Family Functioning, Perceived Social Support, and Adaptation to a Stoma: A Descriptive, Cross-sectional Survey.

The creation of a stoma is a life-saving surgical procedure that requires major adjustments. PURPOSE: The aim of this study was to examine the relationships among family functioning, perceived social support, and adaptation to living with a stoma. METHOD: A descriptive, cross-sectional survey was conducted between October 2013 and June 2015 among consecutive patients who visited the stomatherapy unit of a university hospital in Ankara, Turkey, for regular follow-up visits. Eligibility criteria stipulated participants must be at least 18 years of age, literate, live with family, have their stoma for at least 2 months, and be willing to participate. Instruments included a demographic and stoma-related information form, the Multidimensional Scale of Perceived Social Support (MSPSS; subscale range 4-28, total score range 12-84; higher scores indicate better perceived support), the McMaster Family Assessment Scale (FAS; range 1.32-3.15; higher scores indicate deteriorating family function), and the Ostomy Adjustment Inventory Scale-23 (OAI-23; range 19-85; higher scores indicate increasing adaptation). Data were entered into statistical software for analysis that included descriptive statistics and Mann-Whitney U and Spearman correlation tests. RESULTS: Among the 75 participants (mean age 55.4 ± 12.96 years; average stoma duration 3.77 ± 4.97 years), 41 (54.7%) were male, 59 (78.7%) were married, and mean duration of living with a stoma was 3.77 ± 4.97 years. The average MSPSS score was 61.0 5 ± 15.00, the average FAS score was 1.98 ± 0.38, and the average OAI-23 score was 49.39 ± 14.62, all within the "moderate" range for their measures. Stoma complications, time since surgery, stoma self-care, marital status, whether the surgery was planned or an emergency, and employment status significantly affected MSPSS, FAS, and OAI-23 scores. As the FAS scores increased, the MSPSS (r = -.399; P = .001), and OAI-23 (r = -.300; P = .009) scores decreased. CONCLUSION: The results suggest wound, ostomy, continence nurses should assess and encourage familial and social support. Prospective studies examining the effect of familial and social support on stoma adjustment are warranted.

Effect of psychological care given to the women who underwent hysterectomy before and after the surgery on depressive symptoms, anxiety and the body image levels.

This study was conducted for the purpose of evaluating the effect of the psychological care given to women before and after hysterectomy surgery on depression levels, anxiety and body image. This experimental study was conducted in the gynecological oncology surgery clinic of Samsun Education and Research Hospital in Turkey between the dates of January 2018 and June 2018. Those who meet the sample selection criterion and agreed to participation to the study among the women who were admitted to the clinic for hysterectomy were assigned randomly to the experimental and control groups. 42 women in total including 21 women in each of experimental and control groups formed the sample of the study. The effect of the psychological care was evaluated through Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI) and Body Catherix Scale (BCS). The evaluation measurements were conducted as pre-test, post-test and follow-up (2-months post-test). The BDI and STAI scores of the women who receive psychological care have decreased and their BPS scores have increased. On the contrary, BDI and STAI scores of the women who receive psychological care in the experimental group have increased and their BCS scores have decreased. These findings show that psychological care has positive effects on depressive symptoms, anxiety and the body image in the women who underwent hysterectomy.IMPACT STATEMENTWhat is already known on this subject? Having a hysterectomy impacts a woman's life in a significant manner. As such, deciding to undergo a hysterectomy is a difficult process for women, especially from a psychological perspective. Following a hysterectomy, women commonly experience changes in body perception, such as perceiving the body as different, feeling disabled, feeling hollow, believing they are different than other women and feeling that their body is attracting notice. The literature reports that women perceive themselves as different, alienated, impaired and changed after a hysterectomy and that they have difficulty making contact with the environment; furthermore, the more changes in body perception increase, the more depression increases.What the results of this study add? This study revealed that psychological care given to women before and after undergoing a hysterectomy decreases anxiety and increases positive body perception. For this reason, psychological care for women undergoing hysterectomies should be part of routine nursing care and should be started upon the hospitalisation of the patient.What are the implications of these findings for clinical practice and/or further research? The findings of this study indicate that after a hysterectomy, women experience not only physiological disease symptoms but also psychological problems. Therefore, women who have undergone or will undergo a hysterectomy also have psychological needs. Further study is suggested to determine what can be done with a professional team to meet the demands for psychological care.

Anxiety, Depression Levels and Quality of Life in Patients with Gastrointestinal Cancer in Turkey.

BACKGROUND: Cancer is a major public health problem in many parts of the world. Gastrointestinal (GI) cancers are responsible for 20% of all cancer-related deaths. In Turkey, stomach cancers account for 8.9%, colon cancer for 6.9%, and pancreatic cancer for 5.9%. This study examined the anxiety-depression levels and the quality of life of patients with GI cancer. MATERIALS AND METHODS: This descriptive study was carried out on 335 adult patients who had gastrointestinal cancer and who were hospitalized in medical oncology clinics. Data were collected by using hospital anxiety and depression scale, EORTC QLQ C-30 and a patient information form. RESULTS: Patients who were male and secondary school graduates/graduates/postgraduates experienced more functional difficulties. Patients with poor economic status experienced more symptoms. Patient general well- being decreased with increase disease duration. The level of functional difficulties decreased with an increasing number of hospital stays. Anxiety scores increased with decreasing age. Both anxiety and depression scores increased with increasing disease duration. Patients who were female, single/widowed/divorced, and literate/ elementary school graduates had higher anxiety and depression scores. Life quality decreased with increasing anxiety and depression. CONCLUSIONS: Patients should be supported to prevent anxiety and depression, and should be followed up with this in mind.

Evaluation of quality of life and anxiety and depression levels in patients receiving chemotherapy for colorectal cancer: impact of patient education before treatment initiation.

BACKGROUND: As a consequence of the improved survival due to the availability of several treatment option cost-effectiveness and health-related quality of life (HRQoL) issues have gained increasing attention in colorectal cancer (CRC). In the present study, we aimed to evaluate quality of life, level of anxiety and depression before and after a 6-month follow-up period in chemotherapy receiving patients with CRC. METHODS: The study was conducted in 50 patients with colon or rectal cancer. All patients were informed and educated about their disease and treatment before getting the treatment and were followed for 6 months, during which they received chemotherapy. A "Questionnaire Form" to collect patient demographic characteristics; the "EORTC QLQ-C30 Scale" and "EQ-5D Scale" to evaluate patient's quality of life; and the "Hospital Anxiety and Depression (HAD) Scale" to evaluate the level of anxiety and depression status of patients, were used as data collecting tools. RESULTS: Quality of life scores in all functional fields were high in the sixth course when compared to the first according to EORTC QLQ-C30 Scale, reaching to statistically significant level in emotional function score compared to the initial ones (P<0.05). Moreover quality of life score measured in the sixth month with EQ-5D was statistically significantly higher than the initial. CONCLUSIONS: These data, shows that with proper patient management, quality of life score, and the anxiety and depression levels improve during the course of treatment.