Restoring embodied control following surgical treatment for colorectal cancer: A longitudinal qualitative study

Background: This article presents the findings of a study about recovery following surgery for colorectal cancer. Most patients diagnosed with this cancer are treated with surgery. Few studies have employed a qualitative approach to examine their experiences and perceptions of recovering from this treatment. Objectives: The purpose of this study was to discover the process of recovery for individuals following curative surgery for colorectal cancer. Design: This qualitative study drew on grounded theory methods and used a prospective longitudinal design. Settings: Ethical approval was granted by three Local Research Ethics Committees enabling patients to be recruited from three different hospitals in the South of England. Participants: Purposive sampling was used to identify patients diagnosed with colorectal cancer who had had surgery with curative intent. Methods: Each participant was interviewed up to four times following their surgery: at 6 weeks then at 3, 6 and 12 months. Sixty-two interviews were conducted. Emerging concepts from the analysis defined further data collection. Relevant literature was theoretically sampled and all data analysed using constant comparison. Theoretical saturation was achieved. Results: Sixteen participants were recruited. Analysis of study data identified four conceptual stages representing the main phases individuals can experience during their recovery. They are: disembodiment, restoring embodiment, reclaiming control and managing embodied control. These occur in a stepwise progression, reflecting the emotional, physical and social processes involved in restoring perceived control over the body. They reflect the difficulty individuals can experience in understanding and self-managing their bodies. There is a desire to regain confidence and certainty over body function but this is threatened by fears about future health. Conclusions: Achieving a sense of control of one's body, after surgery for colorectal cancer, proves to be a major challenge. Greater recognition of the consequences of cancer and its treatment upon the body and individualised management is required. Addressing how individuals can regain embodied control during their recovery needs to be integral within post-treatment support. (C) 2009 Elsevier Ltd. All rights reserved.