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At least 19 recordsLinked to original sources
PubMedDate not supplied

Acceptance of ostomy and the visitor role in a self-help group for ostomy patients.

The helper therapy principle, which underscores the benefits from helping another person, has been relatively unexplored in the self-help movement. This study examined whether persons enrolled in the United Ostomy Association, a self-help group for ostomates, who functioned in a helping role as visitors demonstrated a greater level of acceptance of their ostomy than those persons enrolled in the same group who have not served in the visitor role. Results indicated that visitors' acceptance of their own ostomies was significantly higher than nonvisitors'. The length of time since visitors and nonvisitors had their first ostomy surgery was not a significant factor in the person's acceptance of ostomy. There was a significant relationship between the person's level of acceptance of ostomy and the length of time the individual had served in the visitor role. Serving in the visitor role contributed significantly to predicting a higher level of acceptance of the ostomy. The length of time since surgery was a significant predictor to serving in the visitor role. Factors of age, sex, type of ostomy, and length of time since surgery did not contribute significantly to predicting a higher level of acceptance of the ostomy.

Adaptation, Psychological↗
PubMed1996

Development and testing of the ostomy concerns scale: measuring ostomy-related concerns of cancer patients and their partners.

This article reports the third phase of a project undertaken to develop and test the Ostomy Concerns Scale. The Ostomy Concerns Scale measures concerns of cancer patients with ostomies and of their partners. The tool was pilot tested for clarity, apparent internal consistency (nonquantitative assessment of homogeneity of content), and content validity by a panel of experts. The scale met or exceeded the preset criteria specified in this phase of testing. Subsequent testing included estimates of the scale's reliability and validity with a sample of 40 patients and their partners. Internal consistency estimates, as measured by Cronbach's alpha coefficient, were 0.92 at two test times. A test-retest reliability estimate of 0.73, as measured by Spearman's correlation coefficient, was obtained. The results are promising and suggest that the Ostomy Concerns Scale provides a clinically useful evaluation of concerns of patients with ostomies and their partners.

Aged↗
PubMed1998

Nurse perceptions of ostomy patients & their ostomy care competence.

The nursing role of caring for ostomy patients has evolved from the bedside nurse to an enterstomal therapist (ET) or a nurse clinical specialist with ostomy care experience. Routine practice calls for staff nurses and physicians to refer patients with a new ostomy or patients with stoma problems to these specialists. The responsibility for successful outcomes typically falls on these specialized nurses.

Adult↗
PubMedDate not supplied

Application of social learning theory to teaching ostomy care to parents of infants with ostomies.

Intestinal stomas are created in infants for a variety of conditions. A neonatal defect or illness has an intense emotional impact on the parents. The ET nurse is challenged to develop a teaching plan that integrates routine physical care of the infant with supportive emotional care for the parents to promote normal parent-infant attachment, effective coping, and normal growth and development of the infant with special needs. Bandura's Social Learning Theory provides the theoretic rationale for the plan of care developed in this article.

Enterostomy↗
PubMed2001

[Ostomy devices. Intestinal and urologic ostomies].

The authors provide a brief historical survey analyzing intestinal stomas and the evolution of instruments which can be used. The authors present the characteristics which must be considered when selecting an instrument, what its basic requirements are, and what kinds of instruments are currently on the market. Bags and accessories are other sections included in this article.

Cystostomy↗
PubMed2002

[Care of ostomies and of patients with ostomies].

Patients with stomas have better care than ten years ago. Care is available to everyone who needs it and improved recently very rapidly and markedly in the Czech Republic. The authors describe briefly the history and present structure of stoma care.

Colostomy↗
PubMed2003

Outcomes of ostomy procedures in patients aged 70 years and older.

HYPOTHESIS: Patients aged 70 years and older undergo proportionately more emergency and permanent fecal ostomy procedures than younger patients. Older patients have comparable short-term outcomes in morbidity and mortality, with adverse outcomes dependent on comorbid conditions and timing of the procedure rather than age alone. Older patients should be treated similarly to younger patients in terms of subsequent ostomy takedown, if an acceptable operative risk. DESIGN: A retrospective review of our facility's experience with fecal ostomies between 1992 and 2002 was performed to determine the effect of advanced age on surgical outcome measures. SETTING: A tertiary managed care medical center. PATIENTS: Three hundred eighty-three consecutive patients who underwent new fecal ostomy procedures between October 1, 1992, and October 1, 2002. One hundred three patients were aged 70 years or older (mean age, 76.4 years), and 280 patients were younger than 70 years (mean age, 49.6 years). There were 220 elective procedures and 163 emergency procedures. Outcome was analyzed between the 2 age groups. MAIN OUTCOME MEASURES: Indications for ostomy, type of ostomy, preoperative comorbidity, postoperative morbidity and mortality, length of intensive care unit and hospital stay, and subsequent ostomy takedown success. RESULTS: Three hundred eighty-three new fecal ostomies were created. The diagnosis leading to creation of the ostomy was more often malignancy in older patients (74.8%) compared with younger patients (45.0%). Both age groups underwent a similar proportion of emergency procedures (older vs younger patients, 43.7% vs 42.1%; P=.07), but more older patients were left with permanent stomas (59.2% vs 41.1%, P=.002). Older patients also had more preoperative comorbidities (P=.001), higher American Society of Anesthesiologists scores (P=.001), longer hospital stays (P=.04), and more postoperative complications. Thirty-day mortality was 6.8% in the older group vs 0.4% in the younger group (P=.001). Fewer older patients were eligible for ostomy reversal (41.1% vs 59.2%), and a smaller proportion of eligible older patients actually underwent the reversal procedure (78.7% vs 95.2%). The complication rate associated with ostomy reversal was not significantly different in the 2 age groups (P=.002). CONCLUSIONS: Patients aged 70 and older undergo proportionately more permanent fecal ostomy procedures than younger patients, with longer hospital stays, more postoperative complications, and higher mortality rates. However, surgical outcome measures in older patients following ostomy procedures remain within acceptable standards. Furthermore, older patients tolerate ostomy reversal with minimal morbidity and should not be denied consideration based on age alone if an eligible candidate.

Adolescent↗
PubMed1991

Morbidity and mortality of ostomy closure.

Ostomy closure following the Hartmann procedure is perceived to be associated with higher morbidity and mortality rates than is ostomy closure following divided colostomy, loop colostomy, and divided ileostomy-colostomy so that ostomy closure after Hartmann procedure may be denied to certain patients. To test that perception, the charts of 59 patients undergoing a Hartmann procedure and 43 patients having ostomy closure after divided colostomy, loop colostomy, or divided ileostomy-colostomy were reviewed. Ostomy closure after Hartmann procedure was accomplished in 46 patients. These 46 patients (Group I) were compared with the 43 patients having ostomy closure following divided colostomy, loop colostomy and divided ileostomy-colostomy (Group II). No deaths occurred in either group. The morbidity rate was 30% for Group I and was 19% for Group II. This difference is not significant. Major complications involved wound, lung, small bowel, and colonic anastomoses. Anastomotic stricture rate was 9% for Group I and 5% for Group II. Small bowel and anastomotic complications in both groups occurred only when ostomy closure was performed after a delay of less than 6 months after ostomy construction. Stricture occurred only after end-to-end colocolostomy and coloproctostomy and did not occur after ileocolostomy or ileoproctostomy. All strictures were successfully treated by reoperation. Anastomotic leak and pelvic abscess did not occur in either group. We conclude that ostomy closure after Hartmann procedure may be more difficult and time consuming than is ostomy closure after loop colostomy, divided colostomy, or divided ileostomy-colostomy, but ostomy closure after Hartmann procedure does not have a higher morbidity rate. We advise a delay of 6 months between ostomy construction and ostomy closure and submit that all patients whose general condition permits reoperation may safely undergo ostomy closure.

Adult↗
PubMedDate not supplied

Perioperative factors that affect long-term adjustment to an incontinent ostomy.

PURPOSE: We sought to identify perioperative factors associated with long-term adjustment to an incontinent ostomy. METHODOLOGY: The Ostomy Adjustment Scale (OAS), a demographic form, and a $5 gift certificate were mailed to 200 ostomates. Associations between items from the Survey of Perioperative Factors of Ostomy Adjustment, demographic forms, and total OAS scores were assessed using bivariate and multiple linear regression analysis. RESULTS: The survey response rate was 74%. About half (70/146, 49%) of the respondents were women, 99% (144/145) were Caucasian, and 74% (109/146) were married. Their mean age was 65+/-14 years. Fifty-six percent (79/141) of the respondents had an ileostomy, 28% (39/141) had a colostomy, and 15% (21/141) had a urostomy. The mean OAS score for all the respondents was 159.5+/-26.2, indicating a good overall adjustment to an incontinent ostomy. In bivariate analyses, the factor associated with a lower OAS score indicating poorer adjustment was distress related to affording and obtaining ostomy supplies. The more helpful the ostomates found the preoperative education provided by a wound, ostomy, and continence specialist nurse, the better was their adjustment as indicated by a higher OAS score. Having ongoing/recurrent illness and having an ostomy created by a specialty surgeon were also associated with better adjustment. When multiple factors were considered in a stepwise regression analysis, adjustment was lowered by distress about obtaining ostomy supplies. Adjustment was improved when preoperative education provided by a wound, ostomy, and continence specialist nurse was considered helpful for the ongoing/ recurrent illness. CONCLUSION: Many ostomates have a good long-term adjustment to ostomy surgery and value education provided by a wound, ostomy, and continence nurse. Perioperative patient education and addressing patient distress over obtaining supplies are areas that can benefit from wound, ostomy, and continence nurse intervention.

Activities of Daily Living↗
PubMed2006

Drawing on international experience to reform the Belgian market for ostomy appliances.

This article aims to review the regulatory framework governing the Belgian ostomy appliance market in the light of the experience of Denmark, France, the Netherlands and Ontario (Canada) with regulation of ostomy appliances. Information about the regulatory framework was derived from the international literature, analysis of legal texts and a survey completed by national experts. The comparative analysis revealed that these countries have adopted varying approaches towards regulating their domestic ostomy appliance market. Strategies to keep down prices include public procurement in Denmark, maximum prices in France and exclusion of expensive appliances from reimbursement in the Netherlands. To contain public expenditure on ostomy appliances, consumption patterns are monitored in the Netherlands, the quantity of reimbursed appliances is limited in Belgium and public reimbursement is restricted in Ontario. Ostomy appliances are generally distributed by community pharmacies and medical equipment shops. In countries that emphasise home care delivery such as Denmark, domiciliary distributors dominate the market to the detriment of community pharmacies which do not seem to be able to offer this service at a competitive price. An avenue for reforming the Belgian ostomy appliance market is proposed which valorizes the role of ostomy care nurses in guiding the choice of ostomy appliances. Furthermore, it is recommended that a competitive tendering process determines the price of ostomy appliances, that reimbursement for service provision by distributors is separated from reimbursement of appliances, and that patients receive a fixed grant from the third-party payer to buy ostomy appliances.

Belgium↗
PubMed2002

Family dynamics and health locus of control in adults with ostomies.

OBJECTIVE: The purpose of this study was to investigate the relationship between family dynamics and health locus of control in families who had a member with an ostomy. DESIGN: The study used a cross-sectional design. SETTING AND SUBJECTS: Data were collected by means of questionnaires completed by 2 groups of families. Twenty-nine subjects in the ostomy group were registered with a local chapter of the United Ostomy Association. Thirty subjects in the non-ostomy control group were recruited from a local church, a university housing complex, and a hospital volunteer service. INSTRUMENTS: The Family Dynamics Measure of 62 Likert-type items measured 6 bipolar dimensions of family dynamics. The Multidimensional Health Locus of Control Scale of 18 Likert-type items measured internal or external locus of control. METHODS: Questionnaires were mailed to subjects by staff at the local ostomy association and other cooperating groups. Completed questionnaires were returned by mail to the researcher. RESULTS: Subjects in the ostomy group perceived significantly greater control by powerful others and greater rigidity in the family compared with the non-ostomy group. When families were perceived as rigid, both groups reported significantly greater control by powerful others. Subjects in the ostomy group who reported greater role reciprocity in the family perceived greater health locus of control by powerful others. CONCLUSIONS: Health care professionals and family members (powerful others) play an important role in helping a person with an ostomy. Assessing family dynamics can help professionals identify which aspects of family life are associated with locus of control for the person with an ostomy.

Adaptation, Physiological↗
PubMed2002

Coping styles of older adults with ostomies.

Various clinical studies throughout the years have shown that individuals with ostomies are a unique group facing adjustment demands. One of the most important challenges for an individual with an ostomy is coping with the physiological and psychological changes. The purpose of this study was to describe coping styles of older adults after undergoing ostomy surgery and to explore its helpfulness in dealing with the stressors related to having an ostomy. Lazarus and Folkman's theory on stress and coping was used as the framework to guide this study. A sample of 27 participants ranging from age 50 to 84 years was obtained from an ostomy association in southeastern Louisiana. Participants were asked to complete a demographic data form and the Revised Jalowiec Coping Scale. This revised scale measured eight coping styles related to Use and Effectiveness. Findings revealed significant differences existed among the means of the eight measures for both Use and Effectiveness at p < .01. Results demonstrated that the optimistic and self-reliant styles of coping were the most frequently used as effective styles for coping with an ostomy. This indicated a positive outlook and dependence on oneself rather than dependence on others when coping with the stressors of having an ostomy. There were no statistically significant differences related to gender or ostomy type. Also, aging did not appear to be a factor when considering coping styles of older adults with ostomies. The nursing role should include assessment of the individual preoperatively to identify fears, concerns, and stressors related to having an ostomy. Also, nurses can provide education on disease management, assist with identification of ineffective coping mechanisms, and promote effective coping skills and stress management techniques.

Adaptation, Psychological↗
PubMed2006

The VA Ostomy Health-Related Quality of Life Study: objectives, methods, and patient sample.

OBJECTIVE: To present the design and methods of a multisite study of health-related quality of life (HR-QOL) in veterans living with ostomies. RESEARCH DESIGN AND METHODS: Veterans from Tucson, Indianapolis, and Los Angeles VA Medical Centers were surveyed using the validated City of Hope ostomy-specific tool (mCOH-QOL-Ostomy) and the SF-36V. Cases (ostomates) had a major gastrointestinal procedure that required an intestinal stoma, while controls had similar procedures for which an ostomy was not required. Ostomy subjects were recruited for four focus groups in each of two sites divided by ostomy type (colostomy versus ileostomy) and overall mCOH-QOL-Ostomy HR-QOL score (highest versus lowest quartile). The focus groups further evaluated barriers, concerns, and adaptation methods and skills. MAIN OUTCOME MEASURES: This report presents recruitment results, reliability of survey instruments, and demographic characteristics of the sample. RESULTS: The overall response (i.e., recruitment) rate across all sites was 48% and by site was 53%, 57%, and 37%, respectively (p < 0.001). Internal consistency reliability estimates indicated that both instruments remain reliable in this population (Cronbach's alpha for HR-QOL domains/scales: 0.71-0.96). Cases and controls were similar in demographic characteristics. Proportions of minority subjects matched projections from the site patient populations. Subjects with ostomies had significantly longer time since surgery than controls (p < 0.001). Focus groups were comprised of two to six subjects per group and demonstrated racial diversity at the Los Angeles site. CONCLUSIONS: The unique design of our study of VA patients with ostomies is an illustration of a successful mixed methods approach to HR-QOL research. We collected meaningful quantitative and qualitative data that will be used in the development of new approaches to care that will lead to improved functioning and well-being in persons living with ostomies. Subsequent reports will provide the results of this research project.

Aged↗
PubMed2001

Dietary choices of people with ostomies.

OBJECTIVE: The objective was to collect data related to individual dietary recommendations and restrictions for people with ostomies. DESIGN: A descriptive survey was used that asked people about food choices/avoidances that occurred because of their ostomy. SUBJECTS: Subjects were members of the United Ostomy Association who had an ostomy and were living at home. METHODS: A 14-item questionnaire was mailed to the United Ostomy Association membership (approximately 40,000 current members) in their quarterly newsletter. RESULTS: Six hundred and four questionnaires were returned. The most frequent reason for ostomy surgery among the respondents was colon cancer (71%; n = 424), and the most common type of ostomy was a colostomy. The majority of respondents (88.4%) stated that they were not following a special diet because of the ostomy; 11.8% (n = 69) stated that they had modified their diet. Of the people who had modified their diet, 55% stated that they were using the special diet indefinitely and were adhering to it very well. More than half of the participants had received dietary instructions, provided mainly by a WOC nurse, at the time of surgery. The foods avoided because of the ostomy included fresh fruits, nuts, coconut, and vegetables such as corn, popcorn, cabbage, beans, and onions. The major problems reported were blockage and increased gas. CONCLUSION: Many respondents reported problems with certain foods. Preoperative teaching and postoperative follow-up must include anticipatory guidance on food selection.

Consumer Organizations↗