A prospective, longitudinal, multicenter, cohort quality-of-life evaluation of an intensive follow-up program for patients with a stoma.

The creation of a stoma can profoundly affect a patient's quality of life. A prospective, 3-month multicenter study was conducted to evaluate stoma patient quality of life among volunteers receiving standard clinical follow-up (S) and those receiving intensive follow-up via telephone (I). A total of 336 patients volunteered to participate; 187 in the S group and 149 in the I group; mean age 63+/-14 years, 65.85% male; the majority (64.3%) had a colostomy. The Stoma Quality of Life Index (SQLI) score was determined at the initial and final visits. No statistically significant difference between the I and S groups was found at baseline except for the subcategory social concerns (P = 0.0123). At 3 months, statistically significant changes were observed between the overall SQLI score of both groups--scores were 58.8 (17.7) and 72.8 (14.6) at baseline and 3 months, respectively (P < 0.0001); in particular, for the subcategories patient satisfaction (P = 0.0173) and medical experience (P = 0.0330). Patients in the I group showed a positive but not statistically significant change in three subscales of the SQLI questionnaire; the I group presented slightly lower differences in the percentage of complications related to the stoma, need for emergency assistance, and for hospitalization. Differences in quality-of-life perceptions also were reflected among geographic areas. Preoperative ostomy nurse care was found to be associated with a greater probability for improvement in select SQLI subscales. The results of this study confirm that personal support and help received pre- and post surgery from ostomy care nurses may enhance ostomate overall quality of life and when additional intensive follow-up was introduced, certain aspects of quality of life improved. The study underscores the need for clinician awareness of their role in patient quality of life.

[Nurse involvement in clinical trials with cell therapy]. / Implicación de la enfermería en ensayos clínicos con terapia celular.

Research with stem cells has made a qualitative leap since the research group from Minnesota University Stem Cell Institute in the USA published a study in July 2002, which showed that the bone marrow stem cells of adults multiplied indefinitely without losing their ability to differentiate. In this hospital the first implant of stem cells derived from adipose tissue was performed in this hospital in 2003 in an attempt to close a complex perianal fistula in a patient with Crohn's disease. As a result of this first success, a multidisciplinary research team was formed to study the application of stem cells in the treatment of complex anal fistula. Since its creation, it has included a nurse whose role is fundamental in the coordination of the different phases of the trials and the involvement of patients in these. The development of these new treatments, along with their complexity and direct effects on the patient, involves the training and presence of the professional nurse in these teams. The improvement shown in tissue healing would make it very worthwhile to demonstrate their efficacy in wound care, pressure sores, diabetic foot, etc.