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During the last decade strong improvements have been made in the medical care of patients with a digestive tract stoma, particularly with regard to nursing skills and to the quality of collecting material for faecal products. Scientific investigation into the psychosocial adjustment of patients after stoma surgery has intensified as well, giving us indications for quality of life. These developments induced a review of the actual state of affairs in psychological issues. After evaluating the results of psychosocial stoma research, it can be concluded that the technical improvements in stoma care during the past decade did not result in a decline in psychosocial problems after stoma surgery. However, there are some serious problems when interpreting the results of studies in this field of investigation. Stoma surgery is not per se solely responsible for the reported psychosocial problems, first, because many conclusions are based on research studies with poor design and, second, because these studies lack a theoretical framework within which the process of psychosocial adjustment has been measured and explained. This review assesses the most current developments and controversies in this field.

Both loneliness and social isolation are linked to numerous negative health outcomes and there is no one-size-fits-all solution to reduce that loneliness and social isolation. Therefore, a new social technology (mobile application) which encourages social participation for community-dwelling older adults was developed and deployed. The objective of this study was to assess the usability, end-user experience, and potential added value of this mobile application among community-dwelling older adults. After recruitment and after the weeks of use participants were asked to complete a range of questionnaires, and log-data was gathered to provide information on actual use. Of the 91 older adults who started using the mobile application 41 (80% female, age 73.4 years (SD 7.8)) were willing to participate in this study. On average the application was used for 11 weeks. The usability was acceptable (SUS score of 65.3 (SD18.0)) and 59% of the participants were willing to continue using the application. To conclude, the mobile application to encourage social participation was accepted by community-dwelling older adults and the measured change in quality of life was positive and clinically meaningful. After improving the technology a next step is to assess the effectiveness and cost-effectiveness.

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