The Relationship Between Health Utility, Quality of Life, and Peristomal Skin Condition

Introduction: Quantifying an individual’s health and well-being commonly involves two metrics; health utility and quality of life. For individuals with a stoma these are often influenced by limitations imposed by health burdens and a perception of what is possible. For the ostomate, a common health burden is comprised peristomal skin. 

Aim: It was the objective of this study to explore the relationship between health utility and quality of life when influenced by four levels of peristomal skin condition.  These are normal skin (intact), and mildly, moderately and severely compromised skin; where compromised peristomal skin is a health stressor common to this population.

Methods: The data is derived from randomly sampling within proprietary ostomy databases in the US, Canada, and UK, resulting in a sample size of 3,146.

The survey measured health utility (SF6D¹) and included a visual analog scale for the determination of QoL.

Results: The analysis of data found that when peristomal skin complications increased (increasingly compromised) that health utility and QOL decreased. The data indicates a statistically significant and moderately strong correlation between health utility and QoL (r=0.601, p<0.001).  As health utility decreased this was accompanied by decreases in the number of quality adjusted life days per month experienced by the ostomate.

Conclusions: The degree of peristomal skin integrity is associated with the health and well-being of the ostomate as demonstrated through the metrics of health utility and QoL. The clinician should be aware of this as peristomal skin problems are indicated as more than dermatologic issues.