Meta-Analysis on the Application Value of Collaborative Nursing in Postcolostomy Nursing of Patients with Colorectal Cancer.

OBJECTIVE: To systematically evaluate the effect of collaborative nursing on self-care ability of postcolostomy patients with colorectal cancer (CRC). METHODS: PubMed, Web of Science, Embase, China National Knowledge Infrastructure, and Wanfang databases were searched to collect relevant literatures on randomized controlled trials of postcolostomy patients with CRC. The search period was started from 2010 to 2021. Statistical analysis was performed on the data extracted from the comprehensive meta-analysis with STATA 16.0 analysis software. RESULTS: As a result, it was found that the incidence of adverse reactions in the control group was higher than that in the treatment group. Seven studies included the preintervention self-care concept and preintervention self-care skills. Six studies included preintervention self-care responsibility and preintervention exercise of self-care agency (ESCA) scale. In the comparison among the concept of self-care after intervention, self-care skills, self-care responsibility, and ESCA scale, all of them had higher scores in the treatment group than in the control group (P < 0.05). It fully explains that collaborative nursing can significantly improve the evaluation indicators of patients' self-care ability and reduce patient complications. CONCLUSION: The application of collaborative nursing in the nursing work of patients with CRC after colostomy can significantly reduce the incidence of adverse nursing reactions.

Telemedicine in postoperative follow-up of STOMa PAtients: a randomized clinical trial (the STOMPA trial).

BACKGROUND: A stoma has severe impact on the patient's quality of life (QoL). Postoperative home community follow-up by teleconsultation (TC) and stoma nurses may reduce the burden of travel and improve QoL. METHODS: A university hospital and five district medical centres participated. Patients with a stoma were randomized to follow-up by either TC (intervention) or hospital (control). Stoma nurses performed the clinical examination at the TC studio, aided remotely by hospital nurses and surgeons. The primary endpoint was the EQ-5D™ index score; secondary endpoints were the Stoma Quality-of-Life Scale, the OutPatient Experiences Questionnaire, and use of hospital resources. RESULTS: A total of 110 patients were randomized to hospital (58 patients) or TC (52) follow-up; 64 patients (hospital 38, TC 26) were followed for more than 12 months and 246 consultations (hospital 151, TC 95) were performed. There were no differences in QoL: EQ-5D™ index score (P = 0·301) and EQ-5D™ visual analogue scale (VAS) score (P = 0·775); Work/Social Function (P = 0·822); Sexuality/Body Image (P = 0·253) and Stoma Function (P = 0·074). Hospital follow-up performed better for organization of care (staff collaboration, P = 0·004; met same persons, P = 0·003) and communication (surgeon understandable, P < 0·001; surgeon caring P = 0·003). TC did not increase the number of hospital consultations (P = 0·684) and reduced the number of journeys of more than 8 h (P = 0·007). CONCLUSION: Telemedicine follow-up by stoma nurses did not improve the QoL of patients, but decreased the readmission rate and burden of travel. Registration number NCT01600508 ( https://www.clinicaltrials.gov).

ANTECEDENTES: Un estoma tiene un gran impacto en la calidad de vida (quality of life, QoL) del paciente. El seguimiento postoperatorio comunitario a nivel del hogar del paciente por Tele Consulta (TC) y enfermeras especializadas en estomas puede reducir la carga de viaje y mejorar la calidad de vida. MÉTODOS: Un hospital universitario y cinco centros médicos de distrito participaron en el estudio. Los pacientes con estoma fueron asignados al azar para el seguimiento mediante TC (intervención) o en el hospital (control). Las enfermeras de estomas realizaron el examen clínico en el estudio de TC, con la ayuda remota de enfermeras y cirujanos del hospital. El objetivo final primario fue la puntuación del índice EQ-5D, los objetivos finales secundarios fueron la Escala de Calidad de Vida del Estoma, el Cuestionario de Experiencias Ambulatorias y la utilización de recursos hospitalarios. Se utilizaron análisis de la varianza (ANOVA) para comparar los grupos. RESULTADOS: Un total de 110 pacientes fueron asignados al azar para el seguimiento en el hospital (n = 58) o por TC (n = 52), 54 pacientes (hospital n = 38, TC n = 26) fueron seguidos durante > 12 meses; se realizaron 245 consultas (hospital n = 151; TC n = 94). No hubo diferencias en la QoL; puntuación del índice EQ-5D (P = 0,30); escala analógica visual (P = 0,77); trabajo y función social (P = 0,82); sexualidad y cuerpo (P = 0,25) y función del estoma (P = 0,07). El seguimiento hospitalario funcionó mejor en la organización de la atención (colaboración del personal P < 0,01; seguimiento por la misma persona P < 0,01), comunicación (cirujano comprensible/afectuoso, P < 0,01). La TC no aumentó las consultas hospitalarias (P = 0,68) y redujo > 8 horas de viaje (P < 0,01). CONCLUSIÓN: El seguimiento por telemedicina realizado por enfermeras especializadas en estomas no mejoró la QoL de los pacientes, pero disminuyó los reingresos y la carga de los viajes.

Effects of hospital-family holistic care model on the health outcome of patients with permanent enterostomy based on the theory of 'Timing It Right'.

AIMS AND OBJECTIVES: To explore the effects of hospital-family holistic care model based on 'Timing It Right' on the health outcome of patients with permanent colostomy. BACKGROUND: Colorectal cancer is a common malignant tumour of digestive system, which seriously threatens human life and health. Colostomy is one of the main treatments for colorectal cancer, which effectively improves the 5-year survival rate of patients. However, the postoperative psychological and physiological rehabilitation nursing is still faced with great challenges due to the change of body image and defecation pathway caused by colostomy. METHODS: A randomised controlled trial was conducted, and 119 patients with permanent enterostomy were randomly divided into two groups, with 60 cases in the intervention group and 59 cases in the control group. The intervention group received routine care follow-up and hospital-family holistic care intervention based on 'Timing It Right', while the control group received routine care and follow-up. The resilience, self-care ability, complications and life quality of patients with permanent enterostomy were compared between two groups before intervention, at discharge, 3 months and 6 months after discharge. CONSORT checklist was applied as the reporting guideline for this study (see Appendix S1). RESULTS: A total of 108 patients with permanent enterostomy completed the study (90.76%). At 3 months and 6 months after discharge, the resilience and quality of life in the intervention group were significantly better than those in the control group (t = 4.158 vs. 7.406, t = 4.933 vs. 8.611, p < .05), while the complications in the intervention group were significantly lower than that in the control group (25.5% vs. 41.51%, 14.45% vs. 30.19%; p < .05). The self-care ability of the intervention group was significantly better than that in the control group (t = 1.543 vs. 3.656 vs. 6.273, p < .05) at discharge, 3 months and 6 months after discharge. The interaction between time and grouping showed that the effect of time factor varied with the grouping. After intervention, there were significant differences in psychological resilience, self-care ability, complications and quality of life between the two groups at different observation points (p < .01). The three evaluation indices of intervention group increased with the migration of observation time points and were significantly better than those of control group, especially the quality of life (84.35 ± 4.25 vs. 60.45 ± 8.42, p < .01). CONCLUSIONS: The hospital-family holistic care model based on 'Timing It Right' can effectively improve the psychological resilience, self-care ability and quality of life; reduce complications; and improve the health outcomes of patients with permanent enterostomy. RELEVANCE TO CLINICAL PRACTICE: Patients with permanent enterostomy have different needs for nursing care at different stages of the disease, and they are dynamically changing. The hospital-family holistic care model based on 'Timing It Right' can effectively improve the health outcomes of patients with permanent enterostomy, which is worthy of clinical application.

No One Knows I Have a Colostomy.

: Editor's note: From its first issue in 1900 through to the present day, AJN has unparalleled archives detailing nurses' work and lives over more than a century. These articles not only chronicle nursing's growth as a profession within the context of the events of the day, but they also reveal prevailing societal attitudes about women, health care, and human rights. Today's nursing school curricula rarely include nursing's history, but it's a history worth knowing. To this end, From the AJN Archives highlights articles selected to fit today's topics and times.This December 1951 article is a patient's account of her struggle to learn how to care for her colostomy. Despite a three-and-a-half-week hospital stay, she received no practical guidance in colostomy care. "My doctor assured me that all I would need to do after I got home would be to get up a half hour earlier to irrigate the colostomy," she writes. "The nurses were kind, cheerful, and patient, but they seldom referred to my colostomy." It took two years "of trial and error, of fear and anxiety" for the patient to figure out how to manage her colostomy.This woman's experience highlighted the need for expert guidance for people with ostomies. Unfortunately, it was 1958 before the first known ostomy specialist began work. The American Association of Enterostomal Therapists, the precursor of the Wound, Ostomy and Continence Nurses Society, was formed in 1968.This article reminds us, once again, of the importance of patient education and support after life-changing surgery. For nurses who are not ostomy specialists, "Stoma and Peristomal Skin Care: A Clinical Review" in this issue offers an update on stoma care.

Tradução de conhecimento e narrativas de famílias nos cuidados à criança após reversão de colostomia: produção de história em quadrinhos / Knowledge translation and families narrative on care for child after surgery of colostomy reversion: production of a comic

Introdução: A produção de um almanaque, na ótica da tradução do conhecimento, sobre o cuidado à criança após a reversão de colostomia é o objeto de estudo dessa pesquisa. Objetivo: a) selecionar narrativas sobre ações cuidativas implementadas por familiares de crianças em reversão de colostomia; b) articular essas ações com as tendências do conhecimento científico relacionadas às demandas de cuidados à criança; c) produzir a história em quadrinhos, no encontro com especialistas. Métodos: Trata-se de um estudo qualitativo desenvolvido em três etapas: seleção de narrativas de famílias (banco de dados, de pesquisa de campo e rede social); revisão integrativa de conteúdos científicos; aplicação da metodologia de tradução de conhecimento. O corpus textual foi organizado no software Iramuteq 0.7 Alfa2. As narrativas dos familiares foram fonte de inspiração para elaboração do roteiro, personagens e cenários. Na segunda etapa, houve a seleção de conteúdos científicos que representaram necessidades de aprendizagem. A revisão integrativa da literatura abordou conteúdos selecionados pelos familiares na etapa anterior. Na terceira etapa procedeu-se a produção da história mediada pela metodologia da tradução do conhecimento. Na quarta etapa ocorreu avaliação da história por especialistas, por consulta individual. A pesquisa foi aprovada pelo CEP/EEAN-UFRJ, número: 1.287.814. Os 27 textos organizados no software deram origem a cinco classes de palavras aproveitamento de 81,06%. A revisão integrativa identificou seis estudos observacionais. As narrativas dos familiares que abordaram a alimentação, o hábito intestinal, a constipação e o direito da criança. Na história em quadrinhos, articularam-se os temas das narrativas à síntese do conhecimento sobre constipação e os conteúdos são apresentados na forma de diálogos, "Você sabia?", "Curiosidades" e "Dicas de Cuidados". Conclui-se que o ciclo da criação da tradução do conhecimento permitiu articular as melhores evidências sobre a criança com os saberes de famílias na produção de uma História em Quadrinhos.

The production of an almanac, from the point of view of the translation of knowledge, about the care of children after colostomy reversal is the object of this research. Aim: a) to select narratives implemented by family members of children in colostomy reversal; b) to articulate these actions with tendencies of scientific knowledge related to demands of care to children; c) to produce a comic in the meeting with specialists. Methods: Qualitative study developed in three steps: selection of families' narratives (field research and social network data bank); integrative review of scientific knowledge; application of knowledge translation methodology. Textual corpus was organized in the Iramuteq 0.7 Alfa2 software. Family member's narratives was inspirational source to elaborate a script, characters and scenery. In the second step, there was the selection of scientific knowledge that represented learning needs. Literature integrative review approached selected knowledge by family members in the previous step. In the third step we proceeded to produce the story mediated by the knowledge translation methodology. In the fourth step there was the story evaluation by specialists, through individual consultation. Research was approved by CEP/EEAN-UFRJ, number: 1.287.814. The 27 texts organized in the software have originated five word classes exploitation of 81,06%. Integrative review identified observational studies. Family members' narratives approached feeding, intestinal habits, constipation and child's rights. In the comic, we articulated narrative themes to knowledge synthesis about constipation and knowledge are presented in the dialogue form, "Did you know?", "Curiosities" e "Care tips". We conclude that creation cycle of knowledge translation enabled to articulate better evidences on children with family knowledge on producing the Comic.

La producción de una historieta, en la óptica de la producción del conocimiento, sobre el cuidado a los niños después de la colostomía es el objeto de estudio en esta investigación. a) seleccionar narrativas sobre acciones de cuidado implementadas por los familiares de niños después de la corrección de la colostomía; b) articular estas acciones con las tendencias de conocimiento científico acerca de las demandas de cuidados a los niños; c) producir una historieta, en el encuentro con los especialistas. Estudio cualitativo desarrollado en tres etapas: selección de narrativas de familias (datos anteriores, investigación del campo y en rede social); revisión integrativa de los contenidos científicos; aplicación de la metodología de la traducción del conocimiento. El corpus textual fue organizado por el software Iramuteq 0.7 Alpha2. Las narrativas de los familiares fueron fuentes de inspiración para el guión, personajes y escenarios. En la segunda etapa, hubo la selección de los contenidos científicos que representaran a las necesidades de aprendizaje. La revisión integrativa abordó los contenidos seleccionados por los familiares en la etapa anterior. En la tercera etapa se hizo la producción de la historieta con el apoyo de la metodología de la traducción del conocimiento. En la cuarta etapa ocurrió evaluación de la historieta por los especialistas, por consulta individual. La investigación fue aprobada en el CEP/EEAN-UFRJ, numero: 1.287.814. Los 27 textos organizados en le software dieran origen a cinco clases de palabras con aprovechamiento de 81,06%. La revisión integrativa identificó seis estudios observacionales. Las narrativas de los familiares abordaran la alimentación, el hábito intestinal, la constipación e el derecho del niño. En la historieta articularon se los temas de las narrativas a la síntesis del conocimiento sobre constipación y los contenidos son presentados en diálogos, "Usted lo sabia", "Curiosidad" y "Consejos de cuidados". Concluí-se que el ciclo de creación del conocimiento permitió articular las mejores evidencias sobre los niños con los saberes de familias en la producción de una historieta.

Evaluación de la calidad de la técnica de enfermería "vacuidad del intestino" en Cirugía Pediátrica / Quality assessment for the nursing technique gut irrigation in children surgery

Introducción: el personal de enfermería debe estar bien entrenado en la preparación del paciente que va a ser intervenido por cirugía en afecciones gastrointestinales o con fines investigativos, para lograr una excelente vacuidad del intestino. Objetivo: evaluar la calidad de la técnica de enfermería "vacuidad del intestino" en cirugía pediátrica. Métodos: se realizó un estudio descriptivo retrospectivo en el Servicio de Cirugía Pediátrica del Hospital Provincial General Docente "Dr. Antonio Luaces Iraola" de Ciego de Ávila, en el período 2010-2013. El universo quedó constituido por 74 pacientes que requirieron limpieza del intestino. La calidad de la técnica fue evaluada de excelente, buena, regular y mala. La información se obtuvo de la historia clínica y procesada con la utilización de frecuencias absolutas y porcentajes. Resultados: el 67,56 por ciento de los niños tenía menos de seis años, el 71,62 por ciento eran del sexo masculino, el 32,43 por ciento de los pacientes fueron preparados en la limpieza del colon con fines diagnósticos y el 67,56 por ciento con fines quirúrgicos. Se evaluó de excelente el 100,00 por ciento de los procedimientos "gastroclisis para cierre de colostomía" realizados, y el 98,64 por ciento de los procedimientos "Irrigación total del intestino para otros procederes". Conclusiones: la técnica de enfermería "vacuidad del intestino" en cirugía pediátrica realizada con los procedimientos de gastroclisis y de irrigación total del intestino para otros procederes fue evaluada de calidad. La experiencia del personal de enfermería es notable, evidenciado en los excelentes resultados obtenidos(AU)

Introduction: The nursing staff should be well trained in preparing the patient to undergo surgery for surgery in gastrointestinal diseases, or research purposes for excellent bowel emptiness. Objective: To evaluate the quality of nursing technique "intestine emptiness" in pediatric surgery. Methods: A retrospective study was conducted at the Pediatric Surgery Provincial General Teaching Hospital "Dr. Antonio Luaces Iraola "Ciego de Avila, in the period 2010-2013. The universe was composed of 74 patients who required bowel cleansing. The quality of the data was assessed as excellent, good, fair and poor. The information was obtained from the clinical history and processed using absolute frequencies and percentages. Results: 67,56 percent of children had less than six years, 71,62 percent were male, 32,43 percent of patients were prepared in cleansing the colon for diagnostic purposes and 67,56 percent for surgical purposes. It was evaluated excellent 100,00 percent of procedures "gastroclisis colostomy closure" made, and 98,64 percent of procedures "whole bowel irrigation for other procedures." Conclusions: nursing technique "intestine emptiness" pediatric surgical procedures performed with gastroclisis and whole bowel irrigation for other procedures was assessed quality. The experience of nursing staff is remarkable, as evidenced by the excellent results obtained(AU)

Educational video as a healthcare education resource for people with colostomy and their families. / Vídeo educativo como recurso para educação em saúde a pessoas com colostomia e familiares.

OBJECTIVE: To know the perceptions of participants in a support group for people with colostomy on the use of video as a resource for health education. METHOD: Qualitative research with 16 participants in a support group for people with colostomy in Santa Maria, Rio Grande do Sul, Brazil. Data were collected in April and May of 2016, through a focus group, and subjected to the thematic analysis proposed by Minayo. RESULTS: The results led to three categories: care and self-care are learned alone: the lived reality; health education and learning through educational video: perceived opportunities; the singularities of the educational video from the viewpoint of people with colostomy and their families. CONCLUSION: The scarcity of guidelines retards independence and hinders autonomy in care and self-care. The audio-visual technology applied in this study complements the educational guidelines, and can enable changes and the opportunity to rethink pedagogical nursing practices.

Perceived Barriers and Home Care Needs When Adapting to a Fecal Ostomy: A Phenomenological Study.

PURPOSE: The aim of this study was to determine perceived barriers to adaptation to life with a fecal ostomy based on the Health Belief Model and to reveal home care needs related to these perceptions. DESIGN: Phenomenological study. SUBJECTS AND SETTING: Twelve participants undergoing ileostomy or colostomy within 3 months of data collection participated in the study. The participants were recruited from Stomatherapy Outpatient Clinic of Dokuz Eylül University Hospital. Their mean age was 54.41 ± 19.14 years (mean ± SD). Eight (67%) underwent ostomy surgery 2 to 3 months prior to study participation; 9 (75%) underwent stoma surgery for the treatment of colorectal cancer, 5 (42%) had a temporary stoma, and 8 also received chemotherapy for the management of an underlying malignancy. METHODS: A semistructured interview form was used to collect data, and obtained data were analyzed with inductive content analysis. The questions were based on the Health Belief Model and were directed at identifying challenges to adaptation to life at home and home care needs in patients with stoma. RESULTS: Inductive content analysis identified 4 main themes: "restriction of daily life activities"; "factors affecting adaptation to stoma"; "need for health professionals"; and "emotional effects." The theme, need for health professionals, was expressed by the highest number of the participants. The respondents explained that services from ostomy nurse specialists should begin in the hospital and continue into the home. Participants suggested that ostomy nurses are needed to improve self-care skills via telephone contact and home visits. They also expressed the need for nursing interventions for the management of adverse effects associated with chemotherapy. CONCLUSIONS: Individuals experience physical, mental, and social barriers when adapting to live with a new stoma and when receiving chemotherapy for underlying cancer. Additional services from ostomy nurses are needed to aid patients when adapting to these challenges.

Evaluation of a new ostomy mouldable seal: an international product evaluation.

A new mouldable seal, Brava® Protective Seal, was evaluated by patients on aspects related to residue, durability, and preference. A total of 135 patients from four countries participated (Denmark, Germany, Japan and the USA) and the new product was compared to the patients' usual pouching systems. Less residue and easier skin cleansing was observed, which may benefit patient quality of life. The possible benefits of less residue for peristomal skin health need further investigation.

Resiliência em famílias de pessoas portadoras de colostomia por câncer: um olhar a partir do sistema de crenças / Resiliencia en familias de personas portadoras de colostomía por cáncer: una visión a partir del sistema de creencias / Resilience in families of people with cancer colostomy: a look from the belief system

RESUMO O objetivo foi identificar as crenças facilitadoras e as restritivas da resiliência em famílias de pessoas portadoras de colostomia por câncer. Trata-se de estudo descritivo, de abordagem qualitativa, realizado com sete famílias, totalizando 15 pessoas. A coleta de dados ocorreu em um hospital do interior do Rio Grande do Sul/Brasil, por meio de entrevista aberta. Os dados foram submetidos à análise de conteúdo temática. Os resultados revelam que as crenças facilitadoras da resiliência relacionam-se a acreditar que as pessoas, mesmo doentes, fazem o possível para seguir em frente e que elas podem contar com a família. As crenças restritivas decorrem do fato de sentirem-se enfraquecidas e pensarem que não podem contar com a família. Ao passar pela experiência de adoecimento de um membro, a família age a partir daquilo em que acredita, para, assim, dar sentido à experiência vivenciada e reunir forças para seguir a caminhada.

RESUMEN El objetivo fue identificar las creencias facilitadoras y las restrictivas de la resiliencia en familias de personas portadoras de colostomía por cáncer. Se trata de un estudio descriptivo, de abordaje cualitativo, realizado con siete familias, totalizando 15 personas. La recolección de datos ocurrió en un hospital del interior de Rio Grande do Sul/Brasil, por medio de entrevista abierta. Los datos fueron sometidos al análisis de contenido temático. Los resultados revelan que las creencias facilitadoras de la resiliencia se relacionan a creer que las personas, aunque enfermas, hacen lo posible para seguir adelante y que ellas pueden contar con la familia. Las creencias restrictivas se deben al hecho se sienten debilitadas y piensan que no pueden contar con la familia. Al pasar por la experiencia de enfermedad de un miembro, la familia actúa a partir de aquello que cree, para, así, dar sentido a la experiencia vivida y reunir fuerzas para seguir el camino.

ABSTRACT The objective was to identify the facilitating and restrictive beliefs of resilience in families of people with cancer colostomy. This is a descriptive study, with a qualitative approach, carried out with seven families, totaling 15 people. Data collection took place at a hospital in the interior of Rio Grande do Sul/Brazil, through an open interview. The data were submitted to thematic content analysis. The results show that resilience-facilitating beliefs relate to believing that people, even the sick ones, do their best to move forward and that they can count on the family. Restrictive beliefs arise from the fact that they feel weak and think that they cannot count on the family. When experiencing the illness of a member, the family acts from what they believe, in order to give meaning to the lived experience and gather forces to follow the walk.

Supportive Communication to Facilitate Chinese Patients' Adaptation to a Permanent Colostomy: A Qualitative Case Study Approach.

This study, which is a part of action research, aims to explore how supportive communication can impact individuals' adaptation to a permanent colostomy in a Chinese cultural context. Two Chinese rectal cancer patients with complexity and difficulty in living with a permanent colostomy were selected using a qualitative case study approach. The researcher (H.T.) interacted with the participants along their journey from the preoperative period until the third postoperative month after discharge via face-to-face or telephone interviews. Content analysis was applied. Supportive communication was characterized by "communication as a supportive tool," which consisted of 4 elements: respect, description, empathy, and empowerment. The nursing strategies included (1) developing a collaborative relationship with patients and families; (2) understanding patients' concerns and problems; (3) discussing potential solutions; (4) encouraging patients to take action; (5) bringing out emotional expression; (6) normalizing negative emotions; and (7) protecting hope. The findings of this study informed that supportive communication is a valuable tool for nurses to provide informational and emotional support to Chinese patients in order to enhance their adaptation to living with a permanent colostomy. Developing an operational manual to enhance supportive communication for patients with colostomy is suggested.

Stoma creation: does onset of ostomy care education delay hospital length of stay?

BACKGROUND: Balancing patient safety with hospital length of stay (LOS) and associated cost is critically important. Subjectively, we have observed that patients undergoing ostomy creation early in the week have a shorter LOS. METHODS: We retrospectively reviewed LOS based on day of the week the operation was performed. RESULTS: We reviewed 180 patients undergoing minimally invasive surgery with planned ostomy. Group 1 underwent surgery on Monday to Wednesday (n = 77), Group 2 on Thursday (n = 49), and Group 3 on Friday (n = 54). The average LOS for Group 1, 2, and 3 was 6.2, 4.9, and 7.2 days, respectively. The average number of visits with ostomy nursing for Group 1, 2, and 3 was 2.7, 1.8, and 2.3, respectively. Day of initial ostomy nursing visit was significantly correlated between the delay to initial visit and LOS with Group 3 delayed most. CONCLUSIONS: Patients with the longest delay to initial nurse visit had the longest LOS, with Friday operations being most delayed. A contributing factor may be absence of ostomy teaching over the weekend.

Vídeo educativo como recurso para educação em saúde a pessoas com colostomia e familiares / Video educativo como un recurso para la educación salud a las personas con colostomia y familiares / Educational video as a healthcare education resource for people with colostomy and their families

RESUMO Objetivo Conhecer as percepções de participantes de um grupo de apoio para pessoas com colostomia sobre a utilização de um vídeo educativo como recurso para atividade de educação em saúde. Método Pesquisa qualitativa com 16 participantes em um grupo de apoio a pessoas colostomizadas de Santa Maria, Rio Grande do Sul, Brasil. Os dados foram coletados em abril e maio de 2016, por meio de grupo focal, submetidos à análise temática proposta por Minayo. Resultados Emergiram três categorias: O cuidar e o cuidar-se aprendido sozinho: a realidade vivida; Educação em saúde e aprendizagem por meio do vídeo educativo: possibilidades percebidas; As singularidades do vídeo educativo na ótica de pessoas colostomizadas e seus familiares. Conclusão A exiguidade de orientações posterga a independência e dificulta a autonomia para o cuidado e o autocuidado. A aplicabilidade da tecnologia audiovisual desenvolvida complementa as orientações educativas, possibilitando transformar e repensar as práticas pedagógicas na enfermagem.

RESUMEN Objetivo Conocer las percepciones de los participantes de un grupo de apoyo para personas con colostomia acerca de la utilización de un video educativo como recurso para la actividad de educación para la salud. Método Estudio cualitativo con 16 participantes de un grupo de apoyo a las personas colostomizada, de Santa Maria, Rio Grande do Sul, Brasil. La recogida de datos ocurrió en abril y mayo de 2016 y se hizo por medio de un grupo focal, que se sometió a análisis tematico propuesto por Minayo. Resultados Emergieron tres categorías: El cuidar y el cuidarse aprendido por sí mismo: la realidad vivida; Educación para la salud y aprendizaje por medio del video educativo: posibilidades percibidas; Las singularidades del video educativo en la óptica de las personas colostomizadas y sus familiares. Conclusión La escasez de orientaciones retrasa la independencia y autonomía para el cuidado y autocuidado. La aplicabilidad de la tecnología audiovisual desarrollada complementa las orientaciones educativas, posibilitando transformar y repensar las prácticas pedagógicas en enfermería.

ABSTRACT Objective To know the perceptions of participants in a support group for people with colostomy on the use of video as a resource for health education. Method Qualitative research with 16 participants in a support group for people with colostomy in Santa Maria, Rio Grande do Sul, Brazil. Data were collected in April and May of 2016, through a focus group, and subjected to the thematic analysis proposed by Minayo. Results The results led to three categories: care and self-care are learned alone: the lived reality; health education and learning through educational video: perceived opportunities; the singularities of the educational video from the viewpoint of people with colostomy and their families. Conclusion The scarcity of guidelines retards independence and hinders autonomy in care and self-care. The audio-visual technology applied in this study complements the educational guidelines, and can enable changes and the opportunity to rethink pedagogical nursing practices.

Profile of ostomy patients residing in Pouso Alegre city / Perfil dos pacientes estomizados residentes no município de Pouso Alegre

The objective was to characterize the clientele of ostomy patients living in Pouso Alegre, Minas Gerais, Brazil. Among the causes that led patients to acquire an ostomy, the most prevalent was neoplasia; the type of ostomy was a permanent colostomy. Most people were not told that they would be submitted to the stoma. In addition, individuals were not subject to stoma demarcation, and irrigation was not performed. Regarding the type of complication, 34 (48.60%) had dermatitis; 14 (20%), retraction; and 13 (18.60%), prolapse. With respect to stoma diameter, 34 (48.60%) had 20-40 mm and 23 (32.90%), 40-60 mm. With this study, we became aware of the profile of ostomized patients treated at the municipality of Pouso Alegre/MG; it is expected that, with these data, the improvement of care to this population can be subsidized. We suggest that nursing professionals think of health action strategies with respect to guidance on stoma manufacture and to measures aiming for the prevention of possible complications, promoting ways to help these patients to make decisions and to verbalize feelings, so that they feel supported in coping with changes in their body image, for the sake of survival. (AU)

O objetivo foi caracterizar a clientela de estomizados residentes em Pouso Alegre, Minas Gerais. maioria das causas que levaram os pacientes a adquirir ostomia foi neoplasia; o tipo de ostomia era colostomia em definitivo. A maioria dos indivíduos não foram comunicados de que seriam submetidos ao estoma. Além disso, os indivíduos não foram submetidos à demarcação do estoma e não foi realizada irrigação. Com relação ao tipo de complicação, 34(48,60%) apresentaram dermatite; 14 (20%), retração e 13 (18,60%), prolapso. Com relação ao diâmetro do estoma, 34 (48,60%) mensuravam 20 a 40 mm e 23 (32,90%), 40 a 60 mm. Este estudo possibilitou conhecer o perfil dos pacientes ostomizados atendidos do município de Pouso Alegre/MG e espera-se que, com esses dados, se possa subsidiar a melhoria da assistência a essa clientela. Sugere-se aqui aos enfermeiros pensar em estratégias de aç ões de saúde com relação às orientaç ões sobre a confecção do estoma, medidas de prevenção de possíveis complicaç ões, promovendo meios para auxiliar esses pacientes a tomarem decisões, verbalizarem sentimentos, de modo que se sintam apoiados no enfretamento das mudanças da sua imagem corporal em prol da sobrevivência. (AU)

Preoperative teaching and stoma marking in an inpatient population: a quality improvement process using a FOCUS-Plan-Do-Check-Act model.

Preoperative teaching and stoma marking are supported by research and included in clinical practice guidelines from the WOCN Society and others. Using a FOCUS-Plan-Do-Check-Act model of Total Quality Management, a multidisciplinary team was formed that developed a flow chart outlining the process of care for patients undergoing planned ostomy surgery that included an educational intervention that enabled staff nurses to perform preoperative stoma site marking and education. After 3 months, we found a statistically significant increase in the number of surgical patients who received these evidence-based interventions (14% vs 64%; χ = 9.32; P = .002).

The influence of social support from the family on health related-quality of life in persons with a colostomy.

PURPOSE: We evaluated the influence of social support on health-related quality of life (HRQOL) in persons with a colostomy, taking into account time since surgery. SUBJECTS AND SETTINGS: The study was conducted in 8 cities in Poland. The sample comprised 128 patients with a colostomy; their mean age was 66.24 years. Forty-five percent of participants had lived with a colostomy for more than 5 years, and 16% had a colostomy for less than 1 year. INSTRUMENTS: The questionnaire used in the study included 76 questions divided into 3 parts. The first part comprised 8 questions that queried demographic characteristics. Parts 2 and 3 included 2 validated scales assessing HRQOL and social support, respectively. Health-related quality of life was assessed using the Functional Assessment of Cancer Therapy-Colorectal instrument. Social support received was assessed using the Berlin Social Support Scale. In the case of both scales, the respondents were asked to assess their status during the last 7 days. METHODS: The study was conducted by an interviewer during monthly meetings of colostomy support groups as well as during hospitalization. The respondents gave their verbal answers to questions read by the interviewer or completed the questionnaires by themselves. After the questionnaire was completed, the interviewer verified completeness of answers. The outcome time elapsed since surgery was categorized as 3 subgroups: (1) respondents having a colostomy 1 year or less, (2) respondents having colostomy for more than 1 or up to 5 years, and (3) respondents having colostomy more than 5 years. RESULTS: Analysis revealed a statistically significant relationship between level of social support and HRQOL among persons with a colostomy (R = 0.361, P = .000029). Moreover, we observed that the time elapsed since colostomy surgery influenced this relationship. Level of social support and HRQOL were not significantly related in persons living with a colostomy ≤1 year (R = 0.155, P = .525). The correlation was significant in persons with a colostomy for more than 1 to but less than 5 years (R = 0.329, P = .02), and in individuals living with a colostomy for more than 5 years (R = 0.482, P = .0001). CONCLUSIONS: Persons with permanent colostomies and the higher level of social support from family reported higher HRQOL than did persons with lower levels of social support. Time elapsed since colostomy surgery exerts a positive effect on this relationship; the longer the patients live with a colostomy, the greater the influence of social support.

Methods for siting emergency stomas in the absence of a stoma therapist.

INTRODUCTION: Stomas often have to be sited in emergencies by trainees who may have had little training in this. Emergency stomas and stomas where the site has not been marked preoperatively by a stoma therapist are more prone to complications. These complications may severely affect a patient's quality of life. Advice in the literature on how to best site stomas is conflicting. We compared two easy anatomical methods of siting stomas to sites chosen by a stoma therapist and looked at how this site was affected by the patients' body mass index (BMI). METHODS: Patients undergoing elective colorectal surgery were seen either pre or postoperatively. Each patient's BMI was recorded and the positions of three different potential stoma positions (site G: the gold standard, marked by a stoma therapist; site S: marked using a pair of scissors against the umbilicus; site H: halfway between the umbilicus and anterior superior iliac spine) were compared. RESULTS: The two fixed anatomical methods described (method S and method H) both gave poor results. The most common reason for poor siting was the proximity of a skin crease. There was a statistically significant correlation between the patient's BMI and the laterality of the gold standard site. CONCLUSIONS: The two simple anatomical methods described here do not provide a shortcut to effective siting. A more effective method may be calculating the laterality of the site using the patient's BMI, and then moving up/down to avoid a skin crease and improve the patient's view for changing the bag. This deserves further study.

Stressors relating to patient psychological health following stoma surgery: an integrated literature review.

PURPOSE/OBJECTIVES: To summarize empirical evidence relating to stressors that may affect patients' psychosocial health following colostomy or ileostomy surgery during hospitalization and after discharge. DATA SOURCES: An extensive search was performed on the CINAHL®, Cochrane Library, PubMed, PsycINFO, Scopus, Science Direct, and Web of Science electronic databases. DATA SYNTHESIS: Eight articles were included with three qualitative and five quantitative research designs. Most studies were conducted in Western nations with one other in Taiwan. Following colostomy or ileostomy surgery, common stressors reported by patients during hospitalization included stoma formation, diagnosis of cancer, and preparation for self-care. After discharge, stressors that patients experienced encompassed adapting to body changes, altered sexuality, and impact on social life and activities. CONCLUSIONS: This review suggests that patients with stomas experience various stressors during hospitalization and after discharge. Additional research is needed for better understanding of patient postoperative experiences to facilitate the provision of appropriate nursing interventions to the stressors. IMPLICATIONS FOR NURSING: To help patients deal with stressors following stoma surgery, nurses may provide pre- and postoperative education regarding the treatment and recovery process and encourage patient self-care. Following discharge, nurses may provide long-term ongoing counseling and support, build social networks among patients with stomas, and implement home visit programs. KNOWLEDGE TRANSLATION: Stoma surgery negatively affects patients' physical, psychological, social, and sexual health. Postoperative education programs in clinical settings mostly focus on physical health and underemphasize psychological issues. More pre- and postoperative education programs are needed to help patients cope with stoma stressors.