Joyce Pittman, PhD, RN, ANP-BC, FNP-BC, CWOCN, FAAN, College of Nursing, University of South Alabama, Mobile.
Janice Colwell, MS, APRN, CWOCN, FAAN, University of Chicago Medical Center, Chicago, Illinois.
J Wound Ostomy Continence Nurs. 2022;49(1):60-68. doi: 10.1097/WON.0000000000000843.
The purpose of this study was to examine ostomy complications and health-related quality of life (QOL) in individuals with an ostomy who wear an ostomy support belt/garment.
A mixed-methods descriptive study.
Two hundred two community-living adults with an ostomy were recruited using an industry distribution list. The target sample had no geographic restrictions.
Descriptive analysis was conducted for all outcomes. Participants were separated into groups depending on type of ostomy belt or belt/garment worn or none. All categorical data were summarized using percentages and numerical data using mean ± standard deviation. Association between categorical factors was evaluated using a χ2 test and proportions of occurrences from 2 groups were compared using a 2-proportion z-test. The mean outcomes for 2 or more groups were compared using t tests or analysis of variance (ANOVA), respectively. If ANOVA showed difference among groups, post hoc analysis of group means was conducted using Tukey's Honestly Significant Difference (HSD) test.
Two hundred two respondents completed the survey. Of the 174 participants who responded to the survey question on leakage, 157 (90%) reported experiencing leakage and 135 (77.59%) reported rash or skin irritation. Comparison of whether participants had ever experienced a leakage event was not significantly different across groups (P = .3663). Those who wore an ostomy support belt/garment reported leakage less often (less than once a month) versus respondents who wore other types of belts or no belt (n = 49, 73.13% vs n = 53, 59.55%; P = .0388). Of the 174 participants who responded to the peristomal skin question, 135 (77.59%) participants reported peristomal skin complications. Significantly fewer participants who wore an ostomy support belt/garment reported having peristomal skin irritation compared to those who wore other types of belts or no belt (69.01% vs 84.16%; P = .0080). The mean cumulative total City of Hope Quality of Life (COH QOL) Ostomy score for all participants was 6.45 ± 1.36 out of 10, with the psychosocial domain scoring the lowest at 5.67 ± 1.30 out of 10. No significant differences were observed in mean QOL domain and total scores by those who wore an ostomy support belt/garment, other type of belt/garment, and none. When comparing COH QOL mean scores and leakage frequency of more/less once a month, those who reported leakage more often had significantly worse QOL scores in all 4 domains as well as total scores: physical (P = .0008), psychological (P = .0154), social (P = .0056), spiritual (P = .0376), and total COH QOL score (P = .0018).
This study provides important information related to ostomy complications and QOL associated with wearing an ostomy belt or belt/garment. The use of an ostomy support belt/garment may offer an additional intervention to decrease frequency of leakage and peristomal skin irritation and improve QOL.
本研究旨在探讨佩戴造口支撑带/服装的造口患者的造口并发症和健康相关生活质量(QOL)。
混合方法描述性研究。
使用行业分发名单招募了 202 名居住在社区的造口成人。目标样本没有地理限制。
对所有结果进行描述性分析。根据佩戴的造口带或带/服装类型或不佩戴任何造口带/服装将参与者分为几组。所有分类数据均以百分比汇总,数值数据以平均值±标准差表示。使用 χ2 检验评估分类因素之间的关联,并使用 2 组的比例 z 检验比较发生率。使用 t 检验或方差分析(ANOVA)分别比较 2 个或更多组的平均值。如果 ANOVA 显示组之间存在差异,则使用 Tukey 的Honestly Significant Difference (HSD) 检验对组平均值进行事后分析。
202 名受访者完成了调查。在 174 名对渗漏问题做出回应的参与者中,157 名(90%)报告经历过渗漏,135 名(77.59%)报告出现皮疹或皮肤刺激。在是否经历过渗漏事件方面,各组之间的比较没有显著差异(P=.3663)。佩戴造口支撑带/服装的患者报告渗漏的频率较低(每月不到一次),而佩戴其他类型带或不带带的患者报告渗漏的频率较高(n=49,73.13%vs n=53,59.55%;P=.0388)。在对造口周围皮肤问题做出回应的 174 名参与者中,135 名(77.59%)报告存在造口周围皮肤并发症。与佩戴其他类型带或不带带的患者相比,佩戴造口支撑带/服装的患者报告造口周围皮肤刺激的发生率显著较低(69.01%vs 84.16%;P=.0080)。所有参与者的城市希望质量生活(COH QOL)造口累积总分平均为 6.45±1.36 分,满分 10 分,其中社会心理领域评分最低,为 5.67±1.30 分。佩戴造口支撑带/服装、其他类型带/服装和不佩戴任何带/服装的患者在 QOL 域和总分方面的平均得分均无显著差异。在比较 COH QOL 平均得分和每月漏尿频率更多/更少一次时,报告漏尿更频繁的患者在所有 4 个域以及总分方面的 QOL 评分明显更差:身体(P=.0008)、心理(P=.0154)、社会(P=.0056)、精神(P=.0376)和总 COH QOL 评分(P=.0018)。
本研究提供了与佩戴造口带/服装相关的造口并发症和 QOL 的重要信息。使用造口支撑带/服装可能是一种额外的干预措施,可以减少渗漏和造口周围皮肤刺激的频率,提高 QOL。