4753 Pouch/appliance discretion and concealment. Importance for the ostomate and products to meet their needs

Patricia Black, M.Sc, RGN, RCNT, FETC, Dip, N , The Hillingdon Hospital NHS Trust, Consultant Nurse, Coloproctology, Uxbridge, Middlesex, UB8 3NN, United Kingdom
Caroline Rudoni , Stoma Care Department, St. Georges Healthcare Trust, Stoma Care Nurse, London, United Kingdom
Teresa Williams , Milton Keynes General Hospital, Stoma Care Nurse Specialist, Milton Keynes, MK6 5LD, United Kingdom
Julie Hemingway , The Leeds General Infirmary, Stoma Care Nurse Specialist, Leeds, United Kingdom
Thomas Nichols, M.S., MBA , Hollister Incorporated, Senior Principal Clinical Research Statistician, Libertyville, IL
Vigdis Hannestad , Dansac A/S, Global Clinical Services Manager, Fredensborg, Denmark
Background: Often ostomates describe a loss of identity, dignity, privacy and independence following ostomy surgery due to a compromised confidence in themselves. Living with a stoma, there are two main factors at stake; convenience and dignity. Convenience should be understood as something which provides ease and comfort to habits and practice. Dignity is more complicated. People with stomas loose the ability to control their bowels; a pouching system is a continual reminder of this, which is often equated as a loss of dignity and being stigmatized from people and society around them.
Purpose /Objective: Appliance discretion is more than product concealment; it is also the ability to unobtrusively function during daily activities.  The new generation ostomy products are intended to improve discretion, comfort and easy positioning. Visibility is a key component of discretion as ostomates may be concerned that the ostomy pouch is apparent to others. A recent study1 indicates that as many as 54 percent of ostomates occasionally or always will worry about the pouch being noticeable to others.  
Method: Multi site, un-blinded, historically controlled assessment of a new 1 piece product.
Results and Discussion: In a recently completed study assessing a redesigned pouch with lower headspace, an off centered starter hole, and redesigned integrated closure intended to improve discretion and comfort as well as enable the ostomate greater freedom to choose clothes and activities that reflect their lifestyle, 72 percent of study subjects were satisfied that the pouch design met its intended purpose; to be less noticeable under clothing,  and 76 percent agreed that it was less noticeable than their current pouch.    
Conclusion: The new pouches were well accepted with the majority subjects and with the additional benefit of improved discretion, the new pouch improve self-confidence and quality of life of those with ostomies.
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