'They are marvellous with you whilst you are in but the aftercare is rubbish': a grounded theory study of patients' and their carers' experiences after discharge following day surgery.

Aims and objectives. To explore patients' experiences following discharge from the day surgery unit. Background. The shape of twenty-first surgical care is changing. Due to political drivers, the self-care ethos and cost containment as well as technological advances, surgery, which previously required a lengthy hospital stay can now be performed in a day. Care that was previously performed by nurses is now transferred to the patient and their carer. Design. A Glaserian grounded theory methodology was used. Methodology. A semi-structured interview took place by telephone on two occasions following discharge from 2004-2006. One hundred and forty-five patients and their carers were recruited from two day surgery units in the UK. Analysis took place by constant comparisons of interview data, line by line analysis and referral to field notes and memos until core categories emerged. Results. Three major themes emerged from this study: the difficulties patients encountered in caring for themselves or their loved ones; the desire for obtaining professional support once they were discharged home; and nostalgia for past times. Conclusion. This study adds new insights to the discharge experiences of day surgery patients. Discharge planning should be started at the pre-assessment stage of the day surgery process and should be a joint venture between community staff, patients and day surgery nurses. More information should be given concerning community services available to the patients and educational programmes need to be developed to address the changing nature of surgical care. Relevance to clinical practice. Raising awareness of the problems patients may experience following discharge from day surgery may encourage a more pro-active attitude towards planning discharge services by a combined approach from day surgery nurses and community (district) nurses. [ABSTRACT FROM AUTHOR]