The relevance of lowered personal control for patients who have stoma surgery to treat cancer

Abstract

We make three recommendations based on the conclusion that improvements could be implemented in the psychological aspects of stoma care and, in particular, the enabling of patient perceived self-efficacy. First, improvements could be made in doctor-patient communication with doctors becoming more aware of their psychological impact on patients. Second, specialist stoma care nurses could be trained to recognize patients with dysfunctional self-efficacy beliefs and/or delayed psychological adaptation. Finally, we identify a need for more prolonged practical and emotional support for at least some stoma out-patients.

Adjusting to bodily change following stoma formation: a phenomenological study

“…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. The transferability of these previous studies is limited by a focus on specific diagnoses and limited follow-up, with Kelly [9] adopting a retrospective approach and McVey et al [17] exploring the experience of stoma formation for cancer prospectively but only up to three months following surgery.…”

“…The transferability of these previous studies is limited by a focus on specific diagnoses and limited follow-up, with Kelly [9] adopting a retrospective approach and McVey et al [17] exploring the experience of stoma formation for cancer prospectively but only up to three months following surgery. An interruption to general physical function, in particular pain and mobility, is most common in the immediate post-operative period [21,29,9,17,41] but what needs to be acknowledged more fully is that mastering general bodily function continues to 20 impact on social reintegration for individuals with a new stoma at a year or more following their surgery.…”

“…Specifically, awareness of a changed body [9], living with bodily changes [10], alienation from the body [10,11] and altered body image [11]). In other studies the experience of bodily change has been described in broad themes relating to loss of wholeness [12], practical stoma management [9,13,14], self-care [15], adapting to change [16], personal control [17,18] and feeling different [19]. Profound feelings of self-deprecation and self-hatred, with reactions of shock, disgust and repulsion are not uncommon among people after undergoing stoma-forming surgery [20,21,15,10,13,11].…”

“…Sutherland et al [20], Kelly [90], McVey et al [17], Rozmovits and Ziebland [14] and Annells [18] all identify a feeling of loss of control related to the particular problems caused by unprompted and unexpected faecal or flatus output from a stoma and the experience of appliance leakage.…”

“…The level of support individuals are given to achieve this influences their perceived control over and adjustment to their stoma [9,13,17,11].…”