Patient perspectives on adherence to a virtual multimodal (P)REHABILITATION program in gastrointestinal cancer: a theory-driven qualitative behavioural analysis
- Author(s)
- Zhou, A; Dhillon, HM; Koh, C; Smith, AB; Mohan, H; Carey, S; Smith, S; Poulton, T; Patton, V; White, K; Laranjo, L; Dieng, M; Liu, X; Denehy, L; Wilson, K; Allman-Farinelli, M; Butow, P; Riedel, B; Morton, RL; Hassett, L; Li, Q; Delbaere, K; Hutchings, O; Martin, O; Shailer, B; Beardsworth, G; Salter, M; Cherry, K; Rubie, F; Reece, L; Chan, A; Shahab, R; Dwyer, O; Pring, K; Cunningham, D; Sheehan, K; Iori, G; Johnander, R; Jeon, C; Reeves, J; Hirst, N; Karunaratne, S; Solomon, M; Steffens, D;
- Journal Title
- Disability and Rehabilitation
- Publication Type
- Online publication before print
- Abstract
- PURPOSE: This qualitative study explored barriers and facilitators to adherence among participants of a virtual multimodal (p)rehabilitation program for gastrointestinal cancer surgery and investigated how these aligned with constructs from Temporal Self-Regulation Theory (TST), a theoretical behaviour change framework. MATERIALS AND METHODS: Semi-structured interviews were conducted with participants of the PRIORITY-CONNECT 2 Pilot Trial, a virtual multimodal (p)rehabilitation program for patients undergoing major gastrointestinal cancer surgery. TST informed the development of the semi-structured interview questions to explore participants' experiences of barriers and facilitators to uptake of the program recommendations. Reflexive thematic analysis was conducted to identify patterns within participants' experiences and perceptions of the (p)rehabilitation program. RESULTS: 13 interviews were conducted. Six themes were identified: (1) Trust in Healthcare Professionals; (2) Overall Program Perceptions; (3) Socioenvironmental Impacts; (4) Personal Characteristics and Motivation; (5) Prior Health Habits; (6) Symptoms Impacting Physical Capacity. These themes mapped to the constructs of TST, identifying how beliefs about program value, contextual barriers, and self-regulatory capacity shape adherence behaviour. CONCLUSIONS: Adherence to virtual (p)rehabilitation was influenced by trust, perceived benefit, and flexible, supervised delivery, but limited by competing demands and treatment-related fatigue. Integrating behaviour-change principles from TST may enhance adherence in future multimodal (p)rehabilitation programs.; Using Temporal Self-Regulation Theory (TST), a theory-based behaviour change framework, to understand patients’ adherence behaviours can inform the development of behavioural strategies to enhance patient adherence in (p)rehabilitation interventions.Contextual and relational factors, including trust and continuity of care between patients and healthcare professionals, and family support, influence motivation and adherence, highlighting the need to strengthen social and relational dimensions of care in (p)rehabilitation interventions.Incorporating self-regulatory supports (e.g., goal setting, self-monitoring, and accountability strategies) and tailoring program strategies to patients’ motivation, existing health habits, and symptom burden can promote adherence to (p)rehabilitation interventions.A virtual format of (p)rehabilitation offers flexibility and supervision for patients with motivational barriers or treatment-related fatigue but may need additional strategies to maintain motivation beyond supervised sessions.; eng
- Keywords
- Prehabilitation; gastrointestinal cancer surgery; patient adherence; rehabilitation; temporal self-regulation theory
- Department(s)
- Anaesthetics; Physiotherapy; Health Services Research
- Publisher's Version
- https://doi.org/10.1080/09638288.2026.2720764
- Open Access at Publisher's Site
https://doi.org/10.1080/09638288.2026.2720764- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2026-10-12 05:40:55
Last Modified: 2026-10-12 05:41:16