“Like a trip to McDonalds”: A grounded theory study of patient experiences of day surgery

Abstract

BackgroundThe amount and complexity of (ambulatory) day surgery is rapidly expanding internationally. Nurses have a responsibility to provide quality care for day surgery patients. To do this they must understand all aspects of the patient experience. There is dearth of research into day surgery using a sociological frame of reference. ObjectiveThe study investigated patients’ experiences of day surgery using a sociological frame of reference. DesignA qualitative study using the grounded theory approach was used. SettingThe study was based in two day surgery units in two urban public hospitals in the United Kingdom. Participants145 patients aged 18–70 years and 100 carers were purposely selected from the orthopaedic, ear nose and throat and general surgical lists. They were all English speaking and were of varied socio-economic background. MethodsThe data was collected from 2004 to 2006. Semi-structured interviews were conducted on three occasions: before surgery, 48h following surgery and one month following discharge. Permission was received from the Local Research Ethics Committee. Analysis of the data involved line-by-line analysis, compilation of key words and phrases (codes) and constant comparison of the codes until categories emerged. FindingsPatients liked day surgery and placed it within the wider societal context of efficiency and speed. Time was a major issue for them. They wished surgery, like all other aspects of their life to be a speedy process. They likened it to a McDonald's experience with its emphasis on speed, predictability and control. ConclusionThis study throws new light on patient experiences and offers an understanding of day surgery against a western culture which emphasises the importance of speed and efficiency. It is a popular choice for patients but at times it can be seen to be a mechanistic way of providing care. The implications for nurses to provide education and information to add to the quality of the patient experience are discussed.