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Lv Q, Yuan Y, Xiang Z. Analysis of risk factors for the sigmoid stoma complications in patients after abdominoperineal resection surgery: An observational study. Medicine (Baltimore) 2024; 103:e38751. [PMID: 38941381 DOI: 10.1097/md.0000000000038751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/30/2024] Open
Abstract
To analyze the risk factors for intraperitoneal sigmoid stoma complications after abdominoperineal resection (APR) surgery to guide clinical practice. Patients who were diagnosed with rectal cancer and underwent APR surgery from June 2013 to June 2021 were retrospectively enrolled. The characteristics of the stoma complication group and the no stoma complication group were compared, and univariate and multivariate logistic analyses were employed to identify risk factors for sigmoid stoma-related complications. A total of 379 patients who were diagnosed with rectal cancer and underwent APR surgery were enrolled in this study. The average age of the patients was 61.7 ± 12.1 years, and 226 (59.6%) patients were males. Patients in the short-term stoma complication group were younger (55.7 vs 62.0, P < .05) and had a more advanced tumor stage (P < .05). However, there was no significant difference between the long-term stoma complication group and the no stoma complication group. Multivariate logistic regression analysis revealed that operation time was an independent risk factor (P < .05, OR = 1.005, 95% CI = 1.000-1.010) for short-term stoma complications. Both the short-term and long-term stoma complication rates in our institution were low. A longer operation time was an independent risk factor for short-term stoma complications after APR surgery.
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Affiliation(s)
- Quan Lv
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ye Yuan
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zheng Xiang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Department of General Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Aubert M, Buscail E, Duchalais E, Cazelles A, Collard M, Charleux-Muller D, Jeune F, Nuzzo A, Pellegrin A, Theuil L, Toutain A, Trilling B, Siproudhis L, Meurette G, Lefevre JH, Maggiori L, Mege D. Management of adult intestinal stomas: The 2023 French guidelines. J Visc Surg 2024; 161:106-128. [PMID: 38448363 DOI: 10.1016/j.jviscsurg.2024.02.002] [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: 03/08/2024]
Abstract
AIM Digestive stoma are frequently performed. The last French guidelines have been published twenty years ago. Our aim was to update French clinical practice guidelines for the perioperative management of digestive stoma and stoma-related complications. METHODS A systematic literature review of French and English articles published between January 2000 and May 2022 was performed. Only digestive stoma for fecal evacuation in adults were considered. Stoma in children, urinary stoma, digestive stoma for enteral nutrition, and rare stoma (Koch, perineal) were not included. RESULTS Guidelines include the surgical landmarks to create digestive stoma (ideal location, mucocutaneous anastomosis, utility of support rods, use of prophylactic mesh), the perioperative clinical practice guidelines (patient education, preoperative ostomy site marking, postoperative equipment, prescriptions, and follow-up), the management of early stoma-related complications (difficulties for nursing, high output, stoma necrosis, retraction, abscess and peristomal skin complications), and the management of late stoma-related complications (stoma prolapse, parastomal hernia, stoma stenosis, late stoma retraction). A level of evidence was assigned to each statement. CONCLUSION These guidelines will be very useful in clinical practice, and allow to delete some outdated dogma.
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Affiliation(s)
- Mathilde Aubert
- Department of Digestive Surgery, hôpital Timone, Aix Marseille University, AP-HM, Marseille, France
| | - Etienne Buscail
- Digestive Surgery Department, hôpital Rangueil, Toulouse, France
| | | | - Antoine Cazelles
- Digestive Surgery Department, hôpital européen Georges-Pompidou, AP-HP, Paris, France
| | - Maxime Collard
- Digestive Surgery Department, hôpital Saint-Antoine, AP-HP, Sorbonne université, 75012, Paris, France
| | | | - Florence Jeune
- Digestive Surgery Department, hôpital Saint-Louis, AP-HP, Paris, France
| | - Alexandre Nuzzo
- Digestive Surgery Department, hôpital Beaujon, AP-HP, Paris, France
| | | | | | - Amandine Toutain
- Digestive Surgery Department, hôpital Saint-Louis, AP-HP, Paris, France
| | | | | | | | - Jérémie H Lefevre
- Digestive Surgery Department, hôpital Saint-Antoine, AP-HP, Sorbonne université, 75012, Paris, France
| | - Léon Maggiori
- Digestive Surgery Department, hôpital Saint-Louis, AP-HP, Paris, France
| | - Diane Mege
- Department of Digestive Surgery, hôpital Timone, Aix Marseille University, AP-HM, Marseille, France.
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Oyania F, Kotagal M, Wesonga AS, Nimanya SA, Situma M. Pull-Through for Hirschsprung's Disease: Insights for Limited-Resource Settings From Mbarara. J Surg Res 2024; 293:217-222. [PMID: 37797389 DOI: 10.1016/j.jss.2023.09.014] [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: 06/13/2023] [Revised: 09/05/2023] [Accepted: 09/07/2023] [Indexed: 10/07/2023]
Abstract
INTRODUCTION In many resource-limited settings, patients with Hirschsprung's Disease (HD) undergo initial diverting colostomy, followed by pull-through, and finally, colostomy closure. This approach allows for decompression of dilated and thickened bowel and improved patient nutritional status. However, this three-stage approach prolongs treatment duration, with significant stoma morbidity, costs, and impact on quality of life. Our aim was to determine whether pull-through for HD can safely be performed with simultaneous stoma closure, reducing treatment approach from three to two stages. METHODS Children with HD and diverting colostomy were prospectively followed as they underwent pull-through with simultaneous stoma closure. Their in-hospital course and 3-mo outpatient course were assessed for postoperative complications. Patients with total colonic HD, redo pull-through, and residual dilated colon were excluded from the study. RESULTS Of the 20 children, 17 were male (n = 17, 85%). All patients had rectosigmoid HD. The median weight, age at colostomy formation, and age at pull-through were 11.05 kg (interquartile range [IQR] 10-12.75), 0.9 y (IQR 0.25-2.8), and 2.08 y (IQR 1.28-2.75), respectively. Mean duration with colostomy before pull-through was 1.1 y (standard deviation 1.51). Median hospital length of stay was 6 d (IQR 5-7). Early complications included anastomotic leak (n = 1), perianal skin excoriation (n = 2), surgical site skin infection (n = 3), and fascial dehiscence (n = 1). Longer-term complications included stricture (n = 1, 5%) and enterocolitis (n = 2, 10%). CONCLUSIONS In this small case series, we have demonstrated that pull-through with simultaneous stoma closure can be safely performed in resource-constrained settings. Further studies are needed to understand the quality of life and economic impact of this change in management for HD patients.
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Affiliation(s)
- Felix Oyania
- Mbarara University of Science and Technology, Uganda.
| | | | | | | | - Martin Situma
- Mbarara University of Science and Technology, Uganda
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Banasiewicz T, Kobiela J, Cwaliński J, Spychalski P, Przybylska P, Kornacka K, Bogdanowska-Charkiewicz D, Leyk-Kolańczak M, Borejsza-Wysocki M, Batycka-Stachnik D, Drwiła R. Recommendations on the use of prehabilitation, i.e. comprehensive preparation of the patient for surgery. POLISH JOURNAL OF SURGERY 2023; 95:62-91. [PMID: 38348849 DOI: 10.5604/01.3001.0053.8854] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
Prehabilitation is a comprehensive preparation of a patient for primarily surgical treatments. Its aim is to improve the patient'sgeneral condition so as to reduce the risk of complications and ensure the fastest possible recovery to full health. Thebasic components of prehabilitation include: improvement of nutritional status, appropriate exercises to improve functioning,psychological support, and help in eliminating addictions. Other important aspects of prehabilitation are: increasinghemoglobin levels in patients with anemia, achieving good glycemic control in patients with diabetes, treatment or stabilizationof any concurrent disorders, or specialist treatment associated with a specific procedure (endoprostheses, ostomyprocedure). This article organizes and outlines the indications for prehabilitation, its scope, duration, and the method to conductit. Experts of various specialties related to prehabilitation agree that it should be an element of surgery preparationwhenever possible, especially in patients with co-existing medical conditions who have been qualified for major procedures.Prehabilitation should be carried out by interdisciplinary teams, including family physicians and various specialists in thetreatment of comorbidities. Prehabilitation requires urgent systemic and reimbursement solutions.
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Affiliation(s)
- Tomasz Banasiewicz
- Klinika Chirurgii Ogólnej, Endokrynologicznej i Onkologii Gastroenterologicznej, Instytut Chirurgii, Uniwersytet Medyczny im K. Marcinkowskiego w Poznaniu
| | - Jarosław Kobiela
- Klinika Chirurgii Ogólnej, Endokrynologicznej i Transplantacyjnej, Gdański Uniwersytet Medyczny
| | - Jarosław Cwaliński
- Klinika Chirurgii Ogólnej, Endokrynologicznej i Onkologii Gastroenterologicznej, Instytut Chirurgii, Uniwersytet Medyczny im K. Marcinkowskiego w Poznaniu
| | - Piotr Spychalski
- Klinika Chirurgii Ogólnej, Endokrynologicznej i Transplantacyjnej, Gdański Uniwersytet Medyczny
| | - Patrycja Przybylska
- Klinika Chirurgii Ogólnej, Endokrynologicznej i Onkologii Gastroenterologicznej, Instytut Chirurgii, Uniwersytet Medyczny im K. Marcinkowskiego w Poznaniu
| | - Karolina Kornacka
- Oddział Chirurgii Ogólnej, Onkologicznej i Kolorektalnej, Wielospecjalistyczny Szpital Miejski im. J. Strusia, Poznań
| | | | - Magdalena Leyk-Kolańczak
- Zakład Pielęgniarstwa Chirurgicznego, Klinika Chirurgii Ogólnej, Endokrynologicznej i Transplantacyjnej, Gdański Uniwersytet Medyczny
| | - Maciej Borejsza-Wysocki
- Klinika Chirurgii Ogólnej, Endokrynologicznej i Onkologii Gastroenterologicznej, Instytut Chirurgii, Uniwersytet Medyczny im K. Marcinkowskiego w Poznaniu
| | - Dominika Batycka-Stachnik
- Oddział Kliniczny Chirurgii Serca, Naczyń i Transplantologii, Krakowski Szpital Specjalistyczny im. Św. Jana Pawła II, Kraków
| | - Rafał Drwiła
- Katedra i Zakład Anestezjologii i Intensywnej Terapii, Collegium Medicum Uniwersytet Jagielloński, Kraków
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Yeo H, Park H. Benefits of a Single-Session, In-Hospital Preoperative Education Program for Patients Undergoing Ostomy Surgery: A Randomized Controlled Trial. J Wound Ostomy Continence Nurs 2023; 50:313-318. [PMID: 37467410 DOI: 10.1097/won.0000000000000991] [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: 07/21/2023]
Abstract
PURPOSE The purpose of this study was to compare the effects of a 45-minute session of video-based preoperative ostomy education on self-care knowledge, self-care proficiency, anxiety, depression, length of hospital stay, and ostomy-related complications to a control group who received 3 postoperative educational sessions. DESIGN This was a randomized controlled trial. SAMPLE AND SETTING The sample comprised 47 patients scheduled to undergo ostomy surgery for colon or rectal cancer surgery at a tertiary referral hospital in Seoul, South Korea, from November 2018 to May 2019. However, 2 participants in the intervention group and 4 in the control group withdrew from the study and data analysis is based on 41 participants who completed study procedures. METHODS Participants were randomly allocated to an intervention group (n = 21) or a control group (n = 20). The intervention group received a single 45-minute session of video-based preoperative ostomy education along with stoma site marking and postoperative education. The control group underwent stoma site marking and 3 postoperative education sessions Self-care knowledge, anxiety, and depression were assessed by validated instruments. Self-care proficiency was assessed via direct observation using a checklist. Ostomy-related complications were evaluated by a WOC nurse. Length of hospital stay and disease-related characteristics were collected from medical records. RESULTS Compared with the control group, the intervention group showed significant improvements in self-care knowledge (P = .001) and self-care proficiency scores (P = .001). Intervention group participants also had lower anxiety scores (P = .025), depression scores (P = .014), shorter hospital stays (P = .008), and fewer ostomy-related complications (P = .001). CONCLUSIONS In patients undergoing ostomy surgery, a single 45-minute session of preoperative video-based ostomy education improved self-care knowledge and proficiency. This intervention also reduced depression, anxiety, and ostomy-related complications.
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Affiliation(s)
- Hyunjung Yeo
- Hyunjung Yeo, MSN, RN, CNS, WOC Nurse, Asan Medical Center, Seoul, Republic of Korea
- Hyojung Park, PhD, RN, Professor College of Nursing, Ewha Womans University, Seoul, Republic of Korea
| | - Hyojung Park
- Hyunjung Yeo, MSN, RN, CNS, WOC Nurse, Asan Medical Center, Seoul, Republic of Korea
- Hyojung Park, PhD, RN, Professor College of Nursing, Ewha Womans University, Seoul, Republic of Korea
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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]
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Irani JL, Hedrick TL, Miller TE, Lee L, Steinhagen E, Shogan BD, Goldberg JE, Feingold DL, Lightner AL, Paquette IM. Clinical Practice Guidelines for Enhanced Recovery After Colon and Rectal Surgery From the American Society of Colon and Rectal Surgeons and the Society of American Gastrointestinal and Endoscopic Surgeons. Dis Colon Rectum 2023; 66:15-40. [PMID: 36515513 PMCID: PMC9746347 DOI: 10.1097/dcr.0000000000002650] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Jennifer L. Irani
- Department of Surgery, Division of Colorectal Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Traci L. Hedrick
- Department of Surgery, University of Virginia Health System, Charlottesville, Virginia
| | - Timothy E. Miller
- Department of Anesthesiology, Duke University, Durham, North Carolina
| | - Lawrence Lee
- Department of Surgery, McGill University, Montreal, Quebec, Canada
| | - Emily Steinhagen
- Department of Surgery, University Hospital Cleveland Medical Center, Cleveland, Ohio
| | - Benjamin D. Shogan
- Department of Surgery, University of Chicago Pritzker School of Medicine, Chicago, Illinois
| | - Joel E. Goldberg
- Department of Surgery, Division of Colorectal Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Daniel L. Feingold
- Department of Surgery, Section of Colorectal Surgery, Rutgers University, New Brunswick, New Jersey
| | - Amy L. Lightner
- Department of Colorectal Surgery, Cleveland Clinic Foundation, Cleveland Clinic
| | - Ian M. Paquette
- Division of Colon and Rectal Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio
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Irani JL, Hedrick TL, Miller TE, Lee L, Steinhagen E, Shogan BD, Goldberg JE, Feingold DL, Lightner AL, Paquette IM. Clinical practice guidelines for enhanced recovery after colon and rectal surgery from the American Society of Colon and Rectal Surgeons and the Society of American Gastrointestinal and Endoscopic Surgeons. Surg Endosc 2023; 37:5-30. [PMID: 36515747 PMCID: PMC9839829 DOI: 10.1007/s00464-022-09758-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2022] [Indexed: 12/15/2022]
Abstract
The American Society of Colon and Rectal Surgeons (ASCRS) and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) are dedicated to ensuring high-quality innovative patient care for surgical patients by advancing the science, prevention, and management of disorders and diseases of the colon, rectum, and anus as well as minimally invasive surgery. The ASCRS and SAGES society members involved in the creation of these guidelines were chosen because they have demonstrated expertise in the specialty of colon and rectal surgery and enhanced recovery. This consensus document was created to lead international efforts in defining quality care for conditions related to the colon, rectum, and anus and develop clinical practice guidelines based on the best available evidence. While not proscriptive, these guidelines provide information on which decisions can be made and do not dictate a specific form of treatment. These guidelines are intended for the use of all practitioners, healthcare workers, and patients who desire information about the management of the conditions addressed by the topics covered in these guidelines. These guidelines should not be deemed inclusive of all proper methods of care nor exclusive of methods of care reasonably directed toward obtaining the same results. The ultimate judgment regarding the propriety of any specific procedure must be made by the physician in light of all the circumstances presented by the individual patient. This clinical practice guideline represents a collaborative effort between the American Society of Colon and Rectal Surgeons (ASCRS) and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) and was approved by both societies.
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Affiliation(s)
- Jennifer L Irani
- Department of Surgery, Division of Colorectal Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Traci L Hedrick
- Department of Surgery, University of Virginia Health System, Charlottesville, VA, USA
| | - Timothy E Miller
- Duke University Medical Center Library, Duke University School of Medicine, Durham, NC, USA
| | - Lawrence Lee
- Department of Surgery, McGill University, Montreal, QC, Canada
| | - Emily Steinhagen
- Department of Surgery, University Hospital Cleveland Medical Center, Cleveland, OH, USA
| | - Benjamin D Shogan
- Department of Surgery, University of Chicago Pritzker School of Medicine, Chicago, IL, USA
| | - Joel E Goldberg
- Department of Surgery, Division of Colorectal Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Daniel L Feingold
- Section of Colorectal Surgery, Rutgers University, New Brunswick, NJ, USA
| | - Amy L Lightner
- Department of Colorectal Surgery, Cleveland Clinic Foundation, Cleveland Clinic, Cleveland, USA
| | - Ian M Paquette
- Division of Colon and Rectal Surgery, University of Cincinnati College of Medicine Surgery (Colon and Rectal), 222 Piedmont #7000, Cincinnati, OH, 45219, USA.
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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.
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Nurse's Roles in Colorectal Cancer Prevention: A Narrative Review. JOURNAL OF PREVENTION (2022) 2022; 43:759-782. [PMID: 36001253 DOI: 10.1007/s10935-022-00694-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/21/2022] [Indexed: 02/07/2023]
Abstract
The objective of this paper is to investigate the different roles of nurses as members of healthcare teams at the primary, secondary, and tertiary levels of colorectal cancer prevention. The research team conducted a narrative review of studies involving the role of nurses at different levels of colorectal cancer prevention, which included a variety of quantitative, qualitative, and mixed-method studies. We searched PubMed, Scopus, Web of Science, Cochrane Reviews, Magiran, the Scientific Information Database (SID), Noormags, and the Islamic Science Citation (ISC) databases from ab initio until 2021. A total of 117 studies were reviewed. Nurses' roles were classified into three levels of prevention. At the primary level, the most important role related to educating people to prevent cancer and reduce risk factors. At the secondary level, the roles consisted of genetic counseling, stool testing, sigmoidoscopy and colonoscopy, biopsy and screening test follow-ups, and chemotherapy intervention, while at the tertiary level, their roles were made up of pre-and post-operative care to prevent further complications, rehabilitation, and palliative care. Nurses at various levels of prevention care also act as educators, coordinators, performers of screening tests, follow-up, and provision of palliative and end-of-life care. If these roles are not fulfilled at some levels of colorectal cancer, it is generally due to the lack of knowledge and competence of nurses or the lack of instruction and legal support for them. Nurses need sufficient clinical knowledge and experience to perform these roles at all levels.
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Kato I, Siegmund LA. Empowering New Ostomy Patients Through a Novel Inpatient Group Education Class: A Quality Improvement Project. J Wound Ostomy Continence Nurs 2022; 49:347-351. [PMID: 35809010 DOI: 10.1097/won.0000000000000887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE A quality improvement project was undertaken that evaluated the results of a group inpatient ostomy education class designed to reinforce information provided by the WOC nurse. A secondary goal was to provide emotional support during the immediate postoperative period following ostomy surgery. PARTICIPANTS AND SETTING Participants were inpatients undergoing fecal ostomies (ileostomies, jejunostomies, or colostomies) and their families. This project took place in an inpatient colorectal unit at the project hospital in Northeast, Ohio. APPROACH The Plan, Do, Check, Act process was used to guide the quality improvement. Using feedback from postoperative patients, a multidisciplinary team designed an inpatient group ostomy class with education targeting patient-identified needs. Educational content was created with feedback from postoperative patients. The 1-hour class was offered twice weekly and was facilitated by a dietician, a pharmacist, and an RN. Content included general postoperative discharge information, appliance self-care, nutrition guidelines, medications, and resources for support. OUTCOMES From 2016 to 2019, more than 1500 patients and family members participated in the educational offerings. During this time, length of hospital stay for ostomy patients decreased from 7.299 to 5.938 days. Readmission rates for patients undergoing fecal ostomies declined from 12.9% to a postclass rate of 11.2%. Written/verbal feedback from class attendees, physicians, and nurses was positive. IMPLICATIONS FOR PRACTICE Project outcomes validated the need for a structured, ongoing inpatient, postoperative, group education for ostomy patients during the immediate postoperative period. Next steps will be to resume the class as it was paused due to COVID-19 restrictions, to continue to revise content, and to implement supplementary materials such as DVDs and online resources.
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Affiliation(s)
- Irene Kato
- Irene Kato, BSN, RN, CMSRN, Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio
- Lee Anne Siegmund, PhD, RN, Office of Nursing Research and Innovation, Cleveland Clinic, Cleveland, Ohio
| | - Lee Anne Siegmund
- Irene Kato, BSN, RN, CMSRN, Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio
- Lee Anne Siegmund, PhD, RN, Office of Nursing Research and Innovation, Cleveland Clinic, Cleveland, Ohio
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Impact of Definitive Chemoradiation on Quality-of-Life Changes for Patients With Anal Cancer: Long-term Results of a Prospective Study. Dis Colon Rectum 2022; 65:642-653. [PMID: 35067501 DOI: 10.1097/dcr.0000000000002385] [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: 02/08/2023]
Abstract
BACKGROUND Maintaining and improving quality of life (QOL) are important goals of anal cancer management. This disease is generally curable, with many long-term survivors. OBJECTIVE Long-term QOL after chemoradiation for patients with anal cancer was evaluated. DESIGN This was a prospective cohort study. SETTINGS This study used data from a prospective study of patients with anal cancer who were treated with chemoradiation between 2008 and 2013. PATIENTS Patients with anal cancer who were treated with image-guided intensity-modulated radiation therapy were included. INTERVENTIONS English-speaking patients completed European Organization for Research and Treatment of Cancer cancer-specific (C30) and site-specific (CR29) QOL questionnaires at baseline, at end of radiation, at 3 and 6 months, and then annually. MAIN OUTCOMES MEASURES Long-term QOL was evaluated clinically (a change in score of ≥10 points was considered clinically significant) and statistically (using repeated-measurement analysis) by comparing the subscale scores at 1, 2, and 3 years with baseline scores. Subanalysis compared patients who received a radiation dose of 45 to 54 Gy versus 63 Gy. RESULTS Ninety-six patients were included (median follow-up of 56.5 months). The symptom and functional scales showed a clinically significant decline at the end of treatment with improvement by 3 months after treatment. There was a long-term statistically significant decline in dyspnea, body image, bowel embarrassment, fecal incontinence, and hair loss, and there was long-term statistically and clinically significant worsening of impotence. Higher radiation dose (63 Gy) was not associated with significantly worse QOL. LIMITATIONS Limitations included single-institution, single-arm study design, and lack of dose reconstruction (ie, analyses were based on prescribed, rather than delivered, dose). CONCLUSIONS Patients with anal cancer treated with chemoradiation reported recovery of overall QOL to baseline levels. Specific symptoms remained bothersome, emphasizing the need to address and manage the chemoradiation-induced symptoms, during treatment and in the long term. See Video Abstract at http://links.lww.com/DCR/B905. IMPACTO DE LA QUIMIORRADIACIN DEFINITIVA EN CAMBIOS EN LA CALIDAD DE VIDA DE LOS PACIENTES CON CNCER ANAL RESULTADOS A LARGO PLAZO DE UN ESTUDIO PROSPECTIVE ANTECEDENTES:Mantener y mejorar la calidad de vida son objetivos importantes del tratamiento del cáncer anal, ya que esta enfermedad generalmente es curable, con muchos sobrevivientes a largo plazo.OBJETIVO:Se evaluó la calidad de vida a largo plazo después de la quimiorradiación en pacientes con cáncer anal.DISEÑO:Este fue un estudio de cohorte prospectivo.ENTORNO CLINICO:Utilizamos datos de un estudio prospectivo en pacientes con cáncer anal tratados con quimiorradiación entre 2008-2013.PACIENTES:Los pacientes con cáncer anal fueron tratados con radioterapia de intensidad modulada guiada por imágenes.INTERVENCIONES:Los pacientes de habla inglesa completaron los cuestionarios de calidad de vida específicos de cáncer (C30) y específicos del sitio (CR29) de la Organización Europea para la Investigación y el Tratamiento del Cáncer al inicio, al final de la radiación, 3 y 6 meses, y luego anualmente.PRINCIPALES MEDIDAS DE RESULTADOS:Se evaluó a largo plazo la calidad de vida clínicamente (un cambio en la puntuación de ≥10 puntos se consideraron clínicamente significativo) y estadísticamente (usando análisis de medición repetida) comparando las subescalas de puntuación al 1, 2, y 3 años. Con puntuaciones de referencia. El subanálisis comparó pacientes que recibieron 45-54 Gy versus 63 Gy.RESULTADOS:Se incluyeron un total de 96 pacientes (mediana de seguimiento: 56,5 meses). La mayoría de las escalas funcionales y de síntomas mostraron una disminución clínicamente significativa al final del tratamiento con una mejoría a los 3 meses posteriores al tratamiento. Hubo una disminución estadísticamente significativa a largo plazo en disnea, imagen corporal, vergüenza intestinal, incontinencia fecal y pérdida de cabello; y hubo un empeoramiento a largo plazo estadística y clínicamente significativo en impotencia. La dosis de radiación más alta (63 Gy) no se asoció con una calidad de vida significativamente peor.LIMITACIONES:Institución única, diseño de estudio de un solo brazo y falta de recomposición de la dosis (es decir, los análisis se basan en la dosis prescrita, en lugar de la administrada).CONCLUSIÓNES:Los pacientes con cáncer anal tratados con quimiorradiación reportaron una recuperación de la QOL en general a los niveles de base. Síntomas específicos siguieron siendo molestos, lo que enfatiza la necesidad de resolver y tartar los síntomas inducidos por la quimiorradiación no solo durante el tratamiento, sino a largo plazo. Consulte Video Resumen en http://links.lww.com/DCR/B905. (Traducción- Dr. Francisco M. Abarca-Rendon).
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Azer SA, AlKhawajah NM, Alshamlan YA. Critical evaluation of YouTube videos on colostomy and ileostomy: Can these videos be used as learning resources? PATIENT EDUCATION AND COUNSELING 2022; 105:383-389. [PMID: 34045092 DOI: 10.1016/j.pec.2021.05.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 03/28/2021] [Accepted: 05/14/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES We aimed at identifying and analyzing the accuracy of YouTube videos on colostomy and ileostomy. METHODS YouTube website was searched independently by researchers for videos on colostomy and ileostomy posted before the 18th of May, 2019. Based on predetermined inclusion and exclusion criteria, the videos matching the research objective were identified. Data related to each video were collected, and the videos were categorized using standardized criteria. RESULTS A total of 357 videos were identified. Finally, 149 videos were included in the study. Of these, 52 (35%) were educationally useful, and 97 (65%) were not useful. None of the video parameters, including the number of viewers, duration, number of likes or dislikes, days on YouTube or number of comments, was able to differentiate between useful or not useful videos. The score of videos was 14.7 ± 0.6 for valuable videos and 11.0 ± 2.0 for not useful videos (p < 0.001). CONCLUSIONS While there were a reasonably number of colostomy and ileostomy videos, there was a smaller number on the surgical procedure. Most non-educational videos were not consistent with clinical guidelines. PRACTICAL IMPLICATIONS YouTube videos on colostomy/ileostomy care can be an important educational resource to patients. However, a collaboration between patients, nurse educators and universities/hospitals is needed to produce high-quality videos.
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Affiliation(s)
- Samy A Azer
- Department of Medical Education, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Nour M AlKhawajah
- Department of Medical Education, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Yafa A Alshamlan
- Department of Medical Education, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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de Queiroz FL, Lacerda-Filho A, Alves AC, de Oliveira FH, Neto PRF, de Almeida Paiva R. Conditions associated with worse acceptance of a simplified accelerated recovery after surgery protocol in laparoscopic colorectal surgery. BMC Surg 2021; 21:229. [PMID: 33941146 PMCID: PMC8091501 DOI: 10.1186/s12893-021-01206-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 04/14/2021] [Indexed: 11/15/2022] Open
Abstract
Background Enhanced Recovery Surgical Programs were initially applied to colorectal procedures and used as multimodal approach to relieve the response to surgical stress. An important factor that negatively impacts the success of these programs is the poor tolerance of these patients to certain items in the adopted protocol, especially with regard to post-operative measures. The identification of these factors may help to increase the success rate of such programs, ensuring that benefits reach a greater number of patients and that resources are better allocated. Thus, the aims of this study were to assess the results of the implementation of a Simplified Accelerated Recovery Protocol (SARP) and to identify possible factors associated with failure to implement postoperative protocol measures in patients submitted to laparoscopic colorectal surgery. Methods 161 patients were randomly divided into two groups. The SARP group (n = 84) was submitted to the accelerated recovery program and the CC group (n = 77), to conventional postoperative care. The SARP group was further divided into two subgroups: patients who tolerated the protocol (n = 51) and those who did not (n = 33), in order to analyze factors contributing to protocol nontolerance. Results The groups had similar sociodemographic and clinical characteristics. The SARP group had a shorter hospital stay, better elimination of flatus, was able to walk and to tolerate a diet sooner (p < 0.0001). Complications rates and readmissions to emergency room were similar between groups. Multivariate analysis revealed that prolonged operating time, stoma creation and rates of surgical complications were independently associated with poor adherence to SARP (p < 0.0001). Conclusions The use of our SARP resulted in improved recovery from laparoscopic colorectal surgery and proved to be safe for patients. Extensive surgeries, occurrence of complications, and the need for ostomy were variables associated with poor program adhesion. Trial registration Trial Registry: RBR2b4fyr—Date of registration: 03 October 2017.
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Affiliation(s)
- Fábio Lopes de Queiroz
- Colorectal Surgery Department, Hospital Felicio Rocho, Rua Felipe Dos Santos, 760, 501-3, Belo Horizonte, Minas Gerais, CEP 30180160, Brazil.
| | - Antonio Lacerda-Filho
- Department of Surgery at the School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Adriana Cherem Alves
- School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.,Semper Hospital- Belo Horizonte, Belo Horizonte, Brazil
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Petersén C, Carlsson E. Life with a stoma-coping with daily life: Experiences from focus group interviews. J Clin Nurs 2021; 30:2309-2319. [PMID: 33829581 DOI: 10.1111/jocn.15769] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/23/2021] [Accepted: 03/04/2021] [Indexed: 12/25/2022]
Abstract
AIMS AND OBJECTIVES To describe patients' experiences of coping with daily life practically and emotionally during the first years after stoma surgery. BACKGROUND For people with a stoma, a new life awaits with altered bowel function and body image. This means a profound change in a person's life. DESIGN A qualitative descriptive design using focus group interviews to gain an understanding of patients' experiences of coping with daily life. This study followed the COREQ checklist for reporting qualitative research. METHOD Six focus groups including 21 patients with a stoma experience of 1-3 years. Mean age was 65 (23-79) and comprised 9 men and 12 women. Thirteen participants had a colostomy, 8 had an ileostomy. The interviews were analysed with a qualitative content analysis. RESULTS Patients lived with uncertainty due to lost control over bowel function and did not feel comfortable with the new body. They had adjusted to the new life with a positive impact, by changing their attitude, enabling a social- and working life and tried to take control over the situation. Patients with a temporary stoma put life on hold. CONCLUSION Patients with a stoma lived with uncertainty, not trusting their body like before. They strived to regain control of their lives according to their own resources and conditions and with support from healthcare professionals. Interacting with others in similar situations and exchanging experiences, in demanding areas such as body image, sexuality and social activities could support patients in coping with their new life with a stoma. RELEVANCE TO CLINICAL PRACTICE The findings can help stoma care nurses and healthcare professionals plan themed lectures and group discussions for patients regarding coping with areas that are especially demanding. A themed evening would give patients the chance to share and exchange experiences and receive affirmation from others in the same situation.
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Affiliation(s)
- Charlotta Petersén
- Surgical Department, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.,Institute of Health and Care sciences, the Sahlgrenska Academy Gothenburg University, Gothenburg, Sweden
| | - Eva Carlsson
- Surgical Department, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.,Institute of Health and Care sciences, the Sahlgrenska Academy Gothenburg University, Gothenburg, Sweden.,Gothenburg Centre for personcentred care, the Sahlgrenska Academy Gothenburg University, Gothenburg, Sweden
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Ssewanyana Y, Ssekitooleko B, Suuna B, Bua E, Wadeya J, Makumbi TK, Ocen W, Omona K. Quality of life of adult individuals with intestinal stomas in Uganda: a cross sectional study. Afr Health Sci 2021; 21:427-436. [PMID: 34394325 PMCID: PMC8356576 DOI: 10.4314/ahs.v21i1.53] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Introduction Intestinal stomas remain important life-saving surgical options in a wide range of gastrointestinal pathologies globally. Living with a stoma has potential to impair the patient's quality of life, often with associated negative psychological effects. Objective To evaluate the quality of life among intestinal stoma patients under Mulago National Referral Hospital (MNRH), with emphasis on psychological effects and effects on family-social interactions. Methodology A cross-sectional study carried out at surgical outpatient clinics of MNRH between January and June 2018. Data was collected using Stoma-QOL questionnaire, PHQ-9 and GAD-7 from 51 participants who had lived with intestinal stomas for at least a month. Results Of the 51 participants, male: female ratio was 4:1 and aged 18–84 years (mean age 44.04+18.47 years). 76.5% had colostomy; 23.5% had ileostomy. Majority (88.2%) had temporary stomas. The overall mean Stoma-QOL score was 55.12+ 17.04. Only about a quarter (24%) of participants had Stoma-QOL scores >70 (best). Most patients exhibited negative psychological effects (anxiety-100%, concerns about changed body image - 96.1% and depression - 88.4%). Conclusion Most participants had low levels of stoma-related quality of life, suffered negative psychological effects and exhibited limited social interactions. This calls for efforts to support Stoma patients adapt beter life.
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Affiliation(s)
- Yasin Ssewanyana
- Department of Surgery, College of Health Sciences, Makerere University, Kampala, Uganda. Tel; +256774988991
| | - Badru Ssekitooleko
- Department of Surgery, Mulago National Referral and Teaching Hospital, Kampala, Uganda
| | - Bashir Suuna
- Department of Surgery, College of Health Sciences, Makerere University, Kampala, Uganda. Tel; +256774988991
| | - Emmanuel Bua
- Department of Surgery, College of Health Sciences, Makerere University, Kampala, Uganda. Tel; +256774988991
| | - Joseph Wadeya
- Department of Surgery, College of Health Sciences, Makerere University, Kampala, Uganda. Tel; +256774988991
| | - Timothy K Makumbi
- Department of Surgery, College of Health Sciences, Makerere University, Kampala, Uganda. Tel; +256774988991
- Department of Surgery, Mulago National Referral and Teaching Hospital, Kampala, Uganda
| | - William Ocen
- Department of Surgery, Mulago National Referral and Teaching Hospital, Kampala, Uganda
| | - Kizito Omona
- Faculty of Health Sciences, Uganda Martyrs University. , Tel: +256706464873
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Zhang X, Lin JL, Gao R, Chen N, Huang GF, Wang L, Gao H, Zhuo HZ, Chen LQ, Chen XH, Li H. Application of the hospital-family holistic care model in caregivers of patients with permanent enterostomy: A randomized controlled trial. J Adv Nurs 2021; 77:2033-2049. [PMID: 33523488 DOI: 10.1111/jan.14691] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 09/07/2020] [Accepted: 10/05/2020] [Indexed: 12/24/2022]
Abstract
AIMS To evaluate the effectiveness of the hospital-family holistic care model based on the theory of 'Timing It Right' in caregivers of patients with permanent enterostomy. DESIGN A prospective randomized controlled trial. METHODS One hundred and twenty-five caregivers of patients with permanent enterostomy were recruited from 1 May 2017-31 August 2019. They were randomized into either intervention group (N = 62) or control group (N = 63). The control group received routine care and follow-up, while the intervention group received routine care, follow-up, and hospital-family holistic care intervention based on 'Timing It Right'. The care ability, psychological distress, and life quality of the caregivers were evaluated between the groups before the intervention, at discharge, and 3 and 6 months after discharge. RESULTS One hundred and eleven caregivers completed the study (88.8%). At 3 and 6 months after discharge, the care ability and life quality in the intervention group were significantly better than those in the control group (t = 8.506/9.783, t = 22.652/26.179, p < 0.05) based on the t tests, and the psychological distress was lower than that in the control group. The ostomy adaptability of the control group was significantly lower than that in the intervention group (p < 0.001) based on the t tests, and the χ2 test showed that ostomy complication was more than that in the intervention group (23.81% vs. 12.90% and 34.92% vs. 19.35%; p < 0.05) at 3 and 6 months after discharge. The interaction between time and group showed that the effect of time factor varied with the group and the four evaluation indexes in the intervention group gradually improved with the extension of the observation time and were better than those in the control group based on generalized estimating equation model. CONCLUSION The hospital-family holistic care model based on 'Timing It Right' can effectively improve the care ability of caregivers of patients with permanent enterostomy, reduce psychological distress, and improve the quality of life. IMPACT The caregivers of patients with permanent enterostomy showed dynamic changes in their care experience and needs at different stages of the disease. The hospital-family holistic care intervention strategy based on 'Timing It Right' can effectively improve the caregiver's care ability, alleviate psychological distress, and improve the quality of life. Additionally, improving the patients' stoma adaptability and reducing the incidence of complications related to ostomy.
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Affiliation(s)
- Xi Zhang
- Department of Gastroenterology, Fujian Provincial Hospital, Fujian Medical University Affiliated Clinical Provincial Medical Institute, Fuzhou, Fujian Province, China
| | - Jin Ling Lin
- Nursing School of Fujian Medical University, Fuzhou, Fujian Province, China
| | - Rui Gao
- Department of Pathology, Fujian Provincial Hospital, Fujian Medical University Affiliated Clinical Provincial Medical Institute, Fuzhou, Fujian Province, China
| | - Ning Chen
- Department of Nursing, Fujian Provincial Hospital, Fujian Medical University Affiliated Clinical Provincial Medical Institute, Fuzhou, Fujian Province, China
| | - Gui Fang Huang
- Department of Gastroenterology, Fujian Provincial Hospital, Fujian Medical University Affiliated Clinical Provincial Medical Institute, Fuzhou, Fujian Province, China
| | - Long Wang
- Department of Gastroenterology, Fujian Provincial Hospital, Fujian Medical University Affiliated Clinical Provincial Medical Institute, Fuzhou, Fujian Province, China
| | - Hong Gao
- Department of Gastroenterology, Fujian Provincial Hospital, Fujian Medical University Affiliated Clinical Provincial Medical Institute, Fuzhou, Fujian Province, China
| | - Hui Zhen Zhuo
- Department of Gastroenterology, Fujian Provincial Hospital, Fujian Medical University Affiliated Clinical Provincial Medical Institute, Fuzhou, Fujian Province, China
| | - Li Qi Chen
- Department of Gastroenterology, Fujian Provincial Hospital, Fujian Medical University Affiliated Clinical Provincial Medical Institute, Fuzhou, Fujian Province, China
| | - Xiao Huan Chen
- Department of Nursing, Fujian Provincial Hospital, Fujian Medical University Affiliated Clinical Provincial Medical Institute, Fuzhou, Fujian Province, China
| | - Hong Li
- Nursing School of Fujian Medical University, Fuzhou, Fujian Province, China.,Department of Nursing, Fujian Provincial Hospital, Fujian Medical University Affiliated Clinical Provincial Medical Institute, Fuzhou, Fujian Province, China
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The Lived Experiences of Persons With Ostomies Attending a Support Group: A Qualitative Study. J Wound Ostomy Continence Nurs 2020; 47:489-495. [PMID: 32925590 DOI: 10.1097/won.0000000000000696] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to describe the lived experiences of patients with ostomies participating in a support group. DESIGN Qualitative, descriptive, phenomenological study. SUBJECT AND SETTING Fifteen adults with different types of ostomies were recruited from support groups in the state of Georgia. METHODS Semistructured interviews were digitally audio-recorded and transcribed verbatim. Analyses of data were performed using Parse's 5-step thematic analysis. RESULTS Four major themes and 10 subthemes emerged from the interviews: (1) theme 1-support group gives hope and changes lives, with 2 subthemes of increased knowledge and provided new knowledge and allows open communication; (2) theme 2-changes in body image had 2 subthemes, some things are different and everyone is the same; (3) theme 3-I am not alone resulted in 4 subthemes of feeling of belonging, willingness to be helped, being supported, and developing lifelong relationships; and (4) theme 4-being independent manifested 2 subthemes including confidence in rejoining society, and building confidence and decreased shame. CONCLUSION We found that participation in an ostomy support group allowed individuals with ostomies to function at more advanced levels than they were before participating in the support group. The lived experiences were characterized by hope, willingness to live fully again, participating in different activities, and making new friends. Participants shared their positive experiences with others who were experiencing the same problems they once experienced. These findings add to and support the body of knowledge related to the interactions between nurses and individuals with ostomies as well as the care needed to ensure a safe discharge from the acute care facility. New knowledge gained may help in the improvement of the education provided during hospitalization. Providing this information will equip patients and families with a better understanding of and methods to care for their new ostomies and develop an acceptance of their new health status.
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Boutry E, Bertrand MM, Ripoche J, Alonso S, Bastide S, Prudhomme M. Quality of life in colostomy patients practicing colonic irrigation: An observational study. J Visc Surg 2020; 158:4-10. [PMID: 32782085 DOI: 10.1016/j.jviscsurg.2020.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS OF THE STUDY The presence of colostomy has a major impact on quality of life that could potentially be improved by performing colonic irrigation (CI), yet few studies have assessed the impact of this technique on quality of life. The aim of this study was to assess the quality of life between two groups of patients having a colostomy; those practicing CI vs those not practicing CI. PATIENTS AND METHODS The French Federation of Ostomy (FFO) members were evaluated by a self-questionnaire assessing their experience of CI. Quality of life as assessed by the Stoma-QOL questionnaire was compared between patients practicing CI or not. RESULTS In total 752 patients were eligible for the study. The median age was 75 years, and 47.26% were men. The median duration between stoma surgery and questionnaire completion was 12.3 years. Forty-one percent of the patients practiced CI. The median quality of life score was significantly higher for the patients practicing the CI: (69.26 vs 58.33, P<0.001). In multivariable analysis, the risk factors for not performing CI were age, obesity, the presence of colostomy for less than six years, and a non-oncologic indication for operation. CONCLUSIONS CI appeared to improve the quality of life of patients with colostomy. This care is a therapeutic education issue and should be proposed to all patients. Supervision by the enterostomal therapy nurse is recommended especially for patients with a high risk of failure.
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Affiliation(s)
- E Boutry
- Department of Digestive Cancer and Surgery Nîmes University Hospital, CHU de Nîmes, place du Professeur-Debré, 30029 Nîmes cedex 09, France
| | - M M Bertrand
- Department of Digestive Cancer and Surgery Nîmes University Hospital, CHU de Nîmes, place du Professeur-Debré, 30029 Nîmes cedex 09, France
| | - J Ripoche
- Department of Digestive Cancer and Surgery Nîmes University Hospital, CHU de Nîmes, place du Professeur-Debré, 30029 Nîmes cedex 09, France
| | - S Alonso
- Department of Biostatistics, Epidemiology, Public Health and Innovation in Methodology (BESPIM), Nîmes University Hospital, 30029 Nîmes, France
| | - S Bastide
- Department of Biostatistics, Epidemiology, Public Health and Innovation in Methodology (BESPIM), Nîmes University Hospital, 30029 Nîmes, France
| | - M Prudhomme
- Department of Digestive Cancer and Surgery Nîmes University Hospital, CHU de Nîmes, place du Professeur-Debré, 30029 Nîmes cedex 09, France.
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- Nîmes University Hospital, 30029 Nîmes, France
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Karaçay P, Toğluk Yigitoglu E, Karadağ A. The validity and reliability of the Stoma Self-Efficacy Scale: A methodological study. Int J Nurs Pract 2020; 26:e12840. [PMID: 32301580 DOI: 10.1111/ijn.12840] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 03/10/2020] [Accepted: 03/25/2020] [Indexed: 11/28/2022]
Abstract
AIMS To assess the validity and reliability of the stoma self-efficacy scale for Turkish-speaking individuals with stoma. BACKGROUND Self-efficacy in stoma care is one of the most important variables requiring compliance for an increase in the quality of life and well-being of individuals with stoma. DESIGN A methodological study. METHODS This study used translation and back translation for the scale's language equivalence and expert opinion for the content validity. An expert panel and 10 individuals with stoma evaluated the scale for face validity. The scale's reliability was assessed by internal consistency, Pearson correlation, and test-retest reliability in a sample of 174 individuals with stomas. The scale's construct validity was tested with confirmatory factor analysis and exploratory factor analysis. RESULTS The content validity index was .96, and Cronbach's alpha was .95. In the test-retest analysis, the intraclass correlation coefficients were high. In the factor analysis, two factors emerged from the scale, and after the confirmatory factor analysis and scale modification, the fit indices of the model were found to provide a good level of validity. CONCLUSION The Turkish version of the stoma self-efficacy scale is a valid and reliable tool to determine the levels of self-efficacy in individuals with stoma.
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Affiliation(s)
| | - Eylem Toğluk Yigitoglu
- Stoma Therapy Unit, Istanbul University Cerrahpaşa Medical Faculty Hospital, Istanbul, Turkey
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Italian guidelines for the surgical management of enteral stomas in adults. Tech Coloproctol 2019; 23:1037-1056. [DOI: 10.1007/s10151-019-02099-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 09/23/2019] [Indexed: 12/14/2022]
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Beeken RJ, Haviland JS, Taylor C, Campbell A, Fisher A, Grimmett C, Ozakinci G, Slater S, Wilson I, Hubbard G. Smoking, alcohol consumption, diet and physical activity following stoma formation surgery, stoma-related concerns, and desire for lifestyle advice: a United Kingdom survey. BMC Public Health 2019; 19:574. [PMID: 31092219 PMCID: PMC6518630 DOI: 10.1186/s12889-019-6913-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 04/29/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Adherence to smoking, alcohol consumption, diet and physical activity (PA) guidelines may improve outcomes for people with a stoma. A better understanding of these behaviours following stoma formation surgery and their experiences and attitudes towards receiving lifestyle advice, could help identify specific gaps and inform interventions going forward. The aim of this study was to describe changes in current lifestyle following stoma formation and to explore concerns, desire for lifestyle information, advice and support among people who have or have had a stoma. METHODS A sample of adults who currently had or in the past had a stoma for treatment for any medical condition was recruited online through relevant charities and companies, and invited to complete a cross-sectional, online survey. Consenting participants (n = 425) provided demographic information and completed brief, validated questionnaires about their lifestyle, alongside questions around their concerns regarding permanent stoma and experiences of lifestyle information and advice. Responses were summarised using descriptive statistics, and associations between reported concerns about stoma and changes in health behaviours were explored. RESULTS Most respondents (93%) still had a stoma at the time of completing the survey. The majority (80%) had not consumed at least 5 portions of fruit and vegetables on the previous day and 20% reported they had not participated in at least 30 min of physical activity on any day in the previous week. Most respondents were non-smokers (84%) and did not exceed recommendations for alcohol intake (60%). Most (56%) felt their PA had decreased following stoma formation. Frequencies of concerns about a permanent stoma were high, and appeared to be associated with reported decreases in PA. Of those reporting nausea, 40% felt their diet had worsened since having their stoma. A large proportion of respondents had not received PA (42%) or dietary (30%) advice, and of these > 90% would have liked guidance. CONCLUSIONS Few respondents to this survey were eating the recommended amount of fruit and vegetables, and most reported a decrease in their PA following stoma surgery. Lifestyle advice would be welcomed by this population, which professionals should take into account when addressing stoma- related concerns.
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Affiliation(s)
| | - Joanne S. Haviland
- Institute of Cancer Research Clinical Trials and Statistics Unit, Division of Clinical Studies, The Institute of Cancer Research, London, UK
| | - Claire Taylor
- St Mark’s Hospital, London North West NHS Healthcare, Harrow, UK
| | | | - Abigail Fisher
- Research Department of Behavioural Science and Health, University College London, London, UK
| | | | - Gozde Ozakinci
- School of Medicine, University of St Andrews, St Andrews, Scotland, UK
| | - Sarah Slater
- Beatson West of Scotland Cancer Centre, Glasgow, Scotland, UK
| | - Iseult Wilson
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, UK
| | - Gill Hubbard
- Department of Nursing, University of the Highlands and Islands, Inverness, UK
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Acevedo‐Ibarra JN, Juárez‐García DM, Espinoza‐Velazco A, Buenaventura‐Cisneros S. Cognitive Behavioral Stress Management intervention in Mexican colorectal cancer patients: Pilot study. Psychooncology 2019; 28:1445-1452. [DOI: 10.1002/pon.5094] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 04/06/2019] [Accepted: 04/08/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Jessica Noemí Acevedo‐Ibarra
- Universidad Autónoma de Nuevo León, Faculty of Psychology Monterrey México
- UMAE Hospital de Especialidades No. 25Centro Médico Nacional del Noreste, Instituto Mexicano del Seguro Social, Department of Oncology Monterrey México
| | | | - Absalón Espinoza‐Velazco
- UMAE Hospital de Especialidades No. 25Centro Médico Nacional del Noreste, Instituto Mexicano del Seguro Social, Department of Oncology Monterrey México
| | - Sergio Buenaventura‐Cisneros
- UMAE Hospital de Especialidades No. 25Centro Médico Nacional del Noreste, Instituto Mexicano del Seguro Social, Department of Oncology Monterrey México
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Elhassan A, Elhassan I, Elhassan A, Sekar KD, Rubin RE, Urman RD, Cornett EM, Kaye AD. Essential Elements for Enhanced Recovery After Intra-abdominal Surgery. Curr Pain Headache Rep 2019; 23:21. [DOI: 10.1007/s11916-019-0753-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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The Effects of Patient Care Results of Applied Nursing Intervention to Individuals With Stoma According to the Health Belief Model. Cancer Nurs 2018; 43:E87-E96. [PMID: 30543570 DOI: 10.1097/ncc.0000000000000678] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Individuals who have undergone stoma surgery take time to adjust to the stoma, and their quality of life is decreasing. OBJECTIVE The aim of this study was to examine the effects of home-based nursing interventions informed by the Health Belief Model on patient care outcomes for individuals having a stoma. METHODS This pretest, posttest, and semiexperimental design with a control group included adults who underwent a stoma operation in the previous 3 months. In total, 30 were assigned to the experimental group and 31 to the control group. Study forms included a sociodemographic questionnaire, the Stoma Quality of Life Scale, the Ostomy Adjustment Inventory, and the Pittman Complication Severity Index. RESULTS After home nursing interventions, there was a significant difference between the compliance rates of the individuals in the experimental group and the complication rates and cost averages (P < .05) with individuals in the control group; no significant difference in quality-of-life scores was found between the 2 groups. CONCLUSION In order to effectively support postoperative individuals following stoma surgery when they are released from the hospital, postdischarge follow-up care informed by the Health Belief Model components should be offered. IMPLICATIONS FOR PRACTICE We recommend creating hospital-based, home care teams that follow individuals with a stoma for at least 6 months after discharge.
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Lotfi M, Ghahremaneian A, Aghazadeh A, Jamshidi F. The Effect of Pre-Discharge Training on the Quality of Life of Burn Patients. J Caring Sci 2018; 7:107-112. [PMID: 29977882 PMCID: PMC6029655 DOI: 10.15171/jcs.2018.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 09/27/2017] [Indexed: 11/09/2022] Open
Abstract
Introduction: Many physical, psychological, social and economic complications have been reported after discharge, which have a negative impact on the quality of life of burn patients. The present research examines the effect of pre-discharge training program on the life quality of patients with burns.
Methods: This is a pre and post-experimental study with control group that was conducted in 2015 in teaching hospital Sina. The control group received the typical instructions upon being discharged from hospital while the experimental group received in-person training in the form of question-answer, pamphlets and a researcher-made instruction booklet. The patients’ life quality was evaluated when they were being discharged, a month and then three months after they were discharged.
Results: The result showed that the quality of life has a significant statistical difference across the three time points. And these differences are compared using Bonferroni’s adjustment multiple comparisons indicating that pre-discharge training affects the quality of life scores and this effect continues over time.
Conclusion: The results show that the pre-discharge training has significantly improved the life quality among the burns patients. The improvement of life quality is also correlated with the quantitative variable of total body surface area percent (TBSA %). Thus, planning and designing in-discharge training programs based on the existing context, combined with training packages focusing on the patients’ needs could be a very significant step in more successful implementation of the follow-up programs on the burn patients and improving their quality of life.
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Affiliation(s)
- Mojgan Lotfi
- Departement of Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Akram Ghahremaneian
- Departement of Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmad Aghazadeh
- Departement of Basic sciences, Paramedical Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Jamshidi
- Departement of Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
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Abstract
Objective The objective of the study was to determine the effect of preoperative stoma site marking on the health- related quality of life (HRQOL). Methods A nonrandomized, quasi-experimental design was used for the study performed from June 2013 to August 2014. The study sample (n:60) included patients for whom a stoma was opened after a planned colorectal surgery. The City of Hope Quality of Life-Ostomy Questionnaire (COHQOL-OQ) was used to measure HRQOL. Results The mean age of the participants in the experimental group was 53.5±12.83, 18(60%) had colostomies, mean BMI was 25.46 ± 4.25 and mean age of that of the control group was 58.00 ± 14.22, 19(63.3%) had colostomies, mean BMI was 25.28 ± 5.00. A comparison of the two groups indicates that the sixth-month total score of the patients in the experimental group on (COHQOL-OQ) is higher than that of the control group (p<0.05). Conclusions The study results demonstrated that patient who underwent stoma site marking reported higher HRQOL than those who did not.
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Affiliation(s)
- Selda Karaveli Cakir
- Selda Karaveli Cakir, RN, PhD, Assistant Professor, Nursing Department, Faculty of Health Science, Kastamonu University, Kastamonu, Turkey
| | - Turkan Ozbayir
- Turkan Ozbayir, RN, PhD, Associate Professor, Surgical Department, Faculty of Nursing, Ege University, Izmir, Turkey
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Faury S, Koleck M, Foucaud J, M'Bailara K, Quintard B. Patient education interventions for colorectal cancer patients with stoma: A systematic review. PATIENT EDUCATION AND COUNSELING 2017; 100:1807-1819. [PMID: 28602564 DOI: 10.1016/j.pec.2017.05.034] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 05/15/2017] [Accepted: 05/25/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To describe the various types of patient education interventions for colorectal cancer patients with stoma and to examine their effects on quality of life, psychosocial skills and self-management skills. METHODS A systematic review was performed. Six electronic databases were searched. Inclusion criteria were: studies about patient education applying quantitative methods including digestive stoma adults with colorectal cancer. The primary outcome was quality of life. Secondary outcomes were psychosocial and self-management skills. RESULTS Thirteen studies were identified and included. Five studies examined quality of life and three reported improvements. Patient education improved some psychosocial and self-management skills. Contrasting findings were reported for specific-disease quality of life, emotional distress, length of hospital stay, stoma complications and readmission rate. CONCLUSIONS Patient education has a positive impact on some psychosocial and self-management skills, indicating that this area should be developed. Contrasting findings were reported for quality of life. Methodologies are heterogeneous making it difficult to produce evidence-based guidelines. This article proposes tools to carry out further studies on this subject and to improve understanding. PRACTICE IMPLICATION Further education intervention for stoma patients with colorectal cancer should be standardized in terms of intervention, duration and outcome measures to compare intervention and determine best practice.
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Affiliation(s)
- Stéphane Faury
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, F-33000 Bordeaux, France.
| | - Michèle Koleck
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, F-33000 Bordeaux, France
| | - Jérôme Foucaud
- "Laboratoire Educations et Pratiques de Santé", EA 3412, Univ. Paris-13 Sorbonne, Paris Cité, 93017 Bobigny, France
| | - Katia M'Bailara
- "Laboratoire de Psychologie", EA 4139, Univ. Bordeaux, Bordeaux, F-33076, France
| | - Bruno Quintard
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, F-33000 Bordeaux, France
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Carmichael JC, Keller DS, Baldini G, Bordeianou L, Weiss E, Lee L, Boutros M, McClane J, Steele SR, Feldman LS. Clinical practice guideline for enhanced recovery after colon and rectal surgery from the American Society of Colon and Rectal Surgeons (ASCRS) and Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). Surg Endosc 2017; 31:3412-3436. [DOI: 10.1007/s00464-017-5722-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 07/10/2017] [Indexed: 12/16/2022]
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Clinical Practice Guidelines for Enhanced Recovery After Colon and Rectal Surgery From the American Society of Colon and Rectal Surgeons and Society of American Gastrointestinal and Endoscopic Surgeons. Dis Colon Rectum 2017; 60:761-784. [PMID: 28682962 DOI: 10.1097/dcr.0000000000000883] [Citation(s) in RCA: 266] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Affiliation(s)
- Fiona Brown
- Community Clinical Nurse Specialist, Stoma Care, Salts Healthcare
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Silva CRDT, Andrade EMLR, Luz MHBA, Andrade JX, Silva GRFD. Qualidade de vida de pessoas com estomias intestinais de eliminação. ACTA PAUL ENFERM 2017. [DOI: 10.1590/1982-0194201700023] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivos Objetivou-se avaliar a qualidade de vida de pessoas com estomias intestinais de eliminação e verificar sua associação com características sociodemográficas e clínicas. Métodos Trata-se de estudo descritivo e transversal realizado com 96 pessoas cadastradas em um Programa de estomizados, utilizando o City of Hope - Quality of Life- Ostomy Questionnary. Resultados O escore médio de QV total deste estudo foi 6,2 ± 2,8. O maior escore médio foi encontrado no domínio Bem-estar espiritual 7,5 (±1,9) e o menor no domínio Bem-estar social 5,6 (±2,1). As características sociodemográficas (renda per capita, escolaridade, religião) e as características clínicas (permanência e adaptação à estomia, tempo de estomizado para sentir-se confortável, dificuldade para o autocuidado e limitação para realização de atividades diárias) associaram-se a qualidade de vida total e seus domínios (p <0,05). Conclusão As estomias intestinais de eliminação interferem na qualidade de vida, principalmente nos âmbitos físico e social.
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Long-term Quality of Life of Patients With Permanent End Ileostomy: Results of a Nationwide Cross-Sectional Survey. Dis Colon Rectum 2017; 60:51-60. [PMID: 27926557 DOI: 10.1097/dcr.0000000000000732] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Patients with permanent end ileostomy are at high risk for detrimental stomal effects on their quality of life. However, little is known about the long-term quality of life of these patients. OBJECTIVE The purpose of this study was to assess long-term quality of life in patients with permanent end ileostomy. DATA SOURCES Registration at the German self-help organization ILCO was used for this study. STUDY SELECTION Selection included a cross-sectional survey of 1434 patients with permanent end ileostomy. MAIN OUTCOME MEASURES Quality of life was assessed using the Medical Outcomes Study Short Form 36, including physical and mental component summary scores, the Gastrointestinal Quality of Life Index, and the Cleveland Global Quality of Life Index. Multivariate risk factor analysis was performed. RESULTS A total of 783 responders were included. Indications for ileostomy included ulcerative colitis (44%), Crohn's disease (38%), and colorectal cancer (7%). Adverse effects on daily life because of stoma were reported by 72% of participants. Quality of life was significantly impaired compared with the general population on all of the summary scores and several subscales (physical component summary: 44.6 ± 10.4 (mean ± SD) vs 50.2 ± 10.2, p < 0.001; mental component summary: 47.5 ± 10.7 vs 51.5 ± 10.2, p < 0.001; Gastrointestinal Quality of Life Index: 94.4 ± 16.4 vs 126.0, p < 0.001). Stoma care problems affecting quality of life were reported by 63% of respondents. These included parastomal hernia (p < 0.001), stenosis (p = 0.003), and prolapse (p = 0.008). Vitamin B12, iron, and zinc deficiencies were also associated with diminished quality of life; in particular, vitamin B12 deficiency was associated with reduced mental and emotional quality of life. LIMITATIONS Not all patients undergoing ileostomy in Germany are registered at ILCO, and there were many nonresponders. In addition, the inherent limitations of cross-sectional studies should be considered, including the response-shift phenomenon. CONCLUSIONS Quality of life was markedly impaired in patients with permanent end ileostomy as compared with the general population. The main reasons were stoma-associated morbidity and nutritional deficiency syndromes. These findings highlight the importance of prevention, screening, and adequate treatment.
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Stenberg U, Haaland-Øverby M, Fredriksen K, Westermann KF, Kvisvik T. A scoping review of the literature on benefits and challenges of participating in patient education programs aimed at promoting self-management for people living with chronic illness. PATIENT EDUCATION AND COUNSELING 2016; 99:1759-1771. [PMID: 27461944 DOI: 10.1016/j.pec.2016.07.027] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 07/14/2016] [Accepted: 07/16/2016] [Indexed: 05/06/2023]
Abstract
OBJECTIVE To give a comprehensive overview of benefits and challenges from participating in group based patient education programs that are carried out by health care professionals and lay participants, aimed at promoting self-management for people living with chronic illness. METHODS We searched 8 literature databases. Full text articles meeting the inclusion criteria were retrieved and reviewed. Arksey and O'Malley's framework for scoping studies guided the review process and thematic analysis was undertaken to synthesize extracted data. RESULTS Of the 5935 titles identified, 47 articles were included in this review. The participants experienced the programs as beneficial according to less symptom distress and greater awareness of their own health, improved self-management strategies, peer support, learning and hope. CONCLUSION A substantial evidence base supports the conclusion that group based self-management patient education programs in different ways have been experienced as beneficial, but more research is needed. PRACTICE IMPLICATIONS The insights gained from this review can enable researchers, health care professionals, and participants to understand the complexity in evaluating self-management patient education programs, and constitute a basis for a more standardized and systematic evaluation. The results may also encourage health care professionals in planning and carrying out programs in cooperation with lay participants.
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Affiliation(s)
- Una Stenberg
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Postboks 4959 Nydalen, 0424 Oslo, Norway; Center for Shared Decision Making and Collaborative Care Research, Oslo University Hospital, Postboks 4959 Nydalen, 0424 Oslo, Norway.
| | - Mette Haaland-Øverby
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Postboks 4959 Nydalen, 0424 Oslo, Norway.
| | - Kari Fredriksen
- Learning and Mastery Center, Stavanger University Hospital, Postboks 8100, 4068 Stavanger, Norway.
| | - Karl Fredrik Westermann
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Postboks 4959 Nydalen, 0424 Oslo, Norway.
| | - Toril Kvisvik
- Patient Education Resource Center, Møre and Romsdal Hospital, Herman Døhlens vei 1, 6508 Kristiansund, Norway.
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Forsmo HM, Pfeffer F, Rasdal A, Sintonen H, Körner H, Erichsen C. Pre- and postoperative stoma education and guidance within an enhanced recovery after surgery (ERAS) programme reduces length of hospital stay in colorectal surgery. Int J Surg 2016; 36:121-126. [PMID: 27780772 DOI: 10.1016/j.ijsu.2016.10.031] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 10/21/2016] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Stoma formation delays discharge after colorectal surgery. Stoma education is widely recommended, but little data are available regarding whether educational interventions are effective. The aim of this prospective study was to investigate whether an enhanced recovery after surgery (ERAS) programme with dedicated ERAS and stoma nurse specialists focusing on counselling and stoma education can reduce the length of hospital stay, re-admission, and stoma-related complications and improve health-related quality of life (HRQoL) compared to current stoma education in a traditional standard care pathway. METHODS In a single-center study 122 adult patients eligible for laparoscopic or open colorectal resection who received a planned stoma were treated in either the ERAS program with extended stoma education (n = 61) or standard care with current stoma education (n = 61). The primary endpoint was total postoperative hospital stay. Secondary endpoints were postoperative hospital stay, major or minor morbidity, early stoma-related complications, health-related quality of life, re-admission rate, and mortality. HRQoL was measured by the generic 15D instrument. RESULTS Total hospital stay was significantly shorter in the ERAS group with education than the standard care group (median [range], 6 days [2-21 days] vs. 9 days [5-45 days]; p < 0.001). Regarding overall major and minor morbidity, re-admission rate, HRQoL, stoma-related complications and 30-day mortality, the two treatment groups exhibited similar outcomes. CONCLUSION Patients receiving a planned stoma can be included in an ERAS program. Pre-operative and postoperative stoma education in an enhanced recovery programme is associated with a significantly shorter hospital stay without any difference in re-admission rate or early stoma-related complications.
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Affiliation(s)
- H M Forsmo
- Department of Gastrointestinal and Emergency Surgery, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, University of Bergen, Norway.
| | - F Pfeffer
- Department of Gastrointestinal and Emergency Surgery, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, University of Bergen, Norway
| | - A Rasdal
- Department of Gastrointestinal and Emergency Surgery, Haukeland University Hospital, Bergen, Norway
| | - H Sintonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - H Körner
- Department of Clinical Medicine, University of Bergen, Norway; Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway
| | - C Erichsen
- Department of Gastrointestinal and Emergency Surgery, Haukeland University Hospital, Bergen, Norway
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Krouse RS, Grant M, McCorkle R, Wendel CS, Cobb MD, Tallman NJ, Ercolano E, Sun V, Hibbard JH, Hornbrook MC. A chronic care ostomy self-management program for cancer survivors. Psychooncology 2016; 25:574-81. [PMID: 26804708 DOI: 10.1002/pon.4078] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 11/19/2015] [Accepted: 12/23/2015] [Indexed: 11/09/2022]
Abstract
BACKGROUND Individuals with ostomies experience extensive changes in health-related quality of life (HRQOL) and daily routine. Patients and families are typically forced to use trial and error to improve self-management. METHODS This is a longitudinal one-group design pilot study of a five-session ostomy self-care curriculum based on the Chronic Care Model to improve HRQOL and self-management for cancer survivors with ostomies. Participants were surveyed to evaluate each session. Multiple instruments were administered to examine outcomes at baseline, post-intervention, and at 6-month follow-up (Patient Activation Measure, self-efficacy, Hospital Anxiety and Depression Scale, Ways of Coping, Group Health Association of America Satisfaction with ostomy care survey, and the City of Hope Quality of Life Ostomy). Changes from pre-intervention to post-intervention and pre-intervention to follow-up were evaluated with paired t-tests. Text responses were coded and evaluated for important themes and recommendations. RESULTS Thirty-eight subjects participated in the study. Most had a history of rectal cancer (60.5%) or bladder cancer (28.9%). Participants rated the overall program high (4.4-4.8 on 5-point scale). Text feedback indicated that participants enjoyed the group forums, wanted more participants, and more hands-on training. Scores on multiple surveys were shown to be improved and sustained, including patient activation (p = 0.0004), self-efficacy (p = 0.006), total HRQOL (p = 0.01), physical well-being (p = 0.005), and social well-being (p = 0.002). Survivor anxiety was significantly reduced by follow-up (p = 0.047). CONCLUSIONS This self-management ostomy program can help cancer survivors with ostomies adapt to their stoma. Initiating this program in the community setting would be beneficial to many cancer survivors.
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Affiliation(s)
- Robert S Krouse
- Southern Arizona Veterans Affairs Health Care System, Tucson, AZ, USA.,University of Arizona College of Medicine, Tucson, AZ, USA
| | - Marcia Grant
- City of Hope National Medical Center/Beckman Research Institute, Duarte, CA, USA
| | | | - Christopher S Wendel
- Southern Arizona Veterans Affairs Health Care System, Tucson, AZ, USA.,University of Arizona College of Medicine, Tucson, AZ, USA
| | - Martha D Cobb
- College of Nursing, University of Arizona, Tucson, AZ, USA
| | - Nancy J Tallman
- Wound Ostomy Continence Nurse, Unaffiliated, Tucson, AZ, USA
| | | | - Virginia Sun
- City of Hope National Medical Center/Beckman Research Institute, Duarte, CA, USA
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O'Flynn SK. Encouraging change: exploring perceptions of stoma care nurses on community stoma care services. ACTA ACUST UNITED AC 2015. [DOI: 10.12968/gasn.2015.13.8.32] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Danielsen AK, Rosenberg J. Health related quality of life may increase when patients with a stoma attend patient education--a case-control study. PLoS One 2014; 9:e90354. [PMID: 24609004 PMCID: PMC3946520 DOI: 10.1371/journal.pone.0090354] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Accepted: 01/26/2014] [Indexed: 12/28/2022] Open
Abstract
Introduction Adaptation to living with a stoma is complex, and studies have shown that stoma creation has a great impact on patients' health related quality of life. The objective was to explore the effect of a structured patient education program on health related quality of life. Therefore, we implemented interventions aimed at increasing health related quality of life during and after hospital admission. Materials and Methods We designed a case/control study aimed at adult patients admitted to the surgical ward for stoma creation, irrespective of type of stoma or reason for creation of stoma. We included 50 patients in the study. Health related quality of life was measured before hospital discharge, three months and six months after stoma creation. The program included educational interventions involving lay-teachers, alongside health professional teachers. Results We found a significant rise in health related quality of life in the intervention group (P<0.001) and no significant change in the control group (P = 0.144). However, we found no significant differences when comparing between groups at 3 and 6 months (p = 0.12 and p = 0.63, respective). Additionally, there were differences in scores in health related quality of life baseline (p = 0.045) with lower scores in the intervention group compared with the intervention group. However, there were no significant differences in the demographic variables at baseline Conclusions Educational activities aimed at increase in knowledge and focusing on patients' psychosocial needs may lead to a rise in patients' health related quality of life. When patients with a stoma attend a structured patient education program it is possible to improve their health related quality of life compared with patients with a stoma, who do not attend the program. Trial Registration ClinicalTrials.gov NCT01154725
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Affiliation(s)
| | - Jacob Rosenberg
- Department of Surgery, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
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Aghajani M, Mirbagher Ajorpaz N, Kafaei Atrian M, Raofi Z, Abedi F, Naeimi Vartoni S, Soleimani A. Effect of self - care education on quality of life in patients with primary hypertension: comparing lecture and educational package. Nurs Midwifery Stud 2013; 2:71-6. [PMID: 25414882 PMCID: PMC4228907 DOI: 10.5812/nms.11655] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 05/13/2013] [Accepted: 09/12/2013] [Indexed: 11/24/2022] Open
Abstract
Background: Hypertension is a dangerous risk factor for public health. It profoundly affects the patients’ quality of life. However, there is lack of agreement on the best method for self-care management in patients with hypertension. Objectives: This study was conducted to compare the effect of lecture and educational pamphlets on quality of life (QOL) in patients with primary hypertension. Patients and Methods: A quasi-experimental study was performed on 90 patients with chronic primary hypertension referred to two outpatient clinics in Kashan city. Patients were randomly divided into three groups including lecture group, educational package group, and control group. The participants’ quality of life was measured using the SF-36 questionnaire at the beginning of the study, and two months later. Data was analyzed using ANOVA and Chi-Square tests. Results: No significant differences were observed between the three groups for demographics characteristics and QOL before the intervention except for marital status. Mean scores of QOL dimensions of the intervention groups were increased at the end of the study, except for the dimension of bodily pain. Tukey post-Hoc test showed that except for general health, the two intervention groups were not significantly different in other dimensions, and significant differences were observed between the control group and the two intervention groups (P < 0.05). At start and the end of the study, the mean differences in the general health dimension in three groups were 2.25 ± 0.1, 0.07 ± 0.01, and -1.70 ± 0.01 respectively. There were significant differences among groups (P = 0.04). Conclusions: Lecture and educational package can both improve some dimensions of the QOL in patients with hypertension. However, as pamphlets are cheap and easy to use, this method may be used as an effective method for self-care education in health care settings in Iran, where the system is faced with nursing shortage.
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Affiliation(s)
- Mohamad Aghajani
- Department of Nursing, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Neda Mirbagher Ajorpaz
- Department of Nursing, Kashan University of Medical Sciences, Kashan, IR Iran
- Corresponding author: Neda Mirbagher Ajorpaz, Department of Nursing, Kashan University of Medical Sciences, Kashan, IR Iran. Tel.: +98-3615550021, Fax: +98-3615556633, E-mail:
| | | | - Zahra Raofi
- Department of Nursing, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Fatemeh Abedi
- Department of Nursing, Kashan University of Medical Sciences, Kashan, IR Iran
| | | | - Akbar Soleimani
- Department of Nursing, Kashan University of Medical Sciences, Kashan, IR Iran
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Marventano S, Forjaz M, Grosso G, Mistretta A, Giorgianni G, Platania A, Gangi S, Basile F, Biondi A. Health related quality of life in colorectal cancer patients: state of the art. BMC Surg 2013; 13 Suppl 2:S15. [PMID: 24267735 PMCID: PMC3851259 DOI: 10.1186/1471-2482-13-s2-s15] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background Colorectal cancer (CRC) is the third most commonly diagnosed cancer in males and the second in females with a progressive increase in prevalence in industrialized countries. The loss of health due to the cancer and/or the consequence of the treatment may result in psychophysical, functional and social impairment; all of these affect health-related quality of life (QoL). Description The most frequently CRC-specific QoL questionnaires is the FACT-C. QoL is not only important for the well-being of cancer patient but it also influences survival and response to therapy. Many studies investigated various determinants involved in the assessment of QoL in CRC, suggesting that symptoms, surgical procedures and the number of comorbidity significantly affected QoL. Conclusion Despite that CRC patients have a relatively good QoL compared with the general population, a wide range of intervention could be undertaken to improve their QoL. The finding of this review may be useful for cancer clinicians in taking therapy and surveillance-related decisions. However, future research should be directed to large-scale prospective studies using well validated QoL instruments to facilitate comparison of results.
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Danielsen AK, Burcharth J, Rosenberg J. Patient education has a positive effect in patients with a stoma: a systematic review. Colorectal Dis 2013; 15:e276-83. [PMID: 23470040 DOI: 10.1111/codi.12197] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Accepted: 11/23/2012] [Indexed: 12/12/2022]
Abstract
AIM A systematic review was performed to assess whether education of patients having stoma formation improves quality of life and whether it is cost effective. METHOD A literature search was performed to identify studies on the structured education of ostomates and outcome using the following databases: MEDLINE, Cinahl, Embase, Cochrane and PsycInfo. Inclusion criteria were: clinical studies reporting effects of educational interventions in relation to patients with a stoma. Commentaries or studies not testing an intervention were excluded. RESULTS Seven articles met the inclusion criteria of having rigorously evaluated an educational programme related to living with a stoma. The programmes were organized in different ways and had explored various interventions. The results showed an increase in health-related quality of life, as measured using a stoma quality of life instrument (P = 0.00001) and with the Short Form 36 (SF-36) (P = 0.000-0.006), an increase in proficiency in management of the stoma (P = 0.0005), two studies pointed to a reduction in postoperative hospital stay (8 days vs 10 days, P = 0.029; and 8 days vs 14 days, P = 0.17), a significant reduction in cost in the intervention group ($US 8570.54) compared with the control group ($US 7396.90) as well as higher effectiveness scores in the intervention group (166.89) compared with the control group (110.98), a significant rise in stoma-related knowledge (P = 0.0000) and an increase in psychosocial adjustment (P = 0.000). CONCLUSION Structured patient education aimed at patients' psychosocial needs seems to have a positive effect on quality of life as well as on cost. The interventions may be performed before, during or after hospital stay. However, the available data come from few studies with differences in interventions and in study design, and further studies are therefore needed before a final conclusion can be drawn.
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Affiliation(s)
- A K Danielsen
- Department of Surgery, Herlev Hospital, University of Copenhagen, Herlev, Denmark.
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