Patients' transition experience of centralized cancer surgery in Sweden, according to the Transition Theory by Meleis

Introduction Advanced cancer surgery has been centralized according to the Sweden National Specialised Medical Care system. Knowledge about how patients experience having surgery far from home is lacking. The aim was to describe the transition experience of elective cancer surgery within the National Specialised Medical Care, including the recovery at the local hospital and returning home. Method Individual interviews was conducted with 20 patients who had undergone cancer surgery between the years 2016 – 2023. The Meleis' Transition Theory was the theoretical framework and content analysis the metod used. Result Being fortunate: Being part of the centralized cancer surgery was perceived as an opportunity, which gave hope for a greater chance of survival. Being alone: The patients found it difficult to be alone, and away from their family. Loneliness was perceived to have a negative impact on recovery. Having to adapt to the system: Patients had no choice but to trust the system. The healthcare system was not always perceived to consider the patient's individual needs. A need for personal engagement: Communication and coordination within and between the hospitals, was perceived as inadequate. Some patients felt that they needed to organise their own examinations, surgery, and return appointments. Discussion Established and well-functioning communication and coordination channels between patient and caregiver are important for a well-functioning system. Care needs to be organised in accordance with the needs and wishes of patients. Staff at all relevant units need to have knowledge of the complexity of the surgery to understand the transition experience and the patient's unique needs.