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I S S U E S A N D IN N O V A T I O N S I N N U R S I N G P R A C T I C E

Patients’ existential situation prior to colorectal surgery
Monica Moene
RN RNT

Lecturer, Doctoral Student, Faculty of Health and Caring Sciences, Institute of Nursing, The Sahlgrenska Academy at Goteborg University, Goteborg, Sweden

Ingegerd Bergbom
Goteborg, Sweden

BSc PhD DHSc RN RNT

Professor, Facultyof Health and Caring Sciences, Institute of Nursing, The Sahlgrenska Academy at Goteborg University,

Carola Skott

PhD RN

Senior Lecturer, Faculty of Health and Caring Sciences, Institute of Nursing, The Sahlgrenska Academy at Goteborg University, Goteborg, Sweden

Accepted for publication 5 July 2005

Correspondence: Monica Moene, Institute of Nursing, The Sahlgrenska Academy atGoteborg University, Goteborg, Sweden. E-mail: monica.moene@fhs.gu.se

M O E N E M . , B E R G B O M I . & S K O T T C . ( 2 0 0 6 ) Journal of Advanced Nursing 54(2), 199–207 Patients’ existential situation prior to colorectal surgery Aim. The aim of this paper is to present a hermeneutic phenomenological study illuminating patients’ existential situation prior to colorectal surgery. The intentionwas also to explore the value of the encounter between patient and nurse. Background. Patients waiting for major surgery experience multifarious reactions. Emotions of anxiety, fears of the unknown, anaesthesia, cancer diagnosis and death can arise. Several earlier studies have reported the importance of information, coping strategies and the need to reduce anxiety and stress in relation to surgery.However, there is a lack of studies focusing on patients’ existential situation in the preoperative phase. Methods. Conversational interviews were conducted with 28 patients 1 week before their surgery during autumn 2002. Analysis of the data was influenced by van Manen’s existential themes: lived space/spatiality, lived body/corporeality, lived time/temporality and lived relation/relationality.Findings. Participants expressed either hope of increased spatiality or fear of restricted spatiality, according to whether they had a benign or malign diagnosis. Statements about lived time were also related to the diagnosis. Patients waiting for surgery for a benign diagnosis could use the time to relax and gather energy, while malignancy gave them high levels of anxiety and stress. Lived bodyexperiences showed the ambivalence felt in entrusting one’s body to professionals. Statements about lived relations drew attention to the need for considerate caregivers to enhance feelings of security and continuity. Conclusion. The existential situation of patients in a preoperative context was shown to be a state of uncertainty with regard to lived space, body, time and relation. The significanceof meeting and talking to the nurse did not appear in the statements. The nurse was invisible. If nurses were to employ the existential themes proposed by van Manen in preoperative encounter with patients, their need for care might be more clearly identified and affirmed.

Ó 2006 Blackwell Publishing Ltd, Journal of Advanced Nursing

199

M. Moene et al.

Keywords: colorectal disease,hermeneutics, interviews, patient participation, phenomenology, research report, surgical nursing

Introduction
People waiting for major surgery are at a vulnerable period of their lives. Any surgical procedure is preceded by multifarious reactions on the part of the patient, and these may be obvious or hidden. Prior to surgery, patients may experience various kinds of fear: of the unknown, ofanaesthesia, of receiving a diagnosis of cancer or of death. They may be concerned about losing control over themselves physically, psychologically or socially, or they may worry about losing independence and integrity. Concerns about the outcome of the operation and what effect it might have on everyday life may trouble them, as well as uncertainties about what a stay in a surgical ward will involve...