Does Resilience Predict Ostomy Adjustment in Patients With Permanent Ostomy?

PURPOSE: This study aimed to evaluate associations between resilience and ostomy adjustment in a group of patients with a permanent ostomy. DESIGN: Descriptive, correlational study. SUBJECTS AND SETTING: One hundred participants were interviewed; most were male (N = 56; 56%), married (N = 77; 77%), illiterate (N = 46; 46%), and self-employed (N = 35; 35%). The most frequent condition leading to ostomy surgery was colorectal cancer (N = 24; 24%). A majority (N = 43; 43%) had been diagnosed with cancer 1 to 5 years before data collection, and 35 (35%) had lived with an ostomy for 1 to 5 years. Participants were recruited from an ostomy clinic of in Kerman, located in southeastern Iran. Data were collected from August to October 2019. METHODS: Data were collected via interviews. A questionnaire, developed for purposes of this study, was developed that included items querying demographic and pertinent clinical characteristics and 2 validated instruments, the Resilience Scale and the Ostomy Adjustment Inventory-23 (OAI-23). Data were analyzed using t tests, analysis of variance, Pearson correlation coefficient, and linear regression. RESULTS: The mean score for ostomy adjustment was 43.37 (SD = 11.57) indicating less than optimal adjustment to life with an ostomy. The mean score of the Resilience Scale was 104.56 (SD = 25.98); most participants (n = 67, 67%) had very low and low resilience. Resilience was weakly associated with ostomy adjustment; specifically, participants who scored higher on the Resilience Scale tended to score higher on the OAI-23 (r = 0.32, P = .006). Linear regression indicated that resilience had the greatest predictive effect on ostomy adjustment (P = .004). CONCLUSIONS: Results suggest that higher levels of resilience may facilitate adjustment to a permanent ostomy. Findings indicate that nurses should design and implement programs to aid ostomy adjustment via resilience assessment.

Studying the effect of structured ostomy care training on quality of life and anxiety of patients with permanent ostomy.

Patients with ostomy are faced with several physical, psychological, and social challenges and need to be prepared to overcome these challenges. Studies have shown that training plays an important role in helping patients to adapt with ostomy, live with it, and improve their psychological well-being and quality of life (QOL). Therefore, the present study aimed to determine the effect of structured ostomy care training on QOL and anxiety of the patients with permanent ostomy. In this randomised clinical trial study, 60 eligible participants were recruited from the only ostomy clinic in Kerman, Iran. They were selected using a purposive sampling method and randomly assigned to either a control group that received routine ostomy care or an intervention group that attended oral and practical training and a question and answer session by a trained ostomy nurse and received an ostomy information booklet besides their routine care. Outcome variables were anxiety and QOL in general and its physical, mental, social, and spiritual dimensions in detail. By using the anxiety subscale of Hospital Anxiety and Depression Scale (HADS) and City of Hope-quality of life [COH-QOL], data were collected before and 2 months after intervention in both groups. Data were analysed by SPSS version 19 using χ², analysis of variance (ANOVA), independent t, and paired t test and multiple regression analysis. The results showed that the intervention group had significantly lower mean scores in anxiety (P = .001) and a higher mean score in overall QOL (P = .009) compared with the control group. The most significant increase was observed for psychological, social, and physical aspects, and the least was in the spiritual aspect, all of which improved after intervention. After controlling the effects of confounding variables such as age, ostomy period, and number of children, the structured training programme still had a positive effect on QOL. Structured ostomy care training, including face-to-face education and personal practice of using ostomy equipment, along with written material provided by the ostomy nurse specialist, may lead to an increase in the overall QOL and a decrease in the perceived anxiety level in patients. This type of training is not routinely delivered to ostomy patients in our health care setting, so it is feasible to prepare surgical wards and to educate nurses to work with their patients before and after ostomy creation. Furthermore, to ease patients' religious concerns, we recommend counselling, and the support of religious leaders in the Muslim community may play a key role to adaptation regarding religious matters after ostomy surgeries and alleviate patients' concerns.