Abstract
BACKGROUND: Enhanced recovery after surgery guidelines aim to optimize perioperative care and improve recovery outcomes. The guidelines contain clinician- and patient-led recommendations for pre- and postoperative care, with patient-led recommendations, including smoking cessation, early mobilization, and early resumption of eating and drinking. While adherence to these recommendations can improve recovery outcomes, it is typically low, and many patients require support. Digital health interventions (DHIs) are increasingly accepted as useful tools in delivering individualized health care and have the potential to support adherence to enhanced recovery after surgery guidelines. Evidence suggests that intervention use is optimized when DHIs are considered acceptable to end users. RecoverEsupport is a DHI designed to support patient adherence to surgical recovery guidelines, following breast cancer surgery, intended as part of a blended approach with standard care. OBJECTIVE: The study aimed to explore the surgical experiences and perceived acceptability of the RecoverEsupport DHI among former patients undergoing breast cancer surgery. METHODS: This qualitative study, underpinned by a constructivist paradigm, explored the recovery experiences and acceptability of RecoverEsupport among women who had undergone mastectomy for breast cancer at a tertiary hospital in New South Wales (NSW), Australia. In total, 57 eligible patients were identified from medical records and invited to participate. Among them, 15 consented and were given access to the RecoverEsupport DHI for approximately 2 weeks. Around 11 participants then participated in a semistructured interview exploring their recovery experiences and feedback on the DHI. Interviews were transcribed and double coded prior to analysis using an inductive thematic approach. RESULTS: Participants reported varied experiences of breast cancer surgery and expressed a consistent need for support, with many reporting uncertainty, anxiety, and limited information and physiotherapy support. RecoverEsupport was perceived as acceptable, with strong potential to reduce anxiety, address gaps in care, and provide reassurance. Participants valued the practical content, particularly physiotherapy exercise videos, which reinforced clinician advice and promoted confidence, autonomy, and self-efficacy. The intervention was seen as empowering patients to manage recovery and support their physical and emotional needs. All participants reported that they would recommend RecoverEsupport to others undergoing breast cancer surgery, highlighting its potential as a valuable adjunct to usual care. CONCLUSIONS: RecoverEsupport was perceived as a valuable adjunct to standard perioperative care. Four key themes were identified. Participants reported that the program addressed key gaps in information, physiotherapy access, and emotional support, while complementing clinical care. The intervention was seen to empower patients by enhancing knowledge, confidence, and self-efficacy, enabling a more active role in their recovery. It also provided reassurance during a vulnerable period. These findings highlight the potential of DHIs to support patients within constrained health care systems and enhance recovery outcomes.