Adjustment to an Ostomy

Abstract

This integrative literature review summarizes recent literature relating to patient adjustment to stoma. The search strategy included 5 databases (CINAHL Plus, PsychINFO, Web of Science, Scopus, and MEDLINE); 65 articles meeting criteria were retrieved. Eleven were removed as duplicates, and a further 29 were removed when read in full, yielding 25 elements. Three were randomized controlled trials; 2 were prospective descriptive studies; 15 were cross-sectional descriptive studies; and 5 were qualitative studies. The quality of studies was evaluated using the Mixed Methods Appraisal Tool (MMAT). The calculated mean quality score was 97%, and no studies were excluded on quality grounds. Limited evidence suggests that adjustment occurs over time and provides some insight concerning how rehabilitation leads to resumption of an altered normality. Some evidence suggests that long-term adjustment is associated with demographic and pre- and postoperative factors. A knowledge gap was identified regarding the role of support groups, which in other fields has been shown to positively benefit psychological well-being. This review revealed a paucity of interventional studies seeking to test ways to address adjustment-related problems. Longitudinal studies are recommended as ostomy care nurses work to facilitate adjustment in the person with a stoma over time.

Does Resilience Predict Ostomy Adjustment in Patients With Permanent Ostomy?

“…This finding is also consistent with the findings by previous researchers who report that time is associated with increased adaptation to life with an ostomy and acceptance of the presence of a stoma. [36][37][38]…”

Factors Affecting Psychosocial Adjustment in Persons With a Recent Ostomy

“…Inclusion criteria were 18 years of age and older, English speaking, and experienced ostomy surgery within 1 year of data collection. This final inclusion criterion was supported by studies that examined adjustment in people with ostomies and reported PSA changes within 12 months 14,15. Study procedures were reviewed and approved by the Institutional Review Boards of St. Elizabeth's Medical Center, Brighton, Massachusetts; Cleveland Clinic, Cleveland, Ohio; and the University of Massachusetts Lowell, Lowell, Massachusetts, prior to data collection.…”

Comparison of Adjustment or Adaptation to the Formation of a Temporary Versus a Permanent Ostomy

“…7 There is emerging evidence that social interaction interventions can aid in ostomy adjustment. 8,9 While current research provides some evidence on determinants of ostomy adaptation and adjustment, they do not provide a comparison between those with a TO and PO.…”

“…Researchers have identified a number of factors associated with adaptation and adjustment to an ostomy; they include the ability to afford ostomy supplies,6 development of anxious preoccupation with their ostomy,7 alterations in willingness to become socially engaged,8 especially in the work environment,7 ostomy education experience prior to and immediately following ostomy surgery, surgery performed by specialists, persistent or recurring illness,6 and resilience 7. There is emerging evidence that social interaction interventions can aid in ostomy adjustment 8,9. While current research provides some evidence on determinants of ostomy adaptation and adjustment, they do not provide a comparison between those with a TO and PO.…”