Nurses' perspectives on perioperative pulmonary rehabilitation for patients with lung cancer in the pre-implementation phase: a CFIR 2.0-guided study.
- 1Department of Thoracic Surgery, Chongqing University Three Gorges Hospital, School of Medicine, Chongqing University, Chongqing, China.
- 2Chongqing University Affiliated Renji Hospital (The Fifth People's Hospital of Chongqing), School of Medicine, Chongqing University, Chongqing, China.
Abstract
Background
Despite strong evidence supporting perioperative pulmonary rehabilitation (PR) for patients undergoing lung cancer surgery, little is known about factors that may influence implementation prior to program rollout, particularly in resource-constrained settings. Guided by the updated Consolidated Framework for Implementation Research (CFIR 2.0), this study aimed to identify anticipated barriers and facilitators to inform program refinement and future implementation strategies.Methods
A descriptive qualitative design was used. Semi-structured interviews were conducted with nurses from the thoracic surgery department of a tertiary hospital in China (September-November 2025). Guided by the four CFIR 2.0 domains (innovation, outer setting, inner setting, individuals), directed content analysis was performed based on nurses' perspectives.Results
Sixteen nurses were interviewed, representing diverse roles: Ward/ICU frontline staff nurses, charge nurses, unit secretaries, administrative nurses and nurse managers. Relevant constructs included 22 of the 29 CFIR 2.0 constructs and 8 subconstructs. Facilitators spanned: innovation (source, evidence base, relative advantage, trialability); outer setting (financing, policy, external pressure); inner setting (relational connections, communication, culture, incentive systems); and individual factors (team needs, leadership/practitioner capability, motivation). Barriers comprised: innovation (adaptability, complexity, cost); outer setting (local condition, partnerships and connections); inner setting (structural characteristics, compatibility, access to knowledge and information); and individuals (recipient needs, capability). Notably, implementation concerns differed across nursing roles, reflecting role heterogeneity and underscoring the need for tailored implementation strategies.Conclusion
Implementation of perioperative PR for patients undergoing lung cancer surgery is influenced by multilevel factors spanning innovation, outer setting, inner setting, and individuals determinants. Differences in concerns across nursing roles highlight the importance of role-tailored implementation strategies. These findings provide a foundation for optimizing implementation approaches and may facilitate the sustainable integration of evidence-based PR into routine practice, particularly in resource-constrained healthcare settings.
Related
- Implementation of i‑PARIHS-guided pulmonary rehabilitation in patients receiving oxygen by high‑flow nasal cannula
- Bridging the Artificial Intelligence Translation Gap in Perioperative Pulmonary and Respiratory Complications: A Practical Framework for Institution-Level Implementation
- Prognostic value of pulmonary artery pulsatility index for perioperative adverse cardiovascular events in patients undergoing surgery for mitral regurgitation
- Healthcare Professionals' Perspectives on Adherence Management in Home-Based Pulmonary Rehabilitation: A Qualitative Study.
- Perioperative Antifibrotic Treatment and Early Postoperative Outcomes in Patients With Idiopathic Pulmonary Fibrosis Undergoing Lung Cancer Surgery: A Systematic Review and Meta‐Analysis
BibTeX
@article{yang2026nurses,
title = {{Nurses' perspectives on perioperative pulmonary rehabilitation for patients with lung cancer in the pre-implementation phase: a CFIR 2.0-guided study.}},
author = {Chunxiao Yang and Yi Liu and Fanfan Li and Chunmei Tan and Xiaoqiong Liu and Wenping Gong and Shirong Ma},
journal = {Frontiers in medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1904755},
url = {https://europepmc.org/article/MED/42898221},
note = {CC BY},
}
RIS
TY - JOUR
TI - Nurses' perspectives on perioperative pulmonary rehabilitation for patients with lung cancer in the pre-implementation phase: a CFIR 2.0-guided study.
AU - Chunxiao Yang
AU - Yi Liu
AU - Fanfan Li
AU - Chunmei Tan
AU - Xiaoqiong Liu
AU - Wenping Gong
AU - Shirong Ma
PY - 2026
DA - 2026/10/05
JO - Frontiers in medicine
DO - 10.3389/fmed.2026.1904755
UR - https://europepmc.org/article/MED/42898221
AB - Background Despite strong evidence supporting perioperative pulmonary rehabilitation (PR) for patients undergoing lung cancer surgery, little is known about factors that may influence implementation prior to program rollout, particularly in resource-constrained settings. Guided by the updated Consolidated Framework for Implementation Research (CFIR 2.0), this study aimed to identify anticipated barriers and facilitators to inform program refinement and future implementation strategies.Methods A descriptive qualitative design was used. Semi-structured interviews were conducted with nurses from the thoracic surgery department of a tertiary hospital in China (September-November 2025). Guided by the four CFIR 2.0 domains (innovation, outer setting, inner setting, individuals), directed content analysis was performed based on nurses' perspectives.Results Sixteen nurses were interviewed, representing diverse roles: Ward/ICU frontline staff nurses, charge nurses, unit secretaries, administrative nurses and nurse managers. Relevant constructs included 22 of the 29 CFIR 2.0 constructs and 8 subconstructs. Facilitators spanned: innovation (source, evidence base, relative advantage, trialability); outer setting (financing, policy, external pressure); inner setting (relational connections, communication, culture, incentive systems); and individual factors (team needs, leadership/practitioner capability, motivation). Barriers comprised: innovation (adaptability, complexity, cost); outer setting (local condition, partnerships and connections); inner setting (structural characteristics, compatibility, access to knowledge and information); and individuals (recipient needs, capability). Notably, implementation concerns differed across nursing roles, reflecting role heterogeneity and underscoring the need for tailored implementation strategies.Conclusion Implementation of perioperative PR for patients undergoing lung cancer surgery is influenced by multilevel factors spanning innovation, outer setting, inner setting, and individuals determinants. Differences in concerns across nursing roles highlight the importance of role-tailored implementation strategies. These findings provide a foundation for optimizing implementation approaches and may facilitate the sustainable integration of evidence-based PR into routine practice, particularly in resource-constrained healthcare settings.
SN - 2296-858X
ER -