ABSTRACT Background: People with colorectal cancer undergoing rectum amputation get a permanent colostomy, which affects the social life. It may be valuable for health care what these people experience living with colostomy in order to provide the greatest possible support. Objective: The aim of this study is to describe how people who received a colostomy experience their daily lives and the support they have received from the health services.Method: Qualitative interview study with six people, with a descriptive phenomenological approach.Results: The analysis of the interviews about how it's like to live with a colostomy resulted in three themes: 1) Living with a colostomy gives an uncertainty that affect the social life, 2) Physical and psychological impact of getting a colostomy and 3) Support for health care and relatives.Conclusion: Subjects had a positive attitude towards life, which contributed to that they could adjust to living with a colostomy and feel a meaningfulness of life. The study shows that all the interviewed people overall were satisfied with the information provided by the healthcare personnel. It was good with both oral and written information and very appreciated with repeated information. One aspect that could be improved was the information given aboute the closure of anus during surgery and the following complications. This was the most painful experience among the interviewed people. Special nurses in surgery should take more responsibility for that the information reaches the patients and also that a follow-up take place.

SANTRAUKA Pacientų su žarnyno stomomis stacionarinės priežiūros poreikiai ir slaugos ypatumai Slaugos magistrantūros studentė Turba Ž. Darbo vadovas – doc. Simutis G. Vilniaus universitetas, Medicinos fakultetas, Vidaus ligų pagrindų ir slaugos katedra Vilnius, 2006 birželio 14 Pacientų su žarnyno stomomis problemos ir priežiūros poreikiai pooperaciniu periodu yra aktualus šiuolaikinės slaugos klausimas. Darbo tikslas: nustatyti, kokie yra pacientų su žarnyno stomomis stacionarinės priežiūros poreikiai ir slaugos ypatumus pooperaciniu periodu. Darbo uždaviniai: 1. Anketavimo būdu nustatyti pacientų problemas po žarnyno stomos suformavimo operacijos ankstyvuoju pooperaciniu periodu. 2. Ištirti pacientų lūkesčius po žarnyno stomos suformavimo operacijos. 3. Įvertinti, ar atitinka slaugytojų teikiamos priežiūros paslaugos pacientų poreikius po žarnyno stomos suformavimo operacijos. 4. Nustatyti priežiūros ypatumus pacientų po žarnyno stomos suformavimo operacijos. 5. Įvertinti slaugytojų kompetencijas slaugant pacientus su žarnyno stomomis. Tyrimui buvo panaudotas anketinės apklausos ir statistiniai dokumentų analizės metodai. Apklausai naudoti du klausimynai. Apklausta 30 pacientų po žarnyno stomos suformavimo operacijos ir 64 slaugytojos dirbančios pilvo chirurgijos skyriuose Vilniaus miesto klinikinėse ligoninėse. Atlikta 73 ligos istorijų statistinė analizė. Rezultatai ir išvados: 1. Dažniausios pacientų problemos po žarnyno stomos suformavimo operacijos yra nerimas, baimė... [toliau žr. visą tekstą] / SUMMARY Requirements of hospital care and nursing features in patients with intestinal stomas Master Final Work by Nursing Department Student Turba Ž. Research Adviser–Docent Simutis G. Vilnius University, Medical Faculty, General Medicine Practice and Nursing Department Vilnius, June 14, 2006 The problems of patients with intestinal stomas and the requirements of their care after surgery are the major questions in the nursing nowadays. Aim of the investigation: to define the hospital care needs and nursing features for patients who underwent surgery with the formation of intestinal stomas. Tasks of the investigation: 1. To define problems during early postoperative period after stoma formation using the method of survey. 2. To analyze the expectations of patients after stoma formation. 3. To evaluate if the nursing services are efficient for patients after intestinal stoma formation. 4. To define nursing features after intestinal stoma formation. 5. To evaluate the competence of nurses in providing care for patients with intestinal stoma formation. The methods of survey using two questionnaires and statistic analysis of documents were used. 30 patients with intestinal stomas and 64 nurses of surgical departments in Vilnius hospitals were questioned. The analysis of 73 cases was performed. Results and conclusions: 1. The most common problems after intestinal stoma formation are fear and concern with the quality of life (70%), postoperative pain (67%), lack of knowledge of... [to full text]

Bakgrund: En stomi är en konstgjord öppning på buken som tillåter kroppsvätskor att tömmas ut. De vanligaste orsakerna till stomioperationer är tumörsjukdomar, inflammatoriska sjukdomar och medfödda missbildningar. Att bli stomiopererad innebär en stor händelse i en patients liv. Psykiska påfrestningar, förlust av kroppsfunktion, förändringar i personlig hygien och avsmak för stomin är affekter som kan uppstå till följd av stomioperationen.  Syfte: Syftet med denna litteraturstudie var att belysa patienters upplevelser av att leva med stomi. Metod: I litteraturstudien har elva kvalitativa studier sammanställts och analyserats utifrån metoden innehållsanalys. Sökningar av artiklar utfördes i databaserna CINAHL, PubMed och PsycINFO.   Resultat: Under analysen identifierades tre huvudkategorier med totalt elva underkategorier.  Huvudkategorin ”Anpassning och acceptans” innehåller underkategorierna ”Svårigheter till acceptans”, ”Lättnad för att ha överlevt”, ”Minskade symtom av sjukdom” och ”Det nya livet”.  Den andra huvudkategorin ”Stöd och information” inrymmer underkategorierna ”Att möta andra personer med stomi”, ”Familj och närstående” och ”God och bristande information”. ”Självbild och intimitet” som utgör den tredje huvudkategorin innehåller ”Sänkt självkänsla”, ”Kroppen förändrad”, ”Sex och närhet” och ”Påverkan på relationer”.   Konklusion: Litteraturstudiens resultat visar att patienters upplevelser av att leva med stomi innebar olika former av anpassning. För att förbättra omvårdnaden av dessa patienter krävs det att sjuksköterskan praktiserar personcentrerad vård för att uppmärksamma deras individuella behov och upplevelser av sin unika situation. / Background: A stoma is an artificial opening in the abdomen which allows body fluids to be discharged. The most common reasons for ostomy surgeries are tumor diseases, inflammatory diseases and congenital malformations. Ostomy surgery is a critical moment in a patient’s life. Psychological stress, loss of bodily function, changes in personal hygiene and a feeling of disgust towards the stoma are affections which may arise as a result of ostomy surgery.     Aim: The purpose of this study was to highlight patients’ experiences of living with a stoma.  Methods: In this literature study eleven studies were compiled and analysed based on the content analysis method. Articles were searched for in the CINAHL, PubMed and PsycINFO databases.  Results: Three main categories and eleven subcategories were identified through analysis. The main category “Adaptation and acceptance” contains the subcategories “Difficulties to acceptance”, “Relief for survival”, “Reduced symptoms of disease” and “The new life”. The other main category “Support and information” includes the subcategories “Meeting others with a stoma”, “Family and relatives” and “Good and poor information”. The third main category “Self-image and intimacy” contains “Lowered self-esteem”, “The changed body”, “Sex and intimacy” and “Impact on relationships”.  Conclusion: The results of the literature study show that patients’ experiences of living with a stoma imply different forms of adjustment. In order to improve the nursing care of these patients, person centred care is required from the nurse to highlight the individual needs and experiences of the patients’ unique situation

Made available in DSpace on 2014-08-20T14:31:33Z (GMT). No. of bitstreams: 1 dissertacao_cibele_velleda_dos_santos.pdf: 1881403 bytes, checksum: 9dda1568c045e6dba2f90387205d8397 (MD5) Previous issue date: 2011-03-31 / The intestinal parasitoses or enteroparasitoses are a serious public health problem particularly in developing countries. Meantime, there are several studies that wrap the prevalence and the incidence of parasitoses in several populations, lacking parasitological investigations involving individuals with a intestinal ostomy. This study aimed to investigate the presence of infectious nature of parasitic diseases in individuals with ostomy enrolled in an Ostomy Program of the Department of Health and Management of the SUS in the city of Pelotas, RS. A questionnaire was given to patients for epidemiological evaluation of demographic, social, and cultural issues that would limit the subjects' knowledge about the parasites. Totaled to 71 individuals also submitted to parasitological tests using the methods of Faust and Ritchie modified Baermann-Moraes. Were collected and analyzed 03 samples per individual. The prevalence of carriers was 5.6%, all by monoparasitism. Among pacients positives were detected in the same proportion (25%), larvae of Enterobius vermicularis eggs of Taenia sp. eggs Enterobius vermicularis and larvae of Strongyloides stercoralis. Among participants, 49.3% were being female and 50.7% male. 76.1% had colostomy and 23.9% had ileostomy. Of the operations for stoma intestinal was necessary 37.1% due to the rectum cancer, 24,3 % for cancer of colon and 15.7% resulting from other intestinal diseases. As to knowledge about parasitic diseases, 69 % of the interviewed ones revealed to know the subject, 56.3% of the individuals showed up the importance of the hygiene of the hands, nails, sets of cutlery and foods, including his appropriate cooking.Meantime, 33.8% of the interviewed ones did not know how will be careful to prevent the intestinal parasitoses, and, even so, 50.7% of the individuals not feel to miss bigger of explanation regarding the approach in question. / As parasitoses intestinais ou enteroparasitoses representam um grave problema de saúde pública particularmente nos países subdesenvolvidos. Entretanto, existem vários estudos que envolvem a prevalência e a incidência de parasitoses em diversas populações, inexistindo investigações parasitológicas que envolvam indivíduos com estomia intestinal. Este estudo objetivou investigar a presença de agentes infecciosos de natureza enteroparasitária em indivíduos estomizados cadastrados em um Programa de Ostomizados da Secretaria de Saúde e Gestão do SUS da cidade de Pelotas/RS. Foi aplicado um questionário epidemiológico aos pacientes para avaliação das variáveis demográficas, sociais e culturais, além de questões que balizavam o conhecimento dos sujeitos sobre as parasitoses. Totalizaram-se 71 indivíduos, também, submetidos a exames coproparasitológicos segundo os métodos de Faust, Ritchie e Baermann-Moraes modificado. Foram recolhidas e analisadas 03 amostras por sujeito. A prevalência de parasitados foi 5,6%, sendo todos por monoparasitismo. Dentre os positivos detectou-se, na mesma proporção (25%), larvas de Enterobius vermiculares, ovos de Taenia sp., ovos de Enterobius vermiculares e larvas de Strongyloides stercoralis. Dentre os participantes, 49,3% eram pertencentes ao sexo feminino e 50,7% ao masculino. 76,1% possuíam colostomias e 23,9% ileostomias. Das intervenções cirúrgicas para estomização intestinal 37,1% foram necessárias devido ao câncer de reto, 24,3% por câncer de cólon e 15,7% decorrentes de outras doenças intestinais. Quanto aos conhecimentos sobre parasitoses, 69% dos entrevistados revelaram conhecer o assunto, 56,3% dos indivíduos evidenciaram a importância da higiene das mãos, unhas, talheres e alimentos, incluindo seu cozimento adequado. Entretanto, 33,8% dos entrevistados não sabiam como tomar os cuidados necessários para prevenir as parasitoses intestinais, e, ainda assim, 50,7% dos indivíduos consideram não sentirem falta de maiores explicações quanto a abordagem em questão.

Aim: To identify the knowledge and skills required by the specialist stoma care nurse to facilitate the needs of patients adapting to a newly formed stoma in order to inform specialist nurse education. Background: Advances in surgical techniques, drug therapies, bowel screening and patient recovery programmes have offered those with colorectal disorders, a potential increased life expectancy and improved disease management. For the specialist nurse, there is the constant challenge to keep abreast of these advances and provide more formal, precise and accurate information, facilitating individualised patient need. In response, an education curriculum needs to foster a comprehensive knowledge base in order to equip and support the nurse to become confident and competent in clinical practice. How knowledge is translated from the classroom into clinical practice is a key feature of this study; in particular the role of the specialist stoma care nurse in facilitating the adaptation of patients following stoma surgery. Method: A qualitative approach was chosen to fulfil the aim and objectives of this two-staged study. Phase one took a phenomenological approach and phase two a focus group methodology approach. Eight patients were interviewed in phase one. This offered insight into the experiences of living with a newly formed stoma. Vignettes (total 18) were created from the patients’ narratives. These were used to stimulate discussion among nurses at the focus groups within phase two of the study. The complexities of translating specialist knowledge and skills among thirty-nine specialist stoma care nurses were explored through one of a series of seven focus groups. The analysis for this study was undertaken in 3 stages; stage 1, thematic analysis of phase 1, stage 2, thematic analysis of phase 2 and stage 3, further analysis of phase 2 using Mayer and Salovey (1997) emotional intelligence theoretical framework. Findings: Phase one highlighted a variety of challenges faced by patients and recognised their coping strategies as they adapted to a newly formed stoma. Six themes emerged from the thematic analysis; seeking assurances, permanence versus reversibility of stoma, anticipated stigma, psychological projection, worthwhile sacrifice and sense of achievement. The thematic analysis of phase two identified five comparable themes; skilled know-how, understanding self, hurdles to accommodate, communication skills and uncertain ground. A further examination through an alternative lens was considered to distil the pedagogy. Mayer and Salovey (1997) emotional intelligence framework guided the third stage of analysis. Five key concepts emerged, forming the essential components to specialist nursing practice; the influence of emotions on critical thinking and clinical decision-making, the use of empathetic and intuitive skills in clinical judgements, the ability to balance true self alongside professional self, the need to foster cognitive activity, good communication and creativity and preserving a conscious awareness of self so to develop personal growth. Conclusion: Individual experiences of patients adapting to a newly formed stoma evidently differed. Both the challenges faced and coping strategies of the patients were revealed. The specialist stoma care nurse is ideally placed to facilitate meeting the patients’ needs as they adapt. The five essential components to specialist practice are identified. Educational strategies for cultivating critical thinking and communication skills, developing self and emotional conscious awareness and nurturing personal growth need to be considered for integration into specialist nurse educational curriculum.

Bakgrund: Sjukdomar som cancer leder till ökat antal patienter som behöver stomi. Patienter med stomi kan få komplikationer efter stomiläggning. Sjuksköterska kan stötta patienter med stomi genom rådgivning och information.  Syfte: Syftet med denna litteraturstudie är att belysa patienters erfarenheter av att ha stomi.  Metod: En systematisk litteraturstudie enligt Rosén (2017) med induktivt förhållningssätt och Kvalitativ metod. Artiklar söktes i två databaser Cinahl och PubMed och kvalitetsgranskades med hjälp av Forsberg & Wengström (2015) granskningsmall. Det resulterades i 10 artiklar som redovisas i resultat. Fribergs (2017) analysmodell användes för att bearbeta samtliga artiklar.  Resultat: Fem kategorier framkom i resultatet. Dessa är fysiska begränsningar i vardagen, utökade psykiska bekymmer i vardagen, minskade sociala interaktioner, försämrad sexualitet och intimitet, förenklad vardag. En del kroppsliga besvär ledde till psykiska besvär och påverkade i sin tur på sociala relationer för patienter med stomi. Slutsats: Patienters erfarenheter med stomi varierade mellan positiva och negativa. En del hade svårigheter med att anpassa sig till den nya situationen medan andra upplevde den som en faktor som hjälpte dem att bli mer sociala. Sjuksköterskor är en viktig stöttepelare i omvårdnad av de patienterna med stomi. / Background: Diseases such as cancer lead to an increased number of patients who need a stoma. The patient with a stoma can have complications after stoma placement. Nurses can support patients with ostomy through counseling and information. Aim: The aim of this literature study is to shed light on patients' experiences of having a stoma. Method: A systematic literature study according to Rosén (2017) with an inductive approach and Qualitative method. Articles were searched in two databases Cinahl and PubMed and quality checked using the Forsberg & Wengström (2015) review template. It resulted in 10 articles which will be reported in thr resualt. Friberg's (2017) analysis model was used to process all articles. Results: Five categories emerged in the results. These are physical limitations in everyday life,increased psychological concerns in everyday life, decreased social interactions, impaired sexuality and intimacy, simplified everyday life. Some physical problems led to mental problems and in turn affected social relations for patients with stoma. Conclusion: Patients' experiences with stoma varied between positive and negative. Onesome had difficulty adapting to the new situation while others experienced it as a factor that helped them become more social. Nurses are an important mainstay in the care of those patients with a stoma.

Stomos suformavimo operacija – viena labiausiai traumuojančių asmenį psichologiškai, todėl labai svarbu, kad būsimas stomuotas pacientas būtų tinkamai paruoštas pokyčiams, įvyksiantiems po operacijos bei gyvenimui su stoma. Lietuvoje stomuotų pacientų priežiūra vis dar yra nepakankama. Ši darbo tema pasirinkta siekiant atkreipti dėmesį į tai, kad reikalinga organizuota ir kvalifikuota pagalba stomą turintiems pacientams. Darbo tikslas – įvertinti perioperacinį pacientų stomos priežiūros apmokymą ir informavimą. Darbo uždaviniai: 1. Įvertinti pacientų apmokymą bei informavimą prieš stomos suformavimo operaciją. 2. Įvertinti pacientų apmokymą bei informavimą po stomos suformavimo operacijos. 3. Nustatyti slaugytojos veiklos svarbą bei kokybę perioperaciniu laikotarpiu. 4. Palyginti pacientų su kolostomom ir ileostomom apmokymą ir informavimą. Tyrimo objektas – pacientų stomos priežiūros apmokymas ir informavimas. Tyrimas atliktas Vilniaus universiteto Onkologijos instituto abdominaliniame chirurgijos skyriuje. Tirti pacientai, kuriems per 2005 metus (2005m. sausio 1d. – 2005 m. gruodžio 31d.) dėl tiesiosios žarnos vėžio buvo suformuota kolostoma arba ileostoma. Duomenys buvo renkami apklausos būdu, anonimiškai anketuojant stomuotus pacientus priešpaskutinę arba paskutinę jų gulėjimo stacionare dieną. Sudarytoje anketoje reikėjo atsakyti į 25 klausimus. Tokiu būdu buvo surinkta 110 anketų iš galimų 137 anketų per 2005 metus. Remiantis atlikto tyrimo duomenimis, priešoperacinis... [toliau žr. visą tekstą] / Operation on stoma formation is one of the most psychologically traumatic so it is of vital importance to ensure that would-be patient with stoma is prepared for changes after operation and life with stoma. The attendance of such patients is still insufficient in Lithuania. This subject was chosen with intention to spotlight the need for organized and qualified help for people with stoma. Objective - assessment of preoperative care and induction of patients with stoma. Tasks: 1. Evaluate the induction and training of patients before operation on stoma formation; 2. Evaluate the induction and training of patients after operation on stoma formation; 3. Estimate the importance and quality of nursing during preoperative care; 4. Compare the induction and training of patients with Colostoma and Ileostoma. Research objective – training and induction of patients on stoma care. Research was conducted in the Abdominal Surgery Department of Oncological Institute of Vilnius University. Patients who due to rectum cancer had colostoma and ileostoma formed during 2005 (the 1st of January 2005 – the 31st of December 2005) were examined. An anonymous questionnaire of 25 questions was given for in-patients during their last days in hospital to gather data. Thus, 110 forms of 137 possible were collected during year 2005. According to research preoperative induction of patients on care of stoma is much lesser (28,2 %) compared to induction after operation (90,9 %). In 78 % of cases the optimal... [to full text]

I this thesis anatomical, physiological and functional information of certain parts of the human body organ systems after the damage of which a stoma must be performed is given. A stoma is indicated either after an injury, an illness or a loss of functionality and patency, It constitutes management of a life threatening situation and facilitates life restoration. Basic types of stoma are described, and since the most common type are colostomy and ileostomy, a greater attention is given to the disease and its treatment in the small and large intestine at the ends of which the stoma is created. The thesis also deals with the stoma aids, leisure time activities, psychological aspects of the disease, social problems and awareness of patients with a stoma. One of the objectives was to find out how patients with a stoma spend their leisure time and if they tend to isolate themselves from society because of their handicap. Another objective was to determine if persons with a stoma are sufficiently informed about leisure time activities they could pursue and where to get the information. The data needed to carry out this survey were obtained through studying professional materials available. The quantitative research method of interviewing was chosen, the data collection technique was an anonymous questionnaire aimed at a certain set of respondents as well as semi-standardized interviews with professionals who were given questionnaires for the respondents. The research set was formed by respondents with a type of a stoma mentioned in the questionnaire. It has been found out that the most common type of a stoma is ileostomy, predominantly in men. The research has shown that persons with a stoma isolate themselves from society and are not sufficiently informed about leisure time activities they could pursue. The research results should bring a better cooperation among professionals and thus enhance awareness and improve care not only for persons with a stoma. The outcomes of the thesis could make professionals produce literature concerning the life of persons with a stoma and update the existing information with new experience, advice and recommendations.

No description available.

Rectal cancer is a common malignancy treated with surgical resection and curative intent in the majority of cases. One treatment option is low anterior resection (LAR) with preserved bowel continuity, often involving the formation of a temporary defunctioning stoma (DS). The general aim of this thesis was to improve understanding of the role of DS in rectal cancer surgery with regard to timing of stoma reversal and development of anastomotic leakage (AL), impact on long-term anorectal function (AF), as well as aspects of cost-effectiveness. Study I addressed the timing of stoma reversal following LAR. We found that 19% of reversed patients were reversed within 4 months of LAR, while 81% of reversals were delayed. In 58% of delayed reversals the delay was due to low priority on surgical waiting lists. Studies II-IV were based on 234 patients randomized to receive a DS or no DS following LAR. Study II compared patients with AL following LAR diagnosed during the initial hospital stay (early leakage, EL) with patients diagnosed after hospital discharge (late leakage, LL). LL was more common in females, and originated more frequently from the transverse stapler line. EL was more common in males, and originated more frequently from the circular stapler line. Study III assessed AF 5 years after LAR with regard to whether patients initially had a DS or no DS. We found no difference in AF between the two randomized groups. When comparing with a 1-year follow-up in the same patient cohort, there were no further changes in AF over time. Study III assessed necessary healthcare resources and cost within 5 years of LAR, depending on whether patients initially had a DS or no DS. The overall cost analysis revealed a higher cost for patients randomized to DS, regardless of the cost-savings associated with a reduced frequency of anastomotic leakage.