Jayarajah Umesh, Samarasekera Dharmabandhu N
Department of Surgery, Faculty of Medicine, University of Colombo, P.O. Box 271, Kynsey Road, Colombo 8, Western Province, Sri Lanka.
BMC Res Notes. 2017 Jan 31;10(1):75. doi: 10.1186/s13104-017-2406-2.
Enteral ostomy creation affects the quality of life (QOL) of stoma patients significantly. Studying the QOL and its determinants is important as it may help in the early identification of those with poor QOL leading to appropriate intervention. This study was aimed to assess the possible contributory factors of QOL of stoma patients.
A cross sectional study was conducted among 43 ostomy patients who presented for follow up at a surgical clinic of a tertiary care hospital in Sri Lanka over a period of 1 year. Relevant demographic and ostomy related data were collected using an interviewer administered questionnaire. Stoma quality of life scale (Stoma-QOL) and stoma care self-efficacy scale (SCSE) which are validated questionnaires were used to assess QOL and self-efficacy in managing stoma respectively. Associations were established using independent samples t test and Spearman's correlation.
The median age of the study participants was 47.5 years (range 18-83). The median follow up duration was 38 months (range 6-183). The mean overall QOL score was 53.07 ± SD 12.68. Approximately 70% of the study participants scored less than 60. Higher QOL was associated with female sex, colostomies, comfortable income and satisfactory sexual activity. Significantly lower overall QOL was found in those who reported a significant change in the style of dressing (p < 0.05), those who felt depressed (p < 0.05), and those who had thoughts of self-harm soon after surgery (p < 0.05). There was a significant positive correlation between QOL and self-efficacy (p < 0.01). Those who took longer time to learn to take care of the stoma had lower QOL (p < 0.05).
The overall QOL score was considerably low in our study. The QOL was significantly associated with self-efficacy which indicates the importance of patient education and training during follow up visits to maintain a higher QOL. Furthermore integrating with other non-surgical specialities to address multi-dimensional problems including psychosocial and sexual aspects may be helpful to achieve a better QOL.
肠造口术的实施对造口患者的生活质量（QOL）有显著影响。研究生活质量及其决定因素很重要，因为这有助于早期识别生活质量差的患者，从而进行适当干预。本研究旨在评估造口患者生活质量的可能影响因素。
在斯里兰卡一家三级护理医院的外科诊所，对43名前来随访的造口患者进行了为期1年的横断面研究。使用访谈式问卷收集相关人口统计学和造口相关数据。采用经过验证的问卷造口生活质量量表（Stoma-QOL）和造口护理自我效能量表（SCSE）分别评估生活质量和造口管理自我效能。使用独立样本t检验和Spearman相关性分析建立关联。
研究参与者的年龄中位数为47.5岁（范围18 - 83岁）。随访时间中位数为38个月（范围6 - 183个月）。总体生活质量平均得分为53.07±标准差12.68。约70%的研究参与者得分低于60分。较高的生活质量与女性、结肠造口术、收入可观和性活动满意有关。报告着装风格有显著变化的患者（p < 0.05）、感到抑郁的患者（p < 0.05）以及术后不久有自残想法的患者（p < 0.05）的总体生活质量显著较低。生活质量与自我效能之间存在显著正相关（p < 0.01）。学习照顾造口花费时间较长的患者生活质量较低（p < 0.05）。
在我们的研究中，总体生活质量得分相当低。生活质量与自我效能显著相关，这表明在随访期间进行患者教育和培训以维持较高生活质量的重要性。此外，与其他非手术专科合作解决包括心理社会和性方面在内的多维度问题可能有助于实现更好的生活质量。
