title: A Prospective, Multicentered Study to Assess Social Adjustment in Patients With an Intestinal Stoma in Turkey.
abstract: Patients with a stoma undergo physiological, psychological, and social adjustment to their new life situation. A descriptive, prospective study was conducted to assess adaptation among patients >18 years of age with a new temporary or permanent colostomy or ileostomy living in Turkey and receiving care at a participating stomatherapy unit. The study took place between September 1, 2011, and September 1, 2012. During hospitalization and following discharge, patients with a stoma received training and counseling according to their individual characteristics and their physiological, psychological, and social needs. Each participant completed the 19-item "Identification Form for Patients with a Stoma" at the beginning of the study to document sociodemographic and stoma characteristics. To assess adjustment to the stoma, The Ostomy Assessment Inventory (OAI-23) was administered 2 times - the first within 1 month and the second within 6 months after surgery or when a temporary stoma was closed (whichever came first). This instrument comprised 23 items regarding adaptation to the stoma using Likert-type response options (0-4 range). Total scores ranged from 10 to 92, with higher scores indicating better adjustment. The instruments were completed by stoma and wound care nurses during face-to-face interviews. Data were analyzed using the Kruskal-Wallis, Mann-Whitney, and Wilcoxon tests. Of the 135 participants, the majority (77, 57.0%) were male; 73 (54.1%) had a colostomy, and 106 (78.5%) had a temporary stoma. The primary reason for stoma creation was cancer (89, 65.9%). Mean total OAI-23 scores were 48.63 ± 13.75 at the first administration and 50.59 ± 13.89 for the second. In terms of sociodemographic factors, significant increases in mean scores from the first to the second survey time were noted among patients in the 50-69 age group, women, married persons, and unemployed persons (P less than 0.05). With regard to stoma characteristics, the OAI-23 scores of patients with planned stoma operations and persons with permanent stomas increased significantly (P less than 0.05) between assessments. Significant increases in OAI-23 scores also were noted among persons who did not receive information before the operation, patients whose stoma site was not marked, and patients who had experienced a complication (P less than 0.05). Postoperatively, it is important to consider sociodemographic and stoma characteristics as well as preoperative variables that may influence adaptation to stoma. Additional larger, multicentered studies with extended patient follow-up are warranted.
authors.affiliation: School of Nursing, Koç University, İstanbul, Turkey.
authors.forename: Ayişe
authors.initials: A
authors.lastname: Karadağ
authors.affiliation: Department of Nursing, Faculty of Health Science, Nuh Naci Yazgan University, Kayseri, Turkey.
authors.forename: Hatice
authors.initials: H
authors.lastname: Karabulut
authors.affiliation: Department of Nursing, Faculty of Health Science, Gazi University, Ankara, Turkey.
authors.forename: Zehra G
authors.initials: ZG
authors.lastname: Baykara
authors.affiliation: Department of Nursing, Faculty of Health Science, İzmir University of Economics, İzmir, Turkey.
authors.forename: Deniz
authors.initials: D
authors.lastname: Harputlu
authors.affiliation: Istanbul University Cerrahpasa Hospital, Istanbul, Turkey.
authors.forename: Eylem
authors.initials: E
authors.lastname: Toyluk
authors.affiliation: Uludag University Hospital, Bursa, Turkey.
authors.forename: Birgül
authors.initials: B
authors.lastname: Ulusoy
authors.affiliation: Turkey High Specialization Education and Research Hospital, Ankara, Turkey.
authors.forename: Sercan
authors.initials: S
authors.lastname: Karadağ
authors.affiliation: Ege University Hospital, Izmir, Turkey.
authors.forename: Aysel
authors.initials: A
authors.lastname: Kahraman
authors.affiliation: Gazi University Hospital, Ankara, Turkey.
authors.forename: Aysel Ören
authors.initials: AÖ
authors.lastname: Hin
authors.affiliation: Istanbul University Capa Hospital, Istanbul, Turkey.
authors.forename: Meral
authors.initials: M
authors.lastname: Altinsoy
authors.affiliation: Çukurova University Hospital, Adana, Turkey.
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Akıl
authors.affiliation: Gazi University Faculty of Medicine, Department of Surgery, Colorectal Cancer Surgery.
authors.forename: Sezai
authors.initials: S
authors.lastname: Leventoğlu
mesh_terms: D000328:Adult; D000368:Aged; D000066498:Emotional Adjustment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012648:Self Care / Q000379:methods / Q000523:psychology*; D012917:Social Adjustment; D054047:Surgical Stomas / Q000009:adverse effects*; D011795:Surveys and Questionnaires; D014421:Turkey