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结直肠癌生存者:长期存在的、持续的造口特定问题和适应。

Surviving colorectal cancer: long-term, persistent ostomy-specific concerns and adaptations.

机构信息

Division of Nursing Research & Education, Department of Population Sciences, City of Hope, Duarte, California 91010, USA.

出版信息

J Wound Ostomy Continence Nurs. 2013 Jan-Feb;40(1):61-72. doi: 10.1097/WON.0b013e3182750143.

Abstract

PURPOSE

The purpose of this article was to describe persistent ostomy-specific concerns and adaptations in long-term (>5 years) colorectal cancer survivors with ostomies.

SUBJECTS AND SETTINGS

Thirty-three colorectal cancer survivors who participated in 8 gender- and health-related quality of life stratified focus groups and 130 colorectal cancer survivors who provided written comments to 2 open-ended questions on ostomy location and pouch problems participated in the study. Data were collected on health maintenance organization members in Oregon, southwestern Washington, and northern California.

METHODS

Qualitative data were analyzed for the 8 focus groups and written comments from 2 open-ended survey questions. Discussions from the focu s groups were recorded, transcribed, and analyzed using content analysis. Written content from the open-ended questions was derived from a mailed questionnaire on health-related quality of life in survivors with ostomies and analyzed using content analysis.

RESULTS

Discussions related to persistent ostomy-related issues more than 5 years after formation were common. Persistent ostomy-related issues were focused on clothing restrictions and adaptations, dietary concerns, issues related to ostomy equipment and self-care, and the constant need to find solutions to adjust and readjust to living with an ostomy.

CONCLUSIONS

Ostomy-specific concerns persist 5 years and more for long-term colorectal cancer survivors after initial ostomy formation. Adaptations tend to be individualized and based on trial and error. Findings underscore the need to develop long-term support mechanisms that survivors can access to promote better coping and adjustment to living with an ostomy.

摘要

目的

本文旨在描述长期(>5 年)造口后的结直肠癌幸存者的持续造口特定问题和适应情况。

受试者和设置

33 名结直肠癌幸存者参加了 8 个按性别和健康相关生活质量分层的焦点小组,130 名结直肠癌幸存者对造口位置和袋问题的 2 个开放式问题提供了书面意见,参与了该研究。数据收集于俄勒冈州、华盛顿州西南部和加利福尼亚州北部的健康维护组织成员。

方法

对 8 个焦点小组的定性数据和 2 个开放式调查问题的书面意见进行了分析。使用内容分析法对焦点小组的讨论进行了记录、转录和分析。来自开放式问题的书面内容源自造口幸存者健康相关生活质量的邮寄问卷,并使用内容分析法进行了分析。

结果

形成造口后超过 5 年,与持续的造口相关问题的讨论很常见。持续的造口相关问题集中在服装限制和适应、饮食问题、与造口设备和自我护理相关的问题,以及不断需要寻找解决方案来调整和重新适应造口生活。

结论

长期结直肠癌幸存者在最初形成造口后 5 年及以上时间,仍存在造口特定问题。适应往往是个体化的,基于反复试验。研究结果强调需要制定长期支持机制,以便幸存者能够获得支持,从而更好地应对和适应造口生活。

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