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Al-Husban RY, Abu Shosha G. The Lived Experience of Jordanian Persons With a Stoma: A Qualitative Study. Gastroenterol Nurs 2022; 45:300-309. [PMID: 36112077 DOI: 10.1097/sga.0000000000000696] [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] [Received: 06/12/2021] [Accepted: 01/27/2022] [Indexed: 11/26/2022] Open
Abstract
Individuals may live with an intestinal stoma either temporarily or for the rest of their lives. The purpose of this study was to understand the lived experience of Jordanian persons living with a stoma. Qualitative design was employed via semistructured interviews with 22 Muslim participants who had an intestinal stoma. Thematic analysis of the transcripts resulted in 3 main themes. The first core theme was stoma burden, which represented difficulties and challenges resulting from the creation of a stoma. This theme was divided into 4 subthemes: physical, self-care, social, and psychological burdens. The second theme was the adaptation to a stoma, whereas the third theme was suggestions for healthcare providers to decrease stoma burden. Conclusively, these themes conveyed that the presence of supportive family members and qualified healthcare providers can decrease the burden of a stoma. Generally, persons with a stoma (ostomates) experienced stoma-related physical, social, psychological, and financial burdens. Therefore, ostomates were in need of training, psychosocial therapy, and more follow-ups to prevent and treat stoma complications and adapt to living easily with the stoma.
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Affiliation(s)
- Raya Yousef Al-Husban
- Raya Yousef Al-Husban, PhD, RN, CNS, is Assistant Professor, Faculty of Nursing, Zarqa University, Zarqa, Jordan
- Ghada Abu Shosha, PhD, RN, CNS, is Associate Professor, Faculty of Nursing, Zarqa University, Zarqa, Jordan
| | - Ghada Abu Shosha
- Raya Yousef Al-Husban, PhD, RN, CNS, is Assistant Professor, Faculty of Nursing, Zarqa University, Zarqa, Jordan
- Ghada Abu Shosha, PhD, RN, CNS, is Associate Professor, Faculty of Nursing, Zarqa University, Zarqa, Jordan
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Alenezi A, Livesay K, McGrath I, Kimpton A. Ostomy-related problems and their impact on quality of life of Saudi ostomate patients: A mixed-methods study. J Clin Nurs 2022. [PMID: 36002978 DOI: 10.1111/jocn.16466] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 07/04/2022] [Accepted: 07/07/2022] [Indexed: 11/28/2022]
Abstract
AIM AND OBJECTIVE The aim of this study is to explore the health-related quality of life outcomes and ostomy-related obstacles among patients with ostomy in Saudi Arabia. BACKGROUND Negative effects on quality of life for patients following ostomy creation are a globally important health concern. Paucity of understanding factors that influenced quality of care after ostomy surgery hinders the ability of healthcare providers to offer appropriate care to improve patient's quality of care. METHODS This mixed-methods study was undertaken through survey (COHQOL-Q Arabic version) for collecting the quantitative data (n = 421) and semi-structured interview for collecting qualitative data (n = 12). This study employed STROBE and GRAMMS checklists. RESULTS Multiple health-related quality of life challenges was indicated by Saudi patients with intestinal stomas. Ostomy surgery interferes with religious practice in Muslim people, particularly obtaining Hajj worship and fasting for Ramadan. The overall QOL mean score was moderate level (M = 7.57) for ostomy patients in Saudi Arabia. The highest domain mean score was the social well-being (M = 7.84) and the lowest in the physical well-being (M = 7.18). Reshaping of religious practices, apprehension and adaptation to living with a stoma were the most common themes that participants discussed related to ostomy issues they experienced following ostomy surgery. CONCLUSION The study findings reported a greater understanding of challenges that patients with stoma experience in Saudi Arabia. The process of the adaptation and the change of their lifestyle also affects patient's quality of life. The healthcare providers can use the study results to create a supportive intervention strategy that needed for maximise QOL for people with stoma. RELEVANCE TO CLINICAL PRACTICE This study identifies issues associated with stoma creation among Saudi people and can help in planning and providing the required nursing care which may support in the reduction of predictable problems. Recommendations for future studies related to nursing professional practice are indicated.
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Affiliation(s)
- Aishah Alenezi
- Discipline of Nursing, RMIT University, Melbourne, Victoria, Australia
| | - Karen Livesay
- Discipline of Nursing, RMIT University, Melbourne, Victoria, Australia
| | - Ian McGrath
- Discipline of Nursing, RMIT University, Melbourne, Victoria, Australia
| | - Amanda Kimpton
- Chiropractic and Exercise Sciences Department, RMIT University, Melbourne, Victoria, Australia
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Burgess-Stocks J, Gleba J, Lawrence K, Mueller S. Ostomy and Continent Diversion Patient Bill of Rights: Research Validation of Standards of Care. J Wound Ostomy Continence Nurs 2022; 49:251-260. [PMID: 35523241 PMCID: PMC9093730 DOI: 10.1097/won.0000000000000876] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
An estimated 725,000 to 1 million people are living with an ostomy or continent diversion in the United States, and approximately 100,000 ostomy surgeries are performed each year in the United States. As a result of ostomy surgery, bodily waste is rerouted from its usual path because of malfunctioning parts of the urinary or digestive system. An ostomy can be temporary or permanent. The ostomy community is an underserved population of patients. United Ostomy Associations of America, Inc (UOAA), is a nonprofit organization dedicated to promoting quality of life for people with ostomies and continent diversions through information, support, advocacy, and collaboration. Over the years, UOAA has received hundreds of stories from people who have received inadequate care. In the United States, patients receiving medical care have certain health rights. For ostomy and continent diversion patients, these rights are known as the "You Matter! Know What to Expect and Know Your Rights-Ostomy and Continent Diversion Patient Bill of Rights" (PBOR). These rights define and provide a guide to patients and health care professionals as to what the best practices are when receiving and providing high-quality ostomy care during all phases of the surgical experience. This includes preoperative to postoperative care and throughout the life span when living with an ostomy or continent diversion. In 2020, the National Quality Forum released "The Care We Need: Driving Better Health Outcomes for People and Communities," a National Quality Task Force report that provides a road map where every person in every community can expect to consistently and predictably receive high-quality care by 2030 (thecareweneed.org). One of the core strategic objectives this report stated is to ensure appropriate, safe, and accessible care. Actionable opportunities to drive change include accelerating adoption of leading practices. The adoption of the PBOR best practices will drive the health care quality improvement change needed for the ostomy and continent diversion population. There are concerns in the ostomy and continent diversion communities among patients and health care professionals that the standards of care outlined in the PBOR are not occurring across the United States in all health care settings. There are further concerns stated by health care professionals that the patient-centered recommendations outlined in the PBOR need to be strengthened by being supported with available published health care evidence. The work of this task force was to bring together members of UOAA's Advocacy Committee, members of the Wound, Ostomy, and Continence Nurses Society (WOCN Society) Public Policy and Advocacy Committee, and representatives from surgical organizations and industry to create a systemic change by validating through evidence the Ostomy and Continent Diversion PBOR. Through the work of the task force, each component of the PBOR has been substantiated as evidence-based. Thus, this article validates the PBOR as a guideline for high-quality standards of ostomy care. We show that when patients receive the standards of care as outlined in the PBOR, there is improved quality of care. We can now recognize that until every ostomy or continent diversion patient receives these health care rights, in all health care settings, will they truly be realized and respected as human rights in the United States and thus people living with an ostomy or continent diversion will receive "the care they need."
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Affiliation(s)
- Joanna Burgess-Stocks
- Joanna Burgess-Stocks, BSN, RN, CWOCN, UOAA Advocacy Committee Co-Chair
- Jeanine Gleba, MEd, UOAA Advocacy Manager
- Kathleen Lawrence, MSN, RN, CWOCN, WOCN Society Public Policy and Advocacy Coordinator
- Susan Mueller, BSN, RN, CWOCN, UOAA Advocacy Committee Co-Chair
| | - Jeanine Gleba
- Correspondence: Jeanine Gleba, MEd, United Ostomy Associations of America, Inc, PO Box 525, Kennebunk, ME 04043 ()
| | - Kathleen Lawrence
- Joanna Burgess-Stocks, BSN, RN, CWOCN, UOAA Advocacy Committee Co-Chair
- Jeanine Gleba, MEd, UOAA Advocacy Manager
- Kathleen Lawrence, MSN, RN, CWOCN, WOCN Society Public Policy and Advocacy Coordinator
- Susan Mueller, BSN, RN, CWOCN, UOAA Advocacy Committee Co-Chair
| | - Susan Mueller
- Joanna Burgess-Stocks, BSN, RN, CWOCN, UOAA Advocacy Committee Co-Chair
- Jeanine Gleba, MEd, UOAA Advocacy Manager
- Kathleen Lawrence, MSN, RN, CWOCN, WOCN Society Public Policy and Advocacy Coordinator
- Susan Mueller, BSN, RN, CWOCN, UOAA Advocacy Committee Co-Chair
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Mukherjee S, Beresford B, Atkin K, Sebastian S. The Need for Culturally Competent Care Within Gastroenterology Services: Evidence from Research with Adults of South Asian Origin Living with Inflammatory Bowel Disease. J Crohns Colitis 2021; 15:14-23. [PMID: 32577761 DOI: 10.1093/ecco-jcc/jjaa117] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS It is widely acknowledged that the incidence of inflammatory bowel disease [IBD] is rising within South Asian populations, yet research into the experiences of this group of patients is rare. In this study the lived experiences of UK South Asian adults with IBD, including support from gastroenterology services, was investigated. METHODS A sample of 33 patients representing the diversity of the UK South Asian population were recruited through five gastroenterology clinics in England. In-depth semi-structured interviews were conducted, audio-recorded, transcribed and analysed using the Framework approach. RESULTS Although many experiences align with those of the general IBD population, participants believed that South Asian cultures and/or religions can lead to additional challenges. These are linked to: family and friends' understanding of IBD; self and family attributions regarding IBD; stigma surrounding ill health; the taboo of bowel symptoms; managing 'spicy food'; beliefs about food and ill health; roles within the family; living with extended family; the use of complementary and alternative therapies; and visits to family overseas. Religious faith helped many to cope with having IBD, but symptoms could hamper their ability to practise faith. Gastroenterology services were viewed positively, but unmet needs were identified, some of which were culturally specific. CONCLUSION Gastroenterology services have an important role to play in helping patients to overcome the challenges they encounter in their everyday life, both by providing individual patients with culturally appropriate care and advice, and via interventions to increase awareness and understanding of IBD within wider South Asian communities.
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Affiliation(s)
| | | | - Karl Atkin
- Health Sciences, University of York, York, UK
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Habib A, Connor MJ, Boxall NE, Lamb BW, Miah S. Improving quality of life for Muslim patients requiring a stoma: A critical review of theological and psychosocial issues. SURGICAL PRACTICE 2020. [DOI: 10.1111/1744-1633.12409] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Abul Habib
- Department of UrologyNorthwick Park Hospital Harrow UK
| | - Martin J. Connor
- Imperial Prostate, Department of Surgery and Cancer, Faculty of MedicineImperial College London, Charing Cross Hospital London UK
| | - Nicholas E. Boxall
- Department of Urology, Cambridge University HospitalAddenbrooke's Hospital Cambridge UK
| | - Benjamin W. Lamb
- Department of Urology, Cambridge University HospitalAddenbrooke's Hospital Cambridge UK
| | - Saiful Miah
- Department of Urology, Cambridge University HospitalAddenbrooke's Hospital Cambridge UK
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Gani C, Gani N, Zschaeck S, Eberle F, Schaeffeler N, Hehr T, Berger B, Fischer SG, Claßen J, Zipfel S, Rödel C, Teufel M, Zips D. Organ Preservation in Rectal Cancer: The Patients' Perspective. Front Oncol 2019; 9:318. [PMID: 31134146 PMCID: PMC6524150 DOI: 10.3389/fonc.2019.00318] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 04/08/2019] [Indexed: 01/04/2023] Open
Abstract
Organ preservation after a clinical complete response to radiochemotherapy is currently one of the most discussed topics in the management of rectal cancer. However, the patients' perspective has only been poorly studied so far. In this multicenter study, we examined 49 patients with locally advanced rectal cancer. The willingness to participate in an organ preservation study and the acceptance of the associated aspects such as intensified radiochemotherapy protocols, the need for close follow-up examinations and local regrowth rates were assessed. Attitudes were correlated with baseline quality of life parameters and psychological scales for "fear of progression", "locus of control", "depression", and the "willingness to take risks". A total of 83% of patients would consider the deferral of surgery in case of a clinical complete response (cCR). Three monthly follow-up studies and a 25% local regrowth rate are considered acceptable by 95% and 94% respectively. While 41% would be willing to exchange cure rates for a non-operative treatment strategy, a potentially more toxic radiochemotherapy in order to increase the probability of a cCR was the aspect with the lowest acceptance (55%). Psychological factors, in particular "locus of control" and "willingness to take risks", influenced patient preferences regarding most of the assessed parameters. While in general a broad acceptance of an organ-preserving treatment can be expected, patient preferences and concerns regarding different aspects of this strategy vary widely and require specific consideration during shared decision making.
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Affiliation(s)
- Cihan Gani
- Department of Radiation Oncology, University Hospital and Medical Faculty Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany.,German Cancer Research Center, Heidelberg and German Cancer Consortium (DKTK), Tübingen, Germany.,Gastrointestinal Cancer Center, Comprehensive Cancer Center Tübingen-Stuttgart, Tübingen, Germany
| | - Nina Gani
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Sebastian Zschaeck
- Department of Radiation Oncology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Fabian Eberle
- Department of Radiotherapy and Radiooncology, Philipps-University, Marburg, Germany
| | - Norbert Schaeffeler
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Thomas Hehr
- Department of Radiation Oncology, Marienhospital Stuttgart, Stuttgart, Germany
| | - Bernhard Berger
- Department of Radiation Oncology, Oberschwabenklinik Ravensburg, Ravensburg, Germany
| | - Stefan Georg Fischer
- Department of Radiation Oncology, University Hospital and Medical Faculty Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Johannes Claßen
- Department of Radiation Oncology, St. Vincentius-Kliniken gAG, Karlsruhe, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Claus Rödel
- Department of Radiotherapy and Oncology, Goethe-University Frankfurt, Frankfurt, Germany
| | - Martin Teufel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.,Department of Psychosomatic Medicine and Psychotherapy, LVR-Clinic Essen, University of Duisburg-Essen, Essen, Germany
| | - Daniel Zips
- Department of Radiation Oncology, University Hospital and Medical Faculty Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany.,German Cancer Research Center, Heidelberg and German Cancer Consortium (DKTK), Tübingen, Germany
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Quality of Life After Ostomy Surgery in Muslim Patients: A Systematic Review of the Literature and Suggestions for Clinical Practice. J Wound Ostomy Continence Nurs 2017; 43:385-91. [PMID: 27196687 DOI: 10.1097/won.0000000000000235] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To determine factors that influence health-related quality of life (HRQOL) after ostomy surgery in Muslim patients. METHODS A systematic literature review of published data was carried out using MeSH terms ("Muslim" OR "Islam") AND ("stoma" OR "ostomy" OR "colostomy" OR "ileostomy") AND "quality of life" AND "outcomes." RESULTS Twelve studies enrolling 913 subjects were deemed suitable for inclusion in the review. HRQOL was found to be particularly impaired in Muslims; this impairment went beyond that experienced by non-Muslim patients. Factors associated with this difference included psychological factors, social isolation, underreporting of complications, and sexual dysfunction leading to breakdown of marital relations as well as diminished religious practices. CONCLUSION Muslims requiring ostomies should receive preoperative counseling by surgeons and ostomy nurses. These discussions should also include faith leaders and/or hospital chaplains. Ongoing support after surgery can be extended into the community and encompass family doctors and faith leaders. Additional research exploring HRQOL after surgery in Muslims living in Western societies is indicated.
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Affiliation(s)
- Jo Sica
- Stoma Care Nurses, Hollister UK, look at the UK's major religions to help gastrointestinal and stoma care nurses factor patients' culture, beliefs and values into their care
| | - Katy Timms
- Stoma Care Nurses, Hollister UK, look at the UK's major religions to help gastrointestinal and stoma care nurses factor patients' culture, beliefs and values into their care
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Affiliation(s)
- Kate Young
- Principal Lecturer and Research Lead, Adult Nursing, University of Hertfordshire
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Schmitz CC, Chow CJ, Rothenberger DA. Colorectal surgeons teaching general surgery residents: current challenges and opportunities. Clin Colon Rectal Surg 2013; 25:134-42. [PMID: 23997668 DOI: 10.1055/s-0032-1322526] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Effective teaching for general surgery residents requires that faculty members with colorectal expertise actively engage in the education process and fully understand the current context for residency training. In this article, we review important national developments with respect to graduate medical education that impact resident supervision, curriculum implementation, resident assessment, and program evaluation. We argue that establishing a culture of respect and professionalism in today's teaching environment is one of the most important legacies that surgical educators can leave for the coming generation. Faculty role modeling and the process of socializing residents is highlighted. We review the American College of Surgeons' Code of Professional Conduct, summarize some of the current strategies for teaching and assessing professionalism, and reflect on principles of motivation that apply to resident training both for the trainee and the trainer.
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Affiliation(s)
- Connie C Schmitz
- Department of Surgery, University of Minnesota Medical School, Minneapolis, Minnesota
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