Correlation between self-efficacy and self-esteem in patients with an intestinal stoma.

BACKGROUND: Patients with an intestinal stoma experience psychological difficulties, including disturbances in self-efficacy and self-esteem. There is evidence that they are interdependent. AIM: This study aimed to determine the correlation between self-efficacy and self-esteem in patients with an intestinal stoma. METHODS: A descriptive-correlational study was conducted with 155 patients with an intestinal stoma. Participants were selected using convenience sampling. Data were collected using demographic questions, the stoma self-efficacy scale and the Rosenberg self-esteem scale, and analysed using descriptive and analytical statistics. FINDINGS: Seventy-nine men and 76 women took part; the 50-70 years age group had the highest proportion of participants. Regarding diagnosis, 52.26% had cancer and 45.81% had inflammatory bowel disease or related conditions. Pearson's correlation coefficient indicated a positive, significant correlation between total self-efficacy and its dimensions with self-esteem (P<0.001; r=0.54). CONCLUSION: Self-efficacy is positively correlated with self-esteem in patients with an intestinal stoma. It is recommended that educational interventions are planned and implemented to boost self-esteem and self-efficacy in these patients.

Aplicabilidade da teoria de Orem no autocuidado de pessoa com estomia intestinal: estudo reflexivo / Aplicabilidad de la teoría de Orem en el autocuidado de personas con ostomía intestinal: un estudio reflexivo / Applicability of the Orem theory in self-care of the person with intestinal stomies: a reflexive study

A confecção de uma estomia intestinal leva a modificações físicas que podem afetar todas dimensões da vida do ser humano. Acredita-se que por meio da Teoria de Enfermagem do Déficit do Autocuidado é possível promover o cuidado de enfermagem à pessoa com estomia intestinal. Dessa forma, o objetivo deste estudo foi refletir sobre a aplicabilidade da Teoria do Déficit do Autocuidado de Dorothea Orem no cuidado de enfermagem à pessoa com estomia intestinal. Trata-se de um estudo teórico-reflexivo e para tanto, realizou-se uma revisão narrativa com busca do material nas bases de dados LILACS, Pubmed e Google Acadêmico e síntese qualitativa dos trabalhos analisados. Diante das mudanças ocasionadas pela presença da estomia, a pessoa necessita realizar cuidados importantes para seu autocuidado. O planejamento da assistência de enfermagem fundamentado na Teoria do Déficit d Autocuidado contribui para a o retorno às atividades de vida diária, a reinserção social, ao cuidado com a estomia e equipamento coletor e prevenir complicações. Assim, a aplicabilidade desta teoria demonstra o seu potencial para subsidiar o planejamento e a implementação da assistência à pessoa com estomia de modo a promover a sua autonomia e independência para realizar o seu autocuidado, além de subsidiar a Prática Avançada de Enfermagem no cenário nacional

La realización de una ostomía conlleva a modificaciones físicas que pueden afectar todas las áreas de la vida del ser humano. Se piensa que por medio de la Teoría de Enfermería del Déficit del Autocuidado, es posible promover el cuidado de enfermería a la persona con ostomía intestinal. De esta forma, el objetivo de este estudio fue reflexionar sobre la aplicabilidad de la teoría del autocuidado de Dorothea Orem en el cuidado de enfermería a la persona con ostomía intestinal. Se trata de un estudio teórico-reflexivo, por tanto, se realizó una revisión narrativa con búsqueda del material en las bases de datos LILACS, Pubmed e Google Académico y una síntesis cualitativa de los trabajos analizados. Durante los cambios ocasionados por la presencia de la ostomía, la persona necesita realizar cuidados importantes para su autocuidado. El planeamiento de la asistencia de enfermería fundamentado en la Teoría del Déficit del Autocuidado, contribuye para el retorno de las actividades de la vida diaria, cuidado de la ostomía y del equipo recolector, prevenir complicaciones, además, del reintegro a la sociedad. En este sentido, la aplicabilidad de la teoría del Autocuidado de Dorothea Orem, demuestra su potencial para subsidiar el planeamiento y la implementación de la asistencia a la persona con ostomía, de tal forma que promueve la autonomía e independencia para realizar su autocuidado, además, de subsidiar la Práctica Avanzada de Enfermería en el escenario nacional

The making of an intestinal ostomy leads to physical changes that can affect all dimensions of human life. It is believed that through the Nursing Theory of Self-Care Deficit it is possible to promote nursing care to people with intestinal ostomy. Thus, the aim of this study was to reflect on the applicability of Dorothea Orem's Self-Care Deficit Theory in nursing care for people with intestinal ostomy. It is a theoreticalreflective study and for that, a narrative review was carried out with search for the material in the LILACS, Pubmed and Google Scholar databases and a qualitative synthesis of the analyzed works. In view of the changes caused by the presence of the ostomy, the person needs to perform important care for their self-care. The planning of nursing care based on the Theory of Self-Care Deficit contributes to the return to activities of daily living, social reintegration, care with the ostomy and collection equipment and preventing complications. Thus, the applicability of this theory demonstrates its potential to support the planning and implementation of assistance to people with ostomy in order to promote their autonomy and independence to perform their self-care, in addition to subsidizing Advanced Nursing Practice in the national scenario

Complicações de estomia intestinal e pele periestoma: evidências para o cuidado de enfermagem / Complications of ostomy bowel and peristomal skin: evidence for nursing care / Complicaciones de la ostomía intestinal y de la piel peristoma: evidencia para el cuidado de enfermeira

Objetivo: identificar e analisar as evidências disponíveis na literatura sobre as complicações de estomia intestinal e pele periestoma. Método: revisão integrativa, em bases virtuais de dados, com inclusão de estudos do tipo ensaio clínico randomizado, publicados nos idiomas inglês, espanhol e português, no período de maio 2013 a maio de 2019. Resultados: foram selecionados 19 estudos e agrupados em três categorias: técnicas cirúrgicas apontando técnicas inovadoras acerca do tipo de suturas, ressecção e exteriorização de alça intestinal, além de reforços para prevenção de hérnias; barreiras de pele e equipamentos coletores, abordando principalmente as barreiras de pele para prevenção e tratamento da dermatite; cuidados de enfermagem mostrando cuidados e programas de acompanhamento, como visitas domiciliares, consultas e programas educativos. Conclusões: As estratégias descritas nos estudos revisados são importantes na medida em que poderão enriquecer o conhecimento do enfermeiro e dessa forma reduzir complicações de estomia e pele periestoma e melhorar a qualidade de vida dessas pessoas.

Objective: to identify and analyze the evidence available in the literature on the complications of intestinal ostomy and peristomal skin. Method: integrative review in virtual databases, including randomized clinical trialstudies published in English, Spanish and Portuguese, from May 2013 to May 2019. Results: 19 studies were selected and grouped into three categories: surgical techniques pointing innovative techniques about the type of sutures, resection and externalization of the intestinal loop, in addition to reinforcements to prevent hernias; skin barriers and collecting equipment, mainly addressing skin barriers for the prevention and treatment of dermatitis; nursing care showing care and follow-up programs such as home visits, consultations, and educational programs. Conclusion: the strategies described in the reviewed studies are important as they may enrich the knowledge of nurses and thus reduce complications of ostomy and peristome skin and improve the quality of life of these people.

Objetivo: identificar y analizar la evidencia disponible en la literatura sobre las complicaciones de la ostomía intestinal y la piel peristomal. Método: revisión integradora en bases de datos virtuales, incluidos estudios de ensayos clínicos aleatorizados publicados en inglés, español y portugués, de mayo de 2013 a mayo de 2019. Resultados: se seleccionaron 19 estudios y se agruparon en tres categorías: técnicas quirúrgicas que apuntan técnicas innovadoras sobre el tipo de suturas, resección y externalización del asa intestinal, además de refuerzos para prevenir hernias; barreras cutáneas y equipos de recolección, principalmente para abordar las barreras cutáneas para la prevención y el tratamiento de la dermatitis; atención de enfermería que muestra programas de atención y seguimiento, como visitas domiciliarias, consultas y programas educativos. Conclusiones: Las estrategias descritas en los estudios revisados on importantes ya que pueden enriquecer el conocimiento de las enfermeras y, por lo tanto, reducir las complicaciones de la ostomía y la piel peristómica y mejorar la calidad de vida de estas personas.

Effect of stoma model based education on knowledge and skill levels of student nurses: a quasi-experimental study from Turkey.

OBJECTIVE: To determine the effect of education with a stoma model on knowledge and skill levels of student nurses. METHODS: The quasi-experimental study was conducted at a professional education and skills laboratory of the Nursing Department within a health sciences faculty in Turkey between March 2015 and November 2016. The sample comprised an experimental group that had students who took a surgical diseases nursing course during the spring, and a control group that had students who took the same course during the autumn. A student information form, a knowledge level evaluation form, and a skill level evaluation form were used data collection. SPSS 20 was used for data analysis. . RESULTS: Of the 133 students, 69(52%) were in the experimental group and 64(48%) in the control group. It was determined that the skill level of the experimental group was higher than the control group (p<0.05) and there was a positive correlation between knowledge and skill levels of student nurses in both groups (p<0.05). CONCLUSIONS: Education with a stoma model increased student nurses' skills and promotes their knowledge.

Nursing care for infants after enterostomy: Experience with 483 cases over a 5-year period.

AIM: To explore and improve nursing care for infants after enterostomy. METHODS: A total of 483 infants who underwent enterostomy from January 2014 to January 2019 were enrolled in this study. RESULTS: During hospitalization and follow-up, there were 30 infants with peripheral skin complications, including 15 cases of allergic dermatitis, 13 cases of faecal dermatitis and two cases of avulsion injury. CONCLUSION: Without proper and effective nursing care, the peripheral skin complications of enterostomy-related can easily develop. Therefore, careful postoperative care and effective family follow-up and guidance are essential after discharge, and using WeChat to follow-up can provide timely and effective follow-up and guidance to patients. IMPLICATIONS FOR NURSING MANAGEMENT: This study summarizes the experience of nursing care for infants over a 5-year period. Nurses must provide sound care for infants after enterostomy, timely and effectively address complications, guide nursing care performed by family members and strengthen follow-up through the WeChat online support group to reduce the occurrence of complications.

Relationship between psychosocial adaptation and health-related quality of life of patients with stoma: A descriptive, cross-sectional study.

OBJECTIVE: To investigate the relationship between psychosocial adaptation and quality of life of patients with ostomies and to provide reference data for clinical care practice. BACKGROUND: Surgical enterostomy impacts the life of patient. Most patients are transferred to home or community hospital after discharge and require long-term nursing care. These patients typically face problems with physical, psychological and social adaptation. DESIGN: Descriptive, cross-sectional study. METHODS: Between March 2017-June 2017, the following questionnaires were electronically administered to 1,053 patients with enterostomy residing in 22 provinces, 4 autonomous regions for ethnic minorities and 4 direct-controlled municipalities in China: Social Support Revalued Scale, validated Chinese version of Ostomy Adjustment Inventory and Stoma-Quality of life-Chinese. Univariate analysis, correlation analysis and hierarchical regression analysis were used to assess the relationship between adaptation level and quality of life of patients with enterostomy, in order to provide reference data for clinical care practice and further improve the quality of life of these patients. The STROBE checklist was used in reporting this study. RESULTS: The mean score for psychosocial adaptation was 43.13 ± 13.09, which corresponded to a medium level; the mean score for quality of life was 56.54 ± 16.87. The level of psychosocial adaptation and each dimension showed a positive correlation with the quality of life of patient and each dimension (r = 0.349-0.890, p < 0.01). Univariate analysis revealed a signification association of quality of life with education level, medical payment method, area of residence, peristomal complications, regular defecation, occurrence of leaking, ability for self-care of stoma, communication between patient and medical staff, and knowledge and skills pertaining to care of stoma. Results of hierarchical regression analysis indicated that psychosocial adaptation level was a predictor of quality of life (R2  = 0.708; p < 0.001). CONCLUSIONS: In this study, the quality of life of patients with enterostomy was generally of a medium level. The level of psychosocial adaptation of the patient was closely linked to quality of life. During clinical care, concerted efforts should be made to encourage the patients to deal with the stoma positively and to help the patient and their families accept the stoma and change of image to reduce the adaption course and improve the quality of life. RELEVANCE TO CLINICAL PRACTICE: Patients tend to take a long time to adapt to the stoma after ostomy formation. Facilitating the adjustment of patients with enterostomy may improve their quality of life. Medical care providers should focus more attention on patients who have lower ostomy adjustment scores.

A Descriptive, Cross-sectional Study Among Chinese Patients to Identify Factors that Affect Psychosocial Adjustment to an Enterostomy.

Physiological, psychological, and social problems may affect adaptation to living with a stoma. A descriptive, cross-sectional study was conducted between March 2017 and June 2017 among patients culled from a manufacturer's database to identify factors that influence psychosocial adjustment in Chinese patients with an enterostoma. Patients with a history of ostomy surgery ≥1 month prior and who were ≥18 years of age, completed a primary school education, and able to communicate in Chinese were eligible to participate unless they had a history of psychosis, cognitive impairment, or participation in other research programs. After providing informed consent, participants completed a questionnaire that addressed demographic (age, gender, employment, educational level, marital status, medical payment method, living status, and area of residence) and stoma-related (date of surgery, preoperative stoma siting, ostomy appliance type, peristomal complications, regular defecation, stoma self-care ability, stoma-related communication with medical staff, level of understanding regarding stoma knowledge and care skills, appliance change knowledge/experience, and leakage history) factors. Social support was assessed using the 10-item Social Support Revalued Scale (SSRS), and 3 dimensions of adjustment (acceptance, continuous worry, and positive life attitude) were assessed using the 20-item Chinese version of the Ostomy Adjustment Inventory (OAI). Questionnaires were administered via an online survey platform. Data were analyzed descriptively, and single-factor analysis and stepwise multiple linear regression were applied to identify the factors that influenced the adjustment level. Incomplete (missing >2 questions), incorrect, or hastily completed (within 600 seconds) records were excluded from analysis. Of the 1109 persons who returned the questionnaire, 1010 (91.1%) completed the entire survey (564 men [55.8%] and 446 women [44.2%], mean age 56.62 ± 15.62 years); 823 (81.5%) had a colostomy and 187 (18.5%) had an ileostomy. The OAI dimension continuous worry was negatively and significantly associated with all 3 dimensions of the SSRS, including subjective support (r = 0.259), objective support (r = 0.259), and utilization of support (r = 0.289), while the dimension acceptance was positively associated with both subjective support (r = 0.082) and objective support (r = 0.074) (all P values <.05). Using multiple linear regression, residence area, peristomal complication, regular defecation, leaking, self-care ability, communication with medical staff regarding ostomy, understanding knowledge or skill needed for stoma care, utilization of social support, and total score of social support were found to be significantly associated with ostomy adjustment level (all P values <.05). Patients living in an urban area, with no history of peristomal complications, who had regular defecation, had not experienced leaking, had better self-care ability, frequently communicated with medical staff, had a high level understanding about knowledge or skill of stoma, and had higher social support scores had higher adjustment scores. Knowledge of the factors that enhance or hinder adaptation of the patient to the ostomy is an important tool in the clinician's care armamentarium.

Stoma-associated problems: the important role of the specialist nurse.

Following on from a study carried out with his colleagues in 2010, Anthony McGrath, Head of Department Adult Nursing and Midwifery, London South Bank University, considers the ongoing problems faced by patients with stomas and the importance of support from stoma care nurses.

Construction and validation of a virtual learning object on intestinal elimination stoma.

OBJECTIVE: To construct and validate a virtual learning object (VLO) on intestinal elimination stoma. METHODS: Applied, descriptive and quantitative study. In 2014, eight stoma therapists and eight experts in computer science took part of the research. The VLO included four steps: i) planning, ii) construction of VLO and changes of content; iii) development of dynamic, and iv) conclusion and analysis. The VLO was inserted into the Moodle virtual learning environment. The ergonomic and pedagogical validation of the VLO was performed. RESULTS: The experts appreciated the VLO satisfactorily, and scored it between good and full agreement. CONCLUSION: The VLO on intestinal elimination stoma is a tool that can be implemented at undergraduate programs in nursing and continuing education programs for nurses in clinical practice, contributing significantly to improve the theoretical skills necessary for the care of ostomized people safely, with quality and enabling self-care.

Staff nurses' knowledge and perceived responsibilities for delivering care to patients with intestinal ostomies: a cross-sectional study.

PURPOSE: The purpose of this study was to explore the opinions of nurses regarding their knowledge of and perceived responsibility for providing ostomy care. SUBJECTS AND SETTING: The target population of this descriptive study was staff nurses working in an acute care hospital in Ankara, Turkey. METHODS: Data were collected by a questionnaire that included 2 sections. The first section queried descriptive information about the nurses, the perceived responsibility for providing ostomy care for patients. The second section included 54 items that focused on knowledge about stoma care. RESULTS: Evaluating the answers of the nurses to all statements in general (54 propositions), the median value of the "I do not know/false" answers (27.50) was observed to be close to the median value of the "true" answers (26.5). These results indicated that the staff nurses' knowledge of ostomy care was not at the desired level. Responses from section 2 indicated that nonspecialty practice staff did not consider stoma care as their responsibility. Factors that influenced knowledge of ostomy care were number of years working as a nurse, level of education, level of reviewing professional literature on ostomy care, and participation in scientific meetings on the subject. CONCLUSIONS: Study findings reveal that knowledge level of nonspecialty nurses about intestinal stoma care is inadequate, and most staff nurses did not consider themselves responsible for stoma care.

Living with intestinal stoma: the construction of autonomy for care.

OBJECTIVE: to investigate the care undertaken in the health services for people with intestinal stoma, from the perspective of articulating the actions proposed in the Amplified and Shared Clinic, with a view to promoting autonomy. METHOD: qualitative study. PARTICIPANTS: 10 people who received a stoma, and their family members. Data was collected between 10th January and 30th June 2011, through two semi-structured interviews. Analysis was through the stages: anxiety, synthesis, theorization and recontextualization. RESULTS: presented in the categories: (1) the need to carry out stoma care; (2) receiving health support and care after discharge from hospital; (3) returning to daily activities and social reinsertion. CONCLUSION: the study identified common factors which influence the process of development of autonomy and the relationship which health professionals have with this achievement.

Complications of stomas: their aetiology and management.

The formation of a stoma is an essential part of many colorectal operations. Despite the frequency with which these surgeries are performed and the number of specialists involved in stoma care, complications are still common. This article investigates the most common complications, explains the reasons for their occurrence and suggests potential management options. Common stoma complications were identified by the colorectal/ stoma clinical nurse specialist (CSCNS) and a literature search was performed using a variety of online databases, including Medline and CINAHL using the keywords stoma, complications, prolapse, ischaemia, retraction, hernia and stenosis. Articles used were selected on the basis of relevance to the topic. The commonest complications of stomas included skin irritation, prolapse, retraction, ischaemia, hernia and stenosis.

Canadian Association for Enterostomal Therapy evidence-based recommendations for conservative sharp wound debridement: an executive summary.

The Canadian Association for Enterostomal Therapy Conservative sharp wound debridement evidence-based recommendations are a result of the decision and commitment to advance clinical nursing practice to improve the provision of care to patients via development of an open source guide. The recommendations were developed by a volunteer group of ET nurses who work in clinical practice, policy development, consultation, and education in wound care. The document was developed over the course of 2 years (2009-2011); it is a distillation of existing literature, guidelines, and expert opinion. The development and dissemination of the recommendations were sponsored by the Canadian Association for Enterostomal Therapy. These recommendations should be considered in the context of the organization or care setting as well as available resources and supports. Resources and supports take the form of access to emergency care, physicians and allied health care professionals, education, administrative support, funding, supplies, equipment, and policy. The recommendations should also be applied with consideration of the evolving evidence that will further define practices in Conservative Sharp Wound Debridement. Refer to the supplemental digital content associated with this article at (supplemental digital content 1, http://links.lww.com/JWOCN/A16) for the complete document.