The psychological challenges of living with an ileostomy: An interpretative phenomenological analysis.

Abstract

CHALLENGES FOR PERSONS WITH AN ILEOSTOMY 2The psychological challenges of living with an ileostomy:an interpretative phenomenological analysis Abstract Objectives: Ileostomy, in which the small intestine is re-directed out of an abdominal wall so that waste is collected using a bag, is used to treat conditions including Inflammatory Bowel Disease and colorectal cancer. This paper reports an in depth idiographic analysis of the experience of living with an ileostomy. Methods: 21 participants took part in semi-structured interviews about their lives and relationships. Those interviews were transcribed verbatim and analysed using the experiential qualitative methodology Interpretative Phenomenological Analysis (IPA). Results: Two super-ordinate themes arose from the data: Ileostomy's intrapersonal impact; the impact of ileostomy on relationships with others. We found that ileostomy may destabilise the sense of self, disrupt body image, and alter experience of age and sexuality. Other participants were able to employ their illness to positively reframe the self. Disclosure of ileostomy status was difficult for some. Intimate and friend relationships were often challenged by stoma status, whilst other family relationships were largely characterised as supportive. Conclusions: Ileostomy may impact upon both intra and interpersonal aspects of the lives of those who live with it, in both negative and positive ways. Consequently, the sense of self can appear challenged, and relationships with partners, family members and friendships could be causes of distress. On the other hand, some partners were supportive, and children were found to be sources of comfort.Keywords: Ileostomy; phenomenology; qualitative; relationships; selfThe psychological challenges of living with an ileostomy:an interpretative phenomenological analysis Ileostomies, in which the small intestine is re-directed out of an opening in the abdominal wall so that waste is collected in a bag, treat various conditions including Crohn's disease, ulcerative colitis, and bowel cancer. It is estimated that nearly 40,000 ileostomies are performed in the US every year, (Husain & Cataldo, 2008), while more than 9,000 ileostomy operations are carried out in the UK annually (NHS, 2014).Prior research has explored life with a range of related procedures: ileostomies, colostomies, and urostomies, collectively known as stomas (eg. Bray, Callery, & Kirk, 2012).The confluence of elements that lead to and follow stoma surgery, which often includes severe pre-and occasionally post-operative illness can be psychologically challenging groups. They contacted the second author if they wanted to take part, and were sent an information sheet giving the details of the study. Twenty-one people living with an ileostomy were interviewed. We recruited a purposive stratified sample to ensure a balanced representation of age and gender and thus we have a relatively large sample for an IPA study.Ethics and Data collection. The study was given ethical clearance by the relevant university b...

Living with an ileostomy: a case study on the transition process

“…Consequently, instead of hiding the bag, the person showed it without fear of rejection. These results are in line with the study of Smith et al (2016), who reported that the relationship between ileostomy patients and their family and friends is often challenged by the new condition/status and that family and social support, when present, helps the person living with an ileostomy. When talking about the activities carried out with friends, for example playing football, there is a clear perception of the difference.…”

“…This does not mean that the patient was satisfied with his diagnosis and the need for an ileostomy, but rather that he had positive expectations about the future resolution of his situation. This result is in line with the study of CARLA REGINA RODRIGUES DA SILVA et al Smith, Spiers, Simpson, and Nicholls (2016), in which stoma surgery was found to have a positive impact on patients if it mitigates previous symptoms, thus improving their quality of life. In view of the above, a transition is influenced by the internal and external conditions of the person who experiences it.…”

Guided Recovery: An Interpretative Phenomenological Analysis of Service Users’ Experiences of Guided Self-Help for Bulimic and Binge Eating Disorders

“…This process was conducted not in order to reach a consensus, but to encourage reflection upon the analysis, and to identify any potential areas that might have been GUIDED SELF HELP FOR EATING DISORDERS 10 influenced by assumptions (Yardley, 2014). It is an important process for ensuring the credibility of the final account (Smith, Spiers, Simpson & Nicholls, 2017).…”

Problem-Based Learning in Professional Studies from the Physiotherapy Students’ Perspective

“…IPA was developed within psychology and it aims to provide detailed examinations of personal lived experience in its own terms rather than using preexisting theoretical preconceptions (e.g., Smith, 2017). IPA subscribes to a hermeneutic phenomenology where both participant and researcher are recognized as sense-making agents (Cassidy, Reynolds, Naylor, & De Souza, 2011;Smith, 2004Smith, , 2011Smith, , 2017Smith, Flowers, & Larkin, 2009;Smith, Spiers, Simpson, & Nicholls, 2017). The key theoretical perspectives of IPA are phenomenology, interpretation (hermeneutics), and idiography.…”

“…The key theoretical perspectives of IPA are phenomenology, interpretation (hermeneutics), and idiography. For IPA, phenomenology involves hermeneutics, which is defined as the theory and practice of the interpretation of the meaning of texts (Smith, 2011(Smith, , 2017Smith et al, 2009;Smith et al, 2017). The IPA approach has a "practical" orientation and is therefore suitable for physiotherapy researchers (Cassidy et al, 2011).…”