Ostomy Autonomy: Using an Anatomical Apron for Visual Instruction

Effective patient rehabilitation following ostomy surgery is dependent on the understanding and mastery of self-care, and mastering self-care depends on the efficacy and consistency of quality patient teaching. Unfortunately, with shortened hospital stays, movement to rehab facilities, and dependency on other healthcare modalities, the overall quality, quantity and consistency of patient teaching becomes fragmented and leads to poor outcomes for patients. Other factors such as anxiety about disease processes or surgery, pain, or the realization that an ostomy appliance will be worn indefinitely can negatively impact their ability to learn and retain new knowledge. For many patients without adequate instruction and mastery of self-care, frustration, psychological and physical problems, and further hospitalization will follow. Therefore it is imperative that patients understand and grasp the concepts and skills of pre- and post-ostomy surgery care so that effective self-care can be readily achieved and positive patient outcomes realized. However, teaching these skills can be both time-consuming and nurse-intensive so effective teaching strategies must be structured for the patient learner. Of the many strategies for teaching and learning, all agree that retention of the learned material increases when tactile and visual models are used as an adjunct to verbal instruction. Hands-on, visual devices encourage a patient to become an active participant in the learning process, stimulate retention of knowledge, plant visual images in the mind for instant recall, and promote overall patient growth towards ostomy autonomy. The anatomical apron, a physical/tactile/visual ostomy model, is a very effective visual teaching strategy that enables patients to visualize the physical and physiological revisions that take place both inside and outside the body when ostomy surgery occurs. It stimulates important questions during teaching sessions and moves patients to a higher degree of understanding and closer to ostomy autonomy.