Ming-Hui Yan1, Lin Lv, Mei-Chun Zheng, Ying Jin, Jun-E Zhang. 1. Author Affiliations: School of Nursing, Sun Yat-sen University, Guangzhou (Mr Yan, Ms Jin, Dr Zhang); Wound and Ostomy Care Center, Gansu Province People's Hospital, Lanzhou (Ms Lv); and Department of Colorectal Surgery, Cancer Centre, Sun Yat-sen University, Guangzhou, China (Ms Zheng).
Abstract
BACKGROUND: Colorectal cancer is one of the most common cancers worldwide. Although colostomies are necessary for disease treatment, they unavoidably affect patient quality of life (QOL), especially in the early postoperative stage. OBJECTIVE: The aim of this study was to investigate the dynamic changes and factors influencing QOL among Chinese patients with permanent colostomy. METHODS: We investigated 74 patients before discharge and at 1 and 3 months after discharge. Instruments included the Quality of Life Questionnaire for People With Ostomy-Chinese version, Stoma Self-efficacy Scale, Stoma Self-care Scale-Early Stage Version, and a demographic and stoma-related information questionnaire. RESULTS: The average QOL increased significantly after discharge (P < .01). Multivariate linear regression showed that the influencing factor of QOL was self-efficacy (before discharge, explained 22.9% of the variance); self-efficacy, truth-telling, average time of stoma care, communicating with friends with colostomy, and family relationship (1 month after discharge, explained 48.8% of the variance); and self-efficacy, body image loss, and participating in activities of patients with colostomy (3 months after discharge, explained 85.2% of the variance). CONCLUSIONS: Clinicians need to give attention to improving the QOL of colostomy patients especially 1 month after discharge. Interventions aimed at improving self-efficacy, preoperative education regarding the surgery, colostomy care ability, family relationship, stoma self-acceptance, and involvement in activities of friends with colostomy should be considered to improve QOL among Chinese patients in this setting. IMPLICATIONS FOR PRACTICE: Transitional care should be provided for colostomy patients especially 1 month after discharge. Interventions should focus on enhancing self-efficacy, stoma self-management, and social-environmental support.
BACKGROUND: Colorectal cancer is one of the most common cancers worldwide. Although colostomies are necessary for disease treatment, they unavoidably affect patient quality of life (QOL), especially in the early postoperative stage. OBJECTIVE: The aim of this study was to investigate the dynamic changes and factors influencing QOL among Chinese patients with permanent colostomy. METHODS: We investigated 74 patients before discharge and at 1 and 3 months after discharge. Instruments included the Quality of Life Questionnaire for People With Ostomy-Chinese version, Stoma Self-efficacy Scale, Stoma Self-care Scale-Early Stage Version, and a demographic and stoma-related information questionnaire. RESULTS: The average QOL increased significantly after discharge (P < .01). Multivariate linear regression showed that the influencing factor of QOL was self-efficacy (before discharge, explained 22.9% of the variance); self-efficacy, truth-telling, average time of stoma care, communicating with friends with colostomy, and family relationship (1 month after discharge, explained 48.8% of the variance); and self-efficacy, body image loss, and participating in activities of patients with colostomy (3 months after discharge, explained 85.2% of the variance). CONCLUSIONS: Clinicians need to give attention to improving the QOL of colostomy patients especially 1 month after discharge. Interventions aimed at improving self-efficacy, preoperative education regarding the surgery, colostomy care ability, family relationship, stoma self-acceptance, and involvement in activities of friends with colostomy should be considered to improve QOL among Chinese patients in this setting. IMPLICATIONS FOR PRACTICE: Transitional care should be provided for colostomy patients especially 1 month after discharge. Interventions should focus on enhancing self-efficacy, stoma self-management, and social-environmental support.