Effect of A Designed Nursing and Patients Self Care Protocol on Reducing the Colostomy and Peristomal Skin Complications among the Elderly Patients.

Abstract

Background: Though creation of an ostomy is a life saving procedure and increased lifespan it may result in significant number of complications which impact body image, daily functioning, social activities and a significant reduction in the quality of life. So persons living with colostomy require comprehensive education, training to manage their stoma and to identify, prevent stomal or peristomal complications during the early postoperative period. Aim of the study: To evaluate the effect of a designed nursing and patients self care protocol on reducing the colostomy and peristomal skin complications among the elderly patients. Research design: A Quasi-experimental research design was utilized in the current study. Subjects: A purposive sample including (60) elderly patients from both sexes (males & females) aged 60yrs old and older were included in the current study, they were classified into two equal groups (no=30) for the study group and (no=30) for the control group. Setting: This study was carried out at General Surgical Department and Surgical Outpatient Clinics in Minia University Hospital. Tools of data collection: Four tools were utilized to collect data. Tool I: Patient assessment sheet, Tool II: Designed colostomy nursing and patient's self-care protocol. Tool III: Observation Check list designed by the researcher, Tool IV: Peristomal skin assessment scale. Results: The results of the current study revealed that, the majority of the study group had normal skin along all observations, while all of the control group didn't have normal skin along the 7 observations. Also, there were statistically significant differences among the study and control groups regarding total DET score along the 7 observations. Conclusion: It was concluded that implementation of the educational guideline about stoma self care had a positive effect on improving awareness regarding practice among the study group which leading to prevention of the peristomal skin complications. Also, it was found the majority of study group didn't have peristomal skin complications along all observations while among the control group there was an increase of peristomal skin complications. Recommendations: proper counseling sessions as well as pre and post operative education for ostomy patients that will help them to adjust to their stoma care in a better way. There is need for a simplified illustrated and comprehensive Arabic-language booklet to be used as reference educational guidance for patients with colostomy. In-service educational programs and job training to upgrade nurse's knowledge, attitudes and practices toward providing essentials components of nursing care.