Caring beyond the procedure: a qualitative study on thoracic surgery nurses' perspectives on chronic illness experiences of individuals with myasthenia gravis undergoing thymectomy

超越手术本身的关怀:一项关于胸外科护士对接受胸腺切除术的重症肌无力患者慢性疾病经历的看法的定性研究

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Abstract

OBJECTIVES: To explore how thoracic surgical nurses perceive and respond to the chronic illness needs of individuals with myasthenia gravis undergoing thymectomy. METHODS: Data were collected through four focus group interviews using a semi-structured interview guide. The analysis followed a hermeneutic approach, identifying recurring themes through iterative interpretation and critical reflection. Nineteen thoracic surgical nurses from ward and postanaesthesia care unit settings participated, representing a diverse range of clinical experience. The study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist for reporting the findings of this study. RESULTS: The analysis identified three overarching themes reflecting nurses' experiences of caring for individuals with myasthenia gravis undergoing thymectomy. First, nurses described how the chronic aspects of the illness often 'disappeared' within the surgical care process, with attention focused mainly on procedural recovery, leaving patients' broader illness needs unaddressed. Second, nurses experienced a dilemma between providing acute surgical care and responding to patients' chronic illness understanding, highlighting uncertainty due to limited knowledge and lack of clear guidelines. Third, nurses emphasised the difficulty of managing the invisible and unpredictable symptoms of myasthenia gravis, which created a heightened need for vigilance but also uncertainty in symptom assessment and support. Across all themes, the findings suggest that surgical care practices may insufficiently recognise patients' ongoing illness experiences, emphasising the need for greater knowledge, interdisciplinary collaboration and chronic illness-sensitive care approaches. CONCLUSIONS: The study highlights the need for increased attention to chronic illness needs in surgical care, supporting interdisciplinary collaboration and tailored nursing practices that address the lived experiences of patients with chronic conditions.

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