title: Topics and structure in preoperative nursing consultations with patients undergoing colorectal cancer surgery.
abstract: BACKGROUND
  The preoperative education, which occurs in preoperative patient consultations, is an important part of the surgical nurse's profession. These consultations may be the building blocks of a partnership that facilitates communication between patient and nurse.
  
  
  OBJECTIVE
  The aim of the study was to describe topics and structure and documentation in preoperative nursing consultations with patients undergoing surgery for colorectal cancer.
  
  
  METHODS
  The study was based on analysis of consultations between seven patients and nurses at a Swedish university hospital. The preplanned preoperative consultations were audio-recorded and transcribed verbatim. The structure of the consultations was described in terms of phases and the text was analysed according to a manifest content analysis RESULTS: The consultations were structured on an agenda that was used variously and communicating different topics in an equally varied manner. Seven main topics were found: Health status, Preparation before surgery, Discovery, Tumour, Operation, Symptoms and Recovery after surgery. The topic structure disclosed a high number of subtopics. The main topics 'Discovery', 'Tumour' and 'Symptoms' were only raised by patients and occupied only 11% of the discursive space. Documentation was sparse and included mainly task-oriented procedures rather than patients' worries and concerns.
  
  
  CONCLUSIONS
  There was no clear structure regarding preoperative consultation purpose and content. Using closed questions instead of open is a hindrance of developing a dialogue and thus patient participation. Preoperative consultation practice needs to be strengthened to include explicit communication of the consultations' purpose and agenda, with nurses actively discussing and responding to patients' concerns and sensitive issues. The results of the study facilitate the development of methods and structure to support person-centred communication where the patient is given space to get help with the difficult issues he/she may have when undergoing surgery.
authors.affiliation: Institute of Health and Care Sciences and Centre for Person-Centred Care, Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden.|Vascular Department, Sahlgrenska University Hospital/Sahlgrenska, Göteborg, Sweden.
authors.forename: Monica E
authors.initials: ME
authors.lastname: Pettersson
authors.affiliation: Institute of Health and Care Sciences and Centre for Person-Centred Care, Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden.|Palliative Research Centre, Ersta Sköndal University College and Ersta Hospital, Stockholm, Sweden.
authors.forename: Joakim
authors.initials: J
authors.lastname: Öhlén
authors.affiliation: Institute of Health and Care Sciences and Centre for Person-Centred Care, Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden.|Department of Health studies, Faculty of Social sciences, University of Stavanger, Stavanger, Norway.
authors.forename: Febe
authors.initials: F
authors.lastname: Friberg
authors.affiliation: Department of Health and Medical Sciences, Linköping University, Linköping, Sweden.
authors.forename: Lars-Christer
authors.initials: LC
authors.lastname: Hydén
authors.affiliation: Institute of Health and Care Sciences and Centre for Person-Centred Care, Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden.|The Colorectal Unit, Sahlgrenska University Hospital, Göteborg, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Carlsson
mesh_terms: D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000451:nursing / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009732:Nursing Care; D011300:Preoperative Care; D012017:Referral and Consultation; D013548:Sweden
keywords: cancer; care; communication; health education; narrative; nurse-patient interaction; patient participation; qualitative approaches