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The patient lived experience for surgical treatment of colorectal liver metastases: A phenomenological study

Published online by Cambridge University Press:  13 February 2009

Laurence E. McCahill*
Affiliation:
College of Medicine and College of Nursing & Health Sciences, The University of Vermont, Burlington, Vermont
Brenda P. Hamel-Bissell
Affiliation:
College of Medicine and College of Nursing & Health Sciences, The University of Vermont, Burlington, Vermont
*
Address correspondence and reprint requests to: Laurence McCahill, University of Vermont, Department of Surgery, 89 Beaumont Avenue, Given E309, Burlington, VT 05405. E-mail: laurence.mccahill@uvm.edu

Abstract

Objective:

The treatment experience for patients undergoing surgical treatment of colorectal cancer (CRC) liver metastasis is understudied. This study sought to identify common themes in this experience in order to identify factors of importance in treatment decision making.

Methods:

The study utilized the phenomenological qualitative research approach. In-depth patient interviews conducted by a nurse researcher were tape-recorded and analyzed using the Colaizzi procedural steps.

Results:

All participants were interviewed and included 7 men and 5 women, ages 43–75, each with treatment experience with both chemotherapy and major surgery. Participants did not recall their decision to undergo liver surgery as a single event, rather as another in a series of health care choices during the long continuum of their CRC cancer disease experience. Seven common themes that emerged from the analyses of interviews as having significant impact on their treatment experience were communication with the health care provider, support from others, the patient's own attitude, cure uncertainty, coping strategies, hospital care concerns, and Internet information.

Significance of results:

This study identified factors of importance to patients that may serve to enhance communication, education, treatment satisfaction, and access to surgery for patients with CRC liver metastases. Further validation of our findings with a broader patient population is necessary.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2009

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References

REFERENCES

Adam, R., Delvart, V., Pascal, G., et al. (2004). Rescue surgery for unresectable colorectal liver metastases downstaged by chemotherapy: A model to predict long-term survival. Annals of Surgery, 240, 644657; discussion 657–658.CrossRefGoogle Scholar
Adam, R., Huguet, E., Azoulay, D., et al. (2003). Hepatic resection after down-staging of unresectable hepatic colorectal metastases. Surgical Oncology Clinics of North America, 12, 211220, xii.CrossRefGoogle ScholarPubMed
Borneman, T., Wagman, L., Ferrell, B., et al. (2003). Concerns of family caregivers of patients with cancer facing palliative surgery for advanced malignancies. Oncology Nursing Forum, 30, 9971005.CrossRefGoogle ScholarPubMed
Colaizzi, P.F. (1978). Psychological research as the phenomenologist views it. In Existentential phenomenological alternative for psychology. Valle, R. & King, M. (eds.), pp. 4871. New York: Oxford University Press.Google Scholar
Ferrell, B.R., Chu, D.Z., Wagman, L., et al. (2003). Online exclusive: Patient and surgeon decision making regarding surgery for advanced cancer. Oncology Nursing Forum, 30, E106E114.CrossRefGoogle ScholarPubMed
Folprecht, G., Grothey, A., Alberts, S., et al. (2005). Neoadjuvant treatment of unresectable colorectal liver metastases: Correlation between tumour response and resection rates. Annals of Oncology, 16, 13111319.CrossRefGoogle ScholarPubMed
Fong, Y., Fortner, J., Sun, R.L., et al. (1999). Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: Analysis of 1001 consecutive cases. Annals of Surgery, 230, 309318; discussion 318–321.CrossRefGoogle ScholarPubMed
Hemming, A.W., Reed, A.I., Howard, R.J., et al. (2003). Preoperative portal vein embolization for extended hepatectomy. Annals of Surgery, 237, 686691; discussion 691–693.CrossRefGoogle ScholarPubMed
Leininger, M.M. (1985). Qualitative Research Methods in Nursing. Orlando, FL: Grunne & Stratton.Google Scholar
McCahill, L. & Ferrell, B. (2002). Palliative surgery for cancer pain. Western Journal of Medicine, 176, 107110.Google ScholarPubMed
McCahill, L.E., Krouse, R.S., Chu, D., et al. (2002 a). Decision making in palliative surgery. Journal of the American College of Surgeons, 195, 411422; discussion 422–423.CrossRefGoogle ScholarPubMed
McCahill, L.E., Krouse, R., Chu, D., et al. (2002 b). Indications and use of palliative surgery—Results of Society of Surgical Oncology survey. Annals of Surgical Oncology, 9, 104112.CrossRefGoogle ScholarPubMed
Salkeld, G., Solomon, M., Butow, P., et al. (2005). Discrete-choice experiment to measure patient preferences for the surgical management of colorectal cancer. British Journal of Surgery, 92, 742747.CrossRefGoogle ScholarPubMed
Salkeld, G., Solomon, M., Short, L., et al. (2004). A matter of trust–patient's views on decision-making in colorectal cancer. Health Expectations, 7, 104114.CrossRefGoogle ScholarPubMed
Scheele, J. & Altendorf-Hofmann, A. (1999). Resection of colorectal liver metastases. Langenbeck's Archives of Surgery, 384, 313327.CrossRefGoogle ScholarPubMed
Scheele, J., Stang, R., Altendorf-Hofmann, A., et al. (1995). Resection of colorectal liver metastases. World Journal of Surgery, 19, 5971.CrossRefGoogle ScholarPubMed
SEER Cancer Statistics Review 2000. (2003). [CD]. Bethesda, MD: U.S. Department of Health and Human Services, National Cancer Institute.Google Scholar
Solomon, M.J., Pager, C.K., Keshava, A., et al. (2003). What do patients want? Patient preferences and surrogate decision making in the treatment of colorectal cancer. Diseases of the Colon and Rectum, 46, 13511357.CrossRefGoogle ScholarPubMed
Speziale, H.S. & Carpenter, D.R. (2007). Qualitative Research in Nursing: Advancing the Humanistic Perspective. (4th ed.). Philadelphia: Lippincott Williams & Wilkins.Google Scholar
Spiegelberg, H. (1975). Doing phenomenology. Dordrecht: Martins, Nijhoff.CrossRefGoogle Scholar
Tomlinson, J.S., Jarnagin, W.R., DeMatteo, R.P., et al. (2007). Actual 10-year survival after resection of colorectal liver metastases defines cure. Journal of Clinical Oncology, 25, 45754580.CrossRefGoogle ScholarPubMed
Walsh, L. & Poston, G. (2002). The potential to increase curative liver resection rates in metastatic colorectal cancer. European Journal of Surgical Oncology, 28, 812814.CrossRefGoogle ScholarPubMed