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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Quality assurance for patients with ostomies a study measuring quality in terms of outcomes, patient perceptions of nursing process, and patient satisfaction /

Doermann, Barbara Ann Wilke. January 1979 (has links)
Thesis (M.S.)--University of Wisconsin--Madison. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 63-69).
2

An experimental study of the two methods of achieving continence after proctocolectomy

Cranley, B. January 1981 (has links)
No description available.
3

An exploratory study of the effects of ostomy surgery on perceptions of sexuality

Gloeckner, Mary Beth Reid. January 1979 (has links)
Thesis (M.S.)--University of Wisconsin-Madison. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 109-112).
4

A study of the adjustment of fourteen patients with ileostomies who attended the Ileostomy Clinic group discussion at the Massachusetts General Hospital

Robinson, Arlene Minerva January 1952 (has links)
Thesis (M.S.)--Boston University
5

Upplevelser av att leva med en ileostomi : Ett patientperspektiv

Hallberg, Hanna, Nyhlen, Rebecka January 2018 (has links)
Bakgrund: En stomi från tunntarmen benämns ileostomi och är ett resultat av ett kirurgiskt ingrepp där hela eller delar av tjocktarmen tagits bort. Att leva med en ileostomi kan både leda till fysisk och psykisk påverkan på patienter. Syfte: Syftet var att belysa patienters upplevelser av att leva med en ileostomi. Metod: En litteraturstudie har genomförts för att sammanställa aktuell forskning. Totalt har fyra kvalitativa och fyra kvantitativa artiklar inkluderats till resultatet och analyserats med en integrerad analys. Resultat: Resultatet presenteras i fyra kategorier: förändrad självbild, förändrade relationer till andra, komplikationer och behandling samt kontakten med sjukvården. En ileostomi kan ge en försämrad kroppsbild som påverkar patienters upplevelser av sig själva negativt. Osäkerhet uppstod inför att avslöja ileostomin för andra och då upplevde patienter påverkan på relationer. Komplikationer upplevdes försämra välbefinnandet. Sjukvården var viktig för patienters upplevelser av välbefinnande. Slutsats: Patienters upplevelser av att leva med en ileostomi varierar och kan vara både positiva och negativa. Kroppsbilden påverkas och patienter kan känna sig onaturliga. Patienter upplevde osäkerhet när sjuksköterskor visade avsky mot ileostomin, medan välbefinnande uppstod när sjuksköterskor var medkännande. / Background: A stoma from the small intestine is called an ileostomy and is a result of a surgical procedure where all or parts of the large intestine has been removed. Living with an ileostomy might entail physical and mental problems for the patient. Aim: The aim was to illuminate patients experiences of living with an ileostomy. Method: A literature study has been conducted to compile current research. In total, four qualitative and four quantitative articles have been included in the results and analyzed with integrated analysis Results: The result is presented in four categories: changed selfimage, changed relationships with others, complications and treatment, contact with healthcare. An ileostomy can cause a deteriorated body image that adversely affects the patient's experiences. Uncertainty arose in order to reveal the ileostomy to others and then patients experienced the impact on relationships. Complications of the ileostomy was found to impair well-beeing. Healthcare was important for patients' experiences of well-being. Conclusion: Patients' experiences of living with an ileostomy vary and may be both positive and negative. The body image is affected and patients may feel unnatural. Patients experienced insecurity when nurses showed disgust towards their ileostomy, while well-beeing aroused when nurses were compassionate.
6

Overall Life Satisfaction of Ileostomates: Conventional Brooke Ileostomy Versus Modified Kock Pouch

Briscoe, Sandra Sisson 01 May 1988 (has links)
The purpose of this thesis is to analyze various aspects of quality of life and to determine if there is a difference in quality of life offered by a conventional ileostomy versus a continent ileostomy. An instrument was developed to measure several factors thought to influence quality of life as well as several structural/demographic variables. This instrument was designed for persons with a conventional ileostomy and was modified for persons who had undergone conversion surgery from conventional to continent ileostomy. Analysis of variance was performed to determine differences in quality of life for persons with a conventional, conversion, or original continent ileostomy. In addition to an overall quality of life measure, measures for specific areas: self esteem, family relationships, marriage relationships and a composite measure, were tested. No difference was detected for the three types of ileostomy for these variables. Analysis of variance was also performed on variables measuring specific aspects of life such as social activities and travel. This identified several differences in the ileostomy types which the analysis of the more general variables failed to detect. Those who had conversion surgery from conventional to continent ileostomies answered each question twice, comparing life with no ileostomy to life with a conventional, then comparing life with a conventional ileostomy to life with a continent. Three analyses were performed on the resulting data: sign test, chi-square test, and Fisher's exact test. The use of these three tests showed differences in results concerning quality of life and differences in the statistical power of the tests. Both aspects are discussed. Significant improvement in quality of life for almost every aspect tested was seen for this group. Finally, principal component analysis was applied to the set of variables measuring specific aspects of quality of life and several new variables developed from the resulting factors. Analysis of variance was performed on these, as well as the original quality of life measures to determine which of the structural/demographic variables had an effect on quality of life.
7

Klinische Bedeutung des abführenden Schenkels im Vergleich zur Rektoskopie in der Diagnostik vor Ileostomarückverlagerung / Clinical significance of the radiological representation of the descending intestinal loop in comparison to rectoscopy in the diagnosis before ileostomy relocation

Clemens, Maximilian 18 August 2020 (has links)
No description available.
8

Den förändrade livsstilen - Personers upplevelse av att leva med stomi : Beskrivande litteraturstudie

Åstrand, Maja, Englund, Isabella January 2020 (has links)
Introduktion: Vid en skada eller sjukdom i mag-tarmkanalen kan inläggning av stomi behövas. Genom kirurgi skapas en öppning mellan tarm och bukväggen och därmed skapar man en ny tömningsväg - en så kallad stomi. För att personer ska kunna axla tillvaron med en stomi krävs det att sjuksköterskan har adekvata kunskaper om stomiutrustning, stomivård, hur det är att leva med stomi och stomikomplikationer. Sjuksköterskans roll är att hjälpa och undervisa personer som är i en krissituation på grund av sjukdom och medicinsk behandling.   Syfte: Syftet är att beskriva personers upplevelse av att leva med stomi.   Metod: En beskrivande litteraturstudie som baseras på 11 vetenskapliga artiklar, varav åtta är kvalitativa och tre är kvantitativa.   Huvudresultat: Resultatet visade att stomiopererade upplevde en förändrad syn på sin kroppsbild, de hade komplikationer som läckage och okontrollerbara gasavgångar som upplevdes med skam och en förlust av kontroll. Detta upplevdes inverka på det sociala livet som påverkats drastiskt och bidrog till att många isolerade sig under den första perioden efter stomikirurgin, medan andra upplevde det som en positiv förändring som skapat en stabilare vardag och ett socialare liv. Det upplevdes en oro för hur den förändrade kroppen skulle påverka eventuella partners. Bristen på information upplevdes påverka egenvårdshanteringen när de senare återgick till hemmet. Kost och aktiviteter upplevdes förändras efter de fått stomin.   Slutsats: Att få en stomi upplevdes som en stor förändring i varje persons liv. De påverkades på många olika sätt och det blev för många en upplevelse av begränsning i kroppsuppfattning, sexualitet, egenvård och socialt. Ofta upplevdes rädsla, oro och skam. Studier visar att stöd, information och kunskap underlättar för personer att anpassa sig till livet med stomi. Sjuksköterskan kan i sin yrkesprofession genom att ha kunskap om detta, bemöta dessa personer med en bättre förståelse för hur upplevelsen av att leva med stomi hanteras.
9

Parastomal hernia : clinical studies on definitions and prevention

Jänes, Arthur January 2010 (has links)
The aims of the studies was to evaluate the short and long term effects on the development of parastomal hernia and stoma complications of a prophylactic prosthetic mesh placed in a sublay position at the index operation.  Also the purpose was to validate a definition of parastomal hernia at clinical examination and a method and a definition of parastomal hernia at CT-scan. In the first two studies 27 patients were randomized to a conventional stoma or to a stoma with the addition of a partly absorbable low weight large pore mesh in sublay position. Patients were examined after one and five years.  After five years the rate of parastomal hernia was 80% with a conventional stoma and 14% with the addition of a mesh.  A prophylactic mesh did not increase the rate of complications. In the third study a prophylactic mesh was intended at stoma formation in 93 consecutive patients in routine surgery. In 75 patients provided with a mesh the rate of parastomal hernia after one year was 13%. Complication rates were not increased in 19 severely contaminated wounds. In the fourth study 27 patients with ostomies were examined by tree surgeons and parastomal hernia was defined as any protrusion in the vicinity of the stoma. CT-scans with patients examined in the supine and prone positions were assessed by three radiologists. Herniation was then defined as any intra abdominal content protruding beyond peritoneum or the presence of a hernia sac. Kappa was 0.85 for surgeons and 0.85 for radiologists with CT-scan in the prone position. Kappa was 0.80 for surgeons and radiologists collectively, with CT-scan in the prone position. Four parastomal hernias detected at CT-scan in the prone position could not be detected in the supine position. A parastomal hernia diagnosed at clinical examination was always detected at CT-scan in the prone position. Conclusions: A prophylactic mesh placed in a sublay position at the index operation reduces the rate of parastomal hernia without increasing the rate of complications. Parastomal hernia should at clinical examination be defined as any protrusion in the vicinity of the stoma with the patient straining in the supine and erect positions.  At CT-scan, with the patient examined in the prone position, herniation should be defined as any intra abdominal content protruding beyond peritoneum or the presence of a hernia sac. / Embargo, publiceras 2011-05-01
10

Resultados imediatos do fechamento de ileostomia em alça / Immediate results of loop ileostomy closure

Victor Edmond Seid 19 January 2005 (has links)
Na atualidade, a ileostomia em alça é indicada para a proteção de anastomoses colorretais baixas ou colo-anais ou para a proteção de anastomoses íleo-anais em intervenções cirúrgicas de proctocolectomia total com confecção de bolsa ileal no tratamento cirúrgico das doenças inflamatórias intestinais, polipose adenomatosa familiar, tumores colorretais, doença diverticular e trauma. Índices de complicações elevados observados têm posto em dúvida o uso ampliado desse tipo de estoma apoiando-se em dados da literatura que, além de controversos, são originários de estudos retrospectivos de casuísticas pequenas. Outrossim, os dados na literatura brasileira são escassos. Assim, realizou-se estudo retrospectivo sobre resultados imediatos do fechamento de ileostomia em alça no período compreendido entre de março de 1991 e março de 2001, no Serviço de Cirurgia do Cólon Reto e Ânus do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. As variáveis consideradas foram ocorrência de complicações e o estado final do paciente (sem ileostomia ou não), correlacionadas com os dados do paciente, da doença que levou à confecção do estoma, dos tratamentos médicos e cirúrgicos anteriores e do próprio procedimento cirúrgico. Os testes estatísticos empregados foram o exato de Fisher para dados pontuais, o não paramétrico de Kruskal-Wallis para os dados temporais e, ao final, análise multivariada. O nível de significância foi de 95% (p<0,05). Foram estudados os prontuários de 131 doentes. Trinta e um apresentavam-se incompletos e, juntamente com três que foram submetidos a fechamento de ileostomia com anastomose mecânica, foram excluídos deste trabalho. A condição que motivou a ileostomia foi doença inflamatória em 73 casos (75,2%), neoplasia em 14,4%, polipose adenomatosa familial em 3% e outras doenças em 7,2%. O uso de corticóides foi assim distribuído: pacientes que nunca tomaram corticóide ?32 (32.9%), que faziam uso de corticóide há menos de 12 meses - quatro casos (4,1%), que faziam uso de corticóide há mais de 12 meses? 11 casos (11.3%), que fizeram uso de corticóide e que na época do fechamento da ileostomia usavam imunossupressor ou imunomodulador - nove casos (9,2%), pacientes que já tomaram corticóide e que interromperam o uso desta droga há menos de 12 meses - 31 (31.9%), e pacientes que já tomaram corticóde mas não faziam uso da droga há mais de 12 meses - 10 (10,3%). Na análise das somatórias das operações anteriores ao fechamento da ileostomia, houve a manipulação considerada menor em 65 casos (67%), e em 32 casos (32,9%) houve maior manipulação cirúrgica prévia ao fechamento da ileostomia. O período entre a confecção e o fechamento da ileostomia teve a mediana de 27 semanas (2 a 146 semanas). Cinqüenta e três pacientes sofreram preparo intestinal anterógrado pré-operatório (54,6%), quarenta não foram submetidos a nenhum tipo de preparo intestinal (41,2%), e quatro pacientes (4,1%) receberam preparo intestinal retrógrado Empregaram-se antibióticos em 91 dos casos (93,8%), dos quais 63 (64,9%) usaram-nos por curto período e 28 casos (28,8%) tiveram seus antibióticos usados.por mais tempo. Detalhes técnicos operatórios estudados compreenderam: 1) graduação do cirurgião, com 77 casos (79,3%) operados por cirurgiões experientes, dez pacientes (10,3%) operados por cirurgiões com pós-graduação concluída no nível de mestrado, e dez (10,3%) operados por equipe formada por médicos residentes e preceptores; 2) acesso cirúrgico por incisão periestomal (93 casos? 95,8%) ou laparotomia longitudinal (quatro casos- 4,1%); 3) ressecção do segmento ileal exteriorizado (nove casos- 9,2%) ou não (88 casos- 90.7%); 4) sutura intestinal contínua (78 casos- 80,4%) ou em pontos separados (19 indivíduos- 19,5%); 5) em um plano (setenta casos- 72,1%) ou dois planos (27 casos- 27,9%); 6) o tipo de fechamento da aponeurose da parede abdominal com sutura contínua empregada em 55 casos (56,7%) e sutura em pontos separados em 42 casos (43,2%). O índice de complicações gerais foi de 40,2% - 39 casos - (29,8% de resolução clínica e 10,3% cirúrgica). A mediana do período de internação dos pacientes foi de 12 dias. Ocorreram cinco casos de deiscência ou abscesso de parede abdominal, três casos de deiscência de anastomose intestinal, um de abscesso intracavitário (drenado cirurgicamente), um de fístula estercorácea, um de estenose da anastomose íleo-anal detectada no pós-operatório, um de insuficiência renal aguda, e um último apresentou vômitos persistentes. Não houve influência do sexo, da faixa etária, da doença que originou o estoma, da manipulação cirúrgica prévia, do emprego do preparo intestinal ou não e os aspectos técnicos operatórios nos índices de complicações. O uso de sutura contínua, apesar de reduzir o tempo cirúrgico (p=0,02), esteve associado a complicações (p=0,04). Por outro lado, o fechamento da aponeurose com sutura contínua, além de reduzir o tempo operatório (p=0,002), foi associada à menor índice de complicações (p=0,002). A realimentação nas primeiras 48 horas de pós-operatório associou-se a maior índice de complicações (p=0,054). O uso crônico de corticóides correlacionou-se com menor proporção de obstrução intestinal (p=0,04). Antibióticos em uso prolongado foram mais relacionados com as complicações (p=0,0001). A análise multivariada (regressão logística) verificou a relação em proporção direta entre o período desde a confecção até o fechamento da ileostomia e a ocorrência de complicações (odds ratio=1,02) e o modo do uso de antibióticos (odds ratio=30,36 para uso prolongado). Do exposto, concluiu-se que a doença e o porte da intervenção cirúrgica que levou à realização de ileostomia em alça não tiveram influência significativa no índice de complicações; que o uso crônico de corticóides gerou menor índice de ocorrência de obstrução intestinal; que o preparo intestinal para o fechamento de ileostomia pôde ser dispensado; que a sutura intestinal contínua associou-se a maior número de complicações; que a experiência do cirurgião responsável pelo fechamento da ileostomia não determinou maior número de complicações; que o tempo decorrido entre a confecção e o fechamento da ileostomia acrescentou maior risco de complicações a cada semana, e que a decisão do cirurgião quanto ao uso prolongado de antibióticos foi correlacionada com maior ocorrência de complicações / Loop ileostomies have been commonly used for diversion of fecal stream, in order to protect low colorectal, coloanal or íleo-anal anastomosis performed for a variety of primary diseases such as colorectal cancer (CRC), inflammatory bowel diseases (IBD), familial adenomatous polyposis (FAP), diverticular disease and trauma. However, high morbidity rates associated with this type of stoma have limited its wide spread use. This limitation is supported by controversial data, based mostly in retrospective studies with small number of patients. Moreover, national data on the subject is minimal. Therefore, a retrospective study was designed to determine immediate results of loop ileostomy closure in the period between March 1991 and March 2001, at the Colorectal Surgery Division of the Hospital das Clínicas University of São Paulo Medical School. Primary end-points included perioperative complication occurrence and final patient status (ileostomy-free or not). These events were correlated to patient demographic data, primary disease requiring loop ileostomy, previous medical treatment, previous operations and loop ileostomy closure characteristics. Statistical analysis was performed using Fisher\'s exact test for categorical variables, Kruskal-Wallis non-parametric test for temporal variables and multivariate analysis. P values of 0.05 or less were considered significant. One hundred and thirty-one patient\'s records were reviewed. Thirty-one patients with unavailable hospital records and three patients managed by mechanical stapled ileostomy closure technique were excluded from the study. Primary disease requiring loop ileostomy construction was IBD in 75.2%, CRC in 14.4%, FAP in 3% and others in 7.2% of the cases. Steroid use was classified into patients that have never used - 32 cases (32.9%), patients that have used only within the last 12 months - 4 cases (4.1%), patients that have used for more than 12 months - 11 cases (11.3%), patients that have used but are now under immunosupressors or immunomodulators - 9 cases (9.2%), patients that have used but are currently off steroids for less than 12 months - 31 cases (31.9%) and patients that have used but are currently off steroids for more than 12 months - 10 cases (10.3%). Previous operations included 4-quadrant procedures in 65 cases (67%) and five or more quadrants (multiple procedures) in 32 cases (32.9%). Median interval between stoma creation and closure was 27 weeks (ranging from 2 to 146 weeks). Fifty-three patients underwent preoperative anterograde mechanical bowel preparation (54,6%), forty underwent no specific preoperative bowel preparation (41.2%) and 4 underwent retrograde mechanical bowel preparation (4.1%). Perioperative antibiotic administration was performed in 91 patients (93.8%). Short-term antibiotic use (less than or up to 72hs) occurred in 63 patients (64.9%) while long-term antibiotic use (more than 72hs) occurred in 28 cases (28.8%). Technical variables included: surgeon?s experience, being 77 cases managed by experienced surgeons (79.3%), 10 cases (10.3%) by surgeons with intermediate experience (post-graduate level) and 10 cases by colorectal surgery residents or fellows (10.3%); access strategy including peri-stomal incision in 93 cases (95.8%) and longitudinal mid-line laparotomy in 4 cases (4.1%); resection of an ileal segment in 9 cases (9.2%) or non-resection in 88 cases (90.7%); continuous intestinal suture line in 78 cases (80.4%) or interrupted suture in 19 cases (19.5%); single suture layer in 70 cases (72.1%) or two-layer suture in 27 cases (27.9%); and type of primary aponeurotic layer closure, being continuous suture in 55 cases (56.7%) and interrupted suture in 42 cases (43.2%). Overall complication rate was 40.2% (39 patients) requiring medical management in 29.8% and surgical management in 10.3% of the cases. Median hospital stay period was 12 days. Complications included wound dehiscence or abscess in five patients, intestinal suture dehiscence in three, an intraperitoneal abscess (surgically drained) in one, a stercoracic fistulae in one, an ileo-anal anastomosis stenosis in one, acute renal insufficiency in one and persistent emesis in one patient. There was no correlation between gender, age, primary disease, previous operations or bowel preparation and complication occurrence. Regarding technical characteristics, continuous intestinal suture was associated with shorter duration of surgery (p=0.02) and with higher rates of complication (p=0.04). On the other hand, continuous aponeurotic layer closure was associated with shorter duration of surgery (p=0.002) but also with decreased complication rates (p=0.002). Early oral food intake (first 48 hours from operation) was associated with higher complication rates (p=0.054). Chronic steroid use was associated with lower risk of post-operative small bowel obstruction (SBO) development (p=0.04). Long-term antibiotic administration was associated with increased complication rates (p=0.0001). Multivariate analysis (logistic regression) revealed a correlation in direct proportion between interval period (stoma creation-closure) and complication occurrence (odds ratio=1.02). Also, a same correlation was observed for antibiotic use pattern (long-term vs short-term) and complication occurrence (odds ratio=30.36 for long-term). In conclusion, primary disease or operation requiring loop ileostomy creation was not associated with complication occurrence; chronic steroid use may have a protective effect on post-operative SOB development; mechanical bowel preparation may be unnecessary; continuous intestinal suture was associated with higher complication rates; surgeon?s experience was not associated with complication occurrence; greater interval between ileostomy creation and closure is associated with increased risk of complication occurrence; and surgeon\'s intention to long-term use of antibiotics is also associated with increased complication rates

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