Psychosocial adjustment following ostomy.

Abstract

Ostomy patients have been identified as a chronic illness population frequently experiencing adjustment difficulties. The present study, based on the biopsychosocial model (Engel, 1977) of chronic illness, examined a range of post-surgical adjustment difficulties in a sample of 131 ostomy patients. The patient population reported experiencing a significant number of technical, emotional, social, marital/family, and sexual difficulties post-surgically. Technical difficulties were associated with impaired emotional, social, and marital/family functioning. Emotional difficulties were also associated with problematic social, marital/family adjustment, and impaired sexual functioning. Technical problems, emotional difficulties, and social problems were all associated with the patient's perception of having received inadequate preparatory information. Marital/family and sexual maladjustment, on the other hand, were associated with low levels of perceived social support. The results of this investigation are interpreted as supporting the biopsychosocial model of chronic illness, and the clinical implications of these findings are discussed as well as their relation to previous research on adjustment to stressful medical procedures.

Psychosocial adaptation to stoma surgery: A review

“…The studies reported important emotional problems as anxiety and depression (McLeod et aL, 1986;Williams and Johnston, 1983;Keltikangas-J~irvinen and J~irvinen, 1987;Thomas et al, 1984Thomas et al, , 1987aWade, 1990), a diminished feeling of self-esteem, feelings of inferiority and shame (MacDonald and Anderson, 1984), serious physical impairment (Foulis and Mayberry, 1990;Williams and Johnston, 1983;MacDonald and Anderson, 1984) decreased self-confidence (Gutman and Reiss, 1985;Foulis and Mayberry, 1990), hopelessness (Keltikangas-J~irvinen and J~irvinen, 1987), and an increased anger and irritation (Follick et aL, 1984;Thomas et al, 1984). The stoma has been marked as a restrictional factor of the social life (Gutman and Reiss, 1985;Foulis and Mayberry, 1990;van de Wiel et aL, 1991;Thomas et al, 1984Thomas et al, , 1987a: Patients appeared to be socially less active and feel restrictions in sports, recreation, travelling, and leisure-time activities.…”

“…The stoma has been marked as a restrictional factor of the social life (Gutman and Reiss, 1985;Foulis and Mayberry, 1990;van de Wiel et aL, 1991;Thomas et al, 1984Thomas et al, , 1987a: Patients appeared to be socially less active and feel restrictions in sports, recreation, travelling, and leisure-time activities. Impaired partner relationship including nonacceptance by the partner (Follick et al, 1984;Macdonald and Anderson, 1984;La Monica et al, 1985) and sexualproblems are frequently mentioned. Sexual problems include functional problems, such as impotence, problems with ejaculation, and painful intercourse, as well as emotional problems, such as decrease in pleasure, interest, and motivation (Gutman and Reiss, 1985;van de Wiel, 1991;MacDonald and Anderson, 1985;La Monica et aL, 1985).…”

“…Several studies (Follick et al, 1984;Gutman and Reiss, 1985;McLeod et al, 1986;Thomas, 1987a) show that stoma-related factors have an evident predictive value regarding the process of psychosocial adaptation. These factors include a technically insufficient stoma (e.g., highly placed on body), a sensitive skin around the stoma, and insufficient skills in stoma care; the latter mark is often found in recently operated patients.…”

Effect of gender on psychosocial adjustment of colorectal cancer survivors with ostomy

“…Furthermore, men significantly predicted low acceptance {β=−3.078, P=0.023, ΔR 2 =0.036, F [4,117] =7.90, P<0.001} and social engagement score {β=−2.501, P<0.001, ΔR 2 =0.098, F [4,117] =6.03, P<0.001}.…”

“…In addition to the detrimental effect of cancer itself, most of the colorectal survivors have to deal with ostomy as a part of their treatment (3). Ostomy refers to a surgical procedure that results in an artificial opening in the abdominal wall (stoma) through which bodily waste are excreted (4). To the ostomate, however, it means substantive changes not only in bodily appearance and functional ability but also in overall personal hygiene (5).…”