Understanding Symptom Distress After Oesophageal Cancer Surgery: A Qualitative Study Based on the Symptom Experience Model.

BACKGROUND: Patients undergoing oesophageal cancer surgery often experience a substantial symptom burden that can persist long after surgery. Previous studies have mainly focused on the prevalence and severity of postoperative symptoms. However, less is known about how patients perceive, interpret and respond to symptoms within everyday life and healthcare contexts. This limits the development of nursing interventions grounded in patients' lived experiences. AIM: Guided by the Symptom Experience Model, this study aimed to explore how patients perceive, interpret, and respond to symptom distress after oesophageal cancer surgery within everyday life and healthcare contexts. METHODS: A qualitative descriptive design was adopted. Data were collected through semi-structured, in-depth interviews with postoperative patients with oesophageal cancer. Framework Analysis was used to analyse the data, informed by the Symptom Experience Model. Rigour was enhanced through member checking, researcher triangulation and an audit trail. RESULTS: Twenty-five patients participated in the study. Six themes and 15 sub-themes were identified. Patients' symptom experiences were shaped by limited symptom-related knowledge, eating-related difficulties, family and healthcare contexts, and different coping strategies. Participants described symptom distress as a dynamic process involving symptom perception, interpretation, and response within family, eating, and healthcare contexts. Eating-related difficulties were experienced as ongoing sources of vigilance and uncertainty, while family support and healthcare encounters influenced how symptoms were understood and managed. Exploratory comparison across postoperative-time groups suggested tentative differences in the emphasis of participants' accounts. Symptom-management uncertainty and eating-related distress were more prominent in earlier stages, whereas chronic symptom adaptation, social role disruption, and existential concerns were more evident during survivorship. CONCLUSION: Symptom experiences after oesophageal cancer surgery are multidimensional and embedded in everyday contexts. Nursing interventions should move beyond physiological symptom management and attend to patients' symptom interpretation, family relationships, healthcare experiences, and individual coping needs. Continuous, context-sensitive nursing support may help patients interpret symptoms, strengthen self-management, and adapt to postoperative life. REPORTING METHOD: Reporting followed the consolidated criteria for reporting qualitative research. PATIENT OR PUBLIC CONTRIBUTION: Patients contributed as interview participants but were not involved in the design, conduct, or reporting of the study.