Effects of Evidence-Based Continuing Care Bundle on Health Outcomes in Rectal Cancer Patients With Temporary Stomas

Abstract

Background The patients with temporary stomas after anterior resection for rectal cancer may experience significant impact on their health outcomes, and hence continuing care is necessary and important for these patients. However, the effects of some single continuing care interventions remain unclear. Continuing care bundle may be an effective approach to address this uncertainty. Objective The aim of this study was to investigate the effects of an evidence-based continuing care bundle on selected health outcomes in patients with temporary stomas after anterior resection for rectal cancer. Methods This was a multicenter randomized controlled trial. A total of 124 patients with temporary stomas after anterior resection for rectal cancer were recruited from 4 general tertiary hospitals in Guangzhou, China, and were randomly assigned to a control group or an intervention group. Both groups received usual care, whereas the intervention group additionally received evidence-based continuing care bundle. Self-efficacy, quality of life, and stoma-related complications were collected at baseline and 4 and 12 weeks after surgery. Satisfaction and outcomes of stoma reversal were collected at the end of the observation. Results The intervention group had significantly improved the self-efficacy (F = 11.88, P = .001), quality of life (F = 17.99, P < .001) over time, satisfaction (t = 4.08, P < .001), and outcomes of stoma reversal (χ 2 = 5.93, P = .015) and reduced the incidence of complications (P < .05). Conclusions Evidence-based continuing care bundle can be an effective method to improve the health outcomes among these patients Implication for Practice By using the evidence-based continuing care bundle, nurses can help these patients improve their health outcomes in stoma-specific nursing.

A systematic review and meta‐analysis of the effectiveness of self‐management interventions in people with a stoma

“…The study that measured generic QoL reported significantly greater improvements in QoL in the intervention group when compared with the usual care group (Cheung et al, 2003), whereas the study that measured overall health-related QoL did not report significant differences between the two groups in regards to QoL (Forsmo et al, 2016). Of the six studies that used stoma and disease-specific QoL questionnaires, four reported greater improvements in scores in the intervention group when compared with the usual care group (Khalilzadeh Ganjalikhani et al, 2019;Sier et al, 2017;Su et al, 2019;Xu et al, 2018). The other two studies found no difference in between the intervention and control group (Cheung et al, 2003;Lim et al, 2019).…”

“…Through searching databases 3141 records were obtained. This resulted in 16 eligible papers for inclusion in the systematic review (Chaudhri et al, 2005;Cheung et al, 2003;Crawford et al, 2012;Forsmo et al, 2016;Khalilzadeh Ganjalikhani et al, 2019;Lim et al, 2019;Lo et al, 2010Lo et al, , 2011Pouresmail et al, 2019;Seo, 2019;Sier et al, 2017;Su et al, 2019;Wang et al, 2018;Wen et al, 2019;Xu et al, 2018;Zhang et al, 2013). Figure 1 presents the PRISMA flow diagram of the study.…”

“…Seven studies measured QoL (Cheung et al, 2003;Forsmo et al, 2016;Khalilzadeh Ganjalikhani et al, 2019;Lim et al, 2019;Sier et al, 2017;Su et al, 2019;Xu et al, 2018). One study used a generic quality of life scale; the WHO Quality of Life Scale (Cheung et al, 2003).…”

“…One study used an overall health-related quality of life scale; 15D (Forsmo et al, 2016). Six studies used disease/stoma-specific measures of quality of life; the Stoma-Quality of Life Questionnaire (Sier et al, 2017;Su et al, 2019), the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Cancer30 (Xu et al, 2018), the City of Hope-Quality of Life-Ostomy Questionnaire (Khalilzadeh Ganjalikhani et al, 2019), the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Colorectal29 (Lim et al, 2019) and the Quality of Life-Colostomy Scale (Cheung et al, 2003).…”

“…Nine studies measured self-efficacy (Crawford et al, 2012;Lim et al, 2019;Pouresmail et al, 2019;Seo, 2019;Su et al, 2019;Wang et al, 2018;Wen et al, 2019;Xu et al, 2018;Zhang et al, 2013). Six studies used the Stoma Self-Efficacy Scale (Lim et al, 2019;Pouresmail et al, 2019;Su et al, 2019;Wang et al, 2018;Xu et al, 2018;Zhang et al, 2013), and three studies developed their own self-efficacy scales (Crawford et al, 2012;Seo, 2019;Wen et al, 2019).…”