The impact of specialty practice nursing care on health-related quality of life in persons with ostomies.

ABSTRACT

PURPOSE: Ostomy patients suffer significant physiological challenges that can affect psychological variables and health-related quality of life (HRQOL). The purpose of this study was to compare HRQOL in a group of patients cared for in hospitals that employed nurses specializing in ostomy care versus patients who were cared for at hospitals that did not employ nurses specializing in ostomy care. DESIGN: Multicenter, quasi-experimental, prospective, longitudinal study. SUBJECTS AND SETTING: This is a national study set in Spain. We collected data from 402 ostomy patients in health centers among 16 Spanish regions from March 2012 to June 2013. The average age of the patients was 61.3 ± 13.71 years (mean ± SD). METHODS: Questionnaires were administered by the investigators prior to and 3 months after the ostomy surgery. Two groups of patients were compared patients in group 1 were treated by nurses specializing in ostomies; patients in group 2 were not treated by an ostomy nurse specialist. Two validated scales were used to determine HRQOL EQ-5 D (Spanish version) and the Montreux questionnaire. RESULTS: Patients in group 1 adapted better to their ostomies than group 2. They exhibited less concern with appearance; increased comfort with cleaning, changing, and throwing away ostomy bags; and decreased pain and pain frequency. They reported less fearfulness; improvements in sleep, weight concerns, and strength; and better overall health, leading to a greater percentage of patients able to lead a normal life (P < .05). Sexual activity was the only variable that worsened in both groups, but it was more satisfactory at postoperation stage in group 1 (P = .015). CONCLUSIONS: Patients who received specialized ostomy care experienced significant improvements in HRQOL compared to patients who were not cared for by specialist nurses. Our findings strongly suggest that patients undergoing ostomy surgery should be provided access to a nurse specialist in ostomy care since our results highlight the potential benefit promoting the HRQOL of patients.