Purpose: To explore the essence of the health self-management experiences and support needs of colorectal cancer patients after surgeries.
Methods: The study was based on qualitative methodology. Participants were recruited from colorectal surgery outpatient clinics in a hospital in Taiwan. Purposive sampling was used to obtain a heterogeneous sample to know how health self-management is experienced among different patients and to provide rich information regarding the research questions. Patients who could most usefully inform the study and maximize the diversity relevant to the research questions were invited to participate. The inclusion criteria were the following: (1) aged 20 and older, (2) a confirmed diagnosis of stage I–III colorectal cancer, (3) received tumour resection surgeries in previous month, and (4) able to speak Mandarin or Taiwanese. The exclusion criteria were the following: (1) diagnosed with a terminal illness, (2) having severe mental illness, (3) receiving IV chemotherapy, and (4) having a colostomy. The theoretical saturation was used as the criterion for stopping recruitment. Data were collected through individual in-depth interviews. A provisional interview topic guide was devised. Participants were asked the following questions with which to share their experiences: Could you please talk about your experience and needs after returning home from the hospital? How does colorectal cancer affect your life in general? How do you cope with your conditions? How do you manage your health? Now (or once), what questions do you want to ask a physician or nurse? What kinds of help do you like to receive from your health care providers? What are treatment and follow-up plans suggested by your health care providers? Data were analyzed by using content analyses. The essences of patients’ self-management experience and support needs were explored through understanding and interpretation of interview data. The study was approved by both the hospital institutional review board.
Results:
Nine adults aged 44–76 years participated in the study. There were Most of them were male (n = 5), married (n = 7), completed middle school or had higher education (n = 7) and were diagnosed with stage III (n = 4) or I (n = 3) cancer. The following three themes emerged from the patterns of categorized interview data: experiencing discomfort and seeking support, transformation after rebirth, and facing cancer positively, as well as building up resilience for the future. Each of the three themes were generated by three sub-themes. The sub-themes for experiencing discomfort and seeking support were experiencing physical discomfort, trusting physicians and comply with treatments, and actively seeking relevant information. The sub-themes for transformation after rebirth were at the life turning point re-planning my life, reflecting myself and changing my life, as well as loving myself and cherishing my family. The sub-themes for building up resilience for the future were adjusting my mindset and learning to grow from it, strengthening self-care through supports from others, and facing challenges and not being a burden to others.
Conclusion: Postoperative colorectal cancer patients experienced tremendous physical and psychosocial challenges after returning home from the hospital. Although burdened with multiple stressors, these patients were able to seeking support, learning to practice self-care, facing cancer positively, and exhibit positive growth in life.
Relevance to clinical practice: Patients with colorectal cancer have to constantly adjust to the impacts of their diseases. The study results may serve as a reference for supporting postoperative adjustment and promoting health self-management among patients with colorectal cancer.