A phenomenological study of the lived experiences of patients with complex abdominal wall hernia (CAWH)

Smith, Olivia (Olivia Antoinette Mary)

July 2021

Thesis or dissertation

© 2021 Olivia Antoinette Mary Smith. All rights reserved. No part of this publication may be reproduced without the written permission of the copyright holder.

This is the first study in the field of Complex Abdominal Wall Hernia (CAWH) that asks patients what matters to them in terms of their Health Related Quality of Life (HRQoL) and how their hernia affects this using qualitative methodology.
15 patients with CAWH were purposively sampled from CAWH specialist clinic; 8 men and 7 women, age range of 36-85 years (median = 65 years). They participated in semi-structured interviews February 2020 – June 2020 until thematic saturation. All verbatim interview transcripts were coded and analysed using NVivo12 software and Interpretative Phenomenological Analysis (IPA).
Five superordinate themes were identified each with several subordinate themes (in italics):
1. Body image – ‘changes to perceptions of self’ and ‘fears concerning perceptions of others’
2. Mental health – ‘emotional responses’, ‘disruptions to previously solid aspects of identity’ and ‘developing coping strategies’
3. Symptoms – ‘managing pain’, ‘freedom of movement’ and ‘restriction and adaptation’
4. Interpersonal relationships – ‘difficulties socially connecting’ and ‘changes in sexual relations’
5. Employment – ‘financial pressure’, ‘return to work issues’ and ‘costs to family’
The themes presented are interrelated and should shape our understanding of the patients with CAWH. Some themes identified are not incorporated in existing CAWH HRQoL instruments suggesting that we are currently not capturing all data relevant to HRQoL in this specific patient group. Further research is needed in order to generate a standardised CAWH HRQoL instrument which incorporates bio-psycho-emotional-social processes important to patients as identified by patients.

Hull York Medical School, The University of Hull and the University of York
Chitsabesan, Praminthra
Sponsor (Organisation)
British Hernia Society; Becton-Dickinson
Qualification level
Qualification name
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