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Hu J, Zhang X, Sun J, Hu H, Tang C, Ba L, Xu Q. Supportive Care Needs of Patients With Temporary Ostomy in Enhanced Recovery After Surgery: A Mixed-Methods Study. J Nurs Res 2024; 32:e329. [PMID: 38727228 DOI: 10.1097/jnr.0000000000000610] [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: 05/31/2024] Open
Abstract
BACKGROUND Enhanced recovery after surgery (ERAS), a global surgical quality improvement initiative, reduces the length of stay in the hospital. Temporary stoma care for rectal cancer is complex, and patients require prolonged care services to adjust to the stoma. The shorter stay durations in the new model challenge the conventional care pathways and create new patient needs. PURPOSE This study was designed to explore the supportive care needs of patients under the new surgical model to provide a reference for the design of ERAS nursing care plans. METHODS A convergent parallel mixed-methods design was used in this study. Patients with temporary stomas for rectal cancer were recruited using a convenience sampling method in gastrointestinal surgery wards and wound & stoma clinics in two public tertiary care hospitals in China. Standardized questionnaires were administered to 140 patients to collect quantitative data, and semistructured interviews were conducted individually with 13 patients to collect qualitative data. The questionnaire data were analyzed using descriptive statistics, and the interview data were analyzed using thematic analysis. RESULTS "Health system and information needs" and "care and support needs" were identified in both the qualitative and quantitative analyses as the most significant unmet needs of the participants. In addition, the qualitative analysis identified receiving focused stoma care instructions and easily understandable information as essential to fulfilling health system and information needs. Care and support needs included access to continued postdischarge services and attention from medical professionals. CONCLUSION/IMPLICATIONS FOR PRACTICE The participants in this study experienced a variety of unmet supportive care needs under the ERAS protocol, with gaps particularly notable in two categories: "health system and information needs" and "care and support needs." Increased perioperative care and shorter hospital stays under the ERAS protocol reduce opportunities for patients to receive targeted instruction and shift much of the ostomy education and care workload out of the hospital, requiring greater attention from clinical nurses to ensure quality of care.
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Affiliation(s)
- Jieman Hu
- PhD, RN, Lecturer, School of Nursing, Nanjing Medical University, Nanjing, China
| | - Xiuling Zhang
- BSN, RN, Department of Gastrointestinal Colorectal and Anal Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Jianan Sun
- MS, RN, Department of Gastrointestinal Colorectal and Anal Surgery, The First Hospital of Jilin University, Changchun, China
| | - Haiyan Hu
- BSN, RN, Head Nurse, Department of Gastrointestinal Colorectal and Anal Surgery, The First Hospital of Jilin University, Changchun, China
| | - Chulei Tang
- PhD, RN, Lecturer, School of Nursing, Nanjing Medical University, Nanjing, China
| | - Lei Ba
- PhD, Associate Professor, National Health Commission Contraceptives Adverse Reaction Surveillance Center, Jiangsu Health Development Research Center, Nanjing, China
| | - Qin Xu
- MS, RN, Professor, School of Nursing, Nanjing Medical University, Nanjing, China
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David JG, Dotson J, Mackner L. Is it "all in the bag?" Multidisciplinary perspectives on ostomy surgery in pediatric IBD across the ImproveCareNow network. JPGN REPORTS 2024; 5:101-109. [PMID: 38756109 PMCID: PMC11093923 DOI: 10.1002/jpr3.12044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/15/2023] [Accepted: 01/15/2024] [Indexed: 05/18/2024]
Abstract
Objectives Pediatric inflammatory bowel disease (IBD) is a chronic illness with various treatments, including ostomy surgery. Ostomy-related medical decision-making (MDM) is complex for multidisciplinary healthcare professionals (HCPs). This study sought to understand national multidisciplinary HCPs' perceptions about pediatric IBD ostomy surgery in the United States. Methods This cross-sectional REDCap survey recruited HCPs in pediatric IBD HCP roles from the ImproveCareNow (ICN) Learning Health System. The survey gathered data on, (1) demographics, (2) participants' perspectives on patients/families' ostomy perceptions, (3) participants' own perspectives on ostomies, and (4) participants' perspectives on multidisciplinary collaboration in ostomy surgery. Results Participants (n = 69, across n = 30 American ICN sites) were 84% White, 62% female, and 54% gastroenterologists. In reflecting on patients/families' perceptions, participants endorsed most (86%) view ostomies as a "failure," various psychosocial concerns (e.g., 97% endorsed body image concerns), and most (81%) have moderate to significant stigma about ostomies. In reflecting on their own perceptions, nearly half (44%) endorsed some to moderate stigma about ostomies and felt ostomy discussions were difficult when families had negative perceptions (88%). Over half (54%) endorsed currently having multidisciplinary care for pediatric IBD surgery. Most (70%) endorsed variability in the amount and/or quality of multidisciplinary collaboration. Conclusion MDM related to pediatric IBD ostomy surgery presents nuanced clinical complexities for HCPs. This work underscores interest in multidisciplinary care, notable ostomy-related psychosocial needs, and ostomy-related stigma. Future work should develop systematic approaches to multidisciplinary pediatric IBD ostomy care, bolster psychosocial support, and evaluate how systematic care may impact psychosocial, and healthcare utilization outcomes.
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Affiliation(s)
- Jennie G. David
- Department of PediatricsThe Ohio State Wexner Medical CenterColumbusOhioUSA
- Nationwide Children's HospitalColumbusOhioUSA
| | - Jennifer Dotson
- Department of PediatricsThe Ohio State Wexner Medical CenterColumbusOhioUSA
- Nationwide Children's HospitalColumbusOhioUSA
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Nationwide Children's HospitalColumbusOhioUSA
- Center for Child Health Equity and Outcomes Research, Abigail Wexner Research Institute at Nationwide Children's HospitalColumbusOhioUSA
| | - Laura Mackner
- Department of PediatricsThe Ohio State Wexner Medical CenterColumbusOhioUSA
- Nationwide Children's HospitalColumbusOhioUSA
- Center for Biobehavioral Health, Nationwide Children's HospitalColumbusOhioUSA
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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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Liu S, Sun B, Tian W, Zhang L, Kong F, Wang M, Yan J, Zhang A. Experience of providing care to a family member with Crohn's disease and a temporary stoma: A qualitative study. Heliyon 2023; 9:e21013. [PMID: 37886749 PMCID: PMC10597855 DOI: 10.1016/j.heliyon.2023.e21013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 09/28/2023] [Accepted: 10/12/2023] [Indexed: 10/28/2023] Open
Abstract
Objectives The aim of this study is to understand the feelings and experiences of the main caregivers of temporary ostomy patien ts with Crohn's disease (CD). And explore the caregivers' inner feelings, to provide reference and basis for constructing the health education content of the main caregivers of CD patients with a temporary stoma. Methods A qualitative descriptive approach was used to conduct an unstructured interview among 11 primary caregivers of CD patients with temporary enterostomy from the gastroenterology department of The Second Hospital of Nanjing. Participants were selected using a purposive sampling technique. Data were collected between July 2021 and September 2021. The interviews were audio recorded and then transcribed for a qualitative thematic analysis. Results Five themes and accompanying subthemes were identified: (1) negative psychological experience (2) perceived caregiver burden (3) future uncertainty (4) disease benefit (5) insufficien support system. Conclusions Study findings suggest that caregivers of CD temporary enterostomy patients have problems such as negative psychology, heavy caregiver burden, uncertain future, lack of support system, etc., but they also have positive experience of feeling of benefit from the disease, and are eager to obtain more disease information from more channels.Therefore, medical staff should improve their professionalism and health education capabilities, carry out diversified and targeted health education activities to reduce the burden of care, stimulate positive caregiver responses and help caregivers respond to and deal with caregiving problems in a timely and accurate manner.
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Affiliation(s)
- Sicong Liu
- Nursing staff room, Changzhou Hygiene Vocational Technology College, Changzhou, China
| | - Bowei Sun
- Nursing staff room, Changzhou Hygiene Vocational Technology College, Changzhou, China
| | - Wenjie Tian
- Neurosurgical intensive care unit, The Affiliated Changzhou No 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Li Zhang
- Wound ostomy nursing clinic,The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Fang Kong
- Department of Gastroenterology Treatment Center,The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Mengmeng Wang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Jing Yan
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Ailing Zhang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
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Xi Z, Rong CM, Ling LJ, Hua ZP, Rui G, Fang HG, Long W, Zhen ZH, Hong L. The influence of stigma and disability acceptance on psychosocial adaptation in patients with stoma: A multicenter cross-sectional study. Front Psychol 2022; 13:937374. [PMID: 36571011 PMCID: PMC9773876 DOI: 10.3389/fpsyg.2022.937374] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 11/15/2022] [Indexed: 12/13/2022] Open
Abstract
Background The stoma can cause serious physical and psychological distress to the patient, leading to an inability to live a normal life; although it effectively improves the 5-year survival rate of patients. Objective The purpose of this study is to explore the status of stigma and disability acceptance of patients with stoma and their influences on psychosocial adaptation. Design A multicenter cross-sectional study. Methods A total of 259 patients with stoma in 6 hospitals from southeast China were enrolled. And this research adhered to the STROBE guideline and approved by the Ethics Committee of Fu Jian Provincial Hospital. The ostomy adjustment inventory-20、acceptance of disability scale and social impact scale were used to collect data. The hypothetical path model was tested using the SPSS version 22.0 software and AMOS version 26.0 software. Results Stigma, disability acceptance and psychosocial adaptation was associated. The sense of stigma was severe (72.76 ± 12.73), the acceptance of disability was medium (179.24 ± 32.29) and the psychosocial adaptation was poor (38.06 ± 8.76). Also, the hypothesis model of this study fitted the data well (AGFI = 0.967>0.08; χ 2/df = 1.723, p = 0.08 > 0.05), and the results showed that disability acceptance positively affected psychosocial adaptation; while stigma negatively affected psychosocial adaptation, and disability acceptance mediated between stigma and psychosocial adaptation (p < 0.01). Conclusion The stigma and disability acceptance of patients with stoma are serious problems that are closely related to their psychosocial adaptation. Medical staff should take some interventions based on different paths to reduce stoma patients' stigma and guide them to improve disability acceptance, thus to improve the level of psychosocial adaptation of patients with stoma.
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Affiliation(s)
- Zhang Xi
- Department of Gastroenterology, Fujian Provincial Hospital, Sheng li Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Chen M. Rong
- Sheng li Clinical Medical College of Fujian Medical University, The School of Nursing, Fujian Medical University, Department of Nursing, Fujian Provincial Hospital, Fuzhou, China
| | - Lin J. Ling
- Graduate School, Fujian Medical University, Nursing School of Fujian Medical University, Fuzhou, China
| | - Zeng P. Hua
- Department of Plastic and burn, Fujian Provincial Hospital, Sheng li Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Gao Rui
- Department of Pathology, Fujian Provincial Hospital, Sheng li Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Huang G. Fang
- Department of Gastroenterology, Fujian Provincial Hospital, Sheng li Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Wang Long
- Department of Gastroenterology, Fujian Provincial Hospital, Sheng li Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Zhuo H. Zhen
- Department of Gastroenterology, Fujian Provincial Hospital, Sheng li Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Li Hong
- Sheng li Clinical Medical College of Fujian Medical University, The School of Nursing, Fujian Medical University, Department of Nursing, Fujian Provincial Hospital, Fuzhou, China,*Correspondence: Li Hong,
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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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Miller LR, Peck BM. Marginalization in the Medical Encounter: Ostomy Patients Experience of Perceived Stigmatizing Sentiments from Medical Clinicians. SAGE Open Nurs 2022; 8:23779608221095315. [PMID: 35493541 PMCID: PMC9044778 DOI: 10.1177/23779608221095315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 03/14/2022] [Accepted: 03/29/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction Ostomy1 stigma negatively impacts the health of people with an ostomy and contributes to
a lower quality of life and health outcomes. Objective To assess whether participants experience perceived stigmatizing sentiments (SS) from
medical clinicians at the time of their ostomy procedure. Methods Using a nonprobability sample of 312 persons with an ostomy, we conducted a
retrospective descriptive study. We measured SS as patients’ self-reports of verbal and
non-verbal communication from clinicians that were perceived to be negative and may
contribute to ostomy stigma. We used thematic analyses to analyze open-ended written
comments. Results Findings indicate that ostomy patients experience stigmatizing sentiments from their
medical clinician before and after surgery. Sixteen percent of patients reported a SS,
such as clinicians stating feelings of disgust, showing visible signs of disgust, or
treating patients negatively regarding the ostomy. Conclusion The perceived treatment that this patient cohort experienced in healthcare likely
contributes to ostomy stigmatization and may impact ostomy patients’ psychosocial
adjustment. Future research should examine the specific consequences of perceived
stigmatizing sentiments from medical clinicians.
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Affiliation(s)
- Leslie Riggle Miller
- Department of Sociology, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - B. Mitchell Peck
- Department of Sociology, University of Oklahoma, Norman, Oklahoma, USA
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Wang Y, Li S, Gong J, Cao L, Xu D, Yu Q, Wang X, Chen Y. Perceived Stigma and Self-Efficacy of Patients With Inflammatory Bowel Disease-Related Stoma in China: A Cross-Sectional Study. Front Med (Lausanne) 2022; 9:813367. [PMID: 35252252 PMCID: PMC8888524 DOI: 10.3389/fmed.2022.813367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 01/24/2022] [Indexed: 11/26/2022] Open
Abstract
Background Patients with inflammatory bowel disease (IBD)-related stoma face physical, psychological, and social adjustment challenges. However, knowledge about stigmatization and self-management, which is important for clinical care and patient education strategies, is lacking. Objective To evaluate the level of stigma and self-management ability of Chinese patients with IBD-related stoma using an online questionnaire. Methods Participants were recruited from two general hospitals in mainland China and the internet platforms of the China Crohn's and Colitis Foundation (CCCF). Participants completed a questionnaire, which gathered data on sociodemographic, clinical, and experience in online groups, self-efficacy scale, and social impact scale. The influencing factors of self-efficacy and perceived stigma were assessed by stepwise multivariate regression analyses. Results One hundred and seventy-six respondents were included. Most of the respondents (78/176, 44.32%) spent between 500 and 999 RMB ($77–153) on ostomy care accessories monthly. Three patients reported using homemade ostomy products. The average score on the self-efficacy scale was 75.79 ± 23.91, which reflected a moderate level of self-efficacy, and 69 (39.2%) respondents had low-level self-efficacy. The average social impact scale score was 62.76 ± 12.69, which reflected a moderate level of perceived stigma. Forty-three (24.43%) patients experienced severe levels of perceived stigma. Stepwise multivariate regression analysis revealed that self-efficacy was associated with educational level (P = 0.007), whereas stigma was associated with nursing privacy (P = 0.021) and acceptance by the closest person (P = 0.005). A total of 91% of respondents who participated in online peer support groups believed the groups were helpful for disease management. Conclusions Chinese patients with IBD-related stoma reported a moderate degree of perceived stigma; their level of self-efficacy was low to moderate. High educational level was associated with high self-efficacy. Notably, acceptance of the stoma by the closest person was an influencing factor protecting patients from perceived stigma. Interventions aimed at improving patient education, reducing economic burden, and strengthening social support should be considered to help improve the living conditions of patients with IBD-related stoma.
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Affiliation(s)
- Yuting Wang
- Center for Inflammatory Bowel Diseases, Department of Gastroenterology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shuyan Li
- Center for Inflammatory Bowel Diseases, Department of Gastroenterology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jianfeng Gong
- Center for Inflammatory Bowel Diseases, Department of General Surgery, Jinling Hospital: East Region Military Command General Hospital, Medical School of Nanjing University, Nanjing, China
| | - Lei Cao
- Center for Inflammatory Bowel Diseases, Department of General Surgery, Jinling Hospital: East Region Military Command General Hospital, Medical School of Nanjing University, Nanjing, China
| | - Dingting Xu
- Center for Inflammatory Bowel Diseases, Department of Gastroenterology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qiao Yu
- Center for Inflammatory Bowel Diseases, Department of Gastroenterology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaoying Wang
- Center for Inflammatory Bowel Diseases, Department of Gastroenterology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yan Chen
- Center for Inflammatory Bowel Diseases, Department of Gastroenterology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Comparison of Face-to-Face Education and Multimedia Software Education on Adjustment of Patients With Intestinal Ostomy: A Randomized Controlled Trial. J Wound Ostomy Continence Nurs 2022; 49:152-157. [PMID: 35255067 DOI: 10.1097/won.0000000000000854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of this study was to compare the effect of face-to-face versus multimedia education on the adjustment of patients to an intestinal ostomy. DESIGN Randomized clinical trial. SUBJECT AND SETTING The sample comprised 135 patients with new ostomies randomly assigned to 3 groups (control, face-to-face, and multimedia education). Data were collected from November 2018 to May 2019; the study setting was Rasul-e Akram and Imam Khomeini Hospitals, Tehran, Iran. METHODS The control group received no additional ostomy education. The face-to-face education group was educated individually in the hospital environment during four 3-hour sessions delivered over 4 consecutive days. The multimedia group viewed a multimedia educational program using a laptop. Data were collected at baseline and 3 months after the intervention. Data collection forms comprised a demographic questionnaire and the Ostomy Adjustment Inventory-23 (OAI-23). RESULTS Before the intervention, the mean OAI-23 adjustment score did not significantly differ among the 3 groups (P = .752). Three months after the intervention, the mean score of adjustment score in the multimedia software group was significantly higher than those of the face-to-face and control groups (P = .000). In addition, the mean score of adjustment of the face-to-face education group was significantly higher than that of the control group (P = .002). CONCLUSION Findings indicate that multimedia education was associated with higher levels of adjustment when compared to face-to-face teaching.
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