title: A cross-sectional study of quality of life in a cohort of enteral ostomy patients presenting to a tertiary care hospital in a developing country in South Asia.
abstract: BACKGROUND
  Enteral ostomy creation affects the quality of life (QOL) of stoma patients significantly. Studying the QOL and its determinants is important as it may help in the early identification of those with poor QOL leading to appropriate intervention. This study was aimed to assess the possible contributory factors of QOL of stoma patients.
  
  
  METHODS
  A cross sectional study was conducted among 43 ostomy patients who presented for follow up at a surgical clinic of a tertiary care hospital in Sri Lanka over a period of 1 year. Relevant demographic and ostomy related data were collected using an interviewer administered questionnaire. Stoma quality of life scale (Stoma-QOL) and stoma care self-efficacy scale (SCSE) which are validated questionnaires were used to assess QOL and self-efficacy in managing stoma respectively. Associations were established using independent samples t test and Spearman's correlation.
  
  
  RESULTS
  The median age of the study participants was 47.5 years (range 18-83). The median follow up duration was 38 months (range 6-183). The mean overall QOL score was 53.07 ± SD 12.68. Approximately 70% of the study participants scored less than 60. Higher QOL was associated with female sex, colostomies, comfortable income and satisfactory sexual activity. Significantly lower overall QOL was found in those who reported a significant change in the style of dressing (p < 0.05), those who felt depressed (p < 0.05), and those who had thoughts of self-harm soon after surgery (p < 0.05). There was a significant positive correlation between QOL and self-efficacy (p < 0.01). Those who took longer time to learn to take care of the stoma had lower QOL (p < 0.05).
  
  
  CONCLUSIONS
  The overall QOL score was considerably low in our study. The QOL was significantly associated with self-efficacy which indicates the importance of patient education and training during follow up visits to maintain a higher QOL. Furthermore integrating with other non-surgical specialities to address multi-dimensional problems including psychosocial and sexual aspects may be helpful to achieve a better QOL.
authors.affiliation: Department of Surgery, Faculty of Medicine, University of Colombo, P.O. Box 271, Kynsey Road, Colombo 8, Western Province, Sri Lanka.
authors.forename: Umesh
authors.initials: U
authors.lastname: Jayarajah
authors.affiliation: Department of Surgery, Faculty of Medicine, University of Colombo, P.O. Box 271, Kynsey Road, Colombo 8, Western Province, Sri Lanka. samarasekera58@yahoo.co.uk.
authors.forename: Dharmabandhu N
authors.initials: DN
authors.lastname: Samarasekera
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010030:Ostomy / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D013188:Sri Lanka; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Enteral ostomy; Quality of life; Self-efficacy