Patients' existential situation prior to colorectal surgery.
OBJECTIVE
The aim of this paper is to present a hermeneutic phenomenological study illuminating patients' existential situation prior to colorectal surgery. The intention was 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.


RESULTS
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 body experiences 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.


CONCLUSIONS
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 significance of 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.
Moene
Monica
M
Faculty of Health and Caring Sciences, Institute of Nursing, The Sahlgrenska Academy at Goteborg University, Goteborg, Sweden. monica.moene@fhs.gu.se
Bergbom
Ingegerd
I
Skott
Carola
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000523:psychology; D001294:Attitude to Health; D003106:Colon / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000523:psychology*; D005239:Fear / Q000523:psychology; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000523:psychology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role; D011300:Preoperative Care / Q000451:nursing; D011369:Professional-Patient Relations; D012007:Rectum / Q000601:surgery*; D012063:Relaxation; D012649:Self Concept; D013315:Stress, Psychological / Q000523:psychology; D013997:Time Factors