Multiphasic psychosocial prehabilitation framework triggers the proactive interventions that focus on the whole process of recovery. To evaluate the multimodal psychosocial prehabilitation interventions on clinical outcomes, functional outcomes, cost of care and healthcare services utilization.

A parallel-arm randomized controlled design was carried out in the urological unit of a university-affiliated hospital in Shanghai, China. A total of 140 patients with prostate cancer received radical prostatectomy were recruited from the outpatient department of urology. Participants were randomly allocated to the experimental and control groups. The former received advanced practice nurse(APN)-led discharge program (figure 1) in addition to the usual perioperative education, while the control group received the usual perioperative education. The prehabilitation framework included patient-involved shared decision making, psychosocial well-being of patients and their caregivers, pelvic floor exercises, sexual well-being, and lifestyle changes. APNs serve as the “hub” along the cancer care continuum embedded within the framework. During the prehabilitation cancer trajectory and beyond, the program met patients and their family members’ spiritual, emotional, social, and physical needs during treatment. Baseline data were collected prior to the intervention (T0). Data were measured on the day of discharge from the hospital (T1) and 30 days after discharge (T2).

Participants in the intervention group showed significant improvement in the surgical outcomes: reduced the incidence of wound infections, deep vein thrombosis, improved urinary continence and erectile function, and lowered readmission rates; in the oncologic outcomes: increased the adherence rate for cancer therapies; in the functional outcomes: activities of daily life and quality of life. Above difference were significant compared to the control group (p < 0.01). However, no statistically significant differences were observed in length of stays and financial costs (p > 0.05).

The prehab program is effective for improving quality of perioperative recovery physically and psychologically, as well as for reducing surgery-related complications and enhancing health and well-being. Integration of prehab program is recommended to facilitate the psychosocial adaption for patients and their family members from prostate cancer.