Recovering at home: participating in a fast-track colon cancer surgery programme

Abstract

Recovering at home: participating in a fast-track colon cancer surgery programme Fast-track surgery programmes are examples of the changes in health care toward implementation of evidence-based practice, decreasing hospitalisation, and increasing demands on patients for self-care after discharge. Documented knowledge of fast-track programmes is primarily related to a medical perspective whereas the patients' perspective is lacking. The aim of this study was to explore the lived experience of participating in a fast-track programme after discharge from the patients' perspective. The study was carried out using a descriptive phenomenological approach. Sixteen patients having undergone colonic resection were interviewed twice. Participating in a fast-track programme after discharge is characterised as a transition process in which the patients change their focus from solely caring about overcoming the operation to being on a course of recovery. Following the fast-track daily regimen leads to a degree of tension in the patients' life world as the patients have to struggle against the body while also protecting it and caring for it. For the patients, the illness represented a fall from equilibrium into an existential limbo, and they needed to re-establish a sense of balance. Recovering from surgery and regaining strength was only one aspect of this process. Healthcare professionals need to pay more attention to the individual patient's lifeworld and to recognise the influence of lifeworld on the individual patient's recovery process.