Two new tools for self‐care in ostomy patients and their informal caregivers: Psychosocial, clinical, and operative aspects

Abstract

Stoma patients and their caregivers need to be autonomous in stoma care, but there are few instruments for measuring the level of self‐care. This study aims to develop and test the psychometric properties of the Ostomy Self‐Care Index (OSCI) and the Caregiver Contribution to Self‐Care in Ostomy Patient Index (CC‐OSCI), from a clinical, operative and psychosocial perspective. A multicentre validation study was conducted on a convenience sample of 468 ostomy patients and 227 caregivers. The signed informed consent forms were obtained before data collection. Tool validation was performed by testing content validity, construct validity, criterion and internal consistency. Two indexes were developed, building on the self‐care theory of chronic illness. For the OSCI, 32 items were developed and grouped into four 5‐point Likert scales: maintenance, monitoring, management and confidence. For the CC‐OSCI, 22 items were developed and grouped into three 5‐point Likert scales: maintenance, monitoring and management. The content validity indexes for the OSCI and CC‐OSCI were 95% and 93%, respectively. Exploratory factor analysis showed appropriate factor loadings (OSCI: min 0.395 to max 0.852; CC‐OSCI: min 0.442 to max 0.841). Criterion validity was established through significant correlation between levels of quality of life, complications, readmissions and self‐care in patients and caregivers. Strong internal consistency was found for the overall index, and within the scales (OSCI: α = 0.975; CC‐OSCI: α = 0.972). The OSCI and CC‐OSCI are valid and reliable indexes. Further studies specifically aimed at predicting the level of self‐care are especially recommended.

A literature review about self‐care on ostomy patients and their caregivers

“…2 The last two instruments created were The Ostomy Self-Care Index (OSCI) and The Caregiver Contribution to Self-Care in Ostomy Patient Index (CC-OSCI). 37 The OSCI is a self-reported tool composed of 32 items split into four scales that use a 5-point Likert scale (never or rarely to always or daily). 37 The OSCI is a self-reported tool composed of 32 items split into four scales that use a 5-point Likert scale (never or rarely to always or daily).…”

“…37 The OSCI was developed by the research team guided by literature to collect data about self-care in ostomy patients. 37 The OSCI is a self-reported tool composed of 32 items split into four scales that use a 5-point Likert scale (never or rarely to always or daily). It captures self-care maintenance (ie, daily routine behaviours), self-care monitoring (ie, stoma and peristomal skin recognition), self-care management (ie, problem recognition and response behaviours) and self-care confidence (ie, confidence in the ability to engage effectively in self-care).…”

“…Both indexes have been shown to be valid and reliable tools for measuring self-care in ostomy patients and their caregivers. 37…”

Describing self‐care and its associated variables in ostomy patients

“…According to the self‐care theory which guided this study (Riegel et al., 2012) and the authors’ previous conceptualization (Villa, Vellone, et al, 2019, p.26), ostomy self‐care is ‘a naturalistic decision‐making process that influences actions related to maintaining the physiological stability of the stoma and peristomal skin (self‐care maintenance), facilitates the perception of problems and complications (self‐care monitoring) and directs the management of these problems and complications (self‐care management)’. Even though it is not part of self‐care, an important variable influencing self‐care is self‐care confidence or self‐care self‐efficacy, which has been defined as the ability of the patient to engage effectively in self‐care (Riegel et al., 2012; Villa, Vellone, et al, 2019).…”

A multi‐phase study for the development of a self‐efficacy measuring scale for ostomy care nursing management

“…The domain of education and relationships encompasses items that stress the importance of education in OCNM and the need for strong nurse–patient relationships. This aspect of OCNM acknowledges the importance of a wide range of educational activities that aim to counter the challenges associated with the psycho‐social adjustments (Dellafiore, Conte, et al, ), nutritional needs (Grant, McCorkle, Hornbrook, Wendel, & Krouse, ) and self‐care of an ostomy (Villa et al, , ). Oftentimes, the impact of education on clinical outcomes is under‐investigated in OCNM (Stokes et al, ), even if said education could lead to improved outcomes (Waller et al, ).…”