Department of Surgery, Center for Surgical Science, Zealand University Hospital, Koege, Denmark.
Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark.
Colorectal Dis. 2023 Nov;25(11):2198-2205. doi: 10.1111/codi.16750. Epub 2023 Oct 9.
The aim was to investigate patients' experiences of being prepared for the development of a parastomal bulge in relation to a stoma.
The paper draws on a qualitative interview study conducted with 20 Danish patients participating in five focus groups. Analysis was performed using a phenomenological-hermeneutic approach.
We identified three themes. The first theme is 'The unforeseen bulge gives rise to increasing concern and a search for an explanation'. Patients searched for explanations in their own life and suspected that their behaviour or previous illness induced the bulge. The second theme is 'Missing or confusing information leads to counterproductive behaviour'. Patients lacked information on the prevention and treatment of parastomal bulging which led to disappointment with healthcare professionals. The third theme is 'Weighing the pros and cons of life with the bulge against the gamble of surgical repair'. Some patients came to terms with their situation, but for others a deadlocked situation arose when surgical repair was not an option.
Healthcare communication directly impacts on patients' experiences and outcomes. When unprepared for the emergence of a parastomal bulge, patients' emotional and psychological well-being are affected and likewise patients' possibility of using their own health beliefs as a preventive strategy. To preserve patient autonomy, satisfaction and well-being, surgeons and stoma nurses should provide patients with tailored information bearing in mind the current lack of clear evidence on the prevention and treatment of parastomal bulging.
旨在调查患者在发生造口旁疝时对其进行准备的体验。
本文基于对 20 名丹麦患者进行的五项焦点小组的定性访谈研究。分析采用现象学-解释学方法进行。
我们确定了三个主题。第一个主题是“意外的膨出引起越来越多的关注和寻找解释”。患者在自己的生活中寻找解释，并怀疑自己的行为或以前的疾病导致了膨出。第二个主题是“缺乏或混淆的信息导致适得其反的行为”。患者缺乏预防和治疗造口旁疝的信息，这导致他们对医护人员感到失望。第三个主题是“权衡带疝生活的利弊与手术修复的风险”。一些患者接受了自己的情况，但对于其他人来说，当手术修复不是一个选择时，就会出现僵局。
医疗保健沟通直接影响患者的体验和结果。当患者对造口旁疝的出现毫无准备时，他们的情绪和心理健康会受到影响，同样，他们利用自己的健康信念作为预防策略的可能性也会受到影响。为了维护患者的自主权、满意度和幸福感，外科医生和造口护士应该根据当前缺乏关于预防和治疗造口旁疝的明确证据，为患者提供量身定制的信息。
