Experiences and Perceptions in Dyads about Ostomy Care. Meta-synthesis of Qualitative Studies

Abstract

Objective. To understand the experiences and perceptions of care dyads (person and caregiver) when having a permanent discharge ostomy.
 Methods. Meta-synthesis that followed the ENTREQ standards and was registered in PROSPERO CRD42020221755; It was developed in three phases: (i). Search for studies in academic search engines, with MeSH terms: [(Patients) AND (Ostomy)) AND (Caregivers)], including qualitative primary studies published between 2000 and 2020; (ii). Assessment of the methodological quality with the CORE-Q instrument and the credibility of qualitative findings under the guidelines of the Johanna Briggs Institute; and (iii). Comparative analysis according to the guidelines by Sandelowski and Barroso.
 Results. The work identified 664 studies; in screening, 35 passed to full-text analysis; 22 to methodological quality evaluation; and 10 to meta-synthesis. The study found 43 qualitative findings that constituted four categories: dyads perform instrumental and emotional care; ambivalent family caregiving feelings and actions; assertive and effective family care; and rejection of bodily changes and sexual dysfunction. These categories constitute the central meta-theme: “The dyads experience a life rupture, which is restored in a sea of ​ambivalent ​emotions and learning; at the same time, affective, instrumental and assertive care is constructed”.
 Conclusions: People who experience having a permanent discharge ostomy express their rejection to the change in bodily image, alterations in sexual life and as a couple. Caregivers and families are the main source of support by being facilitators in self-care, through relationships of mutuality and reciprocity.

La importancia de educar a los pacientes ostomizados: un compromiso de cuidado continuo en la enfermería

“…De esta estadística, muchas de las cirugías son de urgencia, por lo que no se prepara al paciente desde un marcaje adecuado para ostomía y conozca el nuevo proceso que le permitirá adaptarse con mayor seguridad a la convivencia con una ostomía. Dentro de los profesionales de la salud, el enfermero, no solo es el responsable de brindar cuidados especializados, sino que su papel es importante como educador y para ello debe reforzar los siguientes aspectos como el autocuidado, la sexualidad, la alimentación, el vestido y sobre todo que el paciente realice sus actividades cotidianas con confianza y seguridad junto a su red de apoyo en su hogar; la pareja o su familia (2).…”