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Koneru S, Patton V, Ng KS. Quality of life in permanent ostomates - what really matters to them? ANZ J Surg 2024. [PMID: 38761003 DOI: 10.1111/ans.19034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 04/29/2024] [Accepted: 05/05/2024] [Indexed: 05/20/2024]
Abstract
PURPOSE The impact of a permanent stoma, such as post-abdominoperineal resection (APR), on quality of life (QoL) is well-documented. While stoma-related QoL tools exist, their relationship with stoma satisfaction is unclear. This study aimed to identify which aspects of QoL were most associated with stoma satisfaction. METHODOLOGY A cross-sectional study of consecutive patients who had an APR for rectal cancer at an Australian tertiary hospital (2012-2021), identified from a prospectively maintained database, was conducted. The Stoma-QoL questionnaire was used. Overall patient satisfaction with stoma function, and whether healthcare advice was sought for stoma dysfunction, were explored. Linear regression assessed the association between individual issues examined in the Stoma-QoL questionnaire and overall patient satisfaction with stoma function. RESULTS Overall, 64 patients (62.5% male, mean 68.1 years) participated. Stoma-QoL score was associated with stoma satisfaction (P < 0.05). QoL items impacting satisfaction were: needing to know nearest toilet location (P = 0.04), pouch smell concerns (P = 0.008), needing daytime rest (P = 0.02), clothing limitations (P = 0.02), sexual attractiveness concerns (P < 0.05), embarrassment (P < 0.05), difficulty hiding the pouch (P = 0.02), concerns about being burdensome (P = 0.04) and difficulty with interpersonal interaction (P = 0.03). Only 11 (17.2%) patients sought healthcare advice for stoma dysfunction. CONCLUSION While stoma-specific QoL is associated with stoma satisfaction, individual QoL aspects impact differently on satisfaction in permanent colostomy patients. These findings may help identify focus areas for peri-operative counselling for clinicians and stomal therapists, highlight the importance of tailored multidisciplinary care in ostomates and suggests that a stoma type-specific Stoma-QoL questionnaire is required.
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Affiliation(s)
- Sireesha Koneru
- Concord Institute of Academic Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
- Division of Colorectal Surgery, Department of Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
- Discipline of Surgery, School of Medicine, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Vicki Patton
- Curtin School of Nursing, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Kheng-Seong Ng
- Concord Institute of Academic Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
- Division of Colorectal Surgery, Department of Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
- Discipline of Surgery, School of Medicine, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
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Kießling C, Wessel LM, Felcht J, Hagl CI, Boettcher M, Khasanov R. Quality of Life of Children with Short Bowel Syndrome from Patients' and Parents' Points of View. CHILDREN (BASEL, SWITZERLAND) 2024; 11:536. [PMID: 38790531 PMCID: PMC11119728 DOI: 10.3390/children11050536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 04/19/2024] [Accepted: 04/27/2024] [Indexed: 05/26/2024]
Abstract
Despite limited research, existing studies using generic quality of life (QOL) tools indicate decreased physical health and compromised emotional functioning in children with IF. This study investigates QOL in children with short bowel syndrome (SBS) and its determinants. The study included 57 pediatric patients with SBS treated at Mannheim's University Hospital between 1998 and 2014. To evaluate QOL, the KINDL questionnaire was used. Three age-specific questionnaire variants were employed, and parental proxy reports were collected. Most patients underwent intestinal lengthening procedures, with varying primary diagnoses. A comparison with healthy children from the patient's perspective revealed no difference but from the parent's perspective showed lower QOL in SBS patients, especially regarding physical and mental well-being. QOL varied with age, with 7-10-year-olds reporting the lowest scores. Several factors, including independence from parenteral nutrition and the presence of a complete colon, positively influenced QOL. The independence of parenteral nutrition and the presence of a complete colon positively influenced QOL. The Bianchi technique for intestinal lengthening has also shown promise but needs further research. The observation sample in this study is too small to generalize about the whole population of SBS patients. However, this study shows that many health and treatment factors affect QOL, and a large multicenter study is necessary. Our findings underline the importance of appropriate psychological support for children with SBS and their families.
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Affiliation(s)
- Charlotte Kießling
- Department of Pediatric Surgery, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy, St. Joseph’s Hospital Berlin Tempelhof, Wüsthoffstraße 15, 12101 Berlin, Germany
| | - Lucas M. Wessel
- Department of Pediatric Surgery, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Judith Felcht
- Department of Pediatric Surgery, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Cornelia I. Hagl
- Carl Remigius Medical School, Infanteriestraße 11a, 80797 München, Germany
| | - Michael Boettcher
- Department of Pediatric Surgery, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Rasul Khasanov
- Department of Pediatric Surgery, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
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Liu X, Han J, Su X. Influence of continuous nursing on surgical site wound infection and postoperative complication for colorectal cancer patients with stoma: A meta-analysis. Int Wound J 2024; 21:e14480. [PMID: 38083831 PMCID: PMC10958097 DOI: 10.1111/iwj.14480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/18/2023] [Accepted: 10/22/2023] [Indexed: 03/23/2024] Open
Abstract
We systematically evaluated the effect of continuous nursing on surgical site wound infections and postoperative complications in colorectal cancer (CRC) patients with stomas. Computerised searches of Embase, PubMed, Cochrane Library, China National Knowledge Infrastructure and Wanfang databases were conducted to collect clinical studies on CRC patients receiving continuous nursing interventions after colorectal stoma surgery; the search period was from the establishment of each database to August 2023. Two researchers independently screened the literature, extracted the data and completed a literature quality assessment. The meta-analysis was performed using Stata 17.0 and included 20 studies with 1759 patients. The meta-analysis showed that continuous nursing significantly lowered the rates of surgical site wound infection (risk ratio [RR] = 0.24, 95% confidence interval [CI]: 0.14-0.43, p < 0.001) and postoperative complications (RR = 0.30, 95% CI: 0.23-0.39, p < 0.001) for CRC stoma patients compared with the control group. Therefore, continuous nursing intervention should be promoted for use in clinical care.
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Affiliation(s)
- Xin‐Ju Liu
- Department of OncologyJinan City People's HospitalJinanShandongChina
| | - Jing Han
- Department of Spinal Joint SurgeryJinan City People's HospitalJinanShandongChina
| | - Xia Su
- Department of NursingJinan City People's HospitalJinanShandongChina
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He F, Yang F, Tang C, Chen D, Zhao D, Xiong J, Zou Y, Huang G, Qian K. Clinical Outcomes of Ileostomy Closure during versus after Adjuvant Chemotherapy in Patients with Rectal Cancer. Can J Gastroenterol Hepatol 2024; 2024:2410643. [PMID: 38550348 PMCID: PMC10977340 DOI: 10.1155/2024/2410643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/10/2023] [Accepted: 01/02/2024] [Indexed: 04/02/2024] Open
Abstract
Background Protective ileostomy can effectively prevent severe anastomotic leakage after rectal cancer surgery; however, the optimal timing for ileostomy closure during adjuvant chemotherapy remains unclear. This study aimed to explore the safety and long-term outcomes of early ileostomy closure during adjuvant chemotherapy. Method Patients who underwent laparoscopic rectal cancer surgery combined with protective ileostomy and adjuvant chemotherapy between April 2017 and April 2021 were retrospectively evaluated. Patients were divided into an early closure group during chemotherapy (group A) and a late closure group after chemotherapy (group B). Results A total of 215 patients were included in this study, with 115 in group A and 100 in group B. There were no significant differences in demographic and clinical characteristics between the two groups. In group A, durations of stoma status (p < 0.001) and low anterior resection syndrome (LARS) (p < 0.001) were shorter, and rectal stenosis (p=0.036) and stoma-related complications (p=0.007), especially stoma stenosis (p=0.041), were less common. However, compliance with chemotherapy was worse (p=0.009). There were no significant differences in operative time, postoperative hospital stay, postoperative complications, incidence and severity of LARS, disease-free survival, or overall survival between groups. Conclusion Early ileostomy closure can effectively reduce the duration of stoma status, duration of LARS, rectal stenosis, and stoma-related complications while not affecting surgical complications and oncological outcomes. Ileostomy closure should not be delayed because of adjuvant chemotherapy. However, follow-up should be strengthened to increase compliance and integrity with chemotherapy.
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Affiliation(s)
- Fan He
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Fuyu Yang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Chenglin Tang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Defei Chen
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Dongqin Zhao
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Junjie Xiong
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Yu Zou
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Guoquan Huang
- Hubei Provincial Key Lab of Selenium Resources and Bioapplications, No. 158 Wuyang Avenue, Enshi 445000, Hubei, China
| | - Kun Qian
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
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Näverlo S, Strigård K, Gunnarsson U, Edin-Liljegren A. Patients' experiences of living with a stoma in rural areas in Northern Sweden. Int J Circumpolar Health 2023; 82:2221767. [PMID: 37300840 DOI: 10.1080/22423982.2023.2221767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 06/12/2023] Open
Abstract
Introduction: Stoma complications are common and interfere with many aspects of everyday life. Stoma problems are usually managed by a specialised stoma nurse, a service not present in the rural areas of South Lapland in Sweden. The aim of this study was to describe how stoma patients in rural areas experience living with a stoma.Methods: A qualitative descriptive study with semi-structured interviews were conducted with 17 stoma patients living in rural municipalities and who received a part of their care at the local cottage hospital. Qualitative content analysis was employed.Results: Initially, the stoma was experienced as very depressing. Participants had difficulties in properly managing the dressing. Over time they learned how to properly care for their stoma, making their life easier. Both satisfaction and dissatisfaction with the healthcare were experienced. Those who were dissatisfied expressed a lack of competence in dealing with stoma-related problems.Conclusions: Living with a stoma in a rural area in northern Sweden is experienced as a learning process and acceptance of the stoma's existence is important. This study emphasises the need for increased knowledge of stoma-related problems in rural primary healthcare in order to help patients cope with everyday life.
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Affiliation(s)
- Simon Näverlo
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden
| | - Karin Strigård
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden
| | - Ulf Gunnarsson
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden
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Rolls N, Gotfredsen JL, Vestergaard M, Hansen AS, Koblauch H. Importance of stoma care nurses in preparing patients for stoma surgery and adjustment to life with a stoma. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2023; 32:S32-S41. [PMID: 37682765 DOI: 10.12968/bjon.2023.32.16.s32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
BACKGROUND Stoma surgery is a life-changing event and patients must subsequently make significant adjustments to their lives. AIM The study set out to understand the level of interaction between patients and stoma care nurses (SCNs) in relation to preparing patients for stoma surgery and in adjustment to life with a stoma. METHODS Retrospective, self-reported questionnaires for patients and SCNs. FINDINGS Most patients (98%) with planned stoma surgery had pre-operative consultations with health professionals in contrast to 36% of patients with unplanned surgery, who did not. One third of patients with unplanned surgery did not feel prepared for life with a stoma based on the information provided during their hospital stay. Two thirds of the nurses reported having sufficient time to prepare patients for stoma surgery and to life with a stoma. CONCLUSION SCNs are key in preparing patients for surgery and for life with a stoma. Variations in care were experienced by patients having planned versus unplanned surgeries.
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Affiliation(s)
- Natasha Rolls
- Lead Stoma Care Nurse, University Hospitals Bristol and Weston NHS Foundation Trust
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Panattoni N, Mariani R, Spano A, Leo AD, Iacorossi L, Petrone F, Simone ED. Nurse specialist and ostomy patient: Competence and skills in the care pathway. A scoping review. J Clin Nurs 2023; 32:5959-5973. [PMID: 37073684 DOI: 10.1111/jocn.16722] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/27/2023] [Accepted: 04/05/2023] [Indexed: 04/20/2023]
Abstract
AIMS AND OBJECTIVES To summarise the evidence published to date regarding nursing core competence in stoma care of any type of ostomy throughout the patient's ostomy surgery candidate care pathway from preoperative to follow-up. BACKGROUND Nurses should play a key role in all ostomy patient care pathways to help them to adapt to the new physics and psychological conditions from the preoperative phases to the prevention of tardive stomal complications. DESIGN Scoping review. METHODS This scoping review was conducted following the methodological framework proposed by Arskey and O'Malley, following the Preferred Reporting Item for Systematic Review and Meta-analysis for Scoping Review. PRISMA-ScR Checklist is included in the manuscript. The following databases were queried: PubMed, EMBASE and CINAHL, from August to October 2022. RESULTS The search strategy in the consulted databases identified 3144 studies. Different types of ostomies were found and investigated: tracheostomy, gastrostomy, jejunostomy, ileostomy, colostomy and urostomy. The results of the included studies helped address the objective that allowed the ostomatherapy skills to be broken down into the different periods of the care pathway. CONCLUSION Caring for an ostomy patient requires advanced skills and a trusting relationship. The skills outlined in this research suggest how essential the stoma care nurse specialist is in these patients' care.
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Affiliation(s)
- Nicolò Panattoni
- Nursing Research Unit IFO - IRCCS Istituti Fisioterapici Ospitalieri - IFO, Rome, Italy
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Riccardo Mariani
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Alessandro Spano
- Nursing Research Unit IFO - IRCCS Istituti Fisioterapici Ospitalieri - IFO, Rome, Italy
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Aurora De Leo
- Nursing Research Unit IFO - IRCCS Istituti Fisioterapici Ospitalieri - IFO, Rome, Italy
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Laura Iacorossi
- Nursing Research Unit IFO - IRCCS Istituti Fisioterapici Ospitalieri - IFO, Rome, Italy
| | - Fabrizio Petrone
- Nursing Research Unit IFO - IRCCS Istituti Fisioterapici Ospitalieri - IFO, Rome, Italy
| | - Emanuele Di Simone
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
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Kovoor JG, Jacobsen JHW, Stretton B, Bacchi S, Gupta AK, Claridge B, Steen MV, Bhanushali A, Bartholomeusz L, Edwards S, Asokan GP, Asokan G, McGee A, Ovenden CD, Hewitt JN, Trochsler MI, Padbury RT, Perry SW, Wong ML, Licinio J, Maddern GJ, Hewett PJ. Depression after stoma surgery: a systematic review and meta-analysis. BMC Psychiatry 2023; 23:352. [PMID: 37217917 DOI: 10.1186/s12888-023-04871-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 05/15/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Depression is the leading cause of global disability and can develop following the change in body image and functional capacity associated with stoma surgery. However, reported prevalence across the literature is unknown. Accordingly, we performed a systematic review and meta-analysis aiming to characterise depressive symptoms after stoma surgery and potential predictive factors. METHODS PubMed/MEDLINE, Embase, CINAHL and Cochrane Library were searched from respective database inception to 6 March 2023 for studies reporting rates of depressive symptoms after stoma surgery. Risk of bias was assessed using the Downs and Black checklist for non-randomised studies of interventions (NRSIs), and Cochrane RoB2 tool for randomised controlled trials (RCTs). Meta-analysis incorporated meta-regressions and a random-effects model. REGISTRATION PROSPERO, CRD42021262345. RESULTS From 5,742 records, 68 studies were included. According to Downs and Black checklist, the 65 NRSIs were of low to moderate methodological quality. According to Cochrane RoB2, the three RCTs ranged from low risk of bias to some concerns of bias. Thirty-eight studies reported rates of depressive symptoms after stoma surgery as a proportion of the respective study populations, and from these, the median rate across all timepoints was 42.9% 42.9% (IQR: 24.2-58.9%). Pooled scores for respective validated depression measures (Hospital Anxiety and Depression Score (HADS), Beck Depression Inventory (BDI), and Patient Health Questionnaire-9 (PHQ-9)) across studies reporting those scores were below clinical thresholds for major depressive disorder according to severity criteria of the respective scores. In the three studies that used the HADS to compare non-stoma versus stoma surgical populations, depressive symptoms were 58% less frequent in non-stoma populations. Region (Asia-Pacific; Europe; Middle East/Africa; North America) was significantly associated with postoperative depressive symptoms (p = 0.002), whereas age (p = 0.592) and sex (p = 0.069) were not. CONCLUSIONS Depressive symptoms occur in almost half of stoma surgery patients, which is higher than the general population, and many inflammatory bowel disease and colorectal cancer populations outlined in the literature. However, validated measures suggest this is mostly at a level of clinical severity below major depressive disorder. Stoma patient outcomes and postoperative psychosocial adjustment may be enhanced by increased psychological evaluation and care in the perioperative period.
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Affiliation(s)
- Joshua G Kovoor
- University of Adelaide, Adelaide, South Australia, Australia.
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia.
- Royal Australasian College of Surgeons, Adelaide, South Australia, Australia.
- Royal Adelaide Hospital, Adelaide, South Australia, Australia.
- Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia.
- Health and Information, Adelaide, South Australia, Australia.
| | | | - Brandon Stretton
- University of Adelaide, Adelaide, South Australia, Australia
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Health and Information, Adelaide, South Australia, Australia
| | - Stephen Bacchi
- University of Adelaide, Adelaide, South Australia, Australia
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia
- Health and Information, Adelaide, South Australia, Australia
| | - Aashray K Gupta
- University of Adelaide, Adelaide, South Australia, Australia
- Health and Information, Adelaide, South Australia, Australia
- Gold Coast University Hospital, Gold Coast, QLD, Australia
| | - Brayden Claridge
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Matthew V Steen
- Glenside Health Services, Adelaide, South Australia, Australia
| | - Ameya Bhanushali
- University of Adelaide, Adelaide, South Australia, Australia
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Lorenz Bartholomeusz
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Suzanne Edwards
- University of Adelaide, Adelaide, South Australia, Australia
| | - Gayatri P Asokan
- Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia
| | - Gopika Asokan
- University of Adelaide, Adelaide, South Australia, Australia
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Amanda McGee
- Stoma Care Services, Adelaide, South Australia, Australia
| | - Christopher D Ovenden
- University of Adelaide, Adelaide, South Australia, Australia
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Health and Information, Adelaide, South Australia, Australia
| | - Joseph N Hewitt
- University of Adelaide, Adelaide, South Australia, Australia
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Health and Information, Adelaide, South Australia, Australia
| | - Markus I Trochsler
- University of Adelaide, Adelaide, South Australia, Australia
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Robert T Padbury
- Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia
| | - Seth W Perry
- State University of New York Upstate Medical University, Syracuse, NY, USA
| | - Ma-Li Wong
- State University of New York Upstate Medical University, Syracuse, NY, USA
| | - Julio Licinio
- Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia
- State University of New York Upstate Medical University, Syracuse, NY, USA
| | - Guy J Maddern
- University of Adelaide, Adelaide, South Australia, Australia
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Royal Australasian College of Surgeons, Adelaide, South Australia, Australia
| | - Peter J Hewett
- University of Adelaide, Adelaide, South Australia, Australia
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
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Farahani MA, Sargolzaei MS, Shariatpanahi S, Dehkordi AH, Dalvand P, Heidari-Beni F. The prevalence of anxiety and depression in patients with ostomy: A systematic review and meta-analysis. Psychooncology 2022; 31:2020-2035. [PMID: 35751501 DOI: 10.1002/pon.5988] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 05/30/2022] [Accepted: 06/19/2022] [Indexed: 12/14/2022]
Abstract
AIM The prevalence of anxiety and depression in patients with ostomy is reported differently. The aim of this systematic review and meta-analysis is to estimate the global prevalence of anxiety and depression in patients with ostomy. METHOD A systematic search of Embase, Proquest, Scopus, PubMed and Web of Science (ISI) databases was conducted from January 1990 up to 5 May 2021. A total of 3392 records were retrieved and 18 studies were ultimately included. Two reviewers independently assessed full-text of articles according to predefined criteria. A random-effects model was used to estimate the prevalence of anxiety and depression and I2 index was used to assess the heterogeneity of the studies. Subgroup analysis and mea-regression were conducted to explore potential sources of heterogeneity. The review protocol is registered in PROSPERO and is available online. Data analysis was performed using R software version 4.3.1. RESULTS In this study, the pooled prevalence of anxiety was 47.60% (95% CI, 29.94-65.26) and the pooled prevalence of depression was 38.86% (95% CI, 29.29-48.43). The subgroup analysis showed the prevalence of anxiety and depression in different regions was not significantly different (p = 0.854, p = 0.143 respectively). Nevertheless, the highest and lowest prevalence of anxiety were in Asia and the America 51.79% and 32.69%, respectively and the highest and lowest prevalence depression were in Asia with 49.80% and Europe with 26.77%, respectively. CONCLUSION The finding of this study showed the global prevalence of anxiety and depression in patients with ostomy is high. Therefore, all health care providers who deal with these patients should use appropriate psychological strategies, techniques and interventions to reduce anxiety and depression in these patients.
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Affiliation(s)
- Mansoureh Ashghali Farahani
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | | | - Shabnam Shariatpanahi
- Department of Community Health Nursing, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Hasanpour Dehkordi
- Community-Oriented Nursing Midwifery Research Center, Nursing and Midwifery School, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Pegah Dalvand
- Department of Mathematics, Shahrood University of Technology, Shahrood, Iran
| | - Farshad Heidari-Beni
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
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Rud CL, Baunwall SM, Bager P, Dahlerup JF, Wilkens TL, Tøttrup A, Lal S, Hvas CL. Patient-Reported Outcomes and Health-Related Quality of Life in People Living With Ileostomies: A Population-Based, Cross-Sectional Study. Dis Colon Rectum 2022; 65:1042-1051. [PMID: 34803144 PMCID: PMC9259033 DOI: 10.1097/dcr.0000000000002100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The impact of a stoma on long-term health-related quality of life in people living with ileostomies is not clear. OBJECTIVE This study aimed to describe important patient-reported outcomes and health-related quality of life in people with ileostomies. DESIGN This is a population-based, cross-sectional study. Patients were invited to answer questionnaires estimating stoma-specific and generic health-related quality of life (EQ-5D-5L and the Major Depression Inventory). Danish norms were retrieved from reference literature. SETTINGS This study was conducted at the major stoma clinic at Aarhus University Hospital, Denmark. PATIENTS We invited all patients with ileostomies who were in contact with the clinic between 2012 and 2017. MAIN OUTCOME MEASURES The primary outcomes measured were patient-reported outcomes specific to people with ileostomies. RESULTS Of 621 identified patients (50% women), 412 (67%) responded to the survey. Among the responders, 178 (43%) reported that they still had an ileostomy at the time of the survey and were included in the analysis. Fatigue was frequent; 68% (95% CI 60%-75%) reported being tired and 26% (95% CI 20%-33%) answered that they were "always tired," whereas 43% (95% CI 36%-51%) lacked energy, 62% (95% CI 54%-69%) reported poor sleep, and 59% (95% CI 52%-66%) needed to rest during the day. Fifty-six percent (95% CI 48%-63%) needed to know the immediate location of the nearest toilet, and 58% (95% CI 51%-66%) felt sexually unattractive because of their ileostomy. Health-related quality of life measured with generic questions indicated 0.124 points lower health-related quality of life than the Danish norm ( p < 0.001), and 18% (95% CI 13%-25%) scored above the threshold for depression, which is 2.6 times higher than the background population (7%, 95% CI 6%-9%; p < 0.001). LIMITATIONS This study was limited by potential selection bias, and all participants did not answer all items. CONCLUSIONS Fatigue and low health-related quality of life is common in people living with ileostomies. Addressing fatigue and stoma-specific challenges in patients with an ileostomy is warranted. See Video Abstract at http://links.lww.com/DCR/B803 . DESENLACES INFORMADOS POR PACIENTES Y CALIDAD DE VIDA RELACIONADA CON LA SALUD EN PERSONAS QUE VIVEN CON ILEOSTOMAS UN ESTUDIO TRANSVERSAL POBLACIONAL ANTECEDENTES:El impacto de un estoma en la calidad de vida relacionada con la salud a largo plazo en personas que viven con ileostomías no está claro.OBJETIVO:Describir desenlaces importantes informados por pacientes y la calidad de vida relacionada con la salud en personas con ileostomías.DISEÑO:Estudio transversal poblacional. Se invitó a los pacientes a responder cuestionarios que estiman la calidad de vida relacionada con la salud general y específica del estoma (EQ-5D-5L y el Inventario de depresión mayor). Las normas danesas se recopilaron de la literatura de referencia.AJUSTES:El estudio se llevó a cabo en la clínica principal de estomas del Hospital Universitario de Aarhus, Dinamarca.PACIENTES:Invitamos a todos los pacientes con ileostomías que estuvieron en contacto con la clínica entre 2012 y 2017.PRINCIPALES MEDIDAS DE RESULTADO:Resultados informados por el paciente específicos para personas con ileostomías.RESULTADOS:De 621 pacientes identificados (50% mujeres), 412 (66%) respondieron la encuesta. Entre los que respondieron, 178 (43%) informaron que todavía tenían una ileostomía en el momento de la encuesta y fueron incluidos en el análisis. La fatiga era frecuente; el 68% (intervalo de confianza del 95%: 60-75%) informó estar cansado y el 26% (20-33%) respondió "siempre cansado", mientras que el 43% (36-51%) carecía de energía, el 62% (54-69%)) refirieron dormir mal y el 59% (52-6%) necesitaba descansar durante el día. El cincuenta y seis por ciento (48-63%) necesitaba saber la ubicación inmediata del baño más cercano y el 58% (51-66%) se sentía sexualmente poco atractivo debido a su ileostomía. La calidad de vida relacionada con la salud medida con preguntas genéricas indicó una calidad de vida relacionada con la salud 0,124 puntos más baja que la norma danesa ( p < 0,001), y el 18% (13-25%) puntuó con depresión, que es 2.6 veces más alta que la población de base (7%, 6-9%, p < 0,001).LIMITACIONES:Posible sesgo de selección, y no todos los participantes respondieron a todos los ítems.CONCLUSIONES:La fatiga y la baja calidad de vida relacionada con la salud es común en las personas que viven con ileostomías. Se justifica abordar la fatiga y los desafíos específicos del estoma en pacientes con una ileostomía. Consulte Video Resumen en http://links.lww.com/DCR/B803 . (Traducción-Juan Carlos Reyes ).
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Affiliation(s)
- Charlotte L. Rud
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Simon M.D. Baunwall
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Palle Bager
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
| | - Jens F. Dahlerup
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
| | - Trine L. Wilkens
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Anders Tøttrup
- Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Simon Lal
- Intestinal Failure Unit, Salford Royal NHS Trust, Salford, United Kingdom
| | - Christian L. Hvas
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
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Gharbi M, Gazdovich S, Bazinet A, Cornu JN. Quality of life in neurogenic patients based on different bladder management methods: A review. Prog Urol 2022; 32:784-808. [DOI: 10.1016/j.purol.2022.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/26/2022] [Accepted: 07/01/2022] [Indexed: 02/06/2023]
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Scientific and Clinical Abstracts From WOCNext® 2022: Fort Worth, Texas ♦ June 5-8, 2022. J Wound Ostomy Continence Nurs 2022; 49:S1-S99. [PMID: 35639023 DOI: 10.1097/won.0000000000000882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Martins L, Andersen BD, Colwell J, Down G, Forest-Lalande L, Novakova S, Probert R, Hedegaard CJ, Hansen AS. Challenges faced by people with a stoma: peristomal body profile risk factors and leakage. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:376-385. [PMID: 35404660 DOI: 10.12968/bjon.2022.31.7.376] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
AIM The Ostomy Life Study 2019 aimed to obtain a better understanding of the challenges faced by people with stoma. METHODS Online survey with participants from 17 countries. FINDINGS Of the 54 614 individuals invited to take part, 5187 responded; 62% of the respondents avoided physical and social activities because of their stoma and 37% had never consulted their stoma care nurse to have the fit of their stoma product checked. In a subgroup receiving questions on leakage (n=4209), output under the baseplate and leakage onto clothes were experienced within the previous month by 76% and 26% of respondents, respectively. Higher chance of leakage was associated with an irregular stoma shape and peristomal body profile; a stoma level at or below the skin surface; and the presence of creases, folds and other changes in the peristomal area. CONCLUSION Leakage and access to a stoma care nurse to provide the necessary care and guidance remain important concerns for individuals with a stoma.
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Affiliation(s)
- Lina Martins
- Clinical Nurse Specialist, Wound, Ostomy and Continence, London Health Sciences Centre, London, Ontario, Canada
| | | | - Janice Colwell
- Advanced Practice Nurse, Ostomy and Wound Care, University of Chicago Medicine, Chicago, Illinois, USA
| | - Gillian Down
- previously Nurse Consultant Stoma Care, Bristol; North Somerset and South Gloucestershire Clinical Commissioning Group, Bristol, UK
| | | | - Svatava Novakova
- Enterostomal Therapist, Masaryk Hospital, Surgery Department, Ústí nad Labem, Czech Republic
| | - Rosalind Probert
- Clinical Nurse Consultant Stomal Therapy, Wound Management Department, Division of Surgery, Queensland, Australia
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Huizer V, Wijekoon N, Roorda D, Oosterlaan J, Benninga MA, van Heurn LWE, Rajindrajith S, Derikx JPM. Generic and disease-specific health-related quality of life in patients with Hirschsprung disease: A systematic review and meta-analysis. World J Gastroenterol 2022; 28:1362-1376. [PMID: 35645538 PMCID: PMC9099180 DOI: 10.3748/wjg.v28.i13.1362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 10/15/2021] [Accepted: 02/23/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Patients with Hirschsprung disease (HD) are at risk of persistent constipation, fecal incontinence or recurrent enterocolitis after surgical treatment, which in turn may impact physical and psychosocial functioning. Generic health-related quality of life (HRQoL) and disease-specific health-related quality of life are relevant outcome measures to assess the impact of HD on the QoL of these patients.
AIM To summarize all available evidence on HRQoL of patients with HD after surgery and the impact of possible moderating factors.
METHODS Pubmed, Web of Sciences, PsycInfo and Embase were searched with search terms related to ‘Hirschsprung disease’, ‘Pediatrics’ and ‘Quality of life’. Mean and standard deviation of generic HRQoL overall and domain scores were extracted from each study, as well as data describing potential factors associated with QoL. Random effect models were used for meta-analytic aggregation of generic HRQoL scores. Meta-regression was used to assess the relationship between patient and clinical characteristics and generic HRQoL. Disease-specific HRQoL outcomes of patients with HD were systematically reviewed.
RESULTS Seventeen articles were included in the systematic review (n = 1137 patients) and 15 in the quantitative meta-analysis (n = 1024 patients). Four studies reported disease-specific HRQoL. Patient’s age ranged between 0 and 21 years. Meta-analytic aggregation showed a non-significantly impaired generic HRQoL (d = -0.168 [95%CI: -0.481; 0.145], P = 0.293, I2 = 94.9) in patients with HD compared to healthy controls. Physical (d = -0.042 [95%CI: -0.419; 0.335], P = 0.829, I2 = 95.1), psychosocial (d = -0.159 [95%CI: -0.458; 0.141], P = 0.299, I2 = 93.6) and social HRQoL (d = -0.092 [95%CI: -0.642; 0.457], P = 0.742, I² = 92.3) were also not significantly lower compared to healthy controls. There was no relation between health-related outcomes and the sex of the patients and whether generic HRQoL was measured by parental proxy or self-report. Disease-specific complaints of patients with HD impaired physical HRQoL, but not psychosocial and social HRQoL.
CONCLUSION In this systematic review and meta-analysis, no evidence was found for impaired generic HRQoL in patients with HD compared to healthy controls, neither for moderating effects of sex, parental proxy or self-report.
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Affiliation(s)
- Veerle Huizer
- Department of Pediatric Surgery, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam Reproduction and Development, Amsterdam 1105 AZ, Netherlands
| | - Naveen Wijekoon
- Department of Surgery, University of Colombo and Department of Paediatric Surgery, Lady Ridgeway Hospital for Children, Colombo 00800, Sri Lanka
| | - Daniëlle Roorda
- Department of Pediatric Surgery, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam Reproduction and Development, Amsterdam 1105 AZ, Netherlands
- Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Emma Neuroscience Group, Amsterdam Reproduction and Development, Amsterdam 1105 AZ, Netherlands
| | - Jaap Oosterlaan
- Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Emma Neuroscience Group, Amsterdam Reproduction and Development, Amsterdam 1105 AZ, Netherlands
| | - Marc A Benninga
- Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Emma Neuroscience Group, Amsterdam Reproduction and Development, Amsterdam 1105 AZ, Netherlands
| | - LW Ernest van Heurn
- Department of Pediatric Surgery, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam Reproduction and Development, Amsterdam 1105 AZ, Netherlands
| | - Shaman Rajindrajith
- Department of Pediatrics, Lady Ridgeway Hospital for Children, Colombo 00800, Sri Lanka
| | - Joep PM Derikx
- Department of Pediatric Surgery, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam Reproduction and Development, Amsterdam 1105 AZ, Netherlands
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Coulter H. Not a bag for life… a bag for living. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:S22-S28. [PMID: 35333564 DOI: 10.12968/bjon.2022.31.6.s22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Stoma products often look and feel medical and can prevent ostomates from living life to the full. They are not designed to address common problems experienced by patients; they can be bulky and visible, allow flatus to escape, need frequent changing (often disrupting sleep) and are uncomfortable. Pelican Healthcare's ModaVi range of ostomy pouches were designed using insight from intestinal ostomates. The company considered their unmet needs and designed products intended to improve patients' quality of life, allowing them to lead the lives they want. ModaVi pouches have innovative features, including being made of a soft fabric that is comfortable and water resistant, and come in black and neutral colours. The pouches are made in different sizes, which can be altered to meet patients' lifestyles and fit in clothing. In addition, they are adapted for people with poor sight or dexterity, and the simple outlet and viewing window make them easier to use. New and established ostomates have evaluated them positively.
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Affiliation(s)
- Helen Coulter
- Community Stoma Care Nurse with Respond Healthcare, Cardiff, Wales
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Ando Y, Takahashi A, Fujii M, Hasegawa H, Kimura T, Yamamoto H, Tajima T, Nishiguchi Y, Kakeji Y, Miyata H, Kitagawa Y. Survey Regarding Gastrointestinal Stoma Construction and Closure in Japan. Ann Gastroenterol Surg 2022; 6:212-226. [PMID: 35261947 PMCID: PMC8889857 DOI: 10.1002/ags3.12521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 10/08/2021] [Accepted: 10/12/2021] [Indexed: 11/09/2022] Open
Abstract
Background and Aim In Japan, the actual number of stoma constructions and stoma closures is not known. The aim of this study was to conduct a survey to determine the number of gastrointestinal stoma constructions and closures in Japan. Methods Enrolled participants comprised patients undergoing selected gastrointestinal surgeries who were recorded in the National Clinical Database. This database uses the "Common Items for Gastrointestinal Surgeons." These procedures were formulated by the Japanese Society of Gastroenterological Surgery during 2013-2018. Results According to the National Clinical Database, a total of 154,323 gastrointestinal stomas were constructed between January 1, 2013 and December 31, 2018. By procedure, there were 78,723 cases of stoma construction, 39,653 of abdominoperineal resection, 2470 total pelvic exenteration procedures, and 33,572 Hartmann's procedures. The ratio of stoma closures to stoma constructions increased annually in patients under 70 y of age but not in older patients. Approximately 35% of total colectomies, 60% of proctocolectomies, and 20% of low anterior resections were accompanied by stoma construction. The number of patients with rectal cancer who underwent colostomy increased gradually during the study period and the number who underwent stoma construction increased among older patients. Conclusion The number of cases of gastrointestinal stoma construction has increased gradually in Japan, and the proportion of older patients is increasing each year. The purposes and surgical techniques for stoma construction are diverse and are expected to increase in Japan, a super-aged society.
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Affiliation(s)
- Yoshiko Ando
- Department of NursingJapanese Red Cross Osaka HospitalOsakaJapan
- Department of Health ScienceGraduate School of MedicineOsaka UniversityOsakaJapan
| | - Arata Takahashi
- NCD Data Quality Management SubcommitteeThe Japanese Society of Gastroenterological SurgeryTokyoJapan
- Department of Health Policy and ManagementSchool of MedicineKeio UniversityTokyoJapan
- Department of Healthcare Quality AssessmentGraduate School of MedicineThe University of TokyoTokyoJapan
| | - Makoto Fujii
- Department of Health ScienceGraduate School of MedicineOsaka UniversityOsakaJapan
| | - Hiroshi Hasegawa
- Project Management SubcommitteeThe Japanese Society of Gastroenterological SurgeryTokyoJapan
| | - Toshimoto Kimura
- Project Management SubcommitteeThe Japanese Society of Gastroenterological SurgeryTokyoJapan
| | - Hiroyuki Yamamoto
- Department of Health Policy and ManagementSchool of MedicineKeio UniversityTokyoJapan
- Department of Healthcare Quality AssessmentGraduate School of MedicineThe University of TokyoTokyoJapan
| | - Tetsuya Tajima
- Department of Health ScienceGraduate School of MedicineOsaka UniversityOsakaJapan
| | | | - Yoshihiro Kakeji
- Database CommitteeThe Japanese Society of Gastroenterological SurgeryTokyoJapan
| | - Hiroaki Miyata
- Department of Health Policy and ManagementSchool of MedicineKeio UniversityTokyoJapan
- Department of Healthcare Quality AssessmentGraduate School of MedicineThe University of TokyoTokyoJapan
| | - Yuko Kitagawa
- The Japanese Society of Gastroenterological SurgeryTokyoJapan
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Azer SA, AlKhawajah NM, Alshamlan YA. Critical evaluation of YouTube videos on colostomy and ileostomy: Can these videos be used as learning resources? PATIENT EDUCATION AND COUNSELING 2022; 105:383-389. [PMID: 34045092 DOI: 10.1016/j.pec.2021.05.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 03/28/2021] [Accepted: 05/14/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES We aimed at identifying and analyzing the accuracy of YouTube videos on colostomy and ileostomy. METHODS YouTube website was searched independently by researchers for videos on colostomy and ileostomy posted before the 18th of May, 2019. Based on predetermined inclusion and exclusion criteria, the videos matching the research objective were identified. Data related to each video were collected, and the videos were categorized using standardized criteria. RESULTS A total of 357 videos were identified. Finally, 149 videos were included in the study. Of these, 52 (35%) were educationally useful, and 97 (65%) were not useful. None of the video parameters, including the number of viewers, duration, number of likes or dislikes, days on YouTube or number of comments, was able to differentiate between useful or not useful videos. The score of videos was 14.7 ± 0.6 for valuable videos and 11.0 ± 2.0 for not useful videos (p < 0.001). CONCLUSIONS While there were a reasonably number of colostomy and ileostomy videos, there was a smaller number on the surgical procedure. Most non-educational videos were not consistent with clinical guidelines. PRACTICAL IMPLICATIONS YouTube videos on colostomy/ileostomy care can be an important educational resource to patients. However, a collaboration between patients, nurse educators and universities/hospitals is needed to produce high-quality videos.
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Affiliation(s)
- Samy A Azer
- Department of Medical Education, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Nour M AlKhawajah
- Department of Medical Education, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Yafa A Alshamlan
- Department of Medical Education, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Prudhomme M, Fabbro-Peray P, Rullier E, Occean BV, Bertrand MM. Meta-analysis and Systematic Review of the Use of a Prosthetic Mesh for Prevention of Parastomal Hernia. Ann Surg 2021; 274:20-28. [PMID: 33378298 DOI: 10.1097/sla.0000000000004704] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The primary endpoint of this meta-analysis was the PSH rate at 1 year of follow-up with or without the use of a mesh. SUMMARY OF BACKGROUND DATA European guidelines currently recommend the use of a mesh at the time of a stoma formation for the prevention of PSH. These recommendations are based on the RCT and meta-analyses published before 2017. More recently 2 large RCT found no benefit in the mesh group. We investigated whether these latest results could change the conclusion of a meta-analysis. METHODS We conducted a comprehensive literature search and analyzed RCT investigating the use of a mesh to prevent PSH formation. All studies including end colostomies were included in the qualitative analysis no matter the surgical technique or the type of mesh. All studies with a limited risk of bias and presenting with usable data were used in the quantitative analysis. RESULTS There is a large heterogeneity among the studies, in terms of position of the mesh, surgical technique, and diagnostic method for the PSH.No statistically significant difference was found on the PSH rate at 1 or 2 years between the mesh and non-mesh groups. CONCLUSIONS Based on this meta-analysis including the latest RCT on the prevention of PSH, the use of a mesh should not be recommended.
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Affiliation(s)
- Michel Prudhomme
- Department of Digestive Surgery, CHU Nimes, Univ Montpellier, Nimes, France
| | - Pascale Fabbro-Peray
- Department of Biostatistics, Epidemiology, Public Health and Innovation in Methodology, CHU Nimes, Univ Montpellier, Nimes, France
| | - Eric Rullier
- Department of Colorectal Surgery, GH Sud Haut-Lévêque - CHU de Bordeaux, Pessac, France
| | - Bob V Occean
- Department of Biostatistics, Epidemiology, Public Health and Innovation in Methodology, CHU Nimes, Univ Montpellier, Nimes, France
| | - Martin M Bertrand
- Department of Digestive Surgery, CHU Nimes, Univ Montpellier, Nimes, France
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Altomare DF, Delrio P, Shelgyn Y, Rybakov E, Vincenti L, De Fazio M, Simone M, Graziano G, Picciariello A. Transanal reinforcement of low rectal anastomosis versus protective ileostomy after total mesorectal excision for rectal cancer. Preliminary results of a randomized clinical trial. Colorectal Dis 2021; 23:1814-1823. [PMID: 33891798 DOI: 10.1111/codi.15685] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 12/12/2022]
Abstract
AIM The study aimed to show if transanal reinforcement of the suture line can prevent anastomotic leakage (AL) after rectal cancer surgery, thus avoiding the need for a covering ileostomy. METHODS This is a prospective, multicentre, parallel-arm randomized controlled equivalence trial. After standard total mesorectal excision, patients with anastomotic line at 1-3 cm from the dentate line were randomized to have transanal suture reinforcement (TAR group) or protective ileostomy (PI group). RESULTS Twenty-nine patients had PI, 25 had TAR. The two groups were comparable both for baseline characteristics and intra-operative aspects. Clinically evident AL occurred in four (16%) and five (17.24%) patients of the TAR and PI group, respectively, resulting in a difference of -1.20% (90% CI -17.93, 15.45), while subclinical AL at proctography was absent in 15 (65.22%) and 13 (50%) patients of the TAR and PI groups, respectively, resulting in a difference of 15% (90% CI -7.74 to 38.17). CONCLUSION Preliminary data suggest that transanal reinforcement of the suture line performed in rectal cancer patients with suture line at 1-3 cm from the dentate line carries a similar (even if not equivalent) AL rate to covering ileostomy, suggesting that a covering ileostomy could be avoided in this selected group of patients. This indication needs to be addressed with future larger trials (clinicaltrials.gov ID number NCT02279771).
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Affiliation(s)
- Donato Francesco Altomare
- Surgical Unit Department of Emergency and Organ Transplantation, University Aldo Moro of Bari, Bari,, Italy.,Surgical Department, IRCCS Istituto Tumori Giovanni Paolo II, Bari, Italy
| | - Paolo Delrio
- Colorectal Surgical Oncology, Abdominal Oncology Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, 'Fondazione Giovanni Pascale' IRCCS, Naples, Italy
| | - Yuri Shelgyn
- Oncoproctology Department, State Scientific Centre of Coloproctology, Moscow, Russia
| | - Evgeny Rybakov
- Oncoproctology Department, State Scientific Centre of Coloproctology, Moscow, Russia
| | - Leonardo Vincenti
- Surgical Unit Azienda Ospedaliero-Universitaria Policlinico Bari, Bari, Italy
| | - Michele De Fazio
- Surgical Unit Department of Emergency and Organ Transplantation, University Aldo Moro of Bari, Bari,, Italy
| | - Michele Simone
- Surgical Department, IRCCS Istituto Tumori Giovanni Paolo II, Bari, Italy
| | - Giusy Graziano
- Center for Outcomes Research and Clinical Epidemiology (CORESEARCH), Pescara, Italy
| | - Arcangelo Picciariello
- Surgical Unit Department of Emergency and Organ Transplantation, University Aldo Moro of Bari, Bari,, Italy
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TAYLAN S, AKSOY G. Telefonla danışmanlık hizmetinin bağırsak stomalı hastalarda stomaya uyum ve yaşam kalitesi üzerindeki etkisi: randomize kontrollü bir çalışma. CUKUROVA MEDICAL JOURNAL 2021. [DOI: 10.17826/cumj.794567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Wulff-Burchfield EM, Potts M, Glavin K, Mirza M. A qualitative evaluation of a nurse-led pre-operative stoma education program for bladder cancer patients. Support Care Cancer 2021; 29:5711-5719. [PMID: 33661368 PMCID: PMC7930519 DOI: 10.1007/s00520-021-06093-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/18/2021] [Indexed: 11/28/2022]
Abstract
Introduction Radical cystectomy remains the standard of care for muscle-invasive bladder cancer and high-risk non-muscle-invasive bladder cancer. Postoperative ostomy education is common, but patients struggle to maintain self-management practices. A preoperative ostomy education program was developed to meet this need, and we conducted a qualitative study with participating patient-caregiver dyads to evaluate the educational and psychosocial impacts of the program and examine alignment with program objectives. Materials and methods A qualitative descriptive study was conducted utilizing a thematic analysis approach. Sixteen patients, eighteen caregivers, and three program educators completed semi-structured interviews from 3 to 18 months post the program. Interviews were audio-recorded and transcribed. Thirteen end-of-course surveys from the initial educational program cohort were transcribed, coded, analyzed; this data was triangulated with patient, caregiver, and educator interviews. Results Analysis uncovered three themes: (1) Patient and caregiver motivation to attend the program, (2) attitudes toward this life-changing event, and (3) education. For theme 1, patients and caregivers cited lack of knowledge, fear, and concern about ostomy surgery and care as motivation. For theme 2, there were a variety of attitudes toward the ostomy, ranging from avoidance to acceptance, and a similar breadth of attitudes toward caregiving, with some patients and caregivers describing ongoing dependence and other patients seeking complete independence. For theme 3, the interactive curriculum was determined to be effective, and the patient advocate was cited as the most memorable program component. Conclusions A formal preoperative ostomy education program employing an interactive educational approach and featuring a patient advocate can prepare bladder cancer patients and caregivers for ostomy self-management and post-ostomy life.
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Affiliation(s)
| | - Maryellen Potts
- University of Kansas School of Nursing, Kansas City, KS, USA
| | - Katherine Glavin
- Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Moben Mirza
- Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA
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22
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Hashmi ZG, Dalton MK, Sheikh SS, McCarty JC, Salim A, Haider AH. National estimates of intestinal ostomy creation and reversal for trauma. J Trauma Acute Care Surg 2021; 90:459-465. [PMID: 33617196 DOI: 10.1097/ta.0000000000003022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Intestinal ostomy creation after trauma is selectively indicated for destructive colon and rectal injuries. However, the nationwide rates of creation of ostomies for trauma and their reversal are not known. The objective of this study was to ascertain national estimates of trauma ostomy creation and reversal. METHODS Weighted analysis of Healthcare Cost and Utilization Project Nationwide Readmissions Database 2014 to 2015 was performed. Adult trauma patients (≥16 years) with a hollow viscus injury were included. Patients with preexisting ostomies and permanent ostomies and those who died within 48 hours of admission were excluded. Rates of ostomy creation and same admission ostomy reversal were calculated. Rates of postdischarge ostomy reversal were calculated using the Kaplan-Meier estimator. Multivariable Cox proportional hazards model was used to determine factors associated with postdischarge trauma ostomy reversal. RESULTS A total of 22,542 patients sustained a hollow viscus injury resulting in the creation of 2,145 ostomies (9.6%). The rate of same-admission ostomy reversal was 0.7% (n = 16). At 1, 3, 6, and 9 months, the cumulative stoma reversal rates were 0%, 7.6%, 31.0%, and 43.1%, respectively. The mean ± SD time from ostomy creation to reversal was 123 ± 6.7 days for those undergoing reversal. Injury Severity Score greater than 9 was significantly associated with ostomy nonreversal after discharge (hazard ratio, 0.41; 95% confidence interval, 0.26-0.66). Age, sex, insurance status, penetrating injury, Charlson Comorbidity Index, and hospital teaching status were not significantly associated with ostomy reversal. CONCLUSION The nationwide rate of ostomy creation after trauma is nearly 10%. At 6 months postinjury, only one third of patients had undergone ostomy reversal. Future study is needed to understand patient and provider-level factors associated with trauma ostomy reversal. LEVEL OF EVIDENCE Epidemiology, level III.
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Affiliation(s)
- Zain G Hashmi
- From the Center for Surgery and Public Health, Department of Surgery (Z.G.H., M.K.D., J.C.M., A.S., A.H.H.), Brigham and Women's Hospital, Harvard Medical School, Harvard T. H. Chan School of Public Health, Boston, Massachusetts; Department of Surgery (Z.G.H.), Sinai Hospital of Baltimore, Baltimore, Maryland; Department of Surgery (S.S.S.), University of Alabama at Birmingham, Birmingham, Alabama; Department of Surgery (J.C.M.), St. Elizabeth's Medical Center, Boston, Massachusetts; and Medical College (A.H.H.), Aga Khan University, Karachi, Pakistan
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Massucco P, Fontana A, Mineccia M, Perotti S, Ciccone G, Galassi C, Giuffrida MC, Marino D, Monsellato I, Paris MK, Perinotti R, Racca P, Monagheddu C, Saccona F, Ponte E, Mistrangelo M, Santarelli M, Tomaselli F, Reddavid R, Birolo S, Calabrò M, Pipitone N, Panier Suffat L, Carrera M, Potente F, Brunetti M, Rimonda R, Adamo V, Piscioneri D, Cravero F, Serventi A, Giaminardi E, Mazza L, Bellora P, Colli F, De Rosa C, Battafarano F, Trapani R, Mellano A, Gibin E, Bellomo P. Prospective, randomised, multicentre, open-label trial, designed to evaluate the best timing of closure of the temporary ileostomy (early versus late) in patients who underwent rectal cancer resection and with indication for adjuvant chemotherapy: the STOMAD (STOMa closure before or after ADjuvant therapy) randomised controlled trial. BMJ Open 2021; 11:e044692. [PMID: 33608405 PMCID: PMC7896613 DOI: 10.1136/bmjopen-2020-044692] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Temporary ileostomy is a valuable aid in reducing the severity of complications related to rectal cancer surgery. However, it is still unclear what is the best timing of its closure in relation to the feasibility of an adjuvant treatment, especially considering patient-reported outcomes and health system costs. The aim of the study is to compare the results of an early versus late closure strategy in patients with indication to adjuvant chemotherapy after resection for rectal cancer. METHODS AND ANALYSIS This is a prospective multicentre randomised trial, sponsored by Rete Oncologica Piemonte e Valle d'Aosta (Oncology Network of Piedmont and Aosta Valley-Italy). Patients undergone to rectal cancer surgery with temporary ileostomy, aged >18 years, without evidence of anastomotic leak and with indication to adjuvant chemotherapy will be enrolled in 28 Network centres. An early closure strategy (between 30 and 40 days from rectal surgery) will be compared with a late one (after the end of adjuvant therapy). Primary endpoint will be the compliance to adjuvant chemotherapy with and without ileostomy. Complications associated with stoma closure as well as quality of life, costs and oncological outcomes will be assessed as secondary endpoints. ETHICS AND DISSEMINATION The trial will engage the Network professional teams in a common effort to improve the treatment of rectal cancer by ensuring the best results in relation to the most correct use of resources. It will take into consideration both the patients' point of view (patient-reported outcome) and the health system perspective (costs analysis). The study has been approved by the Ethical Review Board of Città della Salute e della Scienza Hospital in Turin (Italy). The results of the study will be disseminated by the Network website, medical conferences and peer-reviewed scientific journals. TRIAL REGISTRATION NUMBER NCT04372992.
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Affiliation(s)
- Paolo Massucco
- Department of General and Oncological Surgery, Azienda Ospedaliera Ordine Mauriziano, Torino, Italy
| | - Andrea Fontana
- Department of General and Oncological Surgery, Azienda Ospedaliera Ordine Mauriziano, Torino, Italy
| | - Michela Mineccia
- Department of General and Oncological Surgery, Azienda Ospedaliera Ordine Mauriziano, Torino, Italy
| | - Serena Perotti
- Department of General and Oncological Surgery, Azienda Ospedaliera Ordine Mauriziano, Torino, Italy
| | - Giovannino Ciccone
- Clinical Epidemiology Unit, Azienda Ospedaliero Universitaria Citta della Salute e della Scienza, Torino, Italy
| | - Claudia Galassi
- Clinical Epidemiology Unit, Azienda Ospedaliero Universitaria Citta della Salute e della Scienza, Torino, Italy
| | | | - Donatella Marino
- Department of Oncology, Azienda Ospedaliera Ordine Mauriziano, Torino, Italy
| | - Igor Monsellato
- Department of Surgery, Azienda Ospedaliera Nazionale SS Antonio e Biagio e C Arrigo, Alessandria, Italy
| | | | - Roberto Perinotti
- Department of Surgery, Ospedale degli Infermi, Ponderano (BI), Italy
| | - Patrizia Racca
- Colorectal Cancer Unit, Azienda Ospedaliero Universitaria Citta della Salute e della Scienza, Torino, Italy
| | - Chiara Monagheddu
- Clinical Epidemiology Unit, Azienda Ospedaliero Universitaria Citta della Salute e della Scienza, Torino, Italy
| | - Fabio Saccona
- Clinical Epidemiology Unit, Azienda Ospedaliero Universitaria Citta della Salute e della Scienza, Torino, Italy
| | - Elisa Ponte
- Department of Surgery, Ospedale Regionale Umberto Parini, Aosta, Italy
| | - Massimiliano Mistrangelo
- Department of Surgical Science, Turin University, Azienda Ospedaliero Universitaria Citta della Salute e della Scienza, Torino, Italy
| | - Mauro Santarelli
- Department of General and Emergency Surgery, Azienda Ospedaliero Universitaria Citta della Salute e della Scienza, Torino, Italy
| | | | - Rossella Reddavid
- Department of Surgical Oncology and Digestive Surgery, Turin University, Azienda Ospedaliero Universitaria San Luigi Gonzaga, Orbassano (TO), Italy
| | - Simone Birolo
- Department of Surgery, Ospedale degli Infermi, Rivoli (TO), Italy
| | - Marcello Calabrò
- Department of Surgery, Ospedale Edoardo Agnelli, Pinerolo (TO), Italy
| | | | | | - Monica Carrera
- Department of Surgery, Ospedale di Ciriè, Ciriè (TO), Italy
| | | | - Marco Brunetti
- Department of Surgery, Ospedale SS Annunziata, Savigliano (CN), Italy
| | - Roberto Rimonda
- Department of Surgery, Ospedale Regina Montis, Mondovì (CN), Italy
| | - Vincenzo Adamo
- Department of Surgery, Ospedale San Lazzaro, Alba (CN), Italy
| | - Domenico Piscioneri
- Department of Surgery, Azienda Ospedaliera Nazionale SS Antonio e Biagio e C Arrigo, Alessandria, Italy
| | - Francesca Cravero
- Department of Surgery, Ospedale Santo Spirito, Casale Monferrato (AL), Italy
| | - Alberto Serventi
- Department of Surgery, Ospedale Mons. Galliano, Acqui Terme (AL), Italy
| | - Eliana Giaminardi
- Department of Surgery, Ospedale San Giacomo, Novi Ligure (AL), Italy
| | - Luca Mazza
- Department of Surgery, Ospedale Cardinal Massaia, Asti, Italy
| | - Paolo Bellora
- Department of Surgery, Eastern Piedmont University, Azienda Ospedaliera Maggiore della Carita, Novara, Italy
| | - Fabio Colli
- Department of Surgery, Azienda Ospedaliera Maggiore della Carità, Novara, Italy
| | - Clemente De Rosa
- Department of Surgery, Presidio Ospedaliero Sant'Andrea, Vercelli, Italy
| | | | - Renza Trapani
- Department of Surgery, Ospedale Castelli, Verbania (VB), Italy
| | | | - Enrico Gibin
- Department of Surgery, Presidio Sanitario Ospedale Cottolengo, Torino, Italy
| | - Paola Bellomo
- Department of Surgery, Humanitas Gradenigo, Torino, Italy
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Perception of sexual activities and the care process in ostomized women. JOURNAL OF COLOPROCTOLOGY 2021. [DOI: 10.1016/j.jcol.2013.05.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Abstract
Introduction the making of a stoma may result in adverse effects on the social and psychological dimensions, affecting relationships with family and friends, at work and in sexual activity.
Objective to analyze the perceptions of ostomized women regarding sexual activity as an important dimension of quality of life and in the care process.
Methods cross-sectional, descriptive epidemiological study. A sample of 40 patients enrolled in the Ostomized Patient Program of Health Secretariat of the Federal District – Brazil was assessed through a demographic and clinical questionnaire and personal interviews. Data were analyzed using the software programs Microsoft® Office Excel 2010 and SPSS (Statistical Package of the Social Sciences, SPSS Inc, Chicago, USA) for Windows 20.0. Statistical significance was set at 5%.
Results ostomized women face several adaptation and rehabilitation problems that interfere with social relationships and, consequently, with body image and self-esteem, which reflects on the sexual activity.
Conclusion the results show the need for health professionals involved with these patients to have a wider view on the making of the stoma, their sequelae and rehabilitation, to ensure the process of care that will improve the quality of life of ostomized women.
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Bayar R, Baccouche S, Mzoughi Z, Chelbi A, Arfa N, Gharbi L, Mestiri H, Khalfallah MT. [Digestive stomas: which professional impact?]. Pan Afr Med J 2021; 38:118. [PMID: 33912288 PMCID: PMC8051210 DOI: 10.11604/pamj.2021.38.118.10700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 08/02/2017] [Indexed: 11/11/2022] Open
Abstract
Introduction les stomies digestives constituent l´aboutissement d´un certain nombre d´interventions chirurgicales. Elles peuvent être temporaires ou définitives. Le patient porteur de stomie se trouve confronté à des aléas d´ordre physique et psychologique. Il nécessite donc une adaptation aux changements et une acceptation de la situation qu´elle soit temporaire ou définitive. Le but de ce travail est d´évaluer l´impact des stomies digestives sur la qualité de vie des patients et leur retentissement professionnel. Méthodes il s´agit d´une étude rétrospective, menée de janvier 2010 à décembre 2014. Au cours de cette période 115 patients avaient eu des stomies digestives. Parmi ces patients, soixante étaient en âge d´activité professionnelle, avaient un emploi fixe et avaient repris leurs travail; ils constituent l´effectif de notre étude. Le recueil des données était réalisé par un questionnaire spécifique: le questionnaire généraliste SF-36 réalisé en post opératoire. Résultats le score moyen pour la qualité de vie globale pour les patients stomisés était 41. Quarante patients avaient une mauvaise qualité de vie avec un score SF-36 qui était inférieur à 50. Notre étude a démontré que les patients stomisés ont éprouvé des difficultés de fonctionnement dans des situations de travail. Quarante-huit patients décrivaient une gêne directement liée à la stomie lors de l´exercice de leurs activités professionnelles. Les causes évoquées étaient d´ordre physique dans 6 cas et d´ordre psychologique dans 3 cas. Six patients étaient mutés vers des postes plus adaptés à leur situation. Conclusion l´objectif de la prise en charge des patients porteurs de stomie digestive doit être la réintégration sociale et professionnelle adéquate. Ceci ne peut se concevoir qu´en impliquant le médecin de travail, le psychologue, le stomathérapeute et les associations dans cette prise en charge.
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Affiliation(s)
- Rached Bayar
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisie.,Service de Chirurgie Viscérale, CHU Mongi Slim, Sidi Daoud, La Marsa, Tunisie
| | - Seifeddine Baccouche
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisie.,Service de Chirurgie Viscérale, CHU Mongi Slim, Sidi Daoud, La Marsa, Tunisie
| | - Zeineb Mzoughi
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisie.,Service de Chirurgie Viscérale, CHU Mongi Slim, Sidi Daoud, La Marsa, Tunisie
| | - Abdelkoddous Chelbi
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisie.,Service de Chirurgie Viscérale, CHU Mongi Slim, Sidi Daoud, La Marsa, Tunisie
| | - Nafaa Arfa
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisie.,Service de Chirurgie Viscérale, CHU Mongi Slim, Sidi Daoud, La Marsa, Tunisie
| | - Lassad Gharbi
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisie.,Service de Chirurgie Viscérale, CHU Mongi Slim, Sidi Daoud, La Marsa, Tunisie
| | - Hafedh Mestiri
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisie.,Service de Chirurgie Viscérale, CHU Mongi Slim, Sidi Daoud, La Marsa, Tunisie
| | - Mohamed Taher Khalfallah
- Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisie.,Service de Chirurgie Viscérale, CHU Mongi Slim, Sidi Daoud, La Marsa, Tunisie
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Tavakoli M, Hasanpoor-Azghady SB, Farahani LA. Predictors of mothers' postpartum body dissatisfaction based on demographic and fertility factors. BMC Pregnancy Childbirth 2021; 21:8. [PMID: 33402110 PMCID: PMC7784021 DOI: 10.1186/s12884-020-03501-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 12/16/2020] [Indexed: 12/18/2022] Open
Abstract
Background There are fundamental and rapid changes in body shape during pregnancy, some of which persist for an extended time after delivery and may cause dissatisfaction with body shape. Therefore, we conducted this study to determine predictors of body dissatisfaction at six months postpartum based on demographic and fertility factors. Methods This cross-sectional study was conducted on 300 women who referred to seven health centers affiliated with Iran University of Medical Sciences, Tehran, Iran. The sampling was multistage and we collected data from a demographic and fertility questionnaire and Cooper’s Body Shape Questionnaire (BSQ-34). The independent t-test, Mann-Whitney U test, chi-square test, one-way ANOVA, Kruskal-Wallis, Pearson correlation coefficient, and multiple linear regression were used for data analysis. The level of significance was set at P < 0.05. Results The mean age of participating women was 29.77 (standard deviation: 5.9) years. Body dissatisfaction had a statistically significant association with variables such as body mass index (BMI) at six months postpartum, gestational age, the receipt of information about body shape, spouse’s views on the shape of a woman’s body, and mode of delivery. These variables predicted 34% of body dissatisfaction based on multiple linear regression. Conclusion Postpartum body dissatisfaction is related to a several variables. Paying attention to these variables will help to plan and improve postpartum counseling and educational programs.
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Affiliation(s)
- Mehrri Tavakoli
- Department of Midwifery and Reproductive, Nursing Care Research Center (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Rashid Yasemi st., Valiasr St, Tehran, 1996713883, Iran
| | - Seyedeh Batool Hasanpoor-Azghady
- Department of Midwifery and Reproductive, Nursing Care Research Center (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Rashid Yasemi st., Valiasr St, Tehran, 1996713883, Iran.
| | - Leila Amiri Farahani
- Department of Midwifery and Reproductive, Nursing Care Research Center (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Rashid Yasemi st., Valiasr St, Tehran, 1996713883, Iran
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Jensen BT, Lauridsen SV, Jensen JB. Optimal Delivery of Follow-Up Care After Radical Cystectomy for Bladder Cancer. Res Rep Urol 2020; 12:471-486. [PMID: 33117747 PMCID: PMC7569073 DOI: 10.2147/rru.s270240] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/24/2020] [Indexed: 01/10/2023] Open
Abstract
Purpose of Review To identify components representing optimal delivery of follow-up care after radical cystectomy because of bladder cancer and report the current level of evidence. Methods We conducted a systematic literature search of the following databases: Cochrane, MEDLINE, Embase, CINAHL, Web of Science, Physiotherapy Evidence Database and ClinicalTrials.gov. The search results were managed in Covidence Reference Manager and abstracts were screened by title. Articles relevant to the subject of interest were included and the results are reported narratively. Results Several studies have evaluated the positive impact of enhanced recovery after surgery (ERAS) on length of stay, albeit not on the further impact on 90-day postoperative complication rate, functional recovery, or mortality. Minimally invasive surgery may result in a slighter shorter length of stay compared to open surgery. Physical training combined with nutritional intervention can improve functional recovery up to one year after surgery. Nutritional supplements can preserve muscle and bone mass, and potentially improve recovery. Patient education in stoma care and prevention of infection can significantly improve self-efficacy and avoid symptoms of infection postoperatively. Moreover, specific devices like applications (apps) can support these efforts. Continued smoking increases the risk of developing postoperative complications while no evidence was found on the impact of continued alcohol drinking. Currently, there is no evidence on psychological well-being, sexual health, or shared decision making interventions with an impact on rehabilitation after radical cystectomy. Conclusion Data are scarce but indicate that peri- and postoperative multi-professional interventions can reduce prevalence of sarcopenia, and improve functional recovery, physical capacity, nutritional status, and self-efficacy in stoma care (level 1 evidence). Continued smoking increases the risk of complications, but the effects of a smoking and alcohol intervention remain unclear (level 3 evidence). The results of this review provide guidance for future directions in research and further attempts to develop and test an evidence-based program for follow-up care after radical cystectomy.
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Affiliation(s)
| | - Susanne Vahr Lauridsen
- Department of Urology, Copenhagen University Hospital, Denmark and WHO-CC, Clinical Health Promotion Centre, The Parker Institute Bispebjerg & Frederiksberg University Hospital, Copenhagen, Denmark
| | - Jørgen Bjerggaard Jensen
- Department of Urology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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The Lived Experiences of Persons With Ostomies Attending a Support Group: A Qualitative Study. J Wound Ostomy Continence Nurs 2020; 47:489-495. [PMID: 32925590 DOI: 10.1097/won.0000000000000696] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to describe the lived experiences of patients with ostomies participating in a support group. DESIGN Qualitative, descriptive, phenomenological study. SUBJECT AND SETTING Fifteen adults with different types of ostomies were recruited from support groups in the state of Georgia. METHODS Semistructured interviews were digitally audio-recorded and transcribed verbatim. Analyses of data were performed using Parse's 5-step thematic analysis. RESULTS Four major themes and 10 subthemes emerged from the interviews: (1) theme 1-support group gives hope and changes lives, with 2 subthemes of increased knowledge and provided new knowledge and allows open communication; (2) theme 2-changes in body image had 2 subthemes, some things are different and everyone is the same; (3) theme 3-I am not alone resulted in 4 subthemes of feeling of belonging, willingness to be helped, being supported, and developing lifelong relationships; and (4) theme 4-being independent manifested 2 subthemes including confidence in rejoining society, and building confidence and decreased shame. CONCLUSION We found that participation in an ostomy support group allowed individuals with ostomies to function at more advanced levels than they were before participating in the support group. The lived experiences were characterized by hope, willingness to live fully again, participating in different activities, and making new friends. Participants shared their positive experiences with others who were experiencing the same problems they once experienced. These findings add to and support the body of knowledge related to the interactions between nurses and individuals with ostomies as well as the care needed to ensure a safe discharge from the acute care facility. New knowledge gained may help in the improvement of the education provided during hospitalization. Providing this information will equip patients and families with a better understanding of and methods to care for their new ostomies and develop an acceptance of their new health status.
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van Loon YT, Clermonts SHEM, Belt R, Nagle D, Wasowicz DK, Zimmerman DDE. Implementation of an easy in-hospital educational stoma pathway results in decrease of home nursing care services after discharge. Colorectal Dis 2020; 22:1175-1183. [PMID: 32180331 DOI: 10.1111/codi.15034] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 02/20/2020] [Indexed: 02/08/2023]
Abstract
AIM New stoma patients often rely heavily on the assistance of the ward nursing staff during the hospital stay and on the availability of home nursing care services (HNCS) after discharge. An easily executable 4-day in-hospital educational stoma pathway was developed and implemented. The aim was to increase their level of independence (LOI) in order to reduce the need for HNCS after discharge. METHOD All new stoma patients on the gastrointestinal surgery ward, physically and psychologically capable of performing independent stoma care (SC), were enrolled in this pathway. They were compared to a retrospective control group of new stoma patients before the onset of the stoma pathway. The primary outcome is the need and frequency of HNCS for SC at the moment of discharge. Secondary outcome is the LOI in SC at discharge. RESULTS A total of 145 patients [m:f = 102:43, median age 67 (range 27-90) years] were included in the present study. Patients requiring daily HNCS for SC decreased from 80% to 50%, P < 0.001; patients discharged without HNCS for SC increased from 5% to 27%. Patients' independence in SC at discharge increased from 8% to 68%, P < 0.001. CONCLUSION This study shows that a clinical 4-day in-hospital educational stoma pathway is feasible and effective in increasing the LOI in SC of new stoma patients and significantly reducing their need for HNCS. Cost-benefit analysis and applicability of this pathway in multicentre settings are currently being investigated.
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Affiliation(s)
- Y T van Loon
- Department of Surgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - S H E M Clermonts
- Department of Surgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - R Belt
- Department of Surgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - D Nagle
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - D K Wasowicz
- Department of Surgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - D D E Zimmerman
- Department of Surgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
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AKIL Y, TAYLAN S. Bağırsak stomalı hastaların stomaya uyumlarını etkileyen faktörler: ilişkisel çalışma. CUKUROVA MEDICAL JOURNAL 2020. [DOI: 10.17826/cumj.640154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Habib A, Connor MJ, Boxall NE, Lamb BW, Miah S. Improving quality of life for Muslim patients requiring a stoma: A critical review of theological and psychosocial issues. SURGICAL PRACTICE 2020. [DOI: 10.1111/1744-1633.12409] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Abul Habib
- Department of UrologyNorthwick Park Hospital Harrow UK
| | - Martin J. Connor
- Imperial Prostate, Department of Surgery and Cancer, Faculty of MedicineImperial College London, Charing Cross Hospital London UK
| | - Nicholas E. Boxall
- Department of Urology, Cambridge University HospitalAddenbrooke's Hospital Cambridge UK
| | - Benjamin W. Lamb
- Department of Urology, Cambridge University HospitalAddenbrooke's Hospital Cambridge UK
| | - Saiful Miah
- Department of Urology, Cambridge University HospitalAddenbrooke's Hospital Cambridge UK
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Indrebø KL, Aasprang A, Olsen TE, Andersen JR. A new model of patient-reported outcome monitoring with a clinical feedback system in ostomy care: rationale, description and evaluation protocol. Health Qual Life Outcomes 2020; 18:12. [PMID: 31941516 PMCID: PMC6961299 DOI: 10.1186/s12955-019-1261-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Accepted: 12/18/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Living with an ostomy can be challenging and adapting to life with an ostomy can be particularly complex, with regard to both the physical and psychosocial aspects. Follow-up with a stoma care nurse (SCN) is usually performed after surgery to support the adaptation process. In the present paper, we describe a new model of ostomy care, where a clinical feedback system (CFS) is implemented in order to improve the adaption process of patients with an ostomy. We also present a plan for evaluating patients experience with the CFS and their clinical outcomes. METHODS In this study, we include patients who had recently performed colostomy, ileostomy, or urostomy surgery. The intervention includes self-reported measures for adaptation to life with an ostomy and health-related quality of life (HRQoL), as well as patient experiences and satisfaction recorded by the clinical feedback system. The measures are electronically assessed before each clinical consultation at 3, 6, and 12 months after surgery. The scores are instantly analysed and graphically presented for use during the consultation and the patient and the SCN can discuss the findings. Patient experiences and satisfaction with care will be measured with the Generic Short Patient Experiences Questionnaire. Adaptation to the life with ostomy will be measured with the Ostomy Adjustment Scale, and HRQoL with the Short Form 36. DISCUSSION This study presents a novel approach that could lead to improved consultation, more patient involvement, and better adaptation to life with an ostomy. TRIAL REGISTER ClinicalTrials.gov Registration Number: NCT03841071. Date 18. February 2019 retrospectively registered.
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Affiliation(s)
| | - Anny Aasprang
- Western Norway University of applied Sciences, Førde, Norway
| | - Torill Elin Olsen
- Department of Surgery, Haukeland University Hospital, Bergen, Norway
| | - John Roger Andersen
- Western Norway University of applied Sciences, Førde, Norway
- Centre of Health Research, Førde Hospital Trust, Førde, Norway
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Medina-Rico M, Zárate-Velasco AM, Quiñonez A, López-Ramos H. Sexuality in People With Ostomies: A Literature Review. SEXUALITY AND DISABILITY 2019. [DOI: 10.1007/s11195-019-09604-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
Angie Perrin, Clinical Lead for Innovation, Salts Healthcare, angie.perrin@salts.co.uk, discusses findings from interviews and surveys regarding ostomists' attitudes to their stoma, adjusting to their new reality, and product choice.
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Affiliation(s)
- Kilian G M Brown
- Surgical Outcomes Research Centre (SOuRCe), Sydney, Australia
- The Institute of Academic Surgery at Royal Prince Alfred Hospital, Sydney, Australia
- Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, Australia
| | - Michael J Solomon
- Surgical Outcomes Research Centre (SOuRCe), Sydney, Australia
- The Institute of Academic Surgery at Royal Prince Alfred Hospital, Sydney, Australia
- Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, Australia
- University of Sydney, New South Wales, Australia
| | - Kate Mahon
- University of Sydney, New South Wales, Australia
- Department of Medical Oncology, Chris O'Brien Lifehouse, Sydney, Australia
| | - Sarah O'Shannassy
- The Institute of Academic Surgery at Royal Prince Alfred Hospital, Sydney, Australia
- Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, Australia
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36
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Hwang JH, Yu CS. Depression and resilience in ulcerative colitis and Crohn's disease patients with ostomy. Int Wound J 2019; 16 Suppl 1:62-70. [PMID: 30793856 DOI: 10.1111/iwj.13076] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 12/31/2018] [Accepted: 01/02/2019] [Indexed: 12/20/2022] Open
Abstract
The purpose of this study is to identify the degree of depression and resilience in ulcerative colitis (UC) and Crohn's disease (CD) patients with ostomy and describe the correlation between depression and resilience in UC and CD patients with ostomy. 24 UC patients and 66 CD patients with ostomy were recruited from Metropolitan Hospital in Seoul, Korea. The total mean scores of depression and resilience in UC patients were 13.42 and 123.75, respectively, and in CD patients with ostomy they were 14.24 and 119.18, respectively. Depression and resilience in UC patients with ostomy were not correlated with general characteristics. Depression in CD patients with ostomy correlated with marital status (t = 2.27, P = 0.027), economic status (F = 3.98, P = 0.012), sleep disorder (t = 4.73, P < 0.001), and sleep time (t = 2.11, P = 0.039). Resilience in UC patients with ostomy correlated with religion (t = 2.47, P = 0.016), marital status (t = -3.61, P = 0.001), economic status (F = 4.06, P = 0.011), and sleep disorder (t = -3.11, P = 0.003). Significant negative correlation was found between depression and resilience in UC (r = -0.668, P < 0.001) and CD patients with ostomy (r = -0.604, P < 0.001). We recommend counselling to wound ostomy continence nurses (WOCNs) about their goal setting, facilitating adaptation of disease and ostomy in clinical setting. And we expect that WOCNs adopt a formalised and tailored long-term approach or program to follow up for UC and CD patients with ostomy.
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Affiliation(s)
- Ji H Hwang
- Department of Nursing, ASAN Medical Center, Seoul, Korea
| | - Chang S Yu
- Division of Colon and Rectal Surgery, Department of Surgery, ASAN Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Ayalon R, Bachner YG. Medical, social, and personal factors as correlates of quality of life among older cancer patients with permanent stoma. Eur J Oncol Nurs 2018; 38:50-56. [PMID: 30717936 DOI: 10.1016/j.ejon.2018.11.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Revised: 11/20/2018] [Accepted: 11/23/2018] [Indexed: 01/05/2023]
Abstract
PURPOSE The vast majority of cancer patients experience a substantial reduction in their quality of life (QOL) following a stoma procedure. There is a paucity of studies that examine QOL of patients with stoma and only a small percentage of these studies focuses on older patients. This study assesses the level of QOL of older patients with a permanent stoma; and examines the associations between three categories of variables -personal, medical, and social -and QOL. METHODS This was a cross-sectional study. Seventy-five older cancer patients (M = 75.1 SD = 8.6) with permanent stoma participated in the study. Participants were recruited by their physicians from hospitals and clinics in the central region of Israel. All study measures were valid and reliable. RESULTS Participants reported a moderate mean level of QOL. Men's QOL scores were higher than those of women. Positive correlations were found between perceived body image, self-care, self-efficacy, social support and QOL. A negative correlation was found between anxiety and QOL. Three variables emerged as significant predictors of QOL: self-efficacy (β = 0.41, P < .001), perceived body image (β = 0.41, P < .001), and gender (β = -0.14, P < .05). The model explained a variance of 73.6%. CONCLUSIONS Self-efficacy, perceived body image, and gender are the most important factors for QOL of older patients with stoma in this study. These three personal variables are more significant to QOL than either the medical or the social variables. The personal variables need to be considered by nurses when developing intervention programs aimed at increasing QOL among older cancer patients with permanent stoma.
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Affiliation(s)
- Ravit Ayalon
- Clalit Health Services, Dan-Petach, Tikva Region, Israel.
| | - Yaacov G Bachner
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
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Bibliometric analysis of literature regarding ostomy research based on the Web of Science database. FRONTIERS OF NURSING 2018. [DOI: 10.1515/fon-2018-0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Objective
To analyze the literature status and research hotspots of Science Citation Index (SCI)-related ostomy in the world and to provide references for scientific research and clinical work in the stoma care field.
Methods
Based on the Web of Science core database and its own analysis function, HistCite analysis software and Excel were used to study the published research about ostomy patients.
Results
A total of 1,262 articles were published between 1910 and 2016 with the authors from 48 countries and regions, 1,347 research institutions, published in 321 journals, with 4,048 first authors and coauthors; globally, there was a trend of slow growth in the number of authors every year. The study in the USA was absolutely in the lead position, and Canada and Turkey were more active. China's circulation volume was the 15th in the world. The periodical that published most often was the Journal of Wound Ostomy and Continence Nursing The most interdisciplinary surgical studies were surgery and nursing, where these should be considered important. The most prolific author in the field was "Grant", and the highest cited article was entitled as "Living with a stoma: a review of the literature".
Conclusions
The related research of global stoma is constantly developing. The research hotspot is nursing before and after stoma surgery. China and the USA are leading countries in research. They should follow the recent trend to improve the depth and breadth of the research in the field.
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Lim SH, Chan SWC, Lai JH, He HG. A qualitative evaluation of the STOMA psychosocial intervention programme for colorectal cancer patients with stoma. J Adv Nurs 2018; 75:108-118. [DOI: 10.1111/jan.13821] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 06/20/2018] [Accepted: 06/27/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Siew Hoon Lim
- Division of Nursing; Singapore General Hospital; Singapore
- Yong Loo Lin School of Medicine; Alice Lee Centre for Nursing Studies; National University of Singapore; Singapore
| | - Sally Wai Chi Chan
- Faculty of Health and Medicine; School of Nursing and Midwifery; The University of Newcastle; Callaghan Australia
| | | | - Hong-Gu He
- Yong Loo Lin School of Medicine; Alice Lee Centre for Nursing Studies; National University of Singapore; Singapore
- National University Health System; Singapore
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Early ileostomy reversal after minimally invasive surgery and ERAS program for mid and low rectal cancer. Updates Surg 2018; 71:485-492. [PMID: 30288693 DOI: 10.1007/s13304-018-0597-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 09/29/2018] [Indexed: 01/26/2023]
Abstract
Diverting loop ileostomy following low anterior resection (LAR) is known to decrease quality of life and prolongs the return back to patients' baseline activity. The aim of this retrospective study was to explore feasibility and safety of an early ileostomy reversal strategy in a cohort of patients undergoing minimally invasive LAR within an enhanced recovery after surgery (ERAS) program. Prospectively collected data from 15 patients who underwent minimally invasive LAR and diverting ileostomy at the Division of General and Hepatobiliary Surgery, University of Verona Hospital Trust between September 2015 and December 2016 were retrospectively analyzed. Of 15 patients, 10 patients underwent laparoscopic LAR and 5 patients a robot-assisted procedure. Post-operative complications were observed in 5 patients. Four patients suffered Clavien-Dindo grade 1 or 2 complications, and one patient required redo surgery due to bowel obstruction at the ileostomy site (grade 3b). Following ileostomy reversal, 10 out of 15 patients experienced complications. Two patients required redo surgery for bowel obstruction (grade 3b), whilst eight patients suffered grade 1 or 2 complications, being surgical site infection the most frequently observed (6 cases). Despite that, 80% of patients had their ileostomy reversed within 30 days and median time from initial surgery to ileostomy reversal was 22 days (range 10-150). Early ileostomy closure after minimally invasive LAR and ERAS program is feasible although it carries non-negligible risk of severe complications which, however, does not hinder its accomplishment.
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Rat P, Robert N, Fernandes I, Edmond D, Mauvais F. Evaluation of a one-piece soft convex ostomy appliance: a prospective, multicentre, open-label pilot study. ACTA ACUST UNITED AC 2018; 27:S20-S28. [DOI: 10.12968/bjon.2018.27.16.s20] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Patrick Rat
- Professor of Medicine and Digestive Surgeon, Bocage Central University Hospital, Dijon, France
| | - Nathalie Robert
- Registered Nurse and Stoma Care Nurse Specialist, Bocage Central University Hospital, Dijon, France
| | - Isabelle Fernandes
- Registered Nurse and Stoma Care Nurse Specialist, Hospital Centre, Beauvais, France
| | - Delphine Edmond
- Director of Scientific Communication and Medical Affairs, B.Braun Medical, Saint Cloud, France
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Wang QQ, Zhao J, Huo XR, Wu L, Yang LF, Li JY, Wang J. Effects of a home care mobile app on the outcomes of discharged patients with a stoma: A randomised controlled trial. J Clin Nurs 2018; 27:3592-3602. [PMID: 29775491 DOI: 10.1111/jocn.14515] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2018] [Indexed: 12/23/2022]
Abstract
AIMS AND OBJECTIVES To explore the effects of a home care mobile app on the outcomes of stoma patients who discharged from hospital. BACKGROUND Patients with a newly formed stoma experience many difficulties after surgery. Mobile application (app) has the potential to help patients self-manage their diseases and adjust to the changes in their lives and is a convenient way to ensure the continuity of care. However, there is a lack of studies about the effects of a mobile app on the transitional care for improving discharged stoma-related health outcomes. DESIGN A randomised controlled trial. METHODS A total of 203 patients with a permanent stoma in tertiary hospitals in China were randomly assigned into two groups. Patients in the control group (n = 103) received routine discharge care. Patients in the intervention group (n = 100) received home care via a mobile app besides routine care. The psychosocial adjustment level, self-efficacy scale and stoma complications incidence were measured in the follow-up period and compared between the two groups. Data were collected at four time points: before intervention (baseline), at 1, 3 and 6 months after discharge. RESULTS The psychosocial adjustment level and stoma self-efficacy score of the intervention group were significantly higher than those of the control group, respectively, at 1-, 3- and 6-month follow-up (all p < 0.05). The incidence of stoma complications in the intervention group was tending to reduce at 1, 3 and 6 months after discharge. CONCLUSION The findings indicated that follow-up care at home via a mobile app can effectively improve the psychosocial adjustment level, self-efficacy scale and other related outcomes of stoma patients. RELEVANCE TO CLINICAL PRACTICE The home care mobile app is an effective intervention to support the psychosocial adjustment and self-efficacy of stoma patients after discharge. It ensures the continuity of care and provides nursing guidance for the patients timely.
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Affiliation(s)
- Qing-Qing Wang
- Department of Fundamental and Community Nursing, School of Nursing, Nanjing Medical University, Nanjing, China
| | - Jing Zhao
- Treatment Room, Jiangsu Province Hospital, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | | | - Ling Wu
- Wound Care Center, Nanjing Drum Tower Hospital, Nanjing, China
| | - Li-Fang Yang
- Ostomy Outpatient Clinic, Jiangsu Cancer Hospital, Nanjing, China
| | - Ju-Yun Li
- Department of Gastroenterological Oncology Surgery, Jiangsu Province Hospital of Traditional Chinese Medicine, Nanjing, China
| | - Jie Wang
- Department of Fundamental and Community Nursing, School of Nursing, Nanjing Medical University, Nanjing, China
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Patient-Reported Outcome After Ostomy Surgery for Chronic Constipation. J Wound Ostomy Continence Nurs 2018; 45:319-325. [DOI: 10.1097/won.0000000000000445] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Dibley L, Czuber-Dochan W, Wade T, Duncan J, Burch J, Warusavitarne J, Norton C, Artom M, O'Sullivan L, Verjee A, Cann D. Patient Decision-Making About Emergency and Planned Stoma Surgery for IBD: A Qualitative Exploration of Patient and Clinician Perspectives. Inflamm Bowel Dis 2018; 24:235-246. [PMID: 29361098 DOI: 10.1093/ibd/izx043] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Many inflammatory bowel disease (IBD) patients worry about stoma-forming surgery (SFS), sometimes enduring poor bowel-related quality of life to avoid it. Anticipation of SFS and whether expectations match experience is underreported. This qualitative study explored influences on patients' SFS decision-making and compared preoperative concerns with postoperative outcomes. METHODS We purposively recruited participants with IBD from UK hospital outpatient and community sources, and IBD clinicians from public hospitals. Four focus groups, 29 semistructured patient participant interviews, and 18 clinician interviews were audio recorded, transcribed, and analysed thematically. Participants had a current temporary, recently-reversed, or permanent stoma, or were stoma naive. RESULTS Four themes emerged: Preoperative concerns and expectations, Patient decision-making, Surgery and recovery, and Long-term outcomes. Participants and clinicians agreed about most preoperative concerns, that outcomes were often better than expected, and support from others with a stoma is beneficial. Patient decision-making involves multiple factors, including disease status. Some clinicians avoid discussing SFS, and the phrase 'last resort' can bias patient perceptions; others recommend early discussion, increasing dialogue when medical management becomes ineffective. The postoperative period is particularly challenging for patients. Stoma acceptance is influenced by personal perceptions and pre- and postoperative clinical and social support. CONCLUSION Patients need balanced information on all treatment options, including surgery, from an early stage. Early multidisciplinary team dialogue about SFS, and contact with others living well with a stoma, could enable informed decision-making. Life with a stoma is often better than anticipated, improving quality of life and control. Ongoing specialist nursing support aids recovery and adjustment.
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Affiliation(s)
- Lesley Dibley
- Faculty of Education and Health, University of Greenwich, London, UK.,Bart's Health NHS Trust, London, UK
| | | | - Tiffany Wade
- Florence Nightingale Faculty of Nursing & Midwifery, King's College London, UK
| | | | | | | | - Christine Norton
- Florence Nightingale Faculty of Nursing & Midwifery, King's College London, UK
| | - Micol Artom
- Florence Nightingale Faculty of Nursing & Midwifery, King's College London, UK
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Peery AF, Shaheen NJ, Cools KS, Baron TH, Koruda M, Galanko JA, Grimm IS. Morbidity and mortality after surgery for nonmalignant colorectal polyps. Gastrointest Endosc 2018; 87:243-250.e2. [PMID: 28408327 PMCID: PMC5634910 DOI: 10.1016/j.gie.2017.03.1550] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 03/28/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS Despite evidence that most nonmalignant colorectal polyps can be managed endoscopically, a substantial proportion of patients with a nonmalignant colorectal polyp are still sent to surgery. Risks associated with this surgery are not well characterized. We describe 30-day postoperative morbidity and mortality and explore risk factors for adverse events in patients undergoing surgical resection for nonmalignant colorectal polyps. METHODS We analyzed data collected prospectively as part of the National Surgical Quality Improvement Program. Our analysis included 12,732 patients who underwent elective surgery for a nonmalignant colorectal polyp from 2011 through 2014. We report adverse events within 30 days of the index surgery. Modified Poisson regression was used to estimate risk ratios and 95% confidence intervals. RESULTS Thirty-day mortality was .7%. The risk of a major postoperative adverse event was 14%. Within 30 days of resection, 7.8% of patients were readmitted and 3.6% of patients had a second major surgery. The index surgery resulted in a colostomy in 1.8% and ileostomy in .4% of patients. Patients who had surgical resection of a nonmalignant polyp in the rectum or anal canal compared with the colon had a risk ratio of 1.58 (95% confidence interval, 1.09-2.28) for surgical site infection and 6.51 (95% confidence interval, 4.97-8.52) for ostomy. CONCLUSIONS Surgery for a nonmalignant colorectal polyp is associated with significant morbidity and mortality. A better understanding of the risks and benefits associated with surgical management of nonmalignant colorectal polyps will better inform discussions regarding the relative merits of management strategies.
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Affiliation(s)
- Anne F. Peery
- University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Nicholas J. Shaheen
- University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Katherine S. Cools
- University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Todd H. Baron
- University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Mark Koruda
- University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Joseph A. Galanko
- University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Ian S. Grimm
- University of North Carolina School of Medicine, Chapel Hill, North Carolina
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Hornbrook MC, Grant M, Wendel C, Bulkley JE, Mcmullen CK, Altschuler A, Temple LK, Herrinton LJ, Krouse RS. Rectal Cancer Survivors' Participation in Productive Activities. Perm J 2017; 22:17-022. [PMID: 29236653 DOI: 10.7812/tpp/17-022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
CONTEXT Rectal cancer and its treatment impair survivors' productivity. OBJECTIVE To assess determinants of market and nonmarket employment, job search, volunteering, and homemaking among survivors five years or longer after diagnosis. DESIGN We mailed questionnaires to 1063 survivors who were members of Kaiser Permanente (Northern California, Northwest) during 2010 and 2011. MAIN OUTCOME MEASURES Productive activities, functional health status, and bowel management at the time of the survey. RESULTS Response rate was 60.5% (577/953). Higher comorbidity burdens were associated with lower productivity for men and women rectal cancer survivors. Productive survivors were younger and had lower disease stage and age at diagnosis, higher household income and educational attainment, and fewer comorbidity burdens and workplace adjustments than did nonproductive survivors (p < 0.05 each; 2-sided). Productive rectal cancer survivors were evenly split by sex. CONCLUSION Staying productive is associated with better mental health for rectal cancer survivors. Rectal cancer survivors with multiple chronic conditions, higher disease stage, lower productive activities, and older age need better access to medical care and closer monitoring of the quality of their care, including self-care. To capture the full extent of the involvement of survivors in all types of productive activities, research should routinely include measures of employment, searching for employment, homemaking, and volunteering. Counting market and nonmarket productive activities is innovative and recognizes the continuum of contributions survivors make to families and society. Health care systems should routinely monitor rectal cancer survivors' medical care access, comorbidities, health-related quality of life, and productive activities.
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Affiliation(s)
- Mark C Hornbrook
- Senior Investigator Emeritus at the Center for Health Research in Portland, OR.
| | - Marcia Grant
- Distinguished Professor in the Department of Nursing Research and Education at the City of Hope National Medical Center in Duarte, CA.
| | - Christopher Wendel
- Instructor at the University of Arizona College of Medicine and Arizona Center on Aging in Tucson.
| | - Joanna E Bulkley
- Research Associate at the Center for Health Research in Portland, OR.
| | - Carmit K Mcmullen
- Medical Anthropologist and Investigator in the Science Programs Department at the Center for Health Research in Portland, OR.
| | - Andrea Altschuler
- Research Project Manager for the Division of Research in Oakland, CA.
| | - Larissa Kf Temple
- Chief of the Division of Colorectal Surgery at the University of Rochester Medical Center in NY.
| | | | - Robert S Krouse
- Instructor of Surgery at the University of Pennslvania School of Medicine and Chief of Surgery for the CMC Veterans Affairs Medical Center in Philadelphia.
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Krogsgaard M, Thomsen T, Vinther A, Gögenur I, Kaldan G, Danielsen AK. Living with a parastomal bulge - patients’ experiences of symptoms. J Clin Nurs 2017; 26:5072-5081. [DOI: 10.1111/jocn.14009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2017] [Indexed: 01/12/2023]
Affiliation(s)
- Marianne Krogsgaard
- Abdominal Centre; Rigshospitalet; University of Copenhagen; Copenhagen Denmark
- Department of Gastroenterology; Herlev and Gentofte Hospital; University of Copenhagen; Herlev Denmark
| | - Thordis Thomsen
- Abdominal Centre; Rigshospitalet; University of Copenhagen; Copenhagen Denmark
- Institute of Clinical Medicine; Faculty of Health Sciences; University of Copenhagen; København N Denmark
| | - Anders Vinther
- Department of Rehabilitation; Herlev and Gentofte Hospital; University of Copenhagen; Herlev Denmark
| | - Ismail Gögenur
- Department of Surgery; Center for Surgical Science; Zealand University Hospital; Koege Denmark
| | - Gudrun Kaldan
- Research Unit 7831; Rigshospitalet; University of Copenhagen; Copenhagen N Denmark
| | - Anne Kjaergaard Danielsen
- Department of Gastroenterology; Herlev and Gentofte Hospital; University of Copenhagen; Herlev Denmark
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Faury S, Koleck M, Foucaud J, M'Bailara K, Quintard B. Patient education interventions for colorectal cancer patients with stoma: A systematic review. PATIENT EDUCATION AND COUNSELING 2017; 100:1807-1819. [PMID: 28602564 DOI: 10.1016/j.pec.2017.05.034] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 05/15/2017] [Accepted: 05/25/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To describe the various types of patient education interventions for colorectal cancer patients with stoma and to examine their effects on quality of life, psychosocial skills and self-management skills. METHODS A systematic review was performed. Six electronic databases were searched. Inclusion criteria were: studies about patient education applying quantitative methods including digestive stoma adults with colorectal cancer. The primary outcome was quality of life. Secondary outcomes were psychosocial and self-management skills. RESULTS Thirteen studies were identified and included. Five studies examined quality of life and three reported improvements. Patient education improved some psychosocial and self-management skills. Contrasting findings were reported for specific-disease quality of life, emotional distress, length of hospital stay, stoma complications and readmission rate. CONCLUSIONS Patient education has a positive impact on some psychosocial and self-management skills, indicating that this area should be developed. Contrasting findings were reported for quality of life. Methodologies are heterogeneous making it difficult to produce evidence-based guidelines. This article proposes tools to carry out further studies on this subject and to improve understanding. PRACTICE IMPLICATION Further education intervention for stoma patients with colorectal cancer should be standardized in terms of intervention, duration and outcome measures to compare intervention and determine best practice.
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Affiliation(s)
- Stéphane Faury
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, F-33000 Bordeaux, France.
| | - Michèle Koleck
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, F-33000 Bordeaux, France
| | - Jérôme Foucaud
- "Laboratoire Educations et Pratiques de Santé", EA 3412, Univ. Paris-13 Sorbonne, Paris Cité, 93017 Bobigny, France
| | - Katia M'Bailara
- "Laboratoire de Psychologie", EA 4139, Univ. Bordeaux, Bordeaux, F-33076, France
| | - Bruno Quintard
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, F-33000 Bordeaux, France
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Trabelsi F, Ben Abeljalil S, Derbal F, Bougmiza I. [Patients’ adaptation strategies for colostomates with a self image disturbance after a month of surgery.]. Rech Soins Infirm 2017:89-103. [PMID: 28956415 DOI: 10.3917/rsi.129.0089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND the establishment of a colostomy is a difficult time for the patient since it undergoes physical, psychological and social changes resulting in the modification of the body self-image. Purpose and Framework : this study aims to identify adaptation strategies for colostomates who have a disturbance of self-image after a month of surgery depending on the Roy Adaptation Model. METHODS a descriptive quantitative study was realized with a sample of 70 patients with colostomy in the department of surgery Farhat Hached and Sahloul Hospital in Sousse. To collect data, an auto-questionnaire (OAI-23) was used after a revalidation in Arabic. The descriptive statistics and the regressions united and multivariated were used to analyze the data. RESULTS our study shows that 85.7 % of the participants always feel sick, and why 57 of them (81,4 %) can't get over the shock of having a stoma 82.9 % are still angry. DISCUSSION the results are discussed from the reference frame then the recommendations were formulated followed by some limits. CONCLUSION the improvement of the adaptation process of colostomized patients should be an ongoing concern of all stakeholders.
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