Assessing support garments in the management of parastomal hernia

Readding, Linda

doi:10.12968/gasn.2014.12.4.32

Cited by 17 publications

(18 citation statements)

References 12 publications

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“…Limited studies have demonstrated the impact of preventive advice regarding core exercises and support garments (Thompson and Trainor, 2005;North, 2014;Readding, 2014).…”

Section: Preventionmentioning

confidence: 99%

“…As these changes occur, inevitably there is an increase in appliance use with potential change of stoma product, the introduction to, or increase in, the use of stoma accessories and also the need for a support garment (Cowin and Redmond, 2012;North, 2014;Readding, 2014); all of these are reliant on the delivery of specialist stoma care nursing. Prevention is therefore key but, perhaps more importantly, there is a need for consistency in assessment, with the use of a risk assessment tool to support prevention of parastomal hernias within the provision of stoma care services.…”

mentioning

confidence: 99%

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Using a risk assessment tool for parastomal hernia prevention

2018

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everal complications are associated with stoma surgery. These include skin irritation, leakages, dehydration, bowel obstruction and prolapse, but perhaps the most common problem is parastomal hernia (Williams et al, 2010). Described as a 'bulge' (Kald et al, 2008; Thompson, 2008), it can affect patients' bodyimage and self-confidence (North, 2014). Parastomal hernias are seen as a long-term complication of stoma surgery (Ripoche et al, 2011) because, following the formation of a stoma, a potential weakness is created within the abdominal muscle as a result of the surgical incision (Pilgrim et al, 2010; Aquina et al, 2014). Such a defect can, over time, allow a loop or loops of bowel to protrude through the abdominal wall, causing a bulge (Rolstad and Boarini, 1996; Kald et al, 2008). Not only does this bulge become visible as it protrudes through clothing, thereby presenting self-image issues for patients, but it also leads to appliance-fitting difficulties, which increases the risk of leakage. This, in turn, causes further distress for the patient with a stoma, as well as adding to the number of management issues that the specialist stoma care nurse needs to consider (Williams et al, 2010).

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“…Limited studies have demonstrated the impact of preventive advice regarding core exercises and support garments (Thompson and Trainor, 2005;North, 2014;Readding, 2014).…”

Section: Preventionmentioning

confidence: 99%

mentioning

confidence: 99%

Using a risk assessment tool for parastomal hernia prevention

2018

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“…The prevention programme in North (2014) indicates potential for immediate post operative exercise when combined with garment support. North (2014) asserts that brand of garment support chosen by the ostomist had no effect on outcome, although expert opinion indicates type of garment is important to achieve optimum outcomes (Readding, 2014). …”

Section: Exercise Advicementioning

confidence: 99%

“…A hernia support garment is thought to alleviate this problem, reducing symptoms and PSH size which makes it less visible through clothing (Williams, 2011;Readding, 2014). However, Cowin and Redmond (2012) showed that although all respondents had ordered a PSH support garment, only 45% regularly wore it, and just 27% thought that wearing a support garment was the best way to manage their stoma.…”

Section: Physical Costmentioning

confidence: 99%

“…patients. Thompson (2009) andReadding (2014) suggest that garment support, education and lifestyle change may be a cost effective PSH prevention strategy and alternative to surgical repair. However, PSH management can be made more costeffective when targeted to reflect the relative risk of PSH for particular patient groups (Figel et al,2012).…”

Section: Physical Costmentioning

confidence: 99%

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Nurse activity to prevent and support patients with a parastomal hernia

Bland

Young²

2015

Gastrointestinal Nursing

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Parastomal hernia (PSH) is a common stoma complication amongst people with a stoma and represents considerable challenge. This paper reviews research evidence to establish how nurses might help to prevent PSH and improve understanding. However, evidence was lacking in this area and found to be of low quality. Studies focused on adults with a stoma who developed a PSH identified that:  An ostomist's waist circumference > 100cm can be a major contributing factor in developing a PSH. The incidence of PSH can be reduced by a non-invasive, nurse-led prevention programme  Pre-operative stoma-siting and education may play a part in preventing PSH.  PSH presents significant physical, psychological and social morbidities for the ostomist, and as a result, many adopt coping strategies rather than seeking professional help.Further research is needed to strengthen the evidence base for care of those with parastomal hernia and elucidate professional opinion.

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Physical activity after colorectal cancer surgery—a cross sectional study of patients with a long-term stoma

Krogsgaard

Andersen

Danielsen

et al. 2021

Support Care Cancer

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Physical activity is recommended to cancer survivors by the World Health Organisation (WHO) and is associated with improved survival after colorectal cancer. It remains unclear whether having a stoma is a barrier for an active lifestyle. We examined the level of physical activity and explored factors impacting physical activity in survivors with a stoma. MethodsA total of 1265 (65%) patients in the Danish Stoma Database completed a multidimensional survey.Physical activity of moderate-and vigorous-intensity was assessed using two validated questions. Based on WHO guidelines, physical activity was categorised into 'Meeting' or 'Not Meeting' recommendations.Multivariate regression analysis, adjusting for potential confounders, provided odds ratio (OR) and 95% confidence intervals (CI) for factors' association with 'Not Meeting' guideline recommendations. ResultsIn total, 571 patients with colorectal cancer reported on physical activity at a median of 4.3 years (interquartile range 3.1-5.8) after stoma surgery. Two hundred ninety-three patients (51%) were 'Meeting recommendations' and 63% of them were 'Highly active'. Two hundred seventy-eight were 'Not meeting' recommendations (49%).Of the factors analysed, patients without support garment were more likely (OR 1.72 [95% CI 1.16; 2.54] not to meet guideline recommendations. We found no association between stoma type, surgical procedure, parastomal bulging and 'problematic stoma' and level of physical activity, respectively. ConclusionIn this large sample of survivors with a stoma half of patients met or exceeded guideline recommendations.Of patients not meeting recommendations some could potentially meet the recommendations by modest increases in either moderate or vigorous activity.

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Assessing support garments in the management of parastomal hernia

Cited by 17 publications

References 12 publications

Using a risk assessment tool for parastomal hernia prevention

Using a risk assessment tool for parastomal hernia prevention

Nurse activity to prevent and support patients with a parastomal hernia

Physical activity after colorectal cancer surgery—a cross sectional study of patients with a long-term stoma

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