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Brady RRW, Sheard D, Howard K, Vestergaard M, Boisen EB, Mather R, Ainsworth R, Hansen HD, Ajslev TA. The Prevalence of Leakage, Peristomal Skin Complications and Impact on Quality of Life in the First Year Following Stoma Surgery. NURSING REPORTS 2025; 15:107. [PMID: 40137682 PMCID: PMC11946121 DOI: 10.3390/nursrep15030107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2024] [Revised: 03/06/2025] [Accepted: 03/12/2025] [Indexed: 03/29/2025] Open
Abstract
Objective: It is well established that having a stoma can negatively impact health-related quality of life (HRQoL), but there is a paucity of research describing the natural history of certain complications associated with living with a stoma, such as leakage and peristomal skin complications (PSCs), and whether these affect QoL within the first year of stoma surgery. The objective of this study was to investigate the pattern of such complications and impact on QoL in individuals who had stoma surgery within the preceding year. Methods: A cross-sectional study was conducted at three hospital sites in the United Kingdom to evaluate the burden of disease in those who had undergone intestinal stoma formation surgery within the preceding year. The study consisted of a one-to-one consultation with a study nurse and the completion of an online questionnaire by the patient (ISRCTN-registry: 23080097). The nurse-led interview directly evaluated peristomal skin health, whilst the online questionnaire evaluated the impact of leakage (using the Ostomy Leak Impact tool), generic mental well-being (by WHO-5) and wider HRQoL (by EQ-5D-5L). Results: A total of 114 individuals with an intestinal stoma completed the evaluations. The participants had a mean age of 55.8 years (range 18-87 years) and 58% were male. Forty-three percent of the participants had experienced leakage of stomal effluent outside the baseplate (e.g., onto clothes) in the preceding two weeks and 85% suffered from PSCs ranging from mild (35%), to moderate (18%), and severe (32%). Leakage and PSCs were associated with lower mental well-being and HRQoL (p < 0.05). Leakage events, HRQoL, mental well-being and peristomal skin health were similar for individuals across different timepoints from the time of surgery within the first year. Conclusions: This study reported a high disease burden in people with a new intestinal stoma. Experiencing frequent leakage incidents and/or living with severe PSCs were associated with reduced HRQoL and mental well-being.
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Affiliation(s)
- Richard R. W. Brady
- Newcastle Centre for Bowel Disease Research Hub, Newcastle Hospitals and Newcastle University, Newcastle upon Tyne NE1 4LP, UK;
| | - Diane Sheard
- Lancashire Teaching Hospital, Royal Preston Hospital, Preston PR2 9HT, UK;
| | - Kevin Howard
- Clinical Trials Research Office, James Paget University Hospital, Great Yarmouth NR31 6LA, UK;
| | - Martin Vestergaard
- Coloplast A/S, Holtedam 1, 3050 Humlebæk, Denmark; (M.V.); (E.B.B.); (H.D.H.)
| | - Esben Bo Boisen
- Coloplast A/S, Holtedam 1, 3050 Humlebæk, Denmark; (M.V.); (E.B.B.); (H.D.H.)
| | - Rebecca Mather
- Coloplast Ltd., Nene Hall, Peterborough Business Park, Peterborough PE2 6FX, UK; (R.M.)
| | - Rachel Ainsworth
- Coloplast Ltd., Nene Hall, Peterborough Business Park, Peterborough PE2 6FX, UK; (R.M.)
| | - Helle Doré Hansen
- Coloplast A/S, Holtedam 1, 3050 Humlebæk, Denmark; (M.V.); (E.B.B.); (H.D.H.)
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Muzii B, Di Bello F, Collà Ruvolo C, Morra S, Polverino F, Pessolano C, Creta M, Califano G, Pezone G, Mangiapia F, Alvino P, Longo N, Maldonato NM. Stoma Acceptance Mediates Body Image Distress and Mental Health-Related Quality of Life: A Single-Center Study on Radical Cystectomy Patients with Ureterostomy. J Clin Med 2024; 13:7682. [PMID: 39768605 PMCID: PMC11676722 DOI: 10.3390/jcm13247682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2024] [Revised: 12/07/2024] [Accepted: 12/13/2024] [Indexed: 01/11/2025] Open
Abstract
Background: Muscle-invasive bladder cancer and subsequent radical cystectomy with ureterocutaneostomy significantly impact patients' body image and quality of life, potentially increasing the risk of adverse mental health outcomes. Acceptance may represent a psychosocial resource to buffer the effects of body image impairment on health, thereby supporting stoma adjustment and preserving quality of life. Objective: This study aimed to investigate the mediating role of stoma acceptance in the relationship between body image distress and mental health. Methods: A single-center cross-sectional survey was conducted with 73 muscle-invasive bladder cancer patients undergoing radical cystectomy with ureterocutaneostomy. Participants completed structured, anonymous self-report measures assessing body image distress, stoma acceptance, and mental health-related quality of life through validated questionnaires. Results: Statistical analyses revealed significant negative correlations between body image distress and mental health and stoma acceptance. Conversely, stoma acceptance was significantly and positively associated with mental health. Regression-based mediation modeling indicated that stoma acceptance exerted a significant mediating effect on the relationship between body image and mental health-related quality of life. Conclusions: These findings highlight the considerable and unprecedented role of stoma acceptance as a mediating factor that may promote the adjustment and enhance the quality of life of urostomy patients. Further research is warranted to explore interventions targeting stoma acceptance to prevent body image distress and promote mental health.
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Affiliation(s)
- Benedetta Muzii
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, Claudia Collà Ruvolo, Via Sergio Pansini 5, 80131 Naples, Italy; (B.M.); (F.D.B.); (S.M.); (F.P.); (M.C.); (G.C.); (G.P.); (F.M.); (P.A.); (N.L.); (N.M.M.)
| | - Francesco Di Bello
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, Claudia Collà Ruvolo, Via Sergio Pansini 5, 80131 Naples, Italy; (B.M.); (F.D.B.); (S.M.); (F.P.); (M.C.); (G.C.); (G.P.); (F.M.); (P.A.); (N.L.); (N.M.M.)
| | - Claudia Collà Ruvolo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, Claudia Collà Ruvolo, Via Sergio Pansini 5, 80131 Naples, Italy; (B.M.); (F.D.B.); (S.M.); (F.P.); (M.C.); (G.C.); (G.P.); (F.M.); (P.A.); (N.L.); (N.M.M.)
| | - Simone Morra
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, Claudia Collà Ruvolo, Via Sergio Pansini 5, 80131 Naples, Italy; (B.M.); (F.D.B.); (S.M.); (F.P.); (M.C.); (G.C.); (G.P.); (F.M.); (P.A.); (N.L.); (N.M.M.)
| | - Federico Polverino
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, Claudia Collà Ruvolo, Via Sergio Pansini 5, 80131 Naples, Italy; (B.M.); (F.D.B.); (S.M.); (F.P.); (M.C.); (G.C.); (G.P.); (F.M.); (P.A.); (N.L.); (N.M.M.)
| | - Colomba Pessolano
- Intradepartmental Program of Clinical Psychopathology, Federico II University Hospital, 80131 Naples, Italy
| | - Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, Claudia Collà Ruvolo, Via Sergio Pansini 5, 80131 Naples, Italy; (B.M.); (F.D.B.); (S.M.); (F.P.); (M.C.); (G.C.); (G.P.); (F.M.); (P.A.); (N.L.); (N.M.M.)
| | - Gianluigi Califano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, Claudia Collà Ruvolo, Via Sergio Pansini 5, 80131 Naples, Italy; (B.M.); (F.D.B.); (S.M.); (F.P.); (M.C.); (G.C.); (G.P.); (F.M.); (P.A.); (N.L.); (N.M.M.)
| | - Gabriele Pezone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, Claudia Collà Ruvolo, Via Sergio Pansini 5, 80131 Naples, Italy; (B.M.); (F.D.B.); (S.M.); (F.P.); (M.C.); (G.C.); (G.P.); (F.M.); (P.A.); (N.L.); (N.M.M.)
| | - Francesco Mangiapia
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, Claudia Collà Ruvolo, Via Sergio Pansini 5, 80131 Naples, Italy; (B.M.); (F.D.B.); (S.M.); (F.P.); (M.C.); (G.C.); (G.P.); (F.M.); (P.A.); (N.L.); (N.M.M.)
| | - Pierluigi Alvino
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, Claudia Collà Ruvolo, Via Sergio Pansini 5, 80131 Naples, Italy; (B.M.); (F.D.B.); (S.M.); (F.P.); (M.C.); (G.C.); (G.P.); (F.M.); (P.A.); (N.L.); (N.M.M.)
| | - Nicola Longo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, Claudia Collà Ruvolo, Via Sergio Pansini 5, 80131 Naples, Italy; (B.M.); (F.D.B.); (S.M.); (F.P.); (M.C.); (G.C.); (G.P.); (F.M.); (P.A.); (N.L.); (N.M.M.)
| | - Nelson Mauro Maldonato
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, Claudia Collà Ruvolo, Via Sergio Pansini 5, 80131 Naples, Italy; (B.M.); (F.D.B.); (S.M.); (F.P.); (M.C.); (G.C.); (G.P.); (F.M.); (P.A.); (N.L.); (N.M.M.)
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Tan Z, Jiang L, Lu A, He X, Zuo Y, Yang J. Living with a permanent ostomy: a descriptive phenomenological study on postsurgical experiences in patients with colorectal cancer. BMJ Open 2024; 14:e087959. [PMID: 39532360 PMCID: PMC11574432 DOI: 10.1136/bmjopen-2024-087959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2024] Open
Abstract
OBJECTIVES To explore the postsurgery lived experiences of patients with colorectal cancer with a permanent ostomy for informing initiatives to improve patient care and future quantitative research. DESIGN A descriptive qualitative phenomenological study. SETTING We conducted this study in the Colorectal Cancer Division at the Cancer Center of West China Hospital, Sichuan University, a premier institution renowned for its comprehensive cancer care and research. PARTICIPANTS 12 patients who had undergone surgeries for colorectal cancer with a permanent ostomy. RESULTS Our interviews revealed profound adjustments in the lives of colorectal cancer survivors living with permanent ostomies. Participants articulated a transition to a 'new normal', characterised by extensive daily life adjustments, psychological adaptation and ongoing management challenges. Key themes identified included the adaptation to a reshaped daily routine and altered perceptions of quality of life. Many faced substantial challenges in stoma care, requiring significant learning and adaptation. Psychological adaptations were marked by a redefinition of body autonomy and personal identity, alongside a recalibration of social interactions and privacy. The need for robust professional guidance and a comprehensive social support system was universally emphasised. CONCLUSIONS Patients with colorectal cancer with permanent ostomies navigate significant changes in their lives postsurgery, undertaking a complex process of reconstructing and adapting to a new normalcy. They recalibrate their physical, psychological and social well-being, demonstrating resilience and adaptability in the face of these challenges. Their pervasive expression of needs for information and support may reflect gaps in the existing patient education and support measures and communication strategies. Healthcare professionals and policy-makers should adopt a patient-centred approach acknowledging the multifaceted nature of postsurgery recovery and adaptation by fostering open communication, tailoring personalised education and facilitating supportive community networks.
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Affiliation(s)
- Zuo Tan
- Colorectal Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lili Jiang
- Colorectal Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Anqing Lu
- Department of Central Transportation, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Xiao He
- West China Medical Simulation Center, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yan Zuo
- West China School of Nursing, Sichuan University, Sichuan, China/Department of Gynecology and Obstetrics Nursing, West China Second University Hospital, Sichuan University/Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, China, Chengdu, Sichuan, China
| | - Jie Yang
- Colorectal Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Lv Q, Yuan Y, Xiang Z. Analysis of risk factors for the sigmoid stoma complications in patients after abdominoperineal resection surgery: An observational study. Medicine (Baltimore) 2024; 103:e38751. [PMID: 38941381 PMCID: PMC11466088 DOI: 10.1097/md.0000000000038751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 06/07/2024] [Indexed: 06/30/2024] Open
Abstract
To analyze the risk factors for intraperitoneal sigmoid stoma complications after abdominoperineal resection (APR) surgery to guide clinical practice. Patients who were diagnosed with rectal cancer and underwent APR surgery from June 2013 to June 2021 were retrospectively enrolled. The characteristics of the stoma complication group and the no stoma complication group were compared, and univariate and multivariate logistic analyses were employed to identify risk factors for sigmoid stoma-related complications. A total of 379 patients who were diagnosed with rectal cancer and underwent APR surgery were enrolled in this study. The average age of the patients was 61.7 ± 12.1 years, and 226 (59.6%) patients were males. Patients in the short-term stoma complication group were younger (55.7 vs 62.0, P < .05) and had a more advanced tumor stage (P < .05). However, there was no significant difference between the long-term stoma complication group and the no stoma complication group. Multivariate logistic regression analysis revealed that operation time was an independent risk factor (P < .05, OR = 1.005, 95% CI = 1.000-1.010) for short-term stoma complications. Both the short-term and long-term stoma complication rates in our institution were low. A longer operation time was an independent risk factor for short-term stoma complications after APR surgery.
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Affiliation(s)
- Quan Lv
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ye Yuan
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zheng Xiang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Department of General Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Wang X, Wang C, Han W, Sun J, Hui Z, Lei S, Wu H, Liu X. Global status of research on gastrointestinal cancer patients' quality of life: A bibliometric and visual analysis from 2003 to 2023. Heliyon 2024; 10:e23377. [PMID: 38148818 PMCID: PMC10750154 DOI: 10.1016/j.heliyon.2023.e23377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 11/24/2023] [Accepted: 12/01/2023] [Indexed: 12/28/2023] Open
Abstract
Objective To analyze the current research status, hotspots, and frontiers in the field of Gastrointestinal (GI) cancer and quality of life (QoL) through the bibliometrics method, and to provide references and guidance for future research. Methods Literature related to GI cancer and QoL from April 1, 2003 to March 31, 2023 was retrieved from the Web of Science Core Collection database. CiteSpace 6.2.R1 was performed for collaboration analysis, keyword co-occurrence analysis, and document co-citation analysis. Results A total of 1224 publications were included in this study. There has been a significant increase in the number of publications in this field over the past two decades. The United States, the Karolinska Institute and the University of Amsterdam, and Pernilla Lagergren are the most prolific country, institution, and author, respectively. The links between most of the research constituents were relatively thin (centrality <0.1). The keyword analysis indicates that the benefits of physical activity on QoL, the levels of psychological distress and its relationship with QoL, as well as the development and validation of QoL measurement tools have been the research hotspots. Open-label/double-blind trials exploring therapeutic interventions and more targeted new drugs or more effective drug combinations, and longitudinal studies determining the direction of the association between psychological distress and QoL at different time points, may be emerging trends in this field. Conclusion The cooperation among countries, institutions, and authors in this field should be strengthened. In addition, the health benefits of light physical activity, interventions for QoL, trajectory and direction of the relationship between psychological distress and QoL may be the focus of future research.
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Affiliation(s)
- Xiaoqin Wang
- Department of Pediatrics, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- School of Nursing, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Caihua Wang
- School of Nursing, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Wenjin Han
- School of Nursing, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Jiaru Sun
- School of Nursing, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Zhaozhao Hui
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Shuangyan Lei
- Department of Radiotherapy, Shaanxi Cancer Hospital, Xi'an, China
| | - Huili Wu
- Department of Oncology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xiaohong Liu
- Department of Pediatrics, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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Sjövall A, Lagergren P, Johar A, Buchli C. Quality of life and patient reported symptoms after colorectal cancer in a Swedish population. Colorectal Dis 2023; 25:191-201. [PMID: 36097801 DOI: 10.1111/codi.16332] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 08/30/2022] [Accepted: 09/02/2022] [Indexed: 02/08/2023]
Abstract
AIM A proportion of patients treated for colorectal cancer have impaired quality of life (QoL) but it is uncertain if the level of QoL differs from the corresponding background population. This population-based cohort study aimed to evaluate health-related QoL in colorectal cancer patients and compare their QoL with that of a Swedish reference population. METHODS Patients who underwent surgery for colorectal cancer Stages I-III in the Stockholm-Gotland region in 2013-2015 received the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and the QLQ-CR29 questionnaires and the low anterior resection syndrome score, 1 year after surgery. Patient and tumour data were collected from the Swedish Colorectal Cancer Registry. The patient cohort was matched to a Swedish reference population regarding EORTC QLQ-C30. Global QoL was compared to the reference population and a patient group with impaired QoL was defined. Detailed patient-reported outcomes were analysed in relation to global QoL in the patient cohort. RESULTS A total of 925 patients returned the questionnaires and 358 patients (38.70%) reported a clinically relevant impaired global QoL compared to the reference population. Patients with impaired QoL reported clinically relevant and statistically significantly more complaints regarding bowel habits, pain and anxiety. After adjustment for sex, age and stoma, anxiety was the strongest predictor for impaired QoL, with OR 6.797 (95% CI 4.677-9.879). CONCLUSION A substantial proportion of patients treated for colorectal cancer have impaired global QoL. This impairment is strongly associated with several physical symptoms and anxiety.
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Affiliation(s)
- Annika Sjövall
- Department of Pelvic Cancer, GI Oncology and Colorectal Surgery Unit, Karolinska University Hospital, Stockholm, Sweden.,Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Pernilla Lagergren
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Surgery and Cancer, Imperial College London, London, UK
| | - Asif Johar
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Christian Buchli
- Department of Pelvic Cancer, GI Oncology and Colorectal Surgery Unit, Karolinska University Hospital, Stockholm, Sweden.,Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
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Bibi S, Edilbe MW, Rao C. The Cost-effectiveness of Watch and Wait for Rectal Cancer. Clin Oncol (R Coll Radiol) 2023; 35:132-137. [PMID: 36266161 DOI: 10.1016/j.clon.2022.10.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 08/25/2022] [Accepted: 10/03/2022] [Indexed: 01/18/2023]
Abstract
The existing literature suggests with a high degree of certainty that watch and wait is more cost-effective than initial total mesorectal excision. However, it is heavily reliant on poor-quality health-related quality of life data. Furthermore, the cost-effectiveness of organ preservation from a broader societal perspective has not been studied. Finally, the cost-effectiveness of emerging adjuncts to watch and wait for organ preservation, such as contact X-ray brachytherapy, local excision and total neoadjuvant therapy, need to be characterised.
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Affiliation(s)
- S Bibi
- The Department of Colorectal Surgery, North Cumbria Integrated Care NHS Foundation Trust, Carlisle, UK
| | - M W Edilbe
- The Department of Colorectal Surgery, North Cumbria Integrated Care NHS Foundation Trust, Carlisle, UK; The Academic Surgical Unit, North Cumbria Integrated Care NHS Foundation Trust, Carlisle, UK
| | - C Rao
- The Academic Surgical Unit, North Cumbria Integrated Care NHS Foundation Trust, Carlisle, UK; The Department of Surgery and Cancer, Imperial College, London, UK.
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Sritan S. Factors contributing to the quality of life among Thai patients diagnosed with colorectal cancer with a stoma: An integrative review. J Adv Nurs 2023; 79:1-14. [PMID: 36226808 DOI: 10.1111/jan.15460] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 09/13/2022] [Accepted: 10/01/2022] [Indexed: 12/15/2022]
Abstract
AIM To appraise and synthesize research investigating the factors contributing to the quality of life (QOL) among Thai patients diagnosed with colorectal cancer (CRC) with a stoma. DESIGN An integrative review. DATA SOURCES The scientific databases CINAHL, Medline, PubMed, Web of Science, Google Scholar and ThaiJO were queried for English or Thai research articles published between 2011 and 2021. REVIEW METHODS Included studies were searched utilizing the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) reporting guidelines. The eligible studies were critically appraised by evaluating the study level and quality using the John Hopkins Research Evidence Appraisal Tool. Whittemore and Knafl's five-stage framework was used to guide this integrative review. Primary data from each suitable study were abstracted, coded and categorized into sub-themes. Finally, themes were identified based on the review question and objective. RESULTS Eight articles met the inclusion criteria. Twelve sub-themes and five significant themes were identified: Sociodemographic and clinical, physiological, psychological, social and spiritual aspects. CONCLUSION Factors contributing to QOL among Thai CRC ostomates can be categorized into five domains. The sociodemographic and clinical, physiological and psychological aspects are similar to those in other countries. In the meanwhile, the social and spiritual domains differ from those in other countries, particularly in extended family support and Buddhist belief. IMPACT By providing the QOL contributing factors, nurses can investigate the significant QOL predictors and create the appropriate interventions for promoting QOL, specifically among Thai CRC adults with a stoma. Likewise, it will be helpful to integrate this result into the nursing curriculum in Thailand and other similar countries to teach nursing students who could give direct holistic care to CRC adults with a stoma. In addition, it will serve as the basis for healthcare policy regarding nursing practice guidelines for assessing the individuals' QOL factors and promoting QOL activities after ostomy surgery. Patient or Public contribution: The ostomy nurses in Thailand are involved in the data analysis stage. They read all the included studies before the meeting. They considered and commented on the generating and synthesizing of codes, subthemes and themes.
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Affiliation(s)
- Sarawut Sritan
- Susan and Alan Solomont School of Nursing, Lowell, Massachusetts, USA.,Boromarajonani College of Nursing Phra-Phutthabat, Faculty of Nursing, Praboromarajchanok Institute, Nonthaburi, Thailand
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The Quality of Life of Patients with Surgically Treated Colorectal Cancer: A Narrative Review. J Clin Med 2022; 11:jcm11206211. [PMID: 36294531 PMCID: PMC9604858 DOI: 10.3390/jcm11206211] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/14/2022] [Accepted: 10/18/2022] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Quality of life is a topic increasingly being addressed by researchers. Due to the increasing incidence of colorectal cancer, this issue is particularly relevant. Despite the increasing number of publications on this topic each year, it still requires further research. The aim of this study was to analyze the available literature from the past 10 years, addressing the topic of QoL in patients with colorectal cancer which has been treated surgically. MATERIAL AND METHODS This review is based on 93 articles published between 2012 and 2022. It analyzes the impact of socioeconomic factors, the location and stage of the tumor, stoma and the method of surgical treatment on patients' QoL and sexual functioning. RESULTS CRC has a negative impact on patients' financial status, social functioning, pain and physical functioning. Patients with stage II or III cancer have an overall lower QoL than patients with stage I. The more proximally the lesion is located to the sphincters, the greater the negative impact on the QoL. There was a significant difference in favor of laparoscopic surgery compared with open surgery. In patients with a stoma, the QoL is lower compared with patients with preserved gastrointestinal tract continuity. The more time has passed since surgery, the more the presence of a stoma has a negative impact on QoL. Surgery for CRC negatively affects patients' sex lives, especially in younger people and among men. CONCLUSIONS This study may contribute to the identification of the factors that affect the QoL of patients with surgically treated colorectal cancer. This will allow even more effective and complete treatment, facilitating patients' return to normal physical, mental and social functioning.
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Queiroz ST, Costa VVL, Cunha RR, Araujo MDS, Silva AFD, Barros KS, Dias LDNM, Barreto JTT, Amaral MPDC. FOOD CONSUMPTION OF MACRONUTRIENTS AND NUTRITIONAL STATUS OF PEOPLE WITH OSTOMY. ESTIMA 2022. [DOI: 10.30886/estima.v20.1224_in] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective: To evaluate the food intake of macronutrients and nutritional status of people with ostomy in the Amazonian context. Method: Quantitative cross-sectional study carried out in the specialized reference unit for people with ostomy, in the period from January to March 2020. The sample consisted of 77 people with ostomies, aged 21 to 88 years old, of both genders. We used sociodemographic information, clinical and behavioral aspects, anthropometric measurements and 24-hour recall. Statistical analysis was performed using BioEstat 5.0 and EpiInfo 3.5.1 software. Results: Most were male, aged between 35 and 50 years old. The most frequent types of ostomy were: colostomy (69%) and ileostomy (21%), with a temporary nature (43%), with neoplastic etiology in both sexes (60%). As for the nutritional status, most presented eutrophy according to the body mass index, but waist circumference showed increased metabolic risk in females, and the triceps skinfold thickness indicated excess adiposity in males (<0.0001). Regarding food consumption, there was inadequacy of energy and macronutrients. Conclusion: Eating habits in the Amazonian context may be related to inadequate food consumption and changes in nutritional status.
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Queiroz ST, Costa VVL, Cunha RR, Araujo MDS, Silva AFD, Barros KS, Dias LDNM, Barreto JTT, Amaral MPDC. CONSUMO ALIMENTAR DE MACRONUTRIENTES E ESTADO NUTRICIONAL DE PESSOAS COM ESTOMIA. ESTIMA 2022. [DOI: 10.30886/estima.v20.1224_pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objetivo:Avaliar o consumo alimentar de macronutrientes e o estado nutricional de pessoas com estomia no contexto amazônico. Método: Estudo transversal quantitativo realizado na unidade de referência especializada às pessoas com estomia, no período de janeiro a março de 2020. A amostra foi constituída de 77 pessoas com estomias, com idade de 21 a 88 anos, de ambos os sexos. Foram utilizados informações sociodemográficas, aspectos clínicos e comportamentais, medidas antropométricas e recordatório 24 h. A análise estatística foi realizada por meio dos softwares BioEstat 5.0 e EpiInfo 3.5.1. Resultados: A maioria era do sexo masculino, com faixa etária entre 35 e 50 anos. Os tipos mais frequentes de estomia foram: colostomia (69%) e ileostomia (21%), com caráter temporário (43%), tendo em ambos os sexos a etiologia neoplásica (60%). Quanto ao estado nutricional, a maioria apresentou eutrofia segundo o índice de massa corporal, no entanto a circunferência da cintura demonstrou risco metabólico aumentado no sexo feminino, e a prega cutânea tricipital indicou obesidade no sexo masculino e eutrofia no sexo feminino (<0,0001). Com relação ao consumo alimentar, observou-se inadequação de energia e de macronutrientes. Conclusão: Os hábitos alimentares no contexto amazônico podem estar relacionados ao consumo alimentar inadequado e às alterações no estado nutricional.
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Zhou XD, Wei HG, Ai FL. Biofeedback therapy combined with Baduanjin on quality of life and gastrointestinal hormone level in patients with colorectal cancer. World J Gastrointest Oncol 2022; 14:1187-1198. [PMID: 35949217 PMCID: PMC9244983 DOI: 10.4251/wjgo.v14.i6.1187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/15/2022] [Accepted: 05/17/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND With the change in people’s lifestyles, the incidence of colorectal cancer (CRC) is increasing. It is essential to study the efficacy of various treatment methods for CRC patients to prevent and treat CRC.
AIM To investigate the efficacy of biofeedback therapy combined with Baduanjin in improving the quality of life and gastrointestinal hormone levels of patients with CRC.
METHODS A total of 120 patients with CRC who were admitted to our hospital from June 2020 to June 2021 were included in the study. They were randomly divided into four groups (n = 30): the control group (group A), the biofeedback therapy intervention group (group B), the Baduanjin exercise intervention group (group C), and the combination group (group D). Patients in group A adopted the standard nursing mode and necessary health education. Patients in group B were treated with biofeedback therapy based on routine nursing care. Patients in group C were given Baduanjin intervention for 12 wk based on conventional drug treatment and care. Patients in group D were treated with biofeedback therapy and Baduanjin exercise. In this study, patients’ quality of life, gastrointestinal hormone levels, and clinical efficacy in the four groups were observed at baseline and 12 wk after intervention. Meanwhile, the correlation between gastrointestinal hormone levels and various functional areas of quality of life was analyzed. By comparing the observed indicators of patients in the four groups, the efficacy of biofeedback therapy combined with Baduanjin in improving the quality of life and gastrointestinal hormone levels of patients with CRC was explored.
RESULTS At baseline, there were no significant differences in quality of life, gastrointestinal hormone levels, or clinical efficacy among the four groups (P > 0.05). Twelve weeks after the intervention, the combination group’s quality of life, gastrointestinal hormone levels, and clinical effectiveness were better than those of the three other groups.
CONCLUSION On the basis of routine nursing care, patients with CRC combined with biofeedback therapy and Baduanjin exercise can improve the quality of life of patients with CRC and the efficacy of gastrointestinal hormone levels.
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Affiliation(s)
- Xiao-Ding Zhou
- Graduate Work Department, Shenyang Sport University, Shenyang 110102, Liaoning Province, China
| | - Hong-Gang Wei
- Wushu and Dance Academy, Shenyang Sport University, Shenyang 110115, Liaoning Province, China
| | - Fu-Lu Ai
- Department of General Surgery, Liaoning Tumor Hospital, Shenyang 110042, Liaoning Province, China
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Neuberger L, Braude P, Weeks K, Braude P, Halliday R, McCarthy K, Carter B. A new stoma for an older person-An association with quality of life and physical function: A systematic review. J Am Geriatr Soc 2022; 70:2415-2425. [PMID: 35506939 DOI: 10.1111/jgs.17803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 02/22/2022] [Accepted: 03/12/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Older people are more likely to have a stoma postabdominal surgery than younger people. Few studies have examined the effect of a stoma on older people. The aim of this review was to explore the effect of a stoma on functional independence of an older person. We explored secondary outcomes of poststoma formation length of hospital stay, quality of life and factors affecting stroma independence. METHODS An exploratory systematic review was developed by our multidisciplinary group including an expert patient, colorectal surgeon, stoma nurse, physiotherapist, geriatrician, and methodologist. Four databases were searched including studies with participants 60 years old or older, who had undergone abdominal surgery for any pathology resulting in an abdominal stoma. RESULTS We identified 857 studies, of which we included 25 in the final review incorporating 6972 participants (average age 67.4 years). There was a strong association between presence of stoma and (1) worse physical function (standardized MD = 0.7; 95% CI 0.21-1.19; I2 = 95) and (2) worse quality of life (standardized MD = 1.61; 95% CI 0.5-2.72, I2 = 98). The same effect was seen in fecal ostomy and urinary diversion. Few studies measured stoma independence and only one examined factors affecting this. No studies examined length of stay. CONCLUSIONS Stoma have a negative association with the physical function and quality of life of older people. Future studies should focus on identifying modifiable factors that may affect physical function, quality of life, and stoma independence.
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Affiliation(s)
- Lydia Neuberger
- Medicine for Older People, CLARITY (Collaborative Ageing Research) Group, North Bristol NHS Trust, Bristol, UK
| | - Philip Braude
- Medicine for Older People, CLARITY (Collaborative Ageing Research) Group, North Bristol NHS Trust, Bristol, UK
| | - Kayleigh Weeks
- Medicine for Older People, CLARITY (Collaborative Ageing Research) Group, North Bristol NHS Trust, Bristol, UK
| | - Peter Braude
- Division of Women's Health, King's College London, London, UK
| | - Ruth Halliday
- Medicine for Older People, CLARITY (Collaborative Ageing Research) Group, North Bristol NHS Trust, Bristol, UK
| | - Kathryn McCarthy
- Medicine for Older People, CLARITY (Collaborative Ageing Research) Group, North Bristol NHS Trust, Bristol, UK
| | - Ben Carter
- Medicine for Older People, CLARITY (Collaborative Ageing Research) Group, North Bristol NHS Trust, Bristol, UK.,Biostatistics and Health informatics, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK.,Cochrane Skin Group, Evidence Based Dermatology, University of Nottingham, Nottingham, UK
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Khoo AM, Lau J, Loh X, Ng CW, Griva K, Tan K. Understanding the psychosocial impact of colorectal cancer on young-onset patients: A scoping review. Cancer Med 2022; 11:1688-1700. [PMID: 35150052 PMCID: PMC8986148 DOI: 10.1002/cam4.4575] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 12/09/2021] [Accepted: 01/10/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE The incidence of young-onset (<50 years) colorectal cancer (CRC) has been increasing internationally. The psychosocial experience of younger cancer patients is vastly different from older patients, especially in domains such as financial toxicity, body image, and sexual dysfunction. What is unknown is the cancer type-specific experience. The aim of the current scoping review was to examine (1) the psychosocial factors and/or outcomes associated with young-onset CRC and (2) other determinants that influences these outcomes. METHODS A systematic search was conducted on four databases (PubMed, CINAHL, Scopus and PsycINFO) from inception to December 2020 using key terms and combinations. Primary literature that examined the psychosocial (e.g., quality-of-life, emotional, social, sexual) impact of young-onset CRC were included. RESULTS A total of 1389 records were assessed by four reviewers, with a total of seven studies meeting inclusion criteria (n = 5 quantitative, n = 1 qualitative and n = 1 case series). All studies indicated there was significant psychosocial impact in younger CRC patients, including emotional impact, social impact, physical burden, sexual impact, work impact, unmet needs, financial impact and global quality of life. Three studies explored other determinants that influenced the psychosocial experience and found that socioeconomic background (e.g., being female, lower education), CRC treatment (e.g., chemotherapy) and health status were associated with worse psychosocial impact. CONCLUSIONS Young-onset CRC patients face severe psychosocial impact unique to this age group, such as self-image and sexual impact. Social support services and resources needs to be uniquely tailored. More empirical investigations are required to understand its long-term impact and influence of other psychosocial domains.
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Affiliation(s)
- Athena Ming‐Gui Khoo
- Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
| | - Jerrald Lau
- Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
- Saw Swee Hock School of Public HealthNational University of SingaporeSingaporeSingapore
| | - Xin‐Sheng Loh
- Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
| | - Celeste Wen‐Ting Ng
- Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
| | - Konstadina Griva
- Lee Kong Chian School of MedicineNanyang Technological UniversitySingaporeSingapore
| | - Ker‐Kan Tan
- Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
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Şengül T, Oflaz F, Odulozkaya B, Altunsoy M. Disgust and Its Effect on Quality of Life and Adjustment to Stoma in Individuals with Ileostomy and Colostomy. Florence Nightingale Hemsire Derg 2021; 29:303-311. [PMID: 34263220 PMCID: PMC9713999 DOI: 10.5152/fnjn.2021.20198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 02/18/2020] [Indexed: 01/01/2023] Open
Abstract
AIM This study aims to determine the effect of disgust sensitivity on the quality of life of patients with ileostomy and colostomy, and their adaptation to stoma. METHODS This study has a cross-sectional and correlational design. The sample consists of 167 patients being treated in a state hospital and a private foundation hospital, who meet the research inclusion criteria. The Patient Information Form, Disgust Sensitivity Scale, Ostomy Adjustment Inventory, and Ostomy Quality of Life Scale (OQLS) are used for data collection. Descriptive statistics, oneway analysis of variance (ANOVA), t-test, and correlation analysis are used in data analysis. RESULTS Of the 86% of the participants diagnosed with cancer, 60% had undergone ileostomy and 40% had undergone a colostomy; 46% of the patients declared that they were capable of handling their own stoma care and 53% stated that they felt self-efficient about care. Participants who were female (88.55 ± 23.17), single (88.40 ± 20.98), or university graduates (93.34 ± 22.92) had higher disgust sensitivity scores. The study found no significant correlation between disgust sensitivity, quality of life, and stoma adjustment scores (p > .05). CONCLUSION The findings proved believe that recognizing the disgust sensitivity will help meet the physical and psychological needs of stoma patients and understand their quality of life and adjustment to stoma. This will help in guiding both patients and healthcare workers, and lead clinical studies.
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Affiliation(s)
- Tuba Şengül
- Department of Fundamental Nursing, Koç University, Faculty of Nursing, İstanbul, Turkey,Corresponding Author: Tuba Şengül E-mail: or
| | - Fahriye Oflaz
- Department of Psychiatric and Mental Health Nursing, Koç University, Faculty of Nursing, İstanbul, Turkey
| | - Birgül Odulozkaya
- Stoma and Wound Care Nurse, Bakırköy Dr. Sadi Konuk Training Research Hospital, İstanbul, Turkey
| | - Meral Altunsoy
- Stoma and Wound Care Nurse, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey
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GÜL A, AYGİN D. Stomalı Hastalarda Dini Ritüeller. İSTANBUL GELIŞIM ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2021. [DOI: 10.38079/igusabder.937111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Yu S, Tang Y. Effects of comprehensive care on psychological emotions, postoperative rehabilitation and complications of colorectal cancer patients after colostomy. Am J Transl Res 2021; 13:6889-6896. [PMID: 34306440 PMCID: PMC8290652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 02/06/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE This study aimed to explore the impacts of comprehensive care on psychological emotion, postoperative rehabilitation and complications of colorectal cancer patients after colostomy. METHODS From August 2018 to February 2020, a total of sixty colorectal cancer patients undergoing colostomy in our hospital were collected and randomly assigned to a control group to receive conventional care and a research group to receive comprehensive care, with 30 patients in each group. The two groups of patients were compared for postoperative recovery, complications, adverse psychological emotions, self-care ability, quality of life, and nursing satisfaction. RESULTS The first time of exhaust, food intake and the recovery of bowel sound in the research group were markedly earlier than those in the control group. Besides, the research group had notably lower incidence of postoperative complications, lower self-anxiety scale (SAS) and self-depression scale (SDS) scores at discharge, and higher average self-care ability than the control group, as well as higher quality of life score and nursing satisfaction. CONCLUSION Comprehensive care intervention can promote postoperative recovery of colorectal cancer patients after colostomy, relieve their negative emotions, reduce postoperative complications, improve quality of life and nursing satisfaction, which are all important and make this type of care worthy of promotion in clinical practice.
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Affiliation(s)
- Saifen Yu
- Outpatient Office, The Fourth Hospital of ChangshaChangsha 410006, Hunan Province, China
| | - Yanping Tang
- General Surgery, The Fourth Hospital of ChangshaChangsha 410006, Hunan Province, China
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