title: A chronic care ostomy self-management program for cancer survivors.
abstract: BACKGROUND
  Individuals with ostomies experience extensive changes in health-related quality of life (HRQOL) and daily routine. Patients and families are typically forced to use trial and error to improve self-management.
  
  
  METHODS
  This is a longitudinal one-group design pilot study of a five-session ostomy self-care curriculum based on the Chronic Care Model to improve HRQOL and self-management for cancer survivors with ostomies. Participants were surveyed to evaluate each session. Multiple instruments were administered to examine outcomes at baseline, post-intervention, and at 6-month follow-up (Patient Activation Measure, self-efficacy, Hospital Anxiety and Depression Scale, Ways of Coping, Group Health Association of America Satisfaction with ostomy care survey, and the City of Hope Quality of Life Ostomy). Changes from pre-intervention to post-intervention and pre-intervention to follow-up were evaluated with paired t-tests. Text responses were coded and evaluated for important themes and recommendations.
  
  
  RESULTS
  Thirty-eight subjects participated in the study. Most had a history of rectal cancer (60.5%) or bladder cancer (28.9%). Participants rated the overall program high (4.4-4.8 on 5-point scale). Text feedback indicated that participants enjoyed the group forums, wanted more participants, and more hands-on training. Scores on multiple surveys were shown to be improved and sustained, including patient activation (p = 0.0004), self-efficacy (p = 0.006), total HRQOL (p = 0.01), physical well-being (p = 0.005), and social well-being (p = 0.002). Survivor anxiety was significantly reduced by follow-up (p = 0.047).
  
  
  CONCLUSIONS
  This self-management ostomy program can help cancer survivors with ostomies adapt to their stoma. Initiating this program in the community setting would be beneficial to many cancer survivors.
authors.affiliation: Southern Arizona Veterans Affairs Health Care System, Tucson, AZ, USA.|University of Arizona College of Medicine, Tucson, AZ, USA.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Krouse
authors.affiliation: City of Hope National Medical Center/Beckman Research Institute, Duarte, CA, USA.
authors.forename: Marcia
authors.initials: M
authors.lastname: Grant
authors.affiliation: Yale School of Nursing, New Haven, CT, USA.
authors.forename: Ruth
authors.initials: R
authors.lastname: McCorkle
authors.affiliation: Southern Arizona Veterans Affairs Health Care System, Tucson, AZ, USA.|University of Arizona College of Medicine, Tucson, AZ, USA.
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Wendel
authors.affiliation: College of Nursing, University of Arizona, Tucson, AZ, USA.
authors.forename: Martha D
authors.initials: MD
authors.lastname: Cobb
authors.affiliation: Wound Ostomy Continence Nurse, Unaffiliated, Tucson, AZ, USA.
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Tallman
authors.affiliation: Yale School of Nursing, New Haven, CT, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Ercolano
authors.affiliation: City of Hope National Medical Center/Beckman Research Institute, Duarte, CA, USA.
authors.forename: Virginia
authors.initials: V
authors.lastname: Sun
authors.affiliation: University of Oregon, Eugene, OR, USA.
authors.forename: Judith H
authors.initials: JH
authors.lastname: Hibbard
authors.affiliation: Kaiser Permanente Center for Health Research, Portland, OR, USA.
authors.forename: Mark C
authors.initials: MC
authors.lastname: Hornbrook
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D019538:Health Care Surveys; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010030:Ostomy / Q000193:education / Q000523:psychology*; D063868:Patient Outcome Assessment; D017060:Patient Satisfaction; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology*; D012004:Rectal Neoplasms / Q000523:psychology / Q000601:surgery*; D012648:Self Care; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data