Ayik Cahide, Ozden Dilek, Cenan Deniz
Dokuz Eylul University, Izmir, Turkey.
Wound Manag Prev. 2019 May;65(5):40-47.
Individual spiritual preferences and adjustment to a stoma may affect quality of life.
This study aimed to investigate the relationship among and the factors that influence spiritual well-being, adjustment to a stoma, and quality of life in patients with a stoma.
A cross-sectional, descriptive study was conducted over 6 months among outpatients with a stoma recruited from general surgery and enterostomal therapy clinics of a university hospital in Turkey. Turkish-speaking patients who were at least 18 years of age and had a colostomy or ileostomy for at least 2 months were eligible to participate. Participants independently (or with researcher help if necessary) completed the Sociodemographic Characteristics Form; the 12-item Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp) that utilized 5-point, Likert-style responses to items regarding meaning, peace, and faith (score range 0-48; higher scores indicate more spiritual well-being); the 23-item Ostomy Adjustment Scale that utilized 5-point, Likert-style responses to items regarding acceptance worry, social adjustment, and anger (score range 0-92; higher scores indicate better adjustment); and the 21-item Stoma Quality of Life Scale that used a combination of scoring methods (score range 0-100; higher scores imply better quality of life) and Likert-style questions. Data were transferred without patient names from the questionnaires directly into a software program for analysis. Descriptive statistics, correlation, and hierarchical regression analyses were applied.
Of the 95 participants (52 [54.7%] men; mean participant age 56.54 ± 13.74 years), mean scores were 31.66 ± 7.39 for spiritual well-being, 51.73 ± 12.28 for adjustment to a stoma, and 55.27 ± 16.45 for quality of life. A statistically significant difference was found between the mean spiritual well-being and quality-of-life (r = 0.525, P <.001) and adjustment to a stoma (r = .549, P <.001) scores, and a significant relationship was noted between the mean quality-of-life and adjustment scores (r = 0.698, P <.001). Stoma adjustment and quality of life significantly correlated with the meaning and peace subscales of FACIT-Sp (P <.001). No correlation was found between faith or stoma adjustment and quality of life. Hierarchical regression analysis showed the most significant factors affecting quality of life were adjustment to a stoma (β = .541) and spiritual well-being (β = .190).
Adjustment and spirituality are important quality-of-life factors in patients with a stoma. Clinical assessments and practices should include the meaning and peace aspects of spiritual well-being and how well the patient is adjusting to the stoma. Well-designed randomized controlled studies that evaluate the impact of the spiritual dimension of nursing care on patient outcomes as well as the effect of spiritual well-being on adjustment to stoma are suggested.
个体的精神偏好和对造口的适应情况可能会影响生活质量。
本研究旨在调查造口患者的精神健康、对造口的适应情况和生活质量之间的关系以及影响这些方面的因素。
在土耳其一所大学医院的普通外科和造口治疗门诊招募有造口的门诊患者，进行为期6个月的横断面描述性研究。年龄至少18岁、有结肠造口或回肠造口且至少2个月的讲土耳其语的患者符合参与条件。参与者独立（必要时在研究人员帮助下）完成社会人口学特征表；12项慢性病治疗功能评估-精神健康量表（FACIT-Sp），该量表对关于意义、安宁和信仰的项目采用5点李克特式回答（得分范围0 - 48；得分越高表明精神健康状况越好）；23项造口适应量表，该量表对关于接受担忧、社会适应和愤怒的项目采用5点李克特式回答（得分范围0 - 92；得分越高表明适应情况越好）；以及21项造口生活质量量表，该量表使用多种评分方法（得分范围0 - 100；得分越高意味着生活质量越好）和李克特式问题。数据从问卷中直接去除患者姓名后转入软件程序进行分析。应用描述性统计、相关性分析和分层回归分析。
95名参与者（52名[54.7%]男性；参与者平均年龄56.54 ± 13.74岁）中，精神健康平均得分为31.66 ± 7.39，造口适应平均得分为51.73 ± 12.28，生活质量平均得分为55.27 ± 16.45。精神健康平均得分与生活质量（r = 0.525，P <.001）和造口适应（r =.549，P <.001）得分之间存在统计学显著差异，生活质量平均得分与适应得分之间存在显著关系（r = 0.698，P <.001）。造口适应和生活质量与FACIT-Sp的意义和安宁子量表显著相关（P <.001）。未发现信仰或造口适应与生活质量之间存在相关性。分层回归分析表明，影响生活质量的最显著因素是造口适应（β =.541）和精神健康（β =.190）。
适应情况和精神状态是造口患者生活质量的重要因素。临床评估和实践应包括精神健康的意义和安宁方面以及患者对造口的适应情况。建议开展精心设计的随机对照研究，评估护理的精神层面维度对患者结局的影响以及精神健康对造口适应的影响。
