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Purpose: Colorectal cancer (CRC) patients requiring intestinal stomas (ostomies) face many obstacles to coping with their new ostomy. It is imperative to design an intervention to help patients adjust after this procedure.
Methods: Two large mixed-methods studies examining health-related quality of life (HRQOL) for 1) veteran and 2) community CRC survivors were undertaken. Phase 1 was a survey comparing ostomates (n = 523) and those who had similar procedures without ostomies (n = 667). Phase 2 was focus groups with ostomates who had high or low HRQOL to better understand coping skills and barriers. Statistics for surveys included regression analysis and standard methods were used for qualitative data.
Results: Many HRQOL issues for ostomates were noted on the survey study, including continued problems with ostomy supplies, dietary function, and intimacy. Focus groups further defined these problems along with recommendations from ostomates. The intervention that was developed is based on the Chronic Care model to be led by an Ostomy Nurse. The program includes multiple sessions focusing on self-care, psychosocial adjustment, and promoting a healthy lifestyle. In addition, there will be the opportunity for patients to discuss issues amongst themselves to promote confidence and acceptance of their stoma. The program includes peer “buddy” ostomates who will be a reference to patients throughout the program. They will participate in each session as well as be available for ongoing concerns of each study participant. Finally, there is also a session for caregivers focusing on the many issues to help them through this process.
Conclusion: The HRQOL-enhancing ostomy self-management intervention for CRC survivors is an innovative program based on extensive background data from two large mixed-methods studies. It is likely to help new CRC survivors cope and adjust more quickly to their ostomy.
Methods: Two large mixed-methods studies examining health-related quality of life (HRQOL) for 1) veteran and 2) community CRC survivors were undertaken. Phase 1 was a survey comparing ostomates (n = 523) and those who had similar procedures without ostomies (n = 667). Phase 2 was focus groups with ostomates who had high or low HRQOL to better understand coping skills and barriers. Statistics for surveys included regression analysis and standard methods were used for qualitative data.
Results: Many HRQOL issues for ostomates were noted on the survey study, including continued problems with ostomy supplies, dietary function, and intimacy. Focus groups further defined these problems along with recommendations from ostomates. The intervention that was developed is based on the Chronic Care model to be led by an Ostomy Nurse. The program includes multiple sessions focusing on self-care, psychosocial adjustment, and promoting a healthy lifestyle. In addition, there will be the opportunity for patients to discuss issues amongst themselves to promote confidence and acceptance of their stoma. The program includes peer “buddy” ostomates who will be a reference to patients throughout the program. They will participate in each session as well as be available for ongoing concerns of each study participant. Finally, there is also a session for caregivers focusing on the many issues to help them through this process.
Conclusion: The HRQOL-enhancing ostomy self-management intervention for CRC survivors is an innovative program based on extensive background data from two large mixed-methods studies. It is likely to help new CRC survivors cope and adjust more quickly to their ostomy.