title: A mixed-method study on the generic and ostomy-specific quality of life of cancer and non-cancer ostomy patients.
abstract: OBJECTIVE
  The aim of this study is to compare the generic and ostomy-specific quality of life (QoL) between cancer and non-cancer ostomy patients using a mixed-method design.
  
  
  METHODS
  All patients with an ostomy participating in the Stomapanel of the Dutch Ostomy Association were asked to complete a generic (RAND-36) and ostomy-specific (Stoma-QoL) QoL questionnaire. In addition, open-ended questions on symptoms, restrictions or adaptations influencing daily life were included. The generic and ostomy-specific QoL between cancer and non-cancer ostomy patients were compared using linear regression analyses. Qualitative responses were analysed using content analysis.
  
  
  RESULTS
  In total, 668 patients were included: 379 cancer patients (80 % colorectal, 17 % bladder and 3 % other) and 289 non-cancer patients (38 % colitis ulcerosa, 22 % Crohn's disease and 40 % other) with a colostomy (55 %), ileostomy (31 %) and/or urostomy (16 %). Adjusted for gender, age, type of ostomy and time elapsed since ostomy surgery, cancer ostomy patients scored higher (better) on Stoma-QoL (β = 2.1) and all RAND-36 domains (9.1 < β ≤ 19.5) except on mental health compared to non-cancer ostomy patients. Of the 33 themes coded for in the content analysis, fatigue or sleeplessness, leakages, pain, bladder or bowel complaints, physical functioning or activity, travelling or being away from home, other daily activities (including work), clothing and diet were among the 10 most frequently reported themes, although ranking differed between both patient groups. Besides, cancer ostomy patients frequently reported on the impact on (engaging in a) relationship or sexual intimacy and non-cancer ostomy patients frequently reported to be relieved of symptoms and restrictions in daily life.
  
  
  CONCLUSIONS
  Cancer patients reported better generic and ostomy-specific QoL than non-cancer ostomy patients. In both cancer and non-cancer ostomy patients, fatigue or sleeplessness, leakages, pain, bladder or bowel complaints, physical functioning or activity, travelling or being away from home, other daily activities (including work), clothing and diet were among the 10 most common reported themes influencing daily life. However, the ranking of these 10 most common themes was different in both patient groups.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
authors.forename: Femke
authors.initials: F
authors.lastname: Jansen
authors.forename: Cornelia F
authors.initials: CF
authors.lastname: van Uden-Kraan
authors.forename: J Annemieke
authors.initials: JA
authors.lastname: Braakman
authors.forename: Paulina M
authors.initials: PM
authors.lastname: van Keizerswaard
authors.forename: Birgit I
authors.initials: BI
authors.lastname: Witte
authors.forename: Irma M
authors.initials: IM
authors.lastname: Verdonck-de Leeuw
mesh_terms: D000328:Adult; D000368:Aged; D005221:Fatigue; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D010030:Ostomy / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D012725:Sexual Behavior; D007319:Sleep Initiation and Maintenance Disorders; D011795:Surveys and Questionnaires