StomaCare: quality of life impact after enhanced follow‐up of ostomy patients by a home healthcare nursing service—a multicentre, randomized, controlled trial

Abstract

Aim A stoma exposes patients to several complications which could impair their quality of life (QoL). In the last decade, the market for stoma therapy in France has evolved, with a significant increase in the activities of home health providers, meeting a need for patient follow‐up and companionship. International studies have demonstrated the impact of the stoma therapist (ST) follow‐up on the improvement of an ostomy patient's QoL. However, the impact of home stoma nurse management has not been analysed. In this context we would like to assess the added value on health‐related QoL from the enhanced follow‐up of ostomy patients by STs. Methods This is a randomized, controlled, open, national and multicentre trial (12 centres) which includes patients with an ostomy who benefit from either standard follow‐up or from an enhanced and personalized follow‐up with, in particular, regular consultations with an ST after discharge. The primary end‐point is the 3‐month QoL score obtained from the Stoma‐QoL questionnaire. The secondary end‐points are satisfaction of the care, comparison of QoL scores (Stoma‐QoL and EuroQuol EQ‐5D) and the economic gains by calculating the consumption of resources between the two arms. There will be a modified intention‐to‐treat analysis with 6‐month follow‐up in both study arms. Discussion The StomaCare trial will be the first randomized controlled study in France to evaluate the impact on QoL of an enhanced follow‐up at home of ostomy patients by an ST.

Changes in the quality of life of adults with an ostomy during the first year after surgery as part of the Best Practice Spotlight Organisation® Programme

“…In addition, according to RNAO's BPG Supporting adults who anticipate or live with an ostomy , the stoma care provided by the stoma therapy nurse at each of the follow‐ups reinforces the training in the handling of the device, and providing standardised educational and informative reminders during the perioperative period up to 1 year of outpatient follow‐up is a fundamental pillar of effective psychosocial coping (RNAO, 2019a). Therefore, there is no doubt that nursing interventions are necessary to reduce complications, to acquire self‐care skills, and to achieve a certain degree of independence, all of which help patients and their families to accept and adjust to the new situation and, consequently, to attain a better quality of life 11,22,32 . Another nursing intervention influencing patient quality of life, as reported in numerous studies, is marking the stoma site.…”

“…Therefore, there is no doubt that nursing interventions are necessary to reduce complications, to acquire self‐care skills, and to achieve a certain degree of independence, all of which help patients and their families to accept and adjust to the new situation and, consequently, to attain a better quality of life. 11 , 22 , 32 Another nursing intervention influencing patient quality of life, as reported in numerous studies, is marking the stoma site. This elective pre‐surgical intervention reduces the number of complications and has a positive impact on quality of life.…”

“…The most effective interventions to improve quality of life and reduce complications include the following: perioperative training for patients and their families on general and specific stoma care recommendations, encouraging self‐acceptance and self‐care; marking the stoma site prior to surgery, which leads to lower rates of peristomal dermatitis and fewer urinary leaks from the device, making it easier to dress or adapt clothing 20 , 21 ; and, in general, all interventions intended to enhance self‐care skills and promote maximum autonomy among these patients, which improves their satisfaction. 22 …”

“…19 The most effective interventions to improve quality of life and reduce complications include the following: perioperative training for patients and their families on general and specific stoma care recommendations, encouraging self-acceptance and self-care; marking the stoma site prior to surgery, which leads to lower rates of peristomal dermatitis and fewer urinary leaks from the device, making it easier to dress or adapt clothing 20,21 ; and, in general, all interventions intended to enhance self-care skills and promote maximum autonomy among these patients, which improves their satisfaction. 22 The two hospitals participating in this study are part of the network of centres included in the Best Practice Spotlight Organisation (BPSO) ® Programme. This is an international programme, widely disseminated in Spain, which aims to implement the best practice guidelines (BPGs) issued by the Registered Nurses' Association of Ontario (RNAO) ® .…”

Resultados de la implementación de una guía de recomendaciones en el cuidado de las personas con ostomías digestivas

“…Estas ostomías generan un impacto importante en la vida diaria de los pacientes, tanto a nivel físico como emocional (cambios en la imagen corporal, sexual y a nivel psicológico), lo que conlleva que las personas ostomizadas necesiten atravesar un proceso de aprendizaje para su autocuidado (5).…”