Ostomy

Ostomy patients are subject to signifi cant negative psychological impact, affecting their quality of life in all respects (physical, psychological, social, economic, and spiritual), especially if they are not properly constructed or if there are complications during the recovery phase. In the light of published research and studies, the main problems are as follows: a) alteration of body image; loss of sphincter control; b) odor, leakage, and complications related to the stoma; c) impairment of sexuality; d) alteration of nutrition and sleep; e) anxiety, depression, and loneliness; embarrassment and shame; f) loss of control of the situation; drop in self-esteem; g) rejection; h) stigmatization; i) disinvestment in social activities; l) abandonment of work and sports activities; isolation; m) diffi culties in couple relationships and social contacts. The psychological problems caused by ostomy can be avoided, or at least contained, by comprehensive care of the patient, both before and after the operation. In addition to purely technical care, teaching, accompaniment and constant support are the main components of care that can make a difference to how the patient will accept his or her ostomy. Setting the care only on the management of the physical dimension will hardly allow the person to integrate the ostomy into his life. The present work proposes a specifi c protocol of psychological intervention (Perrotta-Guerrieri Psychological Care for Ostomy Patients, PCOP), for all the clinical phases (pre-operative, operative, postoperative, follow-up) and a specifi c questionnaire (Perrotta-Guerrieri Psychological Care for Ostomy Patients Questionnaire-fi rst version, PCOP-Q1) to be submitted to the patient which investigates the 9 subjective functions (physical, psychological, sexual, emotional, sentimental, work, family and social), in 45 items with a response on L1-5 scale, for the study of quality of life in the ostomised patient.

Aim: The aim of this literature review is to qualitatively and quantitatively evaluate research and publications on patients with stoma in Turkey and to contribute and improve the quality of care for patients with stoma by shedding light on new studies. Method: Dokuz Eylül University electronic data base (n=71), ULAKBİM (Turkish Academic Network and Information Center), Pubmed, Council of Higher Education Thesis Center, Google Scholar, congress websites, accessible conference/symposium books and reference lists of articles were searched online. Results: Two hundred and seventy-eight studies (between January 1981 and January 2016) were reached. These studies were 54% (n=100) research articles, 14% (n=27) thesis, 15% (n=28) review articles, 14% (n=27) case reports and 3% (n=6) qualitative research; Rate of studies being published in international journals was 7% (n=20). More than half, 65% (n=182) of the studies were in the form of full/summary text. Descriptive (retrospective, prospective, cross-sectional) research articles made up 80% (n=80), ampirical articles made up 8% (n=8) and methodological research made up 6% (n=6) of research articles; 58% (n=19) of the thesis was of master's, 11% (n=3) was of expertise in medicine, 18% (n=5) was PhD thesis; 15% (n=6) of thesis was published in a journal. It was found that out of 107 studies that were presented at the congress 71% (n=76) was original research, 18% (n=19) was case report and 9% (n=11) was review. Studies were on stoma complications (17%), life quality (12%), stoma surgery techniques and comparison of effectiveness (10%), patient follow-up results (6%), sexuality (6%), patient experience (4%), adaptation to ostomy (4%), body image (4%), self-esteem (3%), nurse/patient knowledge level about ostomy care (3%). Conclusion: It was seen that most of the studies were descriptive and on stoma complications and quality of life. Morever, the ratio of publications published in international journals were low. More interventional studies should be conducted on adaptation to life with stoma for the patients in Turkey; these studies should be presented in congress and published in national/international journals.

Support surfaces are an integral component of pressure ulcer prevention and treatment, but there is insufficient evidence to guide clinical decision making in this area. In an effort to provide clinical guidance for selecting support surfaces based on individual patient needs, the Wound, Ostomy and Continence Nurses Society (WOCN®) set out to develop an evidence- and consensus-based algorithm. A Task Force of clinical experts was identified who: 1) reviewed the literature and identified evidence for support surface use in the prevention and treatment of pressure ulcers; 2) developed supporting statements for essential components for the algorithm, 3) developed a draft algorithm for support surface selection; and 4) determined its face validity. A consensus panel of 20 key opinion leaders was then convened that: 1.) reviewed the draft algorithm and supporting statements, 2.) reached consensus on statements lacking robust supporting evidence, 3.) modified the draft algorithm and evalu...

This article aims to review the regulatory framework governing the Belgian ostomy appliance market in the light of the experience of Denmark, France, the Netherlands and Ontario (Canada) with regulation of ostomy appliances. Information about the regulatory framework was derived from the international literature, analysis of legal texts and a survey completed by national experts. The comparative analysis revealed that these countries have adopted varying approaches towards regulating their domestic ostomy appliance market. Strategies to keep down prices include public procurement in Denmark, maximum prices in France and exclusion of expensive appliances from reimbursement in the Netherlands. To contain public expenditure on ostomy appliances, consumption patterns are monitored in the Netherlands, the quantity of reimbursed appliances is limited in Belgium and public reimbursement is restricted in Ontario. Ostomy appliances are generally distributed by community pharmacies and medical equipment shops. In countries that emphasise home care delivery such as Denmark, domiciliary distributors dominate the market to the detriment of community pharmacies which do not seem to be able to offer this service at a competitive price. An avenue for reforming the Belgian ostomy appliance market is proposed which valorizes the role of ostomy care nurses in guiding the choice of ostomy appliances. Furthermore, it is recommended that a competitive tendering process determines the price of ostomy appliances, that reimbursement for service provision by distributors is separated from reimbursement of appliances, and that patients receive a fixed grant from the third-party payer to buy ostomy appliances.

to assess self-esteem (SE) and health-related quality of life (HRQoL) in ostomized patients due to colorectal cancer. cross sectional research with a quantitative approach. Three instruments were used for data collection: one instrument containing sociodemographic and clinical data, Rosenberg's Self-Esteem Scale, and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. SE and HRQoL were considered satisfactory. Significant statistical difference was found in the social function domain and marital status, ostomy duration, location, and time; global health scale and ostomy type; cognitive function and pain in the ostomy site. There was a correlation between self-esteem and all the functional scales and the global health scale. knowing SE and HRQoL levels, in addition to the variables that influence them, supports ostomized patients' care planning, rehabilitation, and social autonomy.

Little published information is available about access failure in children undergoing chronic peritoneal dialysis. Our objectives were to evaluate frequency, risk factors, interventions, and outcome of peritoneal dialysis access revision. Data were derived from 824 incident and 1629 prevalent patients from 105 pediatric nephrology centers enrolled in the International Pediatric Peritoneal Dialysis Network Registry between 2007 and 2015. In total, 452 access revisions were recorded in 321 (13%) of 2453 patients over 3134 patient-years of follow-up, resulting in an overall access revision rate of 0.14 per treatment year. Among 824 incident patients, 186 (22.6%) underwent 188 access revisions over 1066 patient-years, yielding an access revision rate of 0.17 per treatment year; 83% of access revisions in incident patients were reported within the first year of peritoneal dialysis treatment. Catheter survival rates in incident patients were 84%, 80%, 77%, and 73% at 12, 24, 36, and 48 mo...

Little published information is available about access failure in children undergoing chronic peritoneal dialysis. Our objectives were to evaluate frequency, risk factors, interventions, and outcome of peritoneal dialysis access revision. Data were derived from 824 incident and 1629 prevalent patients from 105 pediatric nephrology centers enrolled in the International Pediatric Peritoneal Dialysis Network Registry between 2007 and 2015. In total, 452 access revisions were recorded in 321 (13%) of 2453 patients over 3134 patient-years of follow-up, resulting in an overall access revision rate of 0.14 per treatment year. Among 824 incident patients, 186 (22.6%) underwent 188 access revisions over 1066 patient-years, yielding an access revision rate of 0.17 per treatment year; 83% of access revisions in incident patients were reported within the first year of peritoneal dialysis treatment. Catheter survival rates in incident patients were 84%, 80%, 77%, and 73% at 12, 24, 36, and 48 mo...

Objectives The purpose of this study was to investigate the role of perceived stress, social support, and body image in predicting the severity of depressive symptoms in ostomy patients. Methods In this descriptive/correlational study with a cross-sectional design, 120 ostomy patients referred to the Iranian Ostomy Society were selected using a convenience sampling technique, and responded to The Depression, Anxiety and Stress Scale, Perceived Stress Scale, Body Image Questionnaire, and Social Support Scale. For data analysis, Pearson correlation and stepwise regression analysis were used. Results The three variables of perceived stress, body image and social support were able to predict the severity of depressive symptoms by %21, %10 and %11, respectively. In Overall, they accounted for 42% of changes in the severity of depressive symptoms. Conclusion Given the role of perceived stress, body image and social support in the severity of depression symptoms, the depression treatment and prevention programs should be facilitated for the patients with ostomy by considering these factors.

... The role of repeat endoscopic third ventriculostomy after failure of the initial procedure Pasquale Gallo, Francesco Sala Pediatric ... 6. 7. Gallo P, Szathmari A, De Biasi S, Mottolese C. Endoscopic third ventriculostomy in obstructive infantile hydrocephalus: remarks about the so ...

Many ostomy patients experience peristomal skin lesions. A descriptive study was conducted to assess the validity, usability, and reliability of the Peristomal Skin Lesions Assessment instrument (SACS instrument) adapted to Turkish from English. The SACS Instrument consists of 2 main assessments: lesion type (utilizing definitions and photographs) and lesion area by location around the ostomy. The study was performed in 2 stages: 1) the SACS language was changed and its content validity established; and 2) the instrument\'92s content validity and inter-observer agreement (consistency) were determined among pairs of nurses who used the tool to assess peristomal skin lesions. Patients (included if they were >18 years old and receiving treatment/observation at 1 of the 4 participating stomatherapy units) and 8 stomatherapy nurses also completed appropriate sociodemographic questionnaires. Of the 393 patients screened during the 7-month study, 100 (average age 56.74 \'b1 14.0...

Little published information is available about access failure in children undergoing chronic peritoneal dialysis. Our objectives were to evaluate frequency, risk factors, interventions, and outcome of peritoneal dialysis access revision. Data were derived from 824 incident and 1629 prevalent patients from 105 pediatric nephrology centers enrolled in the International Pediatric Peritoneal Dialysis Network Registry between 2007 and 2015. In total, 452 access revisions were recorded in 321 (13%) of 2453 patients over 3134 patient-years of follow-up, resulting in an overall access revision rate of 0.14 per treatment year. Among 824 incident patients, 186 (22.6%) underwent 188 access revisions over 1066 patient-years, yielding an access revision rate of 0.17 per treatment year; 83% of access revisions in incident patients were reported within the first year of peritoneal dialysis treatment. Catheter survival rates in incident patients were 84%, 80%, 77%, and 73% at 12, 24, 36, and 48 mo...