delivered via Zoom. We collected data for referrals, enrollment, participation, and evaluated patient reported satisfaction and experience. We conducted brief semi-structured interviews about participants’ experience.

      RESULTS

      Among 278 patients referred, 260 were approached, and of those 197 (76%) patients agreed to participate. Among participants, 140 (71%) attended at least one class, with an average of 11 attendees per class. Majority of participants reported being extremely satisfied (97.8%), extremely likely to recommend the classes to others (91.2%), and indicated that classes were very much helpful in preparing for surgery (90.8%). Patients also reported that the classes helped reduce anxiety/stress (94.2%), fatigue (88.5%), pain (80.7%), and shortness of breath (86.5%). Qualitative data further suggest that the program made participants feel stronger, more connected to their peers, and better prepared for surgery.

      CONCLUSION

      This virtual mind-body prehab program was well-received with high satisfaction and benefits and is highly feasible to implement. This approach may help overcome some of the challenges to in-person participation.

      Graphical abstract

      Figure thumbnail fx1
      Graphical Abstract

      Keywords

      Abbreviations:

      Prehab, Prehabilitation (The process of enhancing physical fitness before surgery to enable the patient to withstand the stress of surgery has been termed prehabilitation. Exercise is an important component of prehabilitation), IMS (Integrative Medicine Service), ASCO (American Society of Clinical Oncology), MSK (Memorial Sloan Kettering Cancer Center), Q&A (Questions and Answers)

      Article info

      Publication history

      Accepted: March 7, 2023
      Received: October 10, 2022

      Publication stage

      In Press Journal Pre-Proof

      Footnotes

      Disclosure Statement: Dr. David R. Jones serves as a consultant for AstraZeneca and on a clinical trial steering committee for Merck. Dr. Daniela Molena serves on a steering committee for AstraZeneca and as a consultant for Johnson & Johnson, Bristol Myers Squibb, Merck, and Genentech. Dr. Gaetano Rocco has financial relationships with Scanlan, AstraZeneca, and Medtronic. Dr. Mao reports grants from Tibet CheeZheng Tibetan Medicine Co. Ltd. outside the submitted work. All other authors have nothing to disclose.

      Funding Statement: This manuscript is supported in part by funding from AKTIV Against Cancer, JDJ Charitable Foundation, and by an MSK National Institutes of Health/National Cancer Institute Cancer Center grant (P30 CA008748).

      Institutional Review Board (IRB) Approval: This manuscript was approved by the Memorial Sloan Kettering Cancer Center (MSK) IRB under retrospective protocol 18-445 on October 18, 2018. This type of protocol indicates that waived consent and waiver of HIPAA authorization are appropriate.

      Central Message

      A virtual synchronous prehabilitation program is highly feasible to implement for patients undergoing thoracic surgery and may help overcome certain challenges to in-person participation.

      Perspective Statement

      Prehabilitation before thoracic surgery has been found to improve outcomes in patients with cancer, however COVID-19 presented challenges to access on-site programs. This virtual synchronous mind-body prehabilitation program, developed in response to COVID-19, was well-received with high satisfaction and benefits among thoracic cancer patients and is highly feasible to implement.

      Central Picture Legend: Virtual Mind-Body Prehabilitation Program for Patients Undergoing Thoracic Surgery

      Identification

      DOI: https://doi.org/10.1016/j.xjon.2023.03.003

      Copyright

      © 2023 The Authors. Published by Elsevier Inc. on behalf of The American Association for Thoracic Surgery

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