RESUMEN
PURPOSE: The purpose of this study was to compare health-related quality of life (HRQOL) in patients receiving preoperative stoma marking by a certified wound, ostomy and continence nurse (CWOCN) to patients who did not receive preoperative marking. DESIGN: Quasi-experimental, nonrandomized comparison cohort study. SUBJECTS AND SETTING: The sample comprised 59 patients immediately following creation of a fecal stoma during an 18-month period between 2008 and 2010. The experimental group consisted of 35 patients with a mean age of 49.7 years who received preoperative stoma site marking by a CWOCN. Six of those 35 patients (17%) received preoperative ostomy education and stoma site marking. The control group consisted of 24 patients with a mean age of 60.1 years who did not receive preoperative stoma site marking or preoperative ostomy education. The study setting was a 500-bed Midwest Magnet-designated teaching hospital. METHODS: Data collection occurred at 2 points: within 72 hours before hospital discharge and 8 weeks after discharge. The Stoma Quality of Life (Stoma-QOL) instrument was used to measure HRQOL. Two CWOCNs and 3 RNs, all members of Memorial's Ostomy & Wound Services, administered the Stoma QOL within 72 hours before hospital discharge. The 2 CWOCNs followed a scripted message to collect functional lifestyle factors and administer the Stoma-QOL, for the second time at 8 weeks after discharge. RESULTS: Groups were compared using analysis of covariance to control for age; analysis demonstrated significantly higher HOQOL in the marked group compared to the unmarked group (F = 4.9, P = .031). CONCLUSION: Findings demonstrated that patients who underwent stoma site marking reported higher HRQOL than those who did not.
Asunto(s)
Colostomía/enfermería , Estado de Salud , Cuidados Preoperatorios/enfermería , Calidad de Vida , Estomas Quirúrgicos , Adulto , Anciano , Estudios de Cohortes , Femenino , Humanos , Estilo de Vida , Masculino , Persona de Mediana Edad , Educación del Paciente como Asunto , AutocuidadoRESUMEN
Incontinence affects 20%-30% of children. Historically, evaluation of voiding problems in children has involved complete urodynamic studies and treatment based primarily on bladder findings and anticholinergic medications. Unfortunately, success with this approach has been poor. This article describes new advances in our understanding of the causes of nonneurologic pediatric incontinence and its associated problems and provides new treatment strategies to manage these patients. A strategy incorporating an escalating approach to evaluation and treatment is the cornerstone of this approach. Minimizing the routine use of invasive studies and medication is the result.