Rehabilitation and stoma care: addressing the psychological needs.

Stoma surgery may be required for many reasons. The circumstances in which intervention is required, with possible permanent changes to the patient's conventional body image and lifestyle, will influence psychological recovery (Borwell, 1997; Black, 2000). Within a diverse multicultural society, addressing the individual psychological problems of the effects of mutilating surgery due to acute/chronic illness can be particularly challenging for health professionals. This can be further compounded if the patient has a physical or mental disability. Stoma care nurses play a vital role in supporting the family of the patient as a whole. Communication is key, encouraging open and genuine dialogue. Listening to patient and family anxieties will facilitate family cohesion and support. Families and/or the significant other of the patient face levels of distress equal to that of the patient, and need to be included in our care package. Psychological adaptation and successful rehabilitation of the patient are potentially achievable by a structured and complete assessment, assisting further understanding of patient, family and social needs. However, existing or additional anxieties will only be revealed if nurses can overcome personal communication difficulties.