To Get My Life Back: Interview Study on Restorative Surgery Decisions After Colectomy in Ulcerative Colitis

ABSTRACT Background and Aims The purpose of restorative surgery after colectomy is to improve quality of life. Still, little is known about patient perspectives. We explored factors influencing ulcerative colitis patients' choice between restorative procedures and stoma, and their experiences of associated healthcare. Methods Semi‐structured interviews were conducted with 21 ulcerative colitis patients subjected to subtotal colectomy and who had either chosen restorative surgery or a permanent stoma. Participants were recruited from two hospitals within the CRUISE trial. Interviews were conducted in person or digitally and analyzed using conventional content analysis as described by Elo and Kyngäs. The COREQ checklist guided reporting. Data collection continued until saturation was reached. Results Twenty‐one participants (14 men, 7 women; median age 34) were interviewed 43 months post‐colectomy. Analysis revealed three main categories and seven subcategories: (1) decisive factors in surgical choice, (2) shared decision‐making, and (3) facilitating factors in patients' choice of restorative surgery or stoma. Participants emphasized striving for normality and high quality of life, regardless of surgical choice. Informed decision‐making and active involvement were central themes. Additionally, the attitude of healthcare professionals, continuity of care, and support structures significantly shaped patients' perceptions and choices. The findings highlight the complex interplay of physical, psychosocial, and systemic factors influencing surgical decisions. Conclusions This study explores the experiences of ulcerative colitis patients after colectomy. Key factors influencing treatment satisfaction and QoL include adequate information, shared decision‐making, and the pursuit of normality. A patient‐centred approach, focusing on informed and individualized decisions, could improve both physical and emotional outcomes in surgical care.