Italian Guidelines for the Nursing Management of Enteral and Urinary Stomas in Adults: An Executive Summary.

PURPOSE: This article is an executive summary of Italian guidelines for nursing management of enteral and urinary ostomies in adults. METHODS: Scoping review and generation of evidence and consensus-based clinical guidelines. SEARCH STRATEGY: The Multidisciplinary Italian Study group for STOmas (MISSTO) was founded in 2018. This group created guidelines for management of enteral and urinary ostomies in adults based on a scoping review of the literature. The research included previous guidelines, systematic reviews, meta-analyses, randomized clinical trials, cohort studies, and case reports. Five main topics were identified: "stoma preparation," "stoma creation," "stoma complications," "stoma care," and "stoma reversal" (for enteral stomas)." All the studies were evaluated according to the GRADE system and AGREE II tool. Recommendations were elaborated in the form of statements, with an established grade of recommendation for each statement. For low levels of scientific evidence statements, a consensus conference composed of expert members of the major Italian scientific societies in the field of stoma management and care discussed, corrected, validated, or eliminated the statements. A final version of the guidelines with definitive recommendations was elaborated and prepared for publication. FINDINGS/CONCLUSIONS: This document represents the first Italian guidelines on enteral and urinary stoma management to assist nurses caring for persons with an enteral or urinary ostomy.

Uso de productos barrera para prevenir complicaciones en la piel periestomal / Use of barrier products in order to prevent complications in the peristomal skin

OBJETIVO: evaluar la eficacia del uso de un aerosol protector barrera para la prevención de la maceración e irritación de la piel periestomal, en el paciente quirúrgico, antes de la colocación de los discos, y valorar la eficacia de la aplicación de dicho aerosol previo a la retirada de los adhesivos. MÉTODO: se llevó a cabo un ensayo clínico aleatorizado con dos grupos de comparación: grupo control (cura habitual) y grupo experimental (cura habitual + aplicación de aerosol como método barrera antes de la colocación del disco y spray quita-adhesivo para su retirada). Se incluyeron a los pacientes ostomizados en el Hospital Universitario Infanta Cristina (Parla, Madrid) en 2019, atendidos en la Consulta de Cirugía General. Se aleatorizaron a dos grupos, 15 por grupo. Se recogieron variables descriptivas el día de la captación y de resultado a los 10 días del seguimiento. Se llevaron a cabo análisis univariante y bivariante. La relación entre las distintas variables se evaluó mediante pruebas estadísticas. RESULTADOS: se aleatorizaron 30 pacientes, 15 en grupo control y 15 en grupo experimental. Se observaron diferencias clínicas en los grupos de comparación al inicio del estudio. Al comparar las variables de resultado a los 10 días de la cirugía en los dos grupos del estudio, se observaron diferencias estadísticamente significativas en la presencia de complicaciones en la piel periestomal (p< 0,001) con un 80% (n= 12) en el grupo control frente al 6,7% (n= 1) en el grupo experimental, y en el tipo de complicaciones entre ambos grupos (0,002), destacando las lesiones de tipo L2 Erosivas. CONCLUSIONES: la utilización tanto de un aerosol protector barrera sobre la piel del paciente antes de la colocación del disco de ostomías como la aplicación para su retirada de un spray quita-adhesivo, parece reducir el riesgo de complicaciones en la piel periestomal en el paciente quirúrgico

OBJECTIVES: to assess the efficacy of using a protective barrier spray for preventing peristomal skin maceration and irritation in surgical patients before disc placement, and to assess the efficacy of the application of said spray before removing the adhesive discs. METHOD: a randomized clinical trial was conducted with two comparison arms: the control group (standard cure) and the experimental arm (standard cure + application of spray as barrier method before disc placement and adhesive remover spray for removing them). The study included ostomized patients from the Hospital Universitario Infanta Cristina (Parla, Madrid) in 2019, seen at the General Surgery Unit. Patients were randomly assigned to two 15-patient arms. Descriptive variables were collected on recruitment day, and for outcomes at 10 days follow-up. Univariate and bivariate analyses were conducted. The relationship between different variables was evaluated through statistical tests. RESULTS: thirty (30) patients were randomized, 15 patients to the control arm and 15 patients to the experimental arm. Clinical differences were observed in the comparison arms at study initiation. When comparing the outcome variables at 10 days after surgery in the two study arms, statistically significant differences were observed regarding the presence of complications in the peristomal skin (p< 0.001) with 80% (n= 12) in the control arm vs. 6.7% (n= 1) in the experimental arm, and in terms of type of complications between both arms (0,002), particularly L2-type erosive lesions. CONCLUSIONS: the use of a protective barrier spray on the skin of the patient before placing the ostomy disc as well as the application of an adhesive remover spray for removal seems to reduce the risk of complications in the peristomal skin of surgical patients

Overview of stoma care for community nurses.

This article explores nursing care for stoma patients, with a focus on colostomies, while providing some broader information covering a multitude of topics that relate to any type of stoma. Nurses must be aware of various factors when caring for stoma patients, as the latter will not always be in touch with their specialist stoma nurse. Therefore, if a community nurse visits more often, they can make a difference with their knowledge and care. Complications are not uncommon, and it is important the correct advice is given on diet, exercise, avoiding complications such as parastomal hernia through certain techniques, medications and aids and appliances. SecuriCare and the Royal College of Nursing have produced clinical nursing standards for the stoma nurse, and these are also relevant to community nurses. A pharmacist can give more specialist advice on medications, a GP can prescribe for infections, and a stoma nurse can provide specialist expertise to the nurse and patient alike, but the community nurse is at the frontline with a community patient. Therefore, they should be equipped with the knowledge and care expertise, so they can know when to act by referral to the appropriate professional, or give the appropriate care and advice. The patient will also have psychological needs to consider, which may require referral if these are beyond the specialist stoma nurse's or community nurse's abilities.

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.

Intervenção de enfermagem à pessoa idosa com ostomia de eliminação intestinal e família em contexto de cuidados de saúde primários / Nursing intervention for the elderly with intestinal elimination ostomy and family in the context of primary health care

O envelhecimento populacional é uma tendência a nível global, refletindo-se na saúde dos indivíduos e conduzindo a um aumento de doenças crónicas. Estas apresentam-se com maior incidência em pessoas cuja idade é de 65 anos ou mais. Em Portugal o cancro do colon e reto é a doença que se confronta com maior número de novos casos anuais, com cerca de 10 270 (WHO, 2018), e é a principal razão para a existência de ostomias de eliminação intestinal (OEI) (Barata, 2010), estimando-se cerca de 20 000 pessoas (Farmácias Portuguesas, 2020), sendo a OEI predominante (Barata, 2010). A presença de uma OEI, especialmente numa pessoa idosa (PI), requer competências, tanto do portador como das suas familias, tornando-se a intervenção de enfermagem essencial para a recuperação e melhoria da qualidade de vida. Após a cirurgia, estes doentes são referenciados para os cuidados de saúde primários, sendo constatado, que os enfermeiros deste nivel de cuidados, nem sempre estão preparados, com o nivel de conhecimentos necessários para poder dar resposta às expectativas destas pessoas. Sendo a relação de ajuda indissociável da intervenção de enfermagem, foi elaborado o projeto "Intervenção de enfermagem à pessoa idosa com ostomia de eliminação intestinal e família em cuidados de saúde primários", com o intuito de ajudar a suprimir as lacunas existentes. Este trabalho, resulta do percurso delineado no projeto e implementado por nós ao longo do estágio. Para a sua concecução, utilizámos a metodologia do projeto, assente no modelo conceptual de défice de autocuidado de Orem. Tivemos como objetivos: desenvolver competências como mestre e enfermeira especialista na intervenção de enfermagem à pessoa idosa com ostomia de eliminação intestinal (PIOEI) e família; envolver a equipa multidisciplinar na promoção do autocuidado à PIOEI e família. O resultado deste percurso permitiu-nos: o desenvolvimento de competências como mestre e enfermeira especialista, nomeadamente na prestação de cuidados à PIOEI e suas familias; a realização de duas sessões de formação à equipe de enfermagem de um agrupamento de centros de saúde (ACES), contribuindo desta forma para a capacitação dos enfermeiros, nos cuidados a prestar a pessoas idosas com OEI e família; elaboração de um manual de boas práticas que foi disponibilizado aos enfermeiros da unidade de cuidados na comunidade (UCC) e aos enfermeiros do ACES que participaram na formação.

Population ageing is a global trend, reflecting on the health of individuals and leading to an increase in chronic diseases. They have a higher incidence in people whose age is 65 years or older. In Portugal colon and rectum cancer is the disease that faces the highest number of new annual cases,, with about 10 270 (WHO, 2018), and is the main reason for the existence of intestinal elimination ostomies (IEO) (Barata, 2010),with an estimated 20 000 people (Portuguese Pharmacies, 2020), with the predominant IOE (Barata, 2010). The presence of an IEO, especially in an old person (OP), requires competencies, from the carrier and their families, making it the essential nursing intervention for the recovery and improvement of quality of life. After surgery, these patients are referred to primary health care, and it is found that nurses at this level of care, are not always prepared with the necessary level of knowledge, to be able to meet the expectations of these people. Since the relationship of help is inseparable from the nursing intervention, the project "Nursing intervention to the old person with intestinal elimination ostomy and family in primary health care" was designed, in order to help eliminate existing gaps. This work results from the path outlined in the project and carried out by us throughout the internship. For its design, we used the project methodology, based on Orem's conceptual self-care deficit theory. We had the objectives: to develop competencies as a master and nurse specialist in the nursing intervention to the old person with intestinal elimination ostomy (OPIEO) and family; to involve the multidisciplinary team in the promotion of self-care to the OPIEO and family. The result of this journey allowed us to: the development of skills as a master and specialist nurse, namely in the provision of care to OPIEO and its families; the realization of two training sessions to the nursing team of a Group of Health Centers (GHC) in Lisbon, thus contributing to the training of nurses, in the care provided to the old person with IEO and family; a guide was prepared and made available to the Community Care Unit nurses and GHC nurses who participated in the training.

Intervención de enfermería en la nutrición de los pacientes ostomizados / Nursing intervention in nutrition of ostomates

Este artículo tiene por objetivo proporcionar información básica acerca de la intervención enfermera en la nutrición de los pacientes portadores de un estoma, ya sea digestivo o urológico. Conocer los efectos que la cirugía, en la que se construye una ostomía digestiva, tiene en la digestión y la absorción de los alimentos, es básico para poder plantear una dieta individualizada a los pacientes ostomizados. La fase más importante es el postoperatorio inmediato, dado que se deben seguir las recomendaciones de adaptación a la resección intestinal en las ostomías digestivas. Cuando se ha completado el tratamiento y la ostomía funciona con normalidad, la mayoría de las personas ostomizadas pueden volver a una dieta normal o a su dieta habitual y si es necesario, con alguna restricción. La dieta en las ostomías urológicas es más sencilla de manejar, pero es importante conocer qué alimentos y qué nutrientes van a ser favorables para un buen funcionamiento y para evitar complicaciones

This article aims to provide basic information on the nurse intervention in the nutrition of patients with a stoma, whether digestive or urological. Knowing the effects that surgery, in which a digestive ostomy is constructed, has on digestion and food absorption is essential to propose an individualized diet to ostomized patients. The most important phase is the immediate postoperative period, as the recommendations for adaptation to intestinal resection in digestive ostomies should be followed. When the treatment has been completed and the ostomy works normally, most ostomized people can return to a normal diet or to their usual diet; if necessary, with some restriction. The diet in urological ostomies is easier to handle, but it's important to know what foods and nutrients are going to be favorable for proper functioning and thus avoid complications

Effect of Ostomy Care Team Intervention on Patients With Ileal Conduit.

PURPOSE: The purpose of this study was to investigate the effect of a nurse-led multicomponent intervention on ostomy-related complications, self-efficacy, and health-related quality of life in patients with an ileal conduit. DESIGN: Randomized controlled trial. SAMPLE AND SETTING: Forty-six patients who underwent radical cystectomy and creation of an ileal conduit participated in the trial; data were collected over a 6-month period. The study setting was Shanghai Pudong Hospital, affiliated with Fudan University, located in Shanghai, China. METHODS: Participants were randomly allocated to an experimental or control group. Participants in the control group received routine care over a 6-month period following ostomy surgery, while those in the experimental group received a nurse-led, multicomponent, structured intervention delivered by an ostomy care team. The Chinese language versions of the Stoma Self-Efficacy Scale (SSES) and the City of Hope Quality of Life-Ostomy (COHQOL-O) questionnaire were used to assess self-efficacy in stoma care and health-related quality of life. Ostomy-related complications including peristomal moisture-associated skin damage and uric acid crystal deposits in the peristomal area were also assessed. Fisher's exact test was used to compare the incidence of ostomy-related complications between the 2 groups. Independent-samples t tests were used to compare SSES and COHQOL-O scores. RESULTS: No statistically significant differences were found between demographic characteristics of the control and experimental groups. After 6 months, the incidence of complications was significantly lower in the experimental group as compared to the control group (4.35% vs 30.43%, P = .047). In addition, the mean SSES score was significantly higher in the experimental group (indicating greater self-efficacy in stoma care) (107.13 ± 11.87 vs 85.65 ± 12.87, P = .000), and the mean COHQOL-O score was also significantly higher in the experimental group, indicating higher health-related quality of life (154.48 ± 16.01 vs 138.26 ± 13.42, P = .001). CONCLUSION: The nurse-led multicomponent intervention provided by the ostomy care team reduced ostomy-related complications and improved the self-efficacy level and health-related quality of life in persons with a new urostomy.

CE: Stoma and Peristomal Skin Care: A Clinical Review.

: Nursing students who don't specialize in ostomy care typically gain limited experience in the care of patients with fecal or urinary stomas. This lack of experience often leads to a lack of confidence when nurses care for these patients. Also, stoma care resources are not always readily available to the nurse, and not all hospitals employ nurses who specialize in wound, ostomy, and continence (WOC) nursing. Those that do employ WOC nurses usually don't schedule them 24 hours a day, seven days a week. The aim of this article is to provide information about stomas and their complications to nurses who are not ostomy specialists. This article covers the appearance of a normal stoma, early postoperative stoma complications, and later complications of the stoma and peristomal skin.

Ileostomy Care: A Guide for Home Care Clinicians.

This article focuses on the care and management of patients living with an ileostomy. Due to shortened hospital stays, patient teaching related to self-care of ostomies has shifted from the hospital to the home setting. It is important for home care clinicians to be knowledgeable about all aspects of ostomy care. Patients with ileostomies are particularly prone to peristomal skin problems, as well as fluid and electrolyte and nutritional imbalances. This article reviews the anatomy and physiology of the gastrointestinal tract, indications for the creation of an ileostomy, and prevention and treatment of early and late complications. Practical advice on ileostomy care and patient teaching is provided.

Plan de cuidados enfermeros a un paciente con complicación temprana en la ileostomía: absceso intraabdominal / No disponible

Paciente que precisó someterse a una sigmoidectomía por neoplasia de colon y posterior reintervención por fuga anastomótica y peritonitis aguda difusa, que conllevó la realización de ileostomía terminal en fosa ilíaca derecha. La presencia de un absceso periestomal con exudado purulento propició la aparición de fugas continuas. Dado el mal estado general del paciente, no fue posible tratar el absceso hasta 33 días después, mediante un catéter Pig-Tail, por parte del servicio de radiología intervencionista. A esta complicación se le añadió la aparición de un alto débito por la ileostomía. Durante este periodo de tiempo, los cuidados de enfermería y la correcta elección de dispositivos y accesorios, han sido fundamentales para mantener el estoma y piel periestomal en buen estado, y de este modo, poder abordar con el paciente y familia el proceso de aceptación y cuidados de la ostomía

No disponible

Cuidados del paciente con ileostomía complicada por una hernia paraestomal / No disponible

Se presenta un caso de un paciente diagnosticado de neoplasia en el recto al que se le practica una ileostomía temporal que se complica por una hernia paraestomal. Como consecuencia, presenta mucho dolor y, debido a las particularidades de la ostomía, su calidad de vida se encuentra comprometida. Se realiza un plan de cuidados ofreciendo, además, dispositivos y recursos adecuados para el manejo de su ileostomía. Con el propósito de minimizar complicaciones y favorecer la resolución de los problemas presentes, se presta información sobre el autocuidado, haciendo hincapié en el control estricto de la evolución del estoma y de la piel periestomal

No disponible

Care of the stoma: complications and treatments.

Quality patient education of how to care for their stoma improves patient outcomes and enhances quality of care and efficacy. There is a need for home visits to assist ostomates with rehabilitation of their stoma formation, as they often feel stigmatised and are likely to withdraw from social activities. It has previously been highlighted that community care is often the weakest link in rehabilitation, highlighting the need for effective teamwork and collaboration between stoma nurse specialists and community nurses. This article will focus on some of the more common complications of stomas which will be seen in the community setting, how to treat these conditions and when patients should be referred to the specialist stoma care nurse.

Novel Pouching Techniques for the Neonate With Fecal Ostomies.

BACKGROUND: Neonatal ostomy management is challenging even under the best circumstances. When complex circumstances are encountered, creative pouching techniques must be employed. CASES: This article describes management of 5 neonates with problematic ostomies. CONCLUSION: Maintaining a neonatal pouch seal at times requires using modified adult pouching products; however, caution should always be used due to the fragility of this patient population.

Cuidados de enfermería en la ureteroileostomía (tipo Bricker). Estudio de un caso clínico / No disponible

La alta incidencia y elevada prevalencia de casos de cáncer de vejiga, traducido ello en un creciente número de ingresos hospitalarios, hacen de esta patología un grave problema de salud pública. A pesar de la elevada incidencia, la mortalidad no es tan alta, debido a que es este un proceso oncológico en muchas ocasiones curable. El diagnóstico precoz de este proceso oncológico es el medio más eficaz de combatir el tumor, cuya capacidad de disminución se produce en una fase avanzada de su evolución. El papel de la enfermería es fundamental para el paciente de cirugía, transmitiendo información sobre el proceso y ayudándole en la adopción de actitudes positivas frente a la enfermedad

The (high incidence and) high prevalence of cases of bladder cancer are provoking an increased number of hospital admissions, making this disease a major public health problem. Despite the high incidence, mortality is not high, as this is a curable cancer process in many situations. Early diagnosis of this cancer is the most effective combat strategy, as the ability to decrease tumours occurs in an advanced stage of their development environment. The role of nursing care is essential for the surgery patient, transmitting information about the process and helping he or she in the adoption of positive attitude

Clinical and Economic Burden of Peristomal Skin Complications in Patients With Recent Ostomies.

PURPOSE: The purpose of this study was to estimate the risk and economic burden of peristomal skin complications (PSCs) in a large integrated healthcare system in the Midwestern United States. DESIGN: Retrospective cohort study. SUBJECTS AND SETTING: The sample comprised 128 patients; 40% (n = 51) underwent colostomy, 50% (n = 64) underwent ileostomy, and 10% (n = 13) underwent urostomy. Their average age was 60.6 ± 15.6 years at the time of ostomy surgery. METHODS: Using administrative data, we retrospectively identified all patients who underwent colostomy, ileostomy, or urostomy between January 1, 2008, and November 30, 2012. Trained medical abstractors then reviewed the clinical records of these persons to identify those with evidence of PSC within 90 days of ostomy surgery. We then examined levels of healthcare utilization and costs over a 120-day period, beginning with date of surgery, for patients with and without PSC, respectively. Our analyses were principally descriptive in nature. RESULTS: The study cohort comprised 128 patients who underwent ostomy surgery (colostomy, n = 51 [40%]; ileostomy, n = 64 [50%]; urostomy, n = 13 [10%]). Approximately one-third (36.7%) had evidence of a PSC in the 90-day period following surgery (urinary diversion, 7.7%; colostomy, 35.3%; ileostomy, 43.8%). The average time from surgery to PSC was 23.7 ± 20.5 days (mean ± SD). Patients with PSC had index admissions that averaged 21.5 days versus 13.9 days for those without these complications. Corresponding rates of hospital readmission within the 120-day period following surgery were 47% versus 33%, respectively. Total healthcare costs over 120 days were almost $80,000 higher for patients with PSCs. CONCLUSIONS: Approximately one-third of ostomy patients over a 5-year study period had evidence of PSCs within 90 days of surgery. Costs of care were substantially higher for patients with these complications.

Caracterización de ileostomizados atendidos en un servicio de referencia de ostomizados / Caracterização dos ileostomizados atendidos em um serviço de referência de ostomizados / Characterization of patients with an ileostomy that are treated on a reference service for patients with an ostomy

Objetivo: Caracterizar a los pacientes ileostomizados registrados en la Asociación de Ostomizados de Río Grande do Norte. Material y Métodos: Estudio exploratorio, retrospectivo, con abordaje cuantitativo, basado en datos obtenidos de las fichas de inscripción de 97 personas con ostomías, en el periodo de noviembre de 2013 a enero de 2014, en una asociación de ostomizados en el estado de Rio Grande do Norte, RN, Brasil. Resultados: Predominaron pacientes de sexo femenino, con edad media de 57,08 años, blanco/pardo, casados, procedentes de la zona costera del este, educación primaria incompleta, jubilados y con 1 salario mínimo. En cuanto a la duración y motivo del origen de la ileostomía, el tumor de recto/neoplasia de recto/cáncer de recto fue la causa principal y la mayoría de ellas fueron temporales. Conclusión: El conocimiento del perfil de estos pacientes permite la identificación de las necesidades de los ostomizados, estimulando al equipo multidisciplinar para implementar comportamientos que ayuden a los pacientes a aceptar y vivir con la ostomía (AU)

Objetivo: Caracterizar os pacientes ileostomizados cadastrados na Associação dos Ostomizados do Rio Grande do Norte. Material e Método: Estudo exploratório retrospectivo, com abordagem quantitativa, baseado nos dados obtidos das fichas cadastrais de 97 pessoas com ostomias, no período de novembro de 2013 a janeiro de 2014, em uma associação de ostomizados no estado do Rio Grande do Norte, RN, Brasil Resultados: Predominaram pacientes do sexo feminino, com média de idade de 57,08 anos, branco/pardo, casados, procedentes da zona litoral oriental, ensino fundamental incompleto, aposentados e 1 salário mínimo. Quanto à duração e motivo para confecção das ileostomias, o tumor de reto/neoplasia de reto/câncer de reto foi a principal causa e a maioria delas eram temporárias. Conclusão: O conhecimento do perfil desses pacientes permite a identificação das necessidades dos ostomizados, estimulando a equipe multiprofissional à execução de condutas que auxiliem o pacientes a aceitar e conviver com a estomia(AU)

Objective: To characterize the patients with ileostomies who are registered in the Ostomy Association of Rio Grande do Norte. Material and Method: Retrospective exploratory study, with quantitative approach, based on the data obtained from the registration forms of 97 people with an ostomy, on the period of November, 2013 to January 2014, from an Ostomy Association that belongs to the state of Rio Grande do Norte, Brazil. Results: There were mainly female patients, with an average age of 57.08 years, white/brown, married, coming from the oriental coastal zone, with incomplete basic education, retired and with one minimum wage. Regarding the duration and reason for the ileostomies' confection, the tumor of rectum/neoplasia of rectum/cancer of rectum was the main cause and most of them were temporary. Conclusion: The knowledge about these patient’s profiles allows to identify their needs, stimulating the multidisciplinary team to make use of conducts that can help the patients to live with the ostomy (AU)

Implementation of an Evidence-Based and Content Validated Standardized Ostomy Algorithm Tool in Home Care: A Quality Improvement Project.

Many nurses have limited experience with ostomy management. We sought to provide a standardized approach to ostomy education and management to support nurses in early identification of stomal and peristomal complications, pouching problems, and provide standardized solutions for managing ostomy care in general while improving utilization of formulary products. This article describes development and testing of an ostomy algorithm tool.

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.