title: 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.
authors.affiliation: The Netherlands Institute of Primary Health Care, NIVEL, Utrecht, The Netherlands. M.BEKKERS@NIVEL.NL
authors.forename: M J
authors.initials: MJ
authors.lastname: Bekkers
authors.forename: F C
authors.initials: FC
authors.lastname: van Knippenberg
authors.forename: A M
authors.initials: AM
authors.lastname: van Dulmen
authors.forename: H W
authors.initials: HW
authors.lastname: van den Borne
authors.forename: G P
authors.initials: GP
authors.lastname: van Berge Henegouwen
mesh_terms: D000223:Adaptation, Psychological; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D015179:Colorectal Neoplasms / Q000401:mortality* / Q000523:psychology* / Q000601:surgery; D003125:Colostomy / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007081:Ileostomy / Q000523:psychology*; D015212:Inflammatory Bowel Diseases / Q000401:mortality* / Q000523:psychology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010352:Patient Dropouts / Q000706:statistics & numerical data; D011446:Prospective Studies; D017741:Survivors / Q000523:psychology*; D013997:Time Factors