Ostomy and Continent Diversion Patient Bill of Rights: Research Validation of Standards of Care

Evaluation of the effect of stoma care training using the pechakucha method on stoma care skills and anxiety in nursing students: A single-blind randomized controlled trial

AIM

This study aimed to evaluate the effects of stoma care training delivered using PechaKucha (PK) on the stoma care skills and anxiety of nursing students.

BACKGROUND

Innovative learning methods are needed to make the educational content of nursing courses more interesting and comprehensible. The PK presentation technique is used in various business sectors and can be considered as a novel teaching strategy for the development of stoma care skills in nursing education. The PK method is a visual and narrative slide-based presentation technique involving 20 slides (usually containing images only) that are shown for 20 s each, for a total presentation length of 6 min and 40 s.

DESIGN

A single-blind randomized controlled study was conducted according to the CONSORT guideline.

METHODS

The study sample comprised 96 first-year nursing students (47 in the intervention group and 49 controls). Data were collected during the 2024 spring semester using a student information form, the Stoma Care Skill Rubric and the State-Trait Anxiety Inventory. Stoma care training was delivered using the PK method for the intervention group and a classic lecture presentation for the control group. SPSS version 25.0 was used for statistical analysis. Independent-samples t-test was used to evaluate differences in mean stoma care skill and anxiety scores between the intervention and control groups.

RESULTS

The mean stoma care skills score two days after training was significantly higher in the intervention group (mean 42.59, SD 4.44) than in the control group (mean 33.87, SD 7.52) (p<0.05). Mean state anxiety scores after training did not differ significantly between the intervention group (mean 41.74, SD 6.51) and the control group (mean 43.08, SD 6.62) (p>0.05; Table 3).

CONCLUSION

The PK method can be used as an alternative to classic slide-based presentations in nursing education. This study offers the first literature data regarding the efficacy of PK-based education for nursing care skills. Concise and image-based PK presentations may make the skill steps easier to understand and remember.

Comparison of adjustment to a temporary or permanent ostomy using the OAI-23

AIM

The aim of this work was to compare adjustment between those with a new temporary or permanent ostomy in a cohort of Australian adults.

METHOD

This is a multicentre, longitudinal observational study. Ostomy adjustment was measured using the Ostomy Adjustment Inventory (OAI-23) at six possible time points ending at 9 months postsurgery or at the time of ostomy closure in those with a temporary stoma. The OAI-23 includes four domains: anger, acceptance, anxious preoccupation and social engagement.

RESULTS

Eligibility criteria were met by 1230 patients, with 849 (69%) recruited and consented. Of these, 108 were excluded as their surgery did not result in the formation of an ostomy and a further 41 were excluded due to there being no data on ostomy type (temporary or permanent). This left a study population of 700, of whom 397 had a temporary and 303 a permanent ostomy. Only small differences were observed between the temporary and permanent ostomy groups at most time points within the four OAI-23 domains. There were no statistically significant differences found beyond 2 weeks postdischarge and the differences were of small size. While no difference was found between the groups in the domain of anxious preoccupation, both groups demonstrated an increase in anxious preoccupation over time. Neither group regained their presurgery confidence to attend social engagements.

CONCLUSION

We found only minor differences in adjustment in those with a new temporary ostomy compared with a new permanent ostomy. Both groups demonstrated increasing anxious preoccupation and problems with social engagement. This suggests that access to education, training and support should be equitable between these two groups in clinical practice, and needs to incorporate a focus on psychological as well as physical outcomes.

'That gave me a lot of comfort, that he would ask my opinion about how we wanted to talk about this': A qualitative analysis of clinical communication experiences of ostomy patients

OBJECTIVES

The purpose of this study was to investigate the communication challenges and successes that people with ostomies experienced during their healthcare encounters.

DESIGN

We conducted semistructured interviews of people with ostomies. Interviews focused on important social situations and health communication strategies for managing these situations. We transcribed interviews and coded them to create themes.

PARTICIPANTS

Participants were eligible to participate if they were above the age of 18 and have had an ostomy for at least a year. 27 people participated in the study.

SETTING

The study was conducted in a university setting.

RESULTS

Interviews with ostomates surfaced several themes related to ostomate needs. Participants benefited from communication that was open, thorough and had a positive outlook on ostomies. Participants found patient-clinician communication to be challenging when there was a lack of knowledge surrounding ostomy care, communication was unclear or inadequate, and when clinicians had a negative outlook on ostomies.

CONCLUSIONS

Findings from this project are intended to amplify existing patient and clinician education materials and to inform the creation of a communication guide specifically for the ostomy context.

Characteristics of Interventional Trials for Patients Living With Intestinal Stoma Registered in ClinicalTrials.gov With a Focus on Inflammatory Bowel Disease

BACKGROUND

This systematic review was performed to characterize the landscape of research conducted in patients with intestinal stoma (IS) and highlight unmet needs for clinical research in Crohn's disease (CD) and IS.

METHODS

We searched ClinicalTrials.gov from inception to May 25, 2022, to identify clinical trials assessing interventions in patients with an IS, as well as those with an IS and CD. Studies were grouped according to type of intervention. We excluded observational studies with no treatment arm.

RESULTS

A total of 253 studies were included in the final analysis. Most studies investigated devices (n = 122 [48.2%]), or surgical procedures (n = 63 [24.9%]), followed by behavioral interventions (n = 30 [11.8%]), drugs (n = 20 [7.9%]), dietary interventions (n = 2 [0.8%]), skin care products (n = 2 0.8%]), and others (n = 14 [5.5%]). A total of 50.9% (n = 129) of studies had completed recruitment, enrolling 11 116 participants. Only 6 studies (surgery: n = 3; physiological studies: n = 2; drugs: n = 1) exclusively included patients with inflammatory bowel disease (IBD), and 16 studies commented that patients with IBD were excluded in their eligibility criteria. No study assessed efficacy of drugs in patients with CD and IS. Approximately one-quarter of studies (n = 65 of 253) included quality of life as an outcome measure.

CONCLUSION

There is a paucity of research in IBD patients with IS, with the majority focusing on devices and surgical procedures. There have been no drug trials evaluating efficacy in patients with CD and IS. There is an urgent need to identify barriers to enrollment and develop eligibility and outcome measures that enable the inclusion of patients with CD with stoma into clinical trials.

Robotic Retromuscular (Recurrent) Parastomal Hernia Repair (r-Pauli-Repair) With Synthetically Reinforced Biological Mesh; Technique, Early Experience, and Short-Term Follow-Up

Introduction: Parastomal hernia repair remains a challenge. We describe a robotic retromuscular non-keyhole mesh repair using a synthetically reinforced biological mesh (Ovitex) for the repair of complex and/or recurrent parastomal hernia and technical modifications we made along the way to improve our technique. Methods: All patients underwent the described retromuscular parastomal hernia repair. Data was collected in a database and a retrospective analysis was performed on direct postoperative results and early follow-up. Results: Eleven patients underwent the operation. Median follow-up was 12 months. Median LOS was 6 days. Two recurrences occurred. One patient suffered postoperative hematoma and skin necrosis, which healed completely, but did lead to a recurrence. One patient had a significant seroma, which subsided without intervention. Both recurrences were reoperated, and a local repair was performed. Conclusion: This paper is the first to describe a modified robotic Pauli repair for complex and recurrent parastomal hernia, using a synthetically reinforced biological mesh. Results are satisfying so far, especially considering the complexity of the cases.

Spontaneous Resolution of Parastomal Gallbladder Herniation After Attempted Surgical Intervention: A Case Report and Review of the Literature

Cholecystic parastomal herniation is a rare condition that has only been documented 16 times in the literature. We present a case report and literature review of cholecystic parastomal herniation managed with diagnostic laparoscopy without cholecystectomy or hernia repair. Furthermore, we assess the demographics, presentation, stoma types, and management of cholecystic parastomal hernias across all documented cases.

Perceptions and Experiences of Privacy Among Persons With an Ostomy Receiving Treatment and Care: A Mixed-Methods Study

PURPOSE

The aim of this study was to determine ostomy patients' experiences and opinions on protection of privacy during treatment and care.

DESIGN

Mixed-methods, descriptive correlational study.

SAMPLE AND SETTING

The study sample comprised 80 patients with an ostomy receiving treatment and care in a university hospital in Turkey.

METHODS

Data were collected using a form developed by the researchers based on literature review. The survey consisted of statements that examined demographic characteristics, experiences, and opinions of patients with an ostomy.

RESULTS

For participants, 64.8% (n = 35/54) defined privacy from a physical dimension, 64.1% (n = 25/39) suffered from ostomy-related psychosocial discomfort, 48.7% experienced ostomy-related discomfort mostly during nursing care (n = 19/39), 48.7% (n = 39/80) were uncomfortable when their ostomy was seen by others, Approximately 56.3% (n = 45/80) thought that they disturbed other patients and their families during ostomy care, and 46.3% (n = 37/80) stated that healthcare professionals discussed information about their ostomy when other patients and their families were present. In addition, 21.3% (n = 17/80) opined that the physical conditions of patient rooms failed to provide privacy. Analysis revealed no significant relationship between education levels and reading the Patient Rights Regulation (P = .129). Analysis also found no significant relationships between age (P = .086), marital status (P = .382), educational background (P = .143), hospitalization experience (P = .427), and satisfaction with perceptions of privacy when receiving ostomy care.

CONCLUSION

Patients with an ostomy reported physical and psychosocial problems concerning privacy, felt uncomfortable about the way information on their ostomy was discussed, and thought that physical conditions were not suitable for ostomy care. We recommend that healthcare professionals be provided with more training on psychosocial problems and privacy for patients with ostomy and that institutional policies and procedures be developed to address patients' problems.