Stoma care problems after stoma surgery in Northern Finland.
OBJECTIVE
Stoma-related complications and problems in stoma care are common after gastrointestinal surgery requiring the construction of a stoma. The frequency and types of such complications and problems were evaluated in a patient cohort operated on in Oulu University Hospital.


METHODS
A detailed questionnaire concerning clinical problems and stoma care was mailed to 163 stoma patients operated on during the years from 1995 to 2001 in Oulu University Hospital. One hundred and nineteen patients (70 percent) answered the questions adequately. The clinical variables concerning stoma complications and the patients' symptoms, problems with stoma care and adaptation to the situation were recorded. Special attention was paid to the patients' general wellbeing and social problems.


RESULTS
Thirty-five patients (30%) had stoma complications, most commonly parastomal hernias (18 cases). Patients with an ileostomy had more difficulties with stoma handling more often than the patients with a colostomy. Seventy-eight patients (66%) were well adapted to their stoma, including 49 (72%) of the patients with a colostomy and 25 (56%) of the patients with an ileostomy. Of the 41 non-adapted patients, 12 did not accept their altered body image, ten had problems in social life and nine had difficulties because of faecal leakage. The quality of life analysis of 114 patients showed that their physical condition was better than before the operation in 55 cases (48%), unchanged in 16 (14%) and worse in 43 (38%). General mental health was better than before the operation in 52 cases (46%), unchanged in 23 (20%) and worse in 39 (34%) patients. Social functioning had improved after stoma surgery in 38 cases (34%), remained unchanged in 27 (24%) and deteriorated in 46 (42%) patients after stoma surgery. Patients with a colostomy reported worse subjective physical condition, mental health and social functioning than the patients with an ileostomy.


CONCLUSIONS
Two-thirds of the patients had adapted to their stoma. The patients with an ileostomy had difficulties in stoma handling and the patients with a colostomy reported their physical, mental and social wellbeing to be affected.
Department of Surgery, Division of Gastroenterology, Oulu University Hospital, Finland. jyrki.makela@oulu.fi
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JT
Mäkelä
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Niskasaari
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D005260:Female; D005387:Finland; D005767:Gastrointestinal Diseases / Q000523:psychology* / Q000601:surgery; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000523:psychology*; D011788:Quality of Life; D054047:Surgical Stomas; D011795:Surveys and Questionnaires