A cross-sectional study of quality of life in a cohort of enteral ostomy patients presenting to a tertiary care hospital in a developing country in South Asia

Factors influencing quality of life in patients with a colostomy due to rectal cancer: A retrospective cohort study with multivariate and subgroup analyses

The quality of life (QOL) of patients with rectal cancer who have undergone colostomy surgery is influenced by various demographic, clinical and socioeconomic factors. Understanding these factors is crucial for improving patient outcomes and guiding clinical interventions. The present study aimed to evaluate the factors associated with QOL in patients with a colostomy following rectal cancer treatment, utilizing multivariate and subgroup analyses to identify key predictors and assess the robustness of the findings. The study was performed as a retrospective cohort study involving 134 patients. Data were collected on demographic characteristics, clinical variables and QOL scores using the European Organization for Research and Treatment of Cancer QOL Questionnaire-Core 30. Univariate analyses were performed to explore associations between individual factors and QOL. Multivariate linear and logistic regression analyses were also conducted to identify independent predictors of QOL. In addition, subgroup analyses were carried out based on sex, time since stoma surgery and residence, and sensitivity analyses were conducted to assess the impact of different data processing methods on the results. Univariate analysis revealed significant associations of higher educational levels, certain occupations such as government officials and teachers, and higher per capita family income with higher QOL scores. Multivariate regression analysis confirmed that higher education (B=7.89, P=0.001), independent stoma self-care (B=9.45, P<0.001) and higher income (B=6.92, P=0.001) were strong independent predictors of improved QOL. Logistic regression revealed that patients with a university education or higher [odds ratio (OR)=0.38, P=0.045] and those with higher income (OR=0.36, P=0.027) were less likely to report a low QOL. Subgroup analysis highlighted the consistent impact of education and stoma self-care ability across different patient groups, with independent stoma care being the most important factor for both sexes and across all time frames post-surgery. Sensitivity analysis demonstrated that the QOL findings were robust across various methods of handling missing data, with no significant changes in outcomes. In summary, educational level, income and stoma self-care ability were found to be the key determinants of QOL in patients with a colostomy following rectal cancer treatment. These findings highlight the need for targeted interventions to improve self-care abilities and mitigate socioeconomic disparities in this patient population. The results of the study are robust across different analytical approaches, reinforcing the validity of the conclusions.

How can we deal with stoma supplies in a resource-limited setting? The Golbasi earthquake experience

Introduction

In winter 2023, two earthquakes struck southern and central Turkey, resulting in an estimated 56.000 deaths and more than 100.000 persons with injuries. The management of patients presenting post-earthquake injuries and the usual surgical emergencies was highly challenging in these extremes' conditions. This report presents a home-made temporary solution for ostomy care and supplies in a resource-limited setting.

Case presentation

A 72-year-old woman, admitted 9 days after the earthquake, presented with a transverse colonic incarceration in a Morgagni-Larrey parasternal diaphragmatic hernia, associated with Hinchey III peritonitis. Extended right colectomy was performed with right ileostomy and left colostomy. A home-made ostomy was designed using as supplies an empty intravenous perfusion bag and transparent film dressings. This cheap, homemade and ready-to-use stoma supply was used during the first 3 postoperative days, without any leak or peri-ostomy skin irritation.

Conclusion

In extreme perioperative condition, in a resource-limited setting, ostomy can be temporary equip using a homemade and ready-to-use stoma supply. This equipment is feasible at a low cost in all condition and fit until definitive ostomy supplies can be provided.

Risk Prediction Model of Peristomal Skin Complications Among Patients with Colorectal Cancer and an Ostomy: A Cross-sectional Study in Shanghai, China

OBJECTIVE

To analyze the risk factors for peristomal skin complications (PSCs) in patients with colorectal cancer and an ostomy, construct a prediction model, and verify its effectiveness.

METHODS

In this cross-sectional study, researchers recruited 265 patients with an ostomy at the stoma clinic of a tertiary hospital, from May 2022 to August 2023. Patients were divided into two groups: complications group (n = 81) and no complications group (n = 184). Researchers constructed a logistic regression prediction model using univariate and multivariate analyses. From May 2023 to August 2023, a validation group of 135 patients with an ostomy was selected for external validation of the model.

RESULTS

The incidence of PSCs was 30.57% in the modeling group and 30.37% in the validation group. The predictor variables were preoperative and postoperative health education, tumor therapy within 3 months, preoperative stoma positioning, stoma height, stoma type, and excrement state. The Hosmer-Lemeshow test yielded a P value of .513, the area under the receiver operating characteristic curve was 0.872, the Youden index was 0.561, and the sensitivity and specificity were 0.827 and 0.734. For external validation, the Hosmer-Lemeshow test yielded a P value of .835, the area under the receiver operating characteristic curve was 0.887, and the sensitivity and specificity were 0.905 and 0.720, respectively.

CONCLUSIONS

The prediction model demonstrates good predictive efficacy and can serve as a reference for clinical caregivers in identifying patients at high risk of PSCs.

"I Am Half of a Person": Lived Experiences of Individuals Living With Ostomy After Surgery in Rural Haiti

Intestinal ostomy can have significant effects on lives and lived experiences. However, limited research exists on the experiences of persons with ostomy in low-resource settings, such as rural Haiti. This study aimed to explore the lived experiences of Haitians with an ostomy, focusing on the physical, psychological, and social aspects of their post-operative lives. We conducted 9 semi-structured, in-depth interviews with participants who had undergone ostomy surgery at the Hôpital Universitaire de Mirebalais in Haiti. Employing interpretative phenomenological analysis (IPA), we iteratively examined transcripts to identify convergent and divergent codes, which were then grouped into themes to better understand the participants' experiences. Three themes emerged: (a) ostomy as a social disease, which has severe impacts on relationships and place in society; (b) ostomy as altering self-image, leading participants to reflect on their identity and the underlying causes of their condition and to reevaluate their necessities and abilities; and (c) ostomy as an arduous medical journey, characterized by pain, distress, uncertainty, and disillusionment, but also resiliency, improvisation, and hope. This study highlights the multifaceted experiences of persons with ostomy in the low-resource rural environment of Haiti and underscores the need for improved access to medical care, financial support, and psychosocial and caregiving resources for these individuals. Findings also emphasize the importance of medical providers' improved understanding in making medical decisions, and cultural and socioeconomic factors in developing effective support strategies.

Stoma care: the role of community nurses

There are many benefits of standardised care but often this is not possible due to variations in the availability of healthcare resources in the UK. Within stoma care, there is evidence to guide care but with limited standardisation, particularly for community nurses. Stoma care is provided inconsistently, possibly due to variations in training and experience of the nurse. It is known that patients have greater needs in the first few months after stoma formation and this need for support is compounded if there are stoma complications. Community nurses can provide practical support and information, as well as psychological support and encouragement to help people become independent with stoma care and adapt to life with a stoma.

Depression after stoma surgery: a systematic review and meta-analysis

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.

Ostomy-Related Quality of Life in Puerto Ricans Living With Inflammatory Bowel Disease: A Prospective Cohort Study

PURPOSE

The aim of this study was to determine ostomy-related quality of life (QOL) in Hispanic Puerto Ricans living with an enteral stoma and inflammatory bowel disease (IBD). We analyzed possible associations between QOL and sex, diagnosis, and type and duration of stoma.

DESIGN

Prospective cohort study.

SUBJECTS AND SETTINGS

The sample comprised 102 adults living with IBD and an ostomy; 60 of 101 (59.4%) were males, 44 of 102 (43.1%) had Crohn's disease, and 60 of 102 (58.9%) had an ileostomy. Participants were receiving care at the Center for IBD of the University of Puerto Rico in San Juan, Puerto Rico, between January 2012 and December 2014.

METHODS

One-hundred two adults Puerto Ricans with IBD completed the Stoma Quality of Life (Stoma-QOL) questionnaire. Data were analyzed using frequency distributions for categorical variables and summary statistics for continuous variables. Independent-group t test and one-way analysis of variance, with the post hoc Tukey test, were used to determine group differences for the variables of age, sex, civil status, time living with an ostomy, type of ostomy, and IBD diagnosis. Results were analyzed according to the number of responses to each variable; the denominator varied for some variables.

RESULTS

Having an ostomy for more than 40 months was significantly associated with a higher QOL score (59.0 vs 50.7; P = .05). Males had significantly higher scores than females (59.94 vs 50.23; P = .0019). Age, IBD diagnosis, and type of ostomy were not associated with the Stoma-QOL scores.

CONCLUSIONS

The achievement (over 40 months) to attain improved ostomy-related QOL suggests that early training in the care of the ostomy and advanced planning when leaving home may enhance ostomy-related QOL. Lower QOL in women may represent an opportunity for a sex-specific educational intervention.

Melaleuca armillaris essential oil as an odor reducer in intestinal ostomy bags: a semi-experimental study

OBJECTIVE

Evaluate the effect of essential oil in odor reduction for intestinal ostomy bags.

METHOD

Primary study, semi-experimental, prospective clinical trial with quantitative approach. A product prepared with Melaleuca armillaris leaves was tested in ostomy pouches, with and without effluents, for adhesion and odor control. Instrument: Labeled Magnitude Scale.

RESULTS

Colostomized participants, with a mean age of 73 ± 14.94, predominantly males; and informal caregivers, with a mean age of 44 ± 8.98, predominantly females. In the visual evaluation of the oil, 100% of the participants perceived its adherence. Regarding the evaluation of effluent odor by the colostomized, five reported "strong odor" before oil use and, six reported "weak" odor after use (p = 0.005). Five informal caregivers reported "very strong" effluent odor before oil use; and one reported "weak" and nine reported "moderate" after use (p = 0.0025).

CONCLUSION

There was a reduction in the odor of effluents in the ostomy pouches with the essential oil of Melaleuca armillaris at 10%. Application for patent registration in the Brazilian National Institute of Industrial Property (INPI) under no. BR 10 2020 026987 9.

Quality of life profiles and their association with clinical and demographic characteristics and physical activity in people with a stoma: a latent profile analysis

Purpose

Quality of life can be negatively impacted by the formation of a stoma and is influenced by a number of factors. Research to date treats people with a stoma as a homogenous group based on their quality of life. We attempted to identify subgroups based upon self-reported quality of life and explored variables associated with group membership.

Methods

The present study is a secondary analysis of a cross-sectional sample of 1419 people with a stoma. Participants completed validated questionnaires for quality of life, physical activity and clinical and demographic characteristics. Latent profile analysis was used to identify the optimal number of subgroups (profiles) and multinomial regression modelling was conducted to identify variables associated with profile membership.

Results

The analysis revealed 4 distinct profiles of people with a stoma: ‘consistently good quality of life’ [N = 891 (62.8%)], ‘some quality of life concerns’ [N = 184 (13.0%)], ‘low quality of life’ [N = 181 (12.8%)] and ‘financial concerns’ [N = 163 (11.5%)]. Modelling revealed that people with a recent stoma (formed < 2 years previously), who have a hernia and are less physically active were more likely to belong to the ‘low quality of life’ profile. Furthermore, those aged 16–55 were more likely to have financial concerns.

Conclusion

This study was the first to identify latent profiles within this population and assess whether certain variables are associated with membership. Future research should build upon this to identify additional variables associated with these profiles, which can help to provide the basis for targeting and tailoring future interventions to specific subgroups of people with a stoma.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11136-022-03102-5.

Óleo essencial de Melaleuca armillaris redutor de odor em bolsas de estomia intestinal: estudo quase experimental

RESUMO Objetivo: Avaliar o efeito do óleo essencial na redução de odor em bolsas de estomia intestinal. Método: Estudo primário, ensaio clínico quase experimental, prospectivo, com abordagem quantitativa. Preparado com folhas de Melaleuca armillaris, foi testado em bolsas coletoras, sem e com efluentes, quanto à aderência e odor. Instrumento: escala de magnitude rotulada. Resultados: Participantes colostomizados, com média de 73 anos ± 14,94, predomínio do sexo masculino; e cuidadores informais, com média de 44 anos ± 8,98, predomínio do sexo feminino. Na avaliação visual do óleo, 100% dos participantes perceberam a aderência. Em relação à avaliação do odor dos efluentes pelos colostomizados, cinco relataram “odor forte” antes do uso do óleo e, após o uso, seis relataram odor “fraco” (p = 0,005). Cinco cuidadores informais detectaram odor “muito forte” dos efluentes antes do uso do óleo e, após o uso, um “fraco” e nove “moderado” (p = 0,0025). Conclusão: Houve redução do odor dos efluentes nas bolsas coletoras com o óleo essencial de Melaleuca armillaris a 10%. Pedido registro de patente no INPI sob nº. BR 10 2020 026987 9.

Effects of continuous care on health outcomes in patients with stoma: A systematic review and meta-analysis

Objective

Continuing care, which is an extension of post-discharge care, is recognized as a crucial element of high-quality health services and is essential to patients. This systematic review aims to identify the effectiveness of continuing care for patients with stomas.

Methods

PubMed, EMBASE, Cochrane Trial Register and Web of Science databases were searched. Study selection and quality appraisal were performed independently by two reviewers. We calculated the mean differences (MD) or the relative risk (RR) with 95% confidence intervals and assessed heterogeneity.

Results

Nine studies (1134 participants) met the inclusion criteria. This meta-analysis revealed that, in the continuous care group, the stoma self-efficacy (MD ​= ​6.46; 95% CI ​= ​3.81–9.11; P ​< ​0.001; I² ​= ​0%), and the quality of life (MD ​= ​7.48; 95% CI ​= ​5.13–9.82; P ​< ​0.001; I² ​= ​0%) increased significantly 1 month after discharge; stoma adjustment and care satisfaction also showed a trend toward improvement while stoma complications (RR ​= ​0.71; 95% CI ​= ​0.58–0.87; P ​= ​0.001; I² ​= ​25%) decreased significantly. Continuing care did not decrease hospital readmission rates or medical costs.

Conclusions

Continuing care showed beneficial effects in improving health outcomes and care satisfaction for patients with stomas compared with routine care. We proposed an integrated continuing care program with different elements and recommendations for its implementation.

The Quality of Life of Patients with Colorectal Cancer and a Stoma in China: A Quantitative Cross-sectional Study

OBJECTIVE

To explore quality of life (QOL) in patients with colorectal cancer and a stoma and factors associated with their QOL.

METHODS

A quantitative cross-sectional study was carried out in the stoma and wound care clinic of a cancer hospital in China. Participants were recruited from clinic patients. Investigators collected demographic data and clinical information; QOL was measured using a Chinese version of the stoma-QOL scale.

RESULTS

In total, 359 participants took part; 161 (44.8%) had an ileostomy, whereas the others had a colostomy, and about half of the participants (46.5%) had a permanent stoma. The mean age was 57.86 ± 11.92 years. The QOL scores of most participants were poor, with a median value of 49.44. Participants whose stoma was cared for by others had a significantly lower QOL score than those who cared for their own stomas (odds ratio [OR], 1.58; 95% confidence interval [CI], 1.05-2.38; P = .029). Participants with a temporary stoma had a lower QOL score than those with a permanent stoma (OR, 2.08; 95% CI, 1.275-3.40; P = .004). Further, participants with a complication had a lower QOL score than those without (OR, 1.62; 95% CI, 1.07-2.43; P = .022).

CONCLUSIONS

These findings suggest a need for well-developed interventions to improve the QOL of these patients. This study provides valuable insights to inform the development of future clinical practice and research in this area in China and beyond.

Early parastomal evisceration of small bowel following a loop ileostomy for malignant intestinal obstruction

Evisceration of bowel through the stoma is a rare complication and only few cases have been reported. Although most cases occur in the context of long-standing parastomal hernias, early evisceration may also occur causing significant morbidity to patients. The reported patient is a 53-year-old male with bronchial asthma who was diagnosed to have metastatic colonic cancer underwent a trephine loop ileostomy for intestinal obstruction. On post-operative Day 7, he developed small bowel evisceration through the ileostomy site. The patient underwent an emergency laparotomy and found to have non-viable prolapsed small bowel segment at the stoma site. Furthermore, there were extensive peritoneal deposits and large para aortic lymph node mass and ascites compromising the peritoneal space. Resection of non-viable small bowel and ileostomy refashioning was carried out. The patient was managed in the intensive care unit and he gained function of the ileostomy on post-operative Day 2. On Day 5, he died due to subsequent pneumonia and worsening acute respiratory distress syndrome. Early parastomal evisceration is an extremely infrequent life-threatening complication that requires urgent treatment. Disseminated cancer, bowel obstruction, poor nutritional status, ascites and exacerbation of bronchial asthma were additional risk factors in our patient.

Clinical characteristics and quality of life among Sri Lankan patients with chronic pancreatitis

Objective

We aimed to describe the clinical characteristics of chronic pancreatitis (CP) and patient quality of life (QOL) in a resource-limited setting.

Methods

We performed a cross-sectional study including patients with clinical and radiological features of CP. We collected clinical data and assessed QOL using the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire.

Results

We included 103 patients (median age 44 years, 84 men). Median age at symptom onset was 36 (4–78) years. Around 70% of patients had diabetes mellitus and 62.1% had consumed alcohol; 36 (35%) were current smokers. The mean overall global QOL score was 68.7. Most patients (91.3%) sought treatment from multiple centers. Nineteen (18.5%) had pancreatic stone disease, 38 (36.9%) had persistent abdominal pain (median severity 7.8/10, 59 (57.3%) had steatorrhea, and 56 (54.4%) had jaundice. Poor QOL was significantly associated with weight loss, loss of appetite, and intractable pain. No correlation with age, sex, or alcohol consumption was noted.

Conclusion

A considerable proportion of patients with CP had troublesome symptoms. Intractable pain, loss of appetite, and weight loss were significantly associated with poor QOL. Further assessment is needed of patients’ psychosocial well-being and its association with QOL.

Quality of life in postostomy surgery patients: A cross-sectional survey

Background and Aim

Ostomy is a radical treatment that is sometimes required due to severe inflammatory bowel disease (IBD), colorectal cancer (CRC), and so on. Around 8000 people in New Zealand live with stoma bags. We studied factors associated with poor quality of life (QoL) in ostomy patients to improve patient care.

Methods

Eligible adult patients identified through the Southern District Health Board database were invited to participate. The survey consisted of the general stoma QoL, IBD, CRC QoL, and dietary and lifestyle questionnaires.

Results

Response rate was 54.5% (n = 241/448). Study participants were a mean (SD) 70.9 (14.2) years old, 60.6% were male, and 89.5% were New Zealand European; 52.5% of the study participants had a colostomy, and 56.4 and 22.4% received their stoma due to CRC and IBD, respectively. Median (first-third interquartile range) duration since ostomy for overall study sample was 6.9 (3.3-15.1) years. Mean (SD) Stoma-QoL score for all the patients was 60.3 (10.8) points (scale 20-80). Stoma-underlying disease (P = 0.28) and type of stoma (P = 0.60) were not associated with Stoma-QoL scores. Older adults had higher Stoma-QoL, IBD questionnaire and QLQ-C30 quality-of-life scores; 73.1% received dietary recommendations for the stoma, And 56.4% changed their diet, 51.4% found it easy to adhere to dietary recommendations, and 9.2% found it quite/very difficult.

Conclusion

This study found high-quality life scores in postostomy patients and no significant association between the underlying disease, time since ostomy, level of comorbidities, and how the appliance worked, which highlight the multifactorial nature of the quality of life concept and difficulties measuring it.

Spontaneous rupture of a parastomal hernia with evisceration of small bowel: a case report

BACKGROUND

Long standing ostomy related complications such as parastomal hernia and stoma prolapse may be at a higher risk of developing spontaneous rupture and evisceration, especially in patients suffering from chronic cough. Such patients may need early refashioning of the stoma to prevent this serious complication. Parastomal evisceration is a very rare complication of stomas and to date, only few cases have been reported in the literature.

CASE PRESENTATION

A 51 year old patient with chronic obstructive pulmonary disease (COPD) and extensive hidradenitis suppurativa of the perineum underwent a temporary defunctioning loop sigmoid colostomy and subsequent perineal skin excision and skin grafting. The ostomy was complicated by a parastomal hernia and stoma prolapse 6 weeks post operatively. Five months later he developed spontaneous rupture of parastomal hernia and evisceration of small bowel. Urgent surgery was done and reduction of small bowel loops and re-siting of the sigmoid colostomy was done.

DISCUSSION AND CONCLUSIONS

Parastomal evisceration is an extremely rare life threatening stoma-related complication which requires urgent treatment.

Medical, social, and personal factors as correlates of quality of life among older cancer patients with permanent stoma

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.

Psychometric validation of the Stoma-QOL questionnaire in a Canadian cross-sectional sample of colostomy and ileostomy patients

OBJECTIVES

The Stoma-QOL questionnaire is a patient-reported outcome (PRO) used to measure quality of life in patients with ileostomy or colostomy. This study assesses the Stoma-QOL's overall and item-level psychometric characteristics in patients with temporary stomas, and whether stoma-related quality of life differs by demographic characteristics.

MATERIALS AND METHODS

Analysis of cross-sectional observational PRO data from hospitals in Vancouver, Canada. Patients registered for elective ileostomy or colostomy closure, over the age of 18, and able to read English were eligible for participation. Emergent and cancer-related cases were excluded. One-way analysis of variance was used to test for demographic differences in Stoma-QOL scores. Cronbach's alpha was used for reliability, and Rasch item-response theory was used to assess overall and item characteristics.

RESULTS

120 patients were included. No statistically significant difference in Stoma-QOL scores was found by age, sex, or socioeconomic status. Reliability was 0.93. Mean item responses ranged from 1.77 to 3.55 and item-total correlation ranged from 0.51 to 0.77. The Rasch item-response theory model demonstrated significant misfit, likely due to the misfit of item 9, which asks about sexuality, and high residual correlations between item pairs 6 and 8 about fatigue, and items 16 and 17 about social relationships.

CONCLUSIONS

The Stoma-QOL questionnaire is a well-designed PRO for measuring stoma-related quality of life. Demographic variables do not appear to have a strong influence on Stoma-QOL scores. Item 9 demonstrated misfit but removal likely does not improve the instrument. Future research should focus on revising items 6, 8, 16, and 17.

Quality of Life and Characteristics of Colostomy Patients

Introduction: Colostomy imposed multiple impacts on the patient’s life including physical, psychological, social, and spiritual. This study aims to identify the level of quality of life as well as to examine the differences of quality of life among colostomy patients with regards to certain demographic characteristics.Methods: This study used a cross-sectional and descriptive analytical approach. Seventy-one colostomy patients were recruited purposively to participate in the study. The studied variables included quality of life and demographic characteristics. The data was collected by using the WHO Quality of Life – BREF instrument. One-way ANOVA and an independent t-test were employed to analyse the differences in quality of life with regards to certain demographic characteristics.Results: The study found that the majority of subjects perceived that their level of quality of life ranged between very low to moderate (77.4%). Satisfaction with support from friends was rated as the highest item of quality of life, whereas satisfaction with sexual relationships was rated as the lowest item of quality of life. There was no significant difference in the patients’ quality of life with regards to age group, educational background, occupation, length of being ostomate, sex, and other health problems.Conclusions: The study implied that nurses need to realise and pay attention to multiple aspects of stoma patient’s quality of life. Nursing care should not merely focus on stoma care but also holistically consider on meeting sexual needs, as well as the psychological, social, and spiritual needs of the patients.

Distúrbio na imagem corporal: diagnóstico de enfermagem e características definidoras em pessoas ostomizadas

Objetivo: identificar en la literatura las características definidoras del diagnóstico de enfermería disturbio en la imagen corporal en estudios desarrollados con personas ostomizadas. Métodos: se trata de una investigación bibliográfica, en la modalidad revisión integradora de la literatura, descriptiva y con enfoque cualitativo, realizada en noviembre del 2015, en las bases de datos Literatura Latinoamericana y del Caribe en Ciencias de la Salud, Medical Literature Analysis and Retrieval System Online, Índice Bibliográfico Español de Ciencias de la Salud, PubMed Central, Cumulative Index to Nursing and Allied Health Literature, Web of Science y SciVerse Scopus. El análisis se llevó a cabo por medio de consulta a la taxonomía NANDA-I, con la que se buscó identificar las características definidoras del diagnóstico en cuestión. Resultados: la muestra fue de 43 publicaciones, en las que se identificaron 14 de las 37 características definidoras que componen el diagnóstico estudiado. Conclusiones: los estudios señalan relaciones entre el disturbio en la imagen corporal y alteraciones en la sexualidad, restricciones sociales, cambios en el estilo de vida y calidad de vida.