Willingness, preference, and resistance to frailty intervention for older gastric cancer based on stakeholder perspective: a qualitative study

基于利益相关者视角的老年胃癌患者对衰弱干预的意愿、偏好和抵触情绪:一项定性研究

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Abstract

BACKGROUND: Frailty is highly prevalent in older gastric cancer patients and seriously affects their prognosis, but gastric cancer-related frailty interventions are rare currently. The purposes of this study are to explore the willingness and preference of demanders, implementers, and administrators of frailty interventions for older gastric cancer patients based on stakeholder perspectives, and to analyze possible resistance in the intervention process. METHOD: Older gastric cancer patients hospitalized in a tertiary hospital in Jiangsu Province from April to August 2023, as well as some healthcare professionals and administrators in this hospital, were selected for qualitative interviews. Colaizzi 7-step analysis was used for coding, categorizing, and extracting data. RESULTS: A total of 3 themes and 13 sub-themes were identified, including willingness to participate (Patients: very willing to participate in frailty interventions and eager to improve health conditions; Healthcare professionals: willingness to participate to improve patient health when time permits; Hospital administrators: willingness to participate in improving the health of patients as permitted by the hospital); preferences (Patients: preference for actionable, cost- and time-efficient interventions; Healthcare professionals: preference for staged, individualized, supervised interventions; Hospital administrators: preference for science-based, implementable, cost-effective interventions with oversight mechanisms); resistance (Patients: lack of self-awareness of health management, insufficient family support and fear of becoming the "burden", insufficient social support and "no channel" for counseling; Healthcare professionals: lack of frailty expertise and intervention experience, limited energy of personnel and easy to lack of motivation; Hospital administrators: lack of standardized management system for frailty, and lack of frailty intervention feedback-evaluation system). CONCLUSION: Administrators need to identify needs and preferences under different positions, address resistance that affect the frailty interventions, and provide a reference basis for the implementation of frailty interventions. CLINICAL TRIAL NUMBER: Not applicable.

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