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The older patient's experience of the healthcare chain and information when undergoing colorectal cancer surgery according to the ERAS concept.
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2018 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702Article in journal (Refereed) Epub ahead of print
Abstract [en]

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. 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. This article is protected by copyright. All rights reserved.

Place, publisher, year, edition, pages
2018.
Keywords [en]
Colorectal cancer, content analysis, experiences, healthcare chain, information, older patients
National Category
Surgery
Identifiers
URN: urn:nbn:se:umu:diva-145534DOI: 10.1111/jocn.14328PubMedID: 29495096OAI: oai:DiVA.org:umu-145534DiVA, id: diva2:1189016
Available from: 2018-03-09 Created: 2018-03-09 Last updated: 2018-06-09

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CiteExportLink to record
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