A cross sectional study of quality of life in patients with enterostomy

Abstract

Background: Enterostomy is one of the commonest surgeries performed in general surgical practise. It leads to considerable alteration in life style of patients after surgery in the form of physical, mental, social, spiritual, economic, educational, vocational, marital, sexual problems. We designed study to assess the extent of these affections on quality of life (QOL) and suggest measure to improve it.Methods: We conducted a cross sectional survey using validated City of Hope-quality of life-Ostomy questionnaire questionnaire which was administered to patients following up for routine stoma care in stoma clinic of our hospital. We included patients who have undergone stoma creation between 2 months to 1 year prior to taking the QOL questionnaire. Demographic data and data collected about four main domains of QOL namely, physical, psychological, social and spiritual was statistically analysed for significance, dependence and correlation.Results: Commonest stoma type in our study was temporary ileostomy done for perforative peritonitis. Presence of ostomy makes significant impact on patients clothing style, occupation and sexual activity and suffered depression. Majority of patients (82.5%) fell in fair to average when their scores of QOL were compared. All four domains of life correlated positively to each other.Conclusions: As all domains of life are related to each other intervention to improve any one of them will cause resultant improvement of all domains of QOL. We suggest holistic approach by pre and postoperative counselling, training by trained enterostomal therapists, psychiatrist, treating surgeons and economic and sexual rehabilitation.

Factors Associated With Quality of Life Among People Living With a Stoma in Nonmetropolitan Areas

“…Our results also showed that nearly two-thirds of respondents identified as being sexually active prior to their ostomy formation, with only approximately one-quarter reporting postsurgical sexual activity. This is consistent with findings of past studies reporting that the presence of a stoma adversely affected one’s ability to engage in intimacy, negatively affecting overall QoL (Anaraki et al, 2012; Dhamnaskar et al, 2019; Gemmill et al, 2010). Lower overall and gender-specific proportions of poststoma sexual activity were reported in an Iranian study (Anaraki et al, 2012).…”

“…The overall level of QoL reported by this sample of people living with a stoma in nonmetropolitan Australia was moderate to high. This result is comparable to the levels of stoma-related QoL reported in studies conducted internationally ( Anaraki et al, 2012 ; Cotrim & Pereira, 2008 ; Dhamnaskar et al, 2019 ; Konjevoda et al, 2020 ; Yilmaz et al, 2017 ). Two studies that also used the QOL-O reported similar findings for the overall QoL score ( Anaraki et al, 2012 ; Konjevoda et al, 2020 ).…”

“…First, our study sample was considerably older than those in other studies of stoma-related QoL ( Anaraki et al, 2012 ; Cotrim & Pereira, 2008 ; Dhamnaskar et al, 2019 ; Konjevoda et al, 2020 ; Liao & Qin, 2014 ; Yilmaz et al, 2017 ), and our modeling showed that older age was independently associated with better QoL. The older median age of our sample likely reflects the demographic characteristics of the study setting, as there is a higher proportion of people aged 65 years and older living in inner and outer regional areas of Australia ( AIHW, 2019 ).…”

“…Poststoma clothing change is a potentially modifiable factor, as it can be dependent on preoperative stoma siting. Preoperative assessment of body habitus and clothing style by a trained stomal therapy consultant or specialist nurse is imperative in optimizing stoma placement ( Burke, 2017 ; Dhamnaskar et al, 2019 ) and reducing the likelihood of clothing change and complications such as hernia ( Anaraki et al, 2012 ). Issues with stoma location were reported by 35% of our participants and, more specifically, among 40% of those with a QoL score in the lowest quintile.…”

“…Research investigating QoL has identified a range of clinical, sociodemographic, and psychosocial factors important to outcomes for patients. Clinical factors negatively affecting QoL among ostomates included poor stoma placement (Anaraki et al, 2012;Vonk-Klaassen et al, 2016), peristomal medical complications (Karadağ et al, 2015;Simmons et al, 2007), length of time since stoma formation (N. M. Silva et al, 2017;Thorpe et al, 2016), and poststoma sexual function (Anaraki et al, 2012;Dhamnaskar et al, 2019;Gemmill et al, 2010). There are also patient characteristics known to promote QoL, including older age (Scarpa et al, 2004;Wong et al, 2013) and being partnered (Pittman et al, 2008).…”