title: Differences in Ostomy Pouch Seal Leakage Occurrences Between North American and European Residents.
abstract: OBJECTIVE
  The purpose of this study was to compare experiences and concerns about pouch seal leakage between persons with ostomies residing in North America (Canada and the United States) and Europe (United Kingdom, Netherlands, Sweden, Germany, Belgium, France, and Italy). Differences in reported pouch wear time and accessories used between the 2 groups were also examined.
  
  
  METHODS
  Secondary analysis of data from a cross-sectional study (Ostomy Life Study).
  
  
  METHODS
  Responses from persons residing in European countries (n = 1939) were compared with responses of 1387 individuals residing in North American countries.
  
  
  METHODS
  Persons with an ostomy completed a questionnaire that focused on 4 topics related to the daily use of an ostomy pouching system (pouch seal leakage, ballooning, appearance of pouching system such as color and size of the pouch and whether it is discrete under clothing, and coupling failure of 2-piece pouching systems). Pouch seal leakage was defined as stomal effluent seeping between the skin and the wafer of the ostomy pouching system. Statistical analysis was performed using a proportional odds model including various variable effects. Special attention was given to frequency of pouch seal leakage occurrences. All tests were 2-sided; P values ≤.05 were deemed statistically significant.
  
  
  RESULTS
  Participants living in the North American countries indicated they were more likely to experience leakage from the ostomy (odds ratio = 2.610, 95% CI 2.187-3.115; P < .0001). Findings also indicated they were more likely to worry about pouch seal leakage than those in the European countries' data set (odds ratio = 2.722, 95% CI 2.283-3.246; P < .0001). Participants residing in the North American countries had significantly longer wear times than those participants in the European countries (P < .0001, χ test). The use of accessories was associated with a longer pouching system wear time.
  
  
  CONCLUSIONS
  Study results suggest that participants from the North American countries indicated significantly more experience with and worries about leakage and longer wear time than the participants from the European population. Additional research is needed to determine the reasons for these differences.
authors.affiliation: Jane Fellows, MSN, RN, CWOCN-AP, Duke University Health System, Durham, North Carolina. Louise Forest Lalande, RN, MEd, ET, Enterostomal Therapy Nursing Consultant and Educator, Montreal, Canada. Lina Martins, MScN, BScN, RN, CETN(C), London Health Sciences Centre, London, Ontario, Canada. Anne Steen, RN, ET, SD, Coloplast A/S Humlebaek, Denmark. Zenia M. Størling, MSc, PhD, Coloplast A/S Humlebaek, Denmark.
authors.forename: Jane
authors.initials: J
authors.lastname: Fellows
authors.forename: Louise
authors.initials: L
authors.lastname: Forest Lalande
authors.forename: Lina
authors.initials: L
authors.lastname: Martins
authors.forename: Anne
authors.initials: A
authors.lastname: Steen
authors.forename: Zenia M
authors.initials: ZM
authors.lastname: Størling
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium; D002170:Canada; D003430:Cross-Sectional Studies; D004322:Drainage / Q000451:nursing; D005260:Female; D005602:France; D005858:Germany; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010030:Ostomy / Q000295:instrumentation* / Q000451:nursing* / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D010361:Patients / Q000523:psychology* / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D011788:Quality of Life / Q000523:psychology; D011795:Surveys and Questionnaires; D013548:Sweden; D006113:United Kingdom; D014481:United States