Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Ostomy”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources
PubMed2006

Outbreak of cutaneous Rhizopus arrhizus infection associated with karaya ostomy bags.

BACKGROUND: We investigated an outbreak involving 2 patients hospitalized at hospital A with cutaneous Rhizopus arrhizus (oryzae) infections of surgically created stomas. METHODS: A cohort study involving all patients having ileostomy or colostomy surgery during the outbreak period (January-April 2005) was performed. Environmental samples, including samples obtained from nonsterile karaya (a plant-derived adhesive) ostomy bags and from select hospital areas, were collected. A point prevalence survey was conducted at 5 unrelated hospitals to assess stoma care practices and mold contamination of karaya ostomy bags outside of hospital A. Zygomycete isolates were identified by standard methods. RESULTS: Infections occurred 7 and 10 days after operations for the 2 patients; 1 patient died. In a 21-patient cohort, receiving the equivalent of > or =0.5 mg/kg per day of prednisone during the week prior to the index date was associated with infection (infection rate, 33% for patients receiving > or =0.5 mg/kg per day of prednisone vs. 0% for patients receiving <0.5 mg/kg per day of prednisone; P=.07). The time to first ostomy bag change was longer for patients with infection (median duration, 8.5 days; range, 7-10 days) than for the 19 patients without infection (median duration, 1.5 days; range, 1-17 days; P=.08). At unrelated hospitals, the median time to first ostomy bag change was 2 days (range, 1-6 days) for 18 patients after ostomy. R. arrhizus was recovered from 10 of 18 karaya ostomy bags from hospital A and from karaya ostomy bags donated from 3 of 5 other hospitals, but it was not recovered from the hospital A environment. CONCLUSIONS: The initial karaya ostomy bag was likely to be the source of Rhizopus infection, and prolonged exposure before the first ostomy bag change might have precipitated infection in these susceptible individuals. Karaya might contain opportunistic molds that can pose an infectious risk among susceptible persons.

Cohort Studies↗
PubMed1996

Comparing adjustment to an ostomy for three groups.

Three groups of persons with fecal ostomies (those with permanent ostomies as a result of disease (n = 13), those with temporary ostomies as a result of disease (n = 16), and those with temporary ostomies as a result of trauma (n = 18) were interviewed with various instruments to explore the psychosocial impact of an ostomy. The three groups did not differ significantly with respect to their scores on the Psychosocial Adjustment to Illness Scale, the Reintegration to Normal Living Index, or the Meaning in Life Scale. Those with a temporary ostomy as result of trauma had significantly higher Escape-Avoidance, Positive Reappraisal, Accepting Responsibility, and Planful Problem Solving subscores on the Ways of Coping instrument. The differences in coping scores may relate to adjustment to the violent act at the same time as the ostomy. These observations add to ostomy research because research about persons with temporary ostomies, especially those caused by a gunshot injury, is scarce.

Adaptation, Psychological↗
PubMed2001

The pouch acting as a mediator between "being a person with an ostomy" and "being a professional": analysis of a pedagogical strategy.

OBJECTIVE: This study analyzes the process of constructing and reconstructing the meanings of the concepts ostomy, ostomy patient, and the nurse's role in managing an ostomy after the experience of wearing a pouch. SUBJECTS AND SETTING: Thirty nurses who were students in the Enterostomal Therapy Nursing Education Program in 1992 and 1993 participated in this study. All of the participants were female, ages 20 to 55 years, had graduated from nursing at least 6 years previously, and had been working at acute care hospital units or at outpatient care centers. The research was completed at the Enterostomal Therapy Nursing Education Program in the Nursing College of the University of São Paulo. METHODS: All participants wore a pouch and lived as an ostomy patient for a 24-hour period and then were interviewed about their experience. Two major themes were identified after analysis: "being a person with an ostomy" and "being a professional." RESULTS: The experience of wearing a pouch promoted changes in perceived role, self-esteem, body image, sexuality, and social relations. These changes were sometimes perceived as stigmatization and sometimes as enhancing social support. The perceptions caused a crisis that provoked the use of coping and social defense mechanisms that ultimately altered the participants' perceptions of the meaning of "being a nurse." Prior to this learning experience, the participants' management of patients with ostomies was fragmented and marked by a dissociation among activity, thinking, and feeling. Before the experiences, participants defined their management of patients with ostomies as mostly technical, focusing on the ostomy and the pouch. Following the experience, participants proposed changes in practice designed to care for the whole human being, revealing an incorporation of the affective, symbolic, and relational dimensions critical to managing the care of patients with an ostomy. CONCLUSION: The results showed that having subjects wear a pouch as a pedagogic strategy was successful in directing the participants' thinking about new meanings concerning "being a professional," resulting in some potential profound changes in the future nursing care of their patients.

Activities of Daily Living↗
PubMed2005

Prescription for excellence: an ostomy clinic.

Individuals scheduled for ostomy surgery and those with a new or established stoma benefit from the services of a Certified Ostomy Care Nurse or Certified Wound Ostomy Continence Nurse provided in an ostomy clinic. The clinic can provide pre- and postoperative services as well as long-term holistic care. Developing a clinic requires an organized and well thought-out plan that identifies unmet patient needs to justify the importance of this ambulatory service to facility administrators. The plan should include configuring and preparing the area where care will be provided, advertising the services offered, and determining hours, staff, policies, and procedures with particular attention paid to facility and regulatory specifications. After establishing a clinic in a large, urban, acute care hospital, patient visits averaged 33 per month and the scheduled 6 hours per week of clinic time needed to be expanded to meet the needs of those requesting appointments. Once established, patient outcomes and provider satisfaction should be recorded. Certified Ostomy Care Nurses and Certified Wound Ostomy Continence Nurses have a responsibility to inform their patients about the ostomy clinic option when it is available and clinic clinicians should continue to share the results of their efforts to proliferate the ostomy clinic concept.

Ambulatory Care Facilities↗
PubMedDate not supplied

Relative satisfaction with nursing care of patients with ostomies.

Nurses and patients engage in an interactive process that is both supportive and educational. The ability of the nurse to communicate with the patient in a manner that the patient perceives as accepting will lead to transaction, goal attainment, effective nursing care, and satisfaction. This study was undertaken to examine the relationship between nurses' perceptions of patients with ostomies and those patients' satisfaction with nursing care. Data were also collected on nurses' confidence in caring for patients with ostomies, the length of time with the patient, and previous experience in caring for patients with new ostomies. Twelve patients with new ostomies and the registered nurses who cared for them on postoperative units at a regional medical center and a community hospital were identified. Reed's 1989 adaptation of Yuker, Block, and Young's 1972 Attitudes Toward Disabled Persons scale was used to obtain the nurse's perceptions of patients with ostomies. The LaMonica-Oberst Patient Satisfaction Scale was used to obtain the ostomy patients' satisfaction with nursing care. No statistically significant relationship was identified between nurses perceptions of patients with ostomies and these patients' satisfaction with care. However, the data suggest that there may be a relationship between higher patient satisfaction scores and three factors: the nurse's confidence in caring for patients with ostomies, the length of the nurse-patient relationship, and the employment of a certified ET nurse in the hospital in which the patient receives nursing care.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2004

Traditional versus telenursing outpatient management of patients with cancer with new ostomies.

PURPOSE/OBJECTIVES: To measure the impact of telenursing on patients discharged with ostomies resulting from cancer treatment. DESIGN: Quasi-experimental design with surveys. SETTING: Large tertiary care center in the southwestern United States. SAMPLE: 28 patients with cancer in two groups: traditional home health and home health plus telenursing. METHODS: Recorded the number of home health and telenursing contacts, dates when ostomy self-care needs were met, supplies used, and distance traveled. Patients completed a satisfaction survey and Maklebusts Ostomy Adjustment Scale. MAIN RESEARCH VARIABLES: Type of care, costs, patient satisfaction, ostomy adjustment, and time to achieve ostomy self-care. FINDINGS: Telenursing patients indicated higher satisfaction. The home health group averaged one more home health visit per patient (telenursing mean= three visits). Overall costs for both types of visits were about equal. The home health group used an average of four more pouches per patient, with increased cost of 52 dollars per patient. Telenursing patients believed that nurses had increased understanding of their problems, and they were more comfortable with what nurses told them about ostomy. Telenursing participants believed that telenursing made care more accessible; they preferred telemedicine rather than waiting for face-to-face visits but still believed that face-to-face visits were best. CONCLUSIONS: Combining traditional home health and telenursing is feasible for supporting discharged patients with new ostomies and enhances traditional home health, resulting in increased satisfaction overall. IMPLICATIONS FOR NURSING: Oncology nurses should develop telenursing programs that include patient and family education regarding oncology issues.

Aged↗
PubMed1999

The effect of ostomy surgery between the ages of 6 and 12 years on psychosocial development during childhood, adolescence, and young adulthood.

OBJECTIVE: To investigate the effect of ostomy surgery performed between the ages of 6 and 12 years on psychosocial development during subsequent childhood, adolescence, and young adulthood. DESIGN: Ethnographic. SETTING AND SUBJECTS: Six women and 4 men (mean age 30.7 years) who responded to a notice in a chapter newsletter of the United Ostomy Association. METHODS: Spradley's Ethnographic interview format was used for this study. One interview was conducted with each informant over a 4-week period, and a second, more detailed interview was conducted with 2 subjects who were identified as key informants. The interviews were audiotaped and transcribed, and the transcripts were analyzed to detect shared patterns in the informants' language. INSTRUMENTS: The Ethnograph computer software program was used as an aid in analyzing the interview transcripts. MAIN OUTCOME MEASURES: The informants' subjective experiences during childhood, adolescence, and young adulthood. RESULTS: Nine of the 10 informants adjusted well in the first years after surgery. Key factors in good adjustment were support from family and a perception of "normalcy," including managing one's own ostomy care. All informants reported that their ostomy had a negative impact on their lives during adolescence and that they would have appreciated contact with other teens facing the same dilemma. The age at which an informant underwent ostomy surgery did not influence the difficulties reported during adolescence. CONCLUSION: Ostomy surgery performed between the ages of 6 and 12 years can have long-term effects on psychosocial development. Nurses should promote normalization, teach self-care of the ostomy as soon as possible after surgery, and refer children and parents to mutual support groups as appropriate.

Adaptation, Psychological↗
PubMed1994

Caring for children with ostomies.

Caring for children with ostomies comprehensively requires that the healthcare professional understand issues related to normal growth and development as well as more specific medical information about disease processes and ostomy care. Parents should have a working knowledge of routine ostomy care and need guidelines to assist them in recognizing ostomy complications. Complications range from mild to severe. Many patients will experience at least one ostomy-related complication during the time they have their diversion. Active support of the child and the parent is essential toward facilitating acceptance and integration of ostomy care in pediatric ostomy clients.

Adolescent↗
PubMed1995

Acceptance of ostomy surgery--a Swedish pilot study.

The main purpose of this pilot study was instrument development, focused on personal adjustment following ostomy surgery. Two instruments were used: a translated and revised version of the Acceptance of Disability Scale, Modified (ADM), and Antonovsky's Sense of Coherence (SOC) questionnaire. A sample of 26 patients enrolled consecutively at the Ostomy Care Centre at a Swedish hospital were included in the study. A Cronbach's coefficient alpha of 0.95 was obtained for the ADM Scale, Swedish version, which is consistent with the results of similar studies. A significant difference between the ADM scores and type of ostomy surgery indicated that persons with a continent ostomy had a greater acceptance of ostomy surgery than had subjects with conventional ostomy surgery. A close correlation between ADM and SOC was obtained, indicating that persons who accept ostomy surgery will also have a good sense of coherence. The result of this pilot study indicates that further research using both measures may be useful in order to identify which factors are of relevance for nursing practice.

Adaptation, Psychological↗
PubMed2004

What proportion of patients with an ostomy (for diverticulitis) get reversed?

A common operation for patients with complicated sigmoid diverticulitis is resection and placement of an ostomy (Hartmann procedure). This population-based study examines that proportion of ostomates who undergo reversal. In the California inpatient file, patients admitted for acute diverticulitis in 1995 were identified, including a subset that had surgical resection. Data regarding receipt of ostomy were obtained (4-year follow-up). Demographics and clinical data (procedure, ostomy reversal, time to reversal, comorbidity score, and complications) were collected. In 1995, 11,582 admissions for diverticulitis occurred in California. Of these, 24.2 per cent (n = 2808) underwent surgery at admission; 88.9 per cent were sigmoid/left colectomies; and 41.7 per cent had a Hartmann procedure. Patients with ostomies were older (P = 0.0004) and male (P = 0.03). Median comobidity score was the same for patients with or without an ostomy. Of the 1176 patients who had the Hartmann procedure, 65 per cent underwent reversal (mean 143 days). A larger proportion of men than women had their ostomies reversed (74.5% vs 55.9%, respectively, P < 0.0001). Median comorbidity scores for both groups were low, 0 for those reversed and 1 for nonreversed. Our study shows that although the majority of patients had their ostomies reversed, over 35 per cent did not at 4-year follow-up. Further studies are required to evaluate how this rate may be improved.

Adolescent↗
PubMed2006

Correlating the Fecal Incontinence Quality-of-Life Score and the SF-36 to a proposed Ostomy Function Index in patients with a stoma.

Quality of life is affected by the creation of a stoma. To assess the validity of the Ostomy Function Index in patients with a stoma, a prospective survey was conducted from July 2000 to September 2001 among patients participating in local United Ostomy Association chapters (N = 99; 55 with a colostomy and 44 with an ileostomy). The Short Form 36 general health survey, Fecal Incontinence Quality of Life Scale, and the proposed Cleveland Clinic Florida Ostomy Function Index were used to assess general health and stoma function in patients with an ostomy. The average proposed function index score (7 = excellent function, 35 = poor function) was 11.97 (range 7 to 22). The proposed function Index correlated with the Fecal Incontinence Quality of Life Scale and the physical and mental component scales of the SF-36 (P < 0.05). The correlation between the proposed function index and the Fecal Incontinence Quality of Life Scale was stronger in colostomy than in ileostomy patients. With the exception of the SF-36 role-emotional domain in ileostomy patients, the function index correlated with all SF-36 scales (P <0.05) in both patient groups. The results of this study suggest that ostomy function is variable and correlates with quality of life and that the Fecal Incontinence Quality of Life Scale offers a limited assessment of quality of life in colostomy patients. The Cleveland Clinic Florida Ostomy Function Index offers an objective assessment of ostomy function that reflects on quality of life. Additional studies to refine measurement of quality of life in stoma patients are warranted.

Activities of Daily Living↗
PubMed1997

Pregnancy, delivery, and postpartum experiences of fifty-four women with ostomies.

OBJECTIVE: The pregnancy, labor, and delivery experiences of women with ostomies are described. DESIGN: Patient survey. SETTINGS AND SUBJECTS: Distribution of surveys to women with these experiences: patients of the Cleveland Clinic Foundation, referrals by networking of ET nurses, and distribution of surveys at a national conference of the United Ostomy Association and through local ostomy associations. INSTRUMENT: A 12-point questionnaire was adopted for each type of diversion: ileostomy, urostomy, continent ileostomy, colostomy, and pelvic reservoir. METHOD: The survey was distributed to attendees at a national United Ostomy Association conference and local United Ostomy Association meetings. Surveys were distributed to other EI nurses in the mideastern United States region and to qualified patients at Cleveland Clinic Foundation. MAIN OUTCOME MEASURE: The subjective experiences of pregnancy, labor and delivery of women with ostomies are described. RESULTS: Seventy-five questionnaires were distributed and 54 women responded. Eight women (15%) had fertility problems. Stoma-related problems during the second or third trimester were reported by 68.5%. Most problems were corrected without medical intervention. CONCLUSIONS: The presence of an ostomy should not be a deterrent to successful pregnancy and delivery.

Aged↗
PubMedDate not supplied

Evidence-based nursing care management for the pregnant woman with an ostomy.

Pregnancy presents many problems without working through additional problems in coping with an ostomy. Yet many women with an ostomy do get pregnant and do deliver healthy babies. Evidence-based nursing is of the utmost importance, as there is little published information on this topic. Because of the scarcity of pregnant subjects within the ostomy category, most studies, by necessity, select a purposive subject base. Therefore, other information sources regarding nursing management of the pregnant woman with an ostomy take on considerably more importance. This article explores other forms of evidence that can be used in managing the care of pregnant ostomy patients and specifically how nurses can integrate various sources of information in designing an evidence-based nursing care plan. Nonpharmacologic forms of relaxation therapy, easily used by nurses, such as mindfulness-based stress reduction, guided imagery, and hypnosis, are also identified as some ways nurses can relieve anxiety and experiential stress associated with pregnancy in women who have an ostomy.

Clinical Competence↗
PubMed2006

Ostomy care and the consultant pharmacist.

Many long-term care residents have ostomies. Three types of ostomy are most common: ostomies of the small bowel (ileostomies/jejunostomies), ostomies of the large bowel (colostomy), and urostomies. Ostomates (people who have had an ostomy) must deal with their physical and psychological repercussions. Complications may include dermatological problems, short-bowel syndrome, and vitamin deficiencies. When the ostomy involves the bowel, medication absorption may be affected. Pharmacists should be aware of contraindicated medications, as well as those that change the color or odor of effluent or stool.

Aged↗
PubMed2005

Quality of care after ostomy surgery: a perspective study of patients.

Ostomy surgery affects life on a variety of levels. Clinicians need to facilitate the patient's adaptation to life with a stoma and provide information and support to ease the transition. To prospectively assess ostomy patients' perceptions of the quality of care received as well as the importance they ascribe to care conditions, 49 patients from nine Swedish hospitals completed a postoperative "Quality of Care from the Patient's Perspective" questionnaire modified to include stoma care variables. The questionnaire consists of 49 items covering 17 quality dimensions factors that address medical-technical competence, physical-technical conditions, identity-oriented approach, and socio-cultural atmosphere. The modified version contains an additional 13 ostomy-specific items that have demonstrated face validity. Responses to questions were provided using 4-point scales to assess perceived reality and subjective importance. "Medical treatment" received the highest score on the perceived reality scale; "interest in view-of-life," "care-room characteristics," and "participation" received the lowest scores. On the ostomy-specific section, patients were satisfied with most aspects of care received; "where to get advice and support concerning the ostomy" received the highest score. "Talking about sexuality with the ET nurse" received the lowest score on both perceived reality and subjective importance scales. Although the majority of patients regarded most aspects of care as important and were highly satisfied with the care they received before and following their ostomy surgeries, periodic follow-up will most likely enhance satisfaction and long-term follow-up results may differ from those obtained shortly after surgery.

Adolescent↗
PubMed2004

Revision and psychometric testing of the City of Hope Quality of Life-Ostomy Questionnaire.

PURPOSE: Ostomies may be performed for bowel or urinary diversion, and occur in both cancer and non-cancer patients. Impact on physical, psychological, social and spiritual well-being is not unexpected, but has been minimally described in the literature. The City of Hope Quality of Life (COH-QOL)-Ostomy Questionnaire is an adult patient self-report instrument designed to assess quality of life. This report focuses on the revision and psychometric testing of this questionnaire. PATIENTS AND METHODS: The revised COH-QOL-Ostomy Questionnaire involved in-depth patient interviews and expert panel review. The format consisted of a 13-item disease and demographic section, a 34-item forced-choice section, and a 41-item linear analogue scaled section. A mailed survey to California members of the United Ostomy Association resulted in a 62% response rate (n = 1513). Factor analysis was conducted to refine the instrument. Construct validity involved testing a number of hypotheses identifying contrasting groups. RESULTS: Factor analysis confirmed the conceptual framework. Reliability of subscales ranged from 0.77 to 0.90. The questionnaire discriminated between subpopulations with specific concerns. CONCLUSIONS: Overall, the analyses provide evidence for the validity and reliability of the COH-QOL-Ostomy Questionnaire as a comprehensive, multidimensional self-report questionnaire for measuring quality of life in patients with intestinal ostomies.

Aged↗
PubMed1994

The psychologic impact of ostomy surgery on persons 50 years of age and older.

There have been few studies on the psychologic effects and reactions to ostomy creation in persons older than 50 years. Eighty-nine patients with ostomies (42 female, 47 male) were evaluated to see how ostomy creation affected them. Six instruments were used to make these assessments: Surgery Preparedness Inventory, Surgical Adjustment Scale, Social Interaction Inventory, Self-Esteem Inventory, Geriatric Depression Scale, and Life Satisfaction Inventory-A. In addition to these six instruments, the participants in the study were asked to state their greatest concern. Older men and women showed similar patterns in surgical preparedness, adjustment to operation, and level of self-esteem. Men reported lower satisfaction with life than did women. Men also had more difficulty in social interactions than did women. Twice as many men as women reported mild to moderate depression. Older women reported poorer health status; if unmarried, they reported less satisfaction with life than younger or married women. More of those reporting good current health reported a positive adjustment to ostomy creation than did those who reported poor health. Those who did not feel hindered by their ostomies reported higher scores on well-being than did those who felt hindered. The more time that has passed after operation, the better patients felt. Four major concerns were reported: (1) concern with being able to care for themselves; (2) leakage from the pouch, odor, and gas noises; (3) other health problems; and (4) recurrence of cancer. Good current health and a sense of well-being are important to positive adjustment after ostomy creation. These areas would be well worth monitoring and should be promoted by the caregivers.

Activities of Daily Living↗
PubMed1998

The role of the WOC nurse in an ostomy support group.

The creation of an ostomy provokes an emotional crisis for its recipient. The ostomy patient typically experiences a wide range of emotions and often feels a profound sense of isolation. Although health care professionals are able to provide substantial education and training, the patient usually requires additional knowledge and experience to manage and cope with the ostomy on a day-to-day basis. An ostomy support group can provide this much-needed information and emotional support. The WOC nurse can serve a vital role as facilitator for the ostomy support group. To fulfill this role, an understanding of key issues in promoting and maintaining a successful support group is necessary. These issues include understanding the role of the support group and how it differs from the self-help group, marketing the group, acting as a group facilitator, recognizing leadership resources within the group, and evaluating its effectiveness.

Humans↗