PURPOSE: Conventional practice in colorectal surgery involves stoma education being imparted postoperatively. Proficiency in stoma management often delays patients' discharge following colorectal surgery. The aim of this randomized, controlled trial was to compare preoperative intensive, community-based stoma education with conventional postoperative stoma educationafter elective colorectal surgery. METHODS:Forty-two elective colorectal patients requiring a stoma were randomized into an intensive preoperative teaching (study) or postoperative (control) group. Intervention for the study group included two preoperative visits in the community during which patients were taught with audiovisual aids to use and change the stoma pouching system. Goal-directed postoperative stoma education was standardized for both groups. Outcomes measured included time to stoma proficiency, postoperative hospital stay, unplanned stoma-related interventions in the community within six weeks of discharge, and preoperative and postoperative hospital anxiety and depression scores. Cost-effectiveness of the intervention was also evaluated. RESULTS: All outcomes measured were improved in the study group, including time to stoma proficiency (5.5 vs. 9 days; P = 0.0005), hospital stay (8 vs. 10 days; P = 0.029), and unplanned stoma-related community interventions per patient (median 0 vs. 0.5; P = 0.0309). No adverse effects of the intervention were noted. The average cost saving per patient was pound 1,119 (dollar 2,104) for the study group compared with the control group. CONCLUSIONS: Stoma education is more effective if undertaken in the preoperative setting. It results in shorter times to stoma proficiency and earlier discharge from the hospital. It also reduces stoma-related interventions in the community and has no adverse effects on patient well-being.
RCT Entities:
PURPOSE: Conventional practice in colorectal surgery involves stoma education being imparted postoperatively. Proficiency in stoma management often delays patients' discharge following colorectal surgery. The aim of this randomized, controlled trial was to compare preoperative intensive, community-based stoma education with conventional postoperative stoma education after elective colorectal surgery. METHODS: Forty-two elective colorectal patients requiring a stoma were randomized into an intensive preoperative teaching (study) or postoperative (control) group. Intervention for the study group included two preoperative visits in the community during which patients were taught with audiovisual aids to use and change the stoma pouching system. Goal-directed postoperative stoma education was standardized for both groups. Outcomes measured included time to stoma proficiency, postoperative hospital stay, unplanned stoma-related interventions in the community within six weeks of discharge, and preoperative and postoperative hospital anxiety and depression scores. Cost-effectiveness of the intervention was also evaluated. RESULTS: All outcomes measured were improved in the study group, including time to stoma proficiency (5.5 vs. 9 days; P = 0.0005), hospital stay (8 vs. 10 days; P = 0.029), and unplanned stoma-related community interventions per patient (median 0 vs. 0.5; P = 0.0309). No adverse effects of the intervention were noted. The average cost saving per patient was pound 1,119 (dollar 2,104) for the study group compared with the control group. CONCLUSIONS: Stoma education is more effective if undertaken in the preoperative setting. It results in shorter times to stoma proficiency and earlier discharge from the hospital. It also reduces stoma-related interventions in the community and has no adverse effects on patient well-being.
Authors: Amir Elhassan; Ihab Elhassan; Amjad Elhassan; Krish D Sekar; Ryan E Rubin; Richard D Urman; Elyse M Cornett; Alan David Kaye Journal: Curr Pain Headache Rep Date: 2019-03-11
Authors: Joseph C Carmichael; Deborah S Keller; Gabriele Baldini; Liliana Bordeianou; Eric Weiss; Lawrence Lee; Marylise Boutros; James McClane; Scott R Steele; Liane S Feldman Journal: Surg Endosc Date: 2017-08-03 Impact factor: 4.584
Authors: Wassim Kassouf; Armen Aprikian; Peter Black; Girish Kulkarni; Jonathan Izawa; Libni Eapen; Adrian Fairey; Alan So; Scott North; Ricardo Rendon; Srikala S Sridhar; Tarik Alam; Fadi Brimo; Normand Blais; Chris Booth; Joseph Chin; Peter Chung; Darrel Drachenberg; Yves Fradet; Michael Jewett; Ron Moore; Chris Morash; Bobby Shayegan; Geoffrey Gotto; Neil Fleshner; Fred Saad; D Robert Siemens Journal: Can Urol Assoc J Date: 2016-02-08 Impact factor: 1.862