Lived Experiences of Patients After Colorectal Cancer and Permanent Colostomy: A Parallel-Design Mixed-Methods Study.

OBJECTIVE: To identify the lived experiences, quality of life (QoL), and level of ostomy adjustment (OA) in patients after colorectal cancer with a permanent colostomy (PC). METHODS: In this parallel-design mixed-methods study, the researchers interviewed 14 patients after colorectal cancer whose PC was created more than 1 year prior. Qualitative data were interpreted using hermeneutic interpretive phenomenological design. Quantitative data were collected with the Stoma QoL Scale and OA Inventory-23. RESULTS: The mean age of the participants was 61.5 (SD, 10.0) years, and the mean PC duration was 7.7 (SD, 5.0) years. Mean QoL and OA scores were just above the median. Three superordinate themes consisting of nine themes emerged from the analysis: (1) early experiences (acceptance, medical problems, and emotional changes); (2) long-term experiences (physiologic experiences, psychosocial experiences, economic experiences, and coping strategies); (3) feelings and expectations about the future (worries and expectations). CONCLUSIONS: Even individuals who have been living with a PC for a long time may not be fully adapted to the process and may not have internalized lifestyle changes. Nurses should provide support to individuals with a PC through routine follow-ups, social support, and facilitative healthcare strategies regardless of the length of time since PC creation.

Quality of Life in Patients Undergoing Emergency Surgery for Complex Colorectal Cancer: Protocol and Piloting of the Surgical Utilization and Recovery Patterns for Advanced Stage Colorectal Cancer Study.

Introduction: Globally, cancer is the leading cause of mortality, with colorectal neoplasia ranking third in terms of incidence and mortality worldwide. Patients face disease- and treatment-specific impacts, which can significantly influence their quality of life (QoL). Aim: This study aimed to propose a protocol to measure in-hospital and long-term QoL in patients with complicated colorectal cancer (CRC). Material and Methods: multicenter prospective observational cohort study. Results: QoL is a multidimensional concept that includes criteria for physical, mental, emotional, and social functionality as perceived by the patient. Periodically evaluating QoL offers measurable and objective tools to intervene at the appropriate time to decrease the Years of Life Lost and Years Lived with Disabilities for CRC patients. However, a structured and functional system requires dedicated and common institutional effort. A pilot study using this protocol included 69 patients, 65.12+-10.92 years, M:F ratio = 56.5:43.5%. Surgical procedure was right hemicolectomy, left colectomy, transverse colectomy, sigmoidectomy, total colectomy, rectal resection, and colorectal resection with stoma (ileostomy or colostomy) in 21.7%, 11.6%, 2.9%, 11.6%, 1.4%, 23.2%, and 27.5% of the cases, respectively. The mean Global Health Status Score, Symptom Score, and Functional Score was 82.36+-18.60, 11.89+-10.27, and 86.27, 74.50-94.11, respectively. Conclusions: CRC diagnosis has major effects on patients physical and psychological status, and concentrated efforts should be made by the involved medical team and healthcare systems to improve QoL throughout the treatment pathway.

Factors Affecting Psychosocial Adjustment in Persons With a Recent Ostomy.

PURPOSE: The aim of this study was to examine the influence of personal and clinical factors on psychosocial adjustment in persons living with an ostomy for less than 1 year. DESIGN: A cross-sectional survey. SUBJECTS AND SETTING: The study sample comprised 183 adult individuals who had a colostomy, ileostomy, or urostomy for less than 1 year, residing in the Northeastern United States. METHODS: Data were collected from May through November 2018 using 2 instruments: a sociodemographic questionnaire and the Ostomy Adjustment Inventory-23 (OAI-23). The OAI-23 items measured 4 psychosocial subscales: acceptance, anxious preoccupation, social engagement, and anger. Data were analyzed using analysis of variance, multivariate analysis of variance, Cramer's V correlations, and multiple regression. RESULTS: Univariate analysis indicated that factors influencing psychosocial adjustment to an ostomy include age, assistance with care, educational background, stomal type, body mass index, ostomy height, preoperative education, and stoma siting. Multivariate analysis of variance identified that those who reported independence with ostomy care experienced higher levels of adjustment in all areas of the OAI-23. CONCLUSIONS: Findings from this study may assist nurses and other care providers to better understand the physical and emotional needs of those with ostomies and to identify interventions to promote optimal health in this population.

Effect of 1 + N Extended Nursing Service on Functional Recovery of Colostomy Patients.

To many hospitals' management as well as to patients, the nursing service is one of the most important aspects. Many diseases like sugar, blood pressure, urine passage, and gas are a little bit dangerous to handle by patients themselves. The earlier stage models are unable to give good services to patients; therefore, an advanced JHE: Effect of 1 + N extended nursing service is necessary to crossover the above limitations. Colostomy and colorectal cancers are very dangerous syndromes thus, disease monitoring is so difficult. In this research work, an extended JHE: Effect of 1 + N extended nursing service modeling is discussed with experimental modeling. Apart from conventional nursing care provided by the observation group, it was given online training as well as service providing. Self-efficacy and self-care competence were assessed in both groups 6 months after the discharge. Quality of life and mental health were also assessed. Besides, their dimensional and total self-care ability scores, and the observation group's self-efficacy ratings were substantially higher than those of the control group (P 0.05) after the intervention. It was observed that the intervention group's 6-month adjustment to the stoma was statistically more favorable than the control group's (P 0.001), and only the intervention group showed a significantly major change (P 0.001) between their two evaluations. This proposed methodology can improve the accuracy rate by 93.23%, and succussive treatment rate of 92.14% had been attained.

Effects of Nutritious Meal Combined with Online Publicity and Education on Postoperative Nutrition and Psychological State in Patients with Low Rectal Cancer After Colostomy.

Objective: To investigate the effects of nutritious meal combined with online publicity and education on postoperative nutrition and psychological state in patients with low rectal cancer after colostomy. Methods: The clinic data of 88 patients with low rectal cancer who received the colostomy in our hospital (August 2020-August 2021) were retrospectively reviewed. Among them, 44 patients received nutritious meal combined with online publicity and education and they made up the study group, and the others were given conventional care and they made up the reference group. The nutrition indicators, scores of the World Health Organization Quality of Life (WHOQOL)-BREF, and other materials of the patients in the two groups were compared. Results: After intervention, the various nutrition indicators, immune indexes, and WHOQOL-BREF score of the study group were all prominently higher than those of the reference group (P < 0.001). Compared with the reference group, the study group after intervention achieved markedly lower self-rating anxiety scale (SAS) score and self-rating depression scale (SDS) score (P < 0.001) and obviously lower total incidence of complications (P < 0.05). Conclusion: Combining nutritious meal with online publicity and education can effectively improve the postoperative nutrition and immune function of the patients with low rectal cancer after colostomy, and this intervention contributes to releasing the patients' adverse emotions. Further study helps to provide these patients with favorable solutions.

Quality of life of adult individuals with intestinal stomas in Uganda: a cross sectional study.

INTRODUCTION: Intestinal stomas remain important life-saving surgical options in a wide range of gastrointestinal pathologies globally. Living with a stoma has potential to impair the patient's quality of life, often with associated negative psychological effects. OBJECTIVE: To evaluate the quality of life among intestinal stoma patients under Mulago National Referral Hospital (MNRH), with emphasis on psychological effects and effects on family-social interactions. METHODOLOGY: A cross-sectional study carried out at surgical outpatient clinics of MNRH between January and June 2018. Data was collected using Stoma-QOL questionnaire, PHQ-9 and GAD-7 from 51 participants who had lived with intestinal stomas for at least a month. RESULTS: Of the 51 participants, male: female ratio was 4:1 and aged 18-84 years (mean age 44.04+18.47 years). 76.5% had colostomy; 23.5% had ileostomy. Majority (88.2%) had temporary stomas. The overall mean Stoma-QOL score was 55.12+ 17.04. Only about a quarter (24%) of participants had Stoma-QOL scores >70 (best). Most patients exhibited negative psychological effects (anxiety-100%, concerns about changed body image - 96.1% and depression - 88.4%). CONCLUSION: Most participants had low levels of stoma-related quality of life, suffered negative psychological effects and exhibited limited social interactions. This calls for efforts to support Stoma patients adapt beter life.

Immediate postoperative experiences before discharge among patients with rectal cancer and a permanent colostomy: A qualitative study.

PURPOSE: Patients with rectal cancer with a permanent colostomy often have issues in physical, psychological and social domains. Since discharge is an important transition period, the patient experience at that time is worthy of attention. The aim of this study was to explore the immediate postoperative experiences before discharge among patients with rectal cancer and a permanent colostomy in China. METHODS: A qualitative design was used. Semi-structured interviews were conducted with 18 patients newly living with colostomy in China, who were asked open-ended questions about their postoperative experience. The thematic analysis approach was used to analyze the data. RESULTS: Four themes and twelve sub-themes were identified from the interviews: (1) psychological reactions (stoma self-acceptance, negative emotion and social isolation), (2) daily life concern (daily life misunderstandings, sexual life compromise and work restriction), (3) stoma care consideration (strong stoma self-care willingness, decreased stoma self-care confidence and access to high-quality stoma care), and (4) support from others (enterostomal nurses, family members and stoma friends). CONCLUSION: Colostomy patients experience various obstacles in physiological, psychological, and societal aspect. Nurses should provide effective discharge guidance to correct misunderstandings about the stoma, refer patients to psychological care, and promote transitional care.

The validity and reliability of the Stoma Self-Efficacy Scale: A methodological study.

AIMS: To assess the validity and reliability of the stoma self-efficacy scale for Turkish-speaking individuals with stoma. BACKGROUND: Self-efficacy in stoma care is one of the most important variables requiring compliance for an increase in the quality of life and well-being of individuals with stoma. DESIGN: A methodological study. METHODS: This study used translation and back translation for the scale's language equivalence and expert opinion for the content validity. An expert panel and 10 individuals with stoma evaluated the scale for face validity. The scale's reliability was assessed by internal consistency, Pearson correlation, and test-retest reliability in a sample of 174 individuals with stomas. The scale's construct validity was tested with confirmatory factor analysis and exploratory factor analysis. RESULTS: The content validity index was .96, and Cronbach's alpha was .95. In the test-retest analysis, the intraclass correlation coefficients were high. In the factor analysis, two factors emerged from the scale, and after the confirmatory factor analysis and scale modification, the fit indices of the model were found to provide a good level of validity. CONCLUSION: The Turkish version of the stoma self-efficacy scale is a valid and reliable tool to determine the levels of self-efficacy in individuals with stoma.

[Experiences and perceptions of people living with a colostomy for a long time: a phenomenological study.] / Vissuti e percezioni delle persone portatrici di colostomia da lungo tempo: uno studio fenomenologico.

Increased life expectancy rates in people with a stoma prompt the need to gain a better understanding of what are the concerns and the strategies of adaptation in this population in the long term to provide appropriate guidance and ongoing care. Therefore, the aim of this study is to explore the experiences and perceptions of people living with a colostomy for at least 20 years with regard to body changes and how these influence stoma care. This is phenomenological study. Five main themes were identified following data analyses: 1) accepting the stoma and living one's life almost fully; 2) changes; 3) practices to which I owe the recovery of my autonomy; 4) we are in need: before, during and after; 5) most people don't know. After many years, interviewees did not report significant changes in the way they had to manage their stoma and activities of daily living. Participants underlined how their healthcare needs continue throughout their lives, thus outlining the key role they attribute to nurses, stoma therapy services and associations of people with a stoma.

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.

City of Hope Quality of Life-Ostomy Questionnaire Validity and Reliability Assessment on a Croatian Sample.

The aim of this study was to validate City of Hope Quality of Life-Ostomy Questionnaire (CoH-QoL-OQ) for assessing the quality of life (QoL) of ostomy patients in the Republic of Croatia. The CoH-QoL-OQ is widely used, but has not been translated or validated so it can be used in the Republic of Croatia. This cross-sectional study encompassed 302 surgery patients with colostomy, ileostomy, or urostomy (182 (60.3%) male and 120 (39.7%) female), whose average age is 59 (M = 59.3, SD = 15.8). The CoH-QoL-OQ was translated into Croatian language using accepted guidelines for translation. Patients were recruited in a telephone conversation, followed by mail containing the CoH-QoL-OQ delivered to the home addresses of the patients who agreed to participate. The collected data were analyzed to verify psychometric properties of the questionnaire on the Croatian sample. All subscales showed high level of internal consistency (Cronbach α = 0.73-0.89). The test-retest reliability indicated a very satisfactory temporal stability (r = 0.99). The Confirmatory Factor Analysis (CFA), showed that the originally established model was not adequate for the data (χ2 = 4237.88, p < 0.01, CFI = 0.540, NNFI = 0.481, RMSEA = 0.113). However, after modification that excluded problematic items, the data showed a better fit with the theoretical model (except for the LR chi-square test that remained statistically significant: χ2 = 1144.28, p < 0.01, CFI = 0.869, NNFI = 0.855 RMSEA = 0.077). We conclude that the CoH-QoL-OQ is a valid, reliable, and reducible instrument for measuring the health-related quality of life (HRQoL) among Croatian patients with ostomy in clinical research and clinical practice.

La experiencia de la persona con cáncer de colon y colostomía: tiempo y espacio que se sufre o se vive / The experience of person with colon cancer and colostomy: time and space suffered or lived / A experiência do pessoa com câncer de cólon e colostomia: tempo e espaço sofrido ou

JUSTIFICACIÓN: En el 2016 en México, el cáncer colorectal en los hombres ocupó el cuarto lugar dentro de las neoplasias a nivel mundial; en las mujeres, se ubicó en el tercer lugar. OBJETIVOS: explorar el la experiencia de las personas con cáncer de colon y que portan una colostomía. METODOLOGÍA: Se trata de un estudio cualitativo descriptivo fenomenológico en ocho informantes seleccionados por muestreo por conveniencia son adultos mexicanos del sexo masculino y femenino y la recolección de datos fue a través de entrevista a profundidad, estableciendo raport con los participantes. El análisis de los datos fue a través de análisis de contenido de Strauss y Corbin. El sustento teórico realizado de acuerdo con Martin Heidegger y Henri Lefebvre. RESULTADOS Y DISCUSIÓN: La experiencia más impactante es el sentir que su vida ya no tiene tiempo, el tiempo se volvió finito después del diagnóstico y no alcanza para cuidar de sí mismo y trabajar. Mientras que el espacio condiciona el tiempo y la forma en que se vive la experiencia de tener cáncer, de hecho la amplitud de un espacio pudiera ser insuficiente cuando se vive la angustia y se desea escapar de la realidad. Es responsabilidad de enfermería apoyar en el proceso de reconocer y aceptar su cuerpo, aprender a cuidarlo y tener el control tan deseado sobre su vida y sus actividades

JUSTIFICATION: In 2016 in Mexico, colorectal cancer in men ranked fourth in neoplasms worldwide; in women, it was in third place. OBJECTIVES: to explore the experience of people with colon cancer and who carry a colostomy. METHODOLOGY: This is a qualitative descriptive phenomenological study in eight informants selected for convenience sampling, Mexican adults of the male and female sex and the data collection was through an in-depth interview, establishing raport with the participants. The data analysis was through content analysis by Strauss and Corbin. The theoretical support made according to Martin Heidegger and Henri Lefebvre. RESULTS AND DISCUSSION: The most shocking experience is the feeling that your life no longer has time, time became finite after diagnosis and it is not enough to take care of yourself and work. While space conditions the time and the way in which the experience of having cancer is lived, in fact the amplitude of a space could be insufficient when the anguish is lived and one wishes to escape from reality. It is the nursing responsibility to support the process of recognizing and accepting your body, learning to take care of it and having the much desired control over their life and activities

JUSTIFICAÇÃO: Em 2016, no México, o câncer colorretal em homens ficou em quarto lugar em neoplasias em todo o mundo; nas mulheres, ficou em terceiro lugar. OBJETIVOS: explorar a experiência de pessoas com câncer de cólon e portadoras de colostomia. METODOLOGIA: Trata-se de um estudo fenomenológico descritivo qualitativo em oito informantes selecionados para amostragem por conveniência, adultos mexicanos do sexo masculino e feminino e a coleta de dados foi realizada por meio de entrevista aprofundada, estabelecendo raport com os participantes. A análise dos dados foi realizada através da análise de conteúdo de Strauss e Corbin. O suporte teórico feito de acordo com Martin Heidegger e Henri Lefebvre. RESULTADOS E DISCUSSÃO: A experiência mais chocante é a sensação de que sua vida não tem mais tempo, o tempo se tornou finito após o diagnóstico e não é suf iciente cuidar de si mesmo e trabalhar. Enquanto o espaço condiciona o tempo e o modo como a experiência de ter câncer é vivida, na verdade a amplitude de um espaço pode ser insuficiente quando a angústia é vivida e se deseja escapar da realidade. É responsabilidade da enfermagem apoiar o processo de reconhecimento e aceitação do seu corpo, aprendendo a cuidar dele e tendo o muito desejado controle sobre sua vida eatividades

Aplicação do cuidado baseado na teoria de Orem ao paciente ostomizado / Aplicación del cuidado basado en la teoría de Orem al paciente ostomizado / Application of care based on Orem's theory to the ostomy patien

Estomia intestinal é realizada para desviar o trânsito intestinal para o exterior do corpo, o autocuidado do sujeito é fundamental para o seu processo de bem-estar físico e psicossocial, visto que ocorre mudança na imagem corporal. OBJETIVO: relatar a experiência da prática da sistematização da assistência de enfermagem, com base nas demandas terapêuticas de autocuidado de acordo com a teoria de Orem. MÉTODO: Trata-se de um estudo descritivo, tipo relato de experiência das residentes do Programa de Residência Multiprofissional em Cuidados continuados integrados na área de concentração em atenção à saúde do idoso no estado de Mato Grosso do Sul (MS). RELATO DE CASO: Cliente 58 anos, branco, casado, profissão vendedor, com diagnóstico médico de choque séptico de foco abdominal. DISCUSSÃO: A equipe multiprofissional nesse âmbito insere no contexto hospitalar uma nova visão do cuidado, tendo como uma das funções costurar o sujeito fragmentado pela medicina, e romper o modelo cartesiano ainda existente no imaginário dos profissionais. CONSIDERAÇOES FINAIS: O conhecimento da equipe multiprofissional acerca da legislação que regulamenta o atendimento das pessoas com estomias é de extrema importância, uma vez que, essa equipe deve desempenhar suas ações com eficiência e eficácia à luz do que a legislação preconiza

La estomía intestinal se realiza para desviar el tránsito intestinal hacia el exterior del cuerpo, el autocuidado del sujeto es fundamental para su proceso de bienestar físico y psicosocial, ya que ocurre un cambio en la imagen corporal. OBJETIVO: relatar la experiencia de la práctica de la sistematización de la asistencia de enfermería, con base en las demandas terapéuticas de autocuidado de acuerdo con la teoría de Orem. MÉTODO: Se trata de un estudio descriptivo, tipo relato de experiencia de las residentes en el Programa de Residencia Multiprofesional en Cuidados continuados integrados en el área de concentración en atención a la salud del paciente en el estado de Mato Grosso do Sul (MS). RELATO DEL CASO: Paciente 58 años, blanco, casado, profesión vendedor, con diagnóstico médico de choque séptico de foco abdominal. DISCUSIÓN: El equipo multiprofesional en ese ámbito inserta en el contexto hospitalario una nueva visión del cuidado, teniendo como una de las funciones coser el sujeto fragmentado por la medicina, y romper el modelo cartesiano aún existente en el imaginario de los profesionales. CONSIDERACIONES FINALES: El conocimiento del equipo multiprofesional acerca de la legislación que regula la atención de las personas con estomias es de extrema importancia, una vez que ese equipo debe desempeñar sus acciones con eficiencia y eficacia a la luz de lo que la legislación indica

Intestinal stomies are performed to divert intestinal transit to the outside of the body, self-care of the subject is fundamental to the process of physical and psychosocial well-being, since there is a change in the body image. OBJECTIVE: to report the experience of the practice of the systematization of nursing care, based on the therapeutic demands of self care according to Orem's theory. METHOD: This is a descriptive study, a experience's report of the experience of the Residents of the Multiprofessional Residency Program in Continuing Care integrated into the area of attention to elderly health care in the state of Mato Grosso do Sul (MS). CASE REPORT: Client, 58 years old, white, married, salesman profession, with medical diagnosis of septic shock of abdominal focus. DISCUSSION: The multiprofessional team in this context inserts in the hospital context a new vision of care, it having as one of the functions to see the subject fragmented by medicine, and to break the Cartesian's model still existing in the professionals' imaginary. FINAL CONSIDERATIONS: The knowledge of the multiprofessional team about the legislation that regulates the care of people with stomies is of extreme importance, since, this team must carry out its actions with efficiency and effectiveness in light of what the law recommends, in addition, it is also the socialization of information with patients and family members about the guarantee of rights

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

PURPOSE: To examine the effects of the addition of lavender essential oil to the colostomy bag of the patients with permanent colostomy on the elimination of odor, quality of life, and ostomy adjustment. METHODS: As a parallel group, single-blinded randomized controlled trial with repeated measures, this study was conducted between November 2016 and February 2018. Patients with a permanent colostomy that had opened at least three months before the study were stratified according to age and sex and were randomized according to days of week. The study sample included 15 patients in the experimental group and 15 in the control group. Patients in the experimental group used lavender essential oil in the ostomy bag, and patients in the control group continued their routine practices about nutrition and stoma care for 1 month. RESULTS: There were no statistically significant differences in demographic characteristics between the experimental and control groups (p > 0.05). As compared with the control group patients, the experimental group patients who used lavender essential oil in the ostomy bag experienced statistically significant less odor, a higher quality of life, and better adjustment to ostomy (all p < 0.05). CONCLUSIONS: The use of lavender essential oil in the ostomy bag is a simple, low-cost, easy-to-use, and natural method that is effective for increasing both ostomy adjustment and quality of life levels and for eliminating odor in permanent colostomy patients.

Disability Among Adults in Brazil With a Colostomy: A Cross-sectional, Descriptive Study.

People with an ostomy need care appropriate to their needs and should be encouraged to adapt to their situation. In Brazil, persons with a stoma meet the legal definition of being disabled, enabling them to access comprehensive health care services. PURPOSE: The objective of this study was to evaluate the degree of disability experienced by persons with a colostomy. METHODS: A cross-sectional study was conducted among people with a colostomy in one Brazilian public health service. Between May 2017 and January 2018, persons at least 18 years of age who had a colostomy for at least 3 months were eligible to participate. Sociodemographic and stoma characteristic variables were collected, and the World Health Organization Disability Assessment Schedule (WHODAS) 2.0 was used to assesses perceived levels of disability. Higher scores indicated greater degree of difficulty. All persons with a WHODAS score ⟩0 were classified as disabled. Descriptive statistics, chi-squared, and Fisher's exact tests were used for data analysis, with a significance level of 5%. RESULTS: Among the 58 predominantly elderly participants (29 women, 29 men; mean age 64 ± 12 years), the overall mean WHODAS score suggested a small degree of impairment (3.1 ± 7.1). The highest scores were observed in the domains participation (6.3 ± 16.1), mobility (5.6 ± 17.3), and life activities (5.3 ± 15.6). The majority of participants (41, 70.7%) had a disability score of 0 (no disability). The proportion of persons who did or did not perceive any level of disability did not differ significantly by the stoma variables assessed. CONCLUSION: Based on the WHODAS scores, the majority of study participants did not perceive themselves as being physically disabled. Other clinical studies should advance this discussion in order to better understand the perception and reality of disability among ostomates.

Psychosocial behaviour reactions, psychosocial needs, anxiety and depression among patients with rectal cancer before and after colostomy surgery: A longitudinal study.

AIMS AND OBJECTIVES: To compare the differences in psychosocial behaviour reactions, psychosocial needs, anxiety and depression before and after colostomy surgery and to explore the predictors of psychosocial behaviour reactions. BACKGROUND: Colorectal cancer is increasing worldwide. Abdominoperineal resection accompanied by permanent colostomy can cause complicated psychosocial reactions and needs. However, colostomy patients' trajectories of psychosocial adjustment at different time points must be discussed. DESIGN: A longitudinal study. METHODS: Using a convenience sampling method, 67 patients planning to undergo colostomy surgery were recruited from a tertiary cancer centre in southern China from January 2013-January 2014. Data collection consisted of two phases, conducted 1-2 days before surgery and 1-2 days prior to discharge. The Ostomy Psychosocial Behaviour Reaction Questionnaire, the Ostomy Psychosocial Needs Questionnaire, the Hospital Anxiety and Depression Scale and a self-designed demographic questionnaire were used to collect data. STROBE guidelines were followed. RESULTS: The participants had a moderate level of psychosocial behaviour reactions, a deep and wide range of psychosocial needs and a high incidence of anxiety and depression before and after surgery. Anxiety before surgery was significantly higher than that after surgery. Psychosocial needs and anxiety were significant predictors of psychosocial behaviour reactions. CONCLUSIONS: Patients' anxiety was alleviated after surgery. The combination of ascertaining and meeting various psychosocial needs and managing negative emotions was helpful in alleviating patients' stress responses before and after surgery. RELEVANCE TO CLINICAL PRACTICE: An increased focus on the relationships among psychosocial behaviour reactions, psychosocial needs, anxiety and depression at different time points in colostomy patients is necessary for future research and practice.

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.

Stress and other factors associated with colorectal cancer outpatients with temporary colostomies.

This study investigated stress and other factors associated with colorectal cancer (CRC) outpatients with temporary colostomies in Taiwan. Temporary colostomies have been incorporated as a defecation alternative to maintain physical function and are accompanied by chemotherapy/radiotherapy in CRC patients. A cross-sectional study was conducted, and a convenience sampling approach was adopted to recruit 110 discharged CRC patients with temporary colostomies from a medical centre in southern Taiwan. The mean score of the Stress of Colostomy Patients Scale was 66.49 (out of 120). Demographic attributes were found to have an impact on different stress types. Stress of changes in familial and social interaction was affected by age, employment status, educational level and colostomy assistant caregiver. The stress of colostomy care was impacted by the factor of employment status, and the stress of changes of self-concept was impacted by the factors of educational level and self-perception of disease. The results provide post-operative information regarding stress and stress types among CRC patients with temporary colostomies, serve as a reference for clinical assessment, practice and care, and generate up-to-date knowledge and comprehension of learning how to live with a temporary colostomy.

Paciente con traumatismo perianal severo / No disponible

Las lesiones traumáticas del esfínter anal, su reconstrucción y la posibilidad de establecer una recomendación estricta resultan complejas y no existe una información actualizada del tratamiento. La glaciloplastia dinámica es una técnica que se recomienda a pacientes jóvenes con traumatismos severos, y que utiliza el músculo gracilis para formar un nuevo esfínter e implanta un estimulador eléctrico para mantener el tono esfinteriano. Este trabajo se ocupa de una mujer joven que, tras un accidente de moto acuática, presentó un desgarro del esfínter anal y mucosa rectal. El caso se desarrolla siguiendo el procedimiento de la técnica antes descrita y la realización de una ostomía para la cicatrización de las heridas quirúrgicas.Se describe el proceso asistencial de enfermería (diagnóstico, resultados (NOC) e intervenciones (NIC) y los patrones funcionales (Marjory Gordon)). El empleo de dispositivos adecuados de ostomía y sistema de irrigación intestinal, junto con el plan de cuidados específico, permitieron mejorar su calidad de vida

No disponible

Colostomy Care: A Guide for Home Care Clinicians.

Surgical creation of a colostomy can have significant physical, emotional, and social effects. Adapting to a new ostomy can be overwhelming and interventions aimed at decreasing barriers to self-care should be a priority for home care patients. Advances in surgical procedures, coupled with decreased length of hospital stays, require home care clinicians to have the skills and knowledge to care for this population through postoperative recovery and the initial phases of learning self-care. This article will focus on the care of patients with a colostomy in the home care setting.