Original Article

Promotion of bowel elimination ostomy self-care: A qualitative study based on the nurses' and patients’ perspectives

Abstract

Background & Aim: The construction of an ostomy has a physical, psychological, and social impact, requiring the need to adapt. The way this event is experienced is influenced by several factors, namely ostomy self-care competence, the aspect most referred to in the literature. Nurses' specific and systematic intervention positively influences the person's adaptation to the ostomy. This study aimed to describe the perception of nurses and people with ostomies about promoting ostomy self-care.
Methods & Materials: A qualitative descriptive study was conducted. Semi-structured interviews were conducted with ten nurses specializing in stoma therapy and twelve people with bowel elimination ostomy. Content analysis was performed according to Bardin with categorical analysis.
Results: Two themes emerged from the interviews: the promotion of awareness, with three categories and four sub-categories, and the promotion of ostomy self-care, with five categories and twenty-four sub-categories. In promoting awareness, the participants mentioned key contents that could be included in the nurse’s approach: assessing awareness, content for promoting awareness, and awareness indicators. Within the scope of promoting self-care, categories emerged, such as the intervention standardization, the contents, the methodologies, and the resources to promote self-care.
Conclusion: This study adds to evidence about promoting awareness of bowel elimination ostomy and self-care competence after the procedure. These results can be useful for nurses, allowing them to reflect on clinical practice and helping to improve the planning of their intervention in promoting stoma self-care.

1. International agency for research on cancer (2020) Cancer Tomorrow. In: Global Cancer Observatory. Available at: https://gco.iarc.fr/tomorrow/en. Accessed 29 Sep 2021.
2. Vonk-Klaassen SM, de Vocht HM, den Ouden ME, Eddes EH, Schuurmans MJ. Ostomy-related problems and their impact on quality of life of colorectal cancer ostomates: a systematic review. Quality of Life Research. 2016 Jan;25(1):125-33.
3. Sousa CF, Santos C, Graça LC. Construção e validação de uma escala de adaptação a ostomia de eliminação. [Construction and validation of an adaptation scale for elimination ostomy] Revista de Enfermagem Referência. 2015;4(4):21-30.
4. Millard R, Cooper D, Boyle MJ. Improving Self-Care Outcomes in Ostomy Patients via Education and Standardized Discharge Criteria. Home Healthcare Now. 2020 Jan 1;38(1):16-23.
5. Soares-Pinto IE, Queirós SM, Alves PJ, Carvalho TM, Santos CS, Brito MA. Nursing Interventions to Promote Self-Care in a Candidate for a Bowel Elimination Ostomy: Scoping Review. Aquichan. 2022 Mar;22(1):e2212.
6. Bird A. Mentioning the unmentionable: a stoma care nurse's journey to discussing sexuality comfortably with ostomates. Gastrointestinal Nursing. 2019 Apr 2;17(3):24-8.
7. Silva C, Sousa F, Lima J, Pinto M, Brito A, Cruz I. Living with an ileostomy: a case study on the transition process. Revista de Enfermagem Referência. 2017;4(Nº14):111-20.
8. Smith MC, Parker ME (2015) Nursing Theories and Nursing Practice, Fourth edição. F.A. Davis Company, Philadelphia, PA 9. Skivington K, Matthews L, Simpson SA, Craig P, Baird J, Blazeby JM, Boyd KA, Craig N, French DP, McIntosh E, Petticrew M. Framework for the development and evaluation of complex interventions: gap analysis, workshop and consultation-informed update. Health Technol Assess.2021; 25(57):1-132.
10. Ayaz‐Alkaya S. Overview of psychosocial problems in individuals with stoma: a review of literature. International Wound Journal. 2019 Feb;16(1):243-9.
11. Díaz CC, Zambrano SM, Muñoz BM, Crisol IS, Marfil MN, Montoya-Juárez R, Montoro CH. Stoma care nurses' perspectives on the relative significance of factors influencing ostomates' quality of life. Gastrointestinal Nursing. 2018 Apr 2;16(3):28-33.
12. Moeini M, Aghaei S, Akbari L, Shahriari M, Abbasi S. Evaluating the relation between spiritual attitude and the quality of life among ostomy patients referring to the public and private medical centers of Isfahan. Nursing Practice Today. 2018 Jan 13;5(1):228-34.
13. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care. 2007 Dec 1;19(6):349-57.
14. Polit DF, Beck CT. Fundamentos de pesquisa em enfermagem: avaliação de evidências para a prática da enfermagem. Artmed Editora; 2011.
15. Diário da República n.º 86/2019 (2019) Regulamento da Competência Acrescida Diferenciada e Avançada em Estomaterapia [Regulation of the competence differentiated and advanced in Stomatherapy].
16. World Medical Association (2013) World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. Journal of the American Medical Association 310:2191-4.
17. Bardin L (2015) Análise de Conteúdo [Content analysis], 1a edição. Edições 70, Lisboa
18. Meleis AI. Transitions theory: Middle range and situation specific theories in nursing research and practice. Springer publishing company; 2010 Feb 17.
19. Registered Nurses’ Association of Ontario (RNAO) (2019) Supporting Adults who Anticipate or Live with an Ostomy, 2nd ed. Toronto (ON): Registered Nurses’ Association of Ontario
20. Mota MS, Gomes GC, Petuco VM, Heck RM, Barros EJ, Gomes VL. Facilitators of the transition process for the self-care of the person with stoma: subsidies for Nursing. Revista da Escola de Enfermagem da USP. 2015 Jan;49:82-8.
21. Villa G, Mannarini M, Della Giovanna G, Marzo E, Manara DF, Vellone E. A literature review about self‐care on ostomy patients and their caregivers. International Journal of Urological Nursing. 2019 Jul;13(2):75-80.
22. Aranda S. Designing nursing interventions. Collegian. 2008;15(1):19-25.
23. Santos R, Fava SMCL, Dázio EMR. Self-care of elderly people with ostomy by colorectal cancer. Journal of Coloproctology. 2019; 39(3):265-73.
24. Pinto IES, Santos C, Brito A, Queirós S (2016) Psychometric Properties of the Form Development of Self-Care Competence of the Person with a Bowel Elimination Ostomy. IV Série:75-84
25. Semi H, Sambari SS, Syam Y, Irwan AM. Effect of Follow-up Telephone by Enterostomal Nurses on Patients with Permanent Colostomy: A Systematic Review. Bangladesh Journal of Medical Science. 2022 Jan 1;21(1):54-66.
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IssueVol 9 No 4 (2022): Autumn QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/npt.v9i4.11205
Keywords
self-care ostomy nurses patient education as topic

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How to Cite
1.
Soares-Pinto IE, Queirós S, Alves P, Santos C, Brito M. Promotion of bowel elimination ostomy self-care: A qualitative study based on the nurses’ and patients’ perspectives. NPT. 2022;9(4):337-348.