Care in the Ostomates Programs: the multidisciplinary team’s perspective

Abstract

Objective: to interpret the multidisciplinary team’s perspective on care for ostomates. Methods: qualitative study involving five professionals from the multidisciplinary team of the Ostomates Program, based on the Social Model of Disability. To collect the data, a focus group, participant and non-participant observation were used, along with a field diary, interpreted using the thematic analysis method. Results: the experience of this team was interpreted based on the theme Challenges for the implementation of the Ostomates Program and the respective thematic nuclei: In search of teamwork and Specialized care demands for intestinal ostomates, which evidenced the influences on the work and the need for improvements in care, infrastructure and human resources. Conclusion: the health professionals’ integration among different public healthcare levels and the ostomates and families’ participation influence the care for ostomates.

Self-care of people with intestinal ostomy: beyond the procedural towards rehabilitation

“…After the surgical procedure, a change occurs to the healthy body of the person with an intestinal ostomy, and they may develop feelings such as shame, insecurity, vulnerability, and non-acceptance of their new condition, despite understanding the need for making this stoma for the resolution of their health problem (1)(2)(3) . Still, the use of a waste output equipment makes social interaction difficult due to the concern with elimination of gases, odor, leakage of feces, and physical discomfort, adopting an attitude of distancing themselves from daily activities, socially and work isolation, resulting in retirement due to disability and changes in daily routine, which makes rehabilitation difficult (1)(2)(3)(4)(5)(6) .…”

“…The experience of self-care of these people is influenced by family support, by significant people, as well as by the specialized support of health professionals to achieve rehabilitation and adaptation to their new condition (1)(2)(3)(7)(8) . Despite this, self-care, which is the start of the rehabilitation process, is not facilitated, as the repercussions of this deficiency in people's lives constitute social barriers in resuming their daily lives.…”

“…The rehabilitation of the person with intestinal ostomy has been linked more towards the physical aspect, however there is a need to plan assistance by integrating physical care with the psychological, cultural, labor, social, and sexual aspects (1)(2)(3)(9)(10)(11) .…”

“…For this study, we adopted the theoretical framework of the Social Model of Disability (12) , which started by Paul Hunt in the United Kingdom, which is justified by the contribution in the interpretation of the physical disability of these people by recognizing that the injured body is linked to situations or conditions imposed by the social structure, considering physical aspects, social barriers, and health care contexts (1)(2)12) . However, the challenge lies in legitimizing collective actions and to repair social inequality, as well as biomedical care to integrate the disability into the person with the modified condition's lifestyle (1)(2)12) , directly influencing self-care and consequently, the reach of rehabilitation.…”

“…This will contribute to the planning of specialized assistance to achieve rehabilitation in order to make the person with intestinal ostomy as independent as possible, analyzing the conditions and limitations for self-care with the ostomy and handling of the waste output equipment, which represent a first aspect, but should not be considered as the only one or the most important (10) . The priority must be on actions to regain control of one's life, with an analysis of the limitations of aptitudes, which should be signaled by the person who experiences the illness and ostomy (1)(2)(3)(13)(14) .…”