Conference Proceedings - School of Nursing & Midwifery - Trinity ...

School of Nursing & Midwifery, Trinity College Dublin: 8 th Annual Interdisciplinary Research Conference
Transforming Healthcare Through Research, Education & Technology: 7 th – 9 th November 2007
Conference Proceedings
Table 1
Categories Themes
Returning Home New Normality
The Disease Physical restoration
Communication/Information Mortality
Fatigue Uncertainty
Elimination Isolation
Nutritional Issues Fear/Anxiety
Rest and Sleep Cancer Identity
Family Issues
Ongoing problems
Professional Issues
The Future
Discussion
The findings of this study confirmed Guex’s (1994) statement that
for these participants the journey back from the land of the ill to
the land of the well was a much slower one than the sudden trip
that took the patient to the land of the ill originally as illustrated by
the comment below.
‘I have a very good appetite. But I was eating very well before
surgery. I felt well before I had the surgery. I felt ill in hospital
and I felt ill when I came home which just seemed strange that you
actually go into hospital feeling 100% although I know I had a
major problem but I felt well. And I came out of hospital feeling ill
with pains and not being able to walk and I thought this is very
strange, you are supposed to come out of hospital feeling better’
(15).
The trend of a shortened hospital stay after cancer surgery has
moved the focus of care from hospital to the community and home,
making this post-discharge phase of the illness trajectory very
important. Throughout the treatment phase, the participants and
their families were encountering nurses, doctors and other
healthcare providers who were concerned about their welfare and
helped them to manage. Following discharge, these people were no
longer available on a day-to-day basis and any problems all had to
be managed in the home setting. The external source of
professional services had been abruptly reduced even though the
physical and emotional problems had not necessarily diminished
and in some cases had actually increased following the transfer to
the home environment.
The post-discharge phase was an emotional time characterised by
social isolation imposed by excessive fatigue, erratic elimination
and fear of incontinence, a significant weight loss often combined
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