Dissertação(Mestrado)-Universidade Federal do Rio Grande, Programa de Pós-Graduação em Enfermagem, Escola de Enfermagem, 2012. / Submitted by eloisa silva (eloisa1_silva@yahoo.com.br) on 2013-04-11T14:31:58Z No. of bitstreams: 1 cristianops.pdf: 667341 bytes, checksum: 1ca4ac24ac74ade0648025cb6e8e7385 (MD5) / Approved for entry into archive by Gabriela Silva da Rosa(gabrielasilvadarosa@gmail.com) on 2013-07-01T23:24:57Z (GMT) No. of bitstreams: 1 cristianops.pdf: 667341 bytes, checksum: 1ca4ac24ac74ade0648025cb6e8e7385 (MD5) / Made available in DSpace on 2013-07-01T23:24:57Z (GMT). No. of bitstreams: 1 cristianops.pdf: 667341 bytes, checksum: 1ca4ac24ac74ade0648025cb6e8e7385 (MD5) Previous issue date: 2012 / As pessoas que realizam cirurgia para a construção de uma estomia, experenciam alterações multidimensionais trazendo reflexos na manutenção de sua identidade. Estas pessoas são envolvidas por complexas mudanças que emergem sob a sua dimensão física, psíquica, espiritual, social e familiar, fazendo assim, que sua identidade siga um itinerário de desconstrução e (re)construção. Para que ocorra uma reestruturação e consolidação da nova identidade é preciso que o enfermeiro otimize primeiramente, a adaptação da pessoa estomizada à presença da bolsa coletora e a nova condição de ser/estar estomizada. Este estudo teve por objetivo compreender o processo de (re)construção da Identidade da Pessoa Estomizada à Luz do Modelo de Adaptação de Roy. Foi realizada uma pesquisa qualitativa, descritiva, apoiada noModelo de Adaptação de Roy. Foi realizada no Serviço de Estomaterapia do Hospital Universitário Dr. Miguel Riet Corrêa Jr. na Cidade do Rio Grande, no Estado do Rio Grande do Sul. Os participantes do estudo foram dez pessoas cadastradas no referido serviço. A coleta de dados ocorreu nos meses de junho e julho de 2011 por meio da técnica de entrevista semi-estruturada. A análise dos dados foi norteada pelos preceitos da análise textual. A pesquisa ocorreu após a autorização do Comitê de Ética em Pesquisa na Área da Saúde sob o parecer n° 77/2011 e foram seguidos todos os preceitos éticos que regem as pesquisas com os seres humanos. A partir da análise dos dados obtiveram-se cinco categorias: A adaptação do corpo fisiológico à nova condição; Autoconceito: percepções abarcadas pelo eu físico e o eu pessoal; O processo adaptativo ao novo papel social; Adequação afetiva: comportamentos relacionados com pessoas significativas e sistemas de apoio; Identidade e adaptação: nexos e reflexos para o viver da pessoa estomizada. O processo de (re)construção da identidade da pessoa estomizada tem uma relação de proporcionalidade com o potencial de adaptação. Quanto mais adaptada, mais desfragmentada e concreta sua identidade se apresenta. Neste sentido, a atuação da enfermagem não deve ser direcionada somente por um modelo de assistência à saúde que tenha o corpo como seu foco. È preciso uma visão integral da pessoa que recebe seus cuidados, auxiliando-a a mobilizar seus recursos próprios, desenvolvendo estratégias que lhe possibilite um adequado enfrentamento e posterior adaptação à nova condição. Com os resultados deste estudo poderá emergir um novo entendimento para a enfermagem, saúde e sociedade acerca do potencial de adaptabilidade e (re)construção da identidade da pessoa estomizada de acordo com o contexto sócio-histórico-cultural no qual está inserida. / People who do surgery for the construction of an ostomy, bringing experience dimensional changes reflected in maintaining their identity. These people are surrounded by complex changes that emerge in their physical, mental, spiritual, social and family, thus, that their identity follow a path of deconstruction and (re)construction. In order to have a restructuring and consolidation of the new identity we need to optimize the nurse first, the adaptation of the person to the presence of stoma collection bag and new condition of being/living with stoma. This study aimed to understand the process of (re) construction of Identity of Person stoma to the Light of the Roy Adaptation Model. We performed a qualitative, descriptive, based on the Roy Adaptation Model. Service was held at the University Hospital Stomatherapy Dr. Miguel Riet Corrêa Jr. in the City of Rio Grande in Rio Grande do Sul The study participants were ten people registered in that service. Data collection occurred during June and July 2011 por the technique of semi-structured interview. Data analysis was guided by the principles of textual analysis. The research took place after the approval of the Committee for Research Ethics in Healthcare in the opinion No. 77/2011 and were followed all ethical guidelines governing research with human beings. From the data analysis yielded five categories: Adapting to the new body's physiological condition; Self: perceptions encompassed by the physical self and personal self; The process of adaptation to the new social role, emotional Adequacy: behavior associated with significant people and systems support, identity and adaptation: connections and reflexes for the person living with stoma. The process of (re) construction of the identity of the stoma has a proportional relationship with the potential for adaptation. The more tailored, more concrete and defragmented your identity is presented. In this sense, the nursing should not be directed only by a model of care that the body has as its focus. It takes a holistic view of the person receiving their care, helping it to mobilize its own resources, developing strategies that will enable an appropriate coping and future adaptation to new conditions. With the results of this study may emerge a new understanding for nursing, health and society about the potential for adaptability and (re) construction of the identity of stoma according to the socio-historical-cultural context in which it operates. / Las personas que hacen la cirugía para la construcción de una ostomía, experenciam cambios multidimensionales trayendo reflexiones en el mantenimiento de su identidad. Estas personas están rodeadas por los cambios complejos que surgen bajo su dimension famíliar, física, mental, espiritual, social y, por tanto, que su identidad si ga el camino de la deconstrucción y la (re)construcción. Con el fin de tener una reestructuración y consolidación de la nueva identidad, necesitamos que la enfermera optmize en primer lugar, la adaptación de la persona a la presencia de bolsa de recolección de estoma y la nueva condición del ser/vivir con estoma. Este estudio tuvo como objetivo comprender el proceso de (re)construcción de la identidad de la persona del estoma a la Luz del Modelo de Adaptación de Roy. Se realizó un estudio cualitativo, descriptivo, basado en el Modelo de Adaptación de Roy. El estúdio se celebró en el servicio de estomaterapia del Hospital Universitario Dr. Miguel Riet Correa Jr. en la ciudad de Río Grande, en Río Grande do Sul. Los participantes del estudio fueron diez personas inscritas en ese servicio. Los datos fueron recolectados durante junio y julio de 2011 por la técnica de entrevista semi-estructurada. El análisis de datos se regirá por los principios de análisis textual. La investigación se llevó a cabo después de la aprobación del Comité de Ética de Investigación en Salud en el dictamen N º 77/2011 y se siguieron todas las normas éticas que rigen la investigación con seres humanos. A partir del análisis de datos arrojó cinco categorías: Adaptación a la condición fisiológica a nueva condición; concepto de sí mismo: percepción abarcadas por la propia física y yo personal; el proceso de adaptación al nuevo papel social; la adecuación emocional: el comportamiento asociado con personas significativas y los sistemas de apoyo; identidad y adaptación: las conexiones y los reflejos de la persona viviendo con el estoma. El proceso de (re) construcción de la identidad del estoma tiene una relación proporcional con el potencial de adaptación. Cuanto más se adapta, más concreto y desfragmentado su identidad se presenta. En este sentido, o rendimiento de La enfermeria no debería estar dirigida sólo por un modelo de atención que tiene el cuerpo como su foco. Se necesita una visión holística de la persona que recibe su cuidado, ayudando a movilizar sus propios recursos, el desarrollo de estrategias que permitan una adecuada adaptación para hacer frente y el futuro a las nuevas condiciones. Con los resultados de este estudio pueden surgir una nueva comprensión de la enfermería, la salud y la sociedad sobre el potencial de la adaptabilidad y la (re)construcción de la identidad da persona del estoma de acuerdo con el contexto socio-histórico-cultural en el que opera.

Resumo: Este estudo objetivou interpretar o significado do primeiro ano de pós- operatório para pessoas com estoma intestinal por câncer colorretal, em seguimento ambulatorial. Utilizamos o referencial teórico da Sociologia da Saúde, que integra ações das pessoas às estruturas sociais em um contexto, com utilização do método etnográfico e análise temática indutiva. Foram realizadas entrevistas em profundidade (Parecer no. 184.720 - CEP/EERP-USP) com treze participantes com estoma intestinal por câncer colorretal, no primeiro ano de pós-operatório em um hospital público universitário, em seguimento de controle oncológico. Foram construídas três unidades de sentidos e dois núcleos temáticos. As unidades de sentido \"Adoecimento oncológico: da suspeita à constatação\", \"Gerenciamento do adoecimento e do tratamento oncológico\" e \"Convivendo com o câncer, com a estomia intestinal e com o eu diferente, mostraram a decisão pelo itinerário terapêutico perpassa pelo reconhecimento do acontecimento de algo grave com o corpo destas pessoas, busca pelo sistema profissional de saúde e a luta pela acessibilidade aos exames especializados e dos tratamentos oncológicos, em busca de cura. O gerenciamento das consequências do tratamento cirúrgico como a estomização intestinal e dos tratamentos adjuvantes como a fadiga levam à reflexividade sobre as mudanças do corpo e as repercussões na vida destas pessoas, contrapondo a normalidade anterior e após o adoecimento oncológico, além do enfrentamento do estigma da doença e do estoma intestinal. Contudo, a vida destas pessoas ficou mais restrita aos acontecimentos clínicos e ao contexto de assistência à saúde, às expectativas de respostas aos tratamentos e as possibilidades de recidiva e de metástase, mas com busca de uma normalidade nesta etapa de sobrevivência. Na perspectiva da Reconfiguração do self os dois temas construídos: \"A etapa de sobrevivência da pessoa com estoma intestinal no seguimento oncológico\" e \"Estomização por CCR no primeiro ano de pós-operatório: o eu reconfigurado\", trouxeram os desafios e sofrimentos vividos por estas pessoas na busca pelo direito à acessibilidade ao exame de colonoscopia e aos tratamentos oncológicos, assim como a demanda de suas necessidades de cuidados no período do seguimento de controle e os limites do sistema profissional. O significado do primeiro ano de pós-operatório das pessoas com estoma intestinal por CCR em seguimento oncológico foi construída mediante o Referencial teórico da Reconfiguração do self na perspectiva da Sociologia Compreensiva, considerando as ações e interações destas pessoas para a mediação da experiência de perdas corporais, dos limites e de sofrimentos em decorrência deste câncer, dos resultados com o tratamento oncológico e da estomização, cuja reflexividade sobre o sentido da vida e do viver, culmina o \"eu diferente\", representado por ter câncer e estoma intestinal, em \"eu reconfigurado\", representado pelo processo de estomização por câncer colorretal, ou seja, estas mudam as suas expectativas de cura para expectativas de se manterem vivas por mais um dia / Abstract: This study aimed to interpret the meaning of the first year after surgery for people with intestinal stoma for colorectal cancer. We use the theoretical framework Sociology of health, integrating actions of those social structures in context, using the ethnographic method and inductive thematic analysis. In-depth interviews were conducted (opinion No. 184,720 - CEP/EERP-USP) with thirteen participants with intestinal stoma for colorectal cancer, in the first year after surgery in a public hospital in outpatient follow-up for cancer control. Three units of meaning and two thematic units were built. The sense units \"cancer Illness: from suspicion to finding\", \"Managing illness and cancer treatment\" and \" Living with cancer, with ostomy and with a different me,\", showed the decision by therapeutic itinerary runs through the recognition of a serious event happening with the body of these people, search for professional health system and the struggle for accessibility to specialized tests and cancer treatments, for healing. The management of the consequences of surgical treatment as the intestinal stomatization and adjuvant treatments as fatigue lead to reflexivity about body changes and the impact on the lives of these people, opposed to normal life before and after the illness, cancer beyond the coping of the stigma of the disease and intestinal stoma. However, their lives became more restricted to clinical events and the health care context, the expectations of treatment response and chances of recurrence and metastasis, but with finding a normal life in this survival stage. From the perspective of self Resetting the two themes built: \"A person\'s survival stage with intestinal stoma following cancer\" and \"stomatization by CRC in the first year after surgery: the self reconfigured\", brought the challenges and sufferings experienced by these people searching for the right to accessibility to colonoscopy and cancer treatments, as well as the demand for their care needs in control of follow-up period and limits of the professional system. The meaning of the first year after surgery for people with intestinal stoma by CRC in oncological was built by the Theoretical framework of self reconfiguration in the perspective of Comprehensive Sociology, considering the actions and interactions of these people to the mediation of the experience of bodily losses, the limits and suffering as a result of this cancer, the consequences with the cancer treatment and stomatization whose reflexivity about the meaning of life and living, culminates the \"me different,\" represented by having cancer and intestinal stoma, on \"I reconfigured\" represented by stomatization process colorectal cancer, so, they change their expectations for curing expectations remain alive for another day

Bakgrund: Bristande information och undervisning av sjuksköterskor påverkar patienters anpassning till och acceptans av det nya livet med stomi, vilket också påverkar anhörigas kapacitet att vårda och stödja sin familjemedlem med stomi. Syfte: Att beskriva patienters upplevelser av att leva med stomi. Metod: Datamaterialet består av 12 kvalitativa artiklar som analyserats utifrån en systematisk litteraturstudie med beskrivande syntes. Resultat: Resultatet presenteras utifrån tre teman: Påverkan av självbild; En förändrad livssituation och Stöd i bemötandet. Slutsats: Att leva med stomi upplevs som en begränsning av fysiska aktiviteter och väcker negativa reaktioner, relaterade till den förändrade kroppen. Trots detta upplever patienterna att livet är mindre besvärligt än förut. Genom god information och undervisning kan sjuksköterskor hjälpa patienterna att tro på sig själva och bli mer självständiga i att sköta stomin. Kunskapen om vardagliga, fysiska men även sexuella aktiviteters anpassningar är något som sjuksköterskor behöver inhämta och dela med patienterna. Detta behöver patienterna veta, för att uppleva sig trygga med sig själva och inte som begränsade. Detta bidrar även till att utforma en bättre vård utifrån patienternas behov vilket lindrar lidandet och förbättrar patienternas livskvalité. / Background: Lack of information and education from nurses, affect patients’ adaptation to and acceptance of their new life with ostomy, which also affects the families’ ability to care for and support their relatives with ostomy. Aim: To describe patients’ experiences of living with the ostomy. Method: The data materials consist of 12 qualitative articles that are analyzed by a systematic literature study with descriptive synthesis. Results: The result is presented in three themes: Impact in self-image; A changed life situation and Support in the treatment. Conclusion: Living with the stoma is perceived as a limitation of physical activity and awakens negative reactions, related to the changed body. Despite that, patients consider that life is less difficult than before and with good information and education, nurses can help patients to believe in themselves, and be more independent in managing the ostomy. Knowledge of everyday life, physical but also sexual activities, is something that nurses need to collect and share with the patients. The patients need to know this, to feel safe with themselves and don’t look upon themselves as limited. This helps to perform better care based on patients’ needs, which relieves suffering and improves life quality for the patients.

The study aim was to describe the lived experience of patients with an ostomy due to cancer following hospital discharge, using a Heideggerian phenomenological lens. Colaizzi’s (1978) process guided a thematic analysis of nine unstructured interviews. The overall essence of patients’ transition experience was Adjusting to a New Way of Living. Four major themes emerged, Some Things are Different, Always on my Mind, Moving Towards Independence, and I’m Not Alone. Results suggest that the transition involves: adjusting to the ostomy and cancer; financial implications; changes in self, physical being, lifestyle, and social aspects of life; and psychological acceptance and preparation for the unexpected. Home care nurses and patients’ support network facilitated meeting their comprehensive care needs; while cancer treatments, the role of the significant other in the loss of privacy, funding inconsistencies, and temporary ostomy status were barriers. Patients need a comprehensive care approach to better facilitate the transition process.

Johansson, J & Marklund, M. Patienters upplevelser efter stomioperation. Enlitteraturstudie. Examensarbete i omvårdnad 15/30 högskolepoäng. Malmöuniversitet: Fakulteten för hälsa och samhälle, Institutionen för vårdvetenskap,2018.Bakgrund: Kroppsuppfattning är ett komplext begrepp som omfattar upplevelser,känslor, attityder och beteenden i relation till kroppen. En stark och välfungerandekropp anses som normen medan den sjuka eller avvikande kroppen måste rättastill. Kroppslig sjukdom förändrar kroppsuppfattningen, kroppen ifrågasätts ochkan vara svår att acceptera. I sjuksköterskans kärnkompetenser ingår bland annatpersoncentrerad vård och informatik, vilka är kompetenser som vid korrekttillämpning kan hjälpa patienten att möta den förändrade kroppen som enstomioperation innebär.Syfte: Syftet var att sammanställa forskning kring patienters upplevelse avkroppsuppfattning och omvårdnadsbehov efter en stomioperation.Metod: En litteraturstudie med kvalitativ ansats genomfördes. DatabasernaPubMed och CINAHL användes, varifrån tio olika kvalitativa artiklar inhämtadesoch kvalitetsgranskades utifrån en granskningsmall. Artiklarnas resultatanalyserades sedan utifrån en analysmetod för litteraturstudier, varpå olikahuvudkategorier sammanställdes.Resultat: Dataanalysen genererades i fyra olika huvudkategorier: “Känslor tillstomin”, “Den förändrade kroppen”, “Acceptans över tid” och “Betydelsen avinformation och utbildning från vården”.Konklusion: Stomins påverkan på kroppsuppfattningen är individuell. Mångapatienter upplever någon form av förändrad kroppsuppfattning. Stomin anses varafrämmande och svår att initialt acceptera. Det finns en rädsla för vad andra skatycka och en önskan om att vilja dölja stomin, vilket även påverkar patientensrelationer. Vissa patienter upplever emellertid positiva aspekter med stomin, oftaberoende på orsaken till stomioperationen. Information och stöd från vårdpersonaluppfattas i många fall vara otillräcklig. / Johansson, J & Marklund, M. Patients’ experiences after ostomy surgery. Aliterature review. Degree project in nursing 15/30 credit points. MalmöUniversity: Faculty of health and society, Department of care science, 2018.Background: Body Image is a complex concept that involves experiences,emotions, attitudes and behaviours connected to the body. A strong and wellfunctioningbody is considered the norm while the diseased or abnormal bodyneeds to be corrected. Bodily disease changes the body image, the body isquestioned and it may be difficult to accept. As a registered nurse the corecompetencies include person-centred care and informatics, which arecompetencies that applied correctly can help the patient to handle the changingbody that a ostomy operation involves.Aim: To compile research about the patients experience of body image and careneeds after ostomy surgery.Method: A literature study with qualitative approach was conducted. Thedatabases PubMed and CINAHL were used, from which ten different qualitativearticles were extracted and quality-reviewed using a review template. The resultsof the articles were analyzed using an analytical methodology for literaturereviews, whereupon different main categories were compiled.Result: The data analysis was generated in four main categories: “Feelingstowards the ostomy”, “The altered body”, “Acceptance over time” and “Theimportance of healthcare information and education”.Conclusion: The ostomy’s influence on body image is individual. Most patientsexperience some kind of altered body image. The ostomy is considered unfamiliarand difficult to initially accept. There is a fear of what other people would thinkand a desire to hide the ostomy, which also affects the patients relations.However, some patients experience the ostomy as something positive, oftendepending on the reason for the ostomy operation. Information and support fromhealthcare professionals is in many cases considered insufficient.

Ranestam, F & Tran, M. Livet med stomi – mer än en påse. En litteraturstudie. Examensarbete i omvårdnad 15 högskolepoäng, Malmö Universitet: Fakulteten för hälsa och samhälle, institutionen för vårdvetenskap, 2021. Att få en stomi innebär en stor förändring som påverkar det dagliga livet, defysiska förutsättningarna, det psykiska samt det psykosociala. Då sjuksköterskanhar i uppgift att stötta dessa patienter är det av vikt att undersöka och beskrivaderas upplevelser av livskvalitet då det kan stötta dessa patienter i återgången tillderas normala liv.Syftet var att undersöka studier om upplevelser och erfarenheter av livskvalitethos personer med stomi. Litteraturstudie med kvalitativ ansats med sökningar idatabaserna Cinahl, Pubmed och PsycInfo. Kvalitetsgranskning utifrån SBU:sgranskningsmall. Innehållsanalys genomgick fem steg för identifikation av huvud-samt underkategorier. Resultatet baserades på 11 studier av kvalitativ ansats. Trehuvudkategorier: fysiska effekter av stomin, kroppsliga upplevelser, stöd ochnärhet och sju underkategorier identifierades utifrån hur deltagarna med stomiupplevde livskvalitet. Utifrån huvudkategorin fysiska effekter av stomin kanstomin ha en påverkan på det dagliga livet genom olika komplikationer vilketkunde leda till sämre livskvalitet, medan andra såg en ökning då derasgrundsjukdom stabiliserades. Utifrån kroppsliga upplevelser kunde bådesjälvbilden och kroppsuppfattningen påverkas av stomin, vilket kunde leda tilllägre självförtroende hos vissa och påverkade livskvaliteten. Stöd och närhet sågssom en viktig faktor för återhämtning samt att partnerns acceptans av stominspelade en stor roll för den fortsatta intima relationen. Slutsatsen är att personermed stomi kräver mer personcentrerad omvårdnad, då resultatet visar attlivskvaliteten kan lida. Stöd från vården bör fortsätta efter utskrivning med bådeutbildning samt information om livet med stomi och olika hjälpmedel för attunderlätta övergången och bibehålla livskvalitet. Nyckelord: känsla, livskvalitet, personer, stomi, upplevelser / Ranestam, F & Tran, M. Life with an ostomy – more than a bag. A literature review. Degree Project in nursing 15 credit points, Malmö University: Faculty of Health and Society, Department of Care Science, 2021. Getting a stoma means a big change affecting daily life, physical conditions,psychological aspects and psychosocial aspects. Since the nurse's task is tosupport these patients, it is important to examine and describe their experiences ofquality of life to support these patients in returning to their normal lives. The aimwas to explore studies on experiences of quality of life in people with a stoma.Literature review with a qualitative approach with searches in the databasesCinahl, Pubmed and PsycInfo. Quality review based on SBU's review template.Content analysis went through five steps for identification of main andsubcategories. The results were based on 11 studies of qualitative approach. Threemain categories: physical effects of the stoma, bodily experiences, support andcloseness and seven subcategories were identified based on how the participants with the stoma experienced quality of life. Based on the main category, physicaleffects of the stoma, it can be seen that the stoma affected daily life throughvarious complications which could lead to decreased quality of life, while somesaw an increase when their underlying disease stabilized. Based on bodilyexperiences, it could be seen that both self-image and body perception weredisturbed by the stoma, which gave lower self-confidence in some and affectedthe quality of life. Support and closeness were seen as an important factor forrecovery and that the partner's acceptance of the stoma played a major role in thecontinued intimate relationship. The conclusion is that people with stoma requirea more person-centered nursing, as the results show that the quality of life cansuffer. Support from health care should continue after discharge with botheducation and information about life with a stoma and various aids to facilitate thetransition and maintain quality of life. Keywords: experiences, feeling, ostomy, people, quality of life

Bakgrund: Stomi innebär en konstgjord öppning i buken som skapats med hjälp av ett kirurgiskt ingrepp. Stomikirurgi utförs när det finns en förändring i den drabbade vävnaden orsakad av till exempel cancer eller inflammatorisk tarmsjukdom (IBD). I sjuksköterskans roll är det viktigt att uppmuntra personer med stomi att hantera vardagliga problem. Förutom att ta itu med fysiologiska problem, vård, utbildning och rådgivning så måste sociala och psykologiska aspekter beaktas. Syfte: Syftet med studien var att beskriva personers erfarenheter av att leva med stomi. Metod: En litteraturöversikt där sökningar genomfördes i PubMed och Cinahl. Tio kvalitativa originalartiklar granskades med en tematisk analys av. Resultat: Två tema och fem subtema identifierades. De två teman var stomins inverkan på livet och behov av stöd. Resultatet visar att personens självbild och kroppsuppfattning förändrades på grund av stomi var något svårt att anpassa sig till vidare visar hur viktigt det är att sjuksköterskan har kunskap och erfarenhet av att undervisa både drabbade personer och närstående. Slutsatser: Den förändrade fysiska förutsättning som en stomi innebär har stor inverkan på livskvaliteten och begränsar vardagsrutiner såsom fysiska aktiviteter. Stomin upplevdes också som räddningen från den tidigare bakomliggande sjukdomen och gav förbättrad livskvalitet. / Background: An ostomy means an artificial opening in the abdomen that is created through surgery. Ostomy surgery is performed when there is a change in the affected tissue caused by, among other things cancer and inflammatory bowel disease (IBD). In the role of the nurse, it is important to encourage people with stoma to deal with everyday problems. In addition to dealing with physiological problems, care, education and counseling as well as extensive social and psychological aspects. Aim: The purpose of the study was to describe people's experiences of living with a stoma. Method: A literature review with a thematic analysis of ten qualitative original articles. Result: Two themes and five subthemes were identified. The two themes were the impact of the stoma on life and the need for support. The results show that the person's self-image and body perception changed due to stoma was somewhat difficult to adapt to further shows how important it is that the nurse has knowledge and experience of teaching both affected people and relatives. Conclusion: The changed physical conditions have a major impact on the quality of life, which means limited daily routines such as physical activities for some people. While others considered the stoma a rescue from a previous, underlying disease and experienced an improved quality of life.

Bakgrund: En stomi är en öppning på buken med syfte att avleda avföring. Bakomliggande sjukdomar är vanligen cancer samt inflammatoriska tarmsjukdomar. En stomi innebär en förändring i kroppsfunktionen med effekter på flertalet dimensioner. Syfte: Syftet med denna litteraturstudie var att belysa patienters upplevelser av att leva med stomi. Metod: Litteraturstudien är baserad på åtta kvalitativa artiklar, som analyserats med Fribergs femstegsmodell och som kvalitetsgranskats utifrån Olsson och Sörensen. Resultat: Fem kategorier identifierades: ”En förändrad kropp”, ”Sociala konsekvenser”, ”Att hantera vardagen”, ”Stöd och bristande stöd från omgivningen” samt ”Möte med vården”.   Konklusion: Att få en stomi beskrivs som en stor förändring i livet med effekter på kroppsbilden, sexlivet samt sociala relationer. Resultatet har i denna litteraturstudie analyserats i relation till Roys adaptionsmodell, som handlar om människans förmåga att anpassa sig till en förändrad miljö och anpassningen av denna miljö med hjälp av copingprocesser och bemästring av hinder. Bemästring av dessa hinder innebär en utmaning som patienten behöver stöd från sjuksköterska och närstående för att hantera. / Background: An ostomy is an opening on the abdominal wall, with its purpose to dispose faeces. Underlying diseases are usually cancer and inflammatory bowel diseases. Recieving an ostomy effects the bodily function and numerous dimensions.  Aim: The purpose of this literature study was to highlight patients’ experiences of living with an ostomy. Methods: The literature study was based upon eight qualitative articles which have been analyzed through Friberg’s five-step model and then quality reviewed based upon Olsson and Sörensen’s quality template. Results: Five categories were identified: ”A changed body”, ”Social consequences”, ”Dealing with daily life”, ”Support and the lack of support” and ”The contact with the healthcare”. Conclusion: Recieving an ostomy is described as a major change in life with effects on body image, sex life and social relationships. The result has been analyzed in relation to the Roy adaption model, which consists of the human’s ability to adapt to changes within one’s context and to change the context itself through coping processes.  Overcoming barriers is a challenge that the patient needs the support from next of kin and nurses to handle.

SAMMANFATTNING Bakgrund   Idag finns det runt 43 000 personer i Sverige som lever med stomi och sedan 2006 har antalet patienter ökat i alla regioner och landsting. Operationen förändrade patientens livssituation och dess upplevelse om den nya vardagen efter stomioperationen påverkade individens livskvalitet. Sjuksköterskans roll i möten med denna patientgrupp är att lindra deras lidande och främja deras livskvalitet. Patienters förändrade välbefinnande och livskvalitet efter stomioperationen ställer krav på sjuksköterskans kapacitet till att främja livskvaliteten.    Syfte Syftet var att beskriva utmaningar, livskvalitet hos patienter efter stomioperation samt behov av stöd av sjuksköterskan.  Metod Denna litteraturöversikt grundar sig på 15 vetenskapliga artiklar, både kvalitativa och kvantitativa studier. Databassökningen genomfördes i databaserna PubMed och CINAHL. De inkluderade artiklarna kvalitetsgranskades enligt Sophiahemmets bedömningstabell och analyserades med stöd av Integrerade analys. Resultat I studien framkom tre kategorier vilka ansågs viktiga för att beskriva patientens utmaningar, livskvalitet hos patienter efter stomioperation samt behov av sjuksköterskans stöd.  Slutsats Sammanfattningsvis visar resultatet att patienter som får stomi upplever negativ i större utsträckning som har sämre inverkan på deras livskvalitet. Sjuksköterska stöd genom rådgivning, stomiutbildning och egenvård kan minska problem och komplikationer i vardagen som har bättre inverkan på livskvalitet. / ABSTRACT Background Today, there are around 43,000 people in Sweden living with an ostomy and since 2006 the number of patients has been increased in all over the country. Changing the patient's life situation and their experience of the new everyday life after the ostomy operation affects the individual's quality of life. The nurse's role in meetings with this group of patients is to alleviate their suffering and promote their quality of life. Patients' changed well-being and quality of life after the ostomy operation lies demand on the nurse's capacity to promote quality of life. Aim The purpose was to describe challenges, quality of life in patients after ostomy surgery and the need for support from the nurse. Method This literature review is based on 15 scientific articles, both qualitative and quantitative studies. The database search was carried out in the databases PubMed and CINAHL. The included articles were peer-reviewed according to Sophiahemmet's assessment table and analyzed with support from Integrated analysis. Results The study identified three categories that were considered important to describe the patient's challenges, the quality of life of patients after ostomy surgery and the need for nurse support. Conclusions In summary, the results show that patients who have an ostomy experience negatively to a greater extent that have a lower impact on their quality of life. Nurse support through counseling, ostomy education and self-care can reduce problems and complications in everyday life that have a better impact on quality of life.

Bakgrund En tarmstomi är en kirurgiskt konstgjord tarmöppning på utsidan av buken som avlägsnar avföring till en anslutande stomipåse. Orsaken till tarmstomi beror på sjukdom, trauma eller ett behov av tillfällig avlastning och kan således vara av temporärt eller permanent slag. Tarmstomi har visat sig både reducera sjukdom samt vara en livräddande insats, dock innebär det en stor livsförändring. Detta kan kopplas ihop med känsla av sammanhang (KASAM) som förklarar huruvida människan upplever och hanterar hälsa och/eller ohälsa. Syfte Syftet var att belysa upplevelser av hälsa hos vuxna som lever med tarmstomi. Metod Denna icke-systematiska litteraturöversikt grundade sig i 17 vetenskapliga artiklar med både kvalitativ- och kvantitativ design. Litteratursökningen gjordes i databaserna PubMed, CINAHL och PsycInfo med hjälp av sökord relevanta för syftet. Innehållet i artiklarna analyserades med hjälp av en integrerad dataanalys i tre steg som slutligen kvalitetsgranskades utifrån Sophiahemmet högskolas granskningsmall. Resultat Litteraturöversiktens resultat redogör för att vuxna stomibärares upplevelse av hälsa är av stor variation och har en stark sammankoppling med acceptans. Vidare redogör resultatet för patienters upplevelse av fysisk hälsa, psykisk hälsa, social hälsa, mötet med vårdpersonal samt hälsofrämjande faktorer hos stomipatienter. Slutsats Den upplevda hälsan hos stomipatienter är individuell och påverkas av varierande faktorer. Den primära orsaken till en försämrad hälsa hos stomipatienter tycks vara svårigheterna att acceptera de begränsningar som sjukdomen och stomin medför. Acceptans och begriplighet har en betydande roll för en god upplevd hälsa. / Background An intestinal ostomy is a surgically artificial intestinal opening on the outside of the abdomen that removes feces to an adjoining ostomy bag. The cause of intestinal stoma is due to illness, trauma or a need for temporary relief and can thus be of a temporary or permanent nature. Intestinal ostomy has been shown to both reduce illness and be a lifesaving effort, however, it means a major life change. This can be linked to a sense of context (KASAM) which explains whether the person experiences and manages health and / or ill health. Aim The purpose was to shed light on experiences of health in adults living with an intestinal ostomy. Method This non-systematic review of literature was based on 17 scientific articles with both qualitative and quantitative designs. The literature search was performed in the databases PubMed, CINAHL, and PsycInfo using keywords relevant to the purpose. The content of the articles was analyzed with the help of integrated data analysis in three steps, which was finally quality-examined based on Sophiahemmet University's review template. Results The literature review results report that adult ostomy carriers' experience of health is of great variation and has a strong connection with acceptance. Furthermore, the results report on patients' experience of physical health, mental health, social health, the meeting with care staff, and health-promoting factors in ostomy patients. Conclusions The perceived health of ostomy patients is individual and is influenced by varying factors.The primary cause of deteriorating health in ostomy patients seems to be the difficulty ofaccepting the disease's limitations and the stoma. Acceptance and comprehensibility play asignificant role in good perceived health.