Prospective Evaluation of Psychosocial Adaption to Stoma Surgery

Abstract

Self-efficacy, one's expectations regarding the ability to perform some specific task, was studied prospectively in the adaptation process of stoma patients. One week after surgery, stoma-related self-efficacy was assessed in 59 patients (26 cancer patients and 33 patients with benign diseases) who had undergone intestinal stoma surgery. Twenty-nine items concerning self-efficacy were formulated. Factor analysis with oblique rotation resulted in two factors: a social functioning-related self-efficacy factor and a stoma care-related self-efficacy factor. Psychosocial adjustment was assessed by means of the Psychosocial Adjustment to Illness Scale (PAIS-SR) at 4 and 12 months after surgery. The PAIS-SR renders one global adjustment score and (in this study) five subscores for adjustment to specific life domains: vocational environment, domestic environment, sexual relationship, social environment, and psychological distress. In a multiple regression analysis, the relevance of self-efficacy for later adjustment was determined after partialing out the effects of relevant sociodemographic and medical factors. Strong evidence was found for the important role of self-efficacy in the process of adapting to a stoma; stronger feelings of self-efficacy shortly after the operation predicted fewer psychosocial problems in the course of the first postoperative year. Stoma care-related self-efficacy appears especially important in the first phase after surgery. Social functioning-related self-efficacy explains significant proportions of the variances in PAIS-SR total score and PAIS-SR subscores, in both the short (4 months after surgery) and long runs (12 months after surgery). If patients expect to be able to take care of their stoma, their postoperative adjustment is relatively good. By strengthening patients' self-efficacy, this adaptation process may be accelerated, and the psychological and social burden can be lightened.

Adjusting to bodily change following stoma formation: a phenomenological study

“…and feeling in control of the body following stoma formation as promoting adaptation to a new stoma [31,5,14,18]. Only Kelly [9,22] and McVey et al [17] investigate the relationship between bodily mastery and social functioning that was evident in the present study.…”

“…Illness history, diagnosis and mode of presentation for surgery are factors that may contribute to the experience of living with a stoma [31,5]. Therefore, a maximum variation purposive sampling strategy was used to facilitate the recruitment of individuals with different diagnoses, illness histories and modes of presentation [32].…”

Colostomia continente com esfíncter artificial de silicone: estudo em cães

“…Uma colostomia definitiva, sem dúvi-da alguma, dá origem a um grande impacto na rotina diária do indivíduo, pois com a abolição de uma função importante do corpo, a capacidade de regular a eliminação dos excrementos fecais, associada a distorção da imagem corporal, acompanhada da mudança do funcionamento físico e dos cuidados pessoais, requerem uma habilidade de ajustamento para se chegar ao domínio da situação 12 .…”

“…No entanto, os estudos psicossociais revelaram que os problemas emocionais persistem, sendo representados pela diminuição dos contatos sociais, da libido e problemas relacionados ao trabalho. Todavia, existem três fatores que são considerados responsá-veis pelas diferenças individuais, quais sejam, o médico, o sociodemográfico e o psicológico 12 .…”

Psychometric Evaluation of the Ostomy Complication Severity Index

“…Stoma care self-efficacy was measured using the Stoma Care SelfEfficacy Scale, a well-established instrument developed by Bekkers and colleagues (13 items, Cronbach alpha= 0.94). 17 In our study, stoma care self-efficacy was measured at two points in time: baseline and follow-up. The patient or the caregiver, whichever person performed stoma care, completed the instrument.…”