The effect of pre-operative prehabilitation program on postoperative recovery in women with gynecological cancer

Aim: The purpose of this research is to determine the effect of the prehabilitation program applied to women diagnosed with gynecological cancer before surgery on postoperative recovery. Method:A single-blind, randomized, controlled experimental study consisted of 44 participants who presented to the gynecologic oncology outpatient clinic of a city hospital in Istanbul between April 2024 and March 2025 and met the inclusion criteria. Participants were assigned to experimental (n=22) and control (n=22) groups using a simple randomization method. In addition to standard care, the experimental group received an average of 2 weeks of preoperative education and practice, followed by weekly telephone calls until the day of surgery. Participants were provided with a booklet. The study concluded at 6 weeks postoperatively. Data collection included the Structured Descriptive Information Form, Mini Nutritional Assessment (MNA), 2-Minute Walk Test, Depression, Anxiety, and Stress Scale (DASS 21), Quality of Recovery Scale (QOR-15), WHODAS Disability Self-Report Form, Patient Follow-Up Form, and Gynecologic Cancer Symptom Form. Results: No significant differences were found in the sociodemographic, general health, and gynecological cancer characteristics of the experimental and control groups (p>0.05). Post-intervention, the experimental group had higher MNA and QOR-15 scores and lower DASS-21 scores, and the differences were statistically significant compared to the control group. Effect sizes showed a moderate effect on DASS depression scores and a large effect on MNA, DASS Stress, and Anxiety scores. Preoperative symptoms of low back pain, vaginal bleeding, anorexia, fatigue, fullness/bloating, and weight loss were found to be more severe in the control group than in the experimental group. After the program, participants in the experimental group were able to walk longer distances according to the 2-minute walk test, and the change over time was statistically significant. No statistically significant differences were found between the experimental and control groups in terms of postoperative follow-up, presence of complications, and WHODAS disability scale (p>0.05). While the mean hospitalization days for the experimental group were 6.36 ± 1.73, the mean hospitalization days for the control group were 7.36 ± 2.01. Conclusion: It has been determined that prehabilitation programs increase postoperative recovery by improving functional capacity. It is recommended to use prehabilitation programs in nursing care in the preoperative period. Keywords: Prehabilitation Program, Preoperative Period Education Program, Preoperative Period Nursing Care, Postoperative Period Recovery