Bridging the gap: perceived educational needs in the inpatient to home care setting for the person with a new ostomy.
OBJECTIVE
The purpose of this study was to investigate what specific ostomy self-care educational content is considered the most useful by the new ostomy patient after discharge.


METHODS
A cross-sectional, correlational design was used to address study aims.


METHODS
The sample comprised 33 men and 27 women with a mean age of 55.58 ± 15.56 (mean ± SD) years, range 27 to 79 years old. The study setting was a 587-bed teaching hospital, level 1 trauma center in the Midwest, with Magnet designation.


METHODS
Demographic data were collected during the patients' hospital stay as part of routine care. This information is used for follow-up with all ostomy patients who have surgery in this hospital. All of the participants in this study completed an interview administered by phone or in person. A semistructured interview guide was used to elicit participant perceptions of the usefulness of 4 categories of ostomy care, including (1) ostomy information (ostomy function), (2) activities of daily living (strategies to manage travel, bathing, intimacy, odor), (3) ostomy care (strategies for managing the ostomy), and (4) other informational needs (social support resources). Participants were asked to rate these 4 areas from most useful to least useful, using a 4-point scale. At the end of the interview, participants were asked, "Has there been anything that has happened or event related to your ostomy that your ostomy teaching did not prepare you for?" The interview took place several weeks after surgery or during their readmission visit for surgical ostomy takedown.


RESULTS
Sixty-two patients were enrolled into the study, and 60 participants completed the data collection. The sample included 26 (43%) patients with ileostomies, 18 (30%) with colostomies, and 16 (27%) with urostomies. Ninety percent ranked the education category of ostomy self-care as the most useful content, 55% ranked information on resuming activities of daily living as the second most useful category, and 55% ranked general information as third most useful content area. Fifty respondents (83%) ranked ostomy support as the least useful. Nine (15%) of the participants felt unprepared for their first pouch leak, and 2 (3%) reported difficulty adjusting to the feel of the stool entering the pouch. Two patients would have liked more photos of peristomal skin conditions and how to treat them.


CONCLUSIONS
Since the category of ostomy self-care ranked highest, patient teaching for the new ostomy patient should focus on this skill set, including stoma care, how, and when to empty and change the pouch.
Sherry Lynn Werth, MSN, RN, CWOCN, Clinical Nurse Specialist for Ostomy/Wound Service, Sparrow Hospital, Lansing, Michigan. Debra L. Schutte, PhD RN, Research Consultant, Sparrow Hospital and Associate Professor, Wayne State University, College of Nursing, Detroit, Michigan. Manfred Stommel, PhD, Professor, Michigan State University, College of Nursing, East Lansing.
Sherry Lynn
SL
Werth
Debra L
DL
Schutte
Manfred
M
Stommel
D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004521:Educational Measurement; D005260:Female; D006699:Home Care Services; D006801:Humans; D007297:Inpatients / Q000193:education*; D008297:Male; D008875:Middle Aged; D015146:Midwestern United States; D010030:Ostomy / Q000451:nursing*; D010465:Perception; D012648:Self Care / Q000379:methods*; D014947:Wounds and Injuries / Q000451:nursing* / Q000534:rehabilitation