A phenomenological study of the postoperative experiences of patients undergoing surgery for 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.

The preoperative experience of patients undergoing surgery for colorectal cancer: a phenomenological study.

Colorectal cancer is associated with significant morbidity and mortality; many patients undergo surgical resection following which they are discharged home to await adjuvant therapy. Using a phenomenological approach, patients' experiences during this period were investigated arising from a concern that their needs may be overlooked. However, though post-discharge experience was the primary focus, informants chose first to talk about their preoperative experiences; these are reported here. As this was not the primary focus, we cannot claim that the data is complete though the findings suggest that this area warrants further investigation. Preoperative experiences, characterised by fear, questions, isolation and uncertainty, exerted significant influence on the respondents. Some believed that cancer was 'their problem', no-one could help them with it although support from the Clinical Nurse Specialist was highly valued. Such reactions are not specific to colorectal disease and it was rarely evident that respondents had this form of cancer. Patients exhibited a desire to protect others from their diagnosis. The findings also show considerable variation in the requirement for information indicating that professionals should take their lead from the individual concerned. Patients with cancer are the 'experts' in living with the disease and their experiences can make a significant contribution to the planning and delivery of care. These findings have the potential to impact on the care received by those with colorectal cancer.