title: Ostomy-related problems and their impact on quality of life of colorectal cancer ostomates: a systematic review.
abstract: OBJECTIVE
  Many long-term ostomates are 'out-of-sight' of healthcare, and it is unknown how ostomates deal with ostomy-related problems and how these problems affect their quality of life (QOL). The aim is to examine patient-related studies describing ostomy-related problems and their impact on the perceived QOL of long-term colostomates.
  
  
  METHODS
  The electronic databases PubMed (MEDLINE), CINAHL, Cochrane Library and PsycINFO were systematically searched. All studies were included in which ostomy-specific QOL was measured using validated multidimensional instruments.
  
  
  RESULTS
  Of the 6447 citations identified, 14 prevailingly descriptive cross-sectional studies were included. Three different validated multidimensional instruments for measuring QOL in ostomates were used (EORTC C30/CR38, MCOHQOLQO, Stoma QOL Questionnaire). All studies demonstrated that living with a colostomy influences the overall QOL negatively. The ostomy-related problems described included sexual problems, depressive feelings, gas, constipation, dissatisfaction with appearance, change in clothing, travel difficulties, feeling tired and worry about noises.
  
  
  CONCLUSIONS
  In conclusion, all 14 studies gave an indication of the impact of ostomy-related problems on the perceived QOL and demonstrated that a colostomy influences the QOL negatively. There is a wide range of ostomy-specific QOL scores, and there seem to be higher QOL scores in the studies where the MCOHQOLQO instrument was used. The MCOHQOLQO and the Stoma QOL Questionnaire gave the most detailed information about which ostomy-related problems were experienced. This review adds knowledge about the impact of stoma-related problems on QOL of long-term ostomates, but more research has to be conducted, to detect ostomy-related problems and especially possible care needs.
authors.affiliation: Research Centre for Elderly Care and Palliative Care, University of Applied Sciences Saxion, PO Box 70.000, 7500 KB, Deventer, Enschede, The Netherlands. s.m.vonk@saxion.nl.
authors.forename: Sylvia M
authors.initials: SM
authors.lastname: Vonk-Klaassen
authors.affiliation: Research Centre for Elderly Care and Palliative Care, University of Applied Sciences Saxion, PO Box 70.000, 7500 KB, Deventer, Enschede, The Netherlands.
authors.forename: Hilde M
authors.initials: HM
authors.lastname: de Vocht
authors.affiliation: Research Centre for Elderly Care and Palliative Care, University of Applied Sciences Saxion, PO Box 70.000, 7500 KB, Deventer, Enschede, The Netherlands.
authors.forename: Marjolein E M
authors.initials: ME
authors.lastname: den Ouden
authors.affiliation: Deventer Ziekenhuis, Deventer, The Netherlands.
authors.forename: Eric Hans
authors.initials: EH
authors.lastname: Eddes
authors.affiliation: Department of Rehabilitation, Nursing Science and Sports, University Medical Center Utrecht, Utrecht, The Netherlands.|Faculty Chair Care for the Chronically Ill and Elderly, University of Applied Sciences Utrecht, Utrecht, The Netherlands.
authors.forename: Marieke J
authors.initials: MJ
authors.lastname: Schuurmans
mesh_terms: D000368:Aged; D001007:Anxiety / Q000523:psychology; D015179:Colorectal Neoplasms / Q000523:psychology* / Q000601:surgery; D003125:Colostomy / Q000523:psychology*; D003248:Constipation; D003430:Cross-Sectional Studies; D004644:Emotions; D005221:Fatigue / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Colostomates; Ostomy-related problems; Quality of life