title: A thematic analysis of experiences of varicose veins and minimally invasive surgery under local anaesthesia.
abstract: OBJECTIVE
  To gain insight into the experience of living with varicose veins and undergoing minimally invasive surgery under local anaesthesia in a private clinic.
  
  
  BACKGROUND
  Minimally invasive surgery under local anaesthesia is replacing traditional surgical stripping for the treatment for varicose veins. Conscious surgery has previously been associated with elevated levels of anxiety and some associated pain. There is limited research exploring the experiences of patients undergoing varicose vein surgery under local anaesthesia.
  
  
  METHODS
  Qualitative semi-structured interviews with 20 patients who took part in a mixed methods study exploring the effects of distraction on intra-operative pain and anxiety.
  
  
  METHODS
  Participants were interviewed eight weeks post surgery about their experiences before, during and after surgery. Interviews were analysed using thematic analysis.
  
  
  RESULTS
  Four themes were captured (1) negative emotions associated with symptoms, (2) unpreparedness for the surgical process, (3) feeling cared for and (4) improvements in well-being. An overarching theme of relationships was identified. Overall, varicose veins had a detrimental impact on quality of life prior to surgery. Patients felt unprepared for their procedure and experienced the operation as anxiety provoking and uncomfortable. This was much helped by the support of nursing staff in the theatre. Post surgery, patients' quality of life was reported as improved.
  
  
  CONCLUSIONS
  More emphasis needs to be placed on preparing patients for surgery under local anaesthesia. The role of the nurse is central to creating a caring, relaxed environment which could improve patient experience.
  
  
  CONCLUSIONS
  Patients' experiences of varicose veins and their treatment both influence, and are influenced by relationships with others at all stages of the management process. Nurses play an important role in improving patient experience during surgery and care needs to be taken to ensure that patients understand and accept the processes of surgery and recovery.
authors.affiliation: School of Psychology, University of Surrey, Guildford, Surrey.
authors.forename: Briony F
authors.initials: BF
authors.lastname: Hudson
authors.affiliation: School of Psychology, University of Surrey, Guildford, Surrey.
authors.forename: Jane
authors.initials: J
authors.lastname: Ogden
authors.affiliation: The Whiteley Clinic, Stirling House, Guildford, Surrey.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Whiteley
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D024802:Nurse's Role; D010149:Postoperative Pain / Q000517:prevention & control*; D017060:Patient Satisfaction; D011788:Quality of Life; D014648:Varicose Veins / Q000451:nursing / Q000523:psychology / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods
keywords: nurse roles; nursing qualities; perception