RESUMO
AIM: Most new ostomy patients are not able to manage ostomy self-care when they are discharged and rely on visiting nurse services for ostomy care. The aim of this study was to determine if a perioperative ostomy educational pathway increases the level of independence and decreases the need for visiting nurse services in new ostomy patients. METHOD: A prospective longitudinal study was conducted between July 2018 and February 2020. Patients who received a colostomy or ileostomy and were treated on the surgery ward were included. Patients who followed a perioperative ostomy educational pathway were compared to a historical control group. The primary outcome measure was the level of independence in ostomy care and the need for visiting nurse services. RESULTS: After discharge, 67.6% of patients in the intervention group (n = 244) were able to independently perform ostomy care and were therefore not relying on visiting nurse services, compared to 15.2% of the patients in the control group (n = 33). The need for visiting nurse services was higher in patients aged ≥70 years (OR 3.20, P < 0.001), those who did not attend the preoperative practice session (OR 3.02, P = 0.002), those with a history of transient ischaemic attack (OR 10.22, P = 0.045) and those with mild cognitive impairment (OR 28.98, P = 0.002). CONCLUSION: A perioperative ostomy educational pathway effectively increased the level of independence and decreased the need for visiting nurse services in new ostomy patients.
Assuntos
Ileostomia , Educação de Pacientes como Assunto , Autocuidado , Humanos , Feminino , Masculino , Idoso , Estudos Prospectivos , Estudos Longitudinais , Pessoa de Meia-Idade , Ileostomia/enfermagem , Educação de Pacientes como Assunto/métodos , Colostomia/enfermagem , Enfermagem em Saúde Comunitária , Assistência Perioperatória/métodos , Idoso de 80 Anos ou mais , Alta do Paciente , Estomia/enfermagemRESUMO
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.
Assuntos
Neoplasias Colorretais/enfermagem , Neoplasias Colorretais/cirurgia , Colostomia/enfermagem , Cuidados Pós-Operatórios/enfermagem , China , Colostomia/efeitos adversos , Biologia Computacional , Humanos , Processo de Enfermagem , Complicações Pós-Operatórias/enfermagem , Complicações Pós-Operatórias/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto , AutocuidadoRESUMO
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.
Assuntos
Colostomia , Ileostomia , Cuidados de Enfermagem/normas , Estomia , Guias de Prática Clínica como Assunto , Estomas Cirúrgicos , Adulto , Colostomia/enfermagem , Consenso , Humanos , Ileostomia/enfermagem , Itália , Estomia/enfermagemRESUMO
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.
Assuntos
Colostomia/enfermagem , Ileostomia/enfermagem , Enfermeiros de Saúde Comunitária , Estomas Cirúrgicos , Humanos , Papel do Profissional de EnfermagemRESUMO
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.
Assuntos
Colostomia/enfermagem , Assistência Domiciliar , Ileostomia/enfermagem , Cuidados Pós-Operatórios/métodos , Consulta Remota , Estomas Cirúrgicos , Idoso , Assistência Ambulatorial/estatística & dados numéricos , Efeitos Psicossociais da Doença , Utilização de Instalações e Serviços , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Noruega , Avaliação de Resultados da Assistência ao Paciente , Readmissão do Paciente/estatística & dados numéricos , Qualidade de Vida , Fatores de Tempo , ViagemRESUMO
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.
Assuntos
Colostomia/psicologia , Enfermagem Holística/métodos , Qualidade de Vida , Idoso , Neoplasias Colorretais/cirurgia , Colostomia/enfermagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Resiliência Psicológica , AutocuidadoRESUMO
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
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Enfermagem , Colostomia/enfermagem , Autogestão , Autocuidado , Colectomia/enfermagem , Colostomia/reabilitação , Colostomia/psicologia , Autoimagem , BrasilRESUMO
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.
Assuntos
Humanos , Idoso , Idoso , Colostomia/enfermagem , Ileostomia/enfermagem , Estomaterapia , Enfermagem Geriátrica , Autocuidado , Família , Educação de Pacientes como AssuntoRESUMO
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
Assuntos
Humanos , Cuidados de Enfermagem , Estomia/enfermagem , Apoio Nutricional/enfermagem , Dieta/enfermagem , Ileostomia/enfermagem , Colostomia/enfermagem , Estado NutricionalAssuntos
Enfermagem em Saúde Comunitária , Estomia/enfermagem , Educação de Pacientes como Assunto , Higiene da Pele/enfermagem , Dermatopatias Infecciosas/enfermagem , Pele/lesões , Estomas Cirúrgicos , Adesivos , Colostomia/enfermagem , Humanos , Ileostomia/enfermagem , Enfermeiros de Saúde Comunitária , Dermatopatias Infecciosas/prevenção & controle , Dermatopatias Infecciosas/terapia , Reino Unido , Derivação Urinária/enfermagemRESUMO
: 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.
Assuntos
Colostomia/enfermagem , Colostomia/psicologia , Cuidados de Enfermagem/normas , Guias de Prática Clínica como Assunto , Estomas Cirúrgicos , Adaptação Psicológica , Adulto , Feminino , História da Enfermagem , História do Século XX , História do Século XXI , Humanos , Estresse Psicológico , Estados UnidosRESUMO
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
Assuntos
Humanos , Feminino , Adulto , Reto/lesões , Canal Anal/lesões , Colostomia/enfermagem , Colostomia/psicologia , Índices de Gravidade do TraumaRESUMO
Se presenta un caso de un paciente con Gangrena de Fournier. Como consecuencia de la dificultad de aislar la cura de las heces y la imposibilidad de poner una sonda rectal para canalizar su salida, se decide hacer colostomía. No terminan ahí las complicaciones: presenta una rotura del estoma con salida de material fecal al abdomen, que precisa de nueva cirugía para repararlo. Infección de herida quirúrgica precisando drenado y curas; dehiscencia del estoma. Sin cuidador principal es primordial la educación sanitaria para que, en el momento del alta, el propio paciente realice un buen manejo del cuidado del estoma. Gracias al plan de cuidados, y mediante una valoración según patrones funcionales de Marjory Gordon, se evitan complicaciones y, las que surgen, se detectan precozmente. De los patrones alterados se realiza el plan de cuidados con la taxonomía NANDA, NOC, NIC
No disponible
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Gangrena de Fournier/cirurgia , Gangrena de Fournier/enfermagem , Colostomia/enfermagem , Educação de Pacientes como Assunto , SeguimentosRESUMO
Las complicaciones derivadas de una ostomía de alto débito provocan graves alteraciones nutricionales, cutáneas e infecciosas. El manejo de estas ostomías por parte de la persona portadora es muy complejo y genera problemas de autoestima y afrontamiento. Presentamos el caso de una mujer con ostomía de alto débito secundaria a síndrome de intestino corto, con malnutrición severa, dermatitis periestomal y grandes dificultades para el manejo de su situación. Tras valoración según necesidades de Virginia Henderson realizamos un abordaje interdisciplinar, con la elaboración de un plan de cuidados que contemplaba todos los aspectos del ser humano, biológicos, psicológicos y sociales. Se utilizaron los dispositivos adecuados para el control del efluente y el tratamiento y posterior prevención de la dermatitis. Las dificultades para el afrontamiento se abordaron desde un punto de vista holístico, facilitando el aprendizaje, proporcionando asesoramiento y apoyo emocional. Se adiestró a la persona en el manejo de la ostomía, la dieta y la higiene en la manipulación de los dispositivos para la TIV. Todo ello contribuyó a una mejor adaptación a su nuevo estado de salud
No disponible
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Síndrome do Intestino Curto/enfermagem , Síndrome do Intestino Curto/cirurgia , Desnutrição Aguda Grave , Jejunostomia/enfermagem , Colostomia/enfermagem , Equipe de Assistência ao PacienteRESUMO
Las APP son aplicaciones digitales cada vez más empleadas en enfermería. Se presenta el caso de un paciente con diverticulitis con colostomía temporal, complicada con una dehiscencia. Se describen los cuidados estomales realizados con la implementación de tres nuevas aplicaciones: - La APP Osteomecum enlaza con una guía farmacológica específica de pacientes ostomizados. Valoró si el tratamiento era adecuado o debía ser revisado.- La aplicación Diario del paciente ostomizado desplegaba un autocuestionario que mejoró el seguimiento estomal, objetivándose una resolución completa de la dehiscencia tras el uso de correctos accesorios y dispositivos.- La APP NandaNicNoc, permitió realizar la consulta de los diagnósticos enfermeros, criterios de resultados (NOC) e intervenciones de enfermería (NIC), cosa que facilitó la estructuración de un plan de cuidados. La incorporación de nuevas tecnologías a la práctica enfermera habitual aporta innovación y mejora la atención en las consultas de estomaterapia
No disponible
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Diverticulite/cirurgia , Colostomia/enfermagem , Deiscência da Ferida Operatória/enfermagem , Deiscência da Ferida Operatória/tratamento farmacológico , Aplicativos Móveis , SeguimentosRESUMO
Las lesiones cutáneas periestomales son una complicación habitual en el cuidado de ostomías. En este trabajo exponemos el caso de una paciente gran quemada portadora de una colostomía con pérdida completa de la cobertura cutánea abdominal y el manejo realizado hasta alcanzar el cierre completo de las heridas abdominales
No disponible
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Queimaduras/cirurgia , Desbridamento/métodos , Colostomia/enfermagem , Resultado do TratamentoRESUMO
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.
Assuntos
Colostomia/enfermagem , Enfermagem Domiciliar/normas , Guias de Prática Clínica como Assunto , Qualidade de Vida , Adaptação Fisiológica , Adaptação Psicológica , Colostomia/psicologia , Feminino , Enfermagem Domiciliar/métodos , Humanos , Masculino , Relações Enfermeiro-Paciente , Educação de Pacientes como Assunto/métodos , Medição de Risco , Autocuidado , Higiene da Pele/métodos , Resultado do TratamentoRESUMO
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.