Effects of transtheoretical model‐based intervention on the self‐management of patients with an ostomy: A randomised controlled trial

Abstract

Aims and objectives To determine the effect of a transtheoretical model (TTM)‐based intervention on patients with an ostomy and provide patient‐centred, accessible assistance and dynamic education to improve patient self‐management. Background Proper self‐management may promote the rehabilitation of patients with an ostomy. TTM‐based interventions have resulted in positive health behavioural changes. Design Randomised controlled trial performed according to the CONSORT guidelines. Subject and setting The sample comprised 55 men and 37 women (24–77 years old, mean ± SD = 52.8 ± 11.13 years). The study settings included three tertiary hospitals in Changsha, Hunan, China. Methods The 92 patients, recruited from August 2012 to March 2013, were randomised into a control group and an intervention group. Randomisation was done by using a block randomisation list with a block size of 4. Self‐management behaviours were assessed at the baseline, 2 days before discharge and after 1, 3 and 6 months of follow‐up. The chi‐squared test, independent sample t test and repeated measures analysis of variance were used to analyse the data. Results Patients in the intervention group were more likely to be at the action and maintenance stages compared with those in the control group. We also observed significant improvements in the self‐management ability in the process of change, the decisional balance and self‐efficacy in the intervention group compared with those in the control group after four intervention sessions and up to 6 months of follow‐up. No serious intervention‐related adverse events were observed. Conclusions The TTM‐based intervention had positive effects on self‐management behaviours of patients with an ostomy. Relevance to clinical practice The TTM‐based intervention had positive effects on self‐management behaviours of patients with an ostomy and may provide a reference for health providers to develop behaviour promotion programmes to improve the self‐management of patients with an ostomy.

Describing self‐care and its associated variables in ostomy patients

“…Information and autonomy might be interrelated, and it is not surprising that they both were associated with self‐care maintenance and monitoring. In fact, prior studies have already shown that educational programmes during the pre‐ and postoperative phases improve ostomy self‐care (Faury, Koleck, Foucaud, M’Bailara, & Quintard, 2017; Seo, 2019; Wen et al., 2019). People who are autonomous in their care are implicitly more likely to perform self‐care.…”

“…Patients with a permanent ostomy can live with it even for several years (Krouse et al., 2016) if we consider the ostomies as the result of colorectal (Sun et al., 2013) or bladder cancer (Jensen, Kiesbye, Soendergaard, Jensen, & Kristensen, 2017), which have a 5‐year survival rate of between 40% and 65% (Liu et al., 2016; Siegel et al, 2017). Therefore, an ostomy can lead to complex and lifelong consequences for patients (Villa, Mannarini, et al, 2019; Wen et al., 2019).…”

Tailoring Health-promoting Programs for Patients with Chronic Kidney Disease: Randomized Controlled Trial

“…Research indicates that individuals fail to engage in regular physical activity due to low self-efficacy, low perceived benefits, and high perceived barriers (Wen et al, 2018). A number of factors are responsible for behavior changes in physical activity.…”

“…Patients’ individual needs, preferences for care, and goals must be considered for optimum outcomes (Richards et al, 2007). A systematic review concluded that tailored interventions, a patient-centered approach in which information delivery is customized to match patient’s characteristics, were nearly 50% more effective than standard interventions in promoting health behavior outcomes (Wen et al, 2018).…”

The development of a behaviour questionnaire for stoma self‐management for persons with bladder cancer and an ileal conduit

“…Self-efficacy refers to the belief that an individual can effectively initiate the necessary activities and perform the necessary behaviours (Bandura, 1997). A study conducted by Wen et al (2019) found that self-management behaviour changes facilitated a positive adaptation to the chronic condition of those living with a stoma. Therefore, an effective tool is needed to accurately measure self-management behaviours and to elucidate its role in the self-management of people living with a stoma after RC and IC.…”