"Like a trip to McDonalds": a grounded theory study of patient experiences of day surgery

Abstract

Background: The amount and complexity of (ambulatory) day surgery is rapidly expanding internationally. Nurses have a responsibility to provide quality care for day surgery patients. To do this they must understand all aspects of the patient experience. There is dearth of research into day surgery using a sociological frame of reference.

Objective: The study investigated patients' experiences of day surgery using a sociological frame of reference.

Design: A qualitative study using the grounded theory approach was used.

Setting: The study was based in two day surgery units in two urban public hospitals in the United Kingdom.

Participants: 145 patients aged 18-70 years and 100 carers were purposely selected from the orthopaedic, ear nose and throat and general surgical lists. They were all English speaking and were of varied socio-economic background.

Methods: The data was collected from 2004 to 2006. Semi-structured interviews were conducted on three occasions: before surgery, 48 h following surgery and one month following discharge. Permission was received from the Local Research Ethics Committee. Analysis of the data involved line-by-line analysis, compilation of key words and phrases (codes) and constant comparison of the codes until categories emerged.

Findings: Patients liked day surgery and placed it within the wider societal context of efficiency and speed. Time was a major issue for them. They wished surgery, like all other aspects of their life to be a speedy process. They likened it to a McDonald's experience with its emphasis on speed, predictability and control.

Conclusion: This study throws new light on patient experiences and offers an understanding of day surgery against a western culture which emphasises the importance of speed and efficiency. It is a popular choice for patients but at times it can be seen to be a mechanistic way of providing care. The implications for nurses to provide education and information to add to the quality of the patient experience are discussed.