The fundamental structure of posthospital surgical convalescence

The research was concerned with the lived experience of posthospital surgical convalescence from the perspective of the individual who was convalescing from total knee replacement surgery. Colaizzi's (1978) phenomenological approach was used.

The fundamental structure of the experience resulted and is set out here. The home is arranged to facilitate the work of the convalescent. Much of the work of convalescence takes place in the home. The home is found to be confining when the convalescent is both physically and emotionally ready to leave it. Both physical help and feeling cared about are needed over time. The convalescent is aware of the various effects of his own convalescence on others and strives to regain independence. Use of ambulatory aids, though cumbersome, enhance independence.

The convalescent returns home with both positive and negative expectations of convalescence that are fulfilled and unfulfilled. Feelings surface during this time. Generally, as progress is noted, feelings such as depression, loneliness, and annoyance diminish. The way in which the individual copes with convalescence is affected by his presurgery personality characteristics. Physical reactions are noted as well: fatigue, inadequate sleep/rest and pain are commonly experienced reactions. Information is needed during convalescence. Unexpected physical reactions such as swollen knee/leg are sources of worry; lack of information causes unnecessary worry. The management of pain must also be learned. The convalescent values the physician's opinion in determining progress.

Self-assessment of progress is also made using certain physical factors and the resumption of occupational tasks as measures of progress. Engagement in physician approved activity is done following consideration of self-assessed degree of healing, potential for injury, and need for assistance from another. Though each convalescence is unique, its management is essentially the responsibility of the convalescent. The work of convalescence is done over time and is facilitated by being at home, having help from another, and taking things slowly. Attainment of the goals of convalescence makes the entire experience endurable.