Cancer patients’ experiences of psychological function in multimodal prehabilitation: A systematic review and meta-ethnography

Introduction: Multimodal prehabilitation is increasingly used to prepare patients for cancer treatment, yet the psychological functions of these programmes and how they are experienced by patients remain poorly understood. This review synthesises qualitative evidence on cancer patients’ experiences of multimodal prehabilitation programmes that included psychological elements. Method: A systematic search of CINAHL, Medline, and PsycINFO was conducted to identify peer-reviewed qualitative studies exploring patient experiences of multimodal prehabilitation for cancer treatment. Eligible programmes explicitly aimed to address psychological outcomes or included elements with a stated psychological function. Study quality was appraised using the Critical Appraisal Skills Programme. Findings were synthesised using meta-ethnography. Results: Ten studies published between 2017 and 2023 were included. Three overarching constructs were identified: (1) the primacy of exercise within prehabilitation, with psychological processes often operating in synergy to support motivation, confidence, and adherence; (2) patient preferences for programme set-up, including personalisation, flexibility, timing, and mode of delivery; and (3) the wider context of patients’ lives and care pathways, including practical constraints, expectations about recovery and rehabilitation, and the involvement of significant others. Psychological benefits were often described as arising through exercise, social interaction, and supportive staff behaviours rather than through discrete psychological sessions. Overall study quality was acceptable, though reporting on staff training, intervention fidelity, and socioeconomic influences was limited. Conclusions: Psychological processes are a prominent feature of patients’ experiences of multimodal prehabilitation and appear to shape engagement, acceptability, and perceived value across programme components. The findings support patient-centred, stratified approaches that integrate psychological function within routine prehabilitation delivery rather than positioning it as an optional add-on. Future research should prioritise co-design, include the perspectives of non-engagers, and articulate programme theories with embedded process evaluation to support effective and equitable implementation of prehabilitation in cancer care.