Psychological issues affecting patients living with a stoma

Abstract

Stoma surgery is an intrusive operation, with outcomes that can impact seriously on daily life, not just in the immediate postoperative and recovery period, but for the rest of the patient's life. There are changes in bodily function, altered body image, physicality and personal care needs. These changes require acceptance and adaptation and can necessitate a re-ordering of daily life, socially, emotionally and in terms of work. Assessing the patient's needs through the trajectory of diagnosis, surgery and a stoma, is not just important during the treatment phase but needs to continue throughout the lifespan. Traditionally, patient outcome measures after bowel surgery have included overall self-efficacy, checking for stoma complications, clinical health status, function and psychological status. However, over the past three decades there has been increasing recognition that quality of life (QoL), which is now regarded as a key measurement, needs further consideration. Patients report difficulties when explaining to health professionals the challenges they face, and their reactions as they try to make the adjustments to their new normal of life with a stoma. This article examines stoma patients' perceptions of their outcomes from recent research. It discusses how more can be done by health professionals to support stoma patients through their initial transition to life with a stoma and for the rest of their life.

Effect of 1 + N Extended Nursing Service on Functional Recovery of Colostomy Patients

“…Black and Notter the importance of quality of life (QoL) has grown over the last three decades, and it is now considered a critical assessment. To better assist stoma patients, health care providers should do more to help them adjust to living with a stoma and throughout their whole lives [ 17 ].…”

The influence of stigma and disability acceptance on psychosocial adaptation in patients with stoma: A multicenter cross-sectional study

“…Stoma destroys the integrity of the patient's body and causes the patient to feel incomplete, making it difficult for the patient to accept physiological changes in a short time. Because the Stoma changes the original appearance and excretion mode of patients, some patients with stoma regard themselves as unattractive and dirty disabled, especially young and middle-aged patients (Black et al, 2021). In the process of postoperative psychological adjustment, how to accept the change of body image is the biggest challenge for patients with stoma; and then it may trigger a series of negative effects.…”

“…Many a studies have shown that the reason for stigma in patients with stoma is the internalization of negative emotions and experience integration ( Pasmatzi et al, 2016 ; Xian et al, 2018 ). In addition, stomas for patients are not a disease but a disability; it is the destruction of the integrity of the body and psychological trauma ( Lack and Notter, 2021 ). After surgery, patients not only face the lack of physiological function but also bear the impact of body shape changes on their social interaction and family function.…”

Peristomal Complications

“…Patients have been found to cope with ostomies in five ways: anxious preoccupation, helplessness or hopelessness, avoidance, fatalism, or having a fighting spirit (Black & Notter, 2021). All those coping strategies have negative consequences on quality of life except for having a fighting spirit, which helps patients adapt to a new routine.…”

“…Also, use of adhesive remover wipes or no-sting wipes may help with the removal and application of the pouching system. If the peristomal skin is severely damaged and draining or weeping, you may need to apply a Retrieved May 20, 2022 from http://www.wocn.org/page/ imageLibrary or hopelessness, avoidance, fatalism, or having a fighting spirit (Black & Notter, 2021). All those coping strategies have negative consequences on quality of life except for having a fighting spirit, which helps patients adapt to a new routine.…”