Experiências de adolescentes turcos de viver com ostomia: um estudo qualitativo / Experiencias de adolescentes turcos que viven con ostomía: un estudio cualitativo / Turkish adolescents' experiences of living with a stoma: a qualitative study

Resumo Objetivo O objetivo deste estudo foi investigar em profundidade as experiências de adolescentes turcos vivendo com ostomia. Métodos Este é um estudo fenomenológico hermenêutico qualitativo. A população do estudo foi composta por 11 adolescentes ostomizados da Turquia, com idades entre 12 e 21 anos. Os adolescentes participaram de entrevistas semiestruturadas com perguntas abertas sobre suas experiências com a ostomia. Os dados foram coletados entre janeiro e maio de 2019. Resultados Quarenta e seis afirmações significativas foram extraídas e agrupadas em sete temas. Os temas foram: desconforto, ocultação da ostomia, imagem corporal alterada, ambiente social protetor, experiências de oração, problemas vivenciados com a bolsa de colostomia e cuidados com ela, planos futuros alterados. Conclusão Os resultados do estudo identificaram uma série de desafios na vida dos adolescentes com ostomia. Os resultados podem ser úteis para os profissionais de saúde apoiarem seus pacientes adolescentes com ostomia. Além disso, esses achados podem servir de base para a realização de estudos futuros para melhorar a qualidade de vida dos adolescentes ostomizados.

Resumen Objetivo El objetivo de este estudio fue el de investigar en profundidad las experiencias de adolescentes turcos que viven con ostomía. Métodos Este es un estudio fenomenológico hermenéutico cualitativo. La población objeto del estudio estuvo compuesta por 11 adolescentes ostomizados de Turquía, con edades entre los 12 y los 21 años. Los adolescentes participaron de entrevistas semiestructuradas con preguntas abiertas sobre sus experiencias con la ostomía. Los datos fueron recopilados entre enero y mayo de 2019. Resultados Cuarenta y seis afirmaciones significativas fueron extraídas y agrupadas en siete temas. Los temas fueron: incomodidad, ocultación de la ostomía, imagen corporal alterada, ambiente social protector, experiencias de oración, problemas vividos con la bolsa de colostomía y sus cuidados, planes futuros alterados. Conclusión Los resultados del estudio identificaron una serie de desafíos en la vida de los adolescentes con ostomía. Los resultados pueden ser de utilidad para que los profesionales de salud les brinden apoyo a sus pacientes adolescentes con ostomía. Además, esos hallazgos pueden servir de base para la realización de estudios futuros para la mejora de la calidad de vida de los adolescentes ostomizados.

Abstract Objective This study's purpose was to investigate the experiences of Turkish adolescents with stoma in greater depth. Methods This is qualitative, hermeneutic phenomenological study. The study population consisted of 11 adolescents with stoma aged 12-21 years, in Turkey. Adolescents took part in semi-structured interviews consisting of open-ended questions about their experiences about stoma. Data were collected between January-May 2019. Results Forty-six significant statements were extracted and clustered in seven themes. The themes were, discomfort, concealing the stoma, changed body image, protective social environment, praying experiences, experienced problems about stoma bag and stoma care, altered future plans. Conclusions The findings of the study identified a number of challenges in the life for adolescent with ostomy. The results can be helpful for the health care providers to support their adolescent patients with ostomy. In addition, these findings can be base data to conduct future studies to improve quality of life of the adolescents with ostomy.

A Prospective, Experimental Study to Assess the Effectiveness of Home Care Nursing on the Healing of Peristomal Skin Complications and Quality of Life.

Home care services are effective in many patient groups. PURPOSE: The authors examined the effect of specialized ostomy care in the home on peristomal skin complications and patient quality of life (QOL). METHOD: A prospective, experimental study was conducted among 35 people >18 years old with a colostomy or ileostomy and peristomal skin complications who were listed in 2 ostomy supplier databases. Participants were alternatively allocated to 6 home care visits (intervention [IG], n = 18) or 2 outpatient/clinic care [CG] visits (control, n = 17). Demographic and patient variables were assessed at the initial visit in both groups. The Ostomy Skin Tool (OST) and the Stoma-Quality of Life instrument were used to assess study characteristics; data were statistically analyzed. RESULTS: The Discoloration, Erosion, Tissue Overgrowth scores of the OST of the 2 groups were similar in the first assessment (IG = 6.22 ± 1.47; CG= 6.11 ± 1.96; P = .776), but a statistically significant difference was noted between groups at the end of study (IG = 0.44 ± 0.85, CG = 4.76 ± 2.30; P = .00). At the first assessment, QOL scores of the IG and CG groups were 72.63 ± 11.48 and 66.73 ± 17.52, respectively (P = .197). At the final assessment, QOL scores were 78.12 ± 9.66 and 71.83 ± 18.37 for IG and CG, respectively (P = .390). CONCLUSION: Home nursing care was found to be effective in treating peristomal skin complications. The QOL scores achieved at the final assessment were significantly improved compared with the initial assessment. The results demonstrated the importance of follow-up after stoma surgery.

The Impact of an Ostomy on the Sexual Lives of Persons With Stomas: A Phenomenological Study.

PURPOSE: The purpose of this study was to describe the lived experiences of persons with stomas related to sexual function and perceptions and their expectations of the ostomy nurses who care for them. DESIGN: Qualitative, phenomenological study. SUBJECTS AND SETTING: Fourteen persons living with an ostomy for least 2 months participated in the study. Data collection occurred at the ostomy and wound care unit at Dokuz Eylul University Hospital in Izmir, Turkey. METHODS: Data were collected using an in-depth interview method. Interviews lasted from 20 to 60 minutes and were audiotaped. These recordings were transcribed and subjected to content analysis. RESULTS: Five themes emerged from the unstructured interviews: (1) changes in sexual life; (2) changes in body image; (3) fear and anxiety experienced during sexual intercourse; (4) psychological impact of sexual problems; and (5) expectations concerning sexual counseling from ostomy nurses. CONCLUSIONS: Study findings suggest that persons with ostomies experience changes in their body image, along with a decrease in sexual desire. Respondents described avoiding sexual intercourse, and abstained from sleeping with their partners. Male respondents described erectile dysfunction, and female respondents reported pain during sexual intercourse (dyspareunia). Participants stated that they did not feel adequately informed about these problems and desired to receive more information and support from ostomy nurses regarding sexual issues. Based on these findings, we recommend that ostomy nurses provide more counseling concerning sexual function and challenges following ostomy surgery.

A Prospective, Multicentered Study to Assess Social Adjustment in Patients With an Intestinal Stoma in Turkey.

Patients with a stoma undergo physiological, psychological, and social adjustment to their new life situation. A descriptive, prospective study was conducted to assess adaptation among patients >18 years of age with a new temporary or permanent colostomy or ileostomy living in Turkey and receiving care at a participating stomatherapy unit. The study took place between September 1, 2011, and September 1, 2012. During hospitalization and following discharge, patients with a stoma received training and counseling according to their individual characteristics and their physiological, psychological, and social needs. Each participant completed the 19-item "Identification Form for Patients with a Stoma" at the beginning of the study to document sociodemographic and stoma characteristics. To assess adjustment to the stoma, The Ostomy Assessment Inventory (OAI-23) was administered 2 times - the first within 1 month and the second within 6 months after surgery or when a temporary stoma was closed (whichever came first). This instrument comprised 23 items regarding adaptation to the stoma using Likert-type response options (0-4 range). Total scores ranged from 10 to 92, with higher scores indicating better adjustment. The instruments were completed by stoma and wound care nurses during face-to-face interviews. Data were analyzed using the Kruskal-Wallis, Mann-Whitney, and Wilcoxon tests. Of the 135 participants, the majority (77, 57.0%) were male; 73 (54.1%) had a colostomy, and 106 (78.5%) had a temporary stoma. The primary reason for stoma creation was cancer (89, 65.9%). Mean total OAI-23 scores were 48.63 ± 13.75 at the first administration and 50.59 ± 13.89 for the second. In terms of sociodemographic factors, significant increases in mean scores from the first to the second survey time were noted among patients in the 50-69 age group, women, married persons, and unemployed persons (P less than 0.05). With regard to stoma characteristics, the OAI-23 scores of patients with planned stoma operations and persons with permanent stomas increased significantly (P less than 0.05) between assessments. Significant increases in OAI-23 scores also were noted among persons who did not receive information before the operation, patients whose stoma site was not marked, and patients who had experienced a complication (P less than 0.05). Postoperatively, it is important to consider sociodemographic and stoma characteristics as well as preoperative variables that may influence adaptation to stoma. Additional larger, multicentered studies with extended patient follow-up are warranted.

A multicenter, retrospective study to evaluate the effect of preoperative stoma site marking on stomal and peristomal complications.

Even though preoperative marking of the stoma area is considered important for the prevention of postoperative complications, not all healthcare institutions have universally adopted this practice. A multicenter, retrospective, descriptive study was conducted to determine the effect of stoma site marking on stomal and peristomal complications. The 1-year study included 748 patients (408 [54.5%] male, mean age 56.60 ± 16.73 years) from eight stomatherapy units in Turkey. Patient data, including age, gender, diagnosis, type of surgery, history of preoperative stoma site marking, person performing the marking, and postoperative complications, were obtained from patient records, abstracted, and analyzed. Cancer was the reason for the operation in 545 (72.9%) of the cases. In 287 patients (38.4%), the stoma and wound care nurse and/or surgeon marked the stoma area; this occurred 1 day before or on the day of surgery according to Wound Ostomy Continence Nurses Society and American Society of Colon and Rectal Surgeons recommendations. Stomal/ peristomal complications developed in 248 (33.2%) persons; the most frequently observed complications in patients were parastomal skin problems (136, 48.7%), mucocutaneous separation (52, 18.6%), and retraction (31, 11.1%). The rate of complications was higher among patients whose stoma site was not marked than among those whose stoma site was marked (22.9% and 46%, respectively; P <0.001). The results of this study confirm the stoma area should be marked preoperatively in all planned surgical interventions in order to reduce the risk of postoperative complications. Additional prospective and experimental studies on effectiveness of preoperative stoma site marking should be conducted with larger sample groups.