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Delaye M, Polomeni A, Faiderbe S, Berlioz N, Benssekoum C, Guillemin A, Pudlarz T, de Montgolfier S. Professionals' Perceptions of the Colorectal Cancer Pathway: Results of a Co-Constructed Qualitative Study. Health Expect 2024; 27:e14146. [PMID: 39003569 PMCID: PMC11246595 DOI: 10.1111/hex.14146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 06/20/2024] [Accepted: 07/01/2024] [Indexed: 07/15/2024] Open
Abstract
INTRODUCTION Qualitative research on the perceptions of healthcare professionals involved in cancer care about their respective roles in the patient care pathway is limited. Therefore, the aim of this qualitative study was to document these perceptions. METHODS A multidisciplinary team that included patient researchers constructed a semi-structured interview guide on the perceptions of the colorectal cancer care pathway by professionals. Interviews were conducted with healthcare professionals from two French hospitals that manage patients with colorectal cancer. Then, the interviews were fully transcribed and analysed by the whole multidisciplinary team. RESULTS Thirteen healthcare professionals were interviewed (six nurses, four physicians, one psychologist, one social worker and one secretary). They described the colorectal care pathway using a great lexical diversity and listed a significant number of professionals as taking part in this pathway. Among the people mentioned were healthcare professionals working inside and outside the hospital, family members and non-conventional medicine practitioners. However, they did not spontaneously mention the patient. Their views on the role of the referring physician, the general practitioner and the patient were further explored. The interviews highlighted the coordination difficulties among the various professionals, particularly between general practitioners and hospital teams. These data provided interesting elements for developing a tool to help coordination among professionals. CONCLUSIONS This preliminary study, with its participatory design, brings interesting elements of reflection on the care pathway for patients with colorectal cancer. It will continue through the creation of a larger participatory project. PATIENT OR PUBLIC CONTRIBUTION Patient partners were included in all steps of this study. This transdisciplinary project was coordinated by a group composed of three patient partners, two healthcare professionals and two humanities and social sciences researchers. Their knowledge of the patient's perspective on the care pathway enriched discussions from the study design to results analysis.
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Affiliation(s)
- Matthieu Delaye
- Department of Medical Oncology, Curie Institute, Versailles Saint‐Quentin UniversityParis Saclay UniversitySaint‐CloudFrance
| | - Alice Polomeni
- Department of Clinical Hematology and Cellular Therapy, Saint‐Antoine Hospital, AP‐HPSorbonne UniversityParisFrance
| | | | | | | | - Aude Guillemin
- Department of Medical Oncology, Curie Institute, Versailles Saint‐Quentin UniversityParis Saclay UniversitySaint‐CloudFrance
| | | | - Sandrine de Montgolfier
- INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAMAix Marseille UniversityMarseilleFrance
- Université Paris Est CréteilCreteilFrance
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Whiteley I, Randall S, Stanaway FF. Comparison of Adjustment or Adaptation to the Formation of a Temporary Versus a Permanent Ostomy: A Systematic Review. J Wound Ostomy Continence Nurs 2024; 51:39-45. [PMID: 37966042 DOI: 10.1097/won.0000000000001031] [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: 11/16/2023]
Abstract
PURPOSE The aim of this systematic review was to review evidence on adjustment or adaptation to an ostomy in persons with a temporary versus permanent ostomy. METHOD Systematic review. SEARCH STRATEGY We comprehensively searched the following bibliographic databases: MEDLINE (Ovid SP), EMBASE (Ovid SP), PsycINFO, CINAHL, Joanna Briggs, Scopus, and EThOS and ProQuest dissertations from inception to July 21, 2021. We located 570 studies. Data were extracted into Covidence, and the risk of bias was assessed using the Newcastle-Ottawa Scale and the Joanna Briggs tool. FINDINGS Thirty-one studies met inclusion criteria and were included; only 2 assessed adjustment using a validated adjustment tool (Ostomy Adjustment Inventory, OAI-23). One found better adjustment in those with a permanent ostomy at 6 months; the second did not formally test for statistically significant differences between groups. Other included studies assessed aspects of adjustment such as health-related quality of life and psychological symptoms. Findings differed between studies; the majority of studies were deemed at a high risk of bias. CONCLUSIONS The quality of evidence among studies evaluating adjustment to an ostomy in permanent versus temporary stomas was poor; the majority did not measure adjustment using a validated adjustment instrument. Therefore, differences in the ways those with a temporary ostomy or permanent ostomy adjust or adapt remain largely unknown. IMPLICATIONS Further high-quality studies are needed that compare adjustment to a temporary or permanent ostomy using a validated instrument. An understanding of differences in adjustment in those with a temporary and permanent ostomy is important for planning how health care services can be better tailored to meet the needs of ostomy patients beyond the initial postoperative period of recovery.
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Affiliation(s)
- Ian Whiteley
- Ian Whiteley, M Clin Nurs, Grad Cert STN, RN, Faculty of Health and Medicine, The University of Sydney, and Concord Repatriation General Hospital, Concord, New South Wales, Australia
- Sue Randall, PhD, RGN, Broken Hill Department of Rural Health, Faculty of Medicine and Health, The University of Sydney Susan Wakil School of Nursing and Midwifery, Broken Hill, New South Wales, Australia
- Fiona F. Stanaway, PhD, MBBS, MPH, The University of Sydney School of Public Health, Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Sue Randall
- Ian Whiteley, M Clin Nurs, Grad Cert STN, RN, Faculty of Health and Medicine, The University of Sydney, and Concord Repatriation General Hospital, Concord, New South Wales, Australia
- Sue Randall, PhD, RGN, Broken Hill Department of Rural Health, Faculty of Medicine and Health, The University of Sydney Susan Wakil School of Nursing and Midwifery, Broken Hill, New South Wales, Australia
- Fiona F. Stanaway, PhD, MBBS, MPH, The University of Sydney School of Public Health, Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Fiona F Stanaway
- Ian Whiteley, M Clin Nurs, Grad Cert STN, RN, Faculty of Health and Medicine, The University of Sydney, and Concord Repatriation General Hospital, Concord, New South Wales, Australia
- Sue Randall, PhD, RGN, Broken Hill Department of Rural Health, Faculty of Medicine and Health, The University of Sydney Susan Wakil School of Nursing and Midwifery, Broken Hill, New South Wales, Australia
- Fiona F. Stanaway, PhD, MBBS, MPH, The University of Sydney School of Public Health, Faculty of Medicine and Health, Sydney, New South Wales, Australia
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Taylor C, Munro J, Goodman W, Russell S, Oliphant R, Beeken RJ, Hubbard G. Hernia Active Living Trial (HALT): an exercise intervention in people with a parastomal hernia or bulge. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2023; 32:S4-S11. [PMID: 38060393 DOI: 10.12968/bjon.2023.32.22.s4] [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: 12/18/2023]
Abstract
BACKGROUND Parastomal hernias are a common consequence of stoma surgery and can occur in up to 50% of patients. They are mangaged either conservatively, through support hosiery, or surgically. A patient feasibility study called the Hernia Active Living Trial (HALT) was designed to examine if a clinical pilates-based exercise programme offers an alternative approach to managing a parastomal hernia or bulge. METHOD Adults with an ileostomy or colostomy who perceived they had a bulge around their stoma were included in the study. The intervention included up to 12 online sessions of an exercise booklet and videos with an exercise specialist. Interviews were conducted to explore participants' experiences of the intervention. The interview data were analysed systematically and thematically. Participants were also asked to complete patient diaries every week. RESULTS Twelve of the 13 participants who completed the intervention agreed to be interviewed. Following analysis, three main themes emerged including managing a hernia/bulge, benefits and barriers. Participants talked about the benefits of this programme including: reduction of the size of their hernia, increased abdominal control, body confidence and posture, as well as increased physical activity levels. The barriers described were generally overcome allowing participants to engage in what was perceived to be a positive and potentially life-changing experience. CONCLUSIONS A clinical pilates-based exercise programme for people with a parastomal hernia can bring both direct and indirect improvements to a patient's hernia management, sense of wellbeing and day-to-day life. Individuals with a hernia should be informed about the need for, and value of, exercise to strengthen core muscles, as part of their non-surgical options for self-management.
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Affiliation(s)
- Claire Taylor
- Macmillan Nurse Consultant in Colorectal Cancer, London North West University Healthcare NHS Trust and Visiting Lecturer, King's College, London
| | - Julie Munro
- Researcher, Department of Nursing & Midwifery, University of the Highlands and Islands, Centre for Health Sciences, Inverness
| | - William Goodman
- Research Fellow, Leeds Institute of Health Sciences, University of Leeds, Leeds
| | - Sarah Russell
- Clinical Exercise Specialist, The Ostomy Studio, Wadhurst, East Sussex
| | - Raymond Oliphant
- Colorectal Consultant Surgeon, NHS Highland, Raigmore Hospital, Inverness
| | - Rebecca J Beeken
- Associate Professor of Behavioural Medicine, Leeds Institute of Health Sciences, University of Leeds, Leeds
| | - Gill Hubbard
- Professor of Health Services Research, Department of Nursing & Midwifery, University of the Highlands and Islands, Centre for Health Sciences, Inverness
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Zhang X, Liu H, Lin L, Xiao H. Effects of Psycho-education Interventions on Colorectal Cancer Patients: A systematic review and meta-analysis. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:1413-1419. [PMID: 37620689 DOI: 10.1007/s13187-023-02349-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/26/2023] [Indexed: 08/26/2023]
Abstract
Colorectal cancer (CRC) patients not only undergo physical symptoms but also psychological suffering. Psycho-education interventions have been implemented widely to improve their psychological well-being. However, the effectiveness of psycho-education is unclear. Therefore, this research evaluates the effectiveness of psycho-education interventions on CRC patient outcomes and identifies effective intervention characteristics. The researchers searched the following databases: PubMed, Embase, PsycINFO, Cochrane, Medline, Web of Science, CINAHL, ProQuest, Wan Fang Data, Chinese National Knowledge Infrastructure, Chinese Biomedicine Database, and China Academic Journals Full-Text Database. Additionally, gray literature and bibliographies of the included studies were also searched. Finally, this review included 11 randomized controlled trials and one controlled clinical trial. The results showed that psycho-education interventions exerted positive impacts on relieving anxiety and depression, improving self-efficacy and quality of life for CRC patients either immediately, post-intervention, or at least 2 months after intervention. Despite the variety of psycho-education interventions, health education, stress management, coping skills training, and social support are also essential components. Future research should include multi-center studies with sufficient sample sizes and rigorous designs.
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Affiliation(s)
- XiaoYing Zhang
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - HuangQin Liu
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - LiYing Lin
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Huimin Xiao
- School of Nursing, Fujian Medical University, Fuzhou, China.
- Research Center for Nursing Humanity, Fujian Medical University, Fuzhou, China.
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Munro J, Goodman W, Oliphant R, Russell S, Taylor C, Beeken RJ, Hubbard G. Hernia Active Living Trial (HALT): a feasibility study of a physical activity intervention for people with a bowel stoma who have a parastomal hernia/bulge. Pilot Feasibility Stud 2023; 9:111. [PMID: 37400863 DOI: 10.1186/s40814-023-01329-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 05/26/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND Parastomal bulging/hernia is a common complication associated with a stoma. Strengthening of the abdominal muscles via exercise may be a useful self-management strategy. The aim of this feasibility work was to address uncertainties around testing a Pilates-based exercise intervention for people with parastomal bulging. METHODS An exercise intervention was developed and tested in a single-arm trial (n = 17 recruited via social media) followed by a feasibility randomised controlled trial RCT (n = 19 recruited from hospitals). Adults with an ileostomy or colostomy with a bulge or diagnosed hernia around their stoma were eligible. The intervention involved a booklet, videos, and up to 12 online sessions with an exercise specialist. Feasibility outcomes included intervention acceptability, fidelity, adherence, and retention. Acceptability of self-report measures for quality of life, self-efficacy, and physical activity were assessed based on missing data within surveys pre- and post-intervention. Interviews (n = 12) explored participants' qualitative experiences of the intervention. RESULTS Nineteen of 28 participants referred to the intervention completed the programme (67%) and received an average of 8 sessions, lasting a mean of 48 min. Sixteen participants completed follow-up measures (44% retention), with low levels of missing data across the different measures, apart from body image and work/social function quality of life subscales (50% and 56% missing, respectively). Themes from qualitative interviews related to the benefits of being involved, including behavioural and physical changes in addition to improved mental health. Identified barriers included time constraints and health issues. CONCLUSIONS The exercise intervention was feasible to deliver, acceptable to participants, and potentially helpful. Qualitative data suggests physical and psycholosical benefits. Strategies to improve retention need to be included in a future study. TRIAL REGISTRATION ISRCTN, ISRCTN15207595 . Registered on 11 July 2019.
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Affiliation(s)
- Julie Munro
- Department of Nursing & Midwifery, Centre for Health Sciences, University of the Highlands and Islands, Inverness, UK.
| | - William Goodman
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | | | | | - Claire Taylor
- London North West University Healthcare NHS Trust & Visiting Lecturer, Chief Nursing Officer Macmillan Cancer saupport King's College, London, UK
| | - Rebecca J Beeken
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Gill Hubbard
- Department of Nursing & Midwifery, Centre for Health Sciences, University of the Highlands and Islands, Inverness, UK.
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Krasnoselskyi MV, Kyrylova OO, Rublova TV, Svynarenko AV, Artiukh SV. ASSESSMENT OF DISTRESS DYNAMICS AND QUALITY OF LIFE OF CANCER PATIENTS AT THE STAGE OF RADIATION THERAPY AND POSSIBILITIES OF THEIR CORRECTION. PROBLEMY RADIATSIINOI MEDYTSYNY TA RADIOBIOLOHII 2022; 27:353-362. [PMID: 36582100 DOI: 10.33145/2304-8336-2022-27-353-362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Indexed: 06/17/2023]
Abstract
Radiation therapy (RT) is the main type of antitumor treatment in inoperable patients. Low awareness and fear of the development of radiation reactions contributes to the destabilization of psycho-emotional state of patients, which can result in withdrawal from treatment and deterioration of their quality of life (QOL). Despite a steady increase in cancer rates in Ukraine, there are currently no studies to develop measures to improve psychological condition of patients undergoing treatment in radiation therapy departments. OBJECTIVE to assess the dynamics of psycho-emotional status and QOL of cancer patients at the stage of radiation therapy. MATERIALS AND METHODS The study involved psychodiagnostic examination of 66 cancer patients who underwent radiation treatment in the clinic of the State Organization «Grigoriev Institute for Medical Radiology and Oncology of the NAMS of Ukraine», of whom Group 1 included 44 patients with head and neck cancer, Group 2 comprised 22 patients with colorectal cancer. Comparison group comprised 30 conditionally «healthy» respondents without cancer. All patients had stage III-IV cancer. The study implied the employment of «Distress Thermometer», Hospital Anxiety and Depression Scale (HADS), and the SF-36 Questionnaire (Short Form). The examination was performed before and following the course of radiation therapy. Group 1 patients underwent only psychodiagnostic examination, Group 2 patients apart from psychodiagnostic were accompanied by a psychologist before undergoing radiation procedures. In the comparison group, the survey was conducted once. RESULTS AND DISCUSSION Assessment of the data showed that before the start of RT most subjects (72.73 % in Group 1 and 77.3 % in Group 2) had a high level of distress, they were worried and nervous before the first radiation procedure, had fears about the consequences and side effects. The level of anxiety in Group 1 at the pathological and subclinical level was recorded in 54.55 % of patients, the rate of depression at the subclinical level was diagnosed in 18.20 %, and in 9.10 % of patients at the clinical one. In Group 2, the level of anxiety that exceeded the norm was recorded significantly less often (27.25 % vs. 54.55 %, pt < 0.05), and the rate of depression at the subclinical level was diagnosed significantly more often than in Group 1 (54.50 % vs. 18.20 %, pt < 0.05), and in 18.2 % of patients at the clinical level. After radiation, 81.81 % of Group 1 patients showed an increase in distress and anxiety, and depressive symptoms tended to worsen. The level of distress in Group 2 after consulting a psychologist in preparation for RT and undergoing radiation procedures decreased almost twice, the level of anxiety decreased to normal, the indicators of depressive symptoms remained unchanged. According to QOL assessments on the scales of physical and role functioning (PF and RP), general health (GH) and mental health (MH), patients in both groups had significantly lower scores before the RT than in the comparison groups. After the procedures, there was a significant deterioration in the RP scale in Group 1 (18.75 vs. 40.00, pt < 0.05), and an improvement of almost 2 times in Group 2 (35.73 vs. 68.33, pt < 0.06). The indicator of general health (GH) at the end of RT in Group 1 did not change, and in Group 2 it tended to improve (20.93 vs. 47.26, pt < 0.06). Life expectancy (LE) in Group 1 tended to decrease further after treatment, having increased 1.7 times in Group 2. CONCLUSIONS The study showed that cancer patients before the onset of RT experienced a rather strong distress and level of anxiety. Psychological correction of the emotional state at the beginning of treatment allowed for a significant improvement in the QOL of patients on the scales of role physical functioning (RF) and vitality (VT). An important area of work of a clinical psychologist at this stage of treatment involved correction of cognitive sphere, support of role functioning and formation of behavior aimed at further treatment.
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Affiliation(s)
- M V Krasnoselskyi
- SE «Grigoriev Institute for Medical Radiology and Oncology of the National Academy of Medical Sciences of Ukraine», 82 Pushkinska St., Kharkiv 61024, Ukraine
| | - O O Kyrylova
- SE «Grigoriev Institute for Medical Radiology and Oncology of the National Academy of Medical Sciences of Ukraine», 82 Pushkinska St., Kharkiv 61024, Ukraine
| | - T V Rublova
- SE «Grigoriev Institute for Medical Radiology and Oncology of the National Academy of Medical Sciences of Ukraine», 82 Pushkinska St., Kharkiv 61024, Ukraine
| | - A V Svynarenko
- SE «Grigoriev Institute for Medical Radiology and Oncology of the National Academy of Medical Sciences of Ukraine», 82 Pushkinska St., Kharkiv 61024, Ukraine
| | - S V Artiukh
- SE «Grigoriev Institute for Medical Radiology and Oncology of the National Academy of Medical Sciences of Ukraine», 82 Pushkinska St., Kharkiv 61024, Ukraine
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Li J, Zhang Q, Wu X, Pang D. The Quality and Clinical Applicability of Recommendations in Ostomy Guidelines: A Systematic Review. Risk Manag Healthc Policy 2022; 15:1517-1529. [PMID: 35971434 PMCID: PMC9375557 DOI: 10.2147/rmhp.s378684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/03/2022] [Indexed: 11/23/2022] Open
Abstract
Aim To systematically search ostomy clinical practice guidelines, critically assess their quality and clinical applicability of recommendations, and summarize the recommendations. Design Systematic review. Data Sources The PubMed, ProQuest and CINAHL databases, eight guideline databases, and three ostomy institution websites were searched on September 3, 2021. Review Methods Appraisal of Guidelines for Research and Evaluation II (AGREE II) and AGREE Recommendation EXcellence (AGREE-REX) were used to assess the guideline. Results The initial search identified 1475 documents. Of these, 27 full-text documents were reviewed. Finally, 10 guidelines were included. Among these, the 2019 Registered Nurses’ Association of Ontario (RNAO) guidelines had the highest total scores using AGREE II and AGREE-REX. The 2019 National Institute for Health and Care Excellence (NICE) and 2018 European Hernia Society (EHS) were also ranked as high-quality and evaluated as “recommended.” The median of the “applicability” domain was the lowest (45%) among the six AGREE II domains. The median of the “values and preferences” domain was the lowest (38%) among the three AGREE-REX domains. In total, 172 recommendations were summarized and parastomal hernia received the most attention among the recommendations. Conclusion The quality of the 10 clinical practice guidelines varied widely. The three identified high-quality guidelines might be appropriate first choices in daily ostomy care and management practice and can be tailored to the local context. Ostomy guidelines require further improvement in the “applicability” and “values and preferences” domains. No Patient or Public Contribution This review only searched and evaluated relevant documents, so such details do not apply to this review.
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Affiliation(s)
- Jiamin Li
- Department of Nursing, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Qiuwen Zhang
- School of Nursing, Health Science Center for Evidence-Based Nursing, Peking University, Beijing, People's Republic of China
| | - Xinjuan Wu
- Department of Nursing, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Dong Pang
- School of Nursing, Health Science Center for Evidence-Based Nursing, Peking University, Beijing, People's Republic of China
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Belaid I, Ben Moussa C, Melliti R, Limam M, Ben Ahmed T, Ezzaari F, Elghali MA, Bouazzi A, Ben Mabrouk M, Bourigua R, Ammar N, Hochlaf M, Fatma LB, Chabchoub I, Ben Ahmed S. Quality of life in Tunisian colorectal cancer patients: a cross-sectional study. J Cancer Res Clin Oncol 2022:10.1007/s00432-022-04154-3. [PMID: 35771260 DOI: 10.1007/s00432-022-04154-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/13/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE Quality of life (QOL) of colorectal cancer (CRC) patients has been little studied in Tunisia. The aim of this work was to evaluate the QOL of CRC patients and to identify factors that may influence it. METHODS A cross-sectional, study spread was made over a period of 6 months on patients with CRC treated in the department of Medical Oncology of Farhat Hached University Hospital of Sousse. The EORTC questionnaires translated and validated in Arabic (QLQ-C30 and QLQ-CR29) were used. RESULTS 142 patients diagnosed with colon or rectal cancer were enrolled. The overall QOL score was 58.5 ± 29.1. The emotional and sexual functional dimensions were the most affected, especially in women and patients under 50 years of age. QOL scores were higher in patients who were in complete remission (71.4 ± 24.7) and in good general condition (63.7 ± 26.6) physical activity may have a significant influence on all functional dimensions of QOL (p < 0.001). Fatigue was significantly (p < 0.001) more present when there was a sedentary lifestyleradiotherapy, palliative chemotherapy (1st and 2nd line) and targeted therapy. CONCLUSION Evaluating quality of life of patients with colorectal cancer in Tunisia is necessary especially those under 50 years old and in women. Laparoscopic surgery with restoration of intestinal continuity, less toxic palliative chemotherapy protocols, more accessibility to new radiotherapy technics will improve QOL of CRC patients. Physical activity and nutrition support are also essential in promoting QOL of these patients.
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Affiliation(s)
- Imtinene Belaid
- Faculté de Médecine de Sousse, Hôpital Farhat Hached, Department of MedicalOncology, Association de Recherhe et d'Information Sur Le Cancer du Centre Tunisien, Université de Sousse, 4000, Sousse, Tunisie.
| | - Chaimaa Ben Moussa
- Faculté de Médecine de Sousse, Department of Epidemiology, Université de Sousse, 4000, Sousse, Tunisie
| | - Rihab Melliti
- Faculté de Médecine de Sousse, Hôpital Farhat Hached, Department of MedicalOncology, Association de Recherhe et d'Information Sur Le Cancer du Centre Tunisien, Université de Sousse, 4000, Sousse, Tunisie
| | - Manel Limam
- Faculté de Médecine de Sousse, Department of Epidemiology, Université de Sousse, 4000, Sousse, Tunisie
| | - Tarek Ben Ahmed
- Faculté de Médecine de Sousse, Hôpital Farhat Hached, Department of MedicalOncology, Association de Recherhe et d'Information Sur Le Cancer du Centre Tunisien, Université de Sousse, 4000, Sousse, Tunisie
| | - Faten Ezzaari
- Faculté de Médecine de Sousse, Hôpital Farhat Hached, Department of MedicalOncology, Association de Recherhe et d'Information Sur Le Cancer du Centre Tunisien, Université de Sousse, 4000, Sousse, Tunisie
| | - Mohamed Amine Elghali
- Faculté de Médecine de Sousse, Hôpital Farhat Hached, Department of Surgery, Université de Sousse, 4000, Sousse, Tunisie
| | - Amal Bouazzi
- Faculté de Médecine de Sousse, Hôpital Sahloul, Department of Surgery, Université de Sousse, 4000, Sousse, Tunisie
| | - Mohamed Ben Mabrouk
- Faculté de Médecine de Sousse, Hôpital Sahloul, Department of Surgery, Université de Sousse, 4000, Sousse, Tunisie
| | - Rym Bourigua
- Faculté de Médecine de Sousse, Hôpital Farhat Hached, Department of MedicalOncology, Association de Recherhe et d'Information Sur Le Cancer du Centre Tunisien, Université de Sousse, 4000, Sousse, Tunisie
| | - Nouha Ammar
- Faculté de Médecine de Sousse, Hôpital Farhat Hached, Department of MedicalOncology, Association de Recherhe et d'Information Sur Le Cancer du Centre Tunisien, Université de Sousse, 4000, Sousse, Tunisie
| | - Makrem Hochlaf
- Faculté de Médecine de Sousse, Hôpital Farhat Hached, Department of MedicalOncology, Association de Recherhe et d'Information Sur Le Cancer du Centre Tunisien, Université de Sousse, 4000, Sousse, Tunisie
| | - Leila Ben Fatma
- Faculté de Médecine de Sousse, Hôpital Farhat Hached, Department of MedicalOncology, Association de Recherhe et d'Information Sur Le Cancer du Centre Tunisien, Université de Sousse, 4000, Sousse, Tunisie
| | - Imene Chabchoub
- Faculté de Médecine de Sousse, Hôpital Farhat Hached, Department of MedicalOncology, Association de Recherhe et d'Information Sur Le Cancer du Centre Tunisien, Université de Sousse, 4000, Sousse, Tunisie
| | - Slim Ben Ahmed
- Faculté de Médecine de Sousse, Hôpital Farhat Hached, Department of MedicalOncology, Association de Recherhe et d'Information Sur Le Cancer du Centre Tunisien, Université de Sousse, 4000, Sousse, Tunisie
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Mrozovski JM. Abord psychologique des patients porteurs d’une stomie. ACTUALITES PHARMACEUTIQUES 2022. [DOI: 10.1016/j.actpha.2021.12.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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10
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Prevalence of Anxiety and Depression in Persons With Ostomies: A Cross-sectional Study. J Wound Ostomy Continence Nurs 2020; 47:595-600. [PMID: 33201146 DOI: 10.1097/won.0000000000000718] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study was to measure the prevalence of anxiety and depression in adults with ostomies and to identify associated factors. DESIGN A descriptive cross-sectional study. SUBJECTS AND SETTING The sample comprised 120 adults; all reside in a health region in the state of Minas Gerais in southeastern Brazil. METHODS Participants responded to a questionnaire designed for purposes of this study. The questionnaire included 2 validated instruments-the Beck Depression Inventory and the Beck Anxiety Inventory. In addition to measuring the prevalence of depression and anxiety, we used logistic regression models to identify factors associated with depression and anxiety. A backward method was adopted and the goodness-of-fit of the model was evaluated through the Hosmer and Lemeshow goodness-of-fit test. An odds ratio (OR) with a 95% confidence interval (95% CI) was used to measure the effect size of these associations. RESULTS The prevalence of depression in our sample was 26.7% (n = 32; 95% CI, 18.6-34.6). Slightly more than half of respondents (53.1%, n = 17) had mild depression, 34.3% (n = 11) had moderate depression, and 12.6% (n = 4) had had severe depression. The prevalence of anxiety in our sample was 52.5% (n = 63; 95% CI, 43.4-61.5). Slightly less than half 47.6% (n = 30) had mild anxiety; 36.5% (n = 23) reported moderate and 15.9% (n = 10) reported severe anxiety. The final multiple logistic regression model indicated that respondents with less supportive family relationships were more likely to have depression than respondents with greater family support (OR, 3.83; 95% CI, 1.30-11.25). Similarly, respondents with anxiety were more likely to experience depression when compared to individuals reporting no anxiety (OR, 6.32; 95% CI, 2.26-17.65). CONCLUSIONS Anxiety and depression are prevalent in adults living with an ostomy; anxiety was more prevalent than depression. Respondents with less support from their family and those with anxiety were more likely to experience depression.
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Hubbard G, Beeken RJ, Taylor C, Oliphant R, Watson AJM, Munro J, Russell S, Goodman W. HALT (Hernia Active Living Trial): protocol for a feasibility study of a randomised controlled trial of a physical activity intervention to improve quality of life in people with bowel stoma with a bulge/parastomal hernia. Pilot Feasibility Stud 2020; 6:142. [PMID: 32983558 PMCID: PMC7517671 DOI: 10.1186/s40814-020-00674-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 09/01/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Parastomal hernia (PSH) can be repaired surgically, but results to date have been disappointing, with reported recurrence rates of 30 to 76%. Other types of intervention are therefore needed to improve the quality of life of people with PSH. One potential intervention is physical activity. We hypothesise that the intervention will increase core activation and control across the abdominal wall at a site of potential weakness and thus reduce the risk of PSH progression. Increases in physical activity will improve body image and quality of life (QoL). METHODS Subjects and sampleThere were approximately 20 adults with a bowel stoma and PSH. People with previous PSH repair will be excluded as well as people who already do core training.Study designThis is a feasibility study of a randomised controlled trial with 2 months follow-up, in 2 sites using mixed methods. Stage 1 involves intervention development and in stage 2, intervention and trial parameters will be assessed.InterventionA theoretically informed physical activity intervention was done, targeting people with PSH.Main outcome of feasibility studyThe main outcome is the decision by an independent Study Steering Committee whether to proceed to a full randomised controlled trial of the intervention.Other outcomesWe will evaluate 4 intervention parameters-fidelity, adherence, acceptability and safety and 3 trial parameters (eligible patients' consent rate, acceptability of study design and data availability rates for following endpoints): I.Diagnosis and classification of PSHII.Muscle activationIII.Body composition (BMI, waist circumference)IV.Patient reported outcomes: QoL, body image and physical functioningV.Physical activity;VI.Psychological determinants of physical activityOther dataIncluded are other data such as interviews with all participants about the intervention and trial procedures.Data analysis and statistical powerAs this is a feasibility study, the quantitative data will be analysed using descriptive statistics. Audio-recorded qualitative data from interviews will be transcribed verbatim and analysed thematically. DISCUSSION The feasibility and acceptability of key intervention and trial parameters will be used to decide whether to proceed to a full trial of the intervention, which aims to improve body image, quality of life and PSH progression. TRIAL REGISTRATION ISRCTN15207595.
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Affiliation(s)
- Gill Hubbard
- Department of Nursing and Midwifery, University of the Highlands and Islands, Centre for Health Science, Old Perth Road, Inverness, IV2 3JH UK
| | - Rebecca J. Beeken
- Leeds Institute of Health Sciences, University of Leeds, Worsley Building, Clarendon Way, Leeds, LS2 9NL UK
| | - Claire Taylor
- St Mark’s Hospital, London North West University Healthcare NHS Trust, Harrow, Middlesex, HA1 3UJ UK
| | - Raymond Oliphant
- Department of Surgery, Raigmore Hospital, NHS Highland, Old Perth Rd, Inverness, IV2 3UJ UK
| | - Angus J. M. Watson
- Department of Surgery, Raigmore Hospital, NHS Highland, Old Perth Rd, Inverness, IV2 3UJ UK
| | - Julie Munro
- Department of Nursing and Midwifery, University of the Highlands and Islands, Centre for Health Science, Old Perth Road, Inverness, IV2 3JH UK
| | | | - William Goodman
- Research Department of Behavioural Science and Health, University College London, Gower Street, London, WC1E 6BT UK
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Folguera-Arnau M, Gutiérrez-Vilaplana JM, González-María E, Moreno-Casbas MT, Obarrio-Fernández S, Lorente-Granados G, Viñoly Torres E, Rodríguez-Soberado MP. Implementation of best practice guidelines for ostomy care and management: Care outcomes. ENFERMERIA CLINICA 2020; 30:176-184. [PMID: 32359975 DOI: 10.1016/j.enfcli.2019.10.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 10/03/2019] [Accepted: 10/25/2019] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Care provided to ostomized people is crucial in their progress and rehabilitation. The Registered Nurses' Association of Ontario clinical practice guidelines include greatest evidence nursing interventions for ostomized patient care. The aim of the study is to analyze the impact on patients' care and health outcomes after Care and management of ostomy guideline implementation. METHOD Pre-post quasi-experimental study, carried out in all patients who underwent a digestive or urological ostomy in 8 centres of Best Practices Spotlight Organization® where the ostomy care and management guideline was implanted from 2012 to 2018. Clinical, process and health outcome variables were analyzed and compared in 3 periods of time. Descriptive analysis and comparison of proportions between the periods was performed, using Chi square, applying Yates correction, considering a 95% confidence interval. RESULTS Preoperative education went from 36.7 to 47.3% (P<.05); stoma site marking from 25.2 to 33.8% (P<.05); postoperative evaluation from 94.8 to 59% (P<.05); postoperative education from 75.5 to 91.9% (P<.05); peristomal skin complications from 16.6 to 10.9% (P<.05), and ostomy complications from 21.8 to 27.9% (P<.05). CONCLUSIONS The implementation of the ostomy care and management improved preoperative care, stoma site marking and peristomal skin complications.
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Affiliation(s)
| | | | - Esther González-María
- Unidad de Investigación en Cuidados y Servicios de Salud (Investén-isciii), Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, España
| | - María Teresa Moreno-Casbas
- Unidad de Investigación en Cuidados y Servicios de Salud (Investén-isciii), Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, España
| | | | - Gloria Lorente-Granados
- Gerencia de Atención Integrada de Alcázar de San Juan, Alcázar de San Juan, Ciudad Real, España
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Adamou H, Amadou Magagi I, Adakal O, Doutchi M, Habou O, Boukari M, James Didier L, Sani R. Perioperative management of gastrointestinal surgery in a resource-limited hospital in Niger: Cross-sectional study. Ann Med Surg (Lond) 2020; 54:10-15. [PMID: 32322389 PMCID: PMC7163210 DOI: 10.1016/j.amsu.2020.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 03/12/2020] [Accepted: 03/27/2020] [Indexed: 11/17/2022] Open
Abstract
Background Perioperative management in digestive surgery is a challenge in sub-Saharan Africa. Objective: To describe the process and outcomes of perioperative management in gastrointestinal surgery. Materials and methods This was a single center cross-sectional study over a 4-month period from June 1 to September 30, 2017, in a Nigerien hospital (West Africa). This study included caregivers and patients operated on gastrointestinal surgery. Results We collected data for 56 caregivers and 253 patients underwent gastrointestinal surgery. The average age of caregivers was 38.6 ± 8.7. The median length of professional practice was 9 years. Almost 52% of caregivers (n = 29) did not know the standards of perioperative care. The median age of patients was 24 years, and male gender constituted 70% of cases (n = 177) with a sex ratio of 2.32. Patients came from rural areas in 78.2% (n = 198). Emergency surgery accounted for 60% (n = 152). The most surgical procedure was digestive ostomies performed in 28.9% (n = 73), followed by hernia repair and appendectomy in 24.5% (n = 62) and 13.9% (n = 35) respectively. The postoperative course was complicated in 28.1% (n = 71) among which 13 deaths. In the group of caregivers, the poor practice of perioperative management was associated with poor professional qualification, insufficient equipment, insufficient motivation (p < 0.05). The ASA3&ASA4 score, undernutrition, emergency surgery, poor postoperative monitoring, and poor psychological preparation were associated with complicated postoperative outcomes (p < 0.05). Conclusion The inadequacy of the technical platform and the lack of continuous training for healthcare staff represented the main dysfunctions of our hospital. The risk factors for complications found in this study need appropriate perioperative management to improve prognosis in gastrointestinal surgery. Perioperative care in gastrointestinal surgery in a challenge in Sub-Saharan countries. This setting is characterised by the difficulty of geographical access to hospital, lack of equipment. Risk factors for complications are multifactorial. This study can be a draft for improvement the quality of care in low resource settings.
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Affiliation(s)
- Harissou Adamou
- Department of Surgery and Surgical Specialties - Zinder National Hospital, Faculty of Health Sciences, University of Zinder, Niger
- Corresponding author. surgeon at the Zinder National Hospital. Faculty of Health Sciences, University of Zinder, PO BOX: 656, Zinder, Niger.
| | - Ibrahim Amadou Magagi
- Department of Surgery and Surgical Specialties - Zinder National Hospital, Faculty of Health Sciences, University of Zinder, Niger
| | - Ousseini Adakal
- Surgery Department, Maradi Hospital Center, Faculty of Health Sciences, University of Maradi, Niger
| | - Mahamadou Doutchi
- Infectiology Department - Zinder National Hospital, Faculty of Health Sciences, University of Zinder, Niger
| | - Oumarou Habou
- Department of Surgery and Surgical Specialties - Zinder National Hospital, Faculty of Health Sciences, University of Zinder, Niger
| | - Mamane Boukari
- Department of Surgery and Surgical Specialties - Zinder National Hospital, Faculty of Health Sciences, University of Zinder, Niger
| | - Lassey James Didier
- Department of Surgery and Surgical Specialties, Faculty of Health Sciences, University of Niamey, Niger
| | - Rachid Sani
- Department of Surgery and Surgical Specialties, Faculty of Health Sciences, University of Niamey, Niger
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Tong G, Zhang G, Liu J, Zheng Z, Chen Y, Li M, Zhong Y, Niu P, Xu X. When do defecation function and quality of life recover for patients with non-ostomy and ostomy surgery of rectal cancer? BMC Surg 2020; 20:57. [PMID: 32228547 PMCID: PMC7106805 DOI: 10.1186/s12893-020-00719-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 03/17/2020] [Indexed: 12/15/2022] Open
Abstract
Background Rectal cancer (RC) surgery often results in permanent colostomy, seriously limiting the quality of life (QOL) in patients in terms of bowel function. This study aimed to examine defecation function and QOL in RC patients who underwent non-ostomy or ostomy surgery, at different time-points after surgery. Methods In total, 82 patients who underwent an ostomy and 141 who did not undergo an ostomy for the treatment of RC at our colorectal surgery department between January 2013 and January 2015 were enrolled. Surgical methods, tumor distance from the anal margin (TD), anastomosis distance from the anal margin (AD) and complications were compered between the non-ostomy and ostomy surgery groups. QOL was compared between the two groups at years 2, 3, and 4 after surgery. The Wexner score and the validated cancer-specific European Organization for Research and Treatment of Cancer (EORTC QLQ-CR30) questionnaire scores were assessed for all patients in January 2017. SPSS 21.0 was utilized for all data analyses. Results Surgical methods, TD, and AD significantly differed between the non-ostomy and ostomy surgery groups (all P < .001). However, no differences were found in the number of complications between the groups (P = .483). For the 192 patients undergoing Dixon surgery, role function (RF), global QOL (GQOL), sleep disturbance, and the incidence of constipation showed significant differences between the two groups (P = .012, P = .025, P = .036, and P = .015, respectively). In the 31 cases of permanent ostomy, we observed significant differences in GQOL scores, dyspnea incidence, and financial difficulties across the different years (P = .002, P = .036, and P < .01, respectively). Across all 223 cases, there were significant differences in social function and GQOL scores in the second year after surgery (P = .014 and P < .001, respectively). However, no differences were observed in the other indices across the three time-points. Conclusions RC patients undergoing ostomy surgery, especially those with low and super-low RC, revealed poorer defecation function and QOL in the present study. However, 2 years after surgery, most of the defecation and QOL indicators showed recovery.
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Affiliation(s)
- Guojun Tong
- Department of Colorectal Surgery, Huzhou Central Hospital, Zhejiang, 313000, China. .,Central Laboratory, Huzhou Central Hospital, Zhejiang, 313000, China.
| | - Guiyang Zhang
- Department of Colorectal Surgery, Huzhou Central Hospital, Zhejiang, 313000, China
| | - Jian Liu
- Department of Colorectal Surgery, Huzhou Central Hospital, Zhejiang, 313000, China.,Vice President of Huzhou Central Hospital, Zhejiang, 313000, China
| | - Zhaozheng Zheng
- Department of Colorectal Surgery, Huzhou Central Hospital, Zhejiang, 313000, China
| | - Yan Chen
- Department of Colorectal Surgery, Huzhou Central Hospital, Zhejiang, 313000, China
| | - Min Li
- Huzhou Central Hospital, Zhejiang, 313000, China
| | - Yan Zhong
- Huzhou Central Hospital, Zhejiang, 313000, China
| | - Pingping Niu
- Central Laboratory, Huzhou Central Hospital, Zhejiang, 313000, China
| | - Xuting Xu
- Central Laboratory, Huzhou Central Hospital, Zhejiang, 313000, China
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Fernández-Cacho LM, Ayesa-Arriola R. Quality of life, pain and anxiety in patients with nephrostomy tubes. Rev Lat Am Enfermagem 2019; 27:e3191. [PMID: 31596421 PMCID: PMC6781322 DOI: 10.1590/1518-8345.3039.3191] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 06/11/2019] [Indexed: 02/08/2023] Open
Abstract
Objective: to evaluate the impact on the quality of life as well as anxiety and pain in patients with nephrostomy tubes. Method: this is a longitudinal descriptive study performed on a sample of n=150 patients. To evaluate the quality of life, the EuroQol-5D questionnaire was used; anxiety was quantified by the Beck Anxiety Inventory; to study pain, a visual analogue scale was employed. Results: statistically significant differences were found in the quality of life, with its worsening (r = 0.51; p <0.01) when evaluated at the first tube replacement. Patients presented mild to moderate anxiety before the procedure, which was reduced at the first tube replacement, although this difference was not significant (r = 0.028, p = 0.393). Finally, the degree of pain was also significantly reduced (r = 0.13, p<0.01) after six weeks. As for gender, women presented the worst values in the three variables studied (worse quality of life and greater anxiety and pain). Conclusions: nephrostomy tubes have a negative impact on the patient’s quality of life. During the time they live with these tubes, patients have mild to moderate pain and anxiety.
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Affiliation(s)
| | - Rosa Ayesa-Arriola
- Hospital Marqués de Valdecilla University, Department of Psychiatry, Santander,Cantabria, Spain.,Instituto de Investigación Valdecilla (IDIVAL), Santander, Cantabria, Spain.,University Of Cantabria, School of Medicine, Santander, Cantabria, Spain.,Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), Spain
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