Perineal colostomy with appendicostomy for antegrade continence enema is a valid and acceptable alternative for a permanent abdominal colostomy in selected patients, with a comparable functional and quality of life outcome.

eligible for inclusion. Patients with isolated patent foramen ovale, rheumatic heart disease, and mental retardation were excluded. For the purpose of this study, we devised a specific questionnaire that could be administered during a telephone interview. Results: During their first pregnancy, 56.9% of the patients had follow-up visits with their cardiologist. Before the implementation of Advanced Practice Nursing in our programme, in the year 2000, the proportion of patients who had cardiac follow-up during pregnancy was 44%. This proportion increased up to 71% since the Advanced Practice Nursing team started with systematic educational interventions (χ 2 =9.63; P=0.002). Conclusion: This study shows that a considerable number of women with congenital heart disease do not present for cardiac follow-up during pregnancy. However, we found the possible impact of the Advanced Practice Nursing team in pregestational counselling. Indeed, Advanced Practice Nurses in adult congenital heart disease can contribute to a better understanding of the rationale for cardiac appointments during pregnancy and a better adherence with follow-up recommendations.

S27 goals. Participants often lacked detailed information about dietary change and how far they could "push" with physical activity levels. They were often uncertain about when hospital care ended and whether other support was available. Co-existing conditions such as diabetes and obesity made dietary change and physical activity a challenge. Conclusion: Participants in this study were aware that they needed to make lifestyle changes but would be better equipped if given more practical skills about how this could be achieved.

patients responses. The content of the Health Buddy® consists of daily dialogues about symptoms, knowledge and behaviour related to their disease, allowing early notification and correction. Included in this pretest-posttest design were 108 patients with heart failure NYHA II, III and IV from three institutions and the follow-up period was 6 months.Results: Mean age was 74.6 years, 55% were men and mean duration of HF was 34 months. Compliance with daily answering the dialogues was high: 85%. Reasons for drop out were: mortality (12), overload (8), demotivation (2), problems with installation (3) unknown (2). Patients were more compliant regarding appointments with care providers (CP) and advices related to diet, activity, smoking and use of alcohol. Disease specific knowledge increased significantly. Hospital admissions decreased by 30%, with unchanged admission duration and amount of contacts with care providers.