Linda McKenna, RN, BSN, CWOCN, Memorial Medical Center, Clinical Nurse IV, Member of Memorial Ostomy & Wound Services, Springfield, IL, Elizabeth Taggart, RN, BSN, CWOCN, Memorial Medical Center, Clinical Nurse III, Member of Memorial Ostomy & Wound Services, Springfield, IL, Joyce Stoelting, RN-C, ADN, CWS, Memorial Medical Center, Clinical Nurse IV, staff nurse and member of Memorial Ostomy & Wound Services, Springfield, IL, Carol Midiri, RN, CWS, Memorial Medical Center, Staff Nurse, Springfield, IL, Tammy Berry, RN, Memorial Medical Center, Clinical Nurse III, Staff nurse, Springfield, IL, Rosalie Mottar, RN, BS, Memorial Medical Center, Nurse Manager, Burn Center and Memorial Ostomy & Wound Services, Springfield, IL, Geri Kirkbride, RN, MSN, PhD(c), Memorial Medical Center, Research Nurse Facilitator, Nursing Research and Academic Partnerships, Springfield, IL, Kay Gaehle, RN, PhD, Southern Illinois University Edwardsville, Assistant Professor of Nursing, Edwardsville, IL, Gordon B. Forbes, PhD, Milikin University-Department of Behavorial Sciences, Statistician, Decatur, IL and Imran Hassan, MD, Southern Illinois University School of Medicine, Assistant Professor, Division of General Surgery, Springfield, IL
BACKGROUND: The Certified Wound Ostomy Continence Nurse (CWOCN) role includes pre-surgical markings for stoma placement. There is a dearth of research on stoma site marking by a CWOCN and quality of life outcomes. The purpose of this study was to determine if patients who receive preoperative stoma markings by a CWOCN have a higher quality of life postoperatively than patients who were not marked. The
Self-Regulation Theory of Coping (Johnson, 1999) guided this study.
METHODS: This IRB approved study, conducted in a 507 bed Midwest Magnet® designated teaching hospital, used a quasi-experimental design. Convenience sampling was used to enroll consented post-operative patients (N=59) who had experienced a fecal stoma, during an 18 month period between 2008 and 2010. Inclusion criteria were cognitively intact, English speaking individuals with no previous abdominal stoma. The experimental group (n=35) received pre-operative marking by a CWOCN and control group (n=24) did not receive pre-operative marking. Three validated tools were used. The Stoma Quality of Life, (Prieto et al, 2005) measured quality of life; the Life Orientation Test-Revised (Scheier et al, 1994) measured pessimism/optimism; and the State Trait Anxiety Tool (Spielberger,1983) measured anxiety. Data collection occurred at two distinct points; within 72 hours prior to discharge (Stoma –QOL) and 8 weeks after discharge (Stoma-QOL, the LOT-R, and the STAI).
RESULTS: Data analysis, using ANCOVA to control for age, demonstrated that QOL was significantly improved in the marked group compared to the un-marked group (F=4.9, p=.031). At time one, patients who were anxious had a lower QOL (r = - .32, p =<.013) and increased optimism was associated with increased QOL (r = .44, p = .001). However, no significant correlations were found between anxiety and optimism-pessimism for either group at time two.
CONCLUSION: Findings illuminate the CWOCNs’ important contribution in improving patient outcomes.
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