The psychometric properties of the Turkish version of the Ostomy Self-Care Index and the Caregiver Contribution to Self-Care in Ostomy Patient Index.

BACKGROUND: Living with an ostomy is a chronic condition, and self-care in such cases improves patient outcomes. PURPOSE: To adapt and test the psychometric properties of the Turkish version of the Ostomy Self-Care Index (T-OSCI) and the Turkish version of the Caregiver Contribution to Self-Care in Ostomy Patient Index (T-CC-OSCI). METHODS: A psychometric study was conducted on a convenience sample of 202 adult patients with an ostomy and their 165 caregivers. Translation and back translation, face and content validity, construct validation, and reliability assessment of the T-OSCI and the T-CC-OSCI were performed. Exploratory factor analysis was used to evaluate the construct validity. Reliability was established using Cronbach α coefficients, ceiling and floor effects, and the Hotelling T2 test, Wilcoxon signed rank test, and intraclass correlation coefficient. RESULTS: Content validity values were in the range of 0.85 to 1 for both the T-OSCI and the T-CC-OSCI. Exploratory factor analysis demonstrated generally acceptable factor loadings. The overall index revealed a high level of internal consistency (T-OSCI = 0.968, T-CC-OSCI = 0.862). No statistically significant difference was found between test-retest measurements. There was no indication of either ceiling or floor effects, or response bias. CONCLUSION: The T-OSCI and the T-CC-OSCI are valid and reliable indexes to measure the self-care of patients with an ostomy and their caregivers. These indexes may allow health care professionals to evaluate self-care in research and clinical settings, identify educational needs, and collaborate in developing and supporting appropriate self-care initiatives for patients with an ostomy and their caregivers.

Risk factors for early ostomy complications in emergency and elective colorectal surgery: A single-center retrospective cohort study.

BACKGROUND AND AIMS: The clinical significance of early ostomy complications has been emphasized worldwide, and the current evidence concerning the impact of emergency or elective surgery on ostomy complications is limited. This study aimed to investigate the effect of elective and emergency colorectal surgery on early ostomy complications and the risk factors associated with specific complications. METHODS: A mandatory colorectal recording system for consecutive ostomy patients between 2012 and 2020 was reviewed retrospectively. Patient socio-demographics, ostomy-related variables, and early period ostomy complications were retrieved from the patient records. The chi-square test, t-test, analysis of variance (ANOVA), and logistic regression were used to analyze the data. RESULTS: The study cohort included 872 patients. At least one or more complications developed in 573 (65.7%) patients, 356 (63.6%) in the emergency group, and 217 (69.6%) in the elective group. When comparing emergency surgery to elective surgery, necrosis (7.4% versus 3.4%, p = 0.009), mucocutaneous separation (37.2% versus 27.1%, p = 0.002), and bleeding (6.1% versus 2.1%, p = 0.003) were more prevalent. Peristomal irritant contact dermatitis (PICD) (37.3% versus 26%, p < 0.001) was more common in elective surgery. Risk factors for PICD were comorbidity (p = 0.003), malignant disease (p = 0.047), and loop ostomy (p < 0.001) in elective surgery; female sex (p = 0.025), neo-adjuvant therapy (p = 0.024), and ileostomy (p = 0.006) in emergency surgery. The height of the ostomy (less than 10 mm) was a modifiable risk factor for mucocutaneous separation in both elective surgery (p < 0.001) and emergency surgery (p = 0.045). CONCLUSION: Early ostomy complications were more likely to occur after emergency colorectal surgery than in an elective setting. Patient- and ostomy-related risk factors for complications differed between elective and emergency surgeries.

Ostomy Complications, Risk Factors, and Applied Nursing Care: A Retrospective, Descriptive Study.

PURPOSE: This study aimed to describe the frequency of colostomy and ileostomy complications and types of nursing interventions as well as to examine patient and ostomy variables associated with early and late complications. METHODS: The records of 572 patients who received ostomy care from a wound ostomy care (WOC) nurse between 2013 and 2017 were abstracted. Patient demographic and ostomy variables, early period (< 30 days after surgery) and late period (> 30 days after surgery) complications, as well as documented nursing interventions were retrieved. Percentages and rates, chi-square statistics, and logistic regression were used to analyze the data. RESULTS: The mean patient age was 59.1 years (standard deviation [SD], 13.86), and the majority of patients were male (302 patients; 52.8%), married (454; 79.4%), and had a temporary (438; 76.6%) end colostomy (253; 44.2%). One (1) or more complications developed in 323 patients (56.5%) in the early period and in 207 patients (36.2%) in the late period. The most common complications in the early period were peristomal irritant contact dermatitis (PICD) (181; 31.6%) and mucocutaneous separation (135; 23.6%). PICD was also the most common complication in the late period (149; 26%). The risk of PICD was significantly higher in patients with a body mass index > 24.9 kg/m2 (odds ratio [OR] = 1.547), who had an ileostomy (OR = 1.654), or a temporary ostomy (OR = 1.728). Variables associated with an increased risk of mucocutaneous separation included obstacles to ostomy care (OR = 2.222), having an end ostomy (OR = 2.171), and ostomy height < 10 mm (OR = 1.964). Complications were treated by the WOC nurse in 67.5% of patients, and the most common intervention was application of skin barrier powder and wipe layers. CONCLUSIONS: The rate of ostomy complications, especially PICD and mucocutaneous separation, in this study was high. Results confirm that patient and ostomy characteristics might significantly affect the risk of complications. The findings support the importance of outpatient follow-up by a WOC nurse. Explorative or randomized controlled studies are needed to identify optimal nursing strategies to decrease complication rates.

Relationships Among Spiritual Well-being, Adjustment, and Quality of Life in Patients With a Stoma: A Cross-sectional, Descriptive Study.

Individual spiritual preferences and adjustment to a stoma may affect quality of life. PURPOSE: This study aimed to investigate the relationship among and the factors that influence spiritual well-being, adjustment to a stoma, and quality of life in patients with a stoma. METHODS: A cross-sectional, descriptive study was conducted over 6 months among outpatients with a stoma recruited from general surgery and enterostomal therapy clinics of a university hospital in Turkey. Turkish-speaking patients who were at least 18 years of age and had a colostomy or ileostomy for at least 2 months were eligible to participate. Participants independently (or with researcher help if necessary) completed the Sociodemographic Characteristics Form; the 12-item Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp) that utilized 5-point, Likert-style responses to items regarding meaning, peace, and faith (score range 0-48; higher scores indicate more spiritual well-being); the 23-item Ostomy Adjustment Scale that utilized 5-point, Likert-style responses to items regarding acceptance worry, social adjustment, and anger (score range 0-92; higher scores indicate better adjustment); and the 21-item Stoma Quality of Life Scale that used a combination of scoring methods (score range 0-100; higher scores imply better quality of life) and Likert-style questions. Data were transferred without patient names from the questionnaires directly into a software program for analysis. Descriptive statistics, correlation, and hierarchical regression analyses were applied. RESULTS: Of the 95 participants (52 [54.7%] men; mean participant age 56.54 ± 13.74 years), mean scores were 31.66 ± 7.39 for spiritual well-being, 51.73 ± 12.28 for adjustment to a stoma, and 55.27 ± 16.45 for quality of life. A statistically significant difference was found between the mean spiritual well-being and quality-of-life (r = 0.525, P <.001) and adjustment to a stoma (r = .549, P <.001) scores, and a significant relationship was noted between the mean quality-of-life and adjustment scores (r = 0.698, P <.001). Stoma adjustment and quality of life significantly correlated with the meaning and peace subscales of FACIT-Sp (P <.001). No correlation was found between faith or stoma adjustment and quality of life. Hierarchical regression analysis showed the most significant factors affecting quality of life were adjustment to a stoma (ß = .541) and spiritual well-being (ß = .190). CONCLUSION: Adjustment and spirituality are important quality-of-life factors in patients with a stoma. Clinical assessments and practices should include the meaning and peace aspects of spiritual well-being and how well the patient is adjusting to the stoma. Well-designed randomized controlled studies that evaluate the impact of the spiritual dimension of nursing care on patient outcomes as well as the effect of spiritual well-being on adjustment to stoma are suggested.