Restoring a Sense of Wellness Following Colorectal Cancer: a Grounded Theory.

Aim: This study aimed to develop a grounded theory to explain the experience of recovery following surgery for colorectal cancer. Background: Studies have adopted a biomedical framework to measure quality of life and symptom distress scores following surgery for colorectal cancer. These studies suggest physical symptoms of pain, insomnia and fatigue may persist for many months following treatment. Fewer studies have considered the individual's experiences and perspectives of the emotional, social and cultural aspects of recovery. Methods: A longitudinal study using grounded theory was conducted with 12 individuals, who had received surgery for colorectal cancer. Semi-structured interviews were conducted at 4 time points over one year following surgery, between 2007 and 2009. Grounded theory analysis was undertaken using Strauss and Corbin's framework. Findings: Recovery is described in three phases: disrupting the self; repairing the self; restoring the self. The core category is Restoring a sense of wellness; fostered through awareness and enjoyment of the physical, emotional, spiritual and social aspects of life. A sense of wellness exists as a duality with a sense of illness, where both perspectives may co-exist but one usually taking precedence. A sense of illness pervades when the individual is preoccupied with illness and the illness continues to disrupt their daily life. Conclusion: Recovery takes time and energy, particularly when the individual is at home and in relative isolation from health professionals. Opportunities exist for nurses to provide information and support to facilitate the individual in their progress towards achieving a sense of wellness