Background: An increasing number of patients worldwide are living with an ostomy. Among them, self-care management skills and stoma self-care abilities are associated with better quality of life. A...

Sociodemographic characteristics and self-care management knowledge of patients with an ostomy.

Background: Quality of life (QOL) and self-care efficacy especially for patients with permanent stoma are importance. Addressing knowledge and self-care practice and their relationship with QOL is needed especially for patients in different age groups. This would serve as a base for developing a culturally competent educational intervention for these specific population.  The aim of present study was to assess the level of knowledge and self-care practice for patients with permanent stoma and its effect on their QOL and self-care efficacy. Methods: A descriptive correlational cross-sectional design was utilized to collect data from Clinical Oncology and Nuclear Medicine Department and its relevant outpatient's clinic of Tanta Main University Hospital and Outpatient's Clinic of General Surgical Department of Emergency Hospital at Tanta University . A convenience sampling of 140 adults and adolescents’ patients with permanent stoma were interviewed. The study questionnaire included a self-reported checklist that include sociodemographic data, knowledge of stoma and stoma self-care practice that was developed by the researchers.  A modified version of the Stoma Quality of Life Scale (SQOL) and Stoma self - Efficacy Scale were also utilized. Results: Majority of the adolescents were males, singles and in age group 16 to 21.  The main cause of stoma among adolescents was cancer, 90% had the operation within 6 months and 57% reported having difficulty with self-care.  Regarding adults, 67% were in age group 31 to 60, 50% were married males, 47% were university graduates with a majority were working.   Causes of stoma were mainly abdominal trauma, 46% were smokers, 57% had the operation within 6 months and 43% reported having difficulty with self-care. Two thirds of adolescents and 41% of adults reported fair level of knowledge of stoma definition, causes, types, complication and risks. More than half of the adolescents reported fair knowledge and more than one third reported good knowledge regarding stoma pouch, appliance for stoma, criteria of changing pouch of stoma.  Fifty-eight percent of the adults reported good knowledge and 27% reported fair knowledge regarding same item.  64% of the adolescents and 50% of adults reported fair knowledge of diet, fluids and activity.  Knowledge of self-care practice was presented as fair among 50% of the adolescents and 43% of adults. Meanwhile, good level of knowledge was reported among 52.9% of adults and 28.6% of adolescents for the same item. Total QOL and all subscales except for sexual aspect were reported as fair with statistically significant association between both groups. Self-care efficacy was negative among majority adolescents and positive among most of the adults. Conclusion and recommendations: The current study provided an evidence of unsatisfactory level of knowledge and self-care practice among adolescents and adults patients with permanent stoma.  Quality of life and self-efficacy were also alarming. There is a need for culturally competent intervention with larger sample and qualitative methods of research to deeply explain this area. Keywords: Stoma, self- Care, quality of life, self-care efficacy, adult, adolescent. DOI : 10.7176/JHMN/60-13 Publication date :March 31 st 2019

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Self- Care Knowledge and Practice for Patients with Permanent Stoma and their Effect on Their Quality of Life and Self Care Efficacy

Background: Colostomy is a stoma which is formed after removing the large bowel or colon and is opening in the abdominal wall that’s made during surgery. The care of patients with colostomy is a complex, challenging and lengthy process .The nurse can play a clinically relevant role in the care of patient undergoing ostomy surgery pre and post-operative education. Aim of the study: to evaluate effect of educational program on nurses' performance about colostomy care. Subjects &Methods: Research design: a quasi-experimental design was utilized to fulfill the purpose of this study.  Sample: Randomized sample conducted on 40 nurses caring for patient with colostomy .Setting:  two setting:  1st setting at Oncology Center &2ndsetting at Minia University Hospital. Tools: Two tools were used for data collection: First Tool: included two parts: part I: socio demographic data sheet for the nurses, part II: structured knowledge questionnaire second tool: observational checklist about colostomy care. Results: Reveled that the mean age of study sample was 32.95 ± 3.65, the majority (85%) of the studied sample had low knowledge before educational program implementation while, after 3 months of program implementation the majority (85%) had a good knowledge about colostomy care. Also all of study sample had weak performance before educational program implementation while, in post immediately of program implementation more than half of studied sample (52.5%) had accepted performance and after 3 months the majority of them had a good performance about colostomy care. Also, there was a highly statistically significant difference in nurses' knowledge and practice pre & post immediately and after 3 months educational program regarding colostomy care. Conclusion: The study concluded that, there was a positive effect of the educational program in improving nurses' knowledge and practices regarding colostomy care. Recommendations: Greater attention and closely observation from hospital on nurses′ performance during care for patient with colostomy and replication of the study should be done on a large sample.

https://msnj.journals.ekb.eg/article_188050_bd32d50ef14666b2991bd0d190464ad6.pdf

Effect of Educational Program on Nurses Performance about Colostomy Care

The aim of the study was to evaluate the effectiveness of self-management program on the patients’ knowledge and practice regarding stoma care. Methods: A purposeful sample consisted of 90 adults with stoma was examined. A pre/post quasi-experimental research design was followed. The setting: The general surgery department and adult surgery outpatient Clinic in Damietta University Hospital. Data collection tools included a structured interview questionnaire (demographic data of patients, their medical history, and their knowledge about stoma), and an observational checklist to assess the patients’ practices regarding stoma care. In addition to a self-management program. Results: The mean age of the studied adults was 47.9± years. Two-thirds of participants were males (65 %) and educated ( 67 %). About two thirds of them (63 %) had bowel cancer, and the majority (94 %) had no family history of stoma. There was a highly significant difference in the patients’ levels of knowledge in pre/immediate, post, and after one month of discharge (P<0.001). There was a highly significant improvement in the patients’ level of practice regarding procedures of stoma care in pre/immediate, post, and after one month of discharge (P<0.001). Conclusions: The studied adult patients’ knowledge and practice regarding stoma care significantly improved after exposure to the self-management program. Recommendations: Adult patients with stoma should receive adequate and continuous education regarding ostomy self-care, lifestyle changes, and self-efficacy. Medical and surgical nurse should provide the adult patient with adequate knowledge, and training about stoma care.

https://asnj.journals.ekb.eg/article_140695_26893e139197fe1aa300d57edb4cd32c.pdf

Effect of Self-Management Program on the Patient’ Knowledge and Practice Regarding Stoma Care

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Identification of Areas of Patient Need Using the Cancer Support Source Program

Background : There are more than 1 million patients with a permanent colostomy and the number is increasing by the rate of 100 000 per year. Clients with a new stoma must master multiple psychomotor skills to remove their pouch, clean the stoma and peristomal skin and empty and dispose of effluent from the pouch. Stoma care self-efficacy has been positively related to ostomy adjustment. Objective : To assess knowledge and practice of stoma care among ostomates. Method : This is a simple descriptive cross sectional study. A total of 94 ostomates who met eligible criteria were purposively sampled. Stoma self care efficacy scale and semi-structured questionnaire was used and face to face interview was done. Data were analyzed using SPSS version 16 program. T test was used to see the mean difference. Result : The knowledge of ostomates on normal stoma and complication of stoma was adequate (61.7%). Majority (92.6%) respondents had good daily care practice like emptying pouch, hand washing before and after procedure and cleaning stoma. Majority of the ostomates suffered from physical problem (89.4%). Of which maximum 72.3% had peristomal skin irritation, then came leakage and odour. More than half (64.9%) of ostomates had higher efficacy. Conclusion : On the basis of findings, it is concluded that there was significant difference in mean knowledge of ostomates with variables pre-operative teaching, training on stoma care, living with stoma for more than 12 months. There was significant difference in mean self care efficacy with variables duration of living with stoma and training on stoma care. Thus training on stoma care should be provided frequently to further improve self care efficacy. Journal of Nobel College of Medicine Vol.4(1) 2015: 36-45

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Knowledge and Practice of Stoma Care among Ostomates at B.P.Koirala Memorial Cancer Hospital

This research entitled “Quality of Life of Patients Undergoing Cancer Treatment in B.P. Koirala Memorial Cancer Hospital, Bharatpur, Chitwan” was conducted to assess the quality of life of cancer patients. It was carried out among patients attending B. P. Koirala Memorial Cancer Hospital, Bharatpur, Chitwan. Background: In patients with different type of cancers and the quality of life (QoL) improvement is the main goal, since survival can be prolonged marginally. A diagnosis is very stressful for people, affecting all aspects of their being and quality of life. Up to date, knowledge on QoL impairments throughout the entire treatment process, often including several treatment modalities is scarce. One objective of this study was to assess the quality of life of cancer patient undergoing cancer treatment. Methods: A quantitative, cross-sectional, descriptive, design was adapted. A total of 245 cancer patients above 20 years old, were enrolled in the studies during August-September, 2013. Inclusion criteria were patients who had already received at least one type of cancer treatment and had attended the hospital for receiving the same or next type of treatment again. Exclusion criteria were any other chronic co-morbidity condition that could be influenced their QoL. The most commonly listed medical co-morbidities were: diabetes mellitus, hypertension, coronary artery disease. Cancer patients who have Eastern Co-operative Oncology Group (ECOG) performance status of 4 (i.e. fully bed-ridden) were excluded from the study. The data was collected by interview, using modified, structured scale of European Organization for Research and Treatment of Cancer Quality of life Questionnaire (EORTC QLQ- C30), prepared by the EORTC group. Information about the patient’s disease condition and treatment were obtained from the patient’s medical records. The collected data was analyzed by using SPSS version 16. Descriptive and inferential statistics were used to describe the respondent’s quality of life (QoL) scores and to identify the factors affecting it respectively. Results: The study findings revealed the quality of life of cancer patients to be influenced by many factors such as: site of cancer, stage of cancer, time elapsed since diagnosis and Eastern Co-operative Oncology Group (ECOG) performance status. The average QoL scores (out of 100) for different scales were 85.54 (global health/QoL), 77.03 (functional), and 16.14 (symptom). Loss of appetite was the most frequent complaint (mean = 20.27) and was present in almost all the patients. As the overall QoL of the patients was significantly correlated with different QoL scales as-, cognitive, emotional, physical, social, role functioning, pain, fatigue, dyspnoea, loss of appetite and nausea/vomiting and financial problem. Conclusion: Hence, in average, the quality of life of cancer patients was found to be relatively better, although there were higher ratings for some (as: cognitive, physical, role and emotional functioning) and lower for others (like social functioning). Additional research should be done in this area for improving the quality of life of specific type of cancer patients in Nepal, though the findings of this study are expected to provide the baseline knowledge regarding it.

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Govinda Prasad Dhungana

Papers

Knowledge and Practice of Stoma Care among Ostomates at B.P.Koirala Memorial Cancer Hospital

Quality of Life of Patients Undergoing Cancer Treatment in B.P. Koirala Memorial Cancer Hospital, Bharatpur, Chitwan, Nepal