Qualified assistance for stoma patients in Lithuania is insufficient. Failure to provide preoperative information to patients results in not only physical, but also psychological trauma, which negatively affects the patients’ postoperative quality of life. Physicians and nurses have insufficient information about stoma care. In Lithuania, there have been no studies that would evaluate the organization of assistance for stoma patients. The aim of the performed study was to identify the drawbacks in the assistance for stoma patients in hospitals, and to propose measures for the elimination of these drawbacks. Methods and results. During the study, several investigations were performed, including questionnaire-based inquiry of patients for the evaluation of their post-operative quality of life following stoma formation, and the inquiry of patients for the comparison of the importance of preoperative and postoperative training on stoma care. The inquiry was performed using standardized quality of life questionnaires EORTC QLQ-C30 (version 3), EORTC QLQ-CR38, and additional questionnaires aimed at the evaluation of the convenience of the stoma site and the influence of preoperative and postoperative training on the quality of life during the distant postoperative period. For the second inquiry, three groups of subjects were formed. The first group included patients in whom optimal site of the stoma was selected before the operation, who were provided with full information on... [to full text]

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.

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.

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The thesis deals with the application of NIC, NOC classifications in patients with stoma. Every nurse uses a classification system of health care which describes activities or interventions done by nurses as a part of planning phase of nursing process in connection with creation of nursing care plan. These classifications also focus on developement of nursing care objectives and evaluating of the effect of nursing care results. Due to these classifications, the nursing care results are mesurable. In the theoretical part of the thesis, we focus on classification systems of nursing care, then on GIT diseases which lead to insertion of stoma, its care, care of patients with stoma and last but not least, on nursing documentation. Several objectives were set to meet the main target of the thesis. Firstly, to map nurses' opinion on nursing classifications; secondly, to find out which NOC indicators are usually judged by nurses in the care of patients with stoma; thirdly, to find out which activities are usually used by nurses in the care of patients with stoma; fourthly, to check up on application of NIC, NOC classification in the care of patients with stoma. The qualitative reserch was hold in two phases. In the first phase of the qualitative research, a nursing documentation was created on the basis of NIC and NOC classification related to care of the patients with stoma. In the second phase of the qualitative research, we interviewed ten nurses who had worked with the particular nursing documentation.