1
|
Zhou L, Zhang Z, Li H, Wang L. A latent profile analysis of psychosocial adjustment in patients with enterostomy after rectal cancer surgery. Eur J Oncol Nurs 2024; 71:102626. [PMID: 38878693 DOI: 10.1016/j.ejon.2024.102626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 05/27/2024] [Accepted: 05/28/2024] [Indexed: 07/22/2024]
Abstract
PURPOSE The aim of this study was to improve the level of psychosocial adjustment and quality of life of patients with enterostomy by analyzing the subgroups of psychosocial adjustment and its influencing factors. METHODS This was a multi-center cross-sectional study. On the basis of investigating the level of psychosocial adjustment of enterostomy patients, a profile model of psychosocial adjustment of patients with enterostomy was established by using latent profile analysis. Univariate analysis and multinomial logistical regression were used to analyze the factors affecting the different psychosocial adjustment subgroups of enterostomy patients. RESULTS Psychosocial adjustment of 3840 patients with enterostomy can be divided into three latent characteristics: Moderately high psychosocial adjustment level and high positive emotion in enterostomy patients (24.5%), Medium psychosocial but low social life adjustment (64.6%), low psychosocial adjustment level and high negative emotion (10.9%). Multinomial logistic regression showed that enterostomy self-care knowledge score, gender, medical payment method, educational background, carer, and self-care ability were affecting the subgroup classification of psychosocial adjustment of enterostomy patients. CONCLUSION The psychosocial adjustment level of enterostomy patients can be divided into three latent profiles, which have obvious classification characteristics. Future studies can provide individualized interventions for different subgroups of enterostomy patients to improve the psychosocial adjustment of enterostomy patients.
Collapse
Affiliation(s)
- Lu Zhou
- Department of Nursing, Peking University People's Hospital, Beijing, China; School of Nursing, Peking University, Beijing, China
| | - Zhengyang Zhang
- Department of Nursing, Peking University People's Hospital, Beijing, China; School of Nursing, Peking University, Beijing, China
| | - Hui Li
- Department of Nursing, Peking University People's Hospital, Beijing, China; School of Nursing, Peking University, Beijing, China
| | - Ling Wang
- Department of Nursing, Peking University People's Hospital, Beijing, China.
| |
Collapse
|
2
|
Lin L, Fang Y, Huang F, Zhang X, Zheng J, Xiao H. Discharge teaching quality positively predicts quality of life in colorectal cancer patients with temporary enterostomy: The mediating role of readiness for hospital discharge and stoma self-efficacy. PLoS One 2024; 19:e0306981. [PMID: 38990912 PMCID: PMC11238961 DOI: 10.1371/journal.pone.0306981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 06/26/2024] [Indexed: 07/13/2024] Open
Abstract
OBJECTIVES This study aimed to examine the mediating role of readiness for hospital discharge (RHD) and stoma self-efficacy (SSE) in the relationship between quality of discharge teaching (QDT) and health-related quality of life (HRQOL) in colorectal cancer patients with temporary enterostomy, and the gender difference of mediating effect. BACKGROUND It is not clear how RHD, QDT, SSE and HRQOL interact in colorectal cancer patients with temporary enterostomy. METHODS This was a prospective follow-up survey. 221 colorectal cancer patients with temporary enterostomy were conveniently recruited from a general hospital in Southeast China. The Quality of Discharge Teaching Scale, Readiness for Hospital Discharge Scale, Stoma Self-Efficacy Scale, and Stoma Quality of Life Scale were used to collect data. Pearson's correlation and structural equation models were used to analyze the data. SPSS 26.0 and Amos 28.0 software were used for analysis the collected data. RESULTS Regarding the relationship of QDT and HRQOL, only QDT-T had a direct effect among colorectal cancer patients with stomas (b = 0.233, P<0.001, percentile 95% CI = [0.145, 0.314]). However, both QDT-T and QDT-R can predict HRQOL indirectly through three paths: (1) the mediating role of SSE (b = 0.050, P = 0.009, percentile 95% CI = [0.013, 0.098]; b = 0.077, P = 0.008, percentile 95% CI = [0.021, 0.164]), (2) the mediating role of RHD (b = 0.044, P = 0.004, percentile 95% CI = [0.014, 0.085]; b = 0.044, P = 0.005, percentile 95% CI = [0.010, 0.102]), and (3) the chain mediating role of SSE and RHD (b = 0.030, P = 0.003, percentile 95% CI = [0.011, 0.059]; b = 0.047, P = 0.003, percentile 95% CI = [0.015, 0.103]). The similar chain mediating effect in male stoma patients was also found (b = 0.041, P = 0.002, percentile 95% CI = [0.016, 0.080]; b = 0.046, P = 0.004, percentile 95% CI = [0.011, 0.114]). CONCLUSIONS Stoma self-efficacy and readiness for hospital discharge played important intermediary roles in the relationship between quality of discharge teaching and health-related quality of life in colorectal cancer patients with stomas. Health care providers can design SSE-enhancing and RHD-enhancing discharge planning for colorectal cancer patients with temporary enterostomies.
Collapse
Affiliation(s)
- Liying Lin
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Yifang Fang
- Department of Colorectal Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Feifei Huang
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Xiaoying Zhang
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Jianwei Zheng
- Department of Oncology, The Union Hospital Affiliated with 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
| |
Collapse
|
3
|
Bendib H, Anou A, Hachlaf R, Oukrine H, Djelali N, Chekman C. Modified delayed coloanal anastomosis following TME for mid and low rectal cancer: 19 consecutive patients from a single center. Updates Surg 2024:10.1007/s13304-024-01936-x. [PMID: 38976219 DOI: 10.1007/s13304-024-01936-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Accepted: 07/02/2024] [Indexed: 07/09/2024]
Abstract
Surgery and management of rectal cancer have made significant progress in recent decades. However, there is still no coloanal anastomosis technique that offers a good compromise between functionality and low morbidity. The aim of this study is to evaluate the safety and efficiency of the modified delayed coloanal anastomosis (mDCA). In this retrospective study, we analyzed the morbi-mortality as well as functional outcomes of 19 patients treated with mDCA, out of 73 colorectal cancer patients treated at our institution from September 2021 to June 2023. The inclusion criteria were cancer of the mid and low rectum (tumor less than 10 cm from the anal verge). Morbidity represented by complications of Clavien-Dindo grade III or higher was estimated at 5.2%. Only one patient experienced an asymptomatic anastomotic leak (AL) grade A. Ischemia of the colonic stump occurred in one patient, taken back to the OR on the 5th postoperative day. No stump retraction was noted. Anastomotic stenosis appeared in one patient (5.2%) during the 90-day postoperative period, and was treated by instrumental dilation. Perioperative mortality was nil. The mean St Marks incontinence score at 90 days was 13.2 points. At the 3-month follow-up, 15 patients (78.9%) had major low anterior resection syndrome (LARS), three (15.7%) had minor LARS, and one patient (5.2%) had no LARS. None of the patients had a diversion loop ileostomy. The mDCA, by decreasing the rate of AL, without the need for diversion ileostomy, might be an interesting alternative to the conventional immediate coloanal anastomosis (ICA), for restoring the GI tract after proctectomy for cancer.
Collapse
Affiliation(s)
- Hani Bendib
- Department of Oncologic Surgery, Debussy Clinic, Pierre & Marie Curie Center, Faculty of Medicine, Algiers 1 University, Algiers, Algeria.
| | - Abdelkrim Anou
- Department of Oncologic Surgery, CLCC Blida, Faculty of Medicine, Blida 1 University, Blida, Algeria
| | - Razika Hachlaf
- Department of Oncologic Surgery, Debussy Clinic, Pierre & Marie Curie Center, Faculty of Medicine, Algiers 1 University, Algiers, Algeria
| | - Hind Oukrine
- Department of Oncologic Surgery, Debussy Clinic, Pierre & Marie Curie Center, Faculty of Medicine, Algiers 1 University, Algiers, Algeria
| | - Nabil Djelali
- Department of Oncologic Surgery, Debussy Clinic, Pierre & Marie Curie Center, Faculty of Medicine, Algiers 1 University, Algiers, Algeria
| | - Chemseddine Chekman
- Department of Oncologic Surgery, Debussy Clinic, Pierre & Marie Curie Center, Faculty of Medicine, Algiers 1 University, Algiers, Algeria
| |
Collapse
|
4
|
Şenol FB, Şenol Y. The effect of drama on psychosocial problems and emotional states of hospitalized children with cancer. J Pediatr Nurs 2024; 77:e276-e282. [PMID: 38670864 DOI: 10.1016/j.pedn.2024.04.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 04/13/2024] [Accepted: 04/13/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND AND PURPOSE Hospitalization is a traumatic experience for children. Especially in the case of childhood cancers that require long-term hospitalization, children need psychosocial support. The study aimed to examine the effectiveness of drama in reducing psychosocial problems in hospitalized paediatric children diagnosed with cancer. METHODS The study used a mixed method approach, combining both qualitative and quantitative methods with a single group. Drama sessions prepared according to the Tasks and Skills Model were used to support their psychosocial conditions. The Facial Expression Form, The Assessment Scale for Psychosocial Symptoms in Hospitalized Children, and the Drawing and Writing Technique were used before and after the drama sessions. RESULTS This study differs from others in its use of drama intervention to reduce psychosocial problems in children undergoing cancer treatment. As a result of the study, it was found that there was a decrease in anxiety, hopelessness, anger-aggression and communication difficulties among psychosocial problems and a change in mood towards feeling happy. The study suggests that drama sessions were effective in relieving emotional distress in paediatric cancer patients. CONCLUSION The study suggests that drama sessions were effective in relieving emotional distress in paediatric cancer patients. PRACTICE IMPLICATIONS Applying drama to children undergoing long-term hospital treatment can help alleviate psychosocial problems by reducing stress, emotional suppression, and compensating for trauma.
Collapse
Affiliation(s)
- Fatma Betül Şenol
- Department of Special Education, Faculty of Education, Afyon Kocatepe University, Afyonkarahisar 03030, Türkiye.
| | - Yiğit Şenol
- Department of Public Health, Afyonkarahisar Provincial Health Directorate, Afyonkarahisar 03030, Türkiye.
| |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Whiteley I, Randall S, Fetheny J, Stanaway F. Comparison of adjustment to a temporary or permanent ostomy using the OAI-23. Colorectal Dis 2024; 26:1231-1238. [PMID: 38616314 DOI: 10.1111/codi.16985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/07/2023] [Accepted: 03/14/2024] [Indexed: 04/16/2024]
Abstract
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.
Collapse
Affiliation(s)
- Ian Whiteley
- Faculty of Medicine and Health, The University of Sydney and Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Susan Randall
- Broken Hill Department of Rural Health, The University of Sydney, Broken Hill, New South Wales, Australia
| | - Judith Fetheny
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Camperdown, New South Wales, Australia
| | - Fiona Stanaway
- Clinical Epidemiology, School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia
| |
Collapse
|
7
|
Yang ML, Brar MS, Kennedy E, de Buck van Overstraeten A. Three-stage versus modified two-stage surgery for ulcerative colitis: a patient-centred treatment trade-off study. Colorectal Dis 2024; 26:1184-1190. [PMID: 38609339 DOI: 10.1111/codi.16984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/08/2024] [Accepted: 03/13/2024] [Indexed: 04/14/2024]
Abstract
AIM There is ongoing debate about whether ileal pouch-anal anastomosis needs temporary diversion at the time of construction. Stomas may reduce risk for anastomotic leak (AL) but are also associated with complications, emergency department visits and readmissions. This treatment trade-off study aims to measure patients' preferences by assessing the absolute risk of AL and pouch failure (PF) they are willing to accept to avoid a diverting ileostomy. METHODS Fifty-two patients with ulcerative colitis, with or without previous pouch surgery, from Mount Sinai Hospital, Toronto, participated in this study. Standardized interviews were conducted using the treatment trade-off threshold technique. An online anonymous survey was used to collect patient demographics. We measured the absolute increased risk in AL and PF that patients would accept to undergo modified two-stage surgery as opposed to traditional three-stage surgery. RESULTS Thirty-two patients (mean age 38.7 ± 15.3) with previous surgery and 20 patients (mean age 39.5 ± 11.9) with no previous surgery participated. Patients were willing to accept an absolute increased leak rate of 5% (interquartile range 4.5%-15%) to avoid a diverting ileostomy. Similarly, patients were willing to accept an absolute increased PF rate of 5% (interquartile range 2.5%-10%). Younger patients, aged 21-29, had lower tolerance for PF, accepting an absolute increase of only 2% versus 5% for patients older than 30 (P = 0.01). CONCLUSION Patients were willing to accept a 5% increased AL rate or PF rate to avoid a temporary diverting ileostomy. This should be taken into consideration when deciding between modified two- and three-stage pouch procedures.
Collapse
Affiliation(s)
- Mei Lucy Yang
- Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Mantaj S Brar
- Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Erin Kennedy
- Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | | |
Collapse
|
8
|
Liu F, Yao K, Liu X. Analysis on effect of psychological nursing combined with extended care for improving negative emotions and self-care ability in patients with colorectal cancer and enterostomy: A retrospective study. Medicine (Baltimore) 2024; 103:e38165. [PMID: 38788010 PMCID: PMC11124709 DOI: 10.1097/md.0000000000038165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 04/17/2024] [Indexed: 05/26/2024] Open
Abstract
This study investigates the effectiveness of combining psychological nursing with extended nursing in patients with colorectal cancer who have undergone enterostomy. Conducted from January 2021 to January 2022, this retrospective study involved 78 patients split into 2 groups of 39 each. The control group received standard nursing care, while the observation group benefitted from both psychological and extended nursing. The evaluation focused on anxiety, depression, sleep quality, mental resilience, and self-care abilities. Results, 3 months postdischarge, indicated that the observation group had significantly lower scores in the Hamilton Depression Rating Scale and the Pittsburgh Sleep Quality Index, and higher scores in the Connor-Davidson Resilience Scale and the Enterostomal Self-Care Ability Scale, compared to the control group (P < .05). The findings suggest that integrating psychological nursing with extended care significantly improves mood, sleep quality, psychological resilience, and self-care capabilities in these patients.
Collapse
Affiliation(s)
- Fang Liu
- Hernia and Colorectal Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Kun Yao
- Hernia and Colorectal Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Xiaoxiang Liu
- Hernia and Colorectal Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| |
Collapse
|
9
|
Du X, Chaiviboontham S, Sumdaengrit B. The experiences of Chinese colorectal cancer survivors in marital intimacy after ostomy creation: A qualitative study. BELITUNG NURSING JOURNAL 2024; 10:222-230. [PMID: 38690303 PMCID: PMC11056837 DOI: 10.33546/bnj.3212] [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: 01/07/2024] [Revised: 02/04/2024] [Accepted: 03/13/2024] [Indexed: 05/02/2024] Open
Abstract
Background Colorectal cancer (CRC) ranks as the third most prevalent cancer globally. The disease and its treatment significantly impact marital intimacy, particularly among individuals who have undergone ostomy creation. Therefore, it is necessary to explore their experiences. Objective This study aimed to explore the experiences of colorectal cancer survivors in marital intimacy after ostomy creation and clarify the domain and sub-domain of marital intimacy in CRC survivors with ostomy. Method This study used a qualitative descriptive design, and participants were selected by purposive sampling from two hospitals in Henan province, China. Sixteen patients participated in this research, and the data were collected through an in-depth interview from June 27 to September 27, 2023. Colaizzi's method was used to analyze the data. Results Five themes emerged from data analysis, including physical intimacy, psychological intimacy, social intimacy, spiritual intimacy, and operational intimacy. Conclusion By profiling the experiences of CRC survivors in marital intimacy after ostomy creation, the domain and sub-domain of marital intimacy were clarified in this cohort and revealed that ostomy had a severe effect on marital intimacy among colorectal cancer survivors. The results from this study could be used by nurses, midwives, and other healthcare professionals to design specific interventions covering all aspects of marital intimacy. Also, the findings will guide the development of a particular instrument for marital intimacy in CRC survivors with ostomy.
Collapse
Affiliation(s)
- Xixi Du
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand
- General Surgery Department, Puyang People’s Hospital, Puyang, China
| | - Suchira Chaiviboontham
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand
| | - Bualuang Sumdaengrit
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand
| |
Collapse
|
10
|
Yang F, Cui S, Cai M, Feng F, Zhao M, Sun M, Zhang W. The experiences of family resilience in patients with permanent colostomy and their spouses: A dyadic qualitative study. Eur J Oncol Nurs 2024; 70:102590. [PMID: 38677217 DOI: 10.1016/j.ejon.2024.102590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 04/07/2024] [Accepted: 04/12/2024] [Indexed: 04/29/2024]
Abstract
PURPOSE With the prolonged survival time of patients with permanent colostomy for colorectal cancer, they and their spouses face tremendous pressure and development dilemmas that can easily lead to family adaptation crises. This qualitative study amid to explore the dyadic experiences of family resilience among Chinese patients with permanent colostomy and their spouses. METHODS A phenomenological research method was adopted. Semi-structured, in-depth, face-to-face interviews with 10 dyads of patients with permanent colostomy and their spouses were recruited through purposive sampling from a public tertiary hospital in China from March 2023 to July 2023.The Dyadic interview analysis and Colaizzi methods were used to analyze the interview data. RESULTS Three themes and nine subthemes were developed. (1) family crisis and dichotomous coping with stress-family crisis and coping pressure caused by enterostomy; (2) Adjustment and adaptation within the family-Joint adjustment and adaptation within the couple's family; and (3) integration and utilization of multi-dimensional social external resources (micro-level, meso-level, and macro-level). CONCLUSIONS Couples living with permanent colostomy often undergo a complex emotional journey, experiencing varied levels of individual stress as they navigate social interactions and daily activities, which can contribute to a decline in family adaptation. With the help of the perspective of family advantage, health practitioners should pay attention to the evaluation of individual factors and family environmental resources, to fully mobilize advantage resources and give effective interventions to improve the family and social adaptation level of patients and their spouses.
Collapse
Affiliation(s)
- Fangfang Yang
- Department of Nursing, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200120, China
| | - Sumin Cui
- Tongji University School of Medicine, Shanghai, 200092, China; Department of Nursing, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 20000, China
| | - Mengyi Cai
- Tongji University School of Medicine, Shanghai, 200092, China
| | - Fangming Feng
- Department of Nursing, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200120, China
| | - Meihui Zhao
- Department of Nursing, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200120, China; Tongji University School of Medicine, Shanghai, 200092, China
| | - Mengchen Sun
- Department of Nursing, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200120, China; Tongji University School of Medicine, Shanghai, 200092, China
| | - Weiying Zhang
- Department of Nursing, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200120, China.
| |
Collapse
|
11
|
van Kessel CS, Palma CA, Solomon MJ, Leslie S, Jeffery N, Lee PJ, Austin KKS. Comparison of urological outcomes and quality of life after pelvic exenteration: partial vs radical cystectomy. BJU Int 2024; 133 Suppl 4:53-63. [PMID: 38379076 DOI: 10.1111/bju.16299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
OBJECTIVE To compare perioperative morbidity, functional and quality-of-life (QoL) outcomes in patients with partial cystectomy vs radical cystectomy as part of pelvic exenteration. PATIENTS AND METHODS Retrospective analysis of a prospectively maintained database of pelvic exenteration patients (1998-2021) was conducted in a single centre. Study outcomes included postoperative complications, quality-of-life, functional and stoma-related outcomes. The 36-item Short-Form Health Survey Physical and Mental Health Components, Functional Assessment of Cancer Therapy-Colorectal questionnaires and Distress Thermometer were available pre- and postoperatively. QoL outcomes were compared at the various time points. Stoma embarrassment and care scores were compared between patients with a colostomy, urostomy, and both. RESULTS Urological complications were similar between both groups, but patients with partial cystectomy experienced less wound-related complications. Overall, 34/81 (42%) partial cystectomy patients reported one or more long-term voiding complication (i.e., incontinence [17 patients], frequency [six], retention [three], high post-voiding residuals [10], permanent suprapubic catheter/indwelling catheter [14], recurrent urinary tract infection [nine], percutaneous nephrostomy [three], progression to urostomy [three]). The QoL improved following surgery in both the partial and radical cystectomy groups, differences between cohorts were not significant. Patients with two stomas reported higher embarrassment scores than patients with one stoma, although this did not result in more difficulties in stoma care. CONCLUSIONS Partial cystectomy patients have fewer postoperative wound-related complications than radical cystectomy patients, but often experience long-term voiding issues. The QoL outcomes are similar for both cohorts, with significant improvement following surgery.
Collapse
Affiliation(s)
- Charlotte S van Kessel
- Surgical Outcomes Research Centre (SOuRCe), Sydney, New South Wales, Australia
- Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Catalina A Palma
- Department of Urology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Michael J Solomon
- Surgical Outcomes Research Centre (SOuRCe), Sydney, New South Wales, Australia
- Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- Institute of Academic Surgery (IAS) at RPAH, Sydney, New South Wales, Australia
- University of Sydney, Sydney, New South Wales, Australia
| | - Scott Leslie
- Department of Urology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- Institute of Academic Surgery (IAS) at RPAH, Sydney, New South Wales, Australia
- University of Sydney, Sydney, New South Wales, Australia
| | - Nicola Jeffery
- Department of Urology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Peter J Lee
- Surgical Outcomes Research Centre (SOuRCe), Sydney, New South Wales, Australia
- Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Kirk K S Austin
- Surgical Outcomes Research Centre (SOuRCe), Sydney, New South Wales, Australia
- Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| |
Collapse
|
12
|
Dourado J, Garoufalia Z, Emile SH, Wignakumar A, Aeschbacher P, Rogers P, Delgado Z, Greer M, Wexner SD. Ostomy continence devices: a systematic review of the literature and meta-analysis. Colorectal Dis 2024; 26:622-631. [PMID: 38358053 DOI: 10.1111/codi.16906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/11/2024] [Accepted: 01/14/2024] [Indexed: 02/16/2024]
Abstract
AIM Colostomy complication rates range widely from 10% to 70%. The psychological burden on patients, leading to lifestyle changes and decreased quality of life (QoL), is one of the largest factors. The aim of this work was to assess the history and efficacy of ostomy continence devices in improving continence and QoL. METHOD In this PRISMA-compliant systematic review and meta-analysis, we searched PubMed, Scopus, Google Scholar and clinicaltrials.gov for studies on continence devices for all ostomies up to April 2023. Primary outcomes were continence and improvement in QoL. Secondary outcomes were leakage, patient's device preference and complications. Risk of Bias 2 and the revised tool to assess risk of bias in non-randomized studies of interventions (ROBINS-1) were used to assess risk of bias. Certainty of evidence was graded using GRADE. RESULTS Twenty-two studies assessed devices from 1978 to 2022. The two main types identified were ball-valve devices and plug systems. Conseal and Vitala were the two main devices with significant evidence allowing for pooled analyses. Conseal, the only currently marketed device, had a pooled rate of continence of 67.4%, QoL improvement was 74.9%, patient preference over a traditional appliance was 69.1%, leakage was 10.1% and complications was 13.7%. Since 2011, five studies have investigated experimental devices on both human and animal models. CONCLUSION Ostomy continence has been a long-standing goal without a consistently reliable solution. We propose that selective and short-term usage of continence devices may lead to improved continence and QoL in ostomy patients. Further research is needed to develop a reliable daily device for ostomy continence. Future investigation should include the needs of ileostomates.
Collapse
Affiliation(s)
- Justin Dourado
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, Florida, USA
| | - Zoe Garoufalia
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, Florida, USA
| | - Sameh Hany Emile
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, Florida, USA
- Colorectal Surgery Unit, General Surgery Department, Mansoura University Hospitals, Mansoura, Egypt
| | - Anjelli Wignakumar
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, Florida, USA
| | - Pauline Aeschbacher
- Department of General Surgery and Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida, USA
- Department for Visceral Surgery and Medicine, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Peter Rogers
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, Florida, USA
| | - Zachary Delgado
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, Florida, USA
| | - Matthew Greer
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, Florida, USA
| | - Steven D Wexner
- Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, Florida, USA
| |
Collapse
|
13
|
Zhou L, Zhang Z, Li H, Wang L. Factors related to psychosocial adjustment in patients with enterostomy: Based on a national cross-sectional survey. J Clin Nurs 2024. [PMID: 38528346 DOI: 10.1111/jocn.17143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 02/22/2024] [Accepted: 03/18/2024] [Indexed: 03/27/2024]
Abstract
AIMS This study aimed to explore the psychosocial adjustment of enterostomy patients on a national scale. DESIGN Based on a national cross-sectional survey. METHODS From December 2021 and February 2023, a total of 22,040 enterostomy patients were assessed using the ostomy adjustment inventory-20. Initial analysis involved employing the chi-square test or Kruskal-Wallis H test to identify factors influencing the psychosocial adjustment of these patients. Subsequently, multinomial logistic regression was used to determine the factors affecting the classification of psychosocial adjustment levels of enterostomy patients. The reporting of this study adhered to the STROBE checklist. RESULTS Eventually 21,124 patients with enterostomy were included in this study, out of which 7788 (36.9%) patients with low level of psychosocial adjustment, 11,803 (55.8%) patients with medium level of psychosocial adjustment and 1533 (7.3%) patients with high level of psychosocial adjustment. The factors influencing the classification of psychosocial adjustment levels of enterostomy patients were gender, educational background, carer, enterostomy self-care knowledge score and medical payment method. CONCLUSIONS The overall psychosocial adjustment level of enterostomy patients is not optimistic, and the factors that may affect the classification of their psychosocial adjustment level are analysed. Individualised intervention should be given according to different psychosocial adjustment levels of enterostomy patients. RELEVANCE TO CLINICAL PRACTICE The number of enterostomy patients with a high level of psychosocial adjustment is small in relation to the total number of enterostomy patients, and caregivers can provide health education to enterostomy patients by analysing the factors affecting the level of psychosocial adjustment of enterostomy patients. PATIENT OR PUBLIC CONTRIBUTION None.
Collapse
Affiliation(s)
- Lu Zhou
- Department of Nursing, Peking University People's Hospital, Beijing, China
- School of Nursing, Peking University, Beijing, China
| | - Zhengyang Zhang
- Department of Nursing, Peking University People's Hospital, Beijing, China
- School of Nursing, Peking University, Beijing, China
| | - Hui Li
- Department of Nursing, Peking University People's Hospital, Beijing, China
- School of Nursing, Peking University, Beijing, China
| | - Ling Wang
- Department of Nursing, Peking University People's Hospital, Beijing, China
| |
Collapse
|
14
|
van der Storm SL, Consten ECJ, Govaert MJPM, Tuynman JB, Oosterling SJ, Grotenhuis BA, Smits AB, Marsman HA, van Rossem CC, van Duyn EB, de Nes LCF, Verdaasdonk E, de Vries Reilingh TS, Vening W, Bemelman WA, Schijven MP. Better stoma care using the Stoma App: does it help? A first randomized double-blind clinical trial on the effect of mobile healthcare on quality of life in stoma patients. Surg Endosc 2024; 38:1442-1453. [PMID: 38191813 PMCID: PMC10881728 DOI: 10.1007/s00464-023-10593-x] [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: 09/11/2023] [Accepted: 11/11/2023] [Indexed: 01/10/2024]
Abstract
BACKGROUND Receiving a stoma significantly impacts patients' quality of life. Coping with this new situation can be difficult, which may result in a variety of physical and psychosocial problems. It is essential to provide adequate guidance to help patients cope with their stoma, as this positively influences self-efficacy in return. Higher self-efficacy reduces psychosocial problems increasing patient's quality of life. This study investigates whether a new mobile application, the Stoma App, improves quality of life. And if personalized guidance, timed support, and peer contact offered as an in-app surplus makes a difference. METHODS A double-blind, randomized controlled trial was conducted between March 2021 and April 2023. Patients aged > 18 years undergoing ileostomy or colostomy surgery, in possession of a compatible smartphone were included. The intervention group received the full version of the app containing personalized and time guidance, peer support, and generic (non-personalized) stoma-related information. The control group received a restricted version with only generic information. Primary outcome was stoma quality of life. Secondary outcomes included psychological adaption, complications, re-admittance, reoperations, and length of hospital stay. RESULTS The intervention version of the app was used by 96 patients and the control version by 112 patients. After correction for confounding, the intervention group reported a significant 3.1-point improvement in stoma-related quality of life one month postoperatively (p = 0.038). On secondary outcomes, no significant improvements could be retrieved of the intervention group. CONCLUSION The Stoma App improves the quality of life of stoma patients. Peer support and personalized guidance are of significant importance in building self-efficacy. It is to be recommended to implement Stoma app-freely available software qualifying as a medical device-in standard stoma care pathways for the benefits of both patients and healthcare providers.
Collapse
Affiliation(s)
- Sebastiaan L van der Storm
- Surgery, Amsterdam UMC, Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
- Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands.
- Amsterdam Public Health, Digital Health, Amsterdam, The Netherlands.
- Department of Surgery, Amsterdam Gastroenterology and Metabolism, Amsterdam Public Health, Digital Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
| | - Esther C J Consten
- Surgery, Meander Medical Center, Amersfoort, The Netherlands
- Surgery, University Medical Center Groningen, Groningen, The Netherlands
| | | | | | | | | | - Anke B Smits
- Surgery, Antonius Ziekenhuis, Nieuwengein, The Netherlands
| | | | | | | | | | | | | | - Wouter Vening
- Surgery, Rijnstate Ziekenhuis, Arnhem, The Netherlands
| | - Willem A Bemelman
- Surgery, Amsterdam UMC, Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands
| | - Marlies P Schijven
- Surgery, Amsterdam UMC, Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
- Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands.
- Amsterdam Public Health, Digital Health, Amsterdam, The Netherlands.
- Department of Surgery, Amsterdam Gastroenterology and Metabolism, Amsterdam Public Health, Digital Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
| |
Collapse
|
15
|
Lahnaoui O, Essangri H, El Bahaoui N, Majbar MA, Benkabbou A, Mohsine R, Souadka A. From burden to relief: The economic and quality-of-life advantages of pseudo continent perineal colostomy in ultra-low rectal cancer patients. J Surg Oncol 2024; 129:297-307. [PMID: 37849420 DOI: 10.1002/jso.27484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 10/09/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND AND OBJECTIVE Pseudo Continent Perineal Colostomy (PCPC) is an alternative technique to left iliac colostomy (LIC) after abdominoperineal resection for ultra low rectal cancer (ULRC). It allows placing the stoma in the perineum to preserve patients' body image. However, concerns about its impact on quality of life and management costs have limited its adoption. We aimed to compare the early outcomes and financial burden of PCPC and LIC in ULRC patients in Morocco, a low-middle-income country. METHODS From January 2018 to December 2019, all patients who underwent abdomino-perineal resection (APR) with LIC or PCPC were prospectively enrolled. For each patient, baseline characteristics, and in hospital and 90 days morbidity with a focus on perineal complications were reported. Quality of life (QOL) was assessed using the validated EORTC-C30 and CR29 questionnaires. Financial burden to patients was reported using declarative out-of-pocket costs (OOPC) analysis. RESULTS Among 49 patients who underwent APR, 33 received PCPC and 16 received definitive LIC. Similar rates of early perineal complications were observed between the two groups (p = 0.49). Readmission rate at POD90 was higher in the LIC-group due to perineal sepsis (p = 0.09). QOL analysis at 6 months revealed that patients with PCPC had a higher global health status (p = 0.006), a better physical functioning and reported fewer symptoms of flatulence and fecal incontinence (p = 0.001). Patients with a LIC reported more financial difficulties with higher median OOPC of stoma management up to €23 versus €0 per month for PCPC (p = 0.0024). PCPC was the only predictive factor of improved patient reported outcomes. CONCLUSIONS PCPC is a cost-effective alternative to the standard definitive colostomy without alteration of the QOL or additional perineal complications during the first 6 months following the surgery. These findings may help convince surgeons to offer this option to patients refusing definitive LIC.
Collapse
Affiliation(s)
- Oumayma Lahnaoui
- Surgical Oncology Department, National Institute of Oncology, Ibn Sina University Hospital, Mohammed Vth Unverisity, Rabat, Morocco
- Equipe de recherche en Oncologie Translationnelle (EROT), Faculty of Medicine and Pharmacy, Rabat, Morocco
| | - Hajar Essangri
- Surgical Oncology Department, National Institute of Oncology, Ibn Sina University Hospital, Mohammed Vth Unverisity, Rabat, Morocco
| | - Nezha El Bahaoui
- Surgical Oncology Department, National Institute of Oncology, Ibn Sina University Hospital, Mohammed Vth Unverisity, Rabat, Morocco
| | - Mohammed Anass Majbar
- Surgical Oncology Department, National Institute of Oncology, Ibn Sina University Hospital, Mohammed Vth Unverisity, Rabat, Morocco
- Equipe de recherche en Oncologie Translationnelle (EROT), Faculty of Medicine and Pharmacy, Rabat, Morocco
| | - Amine Benkabbou
- Surgical Oncology Department, National Institute of Oncology, Ibn Sina University Hospital, Mohammed Vth Unverisity, Rabat, Morocco
- Equipe de recherche en Oncologie Translationnelle (EROT), Faculty of Medicine and Pharmacy, Rabat, Morocco
| | - Raouf Mohsine
- Surgical Oncology Department, National Institute of Oncology, Ibn Sina University Hospital, Mohammed Vth Unverisity, Rabat, Morocco
- Equipe de recherche en Oncologie Translationnelle (EROT), Faculty of Medicine and Pharmacy, Rabat, Morocco
| | - Amine Souadka
- Surgical Oncology Department, National Institute of Oncology, Ibn Sina University Hospital, Mohammed Vth Unverisity, Rabat, Morocco
- Equipe de recherche en Oncologie Translationnelle (EROT), Faculty of Medicine and Pharmacy, Rabat, Morocco
| |
Collapse
|
16
|
Yousef J, Al Hasanat A, Othman S, Alrahma S, Alloubani A. Effects of lavender oil on odor elimination, ostomy adjustment and quality of life in patients with permanent colostomy: A randomized controlled trial. Eur J Oncol Nurs 2024; 68:102471. [PMID: 38016202 DOI: 10.1016/j.ejon.2023.102471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 11/13/2023] [Accepted: 11/16/2023] [Indexed: 11/30/2023]
Abstract
PURPOSE The aim of this study is to assess the impact of lavender oil on odor elimination, ostomy adjustment and quality of life outcomes in patients with permanent colostomy. Specifically, the study aims to compare the outcomes of an experimental group receiving lavender oil intervention with those of a control group. METHODS A randomized controlled trial design was employed, including an experimental group receiving lavender oil intervention and a control group receiving standard care. The study participants were patients with permanent colostomy. Various variables were assessed, including odor scale, work and social functioning, sexuality and body image, stoma function, financial concerns, acceptance, anxiety/preoccupation, social engagement and anger. RESULTS The post-scores assessment showed significant differences between the experimental and control groups in all variables. The experimental group exhibited significantly more positive outcomes concerning the reduction of odor (p<0.001), performance in the workplace (p<0.001), body image connected to sexuality (p<0.001), stoma functionality (p<0.001), financial worries (p=0.005), acceptance levels (p<0.001), anxiety levels (p<0.001), social involvement (p<0.001), and irritability (p<0.001). Effect sizes were substantial (=0.88-0.98 in all variables but one), indicating significant differences in average scores before and after the intervention. CONCLUSION The findings of this study suggest that lavender oil intervention effectively improved odor elimination, ostomy adjustment and quality of life outcomes in patients with permanent colostomy.
Collapse
|
17
|
Yang S, Park JW, Hur H, Kim MJ, Jeong SY, Park K, Kim IY. Development of a home health care service platform for ostomy patient management. Ann Coloproctol 2024; 40:36-43. [PMID: 36404498 PMCID: PMC10915528 DOI: 10.3393/ac.2022.00360.0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/12/2022] [Accepted: 07/18/2022] [Indexed: 11/22/2022] Open
Abstract
PURPOSE The use of an ostomy for urination and defecation leads to reduced quality of life. Although many ostomy management strategies are needed, such strategies are often implemented by patients. Thus, there is a need for a home health care service platform that can be used in ostomy patient management. METHODS We developed an ostomy patient management platform by identifying the needs of patients and medical staff through the Chronic Care Ostomy Self-Management Training Program in the United States and from studies conducted in Korea. RESULTS The platform encompassed physical management, psychological management, maintenance of social function, spiritual stability, and home medical care. These components were implemented through monitoring, self-care guidance, and a community platform. For the monitoring function, patients entered their health status in a mobile application (app); the medical staff at the affiliated hospital then monitored the stoma status through a web interface. CONCLUSION Our platform allows medical staff to monitor ostomy patients through a web interface and help such patients to fully manage their ostomy at home using an app. We expect that the continued development of patient-oriented functions in our app will allow ostomy patients to experience quality-of-life improvements.
Collapse
Affiliation(s)
- Seongwoo Yang
- HERINGS, The Institute of Advanced Clinical and Biomedical Research, Seoul, Korea
| | - Ji Won Park
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hyuk Hur
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
- Korean Wound and Ostomy Study Group, The Korean Society of Coloproctology, Seoul, Korea
| | - Min Jung Kim
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Seung-Yong Jeong
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Kyounghoon Park
- HERINGS, The Institute of Advanced Clinical and Biomedical Research, Seoul, Korea
| | - Ik Yong Kim
- Division of Colorectal Surgery, Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea
- Korean Wound and Ostomy Study Group, The Korean Society of Coloproctology, Seoul, Korea
| |
Collapse
|
18
|
Burch J. Stoma care: the role of community nurses. Br J Community Nurs 2024; 29:20-23. [PMID: 38147444 DOI: 10.12968/bjcn.2024.29.1.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
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.
Collapse
Affiliation(s)
- Jennie Burch
- Head of Gastrointestinal Nurse Education, St Mark's The National Bowel Hospital, London, UK
| |
Collapse
|
19
|
Afiyanti Y, Milanti A, Wahidi KR, Fitch M. Embracing My Stoma: Psychosocial Adjustment of Indonesian Colorectal Cancer Survivors Living With a Stoma. Cancer Nurs 2023:00002820-990000000-00203. [PMID: 38112431 DOI: 10.1097/ncc.0000000000001303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
BACKGROUND After surgical treatment of colorectal cancer (CRC), most survivors need to have an ostomy, which can lead to restrictions in their psychological and social functioning. How Indonesian CRC survivors adjust to living well with the stoma remains an understudied area. OBJECTIVE This study aimed to explore the lived experiences of Indonesian CRC survivors living with a stoma regarding their psychosocial adjustment. METHODS This study adopted Heidegger's interpretive phenomenology approach. Using semistructured in-depth interviews, data were collected until saturation from 11 CRC survivors. Data were analyzed using thematic analysis, with a Heideggerian stance. RESULTS Three themes with corresponding subthemes were identified: (1) achieving self-reconciliation (subthemes: stoma as a savior, embracing the stoma's existence, being confident as an ostomate), (2) getting tremendous social support (subthemes: getting support from partner, family and community, and peer ostomates), and (3) making practical adjustments in daily life (subthemes: adjustment in clothing, food and drink, physical activities and exercise, religious activities, and traveling). These 3 themes describe the essence of the "lived psychosocial experiences of the CRC survivors with stoma." CONCLUSIONS In contrast to previous study findings conducted primarily in Western countries, most of the Indonesian CRC survivors living with a stoma described positive psychosocial adjustment regarding their ostomy. In this work, social support and cultural-religious aspects made a significant contribution to this adjustment. IMPLICATIONS FOR PRACTICE Healthcare professionals, especially nurses, can use this knowledge in providing psychosocial support for CRC survivors with ostomy to facilitate a smooth adaptation and adjustment journey.
Collapse
Affiliation(s)
- Yati Afiyanti
- Author Affiliations: Department of Maternity and Women's Health Nursing, Faculty of Nursing, Universitas Indonesia (Dr Afiyanti), Depok; Faculty of Nursing and Midwifery, Binawan University (Dr Milanti); and Faculty of Health Sciences, Esa Unggul University (Dr Wahidi), Jakarta, Indonesia; and Bloomberg Faculty of Nursing, University of Toronto (Dr Fitch), Ontario, Canada
| | | | | | | |
Collapse
|
20
|
Zhou L, Zhang F, Li H, Wang L. Post-discharge health education for patients with enterostomy: A nationwide interventional study. J Glob Health 2023; 13:04172. [PMID: 38085224 PMCID: PMC10716631 DOI: 10.7189/jogh.13.04172] [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: 12/18/2023] Open
Abstract
Background After discharge, patients with enterostomy face problems with poor self-nursing ability and low levels of psychological and social adjustment, which, without timely intervention, seriously affect their quality of life. We delivered health education to discharged enterostomy patients based on a WeChat health management program and evaluated its impact on their ostomy self-care ability and psychosocial adaptation level. Methods Based on the WeChat health management program, we conducted continuous health education in the first, third, seventh, 11th, and 23rd weeks after discharge of enterostomy patients/before temporary enterostomy restoration to observe its impact on their self-care ability and psychosocial adaptation levels, as evaluated by an ostomy self-care ability questionnaire and ostomy adjustment inventory-20 checklist. Results We included 4201 patients with enterostomy. Our findings showed that the self-care score of patients with enterostomy at discharge (baseline) (mean = 15.23, standard deviation (SD) = 5.22) was lower than that after intervention (mean = 17.71, SD = 1.28) (P < 0.05). The enterostomy psychosocial adaptation score of the enterostomy patients at discharge (baseline) (mean = 44.59, SD = 9.82) was lower than that after intervention (mean = 50.25, SD = 12.97) (P < 0.05). Conclusions Health education for enterostomy patients after discharge can improve their self-care ability and psychological adaptation. Future studies could further explore the views and attitudes of this population toward health education based on the WeChat health management program.
Collapse
Affiliation(s)
- Lu Zhou
- Department of Nursing, Peking University People's Hospital, Beijing, China
- School of Nursing, Peking University, Beijing, China
| | - Fengjiao Zhang
- Department of Nursing, Peking University People's Hospital, Beijing, China
- School of Nursing, Peking University, Beijing, China
| | - Hui Li
- Department of Nursing, Peking University People's Hospital, Beijing, China
- School of Nursing, Peking University, Beijing, China
| | - Ling Wang
- Department of Nursing, Peking University People's Hospital, Beijing, China
| |
Collapse
|
21
|
Zhou L, Qin Z, Wang L. Risk factors and incidence of non-closure stoma in patients with anterior resection of rectal cancer with temporary stoma: A systematic review and meta-analysis. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2023; 49:107120. [PMID: 37907017 DOI: 10.1016/j.ejso.2023.107120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 10/07/2023] [Accepted: 10/17/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND To further define the risk factors and incidence of non-closure stoma in patients with anterior resection of rectal cancer with temporary stoma. METHODS Records from five English databases and four Chinese databases. Odds ratios (OR) and 95 % confidence intervals (CI) were used to indicate the risk of inclusion of risk factors. The non-closure stoma rate used the risk difference (RD) and 95 % CI. Risk factors were evaluated for quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS Risk factors of non-closure stoma in patients with anterior resection of rectal cancer with temporary stoma were Age ≥60 years[OR:1.57, 95%CI(1.44,1.72)], Tumor IV stage[OR:4.21, 95%CI(2.29,7.74)], American Society of Anesthesiologists (ASA)≥3[OR:1.48, 95%CI(1.33,1.65)], Neoadjuvant chemoradiotherapy[OR:1.41, 95%CI(1.09,1.82)],Open surgery[OR:1.45, 95%CI(1.09,1.93)], Postoperative chemotherapy[OR:1.37, 95%CI(1.03,1.82)], Anastomotic leakage[OR:4.61, 95%CI(2.86, 7.44)], Local recurrence[OR:7.16, 95%CI(4.70, 10.91)]. The rate of non-closure stoma after anterior resection for rectal cancer was: 0.20, 95 % CI (0.17, 0.23). The quality of evidence for stage IV tumors and anastomotic leakage was moderate, and other risk factors were low to very low. CONCLUSIONS Risk factors of non-closure stoma in patients with anterior resection of rectal cancer with temporary stoma were Age≥60 years, Tumor IV stage, ASA≥3, Neoadjuvant chemoradiotherapy, Open surgery, Postoperative chemotherapy, Anastomotic leakage, Local recurrence, and one in five anterior resection patients with a temporary stoma fails to close.
Collapse
Affiliation(s)
- Lu Zhou
- Peking University People's Hospital, Beijing, China; School of Nursing, Peking University, Beijing, China
| | - Zuming Qin
- The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ling Wang
- Peking University People's Hospital, Beijing, China.
| |
Collapse
|
22
|
Saunders B, Polidano K, Chew-Graham CA, Fisher T, Corp N, McDermott-Hughes M, Farmer AD, Bray L. Healthcare professionals' priorities for training to identify and manage distress experienced by young people with a stoma due to inflammatory bowel disease: a consensus study using online nominal group technique. BMJ Open 2023; 13:e072360. [PMID: 38030248 PMCID: PMC10689392 DOI: 10.1136/bmjopen-2023-072360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 07/18/2023] [Indexed: 12/01/2023] Open
Abstract
OBJECTIVES Young people with a stoma due to inflammatory bowel disease (IBD) commonly experience distress; however, this is not always well managed in clinical settings. More effective support may/is likely to reduce the possibility of individuals experiencing sustained distress, which may engender depression or anxiety. This study aimed to gain consensus among a multidisciplinary group of healthcare professionals (HCPs) on priorities for training in the identification and management of distress in this population. One of the authors is a young person with a stoma. DESIGN Participants were recruited through Twitter (X) and the researchers' clinical/research contacts. Two consensus group meetings were conducted using Nominal Group Technique, involving participants generating, discussing and rating on a Likert scale, topics for inclusion in an HCP training package. SETTING Online video conferencing. Participants were located across England, with one based in the USA. PARTICIPANTS Nineteen HCPs participated: three general practitioners, three stoma nurses, two IBD nurses, nine clinical psychologists and two gastroenterologists. RESULTS Twenty-five topics were generated by participants; 19 reached consensus of ≥80%, that is, a mean of ≥5.6 on a 7-point Likert scale. These included: recognising and validating different levels of, and variation in, distress; tackling stigma and normalising having a stoma; everyday practicalities of stoma management, including food and sleep; opening and holding conversations about stoma-related distress; considering the impact of different cultural beliefs on adaptation after stoma surgery; training in simple techniques for gauging the patient's distress during clinical encounters; having conversations about body image; and myth-busting common fears, such as odour. CONCLUSIONS This study is the first to identify HCP training priorities for managing stoma-related distress in young people. Consensus was reached for 19 topics, reflecting the varied needs of young people with a stoma. Findings will inform development of a training package for HCPs treating young people with IBD and a stoma.
Collapse
Affiliation(s)
| | - Kay Polidano
- Department of Sociology, University of Malta, Msida, Malta
| | | | | | - Nadia Corp
- School of Medicine, Keele University, Keele, UK
| | | | - Adam D Farmer
- Department of Gastroenterology, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
| | | |
Collapse
|
23
|
Wohrer H, Koual M, Bentivegna E, Benoit L, Metairie M, Bolze PA, Kerbage Y, Raimond E, Akladios C, Carcopino X, Canlorbe G, Uzan J, Lavoue V, Mimoun C, Huchon C, Koskas M, Costaz H, Margueritte F, Dabi Y, Touboul C, Bendifallah S, Ouldamer L, Delanoy N, Nguyen-Xuan HT, Bats AS, Azaïs H. Prognostic impact of cytoreductive surgery conducted with primary intent, versus cytoreductive surgery after neoadjuvant chemotherapy, in the management of patients with advanced epithelial ovarian cancers: a multicentre, propensity score-matched study from the FRANCOGYN group. BJOG 2023; 130:1511-1520. [PMID: 37165717 DOI: 10.1111/1471-0528.17524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/05/2023] [Accepted: 04/15/2023] [Indexed: 05/12/2023]
Abstract
OBJECTIVE To compare survival and morbidity rates between primary cytoreductive surgery (pCRS) and interval cytoreductive surgery (iCRS) for epithelial ovarian cancer (EOC), using a propensity score. DESIGN We conducted a propensity score-matched cohort study, using data from the FRANCOGYN cohort. SETTING Retrospective, multicentre study of data from patients followed in 15 French department specialized in the treatment of ovarian cancer. SAMPLE Patients included were those with International Federation of Gynaecology and Obstetrics (FIGO) stage III or IV EOC, with peritoneal carcinomatosis, having undergone CRS. METHODS The propensity score was designed using pre-therapeutic variables associated with both treatment allocation and overall survival (OS). MAIN OUTCOME MEASURES The primary outcome was OS. Secondary outcomes included recurrence-free survival (RFS), quality of CRS and other variables related to surgical morbidity. RESULTS A total of 513 patients were included. Among these, 334 could be matched, forming 167 pairs. No difference in OS was found (hazard ratio, HR = 0.8, p = 0.32). There was also no difference in RFS (median = 26 months in both groups) nor in the rate of CRS leaving no macroscopic residual disease (pCRS 85%, iCRS 81.4%, p = 0.76). The rates of gastrointestinal tract resections, stoma, postoperative complications and hospital stay were significantly higher in the pCRS group. CONCLUSIONS Analysis of groups of patients made comparable by propensity score matching showed no difference in survival, but lower postoperative morbidity in patients treated with iCRS.
Collapse
Affiliation(s)
- Henri Wohrer
- Department of Gynaecological Oncological and Breast Surgery, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, Paris, France
| | - Meriem Koual
- Department of Gynaecological Oncological and Breast Surgery, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, Paris, France
- INSERM UMR-S 1124, University of Paris Cité, Centre Universitaire des Saint-Père, Paris, France
| | - Enrica Bentivegna
- Department of Gynaecological Oncological and Breast Surgery, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, Paris, France
| | - Louise Benoit
- Department of Gynaecological Oncological and Breast Surgery, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, Paris, France
- INSERM UMR-S 1124, University of Paris Cité, Centre Universitaire des Saint-Père, Paris, France
| | - Marie Metairie
- Department of Gynaecological Oncological and Breast Surgery, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, Paris, France
| | - Pierre-Adrien Bolze
- Department of Gynecologic and Oncologic Surgery and Obstetrics, Lyon Sud University Hospital, Hospices Civils de Lyon, Université Lyon 1, Lyon, France
| | - Yohan Kerbage
- CHU Lille, Service de Chirurgie Gynécologique, Université Lille, Lille, France
| | - Emilie Raimond
- Department of Obstetrics and Gynaecology, Institute Alix de Champagne University Hospital, Reims, France
| | - Cherif Akladios
- Department of Gynaecology, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Xavier Carcopino
- Department of Obstetrics and Gynaecology, Hôpital Nord, APHM, Aix-Marseille University (AMU), Univ Avignon, CNRS, IRD, IMBE UMR 7263, Marseille, France
| | - Geoffroy Canlorbe
- Department of Gynecological and Breast Surgery and Oncology, Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP), University Hospital, Paris, France
- Centre de Recherche Saint-Antoine (CRSA), INSERM UMR_S_938, Cancer Biology and Therapeutics, Sorbonne University, Paris, France
- University Institute of Cancer, Sorbonne University, Paris, France
| | - Jennifer Uzan
- Department of Obstetrics Gynecology and Reproductive Medicine, University Paris Est Créteil, Centre Hospitalier Inter-Communal de Créteil, Creteil, France
| | - Vincent Lavoue
- Service de Gynécologie, INSERM 1242, Oncogenesis, Stress and Signaling, CRLC Eugène Marquis, Université de Rennes 1, Hopital Sud, CHU de Rennes, Rennes, France
| | - Camille Mimoun
- Service de Chirurgie Gynécologique - Université de Paris, Hôpital Lariboisière, Paris, France
| | - Cyrille Huchon
- Service de Chirurgie Gynécologique - Université de Paris, Hôpital Lariboisière, Paris, France
| | - Martin Koskas
- Division of Gynaecologic Oncology, Bichat University Hospital, Paris, France
| | - Hélène Costaz
- Department of Surgical Oncology, Georges-Francois Leclerc Centre, Dijon, France
| | - François Margueritte
- Department of Gynaecology, Centre Hospitalier Intercommunal de Poissy-Saint-Germain-en-Laye Site Hospitalier de Poissy, Poissy, France
| | - Yohann Dabi
- Department of Gynaecology and Obstetrics, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Cyril Touboul
- Department of Gynaecology and Obstetrics, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Sofiane Bendifallah
- Department of Gynaecology and Obstetrics, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Lobna Ouldamer
- Department of Gynaecology, Hôpital Universitaire de Tours, Tours, France
| | - Nicolas Delanoy
- Institut du Cancer Paris CARPEM, Université de Paris Cité, Paris, France
- Department of Medical Oncology, AP-HP Centre, Hopital Européen Georges Pompidou, Paris, France
| | - Huyen-Thu Nguyen-Xuan
- Department of Gynaecological Oncological and Breast Surgery, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, Paris, France
| | - Anne-Sophie Bats
- Department of Gynaecological Oncological and Breast Surgery, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, Paris, France
- Institut du Cancer Paris CARPEM, Université de Paris Cité, Paris, France
- INSERM UMR-S 1147, Centre de Recherche des Cordeliers, University of Paris Cité, Paris, France
| | - Henri Azaïs
- Department of Gynaecological Oncological and Breast Surgery, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou, Paris, France
- Institut du Cancer Paris CARPEM, Université de Paris Cité, Paris, France
- INSERM UMR-S 1147, Centre de Recherche des Cordeliers, University of Paris Cité, Paris, France
| |
Collapse
|
24
|
Nehemiah A, Zhang S, Appel S, Dizon D, Sun V, Grant M, Holcomb MJ, Hornbrook MC, Krouse RS. Intimacy and survivors of cancer with ostomies: findings from the Ostomy Self-management Training trial. J Sex Med 2023; 20:1319-1324. [PMID: 37769350 PMCID: PMC10627782 DOI: 10.1093/jsxmed/qdad119] [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: 04/19/2023] [Revised: 07/16/2023] [Accepted: 08/22/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND Many people with abdominal or pelvic cancers require an ostomy during surgical treatment, which can cause significant issues with physical and emotional intimacy in relationships. AIM To evaluate the effect of a telehealth-based education program on intimacy over time for survivors of cancer with ostomies. METHODS We performed a secondary analysis of our multicenter randomized controlled trial to determine intimacy outcomes and to compare the effects of the Ostomy Self-management Training (OSMT) program vs usual care. Partnered patients were included who provided answers to the City of Hope Quality of Life-Ostomy survey for at least 2 time points during the study. We evaluated the effect of baseline information, such as gender on intimacy. OUTCOMES The primary outcome was intimacy, estimated by a composite score created from questions within the City of Hope Quality of Life-Ostomy survey. RESULTS Of 216 enrolled volunteers, 131 had a partner: 68 in the OSMT arm and 63 in the usual care arm. Of these, 48 were women and 83 were men. The tumor types represented in this study were colorectal (n = 69), urinary (n = 45), gynecologic (n = 10), and other (n = 7; eg, melanoma, liposarcoma). From the cohort, 87 answered the 5 composite intimacy score questions at 2 time points, including baseline. There was significant improvement over time in composite intimacy scores for participants in the OSMT arm vs the usual care arm. CLINICAL IMPLICATIONS Our OSMT intervention had a positive effect on factors that contribute to intimacy for survivors of cancer with ostomies, suggesting that a survivorship curriculum can improve their experiences after ostomy surgery. STRENGTHS AND LIMITATIONS OSMT allowed for discussion of intimacy and other sensitive topics, which can be challenging. These discussions demonstrate benefit to participants and can serve as frameworks for cancer treatment providers. The focus of this work on partnered participants provides insight into the interpersonal challenges of a life with an ostomy, but it may overlook the important perspectives of nonpartnered participants and the partners themselves. Furthermore, limited power prevented us from conducting subgroup analyses exploring the effects of factors such as gender and tumor type on intimacy. CONCLUSION At 6-month follow-up, the novel intimacy composite score indicated improvement for participants completing the OSMT intervention. Future research studies with higher power will validate this intimacy measurement and identify intimacy differences in similar populations based on tumor type.
Collapse
Affiliation(s)
- Ariel Nehemiah
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Siqi Zhang
- Biostatistics Analysis Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Scott Appel
- Biostatistics Analysis Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Don Dizon
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI 02903, United States
| | - Virginia Sun
- Arizona Telemedicine Program, University of Arizona, Tucson, AZ 85724, United States
| | - Marcia Grant
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, CA 91010, United States
| | - Michael J Holcomb
- Arizona Telemedicine Program, University of Arizona, Tucson, AZ 85724, United States
| | - Mark C Hornbrook
- Kaiser Permanente Center for Health Research, Portland, OR 97227, United States
| | - Robert S Krouse
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
- Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA 19104, United States
| |
Collapse
|
25
|
Robitaille S, Maalouf MF, Penta R, Joshua TG, Liberman AS, Fiore JF, Feldman LS, Lee L. The impact of restorative proctectomy versus permanent colostomy on health-related quality of life after rectal cancer surgery using the patient-generated index. Surgery 2023; 174:813-818. [PMID: 37495462 DOI: 10.1016/j.surg.2023.06.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/16/2023] [Accepted: 06/18/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND The impact of bowel dysfunction versus colostomy on quality of life after rectal cancer surgery is poorly understood. BACKGROUND To evaluate the quality of life after rectal cancer surgery in patients with colostomy versus restorative proctectomy. METHODS A mixed-methods study measuring quality of life using the Patient-Generated Index, patients were asked to list up to 5 areas of their life affected by their surgery. Areas were then weighted according to patients' preferences for improvement to generate a score from 0-100. The areas reported by patients were linked to the International Classification of Functioning for content analysis. Bowel dysfunction was measured using the low anterior resection syndrome score, and patients were then grouped according to (1) colostomy, (2) no/minor, or (3) major low anterior resection syndrome. Quality of life was compared between groups. RESULTS Overall, 121 patients were included (colostomy n = 39, restorative proctectomy n = 82). There were no differences in demographics, neoadjuvant radiotherapy, or time to follow-up between groups. In the restorative proctectomy group, 53% had no/minor, and 47% had major low anterior resection syndrome. Overall, patients with colostomy had significantly lower quality-of-life scores than those with restorative proctectomy. However, patients with major low anterior resection syndrome scored similarly to those with colostomy. On content analysis, patients with colostomies reported more problems with sexual function, body image, and sports. Patients with restorative proctectomy reported more problems with sleep, using transportation, and taking care of themselves. CONCLUSION Colostomy has a more detrimental impact on quality of life than restorative proctectomy. However, bowel dysfunction severity is important to consider. The patient experience between treatments differs.
Collapse
Affiliation(s)
- Stephan Robitaille
- Department of Surgery, McGill University Health Centre, Montreal, Quebec, Canada; Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, Quebec, Canada. https://twitter.com/sarobitaille
| | - Michael F Maalouf
- Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, Quebec, Canada. https://twitter.com/MichaelMaalouf
| | - Ruxandra Penta
- Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, Quebec, Canada. https://twitter.com/ruxi0077T
| | - Temitope Grace Joshua
- Department of Surgery, McGill University Health Centre, Montreal, Quebec, Canada; Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, Quebec, Canada
| | - A Sender Liberman
- Department of Surgery, McGill University Health Centre, Montreal, Quebec, Canada; Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, Quebec, Canada. https://twitter.com/senderliberman
| | - Julio F Fiore
- Department of Surgery, McGill University Health Centre, Montreal, Quebec, Canada; Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, Quebec, Canada. https://twitter.com/JulioFioreJr
| | - Liane S Feldman
- Department of Surgery, McGill University Health Centre, Montreal, Quebec, Canada; Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, Quebec, Canada. https://twitter.com/lianefeldman
| | - Lawrence Lee
- Department of Surgery, McGill University Health Centre, Montreal, Quebec, Canada; Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, Quebec, Canada.
| |
Collapse
|
26
|
van der Storm SL, Bemelman WA, van Dieren S, Schijven MP. A personalized app to improve quality of life of patients with a stoma: A protocol for a multicentre randomized controlled trial. Colorectal Dis 2023; 25:2071-2077. [PMID: 37587614 DOI: 10.1111/codi.16694] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/02/2023] [Accepted: 06/19/2023] [Indexed: 08/18/2023]
Abstract
AIM Proper education, guidance and support is crucial before and following creation of a stoma. Patients with a stoma and their close relatives need to adapt to and cope with this new - and sometimes unforeseen - situation, which may result in insecurities and a variety of psychosocial problems. Self-efficacy is associated both with a reduction in psychosocial problems and with improved quality of life. The main objective of this study was to investigate whether self-reported quality of life of patients with a stoma can be enhanced by offering personalized and timed guidance, as well as peer contact, in a patient-centred mobile application. METHOD A multicentre, double-blind, randomized controlled trial will be conducted. Consented adults >18 years of age who will receive an ileostomy or colostomy and possess an eligible smartphone will be included. The intervention group will be given the full version of the application (containing personalized and timed guidance, such as operation-specific information and information on the associated care pathway) to install on their smartphone. In addition, the intervention group has access to a protected peer-support platform within the app. The control group will receive a restricted version of the application that contains only generic (non-personalized) stoma-related information. The primary outcome is quality of life, 3 months postoperatively. Secondary outcomes are Patient Reported Outcome Measures (PROMs), such as psychological adaption, as well as number of complications, re-admission and re-operation rates and the length of hospital stay. RESULTS Patient enrolment began in March 2021. Data collection was not complete when this protocol was submitted. CONCLUSION We hypothesize that patients with a stoma who are supported by the intervention version of the app will report a significantly higher quality of life than patients with a stoma who are supported by the control version of the app (ie, are not offered personalized and timed guidance and information and do not have access to peer support in the app).
Collapse
Affiliation(s)
- Sebastiaan L van der Storm
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands
- Amsterdam Public Health, Digital Health, Amsterdam, The Netherlands
| | - Willem A Bemelman
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands
| | - Susan van Dieren
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marlies P Schijven
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands
- Amsterdam Public Health, Digital Health, Amsterdam, The Netherlands
| |
Collapse
|
27
|
Liu M, Li MF, Wang SY, Yang FG, Chen DX, Liu JZ. Health information avoidance and health promotion behavior in patients with enterostomy. Shijie Huaren Xiaohua Zazhi 2023; 31:732-741. [DOI: 10.11569/wcjd.v31.i17.732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 08/25/2023] [Accepted: 09/01/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Enterostomy is currently the main treatment method for colorectal cancer. Health promotion behavior can improve the quality of life of patients undergoing enterostomy and is of great significance in maintaining their health status. However, health information avoidance can drive patients to avoid health risk information, which is not conducive to their own health. This study hypothesized that health information avoidance in patients undergoing colostomy is the main factor influencing health promotion behavior.
AIM To investigate the status of health information avoidance and health promoting behavior among enterostomy patients and discuss their relationship, in order to provide reference for improving the prognosis and quality of life of patients with enterostomy.
METHODS By using the convenient sampling method, 205 enterostomy patients were selected from a hospital in Qingdao. General information questionnaire, Health Information Avoidance Scale, and Health Promoting Lifestyle Profile-Ⅱ were used to conduct the investigation.
RESULTS The health information avoidance score of patients with enterostomy was (25.99 ± 8.81), and 105 patients (56.10%) had varying degrees of health information avoidance behavior, of whom 64 (31.20%) had mild avoidance and 41 (24.90%) had severe avoidance. The Health Promoting Lifestyle Profile-Ⅱ score was (126.19 ± 15.32), which was overall in the middle level. Health information avoidance was negatively correlated with health promotion behavior. Multiple linear regression analysis showed that health information avoidance behavior was a significant influencing factor of health promotion behavior.
CONCLUSION The health information avoidance behavior and health promotion behavior of patients with enterostomy need to be improved. The medical staff should understand the obstacles of patients in the process of receiving health information, in order to help them effectively cope with the avoidance of health information and improve their health behavior and quality of life.
Collapse
Affiliation(s)
- Meng Liu
- School of Nursing, Qingdao University, Qingdao 26600, Shandong Province, China
| | - Meng-Fei Li
- School of Nursing, Qingdao University, Qingdao 26600, Shandong Province, China
| | - Shu-Yun Wang
- Emergency Surgery Department of Laoshan Hospital of Qingdao University Affiliated Hospital, Qingdao 26600, Shandong Province, China
| | - Fu-Guo Yang
- School of Nursing, Qingdao University, Qingdao 26600, Shandong Province, China
| | - De-Xin Chen
- School of Nursing, Qingdao University, Qingdao 26600, Shandong Province, China
| | - Jing-Zhe Liu
- School of Nursing, Qingdao University, Qingdao 26600, Shandong Province, China
| |
Collapse
|
28
|
Moon J, Garfinkle R, Zelkowitz P, Dell'Aniello S, Vasilevsky CA, Brassard P, Boutros M. Incidence and Factors Associated With Mental Health Disorders in Patients With Rectal Cancer Post-Restorative Proctectomy. Dis Colon Rectum 2023; 66:1203-1211. [PMID: 37399122 DOI: 10.1097/dcr.0000000000002744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
BACKGROUND Most patients with rectal cancer experience bowel symptoms post-restorative proctectomy. The incidence of mental health disorders post-restorative proctectomy and its association with bowel symptoms are unknown. OBJECTIVES This study aimed 1) to describe the incidence of mental health disorders in patients who underwent restorative proctectomy for rectal cancer and 2) to study the association between incident mental health disorders and bowel dysfunction after surgery. DESIGN This retrospective cohort study used the Clinical Practice Research Datalink and Hospital Episode Statistics databases. SETTINGS The databases were based in the United Kingdom. PATIENTS All adult patients who underwent restorative proctectomy for a rectal neoplasm between 1998 and 2018 were included. MAIN OUTCOME MEASURES The primary outcome was an incident mental health disorder. The associations between bowel, sexual, and urinary dysfunctions and incident mental health disorders were studied using Cox proportional hazard regression models. RESULTS In total, 2197 patients who underwent restorative proctectomy were identified. Of 1858 patients without preoperative bowel, sexual, or urinary dysfunction, 1455 had no preoperative mental health disorders. In this cohort, 466 patients (32.0%) developed incident mental health disorders following restorative proctectomy during 6333 person-years of follow-up. On multivariate Cox regression, female sex (adjusted HR 1.30; 95% CI, 1.06-1.56), metastatic disease (adjusted HR 1.57; 95% CI, 1.14-2.15), incident bowel dysfunction (adjusted HR 1.41, 95% CI, 1.13-1.77), and urinary dysfunction (adjusted HR 1.57; 95% CI, 1.16-2.14) were found to be associated with developing incident mental health disorders post-restorative proctectomy. LIMITATIONS This study was limited by its observational study design and residual confounding. CONCLUSIONS Incident mental health disorders after restorative proctectomy for rectal cancer are common. The presence of bowel and urinary functional impairment significantly increases the risk of poor psychological outcomes among rectal cancer survivors. CON LOS TRASTORNOS DE SALUD MENTAL EN PACIENTES CON CNCER DE RECTO POSTERIOR A PROCTECTOMA RESTAURADORA ANTECEDENTES: La mayoría de los pacientes con cáncer de recto experimentan síntomas intestinales después de la proctectomía restauradora. Se desconoce la incidencia de trastornos de salud mental posteriores a la proctectomía restauradora y su asociación con síntomas intestinales.OBJETIVOS: Los objetivos de nuestro estudio son: a) describir la incidencia de trastornos de salud mental en pacientes sometidos a proctectomía restauradora por cáncer de recto; b) estudiar la asociación entre los trastornos de salud mental incidentes y la disfunción intestinal después de la cirugía.DISEÑO: Este fue un estudio de cohorte retrospectivo que utilizó las bases de datos Clinical Practice Research Datalink y Hospital Episode Statistics.ENTORNO CLÍNICO: Las bases de datos se basaron en el Reino Unido.PACIENTES: Se incluyeron todos los pacientes adultos que se sometieron a una proctectomía restauradora por una neoplasia rectal entre 1998 y 2018.PRINCIPALES MEDIDAS DE VALORACIÓN: El resultado primario fue un trastorno de salud mental incidente. Las asociaciones entre la disfunción intestinal, sexual y urinaria y los trastornos de salud mental incidentes se estudiaron utilizando modelos de regresión de riesgos proporcionales de Cox.RESULTADOS: En total, se identificaron 2.197 pacientes que se sometieron a proctectomía restauradora. De 1.858 pacientes sin disfunción intestinal, sexual o urinaria preoperatoria, 1.455 personas tampoco tenían trastornos de salud mental preoperatorios. En esta cohorte, 466 (32,0 %) pacientes desarrollaron trastornos de salud mental incidentes después de la PR durante 6333 años-persona de seguimiento. En la regresión multivariada de Cox, sexo femenino (HRa 1,30, IC 95% 1,06-1,56), enfermedad metastásica (HRa 1,57, IC 95% 1,14-2,15) e incidencia intestinal (HRa 1,41, IC del 95 %: 1,13 a 1,77) y la disfunción urinaria (aHR 1,57, IC del 95 %: 1,16 a 2,14) se asociaron con el desarrollo de trastornos de salud mental incidentes después de la proctectomía restauradora.LIMITACIONES: Este estudio estuvo limitado por el diseño del estudio observacional y la confusión residual.CONCLUSIÓN: Los trastornos de salud mental incidentes después de la proctectomía restauradora para el cáncer de recto son comunes. La presencia de deterioro funcional intestinal y urinario aumenta significativamente el riesgo de malos resultados psicológicos entre los sobrevivientes de cáncer de recto. (Traducción- Dr. Ingrid Melo ).
Collapse
Affiliation(s)
- Jeongyoon Moon
- Division of Colon and Rectal Surgery, Jewish General Hospital, Montreal, QC, Canada. Centre for Clinical Epidemiology, Lady Davis Institute-Jewish General Hospital; Department of Epidemiology and Biostatistics and Department of Medicine, McGill University, Montreal, QC, Canada
| | | | | | | | | | | | | |
Collapse
|
29
|
van der Storm SL, Hensen N, Schijven MP. Patient satisfaction with stoma care and their expectations on mobile apps for supportive care. Colorectal Dis 2023; 25:1852-1862. [PMID: 37507846 DOI: 10.1111/codi.16658] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 04/25/2023] [Accepted: 05/17/2023] [Indexed: 07/30/2023]
Abstract
AIM Self-efficacy in stoma care is essential, as it reduces morbidity and psychosocial problems. Mobile applications (apps) may optimise patients' self-efficacy. This article investigates patients' satisfaction with stoma care, their attitudes towards a supporting app aiming to promote self-efficacy and evaluate which functionalities are desired. METHOD A survey was sent to members of the two stoma-related patient associations in the Netherlands. Associations between patient characteristics, satisfaction concerning received stoma care, and willingness to use an app were evaluated. RESULTS The survey was completed by 1868 patients. Overall satisfaction was scored as 6.6, with shortfalls reported in the preoperative information provision, stoma site selection, and postoperative care. Patients of older age, who were unaware of getting a stoma, had an ileostomy, a low quality of life or psychosocial problems, were less satisfied. An app was expected to be of added value by 59.4% of the patients having a stoma for less than three years, compared to the significantly lower 43.8% expectation rate of the remaining study population (p < 0.001). Moreover, patients with a high frequency of physical or psychosocial problems expressed higher levels of interest. CONCLUSION Patients were only moderately satisfied with their received stoma care. A supportive app is most likely beneficial for patients who had a stoma for less than three years, were in an acute situation, and/or have stoma-related problems. Most patients prefer information via internet or on paper, although apps may offer additional benefits. It is important to acknowledge digital literacy and to council patients appropriately about the benefits and help them to use apps.
Collapse
Affiliation(s)
- Sebastiaan L van der Storm
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands
- Amsterdam Public Health, Digital Health, Amsterdam, The Netherlands
| | - Nikita Hensen
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marlies P Schijven
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands
- Amsterdam Public Health, Digital Health, Amsterdam, The Netherlands
| |
Collapse
|
30
|
Iovino P, De Maria M, Corvese F, Giordano V, Alvaro R, Vellone E, Villa G. The influence of patient and caregiver depression on patient self-care and caregiver contribution to self-care in ostomy: A dyadic analysis. J Clin Nurs 2023; 32:6441-6449. [PMID: 36880219 DOI: 10.1111/jocn.16676] [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: 09/11/2022] [Revised: 12/16/2022] [Accepted: 02/20/2023] [Indexed: 03/08/2023]
Abstract
AIMS AND OBJECTIVES To explore the association between patient and caregiver depression and patient self-care and caregiver contribution to self-care in the context of ostomy care. BACKGROUND Self-care is essential for ostomy patients and their caregivers. The ostomy self-care process can be considered a dyadic phenomenon in which the patient and the caregiver interact together and work as a team. The presence of depressive symptoms may limit the patient's ability to perform self-care and caregivers' abilities to engage in caregiving tasks. Research into the dyadic influence of depression on self-care behaviours from the perspective of ostomates and their caregivers is still in its infancy. DESIGN Secondary analysis of a multicentre, cross-sectional study. The STROBE checklist was used to report the present study. METHODS Patient-caregiver dyads were recruited from eight ostomy outpatient clinics from February 2017 to May 2018. Depression was assessed with the nine-item Patient Health Questionnaire in both patients and caregivers. Patient self-care was evaluated with the Ostomy Self-Care Index, and caregiver contribution to self-care was assessed with the Caregiver Contribution to Ostomy Self-Care Index. Both instruments measure the dimensions of maintenance, monitoring and management. The actor-partner interdependence model was performed for the dyadic analysis. RESULTS In total, 252 patient-caregiver dyads (patients: 69.8% male, mean age 70.05; caregivers: 80.6% female, mean age 58.7) were enrolled. Patient depression was positively associated with caregiver contribution to self-care maintenance. Caregiver depression was negatively associated with self-care management. RELEVANCE TO CLINICAL PRACTICE These findings add a better understanding of the reciprocal influence of dyadic depression on patient and caregiver contributions to self-care in ostomy contexts was found. Patient and caregiver depression influence patient self-care and caregiver contribution to self-care. Therefore, clinicians should assess and treat depression in both members of the dyad to improve self-care.
Collapse
Affiliation(s)
- Paolo Iovino
- Health Sciences Department, University of Florence, Florence, Italy
| | - Maddalena De Maria
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Francesco Corvese
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Vittoria Giordano
- UniCamillus - Saint Camillus International University of Health Sciences, Rome, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Giulia Villa
- Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, Milan, Italy
| |
Collapse
|
31
|
Dahouri A, Sahebihagh MH, Gilani N. Comparison of sexual function of people with colorectal cancer with and without colostomy bag in Iran: a comparative cross-sectional study. Sci Rep 2023; 13:12558. [PMID: 37532774 PMCID: PMC10397230 DOI: 10.1038/s41598-023-39728-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 07/30/2023] [Indexed: 08/04/2023] Open
Abstract
The aim of this study was to investigate and compare sexual function in individuals with colorectal cancer, with and without a colostomy bag. A quantitative, descriptive-comparative design was employed, and a cluster random sampling method was used to recruit 252 patients with colorectal cancer. Data collection tools included a participants characteristics form, the International Index of Erectile Function (IIEF) for men, and the Female Sexual Function Index (FSFI) for women. The mean IIEF total score for men with a colostomy was 26.17 ± 15.30, and for men without a colostomy, it was 29.05 ± 17.14. The mean FSFI total score for women with a colostomy was 6.40 ± 7.21, and for women without a colostomy, it was 9.10 ± 14.67. There was no statistically difference in IIEF scores between men with and without colostomy bags (p > 0.05). However, women with colostomy bags had significantly lower FSFI scores compared to women without colostomy bags (p < 0.05). Addressing sexual concerns in individuals with colorectal cancer is crucial for enhancing their sexual well-being and overall quality of life. Comprehensive support, timely interventions, and targeted services are essential to help patients navigate the challenges and improve their overall well-being.
Collapse
Affiliation(s)
- Amirmohammad Dahouri
- Departement of Community Health Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Hassan Sahebihagh
- Departement of Community Health Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Neda Gilani
- Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
32
|
Jiang L, Wang M, Chen Y, Liu Q. Mediating role of resilience between family functioning and quality of life in patients with advanced colorectal cancer. J Psychosoc Oncol 2023; 42:175-189. [PMID: 37435830 DOI: 10.1080/07347332.2023.2231431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
To better understand the relationship between family functioning, resilience, and quality of life (including physical and mental component score, PCS and MCS) in patients with advanced colorectal cancer (CRC) to predict and improve their quality of life. A cross-sectional study was conducted in which a total of 165 patients with advanced colorectal cancer participated in a one-time survey. Measures included the Family Functioning Assessment Device, the 10-item Connor-Davidson Resilience Scale, and the SF-12 Health Survey Assessment Scale. The data analysis methods included descriptive analysis, pearson's correlation analysis, t-tests, and nonparametric tests. Of the patients with advanced CRC, 47.27% and 72.73% had moderate or low mental and physical health components, respectively. The results indicated that in patients with advanced CRC, family function was negatively correlated with resilience (p < 0.01), family functioning was negatively correlated with MCS (p < 0.01), and resilience was positively correlated with PCS (p < 0.05) and MCS (p < 0.01). The mediating analysis revealed that family functioning regulated MCS through resilience (effect value = 13.17%). Our findings suggest that the MCS of patients with advanced CRC is influenced by both family functioning and resilience. PCS in patients with advanced CRC appears to be influenced by resilience but not by family functioning.
Collapse
Affiliation(s)
- Liqing Jiang
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Meng Wang
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Ying Chen
- Department of Oncology, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Quan Liu
- Department of Oncology, Affiliated Hospital of Jiangnan University, Wuxi, China
| |
Collapse
|
33
|
Mori S, Tanabe K, Wada M, Hamada Y, Yasudome R, Sonoda T, Matsushita D, Shimonosono M, Arigami T, Sasaki K, Kurahara H, Nakajo A, Ohtsuka T. Modified pull-through coloanal anastomosis to avoid permanent stomas and reduce postoperative complications for lower rectal tumors. Surg Endosc 2023:10.1007/s00464-023-10184-w. [PMID: 37311894 DOI: 10.1007/s00464-023-10184-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 05/30/2023] [Indexed: 06/15/2023]
Abstract
BACKGROUND We performed pull-through hand-sewn coloanal anastomosis immediately after sphincter-preserving ultralow anterior resection (ULAR) [pull-through ultra (PTU)] to avoid permanent stoma and reduce postoperative complications of lower rectal tumors. This study aimed to compare the clinical outcomes of PTU versus non-PTU (stapled or hand-sewn coloanal anastomosis with diverting stoma) after sphincter-preserving ULAR for lower rectal tumors. METHODS This retrospective cohort study analyzed prospectively maintained data from 100 consecutive patients who underwent PTU (n = 29) or non-PTU (n = 71) after sphincter-preserving ULAR for rectal tumors between January 2011 and March 2023. In PTU, hand-sewn coloanal anastomosis was immediately performed using 16 stitches of 4-0 monofilament suture during primary surgery. The clinical outcomes were assessed. The primary outcomes were rates of permanent stomas and overall postoperative complications. RESULTS The PTU group was significantly less likely to require a permanent stoma than the non-PTU group (P < 0.01). None of the patients in the PTU group required permanent stoma and the rate of overall complications was significantly lower in the PTU group (P = 0.01). The median operative time was comparable between the two groups (P = 0.33) but the median operative time during the second stage was significantly shorter in the PTU group (P < 0.01). The rates of anastomotic leakage and complications of Clavien-Dindo grade III were comparable between the two groups. Diverting ileostomy was performed in two patients with an anastomotic leak in the PTU group. The PTU group was significantly less likely to require a diverting ileostomy than those in the non-PTU group (P < 0.01). The composite length of hospital stay was significantly shorter in the PTU group (P < 0.01). CONCLUSIONS PTU via immediate coloanal anastomosis for lower rectal tumors is a safe alternative to the current sphincter-preserving ULAR with diverting ileostomy for patients who wish to avoid a stoma.
Collapse
Affiliation(s)
- Shinichiro Mori
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima City, Kagoshima, 890-8520, Japan.
| | - Kan Tanabe
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Masumi Wada
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Yuki Hamada
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Ryutaro Yasudome
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Tomohiro Sonoda
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Daisuke Matsushita
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Masataka Shimonosono
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Takaaki Arigami
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Ken Sasaki
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Hiroshi Kurahara
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Akihiro Nakajo
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima City, Kagoshima, 890-8520, Japan
| | - Takao Ohtsuka
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima City, Kagoshima, 890-8520, Japan
| |
Collapse
|
34
|
Kovoor JG, Jacobsen JHW, Stretton B, Bacchi S, Gupta AK, Claridge B, Steen MV, Bhanushali A, Bartholomeusz L, Edwards S, Asokan GP, Asokan G, McGee A, Ovenden CD, Hewitt JN, Trochsler MI, Padbury RT, Perry SW, Wong ML, Licinio J, Maddern GJ, Hewett PJ. Depression after stoma surgery: a systematic review and meta-analysis. BMC Psychiatry 2023; 23:352. [PMID: 37217917 DOI: 10.1186/s12888-023-04871-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 05/15/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Depression is the leading cause of global disability and can develop following the change in body image and functional capacity associated with stoma surgery. However, reported prevalence across the literature is unknown. Accordingly, we performed a systematic review and meta-analysis aiming to characterise depressive symptoms after stoma surgery and potential predictive factors. METHODS PubMed/MEDLINE, Embase, CINAHL and Cochrane Library were searched from respective database inception to 6 March 2023 for studies reporting rates of depressive symptoms after stoma surgery. Risk of bias was assessed using the Downs and Black checklist for non-randomised studies of interventions (NRSIs), and Cochrane RoB2 tool for randomised controlled trials (RCTs). Meta-analysis incorporated meta-regressions and a random-effects model. REGISTRATION PROSPERO, CRD42021262345. RESULTS From 5,742 records, 68 studies were included. According to Downs and Black checklist, the 65 NRSIs were of low to moderate methodological quality. According to Cochrane RoB2, the three RCTs ranged from low risk of bias to some concerns of bias. Thirty-eight studies reported rates of depressive symptoms after stoma surgery as a proportion of the respective study populations, and from these, the median rate across all timepoints was 42.9% 42.9% (IQR: 24.2-58.9%). Pooled scores for respective validated depression measures (Hospital Anxiety and Depression Score (HADS), Beck Depression Inventory (BDI), and Patient Health Questionnaire-9 (PHQ-9)) across studies reporting those scores were below clinical thresholds for major depressive disorder according to severity criteria of the respective scores. In the three studies that used the HADS to compare non-stoma versus stoma surgical populations, depressive symptoms were 58% less frequent in non-stoma populations. Region (Asia-Pacific; Europe; Middle East/Africa; North America) was significantly associated with postoperative depressive symptoms (p = 0.002), whereas age (p = 0.592) and sex (p = 0.069) were not. CONCLUSIONS Depressive symptoms occur in almost half of stoma surgery patients, which is higher than the general population, and many inflammatory bowel disease and colorectal cancer populations outlined in the literature. However, validated measures suggest this is mostly at a level of clinical severity below major depressive disorder. Stoma patient outcomes and postoperative psychosocial adjustment may be enhanced by increased psychological evaluation and care in the perioperative period.
Collapse
Affiliation(s)
- Joshua G Kovoor
- University of Adelaide, Adelaide, South Australia, Australia.
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia.
- Royal Australasian College of Surgeons, Adelaide, South Australia, Australia.
- Royal Adelaide Hospital, Adelaide, South Australia, Australia.
- Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia.
- Health and Information, Adelaide, South Australia, Australia.
| | | | - Brandon Stretton
- University of Adelaide, Adelaide, South Australia, Australia
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Health and Information, Adelaide, South Australia, Australia
| | - Stephen Bacchi
- University of Adelaide, Adelaide, South Australia, Australia
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia
- Health and Information, Adelaide, South Australia, Australia
| | - Aashray K Gupta
- University of Adelaide, Adelaide, South Australia, Australia
- Health and Information, Adelaide, South Australia, Australia
- Gold Coast University Hospital, Gold Coast, QLD, Australia
| | - Brayden Claridge
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Matthew V Steen
- Glenside Health Services, Adelaide, South Australia, Australia
| | - Ameya Bhanushali
- University of Adelaide, Adelaide, South Australia, Australia
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Lorenz Bartholomeusz
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Suzanne Edwards
- University of Adelaide, Adelaide, South Australia, Australia
| | - Gayatri P Asokan
- Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia
| | - Gopika Asokan
- University of Adelaide, Adelaide, South Australia, Australia
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Amanda McGee
- Stoma Care Services, Adelaide, South Australia, Australia
| | - Christopher D Ovenden
- University of Adelaide, Adelaide, South Australia, Australia
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Health and Information, Adelaide, South Australia, Australia
| | - Joseph N Hewitt
- University of Adelaide, Adelaide, South Australia, Australia
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Health and Information, Adelaide, South Australia, Australia
| | - Markus I Trochsler
- University of Adelaide, Adelaide, South Australia, Australia
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Robert T Padbury
- Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia
| | - Seth W Perry
- State University of New York Upstate Medical University, Syracuse, NY, USA
| | - Ma-Li Wong
- State University of New York Upstate Medical University, Syracuse, NY, USA
| | - Julio Licinio
- Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia
- State University of New York Upstate Medical University, Syracuse, NY, USA
| | - Guy J Maddern
- University of Adelaide, Adelaide, South Australia, Australia
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Royal Australasian College of Surgeons, Adelaide, South Australia, Australia
| | - Peter J Hewett
- University of Adelaide, Adelaide, South Australia, Australia
- The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
| |
Collapse
|
35
|
Lin S, Yin G, Chen L. The sexuality experience of stoma patients: a meta-ethnography of qualitative research. BMC Health Serv Res 2023; 23:489. [PMID: 37189102 DOI: 10.1186/s12913-023-09532-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/10/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND As the quality of life of stoma patients has become a research hotspot, sexual health as an integral part of patients' lives has received more and more attention. However, there is a lack of comprehensive reviews on the sexual experiences of patients with stomas. This study aims to synthesize the qualitative literature on the subjective experience of stoma patients' sexual life, to identify their sexual needs, and to provide evidence for the content and methods of sexual health interventions for healthcare professionals. METHODS PubMed, Embase, Web of Science, CINAHL, and Scopus were searched for qualitative studies on the sexual experience of stoma patients (from the inception to January 2023). Titles, abstracts, and full texts were reviewed by two researchers. We used the Critical Appraisal Program (CASP) checklist to assess the quality of included articles. RESULTS A total of 1388 articles were retrieved, and eight studies were included. Data was extracted, including three main themes: 1) sexual problems due to changes in physical function and psychological disorders; 2) the relationship with spouse changes; 3) the cognition of sexual life and the need for sexual knowledge. CONCLUSION Healthcare professionals should pay attention to the sexual life status and sexual health needs of stoma patients and their partners, and give professional guidance and support in treatment and nursing to improve the quality of sexual life of stoma patients.
Collapse
Affiliation(s)
- Siting Lin
- School of Nursing and Health, Nanfang College Guangzhou, Guangzhou, China
| | - Guo Yin
- School of Nursing and Health, Nanfang College Guangzhou, Guangzhou, China.
| | - Linghui Chen
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College, London, UK.
| |
Collapse
|
36
|
Mørkhagen AE, Nortvedt L. A Qualitative Study on How Younger Women Experience Living with an Ostomy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095627. [PMID: 37174147 PMCID: PMC10178502 DOI: 10.3390/ijerph20095627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/30/2023] [Accepted: 04/17/2023] [Indexed: 05/15/2023]
Abstract
There is a growing demand that ostomy patients receive more systematic and individualised follow-up by ostomy nurses. The purpose of the study was to explore how younger women experience everyday life after an ostomy and to map what healthcare personnel can do to ensure that the patient group can feel safe and looked after. This qualitative study included four younger women who had a stoma fitted. Individual in-depth interviews were conducted, and two participants were interviewed twice. The findings resulted in three main themes: (1) The importance of follow-up and information from healthcare personnel, (2) Experience with illness and freedom in everyday life and (3) Self-image and social relationships. We found that time to prepare before surgery and learning to live with the stoma provide a good basis for handling the new everyday life with a stoma. We conclude that ostomy nurses provide support and security to those undergoing ostomy operations. Healthcare professionals should focus on providing individually tailored information to ensure that patients are receptive to the information being shared with them. Having parts of a bowel removed can be experienced as relief, especially when the disease has previously contributed to poor self-image and social isolation.
Collapse
Affiliation(s)
- Andrea Emilie Mørkhagen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet, Oslo Metropolitan University, 0130 Oslo, Norway
| | - Line Nortvedt
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet, Oslo Metropolitan University, 0130 Oslo, Norway
| |
Collapse
|
37
|
Naseh L, Shahriari M, Hayrabedian A, Moeini M. Nurses' viewpoints on factors affecting ostomy care: A qualitative content analysis. Nurs Open 2023. [PMID: 37084269 DOI: 10.1002/nop2.1764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 03/23/2023] [Accepted: 04/04/2023] [Indexed: 04/23/2023] Open
Abstract
AIMS Ostomy plays an important role in management of medical conditions, especially postoperative status of colorectal and bladder cancers. Nurses who have the highest contact level with these patients, face many situations while providing care and need to acquire adequate knowledge and practice responding to patients' needs. The aim of this study was to explore the lived experiences of nurses in caring of abdominal ostomy patients. DESIGN A qualitative content analysis study. METHODS In this qualitative content analysis study, 17 participants were selected using purposeful sampling method and data were collected through in-depth and semi-structured interviews. Data analysis was done using conventional content analysis method. RESULTS Analysis of the findings led to the emergence of 78 sub-subcategories, 20 subcategories and seven main themes, including 'Inefficient educational system', 'Nurse Characteristics', 'Workplace challenges', 'Nature of ostomy care', ' Counseling and preparation of patients for surgery', 'Acquaintance with ostomy complications', and 'Proper planning of patient education'. Results showed that nurses in surgical wards provide non-special ostomy care due to lack of sufficient knowledge and skills and absence of up-to-date and local clinical guidelines which is vital to provide evidence-based scientific care and avoid unfounded and arbitrary care.
Collapse
Affiliation(s)
- Ladan Naseh
- Department of Nursing, Faculty of Rehabilitation, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohsen Shahriari
- Nursing and Midwifery Care Research Center, Adult Health Nursing Department, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Aygineh Hayrabedian
- Nursing and Midwifery Care Research Center, Adult Health Nursing Department, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahin Moeini
- Operating Room Department, Research Center of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
38
|
Willging A, Castro E, Galet C, Xu J. Exploring Outcomes Related to Residential Determinants in Acute Mesenteric Ischemia Patients. J Surg Res 2023; 289:69-74. [PMID: 37086598 DOI: 10.1016/j.jss.2023.03.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 03/20/2023] [Accepted: 03/26/2023] [Indexed: 04/24/2023]
Abstract
INTRODUCTION To access the relationship between residential status and outcomes in surgical acute mesenteric ischemia (AMI) patients. METHODS Retrospective chart review of 153 AMI patients admitted to our institution between 2007 and 2021. Residential median income and Rural-Urban Commuting Area (RUCA) code were used as residential proxies. RESULTS Being of the female sex (odds ratio [OR] = 3.116 [1.276-7.609] P = 0.013) and having a vascular intervention performed (OR = 2.927 [1.087-7.883] P = 0.034) were both associated with a threefold increase in the risk of mortality. Increased age (OR = 1.037 [1.002-1.073] P = 0.039), elevated blood urea nitrogen (OR = 1.032 [1.012-1.051] P = 0.001), and living in higher residential income area (OR = 1.049 [1.009-1.091] P = 0.017) had a small, but statistically significant, increased risk of mortality. Patients in higher median income areas were less likely to undergo colonic resection (OR = 0.953 [0.911-0.997] P = 0.038) and tended to have a lower likelihood of receiving an ostomy (OR = 0.963 [0.927-1] P = 0.051). Being from urban or rural areas was not associated with mortality (OR = 1.565 [0.647-3.790] P = 0.321, although rural patients were more likely to undergo colon resection (OR = 2.183 [0.938-5.079] P = 0.070). Furthermore, rural patients were much more likely to be readmitted than urban dwellers (OR = 4.700 [1.022-21.618] P = 0.047). CONCLUSIONS AMI patients living in rural or small-town areas were more likely to be readmitted and tended to undergo colonic resection. Patients residing in higher income areas had a slightly higher risk of mortality but tended to be less likely to require ostomy or colonic resection. These findings suggest a potential need for postoperative care initiatives focused on AMI patients living in rural and lower income areas.
Collapse
Affiliation(s)
- Abbygale Willging
- Department of Surgery, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Elvis Castro
- Department of Surgery, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Colette Galet
- Department of Surgery, University of Iowa, Iowa City, Iowa
| | - Jun Xu
- Department of Surgery, University of Iowa, Iowa City, Iowa.
| |
Collapse
|
39
|
Choi HR, Park HS, Hong Y, Kim YA. The lived experience of colorectal cancer patients with a temporary ileostomy and the patient's perception of the ostomy nurses' educational interventions. Support Care Cancer 2023; 31:276. [PMID: 37071187 DOI: 10.1007/s00520-023-07748-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 04/12/2023] [Indexed: 04/19/2023]
Abstract
PURPOSE This study is aimed at exploring the lived experiences of colorectal cancer patients regarding temporary ileostomy and the educational interventions of ostomy nurses. METHODS This study is conducted using Heideggerian phenomenological focus group. Focus group interviews were conducted from November 2021 to February 2022 using a semi-structured guide with nine colorectal cancer patients having a temporary ileostomy. The interview data were analyzed using latent content analysis RESULTS: Four main categories and 13 sub-categories are identified as the result of data analysis. Main categories were "colorectal cancer and ileostomy: patient's adaptation," "supporting resources for the patient with ileostomy," "ileostomy closure: hope and concerns," and "ostomy nurse's professionalism." The main categories reflect the shared experiences and perceptions of colorectal cancer patients, across the timeline from colorectal cancer diagnosis to ileostomy closure. CONCLUSION This study provides a timely response to a pilot project for recognizing ostomy nurse's education for patients with stomas. Also, the findings of this study contribute to nursing knowledge by providing patients' perspectives on the education provided to them by the ostomy nurse. Lastly, this study inspires future studies to evaluate and recognize ostomy nurse's practice by using various methodological approaches.
Collapse
Affiliation(s)
- Hye Ri Choi
- School of Nursing, University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Hyun Suk Park
- Department of Nursing, Severance Hospital Yonsei University, Seoul, Republic of Korea
| | - YongEun Hong
- Department of Nursing, National Cancer Center, Goyang-si, Republic of Korea
| | - Young Ae Kim
- National Cancer Survivorship Center, National Cancer Control Institute, National Cancer Center, Goyang-si, Republic of Korea.
| |
Collapse
|
40
|
Indrebø KL, Aasprang A, Olsen TE, Andersen JR. Experiences and results from using a novel clinical feedback system in routine stoma care nurse follow-up of patients with an ostomy: a longitudinal study. J Patient Rep Outcomes 2023; 7:27. [PMID: 36913078 PMCID: PMC10010226 DOI: 10.1186/s41687-023-00573-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 03/04/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND A faecal or urinary ostomy may be lifesaving. However, it involves significant bodily change, and the adjustment process to life with an ostomy includes a broad spectre of physical and psychosocial challenges. Thus, new interventions are needed to improve adaptation to living with an ostomy. This study aimed to examine experiences and outcomes using a new clinical feedback system with patient-reported outcome measures in ostomy care. METHODS In this longitudinal explorative study, 69 ostomy patients were followed by a stoma care nurse in an outpatient clinic, using a clinical feedback system postoperatively at 3, 6 and 12 months. The patients responded electronically to the questionnaires before each consultation. The Generic Short Patient Experiences Questionnaire was used to measure patient experiences and satisfaction with follow-up. The Ostomy Adjustment Scale (OAS) measured adjustment to life with an ostomy, and the Short Form-36 (SF-36) assessed the patient's health-related quality of life. Longitudinal regression models with time as an explanatory (categorical) variable were used to analyse changes. The STROBE guideline was applied. RESULTS The patients were satisfied with their follow-up (96%). Especially, they felt they received sufficient and individualised information, were involved in treatment decisions, and benefited from the consultations. The OAS subscale scores for 'daily activities', 'knowledge and skills' and 'health' improved over time (all p < 0.05), as did the physical and mental component summary scores of the SF-36 (all p < 0.05). Effect sizes of changes were small (0.20-0.40). Sexuality was the most challenging factor reported. CONCLUSIONS The clinical feedback system could be helpful because outpatient follow-ups for ostomy patients may be more tailored when clinicians use clinical feedback systems. However, further development and testing are needed.
Collapse
Affiliation(s)
- Kirsten Lerum Indrebø
- Department of Surgery, Førde Central Hospital, Svanehaugvegen 2, 6812, Førde, Norway. .,Western Norway University of Applied Sciences, Førde, Norway.
| | - Anny Aasprang
- Centre of Health Research, Førde Hospital Trust, Førde, Norway.,Western Norway University of Applied Sciences, Førde, Norway
| | - Torill Elin Olsen
- Western Norway University of Applied Sciences, Bergen, Norway.,Department of Surgery, Haukeland University Hospital, Bergen, Norway
| | - John Roger Andersen
- Centre of Health Research, Førde Hospital Trust, Førde, Norway.,Western Norway University of Applied Sciences, Førde, Norway
| |
Collapse
|
41
|
Systematic review with meta-analysis: Current and emerging models of preoperative psychological preparation for individuals undergoing stoma surgery. J Psychosom Res 2023; 168:111211. [PMID: 36898315 DOI: 10.1016/j.jpsychores.2023.111211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 02/21/2023] [Accepted: 02/28/2023] [Indexed: 03/12/2023]
Abstract
OBJECTIVE Stoma surgery is a profoundly life changing event that can result in a range of negative psychological and mental health outcomes, often requiring significant postoperative adaption. While postoperative avenues of support to address these outcomes exist, there remains a lack of preoperative psychological preparation for surgical candidates in standard models of care. The present systematic review and meta-analysis aims to examine the current and emerging models of psychological preparation available to stoma surgery candidates during the preoperative period. METHODS A systematic search of PubMed, Embase, Emcare, PsycINFO, CINAHL, and SCOPUS was conducted. All studies examining the effects of preoperative psychological interventions targeting postoperative psychological adjustment and/or mental health outcomes for individuals planning to undergo or who had undergone stoma surgery were included. RESULTS Overall, 15 publications meeting inclusion criteria were identified, encompassing 1565 total participants. Intervention types ranged from psychoeducational, counselling, and practical based skills, examining the postoperative outcomes of anxiety, depression, quality of life, adjustment, self-efficacy, and systematic improvements to standard models of care. Five studies examining postoperative anxiety were included for meta-analysis, demonstrating an overall significant effect (SMD = -1.13, 95% CI -1.96 to -0.30, p = .008). Due to the high level of heterogeneity between remaining studies, articles examining postoperative outcomes other than anxiety were synthesised in narrative form. CONCLUSION Despite some promising advancements in the field, there remains insufficient evidence to judge the overall effectiveness of current and emerging models of preoperative psychological preparation on postoperative psychological outcomes for individuals facing stoma surgery.
Collapse
|
42
|
Patient Education for Stoma Patients. SEMINARS IN COLON AND RECTAL SURGERY 2023. [DOI: 10.1016/j.scrs.2023.100952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
|
43
|
Psychosocial Considerations in Ostomy Surgery for Pediatric IBD Patients. J Wound Ostomy Continence Nurs 2023; 50:104-106. [PMID: 36867031 DOI: 10.1097/won.0000000000000954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
|
44
|
Farina E, Rosso M, Dansero L, Ippoliti R, Numico G, Macciotta A, Bena A, Ricceri F. Short-term effect of colorectal cancer on income: analysis of an Italian cohort. J Epidemiol Community Health 2023; 77:196-201. [PMID: 36707238 DOI: 10.1136/jech-2022-220088] [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: 11/16/2022] [Accepted: 01/17/2023] [Indexed: 01/28/2023]
Abstract
INTRODUCTION The ability to return to work after a cancer diagnosis is a key aspect of cancer survivorship and quality of life. Studies have reported a significant risk of income loss for cancer survivors; however, there is limited evidence of the Italian context. METHODS The Work Histories Italian Panel (WHIP)-Salute database was used to select a cohort of incident cases of colorectal cancer (CRC) among workers in the private sector, based on hospital discharges. A propensity score matching was used to find a balanced control group for several confounders. Ordinary least square and logistic regressions were used to estimate the effect of a CRC diagnosis on annual income and the probability of switching from a full-time contract to a part-time one considering 3 years after the diagnosis. RESULTS Overall, we identified 925 CRC incident cases from 2006 until 2012. Our results confirm a statistically significant reduction in survivors' income compared with controls. This reduction was greater in the first year and then tend to decrease, with an average income loss over 3 years of about €12 000. Stratified analyses by sex and position confirmed the overall trend while indicating a strong effect modification. Regarding the switching from full-time to part-time employment, the results were never significant. CONCLUSION Income loss does not seem to be related to an increase in part-time contracts, but rather to survivors' reduced work capacity following the invasive treatments. Further research is needed to investigate the complex dynamics behind this association.
Collapse
Affiliation(s)
- Elena Farina
- Department of Epidemiology, ASL TO3, Grugliasco, Piemonte, Italy
| | - Marco Rosso
- Department of Economics, University of Bologna, Bologna, Italy
| | - Lucia Dansero
- Centre for Biostatistics, Epidemiology, and Public Health (C-BEPH), Department of Clinical and Biological Sciences, Università degli Studi di Torino, Orbassano, Piemonte, Italy
| | - Roberto Ippoliti
- Faculty of Business Administration and Economics, University of Bielefeld, Bielefeld, Germany
| | - Gianmauro Numico
- Department of Medical Oncology, Santa Croce e Carle Hospital, Cuneo, Italy
| | - Alessandra Macciotta
- Centre for Biostatistics, Epidemiology, and Public Health (C-BEPH), Department of Clinical and Biological Sciences, Università degli Studi di Torino, Orbassano, Piemonte, Italy
| | - Antonella Bena
- Documentation Centre for Health Promotion, ASL TO3, Grugliasco, Piemonte, Italy
| | - Fulvio Ricceri
- Centre for Biostatistics, Epidemiology, and Public Health (C-BEPH), Department of Clinical and Biological Sciences, Università degli Studi di Torino, Orbassano, Piemonte, Italy
| |
Collapse
|
45
|
Yang YW, Huang SC, Cheng HH, Chang SC, Jiang JK, Wang HS, Lin CC, Lin HH, Lan YT. Protective loop ileostomy or colostomy? a risk evaluation of all common complications. Ann Coloproctol 2023:ac.2022.00710.0101. [PMID: 36702474 DOI: 10.3393/ac.2022.00710.0101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 12/15/2022] [Indexed: 01/28/2023] Open
Abstract
Purpose Protective ileostomy and colostomy are performed in patients undergoing low anterior resection with a high leakage risk. We aimed to compare surgical, medical, and daily care complications between these 2 ostomies in order to make individual choice. Methods Patients who underwent low anterior resection for rectal tumors with protective stomas between January 2011 and September 2018 were enrolled. Stoma-related complications were prospectively recorded by wound, ostomy, and continence nurses. The cancer stage and treatment data were obtained from the Taiwan Cancer Database of our Big Data Center. Other demographic data were collected retrospectively from medical notes. The complications after stoma creation and after the stoma reversal were compared. Results There were 176 patients with protective colostomy and 234 with protective ileostomy. Protective ileostomy had higher proportions of high output from the stoma for 2 consecutive days than protective colostomy (11.1% vs. 0%, P<0.001). Protective colostomy resulted in more stoma retraction than protective ileostomy (21.6% vs. 9.4%, P=0.001). Female sex, open operation, ileostomy, and carrying stoma more than 4 months were also significantly associated with a higher risk of stoma-related complications during diversion. The incidence of complication after stoma reversal did not differ between colostomy group and ileostomy group (24.3% vs. 20.9%, P=0.542). Conclusion We suggest avoiding colostomy in patients who are female and potential prolong diversion when stoma retraction is a concern. Otherwise, ileostomy should be avoided for patients with impaired renal function. Wise selection and flexibility are more important than using one type of stoma routinely.
Collapse
Affiliation(s)
- Yi-Wen Yang
- Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Sheng-Chieh Huang
- Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hou-Hsuan Cheng
- Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shih-Ching Chang
- Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jeng-Kai Jiang
- Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Huann-Sheng Wang
- Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chun-Chi Lin
- Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hung-Hsin Lin
- Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yuan-Tzu Lan
- Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| |
Collapse
|
46
|
Rivera García S, Espejo Lunar EM, Rodríguez-Almagro J, Louzao Méndez S. Evaluation of Clinical Results regarding Peristomal Skin Health Associated with the Adjustment and Formulation of the New Moderma Flex One-Piece Ostomy Devices. J Pers Med 2023; 13:jpm13020219. [PMID: 36836453 PMCID: PMC9962063 DOI: 10.3390/jpm13020219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 01/28/2023] Open
Abstract
In order to determine the perception of ostomized patients about the performance and safety of the new one-piece device Moderma Flex, as well as the evolution of peristomal skin health after its use. The pre- and post-experimental multicenter study after the use of the Moderma Flex one-piece ostomy device on 306 ostomized people from 68 hospitals in Spain. We used a self-made questionnaire on the usefulness of different parts of the device and the perception of peristomal skin improvement. The sample was composed of 54.6% (167) men and had an average age of 64.5 years (standard deviation = 15.43). The type of device most commonly used according to its opening was closed by 45.1% (138). In addition, for the type of barrier, the most frequently used is the flat one; 47.7% (146) and 38.9% (119) used a model of soft convexity. A total of 48% scored with the highest assessment in the perception of skin improvement. The percentage of patients with peristomal skin problems decreased from 35.9% at the first visit to less than 8% after the use of Moderma Flex. Further, 92.4% (257) had no skin problems, the most frequent being erythema. The use of the Moderma Flex device seems to be related to a reduction in peristomal skin complications and a perception of improvement.
Collapse
|
47
|
Effect of Prehabilitation on Stoma Self-Care, Anxiety, Depression, and Quality of Life in Patients With Stomas: A Randomized Controlled Trial. Dis Colon Rectum 2023; 66:138-147. [PMID: 35195553 DOI: 10.1097/dcr.0000000000002275] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND An intestinal stoma has severe psychosocial effects on patients. OBJECTIVE This study aimed to measure the effects of prehabilitation on stoma self-care, quality of life, anxiety, and depression levels. DESIGN This study was a a randomized controlled trial. SETTINGS Patients were allocated into 3 groups according to enterostomal management: group A (stoma marking and postoperative education), group B (marking and pre- and postoperative education), and group C (prehabilitation group) (marking and preoperative education with introduction of the stoma appliance preoperatively and postoperative education). A stoma care follow-up form, the Hospital Anxiety and Depression Scale, and a stoma-specific quality-of-life questionnaire were used for evaluation. PATIENTS Patients who underwent colorectal surgery and fecal diversion at the Ankara University, Ankara, Turkey, between 2011 and 2016 were included. MAIN OUTCOME MEASURES The primary outcome was the effect of stoma prehabilitation on self-care ability. RESULTS Two hundred forty patients were included in the study. The outcome of stoma self-care revealed that 24 patients (31.2%) in group A, 51 patients (78.5%) in group B, and 72 patients (94.7%) in group C could perform stoma care independently ( p < 0.001). Among patients with temporary stomas, group C had a better outcome than patients in groups A and B ( p < 0.001). There was no similar relationship among patients with permanent stomas. The prehabilitation group had fewer patients with anxiety and depression than the other groups. Among patients with temporary stomas, similar findings were found. No differences were found in either anxiety or depression among patients with permanent stomas. Stoma quality-of-life scores were significantly higher in the prehabilitation group ( p < 0.001). Among patients with temporary stomas, similar findings were found. There was no difference among those with permanent stoma. LIMITATIONS This was a single-center study of heterogeneous groups. CONCLUSIONS Prehabilitation facilitates stoma self-care, decreases predisposition to anxiety and depression and improves quality of life in patients with stomas. See Video Abstract at http://links.lww.com/DCR/B918 . CLINICAL TRIAL REGISTRATION ClinicalTrials.gov NCT04692610. EFECTO DE LA PREHABILITACIN EN EL AUTOCUIDADO, LA ANSIEDAD, LA DEPRESIN Y LA CALIDAD DE VIDA EN PACIENTES OSTOMIZADOS ENSAYO CONTROLADO ALEATORIO ANTECEDENTES:Una estoma intestinal ejerce serios efectos psicosociales en los pacientes. La prehabilitación tiene el potencial de superar estos problemas.OBJETIVO:Este estudio tiene como objetivo medir los efectos de la prehabilitación en el autocuidado de la estoma, la calidad de vida, la ansiedad y los niveles de depresión.DISEÑO:Este estudio fue un ensayo aleatorio controlado ( ClinicalTrials.gov NCT04692610).AJUSTE:Los pacientes fueron distribuidos en 3 grupos según su manejo enterostomal: grupos A (marcación preoperatoria de la estoma, educación posoperatoria), B (marcación preoperatoria y educación preoperatoria y posoperatoria) y C (el grupo de pre habilitación con marcación preoperatoria y educación preoperatoria con introducción del paciente al aparato ostomal de manera preoperatoria y educación posoperatoria). Para la evaluación se utilizaron el formulario de seguimiento del cuidado de la estoma, la Escala Hospitalaria de Ansiedad y Depresión y un cuestionario específico de la estoma sobre la calidad de vida.PACIENTES:Se incluyeron pacientes que fueron sometidos a cirugía colorrectal y derivación fecal en la Universidad de Ankara entre 2011 y 2016.PRINCIPALES MEDIDAS DE RESULTADO:El resultado principal fue el efecto de la prehabilitación de la estoma sobre la capacidad de autocuidado.RESULTADOS:Se incluyeron en este estudio 240 pacientes. Autocuidado de la estoma: Veinticuatro (31,2%), 51 (78,5%), y 72 (94,7%) pacientes de los grupos A, B, y C, respectivamente, pudieron realizar el cuidado de la estoma de forma independiente ( p < 0,001). En el análisis de subgrupos, entre los pacientes con ostomía temporal, los pacientes del grupo de prehabilitación también fueron mejores que los pacientes de los grupos B y C ( p < 0,001); sin embargo, no hubo una relación similar entre los pacientes con ostomía permanente. HADS: El grupo de prehabilitación tuvo menos pacientes con ansiedad y depresión con respecto a los demás grupos. Entre los pacientes con estomas temporales, el grupo de prehabilitación también tuvo menos pacientes con ansiedad y depresión. No hubo diferencias con la ansiedad o depresión entre los pacientes con estomas permanentes. Estoma-QoL (calidad de vida): Las puntuaciones de QoL (calidad de vida) fueron significativamente más altas en el grupo de prehabilitación ( p < 0,001). Entre los pacientes con estoma temporal, el grupo de prehabilitación fue significativamente mejor que los otros grupos ( p < 0,001). No hubo diferencias entre los portadores de estoma permanente.LIMITACIONES:Este fue un estudio de un solo centro y grupos heterogéneos.CONCLUSIÓNES:La prehabilitación facilita el autocuidado de la estoma, disminuye la predisposición a la ansiedad y la depresión y mejora la calidad de vida de los pacientes con ostomía. Consulte Video Resumen en http://links.lww.com/DCR/B918 . (Traducción-Dr. Osvaldo Gauto )Registro de ensayos clínicos:ClinicalTrials.gov NCT04692610.
Collapse
|
48
|
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.
Collapse
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,
| |
Collapse
|
49
|
Bedell A, Friedlander A. Management of Sexual Dysfunction in Gastrointestinal Disorders. Gastroenterol Clin North Am 2022; 51:815-828. [PMID: 36375998 DOI: 10.1016/j.gtc.2022.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Patients with gastrointestinal (GI) disorders are at increased risk of sexual dysfunction (SD) due to a combination of biomedical, psychological, social, and interpersonal factors. While most patients desire information on the impact of their GI disorder on sexual function, few providers initiate this conversation. GI providers should routinely assess their patients for SD, validate these concerns, and provide brief education and a referral for evaluation and/or treatment. Treatment of sexual concerns is often multidisciplinary and may involve a sexual medicine physician, pelvic floor physical therapists, and sex therapists.
Collapse
Affiliation(s)
- Alyse Bedell
- Department of Psychiatry & Behavioral Neuroscience, The University of Chicago, 5841 South Maryland Avenue, MC 3077, Chicago, IL 60637, USA.
| | - Alana Friedlander
- Department of Psychiatry & Behavioral Neuroscience, The University of Chicago, 5841 South Maryland Avenue, MC 3077, Chicago, IL 60637, USA; Department of Psychology, Roosevelt University, 430 South Michigan Avenue, Chicago, IL 60605, USA
| |
Collapse
|
50
|
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.
Collapse
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
| |
Collapse
|