Behavioural profile and human adaptation of survivors after radical cystectomy and ileal conduit.
BACKGROUND
There is a lack of good data in the literature evaluating the Health-Related Quality of Life (HR- QoL) in patients with urinary diversions. The aim of this study was to examine the changes in expectation and needs in terms of human adaptation and behavioural profiles in patients with ileal conduit (IC) after radical cystectomy (RC) for bladder cancer (BC).


METHODS
A qualitative, multicenter cross-sectional study using a "narrative based" approach was planned. We proceed with a sampling reasoned choice (purposive), selecting groups of patients with follow-up from one up to more than 7 years after surgery. Data were collected through individual interviews.


RESULTS
Thirty patients participated in the study. The processing of the interviews allowed us to identify 2 major profiles: positive and negative. Patients with a positive profile resumed normal daily activities with no or limited restrictions both on the personal and the social level. This profile reflects a good HR-QoL. The negative profile reflects the patients for whom the ostomy has meant a worsening of HR-QoL. A positive profile was statistically more frequent in older patients (p = 0.023), with a longer follow-up (p = 0.042) and less complications rates (p = 0.0002). According to the length of follow-up and the occurrence of complitations, we identified further 5 intermediate profiles.


CONCLUSIONS
Patients' satisfaction is related to the degree of adaptation to their new life with an urinary stoma and its correct management. Live "with urinary diversion" represents a new phase of life and not a deterioration.
Maria Angela
MA
Cerruto
Urology Clinic, University of Verona, P,zza L,A, Scuro 10, Verona 37134, Italy. karolinedelia@gmail.com.
Carolina
C
D'Elia
Giovanni
G
Cacciamani
Davide
D
De Marchi
Salvatore
S
Siracusano
Massimo
M
Iafrate
Mauro
M
Niero
Cristina
C
Lonardi
Pierfrancesco
P
Bassi
Emanuele
E
Belgrano
Ciro
C
Imbimbo
Marco
M
Racioppi
Renato
R
Talamini
Stefano
S
Ciciliato
Laura
L
Toffoli
Michele
M
Rizzo
Francesco
F
Visalli
Paolo
P
Verze
Walter
W
Artibani
D000203:Activities of Daily Living / Q000523:psychology; D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D015653:Cystectomy / Q000009:adverse effects / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology; D017741:Survivors / Q000523:psychology; D001749:Urinary Bladder Neoplasms / Q000523:psychology / Q000601:surgery; D014547:Urinary Diversion / Q000009:adverse effects / Q000523:psychology*