Survival and psychosocial adjustment to stoma surgery and nonstoma bowel resection: A 4-year follow-up

Abstract

A prospective 4-year follow-up study was conducted to compare the psychosocial adjustment process and survival rate of 59 stoma patients with 64 bowel-resected nonstoma patients. Adjustment was assessed at 4 months. 1 year, and 4 years after surgery by the Psychosocial Adjustment to Illness Scale, a self-report questionnaire (PAIS-SR). Analyses of covariance demonstrated that both subgroups experienced the same level of psychosocial problems 4 years after surgery. Interestingly, patients with poor early adjustment scores (4 months after surgery) were at significantly higher risk of dropping out because of death and terminal status during the follow-up period (1 and 4 years postoperatively). The presence of a stoma did not influence the risk rate for dropping out. These results demonstrate the need for prolonged psychosocial guidance of outpatients who have been surgically treated for colorectal cancer or inflammatory bowel disease.

Psychosocial adjustment among patients with ostomy: a survey in stoma clinics, Nepal

“…Other studies also suggest that family support is essential for positive adjustment. 2,11,12 Increased time since ostomy surgery significantly predicted a higher psychosocial adjustment score. In this study, the time since ostomy surgery ranged from 6 months to 25 years, mean time being 3.04 years.…”

“…This finding is in agreement with a study conducted in the People's Republic of China 4 which reported a significant difference in psychosocial adjustment scores between the subjects who did and those who did not independently care for their own stoma (P=0.005). Given the volume of evidence 2,4,7,13 confirming the predictive effect of self-care ability on adjustment, it should be a major focus of the treatment in ostomates.…”

“…2 The study compared psychosocial adjustment and survival rate of 59 ostomates with that of 64 patients with no stoma. The measurement was taken at 4 months, 1 year, and 4 years after surgery using Psychosocial Adjustment to Illness Scale -Self-Report.…”

“…Likewise, patients reported strong adjustment to extended family relationship, but poor adjustment to sexual relationship in another study. self-care ability, 2,4,5,7,13 and distress about obtaining supplies. 6 A large number of research studies have been conducted worldwide; however, only one study 14 in Nepal has focused on psychosocial problems of ostomates.…”

Adjusting to bodily change following stoma formation: a phenomenological study

“…Time-points of nine and fifteen months could explore adjustment to a new stoma over time and re-examine the proposition that adjustment to a stoma is complete by one year postsurgery [28,29,30,6]. …”