Expressing needs and concerns during nursing care: An ethnographic study of patients undergoing open abdominal aneurysm repair

Patients’ lived experiences of nursing care during hospitalization for planned open abdominal aortic aneurysm repair: An ethnographic study

Background: In the study setting, nursing practice is guided by the Excellent Nursing Framework, a value-based approach grounded in well-being, ethics, trust, relationships, professionalism, person-centeredness, and authentic presence. Abdominal aortic aneurysm is a potentially life-threatening condition, and planned open repair is a major surgery that places substantial demands on postoperative nursing care.
Aim: To present ethnographic findings on patients’ lived experiences of nursing care during hospitalization for planned open abdominal aortic aneurysm repair, focusing on how physical, emotional, and existential needs and concerns are expressed and responded to in bedside interactions.
Methods: A focused ethnographic study was conducted in a vascular surgery ward at a Danish university hospital from December 2024 to September 2025. Ten patients were purposively recruited as information-rich cases and followed through participant observation and informal bedside conversations in single rooms (85 hours). Field notes were analysed using Spradley’s Developmental Research Sequence. Rigour was supported through systematic field-note writing, reflexive analytic discussions, ethics approval, and COREQ-guided reporting. Findings are illustrated through constructed cases.
Methods: An ethnographic study was conducted in a vascular surgery ward at a university hospital in Denmark. Fieldwork took place from December 2024 to September 2025. Ten purposively recruited patients were followed through participant observation and informal bedside conversations in single rooms (85 hours). Field notes were analyzed using Spradley’s Developmental Research Sequence. Findings are illustrated through constructed cases. Reporting followed the consolidated criteria for reporting qualitative research checklist (COREQ).
Results: The overarching theme was “What is brought into talk becomes the focus of care.” Bedside interactions centered on voiced physical recovery needs. Emotional and existential distress was often implicit or expressed indirectly and therefore less likely to be acknowledged or acted upon. Three analytic domains captured this pattern: (1) Unspoken suffering in contrast to well-being; (2) Family members stepping into the nursing role; and (3) Becoming a patient dependent upon nursing.
Discussion: The study contributes a transferable understanding of how interactional norms can shape what becomes legitimate nursing work after major surgery, with implications for person-centered care beyond vascular settings.
Conclusion: Nurses may benefit from training and ward-level support to recognize indirect expressions of distress and to create brief, respectful openings that legitimize emotional and existential concerns alongside physical recovery.

Keywords
Abdominal aortic aneurysm; ethnography; nursing care; open repair; patient experiences; vascular surgery.