Barbara Worster1, Susan Holmes. 1. Faculty of Health and Social Care, Canterbury Christ Church University, North Holmes Road, Canterbury, Kent, UK.
Abstract
PURPOSE: This study was designed to investigate patients' experience during the postoperative phase of recovery following colorectal resection with end-to-end anastomosis. METHOD AND SAMPLE: This was a descriptive phenomenological study reliant upon individual interviews. The sample was purposefully drawn from those admitted for surgery. Interviews continued until no new data could be identified from the transcripts. KEY RESULTS: After initial relief that surgery was over, the experience was dominated by 'tubes and drains', the consequences of epidural anaesthesia and ongoing pain relief. Themes encompassed loss of dignity and control, inability to eat and drink and lack of sleep. Some found it embarrassing discussing and coping with intimate bowel issues in a communal environment, particularly in mixed sex wards. Patients' emotional state initially reflected their physical condition rather than their disease; as independence was regained, awareness that they were suffering from cancer recurred and was associated with fear and anxiety. Variations in requirements for information were evident indicating that communication does not always equate with understanding. Participants passed through a stage of complete dependence to a degree of renewed independence at discharge, which was itself associated with mixed emotions. For some, there was relief while others were anxious about leaving the 'safety' of the hospital environment. CONCLUSIONS: These findings provide considerable insight into the experience of colorectal surgery and so can make a significant contribution to the planning and delivery of care; they have the potential to impact on the care received by those with colorectal cancer.
PURPOSE: This study was designed to investigate patients' experience during the postoperative phase of recovery following colorectal resection with end-to-end anastomosis. METHOD AND SAMPLE: This was a descriptive phenomenological study reliant upon individual interviews. The sample was purposefully drawn from those admitted for surgery. Interviews continued until no new data could be identified from the transcripts. KEY RESULTS: After initial relief that surgery was over, the experience was dominated by 'tubes and drains', the consequences of epidural anaesthesia and ongoing pain relief. Themes encompassed loss of dignity and control, inability to eat and drink and lack of sleep. Some found it embarrassing discussing and coping with intimate bowel issues in a communal environment, particularly in mixed sex wards. Patients' emotional state initially reflected their physical condition rather than their disease; as independence was regained, awareness that they were suffering from cancer recurred and was associated with fear and anxiety. Variations in requirements for information were evident indicating that communication does not always equate with understanding. Participants passed through a stage of complete dependence to a degree of renewed independence at discharge, which was itself associated with mixed emotions. For some, there was relief while others were anxious about leaving the 'safety' of the hospital environment. CONCLUSIONS: These findings provide considerable insight into the experience of colorectal surgery and so can make a significant contribution to the planning and delivery of care; they have the potential to impact on the care received by those with colorectal cancer.
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