Following Gastrointestinal Surgery for Cancer: How Patients Pursue Surgical Treatment

Previous studies have shown that, after postoperative recovery from upper and lower gastrointestinal surgery for cancer, patients use peculiar modalities to describe their health. The purpose of this study is to determine how upper and lower gastrointestinal cancer surgery is considered by patients when they set their health. A structured interview was developed and 47 consecutive patients were interviewed postoperatively. Answers were analyzed through M.A.D.I.T., a quantitative and qualitative methodology that allows for the detection of discursive processes comprising the text, beyond thematic analysis. Four dimensions have been analyzed: representation of the postoperative period in daily life; use of resources; participation in achieving the clinical objective after hospital discharge; and continuing to respect the surgeons' indications. A corpus of 2374 text occurrences was analyzed. Without differences between types of surgery, surgical patients described the time after surgical intervention as a critical scenario. Patients expressed their personal opinions, expecting normality after surgery and having difficulty envisioning the future: their representation of inflexibility in the postoperative period prevented them from finding new coping strategies. Overall, across all four dimensions, participants used stabilization discursive modalities in more than 50% of cases, representative of a situation bound within strict ties and personal theories. When defining their health, cancer surgery patients tend not to consider their condition as a new and different one from before; they imagine that they will be able to fully resume their previous habits. However, this can risk undermining the achievement of the clinical objective. Thus, during early surgical consultations, as well as in surgical recovery, exploring differences after surgery and solutions could help patients in their engagement with surgical outcomes and consequences.