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. 2025 May 8:1-17.
doi: 10.1159/000546272. Online ahead of print.

Co-Developed Logic Model for Surgical Prehabilitation in an Acute Care Setting: A Qualitative Study of Stakeholders' Perspectives

Jade Corriveau  1   2 , Michelle St-Jacques  3 , Sophia Yeung  4 , Francesco Carli  5 , A Sender Liberman  6 , Debbie Watson  7 , Rona Fleming  8   9 , Andre Guigui  10 , Michel Picard  11 , Julio F Fiore Jr  6 , Nancy Mayo  12   13   14   15 , Stéphanie Chevalier  16   3   12 , Chelsia Gillis  16   5   6
Affiliations

Co-Developed Logic Model for Surgical Prehabilitation in an Acute Care Setting: A Qualitative Study of Stakeholders' Perspectives

Jade Corriveau et al. Ann Nutr Metab. .

Abstract

Introduction: Prehabilitation programs treat modifiable risk factors to improve surgical outcomes. However, translation of research into practice remains challenging. Logic models, visual representations of how a program works, have the potential to bridge research-to-practice gaps. We aimed to develop a logic model for prehabilitation programs in tertiary care centers by interviewing stakeholders about what should be the mission, inputs, outputs (activities and participants), and targeted outcomes for prehabilitation.

Methods: A multi-site qualitative study was conducted from June 2022 to December 2023. Interviews were analyzed using manifest summative content analysis to determine logic model items. Focus groups for member checking were performed with stakeholders throughout the analysis process.

Results: Sixty-one interviews were conducted with stakeholders: prehabilitation staff (n = 12), patients (n = 10), perioperative care physicians (n = 10), nurses (n = 9), dietitians (n = 9), physiotherapists (n = 5), and hospital administrators (n = 6). Findings underscored unanimous support for prehabilitation yet revealed challenges that hindered efficient and equitable resource utilization, which have been addressed in the logic model. To evaluate the success of prehabilitation, both clinician- (n = 44) and patient-oriented outcomes (n = 32) were valued by stakeholders; however, priority outcomes varied by stakeholder group: intervention adherence (prehabilitation staff), experience and satisfaction (patients), and facilitation of discharge (clinicians and hospital administrators).

Conclusion: This co-developed logic model was designed to improve the efficiency, accessibility, and sustainability of acute care prehabilitation programs by offering a detailed blueprint. Researchers and clinicians can draw on the insights from this co-production process to develop, implement, and evaluate their own prehabilitation programs.

Keywords: Enhanced recovery; Implementation; Logic model; Patient-oriented care; Perioperative outcomes; Pre-habilitation; Preoperative care; Surgical risk.

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Conflict of interest statement

C.G. and S.L. have received honoraria for giving educational talks sponsored by Abbott Nutrition, Nestle Nutrition, and Fresenius Kabi and by Abbott Nutrition and Takeda, respectively. C.G. was a member of the journal’s Editorial Board at the time of submission.

Figures

Fig. 1.
Fig. 1.
Co-developed logic model for surgical prehabilitation in acute care setting. BIA, bioelectrical impedance; DEXA, dual X-ray absorptiometry; ERAS, enhanced recovery after surgery; DREAMS, Drinking, Eating, Analgesia, Mobilizing and Sleeping; LOS, length of stay; PROM, patient-reported outcome measure; EMR, electronic medical record; HCP, healthcare professional; ADL, activities of daily living.
Fig. 2.
Fig. 2.
Example of how the logic model can be applied in cancer care prehabilitation programs. 6MWT, 6-minute walk test; BIA, bioelectrical impedance; CPET, cardiopulmonary exercise testing; DEXA, dual X-ray absorptiometry; FTE, full time equivalent; LOS, length of stay; PG-SGA, patient-generated subjective global assessment; PROM, patient-reported outcome measure; ADL, activities of daily living.
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References

    1. Gillis C, Ljungqvist O, Carli F. Prehabilitation, enhanced recovery after surgery, or both? A narrative review. Br J Anaesth. 2022;128(3):434–48. - PubMed
    1. Molenaar CJ, van Rooijen SJ, Fokkenrood HJ, Roumen RM, Janssen L, Slooter GD. Prehabilitation versus no prehabilitation to improve functional capacity, reduce postoperative complications and improve quality of life in colorectal cancer surgery. Cochrane Database Syst Rev. 2023;5(5). - PMC - PubMed
    1. Corriveau J, Alavifard D, Gillis C. Demystifying malnutrition to improve nutrition screening and assessment in oncology. Semin Oncol Nurs. 2022;38(5):151336. - PubMed
    1. GlobalSurg Collaborative and NIHR Global, Health Unit on Global Surgery, Knight SR, Ghosh D, Kingsley PA, Lapitan MC, Parreno-Sacdalan MD. Impact of malnutrition on early outcomes after cancer surgery: an international, multicentre, prospective cohort study. Lancet Glob Health. 2023;11(3):e341–9. - PubMed
    1. Bellafronte NT, Nasser R, Gramlich L, Carli F, Liberman S, Santa Mina D, et al. A survey of preoperative surgical nutrition practices, opinions, and barriers across Canada. Appl Physiol Nutr Metabol. 2024;49(5):687–99. - PubMed