Topics and structure in preoperative nursing consultations with patients undergoing colorectal cancer surgery
Sammanfattning
Background: The preoperative education, which occurs inpreoperative patient consultations, is an important part ofthe surgical nurse’s profession. These consultations maybe the building blocks of a partnership that facilitatescommunication between patient and nurse.Aim: The aim of the study was to describe topics andstructure and documentation in preoperative nursingconsultations with patients undergoing surgery for col-orectal cancer.Method: The study was based on analysis of consultationsbetween seven patients and nurses at a Swedish univer-sity hospital. The preplanned preoperative consultationswere audio-recorded and transcribed verbatim. The struc-ture of the consultations was described in terms of phasesand the text was analysed according to a manifest con-tent analysisResults: The consultations were structured on an agendathat was used variously and communicating differenttopics in an equally varied manner. Seven main topicswere found: Health status, Preparation before surgery,Discovery, Tumour, Operation, Symptoms and Recoveryafter surgery. The topic structure disclosed a high numberof subtopics. The main topics ‘Discovery’, ‘Tumour’ and‘Symptoms’ were only raised by patients and occupiedonly 11% of the discursive space. Documentation wassparse and included mainly task-oriented proceduresrather than patients’ worries and concerns.Conclusion: There was no clear structure regarding pre-operative consultation purpose and content. Usingclosed questions instead of open is a hindrance of devel-oping a dialogue and thus patient participation. Preoper-ative consultation practice needs to be strengthened toinclude explicit communication of the consultations’purpose and agenda, with nurses actively discussing andresponding to patients’ concerns and sensitive issues.The results of the study facilitate the development ofmethods and structure to support person-centred com-munication where the patient is given space to get helpwith the difficult issues he/she may have when under-going surgery. Published by arrangement with John Wiley & Sons.