A prospective, longitudinal, multicenter, cohort quality-of-life evaluation of an intensive follow-up program for patients with a stoma.
The creation of a stoma can profoundly affect a patient's quality of life. A prospective, 3-month multicenter study was conducted to evaluate stoma patient quality of life among volunteers receiving standard clinical follow-up (S) and those receiving intensive follow-up via telephone (I). A total of 336 patients volunteered to participate; 187 in the S group and 149 in the I group; mean age 63+/-14 years, 65.85% male; the majority (64.3%) had a colostomy. The Stoma Quality of Life Index (SQLI) score was determined at the initial and final visits. No statistically significant difference between the I and S groups was found at baseline except for the subcategory social concerns (P = 0.0123). At 3 months, statistically significant changes were observed between the overall SQLI score of both groups--scores were 58.8 (17.7) and 72.8 (14.6) at baseline and 3 months, respectively (P < 0.0001); in particular, for the subcategories patient satisfaction (P = 0.0173) and medical experience (P = 0.0330). Patients in the I group showed a positive but not statistically significant change in three subscales of the SQLI questionnaire; the I group presented slightly lower differences in the percentage of complications related to the stoma, need for emergency assistance, and for hospitalization. Differences in quality-of-life perceptions also were reflected among geographic areas. Preoperative ostomy nurse care was found to be associated with a greater probability for improvement in select SQLI subscales. The results of this study confirm that personal support and help received pre- and post surgery from ostomy care nurses may enhance ostomate overall quality of life and when additional intensive follow-up was introduced, certain aspects of quality of life improved. The study underscores the need for clinician awareness of their role in patient quality of life.
de la Quintana Jiménez
Paloma
P
La Paz Hospital, Madrid, Spain.
Pastor Juan
Catalina
C
Prados Herrero
Isabel
I
Pérez López
Concepción
C
González Fuentes
Margarita
M
de Mena Casaseca
Carmen
C
Real Romaguera
Arcadio
A
Tejido Valentí
Montserrat
M
Garcia-Alamino
Josep M
JM
Espirac
Brigitte
B
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D054047:Surgical Stomas