title: Demographic and clinical factors related to ostomy complications and quality of life in veterans with an ostomy.
abstract: OBJECTIVE
  The purpose of this study is to describe demographic, clinical, and quality-of-life variables related to ostomy complications (skin irritation, leakage, and difficulty adjusting to an ostomy) in a veteran population in the United States.
  
  
  METHODS
  The original study employed a descriptive crosssectional study using a mixed method design. This secondary analysis used the quantitative data collected.
  
  
  METHODS
  Two hundred thirty-nine veterans with intestinal ostomies from 3 Veteran's Administration hospitals participated in the study.
  
  
  METHODS
  Instruments used for this investigation included the City of Hope Quality of Life: Ostomy Instrument. Demographic and medical history data were collected from the survey, the Veteran's Administration health information system, and the Tumor Registry database. A self-administered survey questionnaire (mCOH-QOL-Ostomy) was mailed to each participant.
  
  
  RESULTS
  The severity of skin irritation, problems with leakage, and difficulty adjusting were significantly related to demographic, clinical, and quality-of-life domains. Univariate analyses showed that age, income, employment, preoperative care (stoma site marking and education), having a partner, ostomy type, reason for ostomy, time since surgery, total quality-of-life scores and scores on all 4 domains of quality of life were related to the severity of these ostomy complications. Age was inversely related to severity of all 3 ostomy complications (skin irritation, leakage, and difficulty adjusting). Having an ileostomy, rather than a colostomy, was associated with higher severity of skin irritation. Having had the stoma site marked preoperatively was associated with less difficulty adjusting to an ostomy, and having had preoperative ostomy education was associated with less severe problems with skin irritation and leakage. Severity of each ostomy complication predicted total quality-of-life scores. Difficulty adjusting to the ostomy was related to all 4 quality-of-life domains (physical, psychological, social, and spiritual).
  
  
  CONCLUSIONS
  This study found important relationships between demographic and clinical factors and ostomy complications. Skin problems, leakage, and difficulty adjusting predicted total quality of life scores and domains. Establishing relationships among ostomy complications and demographic, clinical factors, and quality of life can enhance identification of patients at risk for the development of complications and is an important first step in identifying the development of effective interventions to reduce the negative impact of complications for people with ostomies. Further study of predictors and outcomes of ostomy complications is needed to improve care.
authors.affiliation: School of Nursing, Indiana University Purdue University at Indianapolis, Indianapolis, Indiana, USA. jpittma3@clarian.org
authors.forename: Joyce
authors.initials: J
authors.lastname: Pittman
authors.forename: Susan M
authors.initials: SM
authors.lastname: Rawl
authors.forename: C Max
authors.initials: CM
authors.lastname: Schmidt
authors.forename: Marcia
authors.initials: M
authors.lastname: Grant
authors.forename: Clifford Y
authors.initials: CY
authors.lastname: Ko
authors.forename: Christopher
authors.initials: C
authors.lastname: Wendel
authors.forename: Robert S
authors.initials: RS
authors.lastname: Krouse
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001294:Attitude to Health; D016022:Case-Control Studies; D003125:Colostomy / Q000009:adverse effects / Q000523:psychology; D003430:Cross-Sectional Studies; D017453:Dermatitis, Irritant / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D007081:Ileostomy / Q000009:adverse effects / Q000523:psychology; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D015404:Nursing Methodology Research; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D014481:United States; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data