Background: Multimodal prehabilitation aims to optimise patients before gastrointestinal cancer surgery, yet patient experiences and engagement remain incompletely understood. We examined PREHAB-GI from the patient perspective and identified barriers and enablers to implementation.
Methods: PREHAB-GI is a two-week hospital-based multimodal program comprising exercise, dietetic care and nursing support for patients undergoing curative-intent gastrointestinal cancer surgery. An independent researcher conducted semi-structured interviews with a subset of participants before hospital discharge and approximately 30 days after surgery. Interviews were transcribed verbatim and analysed using framework analysis. A hybrid deductive–inductive approach used a pre-specified framework informed by intervention components and the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance), allowing refinement of subthemes. Transcripts were independently double-coded and reconciled through consensus.
Results: Twenty-two participants were interviewed (mean age 61 years; 12 male; 19 colorectal and three upper gastrointestinal). Six themes were identified. 1. Doing something positive—prehabilitation transformed an overwhelming waiting period into an opportunity to prepare. 2. Someone was looking out for me— trusted relationships and multidisciplinary support were consistently described as the most valued aspects of the program. 3. Knowing what to do—practical exercise and nutrition guidance fostered confidence, structure and a sense of control. 4. Not enough time—compressed diagnosis-to-surgery pathways limited participation and perceived benefit. 5. Getting there was part of the burden—travel, fixed appointments and hospital-based delivery hindered accessibility and prompted calls for longer, more flexible community and hybrid models. 6. Support stopped too soon—participants described a loss of structured support after discharge and wanted continued multidisciplinary care throughout recovery.
Conclusion: Patients valued prehabilitation for more than physical preparation. Integrated exercise, nutrition and multidisciplinary support helped them feel informed, supported and empowered. Preserving these patient-valued components while improving flexibility and continuity may strengthen future implementation.