CHALLENGES FOR PERSONS WITH AN ILEOSTOMY 2The psychological challenges of living with an ileostomy:an interpretative phenomenological analysis Abstract Objectives: Ileostomy, in which the small intestine is re-directed out of an abdominal wall so that waste is collected using a bag, is used to treat conditions including Inflammatory Bowel Disease and colorectal cancer. This paper reports an in depth idiographic analysis of the experience of living with an ileostomy. Methods: 21 participants took part in semi-structured interviews about their lives and relationships. Those interviews were transcribed verbatim and analysed using the experiential qualitative methodology Interpretative Phenomenological Analysis (IPA). Results: Two super-ordinate themes arose from the data: Ileostomy's intrapersonal impact; the impact of ileostomy on relationships with others. We found that ileostomy may destabilise the sense of self, disrupt body image, and alter experience of age and sexuality. Other participants were able to employ their illness to positively reframe the self. Disclosure of ileostomy status was difficult for some. Intimate and friend relationships were often challenged by stoma status, whilst other family relationships were largely characterised as supportive. Conclusions: Ileostomy may impact upon both intra and interpersonal aspects of the lives of those who live with it, in both negative and positive ways. Consequently, the sense of self can appear challenged, and relationships with partners, family members and friendships could be causes of distress. On the other hand, some partners were supportive, and children were found to be sources of comfort.Keywords: Ileostomy; phenomenology; qualitative; relationships; selfThe psychological challenges of living with an ileostomy:an interpretative phenomenological analysis Ileostomies, in which the small intestine is re-directed out of an opening in the abdominal wall so that waste is collected in a bag, treat various conditions including Crohn's disease, ulcerative colitis, and bowel cancer. It is estimated that nearly 40,000 ileostomies are performed in the US every year, (Husain & Cataldo, 2008), while more than 9,000 ileostomy operations are carried out in the UK annually (NHS, 2014).Prior research has explored life with a range of related procedures: ileostomies, colostomies, and urostomies, collectively known as stomas (eg. Bray, Callery, & Kirk, 2012).The confluence of elements that lead to and follow stoma surgery, which often includes severe pre-and occasionally post-operative illness can be psychologically challenging groups. They contacted the second author if they wanted to take part, and were sent an information sheet giving the details of the study. Twenty-one people living with an ileostomy were interviewed. We recruited a purposive stratified sample to ensure a balanced representation of age and gender and thus we have a relatively large sample for an IPA study.Ethics and Data collection. The study was given ethical clearance by the relevant university b...
BackgroundLittle is known about the technical adequacy of portfolios in reporting multiple complex academic and performance-based assessments. We explored, first, the influencing factors on the precision of scoring within a programmatic assessment of student learning outcomes within an integrated clinical placement. Second, the degree to which validity evidence supported interpretation of student scores.MethodsWithin generalisability theory, we estimated the contribution that each wanted factor (i.e. student capability) and unwanted factors (e.g. the impact of assessors) made to the variation in portfolio task scores. Relative and absolute standard errors of measurement provided a confidence interval around a pre-determined pass/fail standard for all six tasks. Validity evidence was sought through demonstrating the internal consistency of the portfolio and exploring the relationship of student scores with clinical experience.ResultsThe mean portfolio mark for 257 students, across 372 raters, based on six tasks, was 75.56 (SD, 6.68). For a single student on one assessment task, 11% of the variance in scores was due to true differences in student capability. The most significant interaction was context specificity (49%), the tendency for one student to engage with one task and not engage with another task. Rater subjectivity was 29%. An absolute standard error of measurement of 4.74%, gave a 95% CI of +/- 9.30%, and a 68% CI of +/- 4.74% around a pass/fail score of 57%. Construct validity was supported by demonstration of an assessment framework, the internal consistency of the portfolio tasks, and higher scores for students who did the clinical placement later in the academic year.ConclusionA portfolio designed as a programmatic assessment of an integrated clinical placement has sufficient evidence of validity to support a specific interpretation of student scores around passing a clinical placement. It has modest precision in assessing students’ achievement of a competency standard. There were identifiable areas for reducing measurement error and providing more certainty around decision-making. Reducing the measurement error would require engaging with the student body on the value of the tasks, more focussed academic and clinical supervisor training, and revisiting the rubric of the assessment in the light of feedback.
Aims To explore treatment and healthcare experiences of people living with ileostomies, so nurses can build on best practice whilst caring for these patients.Background Ileostomies, in which the small intestine is re-directed out of a stoma in
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.