Het effect van een gecombineerde voeding- en bewegingsinterventie bij patiënten na oncologische chirurgie

A multicentre RCT will be conducted to investigate the effect of a blended intervention in adult patients after gastro-intestinal or lung cancer surgery. The blended intervention consists of a app, physical activity monitor and coaching by a dietician and physiotherapist. The intervention aims to increase physical activity and protein intake after hospital discharge by stimulating patients self-management. The main study parameter is the postoperative recovery in physical functioning measured with the CAT-PROMIS-physical functioning.

Patients in the intervention group will be stimulated to increase their level of PA and protein intake after hospital discharge by using multiple behavioural change techniques. Higher levels of PA and achieving protein requirements are expected to have a positive effect on the recovery in physical functioning after discharge. Therefore, it is hypothesized that patients in the intervention group will have a faster and better recovery in physical functioning during the first 3 months after discharge.

T0 (Baseline): 2-6 weeks prior to surgery T1: Hospital discharge T2: 1 week after discharge T3: 4 weeks after discharge T4: 8 weeks after discharge T5: 12 weeks after discharge T6: 3 months after discharge

The blended intervention consists of a smartphone application and corresponding accelerometer in combination with coaching by a physiotherapist and dietician. With the app, patients are able to self-monitor their daily protein intake and PA level, have insight in personal goals on protein intake and receive (real-time) feedback. The patients receive an ankle-worn PA monitor (PAM) and corresponding application one week prior to surgery to get familiarized with the application. After discharge, the patients continue the use for 3 months and patients will be monitored and coached by a physiotherapist and dietician during this period. The intervention will be tailored on the patients personal needs and preferences based on a shared decision making process with the patient. The patients will be coached by the physiotherapist and dietician following the principles of Motivational Interviewing.