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Shoja M, Arsalani N, Fallahi-Khoshknab M, Mohammadi-Shahboulaghi F, Shirozhan S. The clarification of the concept of colostomy nursing care in ostomy care centers: A concept analysis through Walker and Avant's method. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 13:132. [PMID: 38784265 PMCID: PMC11114522 DOI: 10.4103/jehp.jehp_482_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 05/22/2023] [Indexed: 05/25/2024]
Abstract
BACKGROUND Specialist nurses need to have an accurate understanding of colostomy care-related concepts to provide care. Although patients with different types of ostomy have different types of needs, terms such as ostomy care, colostomy care, and ileostomy nursing are interchangeably used. Moreover, there are limited concept analysis studies into the concept of colostomy nursing care (CNC) in ostomy care centers (OCCs). The aim of this study was to analyze and clarify the concept of CNC in outpatient OCCs. METHODS AND MATERIAL This was a concept analysis study. This concept analysis was conducted using Walker and Avant's eight-step method. The online databases were searched until 2022 to retrieve documents on CNC. Finally, 35 articles and four books were included in the analysis, the defining attributes, antecedents, and consequences of the concepts were determined, and model and additional cases as well as empirical referents were presented. RESULTS The defining attributes of CNC in OCCs are the development of professional role, participatory practice and interdisciplinary care, selection of the best clinical procedures, care based on patient education, and patient rehabilitation. The antecedents of the concept are nurse-related antecedents, patient- and family-related antecedents, environmental antecedents, and professional rules and regulations. Its consequences are patients' and families' greater care-related knowledge, improvement of nurses' care quality, patient autonomy, and self-efficacy. CONCLUSION The concept of CNC in OCCs can be defined as "a continuous and coherent care based on knowledge, skill, expertise, experience, and colostomy type which uses interdisciplinary collaboration and the best available evidence in order to select and provide the best services according to patients' and families' culture and background, fulfill patients' physical, mental, sexual, social, and spiritual needs, and timely refer patients to specialists, with the ultimate goal of improving patient autonomy and facilitating their return to normal life."
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Affiliation(s)
- Maryam Shoja
- Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Narges Arsalani
- Department of Nursing, Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Farahnaz Mohammadi-Shahboulaghi
- Department of Nursing, Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Shima Shirozhan
- Health in Emergency and Disaster Research Center, Social Health Research Institute, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Afiyanti Y, Milanti A, Wahidi KR, Fitch M. Embracing My Stoma: Psychosocial Adjustment of Indonesian Colorectal Cancer Survivors Living With a Stoma. Cancer Nurs 2023:00002820-990000000-00203. [PMID: 38112431 DOI: 10.1097/ncc.0000000000001303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
BACKGROUND After surgical treatment of colorectal cancer (CRC), most survivors need to have an ostomy, which can lead to restrictions in their psychological and social functioning. How Indonesian CRC survivors adjust to living well with the stoma remains an understudied area. OBJECTIVE This study aimed to explore the lived experiences of Indonesian CRC survivors living with a stoma regarding their psychosocial adjustment. METHODS This study adopted Heidegger's interpretive phenomenology approach. Using semistructured in-depth interviews, data were collected until saturation from 11 CRC survivors. Data were analyzed using thematic analysis, with a Heideggerian stance. RESULTS Three themes with corresponding subthemes were identified: (1) achieving self-reconciliation (subthemes: stoma as a savior, embracing the stoma's existence, being confident as an ostomate), (2) getting tremendous social support (subthemes: getting support from partner, family and community, and peer ostomates), and (3) making practical adjustments in daily life (subthemes: adjustment in clothing, food and drink, physical activities and exercise, religious activities, and traveling). These 3 themes describe the essence of the "lived psychosocial experiences of the CRC survivors with stoma." CONCLUSIONS In contrast to previous study findings conducted primarily in Western countries, most of the Indonesian CRC survivors living with a stoma described positive psychosocial adjustment regarding their ostomy. In this work, social support and cultural-religious aspects made a significant contribution to this adjustment. IMPLICATIONS FOR PRACTICE Healthcare professionals, especially nurses, can use this knowledge in providing psychosocial support for CRC survivors with ostomy to facilitate a smooth adaptation and adjustment journey.
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Affiliation(s)
- Yati Afiyanti
- Author Affiliations: Department of Maternity and Women's Health Nursing, Faculty of Nursing, Universitas Indonesia (Dr Afiyanti), Depok; Faculty of Nursing and Midwifery, Binawan University (Dr Milanti); and Faculty of Health Sciences, Esa Unggul University (Dr Wahidi), Jakarta, Indonesia; and Bloomberg Faculty of Nursing, University of Toronto (Dr Fitch), Ontario, Canada
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Coulter H. Not a bag for life… a bag for living. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:S22-S28. [PMID: 35333564 DOI: 10.12968/bjon.2022.31.6.s22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Stoma products often look and feel medical and can prevent ostomates from living life to the full. They are not designed to address common problems experienced by patients; they can be bulky and visible, allow flatus to escape, need frequent changing (often disrupting sleep) and are uncomfortable. Pelican Healthcare's ModaVi range of ostomy pouches were designed using insight from intestinal ostomates. The company considered their unmet needs and designed products intended to improve patients' quality of life, allowing them to lead the lives they want. ModaVi pouches have innovative features, including being made of a soft fabric that is comfortable and water resistant, and come in black and neutral colours. The pouches are made in different sizes, which can be altered to meet patients' lifestyles and fit in clothing. In addition, they are adapted for people with poor sight or dexterity, and the simple outlet and viewing window make them easier to use. New and established ostomates have evaluated them positively.
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Affiliation(s)
- Helen Coulter
- Community Stoma Care Nurse with Respond Healthcare, Cardiff, Wales
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4
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Gürçayır D, Karabulut N. The quality of life in colorectal cancer patients: a mixed-methods study. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2022. [DOI: 10.15452/cejnm.2021.12.0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Goodman W, Downing A, Allsop M, Munro J, Taylor C, Hubbard G, Beeken RJ. Quality of life profiles and their association with clinical and demographic characteristics and physical activity in people with a stoma: a latent profile analysis. Qual Life Res 2022; 31:2435-2444. [PMID: 35217962 PMCID: PMC9250477 DOI: 10.1007/s11136-022-03102-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2022] [Indexed: 12/03/2022]
Abstract
Purpose Quality of life can be negatively impacted by the formation of a stoma and is influenced by a number of factors. Research to date treats people with a stoma as a homogenous group based on their quality of life. We attempted to identify subgroups based upon self-reported quality of life and explored variables associated with group membership. Methods The present study is a secondary analysis of a cross-sectional sample of 1419 people with a stoma. Participants completed validated questionnaires for quality of life, physical activity and clinical and demographic characteristics. Latent profile analysis was used to identify the optimal number of subgroups (profiles) and multinomial regression modelling was conducted to identify variables associated with profile membership. Results The analysis revealed 4 distinct profiles of people with a stoma: ‘consistently good quality of life’ [N = 891 (62.8%)], ‘some quality of life concerns’ [N = 184 (13.0%)], ‘low quality of life’ [N = 181 (12.8%)] and ‘financial concerns’ [N = 163 (11.5%)]. Modelling revealed that people with a recent stoma (formed < 2 years previously), who have a hernia and are less physically active were more likely to belong to the ‘low quality of life’ profile. Furthermore, those aged 16–55 were more likely to have financial concerns. Conclusion This study was the first to identify latent profiles within this population and assess whether certain variables are associated with membership. Future research should build upon this to identify additional variables associated with these profiles, which can help to provide the basis for targeting and tailoring future interventions to specific subgroups of people with a stoma. Supplementary Information The online version contains supplementary material available at 10.1007/s11136-022-03102-5.
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Affiliation(s)
- William Goodman
- School of Medicine, University of Leeds, Clarendon Way, Leeds, LS2 9JT, UK
| | - Amy Downing
- School of Medicine, University of Leeds, Clarendon Way, Leeds, LS2 9JT, UK
| | - Matthew Allsop
- School of Medicine, University of Leeds, Clarendon Way, Leeds, LS2 9JT, UK
| | - Julie Munro
- Department of Nursing, University of the Highlands and Islands, 12b Ness Walk, Inverness, IV3 5SQ, UK
| | - Claire Taylor
- London North West Healthcare NHS Trust, Watford Road, Harrow, HA1 3UJ, UK
| | - Gill Hubbard
- Department of Nursing, University of the Highlands and Islands, 12b Ness Walk, Inverness, IV3 5SQ, UK
| | - Rebecca J Beeken
- School of Medicine, University of Leeds, Clarendon Way, Leeds, LS2 9JT, UK.
- Research Department of Behavioural Science and Health, University College London, Gower Street, London, WC1E 6BT, UK.
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Abstract
Leaks and peristomal skin complications are highly prevalent among people with a stoma, reported by over 80% of ostomates within 2 years of surgery. This suggests that there is room for improvement in ostomy appliances, particularly in their hydrocolloid-based adhesive flanges. Hydrocolloid has an absorptive method of moisture management that, over time, risks maceration and skin stripping, potentially leading to moisture-associated skin damage (MASD) and medical adhesive-related skin injury (MARSI). The newly developed Genii ostomy appliances (Trio Healthcare) use novel Sil2 Breathable Silicone Technology to provide secure, effective adhesion and manage moisture levels by replicating natural transepidermal water loss (TEWL). This has the potential to increase appliance wear time, reduce incidence of MASD and permit atraumatic removal without adhesive remover, reducing the risks of MARSI, as well as time burdens on the user and economic burdens on the healthcare system. Meanwhile, the silicone flanges and water-resistant sports fabric pouches are lightweight, flexible and unobtrusive, and they are the first appliances to be available in colours to match different skin tones, all of which provides security, comfort, confidence and discretion. This article explores the features of Sil2 and Genii ostomy appliances, with reference to preliminary data from a user evaluation.
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Affiliation(s)
- Peta Lager
- Stoma Care Clinical Nurse Specialist, Basildon University Hospital
| | - Lisa Loxdale
- Stoma Care Clinical Nurse Specialist, Basildon University Hospital
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Capilla-Díaz C, Moya-Muñoz N, Matas-Terrón JM, Pérez-Morente MÁ, Álvarez-Serrano MA, Montoya-Juárez R, Hueso-Montoro C. Evaluation of interventions in people with digestive stoma through the Nursing Interventions Classification. Int J Nurs Knowl 2021; 33:40-48. [PMID: 34003579 DOI: 10.1111/2047-3095.12328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 04/20/2021] [Accepted: 04/21/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE To determine which nursing interventions are used in individuals with a digestive stoma and the relationships between nursing interventions used and sociodemographic and clinical variables. METHODS The present study is an observational, cross-sectional, descriptive. Data from 102 individuals in the general surgery unit of a first-level hospital (University Hospital Complex of Granada, Spain) were analyzed. Data on the use of nursing interventions and sociodemographic and clinical variables were collected. Univariate, bivariate, and multivariate data analyses were conducted. FINDINGS Interventions: Decision-Making Support (5250) and Ostomy Care (0480) were the most prevalent interventions in the sample. The period of care (postoperative and follow-up) was the most common significant variable (p < 0.05) among the interventions observed. Anxiety Reduction (5820), Nutritional Counseling (5246), Self-Esteem Enhancement (5400), and Body Image Enhancement (5220) were also relevant findings. CONCLUSIONS The present study contributes to determining which nursing interventions are used in individuals with a digestive stoma. IMPLICATIONS FOR NURSING PRACTICE This study could be useful in planning nursing interventions in individuals with a digestive stoma.
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Affiliation(s)
| | | | | | | | | | - Rafael Montoya-Juárez
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - César Hueso-Montoro
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain
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Kim H, Son H. Moderating Effect of Posttraumatic Growth on the Relationship Between Social Support and Quality of Life in Colorectal Cancer Patients With Ostomies. Cancer Nurs 2021; 44:251-259. [PMID: 33886236 PMCID: PMC8081094 DOI: 10.1097/ncc.0000000000000887] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2020] [Indexed: 12/04/2022]
Abstract
BACKGROUND Little research has examined the moderating influence of posttraumatic growth (PTG) on the relationship between social support and quality of life. OBJECTIVES This study examined the relationship between social support and quality of life by the level of PTG in colorectal cancer patients with ostomies. METHODS Using a cross-sectional design, colorectal cancer patients with ostomies (n = 140) were recruited using convenience sampling. The City of Hope Quality of Life-Ostomy, the Multidimensional Scale of Social Support, and the Posttraumatic Growth Inventory measured quality of life, social support, and PTG, respectively. RESULTS Social support and PTG were positively related to psychological and social well-being. Higher social support was associated with better psychological and social well-being. Posttraumatic growth moderated the relationship between psychological and social well-being. At a low and moderate level of PTG, social support was more strongly associated with psychological and social well-being, whereas at high levels, this association was not significant. CONCLUSIONS Findings highlight the significance of social support to improve the quality of life for colorectal cancer patients with an ostomy, particularly those with low levels of PTG. IMPLICATIONS FOR PRACTICE Screening for patients' positive cognitive adaptations while living with an ostomy could identify those who might need further social support to improve their quality of life. Further, intensive social support programs might promote the quality of life for colorectal patients with an ostomy, which was found to be effective for those with low levels of PTG.
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Lager P, Loxdale L. Use of breathable silicone technology in an ostomy appliance flange. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2021; 30:S25-S35. [PMID: 37733646 DOI: 10.12968/bjon.2021.30.sup6a.s25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
Leaks and peristomal skin complications are highly prevalent among people with a stoma, reported by over 80% of ostomates within 2 years of surgery. This suggests that there is room for improvement in ostomy appliances, particularly in their hydrocolloid-based adhesive flanges. Hydrocolloid has an absorptive method of moisture management that, over time, risks maceration and skin stripping, potentially leading to moisture-associated skin damage (MASD) and medical adhesive-related skin injury (MARSI). The newly developed Genii ostomy appliances (Trio Healthcare) use novel Sil2 Breathable Silicone Technology to provide secure, effective adhesion and manage moisture levels by replicating natural transepidermal water loss (TEWL). This has the potential to increase appliance wear time, reduce incidence of MASD and permit atraumatic removal without adhesive remover, reducing the risks of MARSI, as well as time burdens on the user and economic burdens on the healthcare system. Meanwhile, the silicone flanges and water-resistant sports fabric pouches are lightweight, flexible and unobtrusive, and they are the first appliances to be available in colours to match different skin tones, all of which provides security, comfort, confidence and discretion. This article explores the features of Sil2 and Genii ostomy appliances, with reference to preliminary data from a user evaluation.
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Affiliation(s)
- Peta Lager
- Stoma Care Clinical Nurse Specialist, Basildon University Hospital
| | - Lisa Loxdale
- Stoma Care Clinical Nurse Specialist, Basildon University Hospital
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10
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Comparison of colonic stents, stomas and resection for obstructive left colon cancer: a meta-analysis. Tech Coloproctol 2020; 24:1121-1136. [PMID: 32681344 DOI: 10.1007/s10151-020-02296-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 07/05/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Emergency surgery (ES) is the standard-of-care for left-sided obstructing colon cancer, with self-expanding metallic stents (SEMSs) and diverting colostomies (DCs) being alternative approaches. The aim of this study was to review the short- and long-term outcomes of SEMS versus ES or DC. METHODS Embase and Medline were searched for articles comparing SEMS versus ES or DC. Primary outcomes were survival and recurrence rates. Secondary outcomes were peri- and postoperative outcomes. SEMS-specific outcomes include success and complication rates. Pooled odds ratio and 95% confidence interval were estimated with DerSimonian and Laird random effects used to account for heterogeneity. RESULTS Thirty-three studies were included, involving 15,224 patients in 8 randomized controlled trials and 25 observational studies. There were high technical and clinical success rates for SEMS, with low rates of complications. Our meta-analysis revealed increased odds of laparoscopic surgery and anastomosis, and decreased stoma creation with SEMS compared to ES. SEMS led to fewer complications, including anastomotic leak, wound infection, ileus, myocardial infarction, and improved 90-day in-hospital mortality. There were no significant differences in 3- and 5-year overall, cancer-specific and disease-free survival. SEMS, compared to DC, led to decreased rates of stoma creation, higher rates of ileus and reoperation, and led to longer hospital stay. CONCLUSIONS SEMS leads to better short-term outcomes but confers no survival advantage over ES. It is unclear whether SEMS has better short-term outcomes compared to DC. There is a lack of randomized trials with long-term outcomes for SEMS versus DC, hence results should be interpreted with caution.
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Hubbard G, Taylor C, Watson AJM, Munro J, Goodman W, Beeken RJ. A physical activity intervention to improve the quality of life of patients with a stoma: a feasibility study. Pilot Feasibility Stud 2020; 6:12. [PMID: 32042438 PMCID: PMC7001297 DOI: 10.1186/s40814-020-0560-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 01/27/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND We hypothesise that a physical activity (PA) intervention will improve the quality of life (QoL) of people with a stoma. A feasibility study of the intervention and trial parameters is necessary to inform a future main trial. METHODS Participants received a weekly PA consultation by telephone, video conferencing, or face-to-face for 12 weeks with a PA instructor who prescribed physical activities and supported participants by addressing stoma-related concerns and using behaviour change techniques. A feasibility study of the intervention and trial parameters was conducted in three UK sites using mixed methods. RESULTS The number of eligible patients consenting to the study was 30 out of 174 (17%). Most participants were female (73%); 73% had an ileostomy and 27% a colostomy; mean time since diagnosis was 6 months. A total of 18 (64%) participants completed pre- (baseline) and post-intervention (follow-up) measures. Results show an improvement on all scales measuring QoL and disease-specific fatigue. The median PA consultation rate per participant was eight sessions. Participants reported completing 75% or more of the prescribed PA each week. Eight stoma-related themes were identified from qualitative interviews: fear of hernia, bending down, fatigue, pain, prolapse, surgical wounds, stoma appliance, and stigma. The intervention appeared to address these issues. CONCLUSION This feasibility study demonstrated that a novel manualised PA intervention for people with a stoma is safe, feasible, and acceptable, and shows promise for improving outcomes. However, difficulties with recruitment will need to be carefully considered to ensure the success of future studies in this area. TRIAL REGISTRATION ISCTN, ISRCTN58613962; Registered 14/9/2017.
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Affiliation(s)
- Gill Hubbard
- Department of Nursing and Midwifery, Centre for Health Science, University of the Highlands and Islands, Old Perth Road, Inverness, IV2 3JH UK
| | - Claire Taylor
- St Mark’s Hospital, London North West University Healthcare NHS Trust, Harrow, Middlesex HA1 3UJ UK
| | - Angus J. M. Watson
- Department of Surgery, Raigmore Hospital, NHS Highland, Old Perth Rd, Inverness, IV2 3UJ UK
| | - Julie Munro
- Department of Nursing and Midwifery, Centre for Health Science, University of the Highlands and Islands, Old Perth Road, Inverness, IV2 3JH UK
| | - William Goodman
- Leeds Institute of Health Sciences, University of Leeds, Worsley Building, Clarendon Way, Leeds, LS2 9NL UK
| | - Rebecca J. Beeken
- Leeds Institute of Health Sciences, University of Leeds, Worsley Building, Clarendon Way, Leeds, LS2 9NL UK
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12
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Taylor C, Munro J, Goodman W, Beeken RJ, Dames N, Oliphant R, Watson AJ, Hubbard G. Experiences of wearing support garments by people living with a urostomy. ACTA ACUST UNITED AC 2019; 28:S26-S33. [PMID: 31835944 DOI: 10.12968/bjon.2019.28.22.s26] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND support garments are commonly worn by people with a urostomy but there are no published data about their experiences of doing so. AIMS to identify the views of people living with a urostomy on the role of support garments. METHODS a cross-sectional survey of the stoma population's experiences of support garments was conducted in 2018. Recruitment was by social media. The free-text responses provided by a sub-sample of 58 people out of 103 respondents with a urostomy, were analysed. FINDINGS thematic analysis revealed four themes: physical self-management; psychosocial self-management; lifestyle; and healthcare advice and support. There were mixed feelings about the value of support garments. Many cited a sense of reassurance and confidence and being able to be more sociable and active; others reported discomfort and uncertainty about their value. CONCLUSION these findings add new understanding of experiences of support garments and provide novel theoretical insights about life with a urostomy.
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Affiliation(s)
- Claire Taylor
- Macmillan Nurse Consultant in Colorectal Cancer, London North West Healthcare NHS Trust
| | - Julie Munro
- Macmillan Nurse Consultant in Colorectal Cancer, London North West Healthcare NHS Trust
| | | | | | | | - Raymond Oliphant
- Department of Surgery, Raigmore Hospital, NHS Highland, Inverness
| | - Angus Jm Watson
- Department of Surgery, Raigmore Hospital, NHS Highland, Inverness
| | - Gill Hubbard
- Department of Nursing and Midwifery, Centre for Health Science, University of the Highlands and Islands, Inverness
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Hubbard G, Beeken RJ, Taylor C, Watson AJM, Munro J, Goodman W. A physical activity intervention to improve the quality of life of patients with a stoma: a feasibility study protocol. Pilot Feasibility Stud 2019; 5:78. [PMID: 31236285 PMCID: PMC6580610 DOI: 10.1186/s40814-019-0461-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 06/04/2019] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Physical activity (PA) is positively associated with quality of life. People with a stoma are less likely to engage in PA than those without a stoma. METHODS In this feasibility intervention study, we will perform the following: (1) Develop a PA intervention for people with a stoma. An Expert Working Group of behavioural scientists, exercise scientists, clinicians and a Patient Advisory Group of people with a bowel stoma will meet with the research team to inform the development of a PA intervention for people with a stoma. A manual of the intervention will be the main output. (2) Explore PA instructors' experiences of delivering the PA intervention. PA instructors will record on paper the number of PA consultations with each patient and a researcher will interview the PA instructors about their experiences of delivering the intervention. (3) Assess the level of patient (bowel cancer or inflammatory bowel disease (IBD) patients with a stoma between 6 weeks and 24 months post-surgery) engagement with the PA intervention and their views on intervention acceptability and usefulness. Patients will keep a PA diary to record daily pedometer recorded step count and type and duration of activities. A researcher will interview patients about their experiences of the PA intervention. (4) Assess screening, eligibility, consent, data completion, loss to follow up, and missing data rates, representativeness of participants and potential treatment effects. A researcher will record on paper all study procedure parameters. Quality of life (stoma-quality of life; Functional Assessment of Cancer Therapy, Short IBD questionnaire), fatigue (FACIT fatigue scale) and PA (accelerometer) will be measured pre- and post-intervention in patients. For IBD patients only, blood will be taken to measure systemic inflammation. DISCUSSION We hypothesise that a PA intervention will be an effective means of improving the quality of life of people with a stoma. Before embarking on a full randomised controlled trial to test this hypothesis, a PA intervention needs to be developed and a feasibility study of the proposed PA intervention conducted. TRIAL REGISTRATION ISRCTN58613962, Protocol version: 0.1. 14 September 2017.
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Affiliation(s)
- Gill Hubbard
- Department of Nursing and Midwifery, University of the Highlands and Islands, Centre for Health Science, Old Perth Road, Inverness, IV2 3JH Scotland, UK
| | - Rebecca J. Beeken
- Leeds Institute of Health Sciences, University of Leeds, Worsley Building, Clarendon Way, Leeds, LS2 9NL England, UK
| | - Claire Taylor
- St Mark’s Hospital, London North West University Healthcare NHS Trust, Harrow, Middlesex, HA1 3UJ England, UK
| | - Angus J. M. Watson
- Department of Surgery, Raigmore Hospital, NHS Highland, Old Perth Rd, Inverness, IV2 3UJ England, UK
| | - Julie Munro
- Department of Nursing and Midwifery, University of the Highlands and Islands, Centre for Health Science, Old Perth Road, Inverness, IV2 3JH Scotland, UK
| | - William Goodman
- Research Department of Behavioural Science and Health, University College London, Gower Street, London, WC1E 6BT England, UK
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Hubbard G, Taylor C, Munro J, Dames N, Goodman W, Oliphant R, Beeken R. Experiences of support garments following bowel stoma formation: analysis of free-text responses in a cross-sectional survey. BMJ Open Gastroenterol 2019; 6:e000291. [PMID: 31275585 PMCID: PMC6577355 DOI: 10.1136/bmjgast-2019-000291] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 04/08/2019] [Accepted: 04/15/2019] [Indexed: 12/13/2022] Open
Abstract
AIM To explore the experiences of support garments when adjusting to bodily change following bowel stoma formation. DESIGN Thematic analyses of free-text responses in a cross-sectional survey of the stoma population in 2018. METHODS Free-text responses were invited so that respondents could describe their experiences in more detail. A process of induction was chosen to allow for themes to emerge directly from the data. The concept 'embodiment' was used as a theoretical framework during interpretation. RESULTS 1425 people with a bowel stoma responded to the survey, of whom 598 provided free-text responses. Four themes about experiences of support garments in the context of changed bodily experiences following stoma formation were identified: body complications, which is about experiences of using support garments to prevent or self-manage parastomal hernia; body appearance, which is about hiding the stoma and stoma appliance; body function, which is about managing stoma appliance complications; and body sensation, which is mainly about negative experiences of ill-fitting garments. CONCLUSION Support garments can be understood as items that are used by people during an ongoing process of adjusting to bodily changes following stoma formation and as part of an ongoing process of reconstructing new embodied selves. IMPACT This is the first study to explore people's experiences of support garments following bowel stoma formation. Support garments are used in the self-management of body complications, appearance, function and sensations. Stoma nurses may draw on the findings of this study to advise patients about the benefits of garments for adjusting to bodily change, and garment suppliers should address people's negative experiences by improving garments.
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Affiliation(s)
- Gill Hubbard
- Department of Nursing and Midwifery, University of the Highlands and Islands, Inverness, UK
| | - Claire Taylor
- St Mark's Hospital, London North West University Healthcare NHS Trust, London, UK
| | - Julie Munro
- Department of Nursing and Midwifery, University of the Highlands and Islands, Inverness, UK
| | | | - William Goodman
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | | | - Rebecca Beeken
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
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15
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Burch J. Research and expert opinion on siting a stoma: a review of the literature. ACTA ACUST UNITED AC 2018; 27:S4-S12. [DOI: 10.12968/bjon.2018.27.16.s4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jennie Burch
- Head of Gastrointestinal Nurse Education, St Mark's Hospital, Harrow, London
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