Marcia Grant1, Virginia Sun2, Nancy J Tallman3, Christopher S Wendel4, Ruth McCorkle5, Elizabeth Ercolano5, Christie Simons4, Julia Mo6, Sabreen Raza6, Deborah Donahue7, Frank Passero7, Joshua Henson8, Lyn MacDougall8, Jonathan Friedlaender9, Pamela Pitcher9, Dan Fry7, Pete Yonsetto10, Michael J Holcomb10, Mark C Hornbrook11, Ronald S Weinstein10, Robert S Krouse12. 1. Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, CA, USA. marciagrant113@gmail.com. 2. Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, CA, USA. 3. Unaffilated, Wound, Ostomy, and Continence Nurse, Tucson, AZ, USA. 4. University of Arizona, Tucson, AZ, USA. 5. School of Nursing and School of Public Health, Yale University, New Haven, CT, USA. 6. University of Pennsylvania, Philadelphia, PA, USA. 7. , Patient Stakeholder, Philadelphia, PA, USA. 8. , Patient Stakeholder, Duarte, CA, USA. 9. , Patient Stakeholder, New Haven, CT, USA. 10. Arizona Telemedicine Program, University of Arizona, Tucson, AZ, USA. 11. Kaiser Permanente Center for Health Research, Portland, OR, USA. 12. Perelman School of Medicine, University of Pennsylvania and the Corporal Michael J Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA.
Abstract
OBJECTIVES: An ostomy results in lifelong quality of life changes for a cancer survivor. We describe the greatest challenges reported from a randomized trial of cancer survivors with stomas (ostomies). METHODS: Cancer survivors with ostomies participating in a multi-site randomized prospective trial of an Ostomy Self-Management Telehealth (OSMT) program versus usual care (UC) were surveyed at six months post accrual. An open-ended question requested greatest challenges after ostomy surgery. Quantitative descriptive and qualitative analyses were used to examine greatest challenges reported. RESULTS: A total of 118 trial participants identified greatest challenges with 55 in the OSMT and 63 in the UC. Six conceptual domains were used to code comments-physical, psychological, social, and spiritual quality of life; ostomy-specific issues, and healthcare issues. The OSMT contributed 187 comments, and UC contributed 235 comments. Ostomy specific issues and social well-being had the most comments overall with UC contributing more comments in all domains except physical well-being. Word Clouds revealed post-operative and treatment-related issues and going out in public as the most common challenges in both groups. Word Clouds compared types of ostomies revealing bowel function challenges (colostomy group), difficulties going out in public (ileostomy group), and positive support (urostomy group). CONCLUSIONS: Fewer challenges submitted by the OSMT group provide the beginning evidence of the OSMT program impact. Dominant challenges across both groups were social well-being and ostomy care. Challenges varied by type of ostomy. Findings support long-term care and support for all cancer survivors with ostomies. TRIAL REGISTRATION: NCT02974634.
OBJECTIVES: An ostomy results in lifelong quality of life changes for a cancer survivor. We describe the greatest challenges reported from a randomized trial of cancer survivors with stomas (ostomies). METHODS: Cancer survivors with ostomies participating in a multi-site randomized prospective trial of an Ostomy Self-Management Telehealth (OSMT) program versus usual care (UC) were surveyed at six months post accrual. An open-ended question requested greatest challenges after ostomy surgery. Quantitative descriptive and qualitative analyses were used to examine greatest challenges reported. RESULTS: A total of 118 trial participants identified greatest challenges with 55 in the OSMT and 63 in the UC. Six conceptual domains were used to code comments-physical, psychological, social, and spiritual quality of life; ostomy-specific issues, and healthcare issues. The OSMT contributed 187 comments, and UC contributed 235 comments. Ostomy specific issues and social well-being had the most comments overall with UC contributing more comments in all domains except physical well-being. Word Clouds revealed post-operative and treatment-related issues and going out in public as the most common challenges in both groups. Word Clouds compared types of ostomies revealing bowel function challenges (colostomy group), difficulties going out in public (ileostomy group), and positive support (urostomy group). CONCLUSIONS: Fewer challenges submitted by the OSMT group provide the beginning evidence of the OSMT program impact. Dominant challenges across both groups were social well-being and ostomy care. Challenges varied by type of ostomy. Findings support long-term care and support for all cancer survivors with ostomies. TRIAL REGISTRATION: NCT02974634.
Authors: Carmit K McMullen; Mark C Hornbrook; Marcia Grant; Carol M Baldwin; Christopher S Wendel; M Jane Mohler; Andrea Altschuler; Michelle Ramirez; Robert S Krouse Journal: J Support Oncol Date: 2008-04