QUALITY of LIFE of Colostomy PATIENTS IN the STATE of Amazonas: PRELIMINARY RESULTS

Although ostomy is a life-saving therapeutic procedure,¹ it has a major impact on an individual’s self-esteem and body-image, compromising quality of life (QOL). The aim of this study was to characterize the colostomy patients in the state of Amazonas according to sociodemographic and clinical variables, while also taking into account age, sex, marital status, job and employment status, and time since colostomy, and determine associations between variables and how they affect QOL. This was a cross-sectional, descriptive correlational study, which is part of the only program of assistance to the ostomy patient in the state of Amazonas. The sample consisted of  patients aged 18 years and older, with colostomy for more than 3 month.The study was approved by the Research Ethic Committee.  Ferrans and Powers Quality of Life Index (QLI), generic version III was used to assess the QOL. The QLI questionnaire has 33 items grouped into 4 subscales: Health and functioning (HF), socioeconomic (SE), psychological/spiritual (PS) and family (Fa). The scores range from 0 to 30, with higher scores indicating better QOL. Descriptive and inferential statistical tests (Wilcox-Shapiro test for normality at 95% confidence level, Analysis of Variance (ANOVA), and Spearman’s correlation coefficient) were used for data analysis. Results: Fifty-eight colostomy patients (96.6%) were from the city of Manaus, had a mean age of 48.7 (SD, 16.8; range, 18-88) years; 51.7% of the patients were females, 50% did not complete elementary school, 58.6% had a domestic partner, and 25% were retired. Colostomy was located on the left in 74% of the patients. Cancer (n=30, 51.7%) and trauma (n=13, 24.1%) were the main reasons for colostomy; the mean time since colostomy was 38.7 (SD, 39.8; range 3-204) months. Fifty percent of the patients (n=29) had colostomy complications (prolapsed colostomy, 34.5%; hernia, 27.6%), and 27.8% had skin problems (dermatitis, 75%). With regard to QOL, the scores for total QLI, HF, SE, PS and Fa were 23.7(SD, 3.5); 23.2 (SD, 3.9); 22.8 (SD, 4.7); 26.2 (SD, 4.4) and 24.5 (SD, 5.1), respectively. Most of the patients had good (n=21, 36%) and very good (n=33, 56%) QLI.⁵ Women reported higher scores for total QLI (p=0.004) and PS (p=0.004); patients with domestic partners reported higher Fa scores (p=0.001); patients without a job had lower total QLI (p=0.013), HF (p=0.23) and SE (p=0.010) scores. The patients with skin complications had lower Fa (p=0.035) scores. Older patients had higher total QLI (p=0.035, r=0.239) and PE (p=0.003, r=0.359) scores. Time since colostomy affected negatively total QLI (p=0.024; r=-0.299) and PE (p=0.032; r=-0.249) scores. Conclusion: There was a predominance of patients from the city of Manaus, who were adult females, with colostomy on the left, with the presence of prolapsed colostomy and hernia, and time since cancer surgery of about 3 years. QLI was satisfactory, especially for women, older patients who had a domestic partner, who worked, had a shorter time since colostomy and no skin complications.  Not having a job, except family, was the factor that most compromised all QLI subscales.