What’s Going on in the Hospital?: A Qualitative Study Investigating Patient Experiences of Prolonged Hospitalization After Video-assisted Thoracoscopic Surgery

Abstract

Patients with lung cancer in “enhanced recovery after surgery” programs are offered the prospect of early hospital discharge before undergoing surgery. Little is known about what patients experience when hospitalization lasts longer than expected. To explore patient experiences of prolonged hospitalization in an “enhanced recovery after surgery” program following video-assisted thoracoscopic surgery lobectomy. Fifteen face-to-face, nonstructured interviews were conducted with patients who had undergone surgery and were hospitalized for 7 days or more. Six themes emerged regarding experiences and coping strategies: lacking information, drawing boundaries, coping with boredom, time for existential thoughts, relying on other patients for reflection, and sufficient time to worry about the aftermath. The analysis was based on Gadamer’s philosophical hermeneutical approach and Antonovsky’s theory of sense of coherence (SOC). Patients had various strategies for coping with their situation when hospitalized for a prolonged period in an “enhanced recovery after surgery” program. Health care professionals had an important role in supporting patients’ individual coping strategies to help patients maintain a SOC. The findings can be used to understand how patients experience hospitalization when their trajectory deviates from standardized programs. Need for an individual approach to patients is recommended. The results indicate an important role for nursing care in “enhanced recovery after surgery” programs and underscore that an individualized approach to patients can bolster coping strategies and thus a SOC.