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News

Patient expectations of functional outcomes after rectal cancer surgery

A study in the latest issue of the Diseases of the Colon & Rectum examines patient expectations of functional outcomes after rectal cancer surgery.

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Rectal cancer patients’ expectations of health and function may affect their disease- and treatment-related experience, but how patients form expectations of postsurgery function has received little study.

Dr Jason Park and colleagues used a qualitative approach to explore patient expectations of outcomes related to bowel function after sphincter-preserving surgery for rectal cancer.

The team performed a cohort study of patients who were about to undergo sphincter-preserving surgery for rectal cancer.

The study was conducted through individual telephone interviews with participants.

The team evaluated 26 patients with clinical TNM stage I to III disease.

Participants expressed much uncertainty about their long-term bowel function
Diseases of the Colon & Rectum

The semistructured interview script contained open-ended questions on patient expectations of postoperative bowel function and its perceived impact on daily function and life.

There were 2 researchers that analyzed the interview transcripts for emergent themes using a grounded theory approach.

Participant expectations of bowel function reflected 3 major themes including information sources, personal attitudes, and expected outcomes.

The expected outcomes theme contained references to specific symptoms and participants’ descriptions of the certainty, importance, and imminence of expected outcomes.

Despite multiple information sources and attempts at maintaining a positive personal attitude, participants expressed much uncertainty about their long-term bowel function.

The research team found that participants were more focused on what they considered more important, imminent concerns about being cancer free, and getting through surgery.

Dr Park's team concludes, "Patient expectations of long-term functional outcomes cannot be considered outside of the overall context of the cancer experience and the relative importance and imminence of cancer- and treatment-related events."

"Recognizing the complexities of the expectation formation process offers opportunities to develop strategies to enhance patient education and appropriately manage expectations, attend to immediate and long-term concerns, and support patients through the treatment and recovery process."

Dis Colon & Rectum 2014: 57(2): 151–157
04 February 2014

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