Patient-Experienced Quality During Postoperative Pain Management - A Phenomenological-Hermeneutic Study.

Abstract Purpose The aim of this study was to describe an in-depth understanding of patients’ experiences and perspectives after use of the erector spinae plane block (ESP) in patients undergoing laparoscopic hemicolectomy due to malignant disease. Knowledge gained throughout the study aimed to ensure increased patient-experienced quality, patient safety and adequate post-surgery pain treatment. Design A qualitative approach based on a phenomenological-hermeneutic framework inspired by Paul Ricoeur's perspectives was used. Methods The empirical material consisted of 11 semi-structured individual interviews with patients, who underwent laparoscopic hemicolectomy and received an ESP block as postoperative pain treatment. Findings Four themes emerged during the analysis and represent the findings: (1)The significance of the pain for everyday life, in which everyday and social relations emerged as fundamental for patients' experience of pain and pain management; (2) Joy and anxiety - two opposites showed experiences of conflicting feelings causing uncertainty and insecurity (3); The theme Painlessness - or not? showed experiences of satisfaction with the ESP block and how patients considered the time perspective of having pain as an element of further insecurity; (4)Losing control over one's own life demonstrated how patients tried regaining control over their own lives during pain and after surgery. Conclusions The findings indicate that the majority of patients were happy with the ESP block because among other things, it reduced the need for rescue medicine including side-effects. Because of an acceptable pain intensity, patients paid more attention to other factors associated with their surgical intervention. Adequate pain management was described as of great importance for their experience of well-being and increased quality of life.