Abdominal Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Department of Gastroenterology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark.
J Clin Nurs. 2017 Dec;26(23-24):5072-5081. doi: 10.1111/jocn.14009. Epub 2017 Oct 8.
To investigate experienced symptoms of parastomal bulging in relation to an ileostomy or colostomy.
Parastomal bulging is a common complication of stoma formation that can affect patients' physical, psychological and social function. Symptom burdens reported by health professionals vary from asymptomatic to high symptom load; however, patients' experiences of symptoms are lacking.
A qualitative design with focus group interviews was chosen for data collection. Twenty patients participated in five semi-structured interviews. Analysis was performed using a phenomenological-hermeneutic approach.
The bulge caused different unfamiliar bodily sensations that interacted with patients' everyday lives. Some but not all of these sensations were modifiable. As the bulge and the ostomy changed size and shape, patients had to adjust and readjust stoma care continuously. The physical change called for patients' awareness and posed a threat to patients' control of the ostomy and challenged stoma self-care. The bulge caused a bodily asymmetry that deformed the patients' bodies in a way that exceeded the perceived alteration already caused by the stoma. To cover the physical disfigurement, new clothing solutions, garment wear and creativity were essential in everyday life. Patients gradually adapted to the bulge over time. Easy access to professional help was crucial in order to find the best appliance and garment solution in relation to the bulge.
Various symptoms related to the parastomal bulge affected patients' everyday lives in different ways and underpinned that an individualised approach is important when addressing patients' problems and complaints. Research into nonsurgical treatments and patient perspectives is limited and highly warranted to improve clinical outcome.
The ever-changing bulge posed a threat to patients' control of the ostomy and required specific care from the stoma therapist. Needs-based access to counselling, advice and supplementary materials is important.
调查与回肠造口或结肠造口相关的造口旁疝的经验症状。
造口旁疝是造口形成的常见并发症，可影响患者的身体、心理和社会功能。健康专业人员报告的症状负担从无症状到高症状负荷不等；然而，患者的症状体验却缺乏。
选择定性设计和焦点小组访谈进行数据收集。20 名患者参加了五次半结构化访谈。分析采用现象学-解释学方法进行。
膨出引起了不同的陌生身体感觉，这些感觉与患者的日常生活相互作用。这些感觉有些是可改变的，但不是全部。随着膨出和造口的大小和形状发生变化，患者必须不断调整和重新调整造口护理。这种身体变化需要患者的意识，并对患者对造口的控制构成威胁，并挑战造口自我护理。膨出导致身体不对称，使患者的身体变形，超出了已经由造口引起的感知改变。为了掩盖身体的畸形，新的服装解决方案、服装穿着和创造力在日常生活中是必不可少的。随着时间的推移，患者逐渐适应了膨出。能够方便地获得专业帮助对于找到与膨出相关的最佳器具和服装解决方案至关重要。
与造口旁疝相关的各种症状以不同的方式影响患者的日常生活，这表明在解决患者的问题和投诉时，个性化方法很重要。关于非手术治疗和患者观点的研究是有限的，非常有必要改善临床结果。
不断变化的膨出对患者对造口的控制构成威胁，需要造口治疗师提供特定的护理。基于需求的咨询、建议和补充材料的获取很重要。
