Endless nights: patients' experiences of posturing face-down following vitreoretinal surgery

The aim of the paper is to report on a qualitative stuy carried out at Manchester Royal Eye Hospital (MREH) as part of a larger action research project. Anecdotal evidence suggested that generally patients found the experience of posturing face down after vitreoretinal surgery difficult. It was known to cause neck, shoulder and backache and some patients had likened the experience to torture. There is a dearth of research literature in this field on which to base practice. The aim of the study therefore was to (i) understand from the patients' perspective the psychological and social effects of vitreoretinal surgery with specific regard to compliance and prone posturing regimes; (ii) understand they physical effects of posturing as experienced by patients; and (iii) discuss the implications for nursing care. The assumption being made is that better posturing will add to the success of the surgery. Patients (n=25) attending post-operative clinics were asked to self-report on their experiences pre- and post-operatively by letter. Patients were also invited to participate in two focus group interviews where issues raised in the letters were explored further. The data were organised into themes that represented patients' 'pathways' through surgery: 'realising something was wrong', 'going for help', 'being prepared for surgery', 'getting the hang of posturing', 'endless nights' and 'readjustment'. It is concluded that patients needed more support pre and post-operatively to cope with post-operative posturing. Some of the subsequent changes to practice are reported.