Psychosocial adaptation to stoma surgery: A review

Abstract

During the last decade strong improvements have been made in the medical care of patients with a digestive tract stoma, particularly with regard to nursing skills and to the quality of collecting material for faecal products. Scientific investigation into the psychosocial adjustment of patients after stoma surgery has intensified as well, giving us indications for quality of life. These developments induced a review of the actual state of affairs in psychological issues. After evaluating the results of psychosocial stoma research, it can be concluded that the technical improvements in stoma care during the past decade did not result in a decline in psychosocial problems after stoma surgery. However, there are some serious problems when interpreting the results of studies in this field of investigation. Stoma surgery is not per se solely responsible for the reported psychosocial problems, first, because many conclusions are based on research studies with poor design and, second, because these studies lack a theoretical framework within which the process of psychosocial adjustment has been measured and explained. This review assesses the most current developments and controversies in this field.

Patients' Views of a Colostomy for Fecal Incontinence

“…Fifty-two of 69 patients (75 percent) reported previous surgery for incontinence (with a median 2 (range, [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] operations in these 52 people). Of these, 34 reported previous anal sphincter repair, 17 previous postanal repair, 15 surgery for rectal prolapse, and 6 other operations.…”

A Stoma Quality of Life Scale

“…12 T he medical literature abounds with articles proclaiming the presumed negative impact that ostomies have on quality of life. [1][2][3][4][5][6][7] In some studies, [8][9][10][11] generic quality of life (QOL) instruments have demonstrated differences between individuals with and without a stoma. Other studies have indicated that a generic measure is not sufficiently specific to identify differences in the impact of a stoma on patient QOL.…”

Psychosocial issues: Pelvic exenterative surgery

“…As to procedures involving the digestive system, Thomas [29] found that dif®culties in coping with the stoma was a greater determinant of later psychiatric disturbance than in coping with the underlying cancer. Bekker et al [30] reviewed the literature and concluded that technical improvements in stoma care did not result in a decline of psychosocial problems after surgery.…”