Prolonged Hospitalisation After Lung Cancer Surgery: A Qualitative Study of Patient Experiences of the Reasons for Their Extended Stay.

Aim: To explore patient experiences of the reasons for prolonged hospitalisation after video-assisted thoracoscopic surgery lobectomy in an enhanced recovery after surgery programme, when no medical reasons have been identified for the extended stay. Design: Qualitative study. Methods: Nine unstructured face-to-face interviews were conducted with patients who had undergone lung cancer surgery and remained hospitalised despite having recovered somatically. Results: Guided by Gadamer's philosophical hermeneutical approach, the analysis identified the following three themes regarding patient experiences: role as patient or caregiver, ready to be discharged and relatives as a shield against worry. Conclusion: Patients who have undergone lung cancer surgery in an enhanced recovery after surgery programme are often discharged as planned. However, some patients are in such different situations that it is not always possible for them to meet criteria for a standard time for hospital discharge. Possible factors that can lead to a decision to prolong hospitalisation include patient circumstances at home, e.g., caring for a sick partner, the healthcare professionals' awareness of the patient's general situation and family members who can give the patient support and reassurance. Implications for the Profession and Patient Care: Healthcare professionals can use the findings to understand why patients sometimes stay in the hospital even though they seem medically ready for discharge. Well-established guidelines may inadvertently overshadow the patients' needs, and healthcare professionals must take an individual approach to patients when discharge planning. Reporting Methods: Consolidated Criteria for Reporting Qualitative Research guidelines were followed.