Abstract
Objective
This research is a descriptive study and was conducted to assess problems of stoma patients they face at home in accordance with “Model of Living”.
Methods
The research was carried out in a hospital in İstanbul. The sample of the study consisted of 70 patients who underwent stoma surgery in the surgical clinics of this hospital between 2013 and 2014. Data were collected through the “Individual Characteristics Form” and the “Daily Living Activities Form”. The analysis of the research was done using descriptive statistical methods, Pearson chi-square test and Fisher exact test.
Results
The average age of the participants was 57.1 (21-87), half of them were women, 77.1% were married and 87.1% were primary school graduates. In addition, it was determined that 70% of the participants had a stoma due to colorectal cancer and a similar rate had a stoma for a temporary period. Problems experienced by patients in daily living activities include regulating nutrition (64%), restricting liquids and food (51%), changing clothing style (54%), leaking from the stoma bag (62%), skin problems (63%), psychological breakdown (70%) and disruption of sleep patterns (64%).
Conclusion
It was determined that the life model was effective in determining the problems of patients with stoma because it was based on the experiences of all healthy or sick individuals, and that the daily living activities of the patients in the study were affected due to stoma and they experienced many problems at home. According to the results obtained, our recommendations are to monitor stoma patients and their families at home and to repeat training on life with a stoma.
Keywords: Stoma, activities of daily living, life model
References
Ayaz S. Stomalı Bireylerde Hemşirenin Rolü. Türkiye Klinikleri. J Med Sci. 2007; 27(1): 86-90.
Akgün EZ, Yoldaş T. Intestinal stoma. Turk J Colorectal Dis. 2012; 22(4): 133-46.
Burch J. Back to basics: How to care for different types of stoma. Nursing&Residential Care. 2013; 15(10): 662-5.
Vural F, Erol F. Ostomili hastalarda yaşam kalitesi nasıl yükseltilir? DEUHYO ED. 2013; 6(1): 34-9.
Mahjoubi B, Mohammadsadeghi H, Mohammadipour M, Mirzaei R, Moini R. Evaluation of psychiatric illness in Iranian stoma patients. J Psychosom Res. 2009; 66(3): 249-53.
Baldwin CM, Grant M, Wendel C, Hornbrook MC, Herrinton LJ, McMullen C, et al. Gender differences in sleep disruption and fatigue on quality of life among persons with ostomies. J Clin Sleep Med. 2009; 5(4): 335-43.
Grant M, McMullen CK, Altschuler A, Mohler MJ, Hornbrook MC, Herrinton LJ, et al. Gender differences in quality of life among long-term colorectal cancer survivors with ostomies. Oncol Nurs Forum. 2011; 38(5): 587-96.
Akbulut G. Nutrition in stoma patients: A practical view of dietary therapy. Uluslararası Hematoloji-Onkoloji Dergisi. 2011; 27(4): 61-66.
Altuntas YE, Kement M, Gezen C, Eker HH, Aydin H, Sahin F, et al. The role of group education on quality of life in patients with a stoma. Eur J Cancer Care (Engl). 2012; 21(6): 776-81.
Anaraki F, Vafaie M, Behboo R, Esmaeilpour S, Safaee A. Clinical profile and post-operative life style changes in cancer and non-cancer patients with ostomy. Gastroenterol Hepatol Bed Bench. 2012; 5(Suppl 1): 26-30.
Sun V, Grant M, McMullen CK, Altschuler A, Mohler MJ, Hornbrook MC, et al. Surviving colorectal cancer: long-term, persistent ostomy-specific concerns and adaptations. J Wound Ostomy Continence Nurs. 2013; 40(1): 61-72.
Barreto APCP, Valença MP. The ostomy patient’s sexuality: integrative review. Journal of Nursing. 2013; 7(7): 4935-43.
Karaveli S, Özbayır T, Karacabay K. Kolorektal kanser ameliyatı geçiren hastaların ameliyat öncesi ve ameliyat sonrası dönemde yaşadıkları deneyimlerin incelenmesi. Journal of Anatolia Nursing and Health Sciences. 2014; 17(2): 90-6.
Martins LM, Sonobe HM, Vieira Fde S, De Oliveira MS, Lenza Nde F, Da Silva Teles AA. Rehabilitation of individuals with intestinal ostomy. Br J Nurs. 2015; 24(22): S4,6,8 passim.
Sasaki VDM, Teles AADS, Silva NM, Russo TMDS, Pantoni LA, Aguiar JC, et al. Self-care of people with intestinal ostomy: beyond the procedural towards rehabilitation. Rev Bras Enferm. 2021; 74(1): e20200088. (English, Portuguese).
Borwell B. Rehabilitation and stoma care: Addressing the psychological needs. Br J Nurs. 2009; 18(4): 20-5.
Özşaker E, Yeşilyaprak T. The problems of patients with stoma and its effects on daily living activities. Medical Science and Discovery. 2018; 5(12): 393-8.
Kaya N. Yaşam Modeli. Babadağ, K, Aştı T. Eds. Hemşirelik esasları uygulama rehberi. İstanbul: İstanbul Medikal Yayıncılık Ltd. Şti; 2008. p. 1-7.
Büyükyılmaz F, Şendir M. Nursing care of bowel elimination problems in surgical patients. Maltepe Üniversitesi Hemşirelik Bilim ve Sanatı Dergisi. 2009; 2: 74-81.
Köşgeroğlu N, Mert S. Yaşam aktivitelerine dayalı hemşirelik modeli (YADHM)’ne göre zihinsel engelli bireylerin sorunları ve hemşirelik. Maltepe Üniversitesi Hemşirelik Bilim ve Sanatı Dergisi. 2011; 4(1): 148-54.
Açıkgöz G, İbrahimoğlu Ö. Preoperative and postoperative nursing care based on the model of daily living activities of a patient with type-a aortic dissection: a case report. Turk J Card Nur. 2019; 10(22): 87-95.
Roper N, Logan W, Tiernay A. VII. The future. Theory development : a blueprint for the 21st century / Afaf I. Meleis. In: Walker PH, Neuman BM, Eds. Blueprint for use of nursing models: education, research, practice, and administration. 1st Edition. Washington: NLN Press; 1996. p. 289.
Velioğlu P. Hemşirelikte kavram ve kuramlar. 1st Edition. İstanbul: Esen Ofset; 2012. p. 364-89.
de la Quintana Jimenez P, Pastor Juan C, Prados Herrero I, Perez Lopez C, Gonzalez Fuentes M, de Mena Casaseca C, et al. A prospective, longitudinal, multicenter, cohort quality-of-life evaluation of an ıntensive follow-up program for patients with a stoma. Ostomy Wound Manag. 2010; 56(5): 44-52.
Sarkar, S. Quality of life outcomes in patients with colostomy and ileostomy, with reference to psychosocial problems and surgical complications. J Evol Med Dent Sci. 2018; 7(49): 5292-7.
Üstündağ H, Demir N, Zengin N, Gül A. Stomalı hastalarda beden imajı ve benlik saygısı. Turkiye Klinikleri J Med Sci. 2007; 27: 522-7.
Kara B, Aslan FE. Stomalı bireylerin evde ilk gün deneyimlerinin incelenmesi. Turkish Journal of Colorectal Disease. 2017; 27(4): 117-25.
Lynch BM, Hawkes AL, Steginga SK, Leggett B, Aitken JF. Stoma surgery for colorectal cancer: A population‐based study of patient concerns. Journal of Wound Ostomy&Continence Nursing. 2008; 35(4): 424-8.
Iqbal F, Kujan O, Bowley DM, Keighley MR, Vaizey CJ. Quality of life after ostomy surgery in Muslim patients: a systematic review of the literature and suggestions for clinical practice. J Wound Ostomy Continence Nurs. 2016; 43(4): 385-91.
Zewude WC, Derese T, Suga Y, Teklewold B. Quality of life in patients living with stoma. Ethiop J Health Sci. 2021; 31(5): 993-1000.
Dabirian A, Yaghmaei F, Rassouli M, Tafreshi MZ. Quality of life in ostomy patients: a qualitative study. Patient Prefer Adherence. 2010; 5: 1-5.
Çevik B, Uğurlu Z, Abbasoğlu A, Karahan A, Saltan Ç. Ostomili bireylerin ostomiye uyumlarının ve etkileyen faktörlerin belirlenmesi. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi. 2020; 7(3): 186-95.
Repić G, Ivanović S. Physical dimension of quality of life in ostomy patients. Acta Medica Medianae. 2014; 53(3): 32-8.
Anaraki F, Vafaie M, Behboo R, Maghsoodi N, Esmaeilpour S, Safaee A. Quality of life outcomes in patients living with stoma. Indian J Palliat Care. 2012; 18(3): 176-80.
Richbourg L, Thorpe JM, Rapp CG. Difficulties experienced by the ostomate after hospital discharge. J Wound Ostomy Continence Nurs. 2007; 34(1): 70-9.
Gray M, Colwell JC, Doughty D, Goldberg M, Hoeflok J, Manson A, et al. Peristomal moisture–associated skin damage in adults with fecal ostomies: a comprehensive review and consensus. J Wound Ostomy Continence Nurs. 2013; 40(4): 389-99.
Persson E, Hellström AL. Experiences of swedish men and women 6 to 12 weeks after ostomy surgery. J Wound Ostomy Continence Nurs. 2002; 29(2): 103-8.
Varma S. A healthy lifestyle for the ostomist in relation to exercise. Br J Nurs. 2009; 18(6): 18-22.
Engel J, Kerr J, Schlesinger-Raab A, Eckel R, Sauer H, Hölzel D. Quality of life in rectal cancer patients: a four-year prospective study. Ann Surg. 2003; 238(2): 203-13.
Çakmak A, Aylaz G, Kuzu AM. Permanent stoma not only affects patients’ quality of life but also that of their spouses. World J Surg. 2010; 34(12): 2872-6.
Kaya Ö, Aygin D. Effects of stoma on sexual life. Androl Bul. 2020; 22: 194-8.
Vorbeck E, Willette-Murphy K, Meiers S, Rudel R, Alakhras M. A descriptive, interventional study to assess the impact of surgical stomas on individuals’ sleep perceptions and response to sleep hygiene intervention. Ostomy Wound Manage. 2010; 56(1): 36-44.

