Understanding support needs for family-participatory prehabilitation before hepatectomy: a qualitative study on Chinese patients and family caregivers.

BACKGROUND/OBJECTIVES: Prehabilitation can improve patients' physical and psychological reserve before hepatectomy, but its value depends on implementation in daily life. Because prehabilitation mainly takes place at home, family caregivers may strongly influence whether patients can follow the program. It remains unclear how family caregivers can be involved effectively. This study explored the support needs, barriers, and facilitators experienced by patients awaiting hepatectomy and their family caregivers, with the aim of informing a family-participatory prehabilitation program that fits real clinical needs. METHODS: A qualitative descriptive dyadic study was conducted at a tertiary hospital in Sichuan Province, China. Purposive maximum variation sampling was used to recruit participants. Guided by a semi-structured interview outline, trained clinical nurse researchers separately interviewed 11 patient-caregiver dyads from February to June 2026. Two researchers independently coded the verified transcripts, and the wider team developed themes through discussion. RESULTS: The patients included nine men and two women aged 43-73 years (mean, 57.4 years). Most family caregivers were patients' spouses (n = 8). Six themes emerged: professional authority helped dyads accept prehabilitation; disease status, finances, work, and family roles shaped preoperative uncertainty; families acted as the main implementation unit; feasibility was limited by symptoms, knowledge gaps, family relationships, and available resources; family support was not always facilitative when patients felt their autonomy was reduced; and participants preferred support that was specific, personalized, low-burden, and sustainable. Patients and caregivers often described burden and acceptable supervision differently. CONCLUSION: Family involvement should not be reduced to asking relatives to monitor patients. A workable family-participatory model needs professional guidance, negotiated patient-caregiver roles, protection of patient autonomy, assessment of caregiver capacity, low-literacy delivery, and attention to cost. These findings provide a practical basis for developing family-participatory prehabilitation interventions before hepatectomy.