The goals of this study is to evaluate the feasibility and the effects of a WhatsApp-assisted prehabilitation for colorectal cancer patients undergoing elective surgery. The main questions are: If the digital prehabilitation is feasible and acceptable by the colorectal cancer patient prior to elective surgery? If this prehabilitation helps to improve the postoperative complications, length of stay, physical activity and psychological well-being for colorectal cancer patients receiving surgery.
Researcher will compare the prehabilitation plus standard care to standard care only to see if the prehabiliation helps the colorectal cancer patients.
Participants will: 1) enrolled in a approximate 4 weeks (3 episodes/ week) prehabilitation program containing educational information of colorectal cancer, dietary advice, exercises training and psychological podcasting. 2) will answer the survey weekly and after surgery. 3) keep the standard care as per department guidelines
diagnosis of colorectal-related cancer
scheduled for elective colorectal cancer surgery as primary treatment
aged 18 years or above
expected surgery date more than 21 days
identified or known premorbid, that inability to follow the programme
able to understand written and spoken Cantonese/ Chinese
Parallel
Intervention
Other interventionIn addition to standard care, participants will receive digital approach of WhatsApp-assisted prehabilitation programme and then start the home-based training for about 3-4 weeks prior to the surgery. The WhatsApp-assisted prehabilitation includes exercises training, dietary advice and psychological support. Contents will contain elements of physical training (e.g. aerobic and resistance exercises) and psychological therapy (e.g. meditation) will be delivered through WhatsApp at three sessions (day 1, 3 \& 5) per week for 30 minutes and 15 minutes respectively, educational information associated with colorectal cancer surgery and prehabilitation(e.g. high risks factors towards surgical complications) and dietary advices (e.g. recipes) will be delivered on weekly
Standard care
Other interventionStandard care as per department guidelines with ERAS protocol (including smoking cessation program, preoperative counselling, early rehabilitation program)
Postoperative complications
measured by the Comprehensive Complication Index (CCI), which integrates in a single formula all complications by severity, ranging from 0 (uneventful course) to 100 (death).
Length of hospital stay (LOS)
to evaluate the length of postoperative hospital stay
Physical activity
measured by the International Physical Activity Questionnaire Short Form (IPAQ-SF), seven items were assessed in frequency and duration over the past seven days, categorizing it into four types: vigorous intensity, moderate intensity, walking, and sitting. An average metabolic equivalents score (MET, min·w-1) was calculated to assess total physical activity as well as for each type of activity, separately. For walking activities, all types of walking were included and an average MET score was derived. The same procedure was carried out for medium intensity and high intensity activities. By calculating the number of activity days multiplied by the average duration per activity, statements about the energy consumption per week and the fitness level can be derived.
Gastrointestinal recovery
measured as time to first flatus (in hours)
Gastrointestinal function
measured as time to first bowel (hours)
Adherence to the prehabilitation
percentage of completed at least 75% of the prehabilitation.
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Tseung Kwan O Hospital, Hong Kong
Lead sponsor
Chinese University of Hong Kong
Collaborator
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