Topic: Long-term adjustment to an incontinent ostomy Purpose: To identify factors associated with long-term adjustment to an incontinent ostomy Methodology: A 64-item survey of factors associated with ostomy adjustment (SFOA) was developed using literature review, clinical experience, and a Needs theory. Long-term ostomy adjustment was measured using the Ostomy Adjustment Scale (OAS, 34-items). The surveys, demographics form, and $5 gift certificate were mailed to 200 ostomates of either the WOC nurse principal investigator or local United Ostomy Association chapter members. Associations between individual items from the SFOA and demographic form and the total OAS score were assessed using correlations or t-tests, then a multiple linear regression analysis was conducted, alpha=.05. Results: The survey response was 74%. Respondents were 52% female, 98% Caucasian, 74% married, and mean(SD) age=65(14) years. 54% of respondents had ileostomies, 27% colostomies, and 14% urostomies. The mean(SD) OAS score of all respondents=157.4(32). Factors associated with lower OAS scores (poorer adjustment) were distress over affording (rho=-.16, p= .05) or obtaining (rho=-.25, p = .002) ostomy supplies. Having more education from a WOC nurse was associated with higher OAS scores (rho=.28, p=.006). Respondents with ongoing/recurrent illness had a higher mean(SD) OAS score (171(19)) than those who did not (152(34)). Multivariate analysis showed significantly poorer adjustment with a parastomal hernia or surgeon other than a colorectal or general, better adjustment with ongoing/recurrent illness (all p<.05). Conclusions: Most respondents reported good long-term adjustment to ostomy surgery but a parastomal hernia, lessened adjustment. Patients with ongoing/recurrent illness may view their ostomy as contributing to extending their survival. There appears to be a patient benefit from the specialty expertise of a colorectal or general surgeon.