Adults with a Permanent Ostomy: Quality of Life, Depression and Suicide

Background:  Ostomy surgery is a life changing event requiring self-management tasks to address the medical, behavioral, and emotional impact while adjusting to the ostomy. These tasks become more difficult with depression.  Quality of life measurement may help to elucidate the prevalence of co-morbid depression after ostomy surgery but earlier screening may lead to earlier treatment and help achieve progress toward healthier outcomes

Purpose:  To describe findings from a secondary analysis of data focusing on adults with a permanent ostomy, QOL and psychological support and/or concerns, including depression and suicide. 

Methods:  Using convenience sampling methods, 230 eligible participants  were invited to complete a voluntary, self-report survey of demographics and the City of Hope Quality of Life-Ostomy Questionnaire.  Descriptive statistics and quantitative data were entered and analyzed using SPSS.

Results:  Of the 140 participants who met inclusion criteria and provided data, the majority were Caucasian (134, 95.7 %) females (83, 59 %) with an ileostomy (86, 61.4 %).   Mean QOL was 7.56 (SD = 1.59, range 3.84 - 10).  When asked about psychological support/concerns, 51 (36.4 %) reported they were depressed after surgery; of these, 12 (8.6 %) reported suicidal thoughts or actions. Independent sample t tests showed that those who reported depression had low current QOL scores on all subscales and the total score and those who considered, or attempted, suicide reported lower QOL than those who did not.

Conclusion/Recommendations:
Mean QOL scores were similar to other QOL studies;  substantial number of respondents reported depression and suicidal ideation.  Patients with an ostomy may experience unrecognized depression.  WOC nurses are in an ideal position to screen for psychological distress, unrecognized depression and thoughts of suicide. Ongoing contact with a WOC nurse or other health care professional is essential to assist the individual to manage their chronic, long-term complex condition.