In a groundbreaking qualitative study conducted by Schöne, Fuchs, Kiselev, and their colleagues, the dynamics surrounding participation in prehabilitation programs prior to orthopedic elective surgeries have been scrutinized, particularly with a focus on elderly patients who are either pre-frail or frail. This significant research highlights the various facilitators and barriers that impact the decision-making process for these patients as they prepare for surgery. The findings provide a unique lens into understanding patient behavior and preferences, fundamentally influencing how health systems can better cater to this vulnerable demographic.
Prehabilitation, defined as organized interventions designed to improve patients’ physical and psychological well-being before undergoing surgery, has emerged as a pivotal aspect of surgical care. It entails various components, including exercise training, nutritional optimization, and psychological support. Yet, despite its proven benefits in enhancing surgical outcomes, including quicker recovery times and reduced complications, participation rates among elderly patients remain suboptimal. This study sheds light on the intricate factors that contribute to this trend.
The qualitative framework utilized in the study involved comprehensive interviews with elderly patients who qualified for orthopedic surgeries. Participants shared their thoughts about prehabilitation, revealing a spectrum of experiences that illustrate not only their willingness to engage but also their hesitations. Among the prime facilitators identified were the motivation to improve post-operative outcomes and the provision of clear and accessible information regarding the prehabilitation process itself. Patients who felt well-informed and supported were significantly more inclined to participate in prehabilitation programs.
Conversely, a variety of barriers emerged from the discussions, many intimately tied to the patients’ health status and cognitive abilities. Frailty, in particular, presented a considerable challenge, as many participants articulated feelings of fatigue or a lack of physical capacity to engage in exercise routines. Furthermore, societal factors such as ageism and stigma regarding frailty were noted to have detrimental impacts on patients’ perceptions of their ability to participate fully in prehabilitation efforts. These insights underscore the need for tailored approaches when designing prehabilitation programs to accommodate the specific challenges faced by elderly individuals.
Additionally, emotional and psychological barriers surfaced as significant obstacles. Many participants expressed feelings of anxiety concerning the surgery itself, compounded by fears related to engaging in physical activity that they had previously perceived as too strenuous. The researchers spotlighted the necessity for adequately addressing mental health concerns within prehabilitation protocols. By fostering a supportive and empathetic environment, practitioners can help alleviate these psychological barriers, ultimately promoting higher participation rates.
The role of family support in facilitating prehabilitation participation also emerged as a crucial theme. Many patients emphasized the positive impact that family members had on their decision to engage in the prehabilitation process. The presence of supportive family and friends not only provided emotional bolstering but also assisted with practical aspects, such as transportation to sessions and encouragement to adhere to exercise routines. This highlights the communal aspect of health and wellness, particularly among the older population, where social networks can dramatically influence health-related behaviors.
From the perspective of healthcare providers, the study emphasizes the imperative of integrating communication strategies that resonate with elderly patients. Tailoring messages about prehabilitation benefits and participation requirements can significantly enhance patient understanding and willingness to participate. Health practitioners are encouraged to actively involve elderly patients in conversations about their care, fostering a sense of agency and autonomy that can ultimately lead to improved engagement levels.
Moreover, the researchers call for heightened awareness among healthcare professionals regarding the multifaceted needs of the elderly population. Understanding the nuances of frailty, both physical and cognitive, allows providers to craft more effective prehabilitation programs that are responsive to the complexities of each individual’s situation. As the number of elderly patients undergoing orthopedic surgeries continues to rise, this understanding becomes even more critical in promoting better overall health outcomes.
In conclusion, the study conducted by Schöne and colleagues serves as a vital contribution to the field of geriatric healthcare. By uncovering the facilitators and barriers that influence the participation of elderly patients in prehabilitation before orthopedic surgery, this research not only illuminates significant areas for improvement but also paves the way for future investigations and interventions aimed at enhancing the surgical experience for this vulnerable population.
The findings underscore the importance of a holistic approach to prehabilitation, emphasizing that physical preparation must go hand-in-hand with emotional and cognitive support. With continued research and innovation in care delivery, there lies the potential to significantly improve the surgical outcomes and quality of life for elderly patients.
In the face of such challenges, the health system must adapt and evolve, ultimately prioritizing the needs and preferences of elderly patients in prehabilitation programs. The next steps should involve translating these findings into actionable strategies that promote greater accessibility and support for the elderly, thereby empowering them to take control of their health and wellbeing.
As the study highlights, driving participation in prehabilitation is not just a matter of logistics; it is deeply rooted in understanding the human experience of aging and frailty. As society anticipates an ever-increasing elderly population, it becomes incredibly urgent to prioritize their voices, ensuring they have equal access to the prehabilitation benefits that can profoundly impact their surgical journeys.
Subject of Research: Prehabilitation prior to orthopedic elective surgery in elderly frail patients.
Article Title: Facilitators and barriers to participation in prehabilitation prior to orthopedic elective surgery – a qualitative study with elderly (pre-)frail patients.
Article References:
Schöne, C., Fuchs, T.I., Kiselev, J. et al. Facilitators and barriers to participation in prehabilitation prior to orthopaedic elective surgery – a qualitative study with elderly (pre-)frail patients. BMC Geriatr 25, 845 (2025). https://doi.org/10.1186/s12877-025-06592-3
Image Credits: AI Generated
DOI: https://doi.org/10.1186/s12877-025-06592-3
Keywords: Prehabilitation, elderly patients, orthopedic surgery, frailty, qualitative study, healthcare, patient participation.
Tags: barriers to prehabilitation programschallenges in orthopedic surgery preparationdecision-making in prehabilitationexercise training for frail patientsfactors influencing prehabilitation participationhealth system adaptations for elderly careimproving surgical outcomes for elderlynutritional optimization for elderly surgerypatient behavior in surgical careprehabilitation for elderly patientspsychological support in prehabilitationqualitative study on frail patients
