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The older patient's experience of the healthcare chain and information when undergoing colorectal cancer surgery according to the enhanced recovery after surgery concept
Author(s) -
Samuelsson Katja Schubert,
Egenvall Monika,
Klarin Inga,
Lökk Johan,
Gunnarsson Ulf,
Iwarzon Marie
Publication year - 2018
Publication title -
journal of clinical nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.94
H-Index - 102
eISSN - 1365-2702
pISSN - 0962-1067
DOI - 10.1111/jocn.14328
Subject(s) - medicine , feeling , anxiety , disappointment , coping (psychology) , health care , disease , nursing , psychology , psychiatry , psychotherapist , social psychology , pathology , economics , economic growth
Aims and objectives To describe how older patients experience the healthcare chain and information given before, during and after colorectal cancer surgery. Background Most persons with colorectal cancer are older than 70 years and undergo surgery with subsequent enhanced recovery programmes aiming to quickly restore preoperative function. However, adaptation of such programmes to suit the older patient has not been made. Design Qualitative descriptive study. Method Semi‐structured interviews were conducted on 16 patients undergoing colorectal cancer surgery at a Swedish University Hospital. The inductive content analysis was employed. Results During the period of primary investigation and diagnosis, a paucity of information regarding the disease and management, and lack of help in coping with the diagnosis of cancer and its impact on future life, leads to a feeling of vulnerability. During their stay in hospital, the patient's negative perception of the hospital environment, their need for support, and uncertainty and anxiety about the future are evident. After discharge, rehabilitation is perceived as lacking in structure and individual adaptation, leading to disappointment. Persistent difficulty with nutrition delays recovery, and confusion regarding division of responsibility between primary and specialist care leads to increased anxiety and feelings of vulnerability. Information on self‐care is perceived as inadequate. Furthermore, provided information is not always understood and therefore not useful. Conclusion Information before and after surgery must be tailored to meet the needs of older persons, considering the patient's knowledge and ability to understand. Furthermore, individual nutritional requirements and preoperative physical activity and status must be taken into account when planning rehabilitation. Relevance to clinical practice Patient information must be personalised and made understandable. This can improve self‐preparation and participation in the own recovery. Special needs must be addressed early and followed up.