Health State Utility Values for Ileostomies and Colostomies: a Systematic Review and Meta-Analysis

Abstract

Following stoma surgery, values placed on quality of life are similar to those obtained from patients with conditions such as asthma and allergies or individuals of similar age without chronic conditions. This confirms the findings of questionnaire-based studies, which report minimal long-term decrements to overall quality of life among stomates.

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for Ostomy Surgery

“…Beyond the typical short-term metrics captured in standard databases, the morbidity of ostomy surgery may also be measured in terms of the stoma-related negative effects on the quality of life and other long-term morbidities related to having an ostomy. [3][4][5][6][7][8] Many patients have ostomies that are considered "problematic" and present with management problems like skin irritation and pouching difficulties that require prolonged and specialized care and result in increased utilization of health care resources and increased costs. [9][10][11][12][13][14][15] The incidence and impact of short-and long-term stoma-related complications can be mitigated by perioperative education and marking, proper surgical technique, and attention to postoperative care pathways.…”

“…Patients living with an ostomy may experience negative effects on their quality of life, sexual difficulties, depression, dissatisfaction with their appearance, and challenges with self-image and travel. 4,13,15,39–44 Stoma creation can also result in feelings of embarrassment or shame; patient concern about disclosing their stoma status to others can lead to self-imposed limits and isolation. 45…”

“…Patients living with an ostomy may experience negative effects on their quality of life, sexual difficulties, depression, dissatisfaction with their appearance, and challenges with self-image and travel. 4,13,15,[39][40][41][42][43][44] Stoma creation can also result in feelings of embarrassment or shame; patient concern about disclosing their stoma status to others can lead to self-imposed limits and isolation. 45 One randomized trial and several observational studies support the value of postdischarge ostomy nursing care, which can be provided in the home, outpatient, or telephone setting.…”

Value-Based Healthcare in Ostomies

“…The difference with other studies mainly revolves around the fact that our work values a new management process, not just patient interventions themselves. Utilities reflect patient preferences for health states and provide an alternate method of quality of life assessment for patients with stoma, although few studies have applied this method [40].…”

Living with and without an intestinal stoma: Factors that promote psychological well‐being and self‐care: A cross‐sectional study

“…These may act as stressors that contribute to a decline in psychological well‐being and QoL (Bird, 2019 ; Gooszen et al., 2000 ; Mahjoubi et al., 2010 ). However, a decline in QoL with stoma is not observed in all studies (Dossa et al., 2018 ; Pachler & Wille‐Jørgensen, 2012 ), as for some it represents a better QoL and a return to normality and freedom from toilet restraints (Diniz et al., 2021 ). Better QoL poststoma was associated with being able continue to wear everyday clothes, being sexually active and being older (Ketterer et al., 2021 ) and having higher emotional intelligence and higher self‐esteem (Saati et al., 2021 ).…”