Loss and grief reactions as responses to surgery.

Using autobiographical material, the patient experience of major surgery (panproctocolectomy and ileostomy) is described. A number of stages are identified in the patient experience: the development of dependence before surgery; disconnectedness from the social world immediately after surgery; and reality shock as grief and loss became apparent. The data are analysed using a theoretical perspective originally developed to describe reactions to bereavement. The practical nursing and counselling implications deriving from the theoretical model are elaborated.