The influence of patient and caregiver depression on patient self-care and caregiver contribution to self-care in ostomy: A dyadic analysis.

AIMS AND OBJECTIVES: To explore the association between patient and caregiver depression and patient self-care and caregiver contribution to self-care in the context of ostomy care. BACKGROUND: Self-care is essential for ostomy patients and their caregivers. The ostomy self-care process can be considered a dyadic phenomenon in which the patient and the caregiver interact together and work as a team. The presence of depressive symptoms may limit the patient's ability to perform self-care and caregivers' abilities to engage in caregiving tasks. Research into the dyadic influence of depression on self-care behaviours from the perspective of ostomates and their caregivers is still in its infancy. DESIGN: Secondary analysis of a multicentre, cross-sectional study. The STROBE checklist was used to report the present study. METHODS: Patient-caregiver dyads were recruited from eight ostomy outpatient clinics from February 2017 to May 2018. Depression was assessed with the nine-item Patient Health Questionnaire in both patients and caregivers. Patient self-care was evaluated with the Ostomy Self-Care Index, and caregiver contribution to self-care was assessed with the Caregiver Contribution to Ostomy Self-Care Index. Both instruments measure the dimensions of maintenance, monitoring and management. The actor-partner interdependence model was performed for the dyadic analysis. RESULTS: In total, 252 patient-caregiver dyads (patients: 69.8% male, mean age 70.05; caregivers: 80.6% female, mean age 58.7) were enrolled. Patient depression was positively associated with caregiver contribution to self-care maintenance. Caregiver depression was negatively associated with self-care management. RELEVANCE TO CLINICAL PRACTICE: These findings add a better understanding of the reciprocal influence of dyadic depression on patient and caregiver contributions to self-care in ostomy contexts was found. Patient and caregiver depression influence patient self-care and caregiver contribution to self-care. Therefore, clinicians should assess and treat depression in both members of the dyad to improve self-care.

Caregiver contribution to self-care and its associated variables among caregivers of ostomy patients: Results of a cross-sectional study.

AIMS AND OBJECTIVES: To describe caregiver contribution (CC) to ostomy self-care and identify its associated variables among caregivers of ostomy patients. BACKGROUND: Self-care is essential for ostomy patients, but it can be difficult to perform. In these cases, caregivers play a key role in promoting self-care behaviours. So far, the CC to ostomy self-care has not been investigated thoroughly. DESIGN: This is a cross-sectional and multicentre study conducted at seven outpatient clinics of two Italian regions. METHODS: We recruited 252 caregivers between February 2017-May 2018. The Caregiver Contribution to Ostomy Self-Care Index (CC-OSCI) was used to measure CC to ostomy self-care. Three multivariable linear regression models were fitted to identify variables associated with CC dimensions (maintenance, monitoring and management). The STROBE checklist was used to report the present study. RESULTS: The sample (mean age = 58.73, SD = 13.98) was mostly female (80.60%), unemployed (58.70%) and resided with the patient (81.00%). Caregivers being employed and those declaring more hours of contribution per week were associated with a significantly lower contribution to self-care maintenance. Caregivers with lower levels of education and those residing with the patient were less likely to contribute to CC to self-care monitoring. Spousal caregivers and those with higher preparedness contributed significantly lower to CC to self-care management. CONCLUSIONS: We found a variety of sociodemographic factors associated with CC to ostomy self-care. RELEVANCE TO CLINICAL PRACTICE: Sociodemographic variables associated with CC to ostomy self-care can help clinicians develop more tailored educational interventions for caregivers who find their contribution challenging.

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

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. AIMS: To identify the sociodemographic and clinical characteristics of Italian ostomy patients and investigate their knowledge of stoma management. METHODS: A questionnaire was used to gather the sociodemographic and clinical data of 433 adult patients. Participants responded to a nine-item survey assessing their knowledge of stoma management. FINDINGS: Respondents reported having received extensive or adequate information in 64.4% of cases, and the remaining 35.6% reported receiving little or no information at any time. The health professional who imparted at least adequate information was a stoma nurse specialist in 32.1% of cases, usually during admission (24.0%) or before and during admission (19.6%). CONCLUSION: This study demonstrated that most patients received adequate information regarding the ostomy.

Describing self-care and its associated variables in ostomy patients.

AIMS: To describe self-care in ostomy patients, to identify socio-demographic and clinical variables associated with self-care and to identify the association between self-care self-efficacy and self-care over and above the variables associated with self-care. DESIGN: Longitudinal and multicentre study. Data were collected between February 2017-May 2018. METHODS: In this study, 523 ostomy patients were enrolled at baseline (T0) and 362 were followed-up after 6 months (T1). The Ostomy Self-Care Index was used to measure self-care maintenance, monitoring, management, and self-efficacy. Correlations between self-care dimensions and patient socio-demographic and clinical characteristics were performed with Pearson's or Spearman's correlations. Three separate two-step hierarchical regression analyses were performed to identify variables associated with self-care maintenance, monitoring, and management. RESULTS: Participants' mean age was 69 years (SD 12.4); 63.9% were male and most had enterostomies (38.8% colostomies, 29.3% ileostomies) and permanent ostomies (72.5%). Patients had adequate self-care maintenance and monitoring at T0 and T1, while they had lower self-care management and self-efficacy at baseline. Significant variables associated with better self-care maintenance and self-care monitoring were female gender, more information received during hospitalization and better autonomy in stoma management, while a better level of education was an additional variable associated with self-care monitoring. Self-care self-efficacy produced a significant increase in the explained variance of self-care maintenance and self-care monitoring. None of the selected variables were significantly associated with self-care management. CONCLUSION: Middle-high levels of self-care maintenance, monitoring, management, and self-efficacy were found. The variables associated with ostomy self-care and the role of self-care self-efficacy identified in this study can help in developing tailored nursing interventions. IMPACT: This study found specific variables associated with ostomy self-care which could contribute to guiding future interventions aimed at improving self-care in ostomy patients.