title: Post-discharge symptoms following fast-track colonic cancer surgery: a phenomenological hermeneutic study.
abstract: OBJECTIVE
  To obtain knowledge of patients' experiences of postoperative symptoms during the initial two weeks following fast-track colonic cancer surgery.
  
  
  METHODS
  Semi-structured in-depth interviews with seven colonic cancer patients two weeks post hospital discharge. Analysis was performed using a phenomenological hermeneutical approach.
  
  
  RESULTS
  During the first two weeks after discharge the patients experienced unfamiliar symptoms that affected their everyday lives. Despite distressing symptoms, they applied a "wait-and-see" strategy, and only reacted when symptoms became intolerable. The patients failed to report their unfamiliar symptoms during hospital nurse follow-up telephone call. While waiting for the final histology patients suffered loss of sleep and chaotic thinking, and experienced ambiguity of hoping for the best and expecting the worst.
  
  
  CONCLUSIONS
  Although fast-track surgery programmes lead to shorter hospitalisation and improved physical performance, post-colonic surgery patients experience various symptoms after discharge. Healthcare professionals need to address symptoms that might have immediate and long-term consequences on patients' everyday life. Follow-up studies are encouraged to explore the patient perspective to identify the needs of individual patients after hospital discharge.
authors.affiliation: Digestive Disease Center, Bispebjerg Hospital, Copenhagen University Hospital, Bispebjerg Bakke 23, DK-2400 Copenhagen, NV, Denmark.
authors.forename: Marianne
authors.initials: M
authors.lastname: Krogsgaard
authors.affiliation: Faculty of Health, Aarhus University, Noerrebrogade 44, building 21,1, DK-8000 Aarhus, Denmark ; Department of Anesthesia and intensive Care Medicine, Aarhus University Hospital, Noerrebrogade 44, building 21,1, DK-8000 Aarhus, Denmark.
authors.forename: Pia
authors.initials: P
authors.lastname: Dreyer
authors.affiliation: Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen, Denmark ; Copenhagen University Hospital Rigshospitalet, Trauma Centre, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Egerod
authors.affiliation: The University Hospitals Centre for Health Research, Rigshospitalet, Ryesgade 27, DK-2200 Copenhagen, N, Denmark.
authors.forename: Mary
authors.initials: M
authors.lastname: Jarden
keywords: Colonic cancer; Early discharge; Fast-track programme; Nursing; Postoperative recovery; Qualitative research; Symptom management