High Subcutaneous Fat Area Is an Independent Risk Factor for Parastomal Hernia after Transperitoneal Colostomy for Colorectal Cancer.

Objectives: Parastomal hernia (PSH) is a common complication of colostomy; however, its risk factors remain poorly investigated. In this study, we examined the associations between sarcopenia, visceral and subcutaneous fat, and PSH in patients who underwent transperitoneal colostomy for colorectal cancer. Methods: This retrospective, single-center, cohort study included 60 patients who underwent laparoscopic or robot-assisted abdominoperineal resection or Hartmann's procedure for colorectal cancer between November 2010 and February 2022. Stoma creation was uniformly performed using the transperitoneal approach, and PSH was diagnosed via abdominal computed tomography (CT) at 1 year postoperatively. Visceral fat areas (VFAs) and subcutaneous fat areas (SFAs) were measured through preoperative CT images using an image analysis system. Risk factors for PSH were retrospectively analyzed. Results: PSH was diagnosed in 13 (21.7%) patients. In the univariate analysis, PSH was significantly associated with body mass index >22.3 kg/m2 (p=0.002), operation time >319 min (p=0.027), estimated blood loss >230 mL (p=0.008), postoperative complications (p=0.028), stoma diameter >18.6 mm (p=0.015), VFA >89.2 cm2 (p=0.005), and SFA >173.2 cm2 (p=0.001). Multivariate analyses confirmed that SFA >173.2 cm2 (odds ratio: 16.7, 95% confidence interval 1.29-217.2, p=0.031) was an independent risk factor for PSH. Conclusions: Subcutaneous fat area is significantly associated with the development of PSH after transperitoneal colostomy. Applying these insights could help to prevent PSH.

The experiences of family resilience in patients with permanent colostomy and their spouses: A dyadic qualitative study.

PURPOSE: With the prolonged survival time of patients with permanent colostomy for colorectal cancer, they and their spouses face tremendous pressure and development dilemmas that can easily lead to family adaptation crises. This qualitative study amid to explore the dyadic experiences of family resilience among Chinese patients with permanent colostomy and their spouses. METHODS: A phenomenological research method was adopted. Semi-structured, in-depth, face-to-face interviews with 10 dyads of patients with permanent colostomy and their spouses were recruited through purposive sampling from a public tertiary hospital in China from March 2023 to July 2023.The Dyadic interview analysis and Colaizzi methods were used to analyze the interview data. RESULTS: Three themes and nine subthemes were developed. (1) family crisis and dichotomous coping with stress-family crisis and coping pressure caused by enterostomy; (2) Adjustment and adaptation within the family-Joint adjustment and adaptation within the couple's family; and (3) integration and utilization of multi-dimensional social external resources (micro-level, meso-level, and macro-level). CONCLUSIONS: Couples living with permanent colostomy often undergo a complex emotional journey, experiencing varied levels of individual stress as they navigate social interactions and daily activities, which can contribute to a decline in family adaptation. With the help of the perspective of family advantage, health practitioners should pay attention to the evaluation of individual factors and family environmental resources, to fully mobilize advantage resources and give effective interventions to improve the family and social adaptation level of patients and their spouses.

Effects of lavender oil on odor elimination, ostomy adjustment and quality of life in patients with permanent colostomy: A randomized controlled trial.

PURPOSE: The aim of this study is to assess the impact of lavender oil on odor elimination, ostomy adjustment and quality of life outcomes in patients with permanent colostomy. Specifically, the study aims to compare the outcomes of an experimental group receiving lavender oil intervention with those of a control group. METHODS: A randomized controlled trial design was employed, including an experimental group receiving lavender oil intervention and a control group receiving standard care. The study participants were patients with permanent colostomy. Various variables were assessed, including odor scale, work and social functioning, sexuality and body image, stoma function, financial concerns, acceptance, anxiety/preoccupation, social engagement and anger. RESULTS: The post-scores assessment showed significant differences between the experimental and control groups in all variables. The experimental group exhibited significantly more positive outcomes concerning the reduction of odor (p<0.001), performance in the workplace (p<0.001), body image connected to sexuality (p<0.001), stoma functionality (p<0.001), financial worries (p=0.005), acceptance levels (p<0.001), anxiety levels (p<0.001), social involvement (p<0.001), and irritability (p<0.001). Effect sizes were substantial (=0.88-0.98 in all variables but one), indicating significant differences in average scores before and after the intervention. CONCLUSION: The findings of this study suggest that lavender oil intervention effectively improved odor elimination, ostomy adjustment and quality of life outcomes in patients with permanent colostomy.

Validation of the Chinese version of the colostomy impact score in rectal cancer patients with permanent colostomy.

OBJECTIVE: To test the reliability and validity of the Chinese version of the colostomy impact score (CIS) among patients with a permanent colostomy in China. METHODS: A total of 218 patients completed the survey either in the clinic or remotely and mailed their responses. Reliability was estimated based on test-retest reliability. Validity was evaluated based on content validity, construct validity, and discriminative validity. The sensitivity and specificity of the score were analysed. The area under the curve was analysed by drawing the receiver-operating characteristic (ROC) curve; the optimal cutoff point was calculated to assess the impact of a stoma on domestic patients. RESULTS: The test-retest reliability of the CIS was 0.967. The content validity was 0.98, and the construct and discriminative validities were good; sensitivity, specificity, and area under the ROC curve were 100, 48.53, and 0.806%, respectively. The optimal cutoff point for the Chinese version of the Colostomy Impact Score was 11.5. CONCLUSIONS: The Chinese version of the CIS indicated good reliability and validity, making it suitable for the evaluation of the impact of a permanent colostomy.

The effect of online training-based continuous nursing care for rectal cancer-patients undergoing permanent colostomy.

OBJECTIVE: The study explored and analyzed the effects of online training based continuous nursing care on the health-related life quality and self-care ability of rectal cancer patients undergoing permanent colostomy. METHODS: A total of 119 patients who were hospitalized and underwent permanent colostomy due to rectal cancer from January 2018 to December 2019 were collected as research subjects and were divided into the control group (n=57) and the observation group (n=62) based on their admission time. The control group received routine nursing, while the observation group was treated with online training based continuous nursing care in addition to routine nursing. Both groups' self-efficacy, self-care ability, quality of life, psychological status and complications within 6 months after discharge were compared. RESULTS: Both groups had increased scores in self-efficacy, and their dimensional scores and total scores of self-care ability after intervention were higher compared with pre-intervention (P<0.05), and the indexes of the observation group after intervention were significantly higher than that of the control group (P<0.05). The two groups had remarkably increased SF-36 scores of each dimension after intervention compared with pre-intervention (P<0.05), and the observation group had apparently higher SF-36 scores than the control group after intervention (P<0.05). The two groups had increased SAS and SDS grades in post-intervention compared with pre-intervention (P<0.05), and the observation group had notably higher SAS and SDS scores than the control group (P<0.05). The complication rate within 6 months after discharge in the observation group was obviously lower than which in the control group (P<0.05). CONCLUSION: An online training based continuous caring model can effectively improve the self-care ability and self-efficacy of rectal cancer patients with permanent enterostomy, thus promoting better life quality and psychological states, and effectively reducing the incidence of complications after discharge.

Quality of life of persons with permanent colostomy: a phenomenological study / Qualidade de vida de pessoas com colostomia permanente: um estudo fenomenológico

ABSTRACT Objectives: To describe the experiences of persons with permanent colostomy regarding their quality of life. Methods: The study design used descriptive phenomenology following the approach of Collaizzi. There were 12 participants who qualified using purposive sampling based on the inclusion criteria.The data generated were in-depth interviews. Analysis and interpretation used verbatim descriptions. Results: The research data revealed seven themes, namely: limitation in daily living activities, limitations in marital relations and social relationship with others, negative feelings about having the colostomy, financial difficulties, increasing demands of living with colostomy, changes in the needs of rest, physical and expectation of complications, and hoping to live a normal life after colostomy. Conclusion: This study revealed that persons with permanent colostomy experience difficulties and limitations pertaining to daily living activities, including marital and social relations. Importantly, they experience psychological concerns, e.g. having negative feelings about ways of living their lives, including financial difficulties and adjusting to new ways of living. However, there is always the hope to live a normal life. This study provides an understanding of the quality of life of persons with permanent colostomy, allowing nurses to provide appropriate nursing care.

RESUMO Objetivos: Descrever as experiências de pessoas com colostomia permanente quanto à qualidade de vida. Métodos: O desenho do estudo utilizou a fenomenologia descritiva seguindo a abordagem de Collaizzi. Havia 12 participantes que se qualificaram usando amostragem intencional com base nos critérios de inclusão. Os dados gerados foram entrevistas detalhadas. A análise e a interpretação usaram descrições literais. Resultados: Os dados da pesquisa revelaram sete temas, a saber: limitação nas atividades da vida diária, limitações nas relações conjugais e relação social com os outros, sentimentos negativos sobre a colostomia, dificuldades financeiras, crescentes demandas de viver com colostomia, mudanças nas necessidades de repouso, físicas e expectativa de complicações, e esperança de viver uma vida normal após a colostomia. Conclusão: Este estudo revelou que pessoas com colostomia permanente apresentam dificuldades e limitações relativas às atividades da vida diária, incluindo relações conjugais e sociais. É importante destacar que têm preocupações psicológicas, p.ex., sentimentos negativos sobre formas de viver suas vidas, incluindo dificuldades financeiras e adaptação a novas formas de viver. No entanto, há sempre a esperança de viver uma vida normal. Este estudo fornece uma compreensão da qualidade de vida de pessoas com colostomia permanente, possibilitando aos enfermeiros fornecer cuidados de enfermagem apropriados.

Quality of life in rectal cancer patients with permanent colostomy in Xi'an.

OBJECTIVES: To observe the quality of life (QOL) in rectal cancer patients with permanent colostomy in different periods after operation. METHODS: A 1-,3-,6-month prospective study of QOL in 51 rectal cancer patients with permanent colostomy and 50 without permanent colostomy was assessed using European Organization for Research and Treatment of Cancer (EORTC) QOL-30 and CR38 questionnaires. RESULTS: The variation of QOL in different periods was "v" type. In the 1st postoperative month, these patients had the lowest quality of life scores, accompanied significantly varied functions and severe symptoms. Almost of all indexes of these patients had improved consistently in the postoperative period. The scores of global QOL even better than pre-operative level at 6th months post-operation, but the social function, body image, chemotherapy side effects and financial difficulties had not restored to the baseline level. Patients without permanent colostomy had a better score in most of categories of QOL-30 and CR38. CONCLUSIONS: The 1st postoperative month was crucial for patients' recovery, in which we should pay great attention to these problems which relate to the recovery of rectal cancer patients with permanent colostomy.