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IRIS
Background: Preoperative mental wellbeing is an important determinant of postoperative recovery, yet psychological care is frequently overlooked within multidisciplinary prehabilitation programmes. When included, psychological interventions are fragmented and inconsistently delivered. This study aimed to establish international multidisciplinary consensus on preferred psychological prehabilitation interventions for patients undergoing urogenital, thoracic or gastrointestinal cancer surgery, and to describe current practice. Methods: A three-round Delphi was conducted between February and September 2025. An international multidisciplinary expert panel rated the perceived effectiveness of each intervention for urogenital, thoracic and gastrointestinal cancer surgery using a 5-point Likert scale. Predefined criteria classified interventions as effective, ineffective, contested or indeterminate. Round 1 also captured current models of psychological prehabilitation delivery. Results: In total, 439 participants completed Round 1, with 191 and 234 completing Rounds 2 and 3, respectively. Nine interventions reached consensus as endorsed across all tumour types, with supportive counselling, personalised coping strategies, cognitive behavioural therapy and mindfulness-based techniques reaching the strongest agreement. Sexual health counselling was endorsed only for urogenital cancers. No interventions reached consensus as ineffective; however, hypnotherapy and eye movement desensitisation and reprocessing were contested in specific cancer groups, whilst metacognitive therapy remained indeterminate. International practice was heterogeneous, with limited routine screening, variable access to psychological services and funding/resource constraints as common barriers. Conclusion: This international Delphi study identified a core set of consensus-based psychological prehabilitation interventions for cancer surgery, providing a foundation for clinical implementation. Future research should prioritise hybrid effectiveness-implementation designs, generating data on optimal providers, delivery formats and patient characteristics.
Prioritising Psychological Prehabilitation Interventions for Cancer Surgery: An International Delphi Study
Hirst N.;Gates J.;Dhillon H. M.;Juraskova I.;Alexander K.;Reeves J.;Bai Z.;Solomon M. J.;McBride K.;Pereira L. S. M.;Drummond Lage A. P.;Steffens D.;Quyn A.;Daoud A.;Abudraz A.;Mohammed A. A.;Ghanam A.;Ghannam A.;Ghannam A.;Ibrahim A. A. A.;Abudyak A.;Fayez A.;Osman A.;Adam A. R. A. N. A.;Kuridan A.;Ismail A.;Shaban A.;Alailesh A. M.;Alyami A.;Ahmed A.;Hussain A.;Haddud A.;Elbushary A.;Drissi-El-Bouzaidi A.;Ibrahim A. M.;Algishary A.;Alqathafi A. B.;Al Othman A.;Mohamed A. M. I.;Youssef A.;Benghatnsh A.;Ahmayda A.;Wahaballah A.;Mohammed A. A. M.;Abdalla A. M. A.;Algeblawi A. A.;Rhab A. E.;Al-Yousufi A. J.;Shawat A. M.;Abbas A. M.;Alhatemi A. Q. M.;Al Sakini A. S.;Kaya A.;Al-Touny A.;Turna A.;Sayed A.;Abdalla A.;Awadallah A.;Heriot A.;Rokohl A. C.;Diamantis A.;Annicchiarico A.;Elhadidy A.;Albashiri A.;Tirihbat A.;Mohamedahmed A. Y.;Jackson A.;Mahoney A.;Khamees A.;Hamza A. N. K.;Bakhit A.;Souadka A.;Moh'd A.;Al Hammoud A.;Ngo-Huang A.;Desai A.;Ristescu A. -I.;Torbey A.;Varazzani A.;Maier A.;Denys A.;Jerath A.;Nutta A.;Hafstr A.;Tamminen A.;Hassan A.;Al-qaidani A. A.;Fraser-McFarland A.;Bakri A.;Mathai A. S.;Sachdeva A.;Kadi A.;Bausys A.;Venara A.;Hamid A. H. E.;Ahmed A.;Elsheikh A.;Saeed A.;Mohammed A.;Saracoglu A.;Emran A.;Al-Tayar B. A.;Fernandez-Torres B.;Qaddoumi B.;Albakosh B.;Zainalabdin B.;George B.;Alkhaffaf B.;Andersson B.;Roxburgh B.;Shailer B.;Roman B.;Nardo B.;Feo C.;Common C.;Tiselius C.;Scheede-Bergdahl C.;Sandroussi C.;Sabajo C.;van Kessel C.;Johnstone C.;Grimmett C.;Gillespie C.;Beilstein C.;Prickett C.;Clancy C.;Bertelsen C. A.;Harris C.;Chase D.;Mina D. S.;Arnal-Velasco D.;Baratti D.;Au D.;Levett D.;Liotiri D.;Abdelmelek D. -E.;Suresh D.;Linardoutsos D.;Lulic D.;D'Ugo D.;Engel D.;Virgilio E.;Ipponi E.;Isbayqah E.;Kassis E.;Van Daele E.;Sexton E.;Alhajal E.;MacInnes E.;Moret-Ruiz E.;Moret-Ruiz E.;Abdullah E.;Luca E.;Elshenawy E.;Abuobaida E. E.;Miralpeix E.;Mela E.;Harrison E. M.;Ausania F.;Elmozoghi F.;Gareb F.;Qudah F.;Elmobark F.;Fahem F. Z.;Singh F.;Oliva F. M.;Arduini F.;D'amico F.;Mongelli F.;Pata F.;Mulita F.;Frizelle F.;Berrevoet F.;Klevebro F.;van Ramshorst G. H.;Wright G.;Bashour G.;Slooter G.;Martinez-Palli G.;Bohsas H.;Aldare H.;Alsadeg H.;Osman H. A. Y.;Aslami H.;El Magrahi H.;Hilal H.;Hamad H. A. H.;Gurbuz H.;de Boer H. D.;Serhan H. A.;El Batae H.;Elbaz H.;Ibrahem H.;Alhaj H.;Al Mohammed H.;Driessens H.;Smid-Nanninga H.;Bakeer H. B.;Yano H.;Bilal H.;Tang H.;Horsfall H. L.;Abuasaker H.;Abuasaker H.;Hasson H.;Embarek H.;Boden I.;Alfrouh I.;Saidahmed I. Y. I.;Lulic I.;Merlini I.;Bouabdallah I.;Khan I.;Shariffuddin I.;Baloyiannis I.;Montroni I.;Gogenur I.;Jakobsen J. K.;Chmelo J.;Dekker J. W. T.;Park J.;Sultan J.;Jeannon J. -P.;Heiman J.;Santos-Costa J.;Burisch J.;Whitaker J.;Alfitian J.;Klaase J.;Kiiski J.;Cotte J.;Mayol J.;Geboes K.;McBride K.;Musa K. M.;Saracoglu K. T.;Tan K. -K.;Ancog K.;Ahmed K. A. H. M.;Abdelwahab K.;Al-Shami K.;Zulit K. M. S.;Saeed K. A. M. D.;Abellaneda-P K.;Raso K. -L.;Edbrooke L.;Murphy-Shaw L.;Lorenzon L.;Schwarz L.;Edgar L.;Notarianni L.;Hendriks L.;Cohen L.;Beuk L.;Bensalem M.;Eissa M.;Gafar M.;Eissa M.;Bilfaqirah M.;Wabran M.;West M.;Hamad M. M. Y.;Attia M.;Athar M.;Lopez-Baamonde M.;Pocard M.;Sparavigna M.;Castagna M. G.;Gomez-Hernandez M. T.;Aboasaad M. I.;Salter M.;Arrigo M.;Sandini M.;Ubre M.;Gruenbart M.;Evans M. D.;McGraw M.;Uccelli M.;Piccinelli M. L.;Slepian M.;Hassan M. A. E.;Estaire-G M.;Kelly M.;Flanagan M.;Rimondini M.;Leon-Arellano M.;Garriz M.;Asp M.;Ukkonen M.;Coca-Martinez M.;Ferr M.;Moharam M.;Alkchr M.;Alabrash M.;Ahmed M. S. A.;Al Gharyani M.;Ibrahim M.;El-Moslemani M.;Elsayed M.;Deghedy M.;Alsori M.;Elbahnasawy M.;Sandal M.;Elfadali M. A.;Abdrabo M. F.;Yassin M. M.;Lawgali M. N.;Mohamedbakheet M.;Abuzenah M.;Al-Shehari M.;Babikir M.;Al-Bouhlala M.;Issa M.;Izzaldin M.;Izzaldin M.;Majbar M. A.;Aldreawi M. M. M.;Le Guen M.;Ali M. A.;Elnasser M.;Mokresh M. E.;Lateiresh M. S. A.;Alahmad M.;Fadlalla M.;Gok M.;Abdelwahab N. A. N. A.;Ansari N.;Badr N. W.;Hanna N.;Alqousi N.;Ahmadi N.;Gallench-Pons N.;Kovac N.;Alkhanffas N.;Smart N.;Pillinger N.;Kalyva N.;Elnady N.;Rizvanovic N.;Ahmed N.;Sulen N.;Srinivasaraghavan N.;De Piccoli N.;Shawabkeh N.;Elmisbah N.;Shaaban N.;Yousif O. A. Y.;Ioannidis O.;Mohamed O.;Elhagbakheit O.;Abdallah O.;Osman O.;Roy P.;Aceto P.;Losurdo P.;Forget P.;Treacy P.;Wuethrich P.;Sutton P.;Kabata P.;Nilsson P. J.;Paal P.;Noordzij P.;Paal P.;Bor P.;Pucher P. H.;Lombardi P. M.;Major P.;Bruzzaniti P.;Coronado P.;Sabbah Q.;Mohamed R.;Muharam R.;Albatool R. H. N.;El-Faouri R.;Garcia R. S.;Abdalla R. Y. A.;Bojesen R. D.;Ghmagh R.;Daoud R.;Farrell R.;Harrison R.;Soudan R.;Copeland R.;Miegel R.;Haidar R.;Navarro-Perez R.;Thanigasalam R.;Franssen R.;Ahmeedah R.;Elsahli S.;Elamin S. I. E.;Karaja S.;Abdulraheem S.;Ali S. H.;Sannoufa S.;Fadlalla S. S. A.;Al-Aish S.;Emgaib S.;Aouadi S. Y.;Braungart S.;Abdelmohsen S.;Mahjoub S. S. A.;Swed S.;Rajsic S.;Karunaratne S.;Leslie S.;Scholch S.;Atici S. D.;Jeon S. W.;Karaja S.;Ganesh S.;Philp S.;Carey S.;Wael S.;Rahman S.;Garzon S.;Ezzi S. H. A.;Orcutt S.;Hogan S.;Bechka S.;Mancin S.;Turi S.;Langton S.;Apostolaki S.;Batarseh S.;Moug S.;Gonz S.;Shandaq T.;Triantafyllou T.;Sammour T.;Simurina T.;Tsoukalas T.;Vilz T.;Bright T.;Joensen U.;Gorey V.;Lohsiriwat V.;Leivaditis V.;Mousafeiris V.;Marinelli V.;Kontinen V.;Zaydfudim V.;Alissa W.;Albarazi W.;Ali W.;Omar W.;Aljbali W.;Ricketts W.;Aljibali W.;Mukhtar Y.;Dorreman Y.;Obadiel Y.;Obadiel Y.;Abbas Y.;Haddad Z.;Mohamed Z.
2026-01-01
Abstract
Background: Preoperative mental wellbeing is an important determinant of postoperative recovery, yet psychological care is frequently overlooked within multidisciplinary prehabilitation programmes. When included, psychological interventions are fragmented and inconsistently delivered. This study aimed to establish international multidisciplinary consensus on preferred psychological prehabilitation interventions for patients undergoing urogenital, thoracic or gastrointestinal cancer surgery, and to describe current practice. Methods: A three-round Delphi was conducted between February and September 2025. An international multidisciplinary expert panel rated the perceived effectiveness of each intervention for urogenital, thoracic and gastrointestinal cancer surgery using a 5-point Likert scale. Predefined criteria classified interventions as effective, ineffective, contested or indeterminate. Round 1 also captured current models of psychological prehabilitation delivery. Results: In total, 439 participants completed Round 1, with 191 and 234 completing Rounds 2 and 3, respectively. Nine interventions reached consensus as endorsed across all tumour types, with supportive counselling, personalised coping strategies, cognitive behavioural therapy and mindfulness-based techniques reaching the strongest agreement. Sexual health counselling was endorsed only for urogenital cancers. No interventions reached consensus as ineffective; however, hypnotherapy and eye movement desensitisation and reprocessing were contested in specific cancer groups, whilst metacognitive therapy remained indeterminate. International practice was heterogeneous, with limited routine screening, variable access to psychological services and funding/resource constraints as common barriers. Conclusion: This international Delphi study identified a core set of consensus-based psychological prehabilitation interventions for cancer surgery, providing a foundation for clinical implementation. Future research should prioritise hybrid effectiveness-implementation designs, generating data on optimal providers, delivery formats and patient characteristics.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.11770/414138
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simulazione ASN
Il report seguente simula gli indicatori relativi alla propria produzione scientifica in relazione alle soglie ASN 2023-2025 del proprio SC/SSD. Si ricorda che il superamento dei valori soglia (almeno 2 su 3) è requisito necessario ma non sufficiente al conseguimento dell'abilitazione. La simulazione si basa sui dati IRIS e sugli indicatori bibliometrici alla data indicata e non tiene conto di eventuali periodi di congedo obbligatorio, che in sede di domanda ASN danno diritto a incrementi percentuali dei valori. La simulazione può differire dall'esito di un’eventuale domanda ASN sia per errori di catalogazione e/o dati mancanti in IRIS, sia per la variabilità dei dati bibliometrici nel tempo. Si consideri che Anvur calcola i valori degli indicatori all'ultima data utile per la presentazione delle domande.
La presente simulazione è stata realizzata sulla base delle specifiche raccolte sul tavolo ER del Focus Group IRIS coordinato dall’Università di Modena e Reggio Emilia e delle regole riportate nel DM 589/2018 e allegata Tabella A. Cineca, l’Università di Modena e Reggio Emilia e il Focus Group IRIS non si assumono alcuna responsabilità in merito all’uso che il diretto interessato o terzi faranno della simulazione. Si specifica inoltre che la simulazione contiene calcoli effettuati con dati e algoritmi di pubblico dominio e deve quindi essere considerata come un mero ausilio al calcolo svolgibile manualmente o con strumenti equivalenti.
