Development of personas to tailor prehabilitation care for patients undergoing cancer surgery: An exploratory study

Background: Prehabilitation is increasingly used to improve postoperative outcomes. Despite the growing emphasis on tailored care, healthcare nowadays is often highly protocolized. Personas, fictional but realistic representations of patients and their needs, might be helpful to design and deliver tailored prehabilitation support. Methods: Exploratory multi-methods study. First, the Nominal Group Technique was used to establish a list of patient characteristics for determining the appropriate mode of prehabilitation support. Second, a cluster analysis was performed and the Proto Persona Development Method was used to develop personas. Third, the modes of prehabilitation support deemed appropriate were determined per persona. Fourth, a patient consultation session was conducted. Results: The first step resulted in a list of 29 patient characteristics: physical fitness, health literacy, frailty, personal preference and motivation were ranked as most important for tailoring prehabilitation. The cluster analysis (n = 291) did not result in distinctive clusters. With experts, four prehabilitation personas were developed: Avoiding Alex, Informed Indy, Overwhelmed Ollie and Social Sam. The interrater reliability of patient characteristics and modes of support per persona ranged from moderate to excellent. Conclusions: The personas show the importance of providing different communication and modes of prehabilitation care. Their use might avoid cognitive biases by adapting the information to the needs per individual patient.