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Erfarenheter av den sexuella hälsan hos individer som lever med stomi – en litteraturbaserad studie / Experiences of sexual health in individuals living with a stoma – a literature based studyKarlsson, Cornelia, Wallin, Julia January 2023 (has links)
Bakgrund: En stomioperation genomförs vid olika indikationer i avseende till att avlasta tarmen. Att leva med stomi innebär ett egenvårdsansvar. Egenvård innebär att patienten utför hälso- och sjukvårdsåtgärder helt eller delvis självständigt. Den sexuella hälsans betydelse är en balans mellan individens mentala, sociala, känslomässiga tillstånd och kroppsliga välbefinnande i relation till sin sexualitet. Att leva med stomi kan innebära ett lidande för individen. Begreppet livskvalitet innefattar bland annat individens upplevelse av lycka och tillfredsställelse med livet. Syfte: Syftet med studien var att beskriva erfarenheter av den sexuella hälsan hos individer som lever med stomi. Metod: Studien utfördes som en litteraturbaserad studie, med tolv kvalitativa vetenskapliga artiklar. Resultat: Två teman identifierades; en omställning i livet på ett personligt plan och rädsla för intimitet på grund av bristande information från hälso- och sjukvården. Under temat en omställning i livet på ett personligt plan har tre subteman identifierats. Konklusion: Slutsatsen av examensarbetet är att stomin inte enbart är en påse på magen. Individer upplever att den sexuella relationen påverkas negativt och därav är det av stor vikt att sjuksköterskor är medvetna om detta och vågar prata om ämnet. Den sexuella hälsan är ett känsligt ämne att prata om för individer med stomi. / Background: A stoma operation is performed to relieving the intestine. Living with a stoma involves self-care for the person. Self-care means that the patient performs health care measures independently. The importance of sexual health is a balance between the individual's mental, social, emotional state and bodily well-being in relation to their sexuality. Living with a stoma can be a suffering for the individual. The concept of quality of life includes the individual's experience of happiness and satisfaction with life. Aim: The purpose of the study was to describe experiences of sexual health in individuals living with a stoma. Method: The study was conducted as a literature based study, with including twelve qualitative scientific articles. Findings: Two themes were identified; a personal adjustment in life and fear of intimacy due to lack of information from healthcare. Under the theme personal changes in life was three subthemes identified. Conclusion: The conclusion of the study is that the stoma is not just a bag on the stomach. People feel that the sexual relationship is negatively affected and therefore it’s of great importance that nurses are aware of this and dare to talk about the subject. Sexual health is a vulnerable topic to talk about.
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Patienters upplevelser av att leva med en stomi : En litteraturstudie / Patients' experiences of living with a stoma : A litterature reviewLindsjö, Hilda, Iheke, Uchechi Comfort January 2023 (has links)
Bakgrund: Sjukdomar som cancer, divertikulit, inflammatoriska tarmsjukdomar ochinkontinens kan vara anledningen till att en patient erhåller en stomi som en del avbehandlingen. Stomi är en konstgjord öppning på magen där tarmen eller urinröret mynnar utoch samlar upp avföring eller urin i en påse. Att leva med en stomi kan innebära mer än attbära en påse på magen för patienten då även starka känslor kan upplevas, såsom ångest ochskuldkänslor. Det är upp till sjuksköterskan att bemöta dessa patienter och deras upplevelserpå bästa professionella sätt. Syfte: Syftet var att beskriva patienters upplevelser av att levamed en stomi. Metod: Databassökningen i Cinahl och PubMed resulterade i elva kvalitativastudier som granskades utifrån SBU kvalitetsgranskningsmall samt analyserades i trekategorier och åtta underkategorier. Resultat: Tre huvudteman identifierades. Det första var “Förändrad identitet” med två underkategorierna “Förändrad kroppsuppfattning”; “Emotionell förändring”. Den andra kategorin “Begränsningar i vardagen” innehåller fyraunderkategorier: "Rädsla och oro för komplikationer och läckage”. “Förändrade matvanor”; “Påverkan på det sociala livet”; “Påverkan på sexuallivet”. Den tredje kategorin “Betydelseav stöd och information” omfattar två underkategorier: “Familj och vänner som stöd”;“Utbildning och stöd från vården”. Slutsats: Upplevelsen av att leva med en stomi varierarfrån person till person med tanke på förändringar i olika sammanhang. Stomin ledde till orooch rädslor för komplikationer, och påverkade patienters fysiska, psykiska, sexuella ochsociala välbefinnande negativt. Information, stöd och uppföljning från sjukvården börförbättras då patienterna upplevde den som bristfällig. / Background: Patients suffering from cancer, diverticulitis, inflammatory bowel diseases andincontinence can be the reason why a patient receives a stoma as part of the treatment. Astoma is an artificial opening in the stomach where the intestine or urethra opens and collectsfeces or urine in a bag. Living with a stoma can mean more than wearing a pouch on thepatient's stomach as strong emotions can be experienced, for example anxiety and guilt. It isup to the nurse to approach these patients and their experiences in the best professional way.Aim: The aim was to describe patients' experiences of living with a stoma. Method: Thedatabase search in Cinahl and PubMed resulted in eleven qualitative articles that werereviewed based on the SBU quality review template and analyzed in three categories andeight subcategories. Results: Three main themes were identified. The first one was "Changed identity" with two subcategories "Changed body image"; "Emotional change"; The secondcategory, "Limitations of stoma in everyday life", contains four subcategories: "Fear andanxiety about complications and leakage"; "Changed eating habits"; "Impact on social life";"Impact on sexual life". The third category "Importance of support and information"comprises two subcategories: "Family and friends as support"; "Education and support fromhealth care". Conclusion: The experience of living with a stoma varies from person to persondue to changes in different contexts. The stoma led to anxiety and fear of complications, andit affected patients’ physical, psychological, sexual, and social well-being negatively.Information, support, and follow ups from healthcare should be improved as patientsconsidered it insufficient.
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Erfarenheter och upplevelser av sexualitet hos personer med tarmstomi : En litteraturöversikt med kvalitativ design / Experiences of sexuality in people with Intestinal Stoma : A literature review with a qualitative design.Younan, Gabreilla, Rosa, Adriana, Nordin, Julia January 2023 (has links)
Bakgrund: Tarmstomi innebär en öppning på buken där tarmen läggs ut. Det finns flera anledningar till att få tarmstomi. Tarmstomi kan leda till både positiva och negativa förändringar. Förändringarna kan påverka sexualiteten på olika sätt. Sexualiteten är viktig i människans liv och är ett av de främsta grundläggande behoven. Syfte: Att beskriva erfarenheter och upplevelser av sexualitet hos personer med tarmstomi. Metod: En litteraturöversikt med kvalitativ ansats genomfördes där 10 artiklar kvalitetsgranskades som sedan användes till resultatet. Artiklarna analyserades enligt Fribergs 5-stegsmodell. Resultat: Teman som framkom var påverkan på sexuell aktivitet, påverkan på relation och intimitet samt behov av stöd. Resultatet visade att tarmstomin påverkadepersoner psykiskt och fysiskt. Personer med tarmstomi behövde anpassa sig på olika sätt för att få en god sexualitet. Ofta var erfarenheterna och upplevelserna av sexualiteten negativa hos personer med tarmstomi, på grund av känslan av att vara annorlunda och förlorat kontroll över tarmfunktionen. Slutsats: Tarmstomi påverkar sexualiteten på olika sätt. Anpassningar för den nya kroppsbilden behövs. Hur personer med tarmstomi accepterar den nya kroppsuppfattningen har stor betydelse för sexualiteten. Att upprätthålla rutiner och riktlinjer inom hälso-sjukvården är viktigt för att ge rätt stöd till personer med tarmstomi. / Background: An intestinal stoma is an opening in the abdomen where the intestine is laid out. There are several reasons for having an intestinal stoma. Intestinal stomas can lead to both positive and negative changes. The changes can affect sexuality in different ways. Sexuality is important in a human’s life and is one of the main basic needs. Aim: To describe experiences of sexuality in people with intestinal stoma. Method: A literature review with a qualitative approach was carried out where 10 articles were quality controlled, then used for the result. The articles were analyzed according to Friberg's 5-step model. Results: The themes that emerged were the impact on sexual activity, the impact on relationships and intimacy, and the need for support. The results showed that intestinal stoma affects people psychologically and physically. People with intestinal stoma had to adapt in different ways to have a good sexuality. Often, the experiences of sexuality were negative in people with an intestinal stoma because of the feeling of being different and losing control over bowel function. Conclusion: Intestinal stoma affects sexuality in different ways. Adjustments for the new body image are needed. How people with an intestinal stoma accept the new body image has great significance for sexuality. Developing routines and guidelines in healthcare is important to provide the right support for people with intestinal stoma.
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Návrat do života a jeho kvalita u pacientů po akutní resekci střev / Return to life and its quality in patients after acute intestinal resectionRadošová, Alena January 2019 (has links)
Introduction: Quality of life is a long-term goal in nursing care. Nursing care in improving the quality of life should focus not only on physical aspects, but especially on support to return to everyday life, managing daily activities, at least to the extent that the patient has been able to handle them before staying at hospital. Methodology: The aim of the work was to evaluate the quality of life of patients before and after staying in ICU with a focus on patients after acute surgery associated with intestinal resection. The research sample consisted of patients who underwent acute surgery associated with intestinal resection and ICU staying. Quality of life was assessed before hospitalization and 3 months after discharging from the ICU. We have chosen SOFA, APACHE scoring systems to obtain data. The quality of life before hospitalization was evaluated by SF-36 and ADL, IADL questionnaires for daily activities. In the ICU dismission, the patients completed HADS (anxiety, depression), MAF (fatigue) questionnaires, 6-minute walk and sit / stand test. After the third month of convalescence, patients completed questionnaires: SF-36, IADL, ADL, HADS, MAF and 6. minute walk and sit / stand test. Results: 38 patients were evaluated. We found a significant difference in the development of all observed...
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As complicações precoces e tardias e a demarcação de estoma intestinal / The early and late complications and the stoma site-markingOliveira, Marissa Silva de 19 September 2014 (has links)
As complicações de estoma e de pele periestoma comprometem a vida dos estomizados intestinais na realização do autocuidado e na sua reabilitação, e a demarcação de estoma pré-operatória tem sido considerada importante na prevenção destas. Este estudo teve como objetivo descrever as complicações de estoma e de pele periestoma de estomizados intestinais demarcados e não demarcados, submetidos ao tratamento cirúrgico no ano de 2009, em um hospital universitário de ensino público (CEP/EERP-USP 341.314). Trata-se de um estudo de abordagem quantitativa, de levantamento de 70 prontuários de pacientes demarcados e não demarcados, submetidos ao tratamento cirúrgico com confecção de estomia intestinal, no ano de 2009. Do total de 70 (100%) analisados, verificamos que 37 (52,9%) pertenciam ao sexo feminino e 33 (47,1%) masculino. Houve predomínio de 31 (44,3%) sem comorbidades, diagnóstico oncológico 46 (65,8%), 54 (77,1%) nunca haviam sido submetidos às cirurgias intestinais prévias, 56 (80%) cirurgias eletivas e 40 (57,1%) registros de tratamentos adjuvantes. Em relação ao tipo de estoma predominou 46 (65,7%) colostomias e 31 (44,3%) estomas definitivos. Do total, 33 (47,1%) foram demarcados no pré-operatório e 37 (52,9%) não. Em relação às complicações de estoma, no G1 Demarcados identificamos 15 complicações, sendo a hérnia periestoma a mais frequente em quatro (12,1%) pacientes. No G2 Não demarcados obtivemos 32 complicações, sendo a dermatite a mais frequente seis (16,1%) pacientes. Entre os 70 prontuários, as complicações mais registradas foram a dermatite 9 (12,9%), a hérnia periestoma 8 (11,4%), mau funcionamento do estoma 5 (7,1%), prolapso 4 (5,7%), sangramento 4 (5,7%) e extravasamento 4 (5,7%). Diante disso, estudos prospectivos controlados sobre os fatores de risco e a influência da demarcação de estoma pré-operatória poderão contribuir para a prevenção destas complicações em estomizados intestinais / Complications of stoma and peristomal skin compromise the lives of individuals with intestinal ostomy in performing self-care and rehabilitation, and the preoperative stoma site-marking has been considered important in preventing these complications. This study aimed to describe the complications of the stoma and peristomal skin in individuals who had preoperative stoma site-marked and who had not preoperative stoma site-marked underwent surgery in 2009 in a university hospital (CEP/EERP-USP 341.314).This is a quantitative, the survey of 70 medical records of patients stoma site marked and stoma site unmarked, underwent surgical treatment with confection of an ostomy, in 2009. Out of 70 (100%) analyzed, we found that 37 (52.9%) were female and 33 male (47.1%). Predominated 31 (44.3%) without comorbidities, oncologic diagnosis was 46 (65.8%), 54 (77.1%) had never been submitted to intestinal surgeries, 56 was (80%) elective surgery and 40 (57,1%) registers of adjuvant treatments. Regarding the type of stoma 46 predominated (65.7%) colostomies and 31 (44.3%) permanent stomas. In general, 33 (47.1%) were marked preoperatively and 37 (52.9%) was not. Regarding complications of stoma, we had identified 15 complications in the G1 demarcated and peristomal hernia was the most common complication with four (12.1%) cases. We have got 32 complications in the G2 not marked and the most common complication was dermatitis with six cases (16.1%). Among the 70 records, the most common complications recorded were dermatitis 9 (12.9%), peristomal hernia 8 (11.4%), malfunction of the stoma 5 (7.1%), prolapse 4 (5.7%) bleeding 4 (5.7%) and leakage 4 (5.7%). Therefore, prospective controlled studies about the risk factors and the influence of preoperative stoma site-marking may contribute to prevention of these ostomy complications
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Educação para o autocuidado de estomizados intestinais no domicílio: do planejamento à avaliação de resultados / Education for self-care of the intestinal ostomy patient at home: from planning to evaluation resultsSilva, Janaina da 06 September 2013 (has links)
Trata-se de um estudo de abordagem qualitativa, que teve como objetivos descrever as características socioculturais, familiares, domiciliares e capacidade para o autocuidado de estomizados cadastrados na Secretaria de Saúde de uma cidade do interior paulista; avaliar a condição clínica do estomizado em relação à estomia e os equipamentos utilizados; e planejar, implementar e avaliar a educação em saúde sobre o autocuidado de estomizados intestinais, com a estratégia do Método do Arco, fundamentado na Pedagogia da Problematização. Utilizou-se o referencial teórico da Pedagogia da Problematização e o método etnográfico para o desenvolvimento do estudo com pacientes cadastrados na Secretaria de Saúde para aquisição de equipamentos coletores para estomia intestinal e urinária, em uma cidade paulista, com participação em três etapas distintas do estudo. Na primeira etapa do estudo foi realizada a avaliação domiciliária, o uso de equipamentos coletores e a capacidade para o autocuidado, cujos dados foram coletados no domicílio com instrumento de avaliação do domicílio e observação participante, com participação de 52 pessoas com estomia intestinal e urinária, durante os meses de setembro e outubro de 2012. Nesta etapa, a média de idade foi de 37 anos, houve predomínio da casa própria, com saneamento básico, uso do convênio de saúde público, a maioria realiza o autocuidado com estomia e equipamentos, mudanças na alimentação e vestuário. Na segunda etapa participaram 19 estomizados intestinais e urinários, que foram avaliados com utilização de um instrumento de avaliação clínica contemplando dados sociodemográficos, clínicos e terapêuticos; curativo e ferida cirúrgica, autocuidado com a estomia e equipamentos; e capacidade para o autocuidado e com a observação participante das pesquisadoras, no período de 30 de outubro a 01 de novembro de 2012. Nesta etapa, participaram 10 homens e 9 mulheres, com média de idade de 54 anos, predominando aposentados, até oito anos de estudos, renda até dois salários mínimos, responsáveis pela manutenção financeira da família. Na terceira etapa, foi desenvolvida a atividade educativa com 10 estomizados intestinais no domicílio, com a estratégia do Método do Arco para o ensino do autocuidado com estomia intestinal e equipamentos, observação participante, diário de campo e gravação em áudio das entrevistas semiestruturadas com os participantes sobre o aprendizado alcançado por cada um destes, no período de novembro de 1012 a fevereiro de 2013. A atividade educativa foi com duas visitas domiciliares para sete participantes e de quatro a nove visitas para os outros participantes, todos passaram a realizar o autocuidado da estomia e do equipamento coletor e foram unânimes em relação aos benefícios desta aprendizagem na melhoria da autoestima e autonomia, com retomada das atividades cotidianas. Acreditamos que os resultados deste estudo contribuirão na melhoria do ensino de autocuidado de estomizados intestinais / This is a qualitative study that aimed to describe the socio-cultural characteristics, family, household and capacity for self-care of ostomy patients registered at the Secretariat of Health of a city in the state of São Paulo; assess the clinical condition of the ostomy patients in relation to the ostomy and the equipment used, and plan, implement and evaluate health education on self-care of intestinal ostomy patientes, with the strategy of the Arc Method, based on problem-solving pedagogy. The theoretical framework of the Curriculum and Pedagogy ethnographic method were used for the development of the study of patients enrolled in the Health Department to purchase equipment for collectors and urinary ostomy in a city in the satate of São Paulo, with participation in three distinct stages of the study. In the first stage of the study the home care was evaluated, the use of collection equipment and the ability for the self-care, data were collected at home with the resident assessment instrument and participant observation, with the participation of 52 people with urinary and intestinal ostomy during the months of September and October 2012. At this stage, the average age of the patients was 37 years old, there was a predominance of home ownership, with sanitation, use of public health plan, the majority performs self-care with ostomy equipment and reported changes in food and clothing. In the second stage 19 intestinal and urinary ostomy patients were involved, they were evaluated with the use of a clinical assessment instrument covering socio- demographic, clinical and therapeutic, curative and surgical wound, ostomy and self- care with the equipment, and capacity for self-care and observation participant of the researchers in the period from October 30 to November 1, 2012. At this stage, 10 men and 9 women were attended, with the average age of 54 years old, especially retired patients, to eight years of study, receiving up to two minimum wages, responsible for the maintenance of the family. In the third stage, the educational activity was developed with 10 intestinal ostomy patients at home, with the strategy of the Arc Method to teach the self-care and ostomy equipment, participant observation, field diary and audio recording of the semi-structured interviews about the learning achieved by each one of them, from November 2012 to February 2013. Educational activity was done with two visits to seven patients and four to nine visits to other patients, all of them began to perform self-care and ostomy equipment collector and were unanimous regarding the benefits of this learning to improve self- esteem and autonomy, with resumption of daily activities. We believe that the results of this study will contribute to the improvement of the teaching self-care of intestinal ostomy
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Rectal cancer surgery : Defunctioning stoma, anastomotic leakage and postoperative monitoringMatthiessen, Peter January 2006 (has links)
The understanding of the mesorectal spread in rectal cancer has lead to wide acceptance of total mesorectal excision (TME) as the surgical technique of choice for carcinoma in the lower and mid rectum. While oncological results and survival have improved with TME-surgery, morbidity and mortality remain important issues. The most feared complication is symptomatic anastomotic leakage. The aim of this thesis was to focus on the role of the defunctioning stoma, risk factors, and postoperative monitoring in regard to anastomotic leakage in sphincter saving resection of the rectum. Intraoperative adverse events were analysed in a retrospective population based case-control study in which all patients who underwent elective anterior resection in Sweden between 1987 and 1995, and who died within 30 days or during the initial hospital stay (n=140), were compared with patients chosen at random (n=423) who underwent the same operation during the same period, but survived the operation. Intraoperative adverse events were more frequent in those who died, and reconstruction of an anastomosis judged unsatisfactory by the surgeon improved the outcome. In a population based retrospective case-control study, risk factors for symptomatic anastomotic leakage were investigated in randomly chosen sample of patients who underwent anterior resection in Sweden between 1987 and 1995 (n=432). Twelve per cent of the patients developed symptomatic leakage, and 25% of the patients with leakage ended up with a permanent stoma. In multivariate regression analysis, low anastomosis, preoperative radiotherapy, male gender and intraoperative adverse events were independent riskfactors for anastomotic leakage. In a randomised multicentre trial patients operated with sphincter saving TME¨surgery for rectal cancer were randomised to a defunctioning stoma (n=116) or not (n=118). The overall rate symptomatic leakage was 19%. Patienst without a defunctioning stoma leaked in 28% and patients with a defunctioing stoma in 10%, a statistically significant difference (p<0.001) not previously demonstrated in any randomised trial of adequate size. Postoperative monitoring with computed tomography scan (CT-scan) on postoperative day 2 and 7, and C-reactive protein (CRP) daily in 33 patients operated on with anterior resection of the rectum, demonstrated larger pelvic fluid collections in patients with leakage before the leakage was clinically diagnosed. CRP was increased from postoperative day 2 and onwards in patients in whom clinical leakage was diagnosed on median postoperative day 8. In 23 patients who underwent anterior resection of the rectum, intraperitoneal metabolism was investigated using microdialysis technique measuring the carbohydrate metabolites lactate, pyruvate and glucose. Intraperitoneal cytokines IL-6, IL-10 and TNF-α were collected through a pelvic drain and analysed. In patients who developed leakage, the latate/pyruvate ratio was increased near the anastomosis on postoperative day 5 and 6, as well as IL-6 and IL-10 which were increased postoperatively day 1 and 2, while TNF-α was higher on day 1.
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Problematika využití urostomických pomůcek z pohledu pacientů s urostomií a sester / Problems of urostomy aids from the perspective of patients with urostomy and nurses.FABINGEROVÁ, Dana January 2015 (has links)
This diploma thesis investigates the issue of urostomy aids from the perspective of the patients with a urostomy and stoma nurse specialists. A urostomy is a surgical procedure which diverts the normal flow of urine from the kidneys and ureters into a specially created stoma. It is one of the techniques of solving urine derivation after the surgical removal of the bladder. The most common indications for this surgery is indisputably a malignant tumour of the urinary bladder. Creating a urostomy is the fundamental turning point and change in the patient´s life. The patient has to learn how to live with a urostomy not only from a physical point of view, but also from the perspective of its great psychological response significance. The right choice and correct use of urostomy aids is crucial for the patients with a urostomy and significantly affects quality of their life. Given these circumstances, the patient with a urostomy should be provided with wide range of urostomy aids. The thesis is divided into the theoretical and empirical part. The theoretical part is described in seven chapters. The empirical part of the thesis includes qualitative research. Data were collected from semi-structured interviews with the patients with a urostomy and stoma nurse specialists. For each group of respondents, several categories and subcategories were formed. These were further described in detail. The collected data were presented in diagrams. Three objectives were defined in the thesis. The first objective examined the level of patient´s knowledge of urostomy aids. The second objective investigated the patient´s possibilities concerning the use of urostomy aids. Based on the initial results of the research, the third objective focused on development of an educational plan specializing in urostomy aids and its verification in practice. This plan will be dedicated to the urostomy nurse specialists when working with the patients. Following these objectives, four research questions were formed. Research question no. 1: What is the level of patient´s knowledge of urostomy aids? Research question no. 2: What are the possibilities of the use of urostomy aids by the patients with a urostomy? Research question no. 3: What is the level of nurse´s knowledge of urostomy aids? Research question no. 4: How the urostomy nurse specialists educate the patients with a urostomy? The results of the qualitative survey demonstrate that the level of patient´s knowledge of urostomy aids is insufficient, despite the contrary opinion provided by the stoma care nurses. Lack of their knowledge is however not related to their contact with the stoma nurse specialist. The results did not confirm that the patients with a urostomy frequenting stoma nurse specialists for regular checks would be better informed than those who do not follow the regular checks. Furthermore, the survey reveals that possibilities of the use of urostomy aids by the patients are very limited. Stoma nurse specialists do not introduce urostomy aids supplied by all companies on our market to the patients and thus they do not provide an option for individual choice of these aids. This situation occurs despite the fact that stoma nurse specialists demonstrated a very good knowledge of urostomy aids. The results of this investigation also confirm that the education carried out by stoma nurse specialists is acceptable and understandable for the patients with a urostomy. The proof is demonstrated by their satisfaction with this education. The outcome of this thesis focuses on the educational plan designated for stoma nurse specialists caring for the patients with a urostomy. The given educational plan was developed based on the results of the research and is particularly focused on the presentation of all available urostomy aids within the postoperative education.
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Uspokojování psychosociálních potřeb stomiků / Meet the psychosocial needs of stoma patiensGREGOROVÁ, Jana January 2012 (has links)
For a person stoma means change both in the health as well as psychosocial area. It is necessary to perceive the person as a bio-psycho-socially-spiritual being requiring satisfaction of all his/her needs. Shortage of satisfaction of psychosocial needs can have very serious impacts on the overall health condition of the client. Stoma nurses and stoma clubs significantly contribute to satisfaction of needs. Stoma nurses deal not only with a preoperative, postoperative care for stoma suffering people, their education but they also help them to solve problems, which occurred in connection with stoma, answer their questions and are their consultants and support. Stoma nurses are a great benefit for stoma suffering people and their families. Stoma clubs are voluntary associations where people suffering stoma meet. Their task is to defend the interests and rights of stoma suffering people, organise meetings, special seminars, cultural events and stays. Versatile activity of the clubs is involved in client?s stoma adaptation, improvement of his/her life and making satisfaction of psychosocial needs easier. The target of the Diploma Thesis was to find out the most frequent psychosocial problems of stoma patients and whether stoma stresses more ileostoma patients than colostomy ones. Targets of the thesis were met. There were defined five hypotheses for the targets. First hypothesis dealt with the question, whether stoma patients suffer lack of satisfaction of psychosocial needs. Second hypothesis analysed, whether stoma disturbed partner life of the stoma patient. Third hypothesis analysed, whether stoma nurses bring benefit to a stoma patient and the fourth one, whether stoma clubs are beneficial for a stoma patient. These hypotheses were proved. The fifth hypothesis analysed, whether stoma stresses more ileostoma than colostomy patients. This hypothesis was not proved. To collect data I used the form of quantitative research using non-standardised questionnaire for people suffering ileostoma and colostomy. This Diploma Thesis shall point out the necessity of satisfaction of psychosocial needs of stoma patients in practice.
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Educação para o autocuidado de estomizados intestinais no domicílio: do planejamento à avaliação de resultados / Education for self-care of the intestinal ostomy patient at home: from planning to evaluation resultsJanaina da Silva 06 September 2013 (has links)
Trata-se de um estudo de abordagem qualitativa, que teve como objetivos descrever as características socioculturais, familiares, domiciliares e capacidade para o autocuidado de estomizados cadastrados na Secretaria de Saúde de uma cidade do interior paulista; avaliar a condição clínica do estomizado em relação à estomia e os equipamentos utilizados; e planejar, implementar e avaliar a educação em saúde sobre o autocuidado de estomizados intestinais, com a estratégia do Método do Arco, fundamentado na Pedagogia da Problematização. Utilizou-se o referencial teórico da Pedagogia da Problematização e o método etnográfico para o desenvolvimento do estudo com pacientes cadastrados na Secretaria de Saúde para aquisição de equipamentos coletores para estomia intestinal e urinária, em uma cidade paulista, com participação em três etapas distintas do estudo. Na primeira etapa do estudo foi realizada a avaliação domiciliária, o uso de equipamentos coletores e a capacidade para o autocuidado, cujos dados foram coletados no domicílio com instrumento de avaliação do domicílio e observação participante, com participação de 52 pessoas com estomia intestinal e urinária, durante os meses de setembro e outubro de 2012. Nesta etapa, a média de idade foi de 37 anos, houve predomínio da casa própria, com saneamento básico, uso do convênio de saúde público, a maioria realiza o autocuidado com estomia e equipamentos, mudanças na alimentação e vestuário. Na segunda etapa participaram 19 estomizados intestinais e urinários, que foram avaliados com utilização de um instrumento de avaliação clínica contemplando dados sociodemográficos, clínicos e terapêuticos; curativo e ferida cirúrgica, autocuidado com a estomia e equipamentos; e capacidade para o autocuidado e com a observação participante das pesquisadoras, no período de 30 de outubro a 01 de novembro de 2012. Nesta etapa, participaram 10 homens e 9 mulheres, com média de idade de 54 anos, predominando aposentados, até oito anos de estudos, renda até dois salários mínimos, responsáveis pela manutenção financeira da família. Na terceira etapa, foi desenvolvida a atividade educativa com 10 estomizados intestinais no domicílio, com a estratégia do Método do Arco para o ensino do autocuidado com estomia intestinal e equipamentos, observação participante, diário de campo e gravação em áudio das entrevistas semiestruturadas com os participantes sobre o aprendizado alcançado por cada um destes, no período de novembro de 1012 a fevereiro de 2013. A atividade educativa foi com duas visitas domiciliares para sete participantes e de quatro a nove visitas para os outros participantes, todos passaram a realizar o autocuidado da estomia e do equipamento coletor e foram unânimes em relação aos benefícios desta aprendizagem na melhoria da autoestima e autonomia, com retomada das atividades cotidianas. Acreditamos que os resultados deste estudo contribuirão na melhoria do ensino de autocuidado de estomizados intestinais / This is a qualitative study that aimed to describe the socio-cultural characteristics, family, household and capacity for self-care of ostomy patients registered at the Secretariat of Health of a city in the state of São Paulo; assess the clinical condition of the ostomy patients in relation to the ostomy and the equipment used, and plan, implement and evaluate health education on self-care of intestinal ostomy patientes, with the strategy of the Arc Method, based on problem-solving pedagogy. The theoretical framework of the Curriculum and Pedagogy ethnographic method were used for the development of the study of patients enrolled in the Health Department to purchase equipment for collectors and urinary ostomy in a city in the satate of São Paulo, with participation in three distinct stages of the study. In the first stage of the study the home care was evaluated, the use of collection equipment and the ability for the self-care, data were collected at home with the resident assessment instrument and participant observation, with the participation of 52 people with urinary and intestinal ostomy during the months of September and October 2012. At this stage, the average age of the patients was 37 years old, there was a predominance of home ownership, with sanitation, use of public health plan, the majority performs self-care with ostomy equipment and reported changes in food and clothing. In the second stage 19 intestinal and urinary ostomy patients were involved, they were evaluated with the use of a clinical assessment instrument covering socio- demographic, clinical and therapeutic, curative and surgical wound, ostomy and self- care with the equipment, and capacity for self-care and observation participant of the researchers in the period from October 30 to November 1, 2012. At this stage, 10 men and 9 women were attended, with the average age of 54 years old, especially retired patients, to eight years of study, receiving up to two minimum wages, responsible for the maintenance of the family. In the third stage, the educational activity was developed with 10 intestinal ostomy patients at home, with the strategy of the Arc Method to teach the self-care and ostomy equipment, participant observation, field diary and audio recording of the semi-structured interviews about the learning achieved by each one of them, from November 2012 to February 2013. Educational activity was done with two visits to seven patients and four to nine visits to other patients, all of them began to perform self-care and ostomy equipment collector and were unanimous regarding the benefits of this learning to improve self- esteem and autonomy, with resumption of daily activities. We believe that the results of this study will contribute to the improvement of the teaching self-care of intestinal ostomy
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