title: Understanding people's experience of vitreo-retinal day surgery: a Gadamerian-guided study.
abstract: OBJECTIVE
  This paper is a report of a study that aimed to understand the individual's experience of day surgery for repair of vitreo-retinal pathology.
  
  
  BACKGROUND
  Day surgery evolved as a global phenomenon in response to tensions existing between community demand for health-care services and fiscal limitations. Since then vitreo-retinal surgery has been routinely performed as day surgery. Whilst studies have reported on patients' experience's following inpatient surgery, there has been limited investigation of vitreo-retinal day surgery from the patient's perspective.
  
  
  METHODS
  In-depth unstructured interviews with 18 people were conducted between July 2006 and December 2007. Data analysis using philosophical hermeneutic techniques enabled a co-constructed understanding, where, the 'conditions of understanding' as described by Gadamer were established.
  
  
  RESULTS
  Guided by a Gadamerian approach to analysis, four constitutive themes were identified: 'the physical Self', 'the psychological Self', 'the historically located Self' and 'the Self located in the community'. Within each theme the participant's positive and negative experiences were understood in the context of human need, and gaps in nursing care became illuminated. These experiences included: pain, nausea, problematic self-care and psychological angst.
  
  
  CONCLUSIONS
  Insights into the experience of vitreo-retinal day surgery, gained from this study can be used to inform nurses planning care for people with vitreo-retinal pathology. Nursing care must address broader patient needs that span multiple human domains, particularly when vision has been threatened by complex pathology.
authors.affiliation: Flinders Eye Centre, Flinders Medical Centre, Adelaide, South Australia, Australia. christine.mccloud@health.sa.gov.au
authors.forename: Christine
authors.initials: C
authors.lastname: McCloud
authors.forename: Ann
authors.initials: A
authors.lastname: Harrington
authors.forename: Lindy
authors.initials: L
authors.lastname: King
mesh_terms: D000359:Aftercare / Q000458:organization & administration / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects / Q000451:nursing / Q000523:psychology*; D000772:Anesthesia, Local / Q000009:adverse effects / Q000523:psychology*; D001766:Blindness / Q000523:psychology; D005239:Fear / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015404:Nursing Methodology Research; D059408:Pain Management / Q000379:methods / Q000592:standards; D010149:Postoperative Pain / Q000188:drug therapy / Q000209:etiology; D017060:Patient Satisfaction; D010687:Philosophy, Nursing; D020250:Postoperative Nausea and Vomiting / Q000209:etiology; D036301:Qualitative Research; D012648:Self Care; D016896:Treatment Outcome; D057586:Vitreoretinal Surgery / Q000009:adverse effects / Q000451:nursing / Q000523:psychology*