A multidimensional modeling of predictors influencing the adjustment to a colostomy.
OBJECTIVE
Factors contributing to the postoperative adjustment of patients who had undergone permanent colostomy surgery were studied.


METHODS
Cross-sectional study.


METHODS
Sixty patients who underwent colostomy surgery at 5 hospitals in Santiago, Chile, between 1987 and 1995 were evaluated. Subjects were between the ages of 27 and 89 and underwent colostomy surgery from 4 months to 19 years before data collection. METHODS AND INSTRUMENTS: A demographic questionnaire and a semistructured interview were used to elicit information concerning psychosocial reactions to a colostomy and perceptions about the changes in lifestyle created by the ostomy. Medical records were reviewed for information about disease-related characteristics and an ostomy self-care scale measured coping skills. Adjustment to the colostomy procedure was measured by means of the Olbrisch ostomy adjustment scale.


RESULTS
Patient adaptation to a colostomy is primarily affected by the following factors: (1) the level of ostomy self-care, (2) psychological support, and (3) social support from family and significant others.


CONCLUSIONS
Successful adjustment to a permanent colostomy is most likely to occur if the patient receives adequate instruction in self-care and has the appropriate psychological support to integrate the new physical changes into a healthy body image. This includes continued acceptance from family and the patient's social network.
Piwonka
M A
MA
Nursing School, Catholic University of Chile, Santiago, Chile.
Merino
J M
JM
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001828:Body Image; D003125:Colostomy / Q000451:nursing / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011788:Quality of Life; D012044:Regression Analysis; D012648:Self Care; D012944:Social Support; D011795:Surveys and Questionnaires