title: Gender differences in quality of life among long-term colorectal cancer survivors with ostomies.
abstract: OBJECTIVE
  To describe how gender shapes the concerns and adaptations of long-term (i.e., more than five years) colorectal cancer survivors with ostomies.
  
  
  METHODS
  Qualitative study using content analysis of focus group content.
  
  
  METHODS
  Oregon, southwestern Washington, and northern California.
  
  
  METHODS
  Four female and four male focus groups (N = 33) selected from 282 quantitative survey participants with health-related quality-of-life (HRQOL) scores in the highest or lowest quartile.
  
  
  METHODS
  Eight focus groups discussed the challenges of living with an ostomy. Content was recorded, transcribed, and analyzed using directive and summative content analysis.
  
  
  METHODS
  HRQOL domains of physical, psychological, social, and spiritual well-being.
  
  
  RESULTS
  All groups reported avoiding foods that cause gas or rapid transit and discussed how limiting the amount of food eaten controlled the output. All groups discussed physical activities, getting support from friends and family, and the importance of being resilient. Both genders identified challenges with sexuality and intimacy. Coping and adjustment difficulties mostly were discussed by women, with men only discussing these issues to a small extent. Difficulties with sleep primarily were identified by women with low HRQOL. Problems with body image and depression were discussed only by women with low HRQOL.
  
  
  CONCLUSIONS
  Common issues included diet management, physical activity, social support, and sexuality. Although both genders identified challenges, women described more specific psychological and social issues than men.
  
  
  CONCLUSIONS
  Application of these gender-based differences can inform educational interventions for colorectal cancer survivors with ostomies.
authors.affiliation: City of Hope National Medical Center, Beckman Research Institute, Duarte, CA, USA. mgrant@coh.org
authors.forename: Marcia
authors.initials: M
authors.lastname: Grant
authors.forename: Carmit K
authors.initials: CK
authors.lastname: McMullen
authors.forename: Andrea
authors.initials: A
authors.lastname: Altschuler
authors.forename: M Jane
authors.initials: MJ
authors.lastname: Mohler
authors.forename: Mark C
authors.initials: MC
authors.lastname: Hornbrook
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Herrinton
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Wendel
authors.forename: Carol M
authors.initials: CM
authors.lastname: Baldwin
authors.forename: Robert S
authors.initials: RS
authors.lastname: Krouse
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000523:psychology / Q000601:surgery*; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D010030:Ostomy / Q000523:psychology*; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology*; D012737:Sex Factors; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data; D013997:Time Factors