Post-discharge health education for patients with enterostomy: A nationwide interventional study.

Background: After discharge, patients with enterostomy face problems with poor self-nursing ability and low levels of psychological and social adjustment, which, without timely intervention, seriously affect their quality of life. We delivered health education to discharged enterostomy patients based on a WeChat health management program and evaluated its impact on their ostomy self-care ability and psychosocial adaptation level. Methods: Based on the WeChat health management program, we conducted continuous health education in the first, third, seventh, 11th, and 23rd weeks after discharge of enterostomy patients/before temporary enterostomy restoration to observe its impact on their self-care ability and psychosocial adaptation levels, as evaluated by an ostomy self-care ability questionnaire and ostomy adjustment inventory-20 checklist. Results: We included 4201 patients with enterostomy. Our findings showed that the self-care score of patients with enterostomy at discharge (baseline) (mean = 15.23, standard deviation (SD) = 5.22) was lower than that after intervention (mean = 17.71, SD = 1.28) (P < 0.05). The enterostomy psychosocial adaptation score of the enterostomy patients at discharge (baseline) (mean = 44.59, SD = 9.82) was lower than that after intervention (mean = 50.25, SD = 12.97) (P < 0.05). Conclusions: Health education for enterostomy patients after discharge can improve their self-care ability and psychological adaptation. Future studies could further explore the views and attitudes of this population toward health education based on the WeChat health management program.

Living with and without an intestinal stoma: Factors that promote psychological well-being and self-care: A cross-sectional study.

AIMS: This study compared those living with and without an intestinal stoma in relation to physical and psychological health, stress and coping, quality of life and resilience. Also, identifying factors that could be used to promote better self-care in stoma patients in the future. DESIGN: A cross-sectional and comparative study design was employed. METHODS: Participants were recruited via email and social media (Facebook and Twitter) between August 2018 and March 2019, to complete an online survey. The data were analysed using analysis of variance to examine group difference and a series of hierarchical linear regression analyses determining predictors of psychological well-being. RESULTS: Of 278 participants aged 18-68 years who completed the survey, 129 (46%) had a stoma and reported significantly poorer physical health. Approximately one-fifth experienced problems with stoma management. Psychological well-being was mediated by the duration of living with a stoma (under 3 years) and frequency of leaks (weekly and monthly).

The impact of stoma management education on the self-care abilities of individuals with an intestinal stoma.

An intestinal stoma is a surgically formed exteriorisation of the large or small bowel on to the anterior abdomen wall, to enable faeces to be excreted from the body. Patients living with a stoma may encounter physical, psychological, and social barriers and challenges. Stoma self-management education is essential to improving self-care competence, and patients who perceive the benefits of self-management education show a better adjustment to living with a stoma. This literature review explored the effectiveness of patient education interventions in improving the self-care knowledge and skills of patients living with an ostomy. The findings from the nine studies reviewed showed that self-management education approaches are effective in improving patients' self-care. The application of different approaches to ostomy self-management education, such as a transtheoretical model, chronic care model, telehealth and multimedia-based programmes - helped improve patients' self-care ability. The review also found that patients needed at least 3 months to develop the skills and maintain their ability to self-care. In addition, two education sessions provided to patients in hospital pre-discharge appeared sufficient for improving and maintaining self-care abilities. Where patients received education in hospital post-surgery, 2 or 3 sessions over 7 days were found to be sufficient to provide them with stoma care skills. Education sessions based on the transtheoretical model and chronic care model or telehealth helped maintain and reinforce self-care behaviours following discharge.

Relationship among self-concept clarity, social support, and psychological resilience in Chinese patients with an enterostomy: A cross-sectional study and structural equation model analysis.

PURPOSE: This study was to explore the relationship between self-concept clarity, social support, and psychological resilience in Chinese enterostomy patients. METHODS: A cross-sectional, descriptive study was conducted from October 2019 to April 2020 among enterostomy patients visiting the stoma clinic and inpatients with an enterostomy in general surgery of three tertiary grade A hospitals in Guangzhou, China. Patients (n=201) were required to complete paper questionnaires, including sociodemographic information, the 10-Item Resilience Scale Specific to Cancer, Self-concept Clarity Scale, and Social Support Rating Scale. Multiple linear regression analyses and structural equation modeling were conducted to explore the effect of self-concept clarity and social support on psychological resilience. RESULTS: Psychological resilience was at a median level among enterostomy patients, with a mean score of 38.21 (SD, 7.24). Education level (ß = 1.032, P = .004), own acceptance of stoma (ß = 2.445, P < .001), social support (ß = 206, P = .001) and self-concept clarity (ß = 0.285, P < .001) were factors related to psychological resilience, explaining 33.1% of the variance of psychological resilience. It was also shown that self-concept clarity exerted its direct positive effect on social support (ß = 0.098, SE = 0.025, BC 95%CI = 0.047/0.143), and it also had an indirect positive effect on psychological resilience through mediating social support (ß = 0.193, SE = 0.033, BC 95%CI = 0.121/0.245). CONCLUSIONS: This study suggests that self-concept clarity has an indirect positive effect on psychological resilience by influencing social support in enterostomy patients. Medical staff should strive to improve the self-concept clarity as a new means to enhance patients' psychological resilience, especially focusing on patients' social support, education level and own acceptance of enterostomy.

The Progress of Social Isolation in Patients with Enterostomy during Discharge Transition Period.

In terms of social and psychological health of enterostomy patients during hospitalization and discharge transition period, the degree of social isolation in patients during discharge transition period is higher than that during hospitalization period, which is usually manifested by poor self-perception of body image changes. Self-esteem (shame) frustration, severe negative emotions, low psychosocial adjustment, and other factors are closely related to postoperative complications, coping self-efficacy, social support level, family living conditions, and other influencing factors. This is an important reason why patients are difficult to adapt to ostomy life and low quality of life. At present, it is believed that the social isolation related evaluation scale can be used to understand the status quo of patients with social isolation and provide nursing guidance, so as to better cope with the adverse medical outcomes caused by social isolation.

The correlation between intimate relationship, self-disclosure, and adaptability among colorectal cancer enterostomy patients.

ABSTRACT: The postoperative physiological changes and psychological pressure of cancer patients affect the patient's adaptability to the disease, and thus affect the spousal intimate relationship. This study aimed to evaluate the correlation between spousal intimate relationship, self-disclosure, and adaptability among colorectal cancer (CCI) patients with enteric stoma.This cross-sectional study selected patients with CCI in Henan Province from February 2018 to October 2020. The Marital Adjustment Test (MAT), the Distress Disclosure Index scale, and the Ostomy adjustment inventory-20 scale were used to collect relevant data of the participants. A Pearson correlation analysis was used to test the correlation between variables, and multiple stepwise regression analysis was used to test the influence of general information on the intimate relationship, self-disclosure, and adaptability.Among the respondents, 42.6% had a spousal intimate relationship problem, 58.4% had a low or moderate level of self-disclosure, and 90.8% were at a low or moderate level of adaptation. Education background, self-care ability, and postoperative time were associated with a couple's intimate relationship. Average monthly household income, gender, and place of residence were associated with self-disclosure. Self-care ability, average monthly household income, postoperative time, and educational background were associated with adaptation.Healthcare workers should provide more health education training to guide CCI enterostomy patients to express their thoughts and feelings with each other increase self-disclosure, so as to enhance their intimate relationship then improve their adoption to ostomy, finally elevate their quality of life.

[Digestive stomas: which professional impact?] / Les stomies digestives: quel impact professionnel?

INTRODUCTION: digestive stomas result from a certain number of surgical interventions. They may be temporary or definitive. The patient with stoma has potentially damaging physical and psychological problems. Therefore patient´s adaptation to the changes and acceptance of this temporary or permanent situation is essential. This study aims to assess the impact of intestinal stomas on patients´ quality of life and professional life. METHODS: we conducted a retrospective study from January 2010 to December 2014. During the study period, 115 patients had intestinal stomas. Among these patients, sixty were of working age, had a fixed employment and had resumed their work; they made up the study population. Data were collected using a specific questionnaire: the Short Form-36 (SF-36) health questionnaire conducted in the post-operative period. RESULTS: the average score for the overall quality of life for patients with stoma was 41. Forty patients had poor quality of life with a score SF-36 less than 50. Our study showed that patients with stoma experienced difficulties at work. Forty-eight patients reported discomfort directly linked to stoma during their professional activities. The causes mentioned were physical in 6 cases and psychological in 3 cases. Six patients were moved into more adapted working positions. CONCLUSION: the management of patients with digestive stomas should aim to an adequate social and professional reintegration. This can only be done by involving the occupational physician, the psychologist, the stoma therapist and the associations.

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.

The association between personality trait and the development of postoperative complications in enterostomized patients. Systematic review of literature.

AIM: To investigate the presence of association between the personality trait and the onset of postoperative complications in patients undergoing enterostomy packaging. MATERIALS AND METHODS: Systematic review of the literature. RESULTS: Type D personality traits and those with a low tendency to optimism and temperament (ex. anxiety-depressive syndrome) would seem to be associated with an increased risk of developing postoperative psychiatric morbidity and reduced levels of health-related quality of life (HRQoL) in enterostomized patients for colorectal cancer (CRC). Also, type-D personality, has been associated with greater risk of multiple comorbidities including an increased risk of heart failure unrelated to other sociodemographic causes 32-34-35. Personality with little tendency to optimism may represent a predictive factor on the development of psychological suffering one year after the diagnosis of CRC 3. Patients with personality traits associated with reduced levels of life satisfaction and / or reduced coping capacity require longer hospitalization time 26. DISCUSSION: Several studies highlight the presence of association between personality traits oriented to performance, persistence and extroversion and outcomes in various areas of surgery 14,2,-27,30. However, in almost all cases, the outcomes measured do not correspond to the early post-operative complications defined in the inclusion criteria but to mediumlong term psychological and rehabilitative outcomes. CONCLUSIONS: From the review study, no sources were found concerning the association between the personality trait and the onset of early postoperative complications in enterostomised patients, highlighting, furthermore, a lack of data on the subject involving the entire field of abdominal surgery. KEY WORDS: Personality trait, Enterostomy, Post-operative complications.

Cancer Survivorship at the Intersections of Care and Personhood.

Surviving colorectal cancer following ostomy surgery with an intestinal stoma presents numerous challenges to the cultural category of full adult personhood. The foremost is managing unpredictable bowel activity. The technical management of the ostomy facilitated by biomedical specialists, is essential for personhood realignment. This article focuses on how some female long-term cancer survivors manage and adapt to this new fecal habitus by mobilizing various assemblages of care - receiving care, continuing to provide particular gendered forms of care, and returning to caregiving roles. These interdependent practices of care realign personhood, or at the very least, minimize the assaults that having an ostomy presents to the cultural category of full adult personhood.

Sexual Experience and Stigma Among Chinese Patients With an Enterostomy: A Cross-sectional, Descriptive Study.

Colorectal cancer is common in China, and studies on the sexuality of patients with an ostomy are limited, particularly information about the relationship between sexual experience and stigma. PURPOSE: A study was conducted to assess the association between sexual experience and stigma in Chinese patients with an enterostomy. METHOD: A cross-sectional, descriptive study was conducted between May 2017 and August 2018 among patients with an ostomy at 3 general hospitals. Patients 18 to 70 years old with a history of ostomy surgery more than 1 month prior, who had a regular sexual partner, and were willing to provide informed consent were eligible to participate; persons with mental illness, preoperative sexual dysfunction (SD), or tumor recurrence or metastasis were excluded. Study participants completed a paper-and-pencil questionnaire including demographic (gender, educational level, occupation, geographic place of residence, and monthly family income) and ostomy-related (type of ostomy, time since ostomy surgery, insurance coverage, ostomy-related complications, and sexual guidance) information. Sexual experience was assessed using the 5-item Chinese version of the Arizona Sexual Experience Scale (C-ASEX) (range 5 to 30; scores >19 reflect sexual dysfunction). Stigma (internalization of perceived shameful experience) was assessed using the 24-item, Likert-type Chinese version of the Social Impact Scale (C-SIS) (score range 24 to 96; lower scores indicate less stigma). Quantitative data from the questionnaires were deindentified and entered into statistical software for analysis by 2 researchers. Multivariate regression analysis was used to assess the associations among sexual experience, stigma, and other factors. RESULTS: Of the 240 questionnaires distributed, 187 (77.9%) were completed and included in the final analysis. The average C-ASEX score was 22.77 ± 6.78, and 118 participants (63.1%) had SD. The average C-SIS score was 59.36 ± 11.20, indicating a moderate level of stigma. A significant association was found between sexual experience and stigma (B = 0.101, P = .006). Sexual experience perceptions were determined by sexual guidance needs (B = 3.179, P <.001), geographic area of residence (B = -2.087, P = .014), receipt of sexual guidance (B = -2.989, P = .001), and insurance coverage (B = 1.822, P = .015). CONCLUSION: Health care workers should strive to reduce the stigma of having a stoma and offer sexual guidance as a means to improve quality of sexual life. Particular attention should be paid to the sexual well-being of persons living in rural areas and those paying for medical expenses out of pocket.

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.

Living With an Intestinal Stoma: A Qualitative Systematic Review.

The main aim of this article is to explore the experiences and life situations of people living with intestinal stomas. Previous studies indicated the need to investigate the concerns of ostomy patients and how these concerns can affect their quality of life and their approaches to the comprehensive conceptualization of the bodily changes. A qualitative systematic review and metasynthesis design was carried out by using the main scientific databases. Original articles from 2002 to 2015 were selected based on their qualitative methodology. Methodological quality was evaluated using the Critical Appraisal Skills Program. The findings were synthesized using the metasynthesis procedure of Sandelowski. The final number of articles included was 95 and 1,982 participants. Regarding the metasummary, the data generated 191 thematic statements that were organized into eight categories. The findings support an explanatory model of the experience of people with ostomy based on three aspects: Acceptance, Adaptation, and Autonomy.

The mediating role of resilience in the relationship between personality and adjustment to disease in patients with a drainage enterostomy.

An understanding of what variables are involved in a better adjustment to chronic disease makes it possible to implement more suitable community healthcare interventions. It also allows the design of educational programmes aimed at increasing the independence of these patients, thereby enabling them to achieve a better health status. Both the personality and the resilience of the patient have been shown to play an important role in the process of adjusting to the new living conditions that result from having a chronic disease. Yet, to date, little research has been conducted in this area. This study uses structural equation modelling to explore the relationships among the personality factors, resilience and the variables of adjustment to disease (i.e. quality of life and level of self-care). The sample consists of 125 patients with a drainage enterostomy. Results show that the relationship model with the best fit is the one that considers resilience as a mediating variable in the relation between personality and disease adjustment variables. The implications of the findings and the limitations of the study are also discussed.

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.

Psychological aspects of patients with intestinal stoma: integrative review.

OBJECTIVE: to analyze evidences of psychological aspects of patients with intestinal stoma. METHOD: integrative review with search of primary studies in the PsycINFO, PubMed, CINAHL and WOS databases and in the SciELO periodicals portal. Inclusion criteria were: primary studies published in a ten-year period, in Portuguese, Spanish or English, available in full length and addressing the theme of the review. RESULTS: after analytical reading, 27 primary studies were selected and results pointed out the need to approach patients before surgery to prevent the complications, anxieties and fears generated by the stoma. The national and international scientific production on the experience of stomized patients in the perioperative moments is scarce. CONCLUSION: it is recomendable that health professionals invest in research on interventions aimed at the main psychological demands of stomized patients in the perioperative period, respecting their autonomy on the decisions to be made regarding their health/illness state and treatments.

Autoestima en mujeres con ostomías intestinales / Self-esteem in women with intestinal ostomies

Objetivo: Evaluar la autoestima de las mujeres con ostomías intestinales y su asociación con características socio-demográficas, clínicas y de autocuidado. Método: Estudio transversal, analítico con abordaje cuantitativo, realizado con 33 mujeres con la Escala de Autoestima de Rosenberg. Resultados: La autoestima media fue de 7,4 (+ - 4,7). Las mujeres con compañero, que poseían enseñanza secundaria completa, con profesión/ocupación, renta superior a un salario mínimo, practicantes de catolicismo, con colostomía definitiva hace más de 5 años de realización, que tenían la neoplasia maligna de colon como causa principal y que no presentaron enfermedades/comorbilidades asociadas, presentaron mayores niveles de autoestima. Conclusión: La autoestima de las mujeres ostomizadas puede mejorar en función de sus características socio-demográficas, clínicas y de autocuidado, por lo que estos factores han de ser considerados en la evaluación del paciente para el desarrollo de acciones multiprofesionales que influyan positivamente en su afrontamiento

Objective: To evaluate the self-esteem of women with an ostomy and its association with sociodemographic, clinical and self-care characteristics. Method: Transversal and analytical study with a quantitative approach, made with 33 women using the Rosenberg Self- Esteem Scale. Results: The self-esteem’s average was off 7.4 (+ - 4.7). Women with a partner, who had completed high school, presence of profession/occupation, income above 1 minimum wage, Catholicism practitioners, with permanent colostomy for more than five years of achievement, who had a malignant neoplasm of the colon as a cause and showed no disease/comorbidities showed self-esteem above average. The self-esteem of ostomized women can improve according to their sociodemographic characteristics, clinic and self-care, so these factors must be considered in the evaluation of the patient for the development of multiprofessional actions that influence their coping

Determinants of self-efficacy and quality of life in patients with temporary enterostomy: a cross-sectional survey.

AIMS AND OBJECTIVES: To identify determinants of self-efficacy and quality of life in patients with temporary enterostomy. BACKGROUND: Anterior resection with temporary enterostomy is the preferred treatment for patients with rectal cancer, which may impair patients' quality of life. So far, most studies have focused on quality of life in patients with permanent enterostomy, but few studies have looked at that in those with temporary enterostomy. Self-efficacy may determine quality of life in these patients, but few studies have identified determinants of self-efficacy and quality of life. DESIGN: Multicentre, cross-sectional survey and regression analysis to identify determinants of self-efficacy and quality of life. METHODS: A convenience sample of patients undergoing temporary enterostomy at five hospitals in Guangdong Province (China) were surveyed at least four weeks after stoma surgery using validated Chinese versions of internationally recognised questionnaires, including a Stoma Self-Efficacy Scale and the City of Hope Quality of Life-Ostomy Questionnaire. Backward multiple regression analysis was performed to identify whether quality of life was determined by self-efficacy and other clinico-demographic characteristics. RESULTS: Of the 180 questionnaires distributed, 149 (82·8%) were returned, and 135 (75%) were used in the final analysis. Mean global quality of life was 5·40 ± 1·58, and mean global self-efficacy was 79·59 ± 20·21. Significant determinants of self-efficacy and quality of life were identified (ß = 0·62, p < 0·01). Quality of life was determined by type of enterostomy (ß = 0·18, p = 0·01) and payment method (ß = 0·14, p = 0·03). CONCLUSIONS: Quality of life may be determined by self-efficacy, type of enterostomy and payment method, after temporary enterostomy. RELEVANCE TO CLINICAL PRACTICE: Promoting stoma-related self-efficacy in patients with temporary enterostomy may improve their quality of life. Healthcare providers should focus on quality of life in those either with temporary loop ileostomy or entirely self-funded for medicine.

Psychological aspects of patients with intestinal stoma: integrative review / Aspectos psicológicos de pacientes estomizados intestinais: revisão integrativa / Aspectos psicológicos de pacientes ostomizados intestinales: revisión integrativa

ABSTRACT Objective: to analyze evidences of psychological aspects of patients with intestinal stoma. Method: integrative review with search of primary studies in the PsycINFO, PubMed, CINAHL and WOS databases and in the SciELO periodicals portal. Inclusion criteria were: primary studies published in a ten-year period, in Portuguese, Spanish or English, available in full length and addressing the theme of the review. Results: after analytical reading, 27 primary studies were selected and results pointed out the need to approach patients before surgery to prevent the complications, anxieties and fears generated by the stoma. The national and international scientific production on the experience of stomized patients in the perioperative moments is scarce. Conclusion: it is recomendable that health professionals invest in research on interventions aimed at the main psychological demands of stomized patients in the perioperative period, respecting their autonomy on the decisions to be made regarding their health/illness state and treatments.

RESUMO Objetivo: analisar as evidências sobre os aspectos psicológicos de pacientes estomizados intestinais. Método: revisão integrativa com a busca de estudos primários nas bases de dados PsycINFO, PubMed, CINAHL e WOS e no portal de periódicos SciELO. Adotou-se como critérios de inclusão: estudos primários publicados no período de 10 anos, nos idiomas português, espanhol ou inglês, disponíveis na íntegra e que responderam à questão norteadora da revisão. Resultados: após leitura analítica, 27 estudos primários foram selecionados, cujos resultados apontaram a necessidade de abordar os pacientes antes da cirurgia para prevenir as complicações, angústias e medos suscitados pela estomia. A produção científica nacional e internacional sobre a vivência do paciente estomizado no perioperatório é escassa. Conclusão: sugere-se investimentos dos profissionais de saúde na condução de pesquisas de intervenções direcionadas para as principais demandas psicológicas do paciente estomizado no perioperatório, respeitando a sua autonomia sobre as decisões a serem tomadas em relação ao seu estado de saúde/doença e tratamentos.

RESUMEN Objetivo: analizar las evidencias sobre los aspectos psicológicos de pacientes ostomizados intestinales. Métodos: revisión integrativa, con la búsqueda de estudios primarios en las bases de datos, PsycINFO, PubMed, CINAHL y WOS y en el portal de periódicos SciELO. Fueron adoptados como criterios de inclusión: estudios primarios publicados en el período de diez años, en los idiomas portugués, español o inglés, disponibles en la íntegra y en los cuales se respondió a la pregunta guía de la revisión. Resultados: después de la lectura analítica, 27 estudios privados fueron seleccionados, cuyos resultados señalaron la necesidad de abordar los pacientes antes de las cirugías para prevenir complicaciones, angustias y miedos suscitados por la ostomía. La producción científica nacional e internacional sobre las vivencias del paciente ostomizado en el perioperatorio es escasa. Conclusión: se sugiere invertir en los profesionales de salud en la conducción de investigaciones de intervenciones dirigidas a las principales demandas psicológicas del paciente ostomizado en el perioperatorio, respetando su autonomía sobre las decisiones a ser tomadas en relación a su estado de salud/enfermedad y tratamiento.