The effects of colostomy on the quality of life in patients with spinal cord injury: a retrospective analysis.
OBJECTIVE
The purpose of this study was to evaluate the effects of colostomy on the quality of life (QOL) in patients with spinal cord injury (SCI) by designing a questionnaire that used self-reported data and correlating these data with the clinical information obtained from patients' medical records.


METHODS
A comprehensive QOL questionnaire was designed to specifically address the following 5 domains: physical health, psychosocial adjustment, body image, self-efficacy, and recreation/leisure. This questionnaire was completed during a telephone or an in-person interview. The subjective data derived from the questionnaire were correlated with objective medical information obtained from a review of medical records.


RESULTS
The QOL improved significantly (t = 9.1 28, P < .0001) after colostomy. All 27 (100%) patients were "satisfied," and 16 (59%) of them were "very satisfied" with colostomy. Nineteen (70%) patients would have preferred to have the colostomy done earlier, and only 3 (11%) patients wished it reversed. Colostomy reduced the number of hospitalizations caused by chronic bowel dysfunction by 70.4%. After colostomy, the average amount of time spent on bowel care was reduced from 117.0 min/day to 12.8 min/day (t = 7.964, P < .0001). All patients stated that colostomy simplified bowel care routine and increased independence. Significant improvements were recorded in the areas of physical health, psychosocial adjustment, and self-efficacy. Stoma prolapse and wound dehiscence were the most common complications of stomal surgery. When compared with medical data, patients were able to reliably recall average time with bowel problems (r = .881, P < .0001) and stomal surgery complications (r = .810, P < .0001).


CONCLUSIONS
Colostomy is a safe and effective treatment for chronic bowel dysfunction in patients with spinal cord injury. It is well accepted by the patients and significantly improves QOL and bowel management procedures. Correlation analysis indicates that subjective patient-reported data are consistent with objective data obtained from the medical records.
Rosito
Olga
O
Spinal Cord Injury Service, VA Palo Alto Health Care System, California 94304, USA.
Nino-Murcia
Matilde
M
Wolfe
Vickie A
VA
Kiratli
B Jenny
BJ
Perkash
Inder
I
D000328:Adult; D000368:Aged; D003125:Colostomy / Q000523:psychology*; D005260:Female; D005772:Gastrointestinal Transit; D006801:Humans; D007410:Intestinal Diseases / Q000209:etiology / Q000523:psychology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D011788:Quality of Life; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications / Q000523:psychology* / Q000601:surgery*; D013997:Time Factors