Sleep Quality and Factors Affecting Sleep in Individuals With an Intestinal Ostomy: A Descriptive Cross-Sectional Study.

BACKGROUND: Multiple factors affect the sleep quality of individuals with intestinal stomas. PURPOSE: This study sought to determine sleep quality and factors affecting sleep in individuals with intestinal ostomies. METHODS: A descriptive cross-sectional design was used. This study followed 68 individuals with intestinal stomas at the stoma therapy unit of a university hospital. A form was used to gather information about patient demographic and stoma-related data (age, sex, work status, stoma duration, cause and type of stoma, stoma care provider, sleep status during the day, daily coffee consumption, and stoma-related factors affecting sleep), and the Pittsburgh Sleep Quality Index was used to score patient sleep patterns. Descriptive statistics, t-test, chi-square test, Fisher's exact test, and logistic regression analysis were used for statistical analysis. RESULTS: The patients' mean age was 53.7 ± 13.8 years; 51.5% were male, and 66.2% were married. Of the 68 patients, 41.2% had a diagnosis of rectal cancer, and 55.9% had ileostomies. Mean stoma duration was 24.1 ± 5.8 months, and 57.4% of participants performed their own stoma care. On a scale of 0 to 21, the participants' mean sleep score was 9.08 ± 5.03, and 66.2% of patients were found to have poor sleep quality. High sleep quality was significantly positively associated with colostomy (odds ratio, 1.78; 95% confidence interval [CI], 1.18-2.69; P = .006) and self-performed stoma care (odds ratio, 1.54; 95% confidence interval, 1.03-2.30; P = .036). CONCLUSION: The results of the current study can provide reference data for future studies and highlight the importance of assessing sleep quality in persons with intestinal stomas.

Disgust and Its Effect on Quality of Life and Adjustment to Stoma in Individuals with Ileostomy and Colostomy

AIM: This study aims to determine the effect of disgust sensitivity on the quality of life of patients with ileostomy and colostomy, and their adaptation to stoma. METHODS: This study has a cross-sectional and correlational design. The sample consists of 167 patients being treated in a state hospital and a private foundation hospital, who meet the research inclusion criteria. The Patient Information Form, Disgust Sensitivity Scale, Ostomy Adjustment Inventory, and Ostomy Quality of Life Scale (OQLS) are used for data collection. Descriptive statistics, oneway analysis of variance (ANOVA), t-test, and correlation analysis are used in data analysis. RESULTS: Of the 86% of the participants diagnosed with cancer, 60% had undergone ileostomy and 40% had undergone a colostomy; 46% of the patients declared that they were capable of handling their own stoma care and 53% stated that they felt self-efficient about care. Participants who were female (88.55 ± 23.17), single (88.40 ± 20.98), or university graduates (93.34 ± 22.92) had higher disgust sensitivity scores. The study found no significant correlation between disgust sensitivity, quality of life, and stoma adjustment scores (p > .05). CONCLUSION: The findings proved believe that recognizing the disgust sensitivity will help meet the physical and psychological needs of stoma patients and understand their quality of life and adjustment to stoma. This will help in guiding both patients and healthcare workers, and lead clinical studies.

Complicated or not complicated: Stoma site marking before emergency abdominal surgery.

BACKGROUND: Marking a stoma site preoperatively decreases the possibility of experiencing later stoma-related problems and improves the quality of life of patients in the postoperative period. Those best equipped to perform this procedure are ostomy nurses and colorectal surgeons, as they receive the stoma therapy education during their training programs. The aim of this study was to compare the rate of stoma problems and quality of life of patients who underwent an operation that included stoma creation (elective or urgent) with and without preoperative stoma siting. The approach and behavior of surgical residents regarding stoma creation was also assessed. METHODS: Patients who had undergone gastrointestinal surgery between January 2012 and December 2013 were assessed. A total of 116 of those patients who had a stoma created during the initial operation were followed by a stoma therapy nurse in the postoperative period and were enrolled in the current study. In addition, a survey of the residents was conducted to evaluate their knowledge about stoma creation and stoma care. RESULTS: A total of 67 (58%) of the 116 patients included were male. The median age was 57±16 years (range: 17-87 years). A body mass index above 30 kg/m2 was detected in 16 patients (14%). The reason for surgery was malignant disease in 93 (80%) patients, and 97 cases (84%) were elective operations. Preoperative stoma marking was performed in 72 patients (62%). The stoma type was an ileostomy in 87 patients (75%). Stoma-related complications were observed in 40 patients (35%). Emergency surgery (p=0.020), preoperative stoma marking (p=0.000), adjuvant therapy (p=0.004), and the stoma caretaker (patient or relatives) (p=0.05) were associated with stoma-related complications. Logistic regression analysis revealed that only the type of surgery (emergency or elective), preoperative stoma marking, and the stoma caretaker increased the rate of stoma-related complications. CONCLUSION: Marking the stoma location before surgery reduces the risk of stoma-related complications and has a positive effect on the patient's quality of life. Multivariable analysis indicated that marking the stoma site before the operation was the only factor that affected the rate of stoma-related complications, regardless of emergency or elective surgical conditions. Since surgeons will encounter the need for a stoma procedure during their professional career and they will not always have the opportunity to work with stoma therapy nurse, stoma care education should be provided during their residency (internship) education, and ascertaining a stoma localization before surgery for all potential stoma cases should be encouraged in emergency shifts.