Objective  To investigate the influencing factors of adherence to exercise prehabilitation in older patients with colorectal cancer.

  Methods  Based on the capacity, opportunity, and motivation of behavior change (COM-B) model, 12 older colorectal tumors patients undergoing elective surgeries at a tertiary-care hospital in Shanghai between August 2022 and December 2022 were enrolled for the study through purposive sampling. The respondents were involved in semi-structured interviews. Directed content analysis of their data was conducted to extract themes.

  Results  A total of 3 themes and 8 sub-themes were deduced from the analysis, including capacity (physical ability to tolerate exercise intensity and psychological experience of worrying about exercise risks), opportunity (adequate information support and professional guidance and simple and feasible exercise prescriptions and prehabilitation conditions), motivation (the intrinsic drive to identify with the prehabilitation values, the positive drive of inherent exercise habits, the continuous drive of exercise benefits, and the dual inspiration of team spirit and family support). These themes and subthemes were identified as influencing factors of adherence to exercise prehabilitation in older patients with colorectal cancer.

  Conclusion  Prehabilitation in older patients with colorectal cancer is influenced by multiple factors. Healthcare professionals should enhance education, develop individualized prehabilitation programs, and improve the diversified social support system to enhance patients' adherence to prehabilitation exercise and maximize the benefits of prehabilitation.