Coping with extended facedown positioning after macular hole surgery: a qualitative diary analysis

Nurs Res. Nov-Dec 2008;57(6):436-43. doi: 10.1097/NNR.0b013e31818c3e8e.


Background: Patients undergoing facedown positioning have to overcome physical and psychological challenges; however, their perspective and experience are rarely documented in the research literature.

Objectives: The objective of this study was to examine the content of a self-motivated diary written by a person who underwent 77 days of facedown positioning after macular hole surgery. Her narrative about the obstacles during this postsurgical requirement resulted in an insightful description of several core topics relevant to patient care.

Methods: The diary content was summarized using qualitative description procedures. This document was selected due to its unique rich nature. Thematic analysis was used to summarize and describe main topics of importance within the diary. Additional data sources (i.e., medical file, research literature, patient follow-up, and Web sites) were consulted to provide a more comprehensive understanding of the diary content.

Results: On the basis of proximity of coded quotes and richness of content, seven areas of interest emerged, including the patient's emotional state, quality of sleep, nutritional considerations, visual functioning, physical status, social support, and entertainment needs.

Discussion: Potential patients and their caregivers can learn from the experiences of an individual who has coped successfully with this treatment. This analysis builds the groundwork for the refinement of guidelines for overcoming prevalent physical and psychological barriers.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living / psychology
  • Adaptation, Psychological*
  • Aged
  • Attitude to Health*
  • Emotions
  • Female
  • Health Services Needs and Demand
  • Humans
  • Leisure Activities
  • Medical Records
  • Models, Psychological
  • Narration
  • Nursing Methodology Research
  • Postoperative Care / adverse effects
  • Postoperative Care / psychology*
  • Postoperative Care / rehabilitation
  • Prone Position*
  • Prospective Studies
  • Qualitative Research
  • Retinal Perforations / psychology*
  • Retinal Perforations / surgery
  • Sleep Deprivation / etiology
  • Sleep Deprivation / psychology
  • Social Support
  • Time Factors
  • Vitrectomy / adverse effects
  • Vitrectomy / psychology
  • Vitrectomy / rehabilitation