title: Going with the flow: quality-of-life outcomes of cancer survivors with urinary diversion.
abstract: OBJECTIVE
  The purpose of this descriptive study was to describe health-related quality of life (HRQOL) concerns among cancer patients with continent urinary diversion (UD) and incontinent UD.
  
  
  METHODS
  Study participants were accrued from members of the California United Ostomy Association and 2 cancer centers in Southern California.
  
  
  METHODS
  The City of Hope HRQOL-Ostomy Questionnaire (COHHRQOL-O) is a modified HRQOL measurement tool based on the original work done over a number of years by Grant and colleagues.
  
  
  METHODS
  The COHHRQOL-O was mailed to 2,890 individuals. Of the 1,600 returns, there were 307 responses from patients with UD, indicating that they had a UD and a diagnosis that clearly indicated cancer.
  
  
  RESULTS
  The majority of respondents were diagnosed with bladder cancer, and the average time since surgery was 9.5 years. While most patients reported being sexually active prior to UD, less than 27% resumed sexual activity after surgery. More than 75% of patients also reported difficulty in adjusting to their UD, with the majority reporting difficulty with urine leakage. Those who were incontinent reported a range of bothersome issues, such as skin problems around the UD, difficulties in managing UD care, fear of recurrence, financial worries, family distress, and uncertainty about the future.
  
  
  CONCLUSIONS
  The results of this study add to our understanding of how patients adjust to a UD and what problems and issues can occur, even years after the initial surgery. Mastering UD care is best done under the guidance of a WOC nurse, and access to WOC nurse is essential when problems occur.
authors.affiliation: Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, California 91010, USA. rgemmill@coh.org
authors.forename: Robin
authors.initials: R
authors.lastname: Gemmill
authors.forename: Virginia
authors.initials: V
authors.lastname: Sun
authors.forename: Betty
authors.initials: B
authors.lastname: Ferrell
authors.forename: Robert S
authors.initials: RS
authors.lastname: Krouse
authors.forename: Marcia
authors.initials: M
authors.lastname: Grant
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D054047:Surgical Stomas; D017741:Survivors / Q000523:psychology*; D016896:Treatment Outcome; D014547:Urinary Diversion / Q000523:psychology*; D014571:Urologic Neoplasms / Q000473:pathology / Q000523:psychology* / Q000601:surgery*