Joyce Pittman, APRN-BC, CWOCN, Clarian Health- Methodist Hospital, Wound/Ostomy FNP, 1701 Senate Blvd, Indianapolis, IN 46206, Susan Rawl, PhD, RN, School of Nursing, Indiana University Purdue University (IUPUI), Associate Professor, 1111 Middle Drive, Indianapolis, IN 46206, Marcia Grant, RN, DNSc, FAAN, City of Hope National Medical Center and Beckman Research, Director, Department of Nursing Research and Education, 1500 East Duarte Rd, Durante, CA 91010-3000, Clifford Ko, MD, VA Greater Los Angeles Healthcare System; UCLA, Staff Colorectal Surgeon; Assistant Professor, Los Angeles, CA, C. Max Schmidt, MD, PhD, Richard L. Roudebush VA Medical Center; Indiana University School of Medicine, Staff General Surgeon; Assistant Professor, Department of Biochemistry and Molecular Biology, Indianapolis, IN 46206, Christopher S. Wendel, M.S., Southern Arizona VA Health Care System, Biostatistician, Research Service Line, 3601 S 6th Ave, Tucson, AZ 85723, and Robert Krouse, MD, Southern Arizona VA Health Care System; University of Arizona, Staff General and Oncologic Surgeon; Professor, Tucson, AZ 85723.
Purpose: The purpose of this study was to describe the demographic factors
, clinical factors and quality of life variables related to ostomy complications (skin problems
, leakage and difficulty adjusting) in the veteran population.
Design: the original study employed a descriptive cross sectional study using a mixed method design. This secondary analysis utilized the quantitative data collected.
Setting and sample: The study was conducted at three VA sites. The sample included 239 veterans with intestinal ostomies.
Methodology: Instrument used for this study was the City of Hope Quality of Life: Ostomy instrument (mCOH-QOL-Ostomy). Demographic and medical history data was collected from the survey and from the VA health information system and Tumor Registry database. A self administered survey questionnaire (mCOH-QOL-Ostomy) was mailed to each participant. Analysis was performed using SPSS software and included descriptive analysis, t test, Chi-square analysis, ANOVA with Bonferroni correction, and logistic regression.
Results: Significant relationships were found between demographic factors such as age, income, partner status and employment and ostomy complications. Younger patients were more likely to have skin problems, leakage and more difficulty adjusting. Those patients that were employed had more difficulty adjusting to an ostomy and those with a partner had less. Significant relationships were also found between clinical factors of abdominal stoma site marking, education, ostomy type, reason for ostomy, and time since surgery. All four domains of quality of life variables (physical, psychological, social, and spiritual) were found to be significantly related to ostomy complications (skin problems, leakage and difficulty adjusting). We also found that the ostomy complications of skin problems, leakage and difficulty adjusting were predictors of QOL for the individual with an ostomy. Conclusions: Demographic and clinical factors are potential risk factors that may possibly be altered and interventions developed to decrease the development of ostomy complications and therefore improve QOL.
