Wuxi Medical College of Jiangnan University, Jiangnan University, Wuxi 214122, Jiangsu Province, China.
Department of Gastrointestinal Surgery, Tongren Hospital Shanghai Jiao Tong University School of Medicine, Shanghai 200335, China.
World J Gastroenterol. 2024 Jun 14;30(22):2893-2901. doi: 10.3748/wjg.v30.i22.2893.
This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and care needs. Protecting the anus surgery combined with temporary colostomy has emerged as a prevalent treatment modality for low rectal cancer. However, the ileostomy is susceptible to peri-stoma skin complications, as well as fluid, electrolyte, and nutritional imbalances, posing challenges to effective management. The successful self-management of patients is intricately linked to their adjustment to temporary colostomy; nonetheless, there remains a dearth of research examining the factors influencing self-care among temporary colostomy patients and the obstacles they confront.
To investigate the lived experiences, perceptions, and care requirements of temporary colostomy patients within their home environment, with the ultimate goal of formulating a standardized management protocol.
Over the period of June to August 2023, a purposive sampling technique was utilized to select 12 patients with temporary intestinal stomas from a tertiary hospital in Shanghai, China. Employing a phenomenological research approach, a semi-structured interview guide was developed, and qualitative interviews were conducted using in-depth interview techniques. The acquired data underwent coding, analysis, organization, and summarization following Colaizzi's seven-step method.
The findings of this study revealed that the experiences and needs of patients with temporary intestinal stomas can be delineated into four principal themes: Firstly, Temporary colostomy patients bear various burdens and concerns about the uncertainty of disease progression; secondly, patients exhibit limited self-care capabilities and face information deficits, resulting in heightened reliance on healthcare professionals; thirdly, patients demonstrate the potential for internal motivation through proactive self-adjustment; and finally, patients express a significant need for emotional and social support.
Home-living patients with temporary intestinal stomas confront multifaceted challenges encompassing burdens, inadequate self-care abilities, informational deficits, and emotional needs. Identifying factors influencing patients' self-care at home and proposing strategies to mitigate barriers can serve as a foundational framework for developing and implementing nursing interventions tailored to the needs of patients with temporary intestinal stomas.
本研究采用质化研究中的现象学研究方法,探讨有临时性肠造口之老年族群于日常生活与照顾需求上所面临的挑战。肛门保护并施行暂时性肠造口术,已成为治疗低位直肠癌的常见治疗模式。然而,临时性肠造口容易发生造口周围皮肤并发症,以及体液、电解质与营养失衡,导致难以妥善管理。患者若能成功自我管理,与他们调整临时性肠造口的适应程度息息相关;然而,目前仍缺乏研究探讨影响临时性肠造口患者自我照护的因素以及他们所面临的障碍。
探讨临时性肠造口患者在居家环境中的生活经验、认知与照顾需求,以期制定标准化的管理方案。
于 2023 年 6 月至 8 月期间,采用立意抽样法,自中国上海一家三级医院选择 12 位有临时性肠造口的患者。采用现象学研究方法,发展出半结构式访谈指南,并使用深入访谈技术进行定性访谈。采用科拉兹(Colaizzi)的七步骤法对获取的数据进行编码、分析、组织和总结。
本研究结果显示,临时性肠造口患者的经验和需求可归纳为四个主要主题:首先,临时性肠造口患者对疾病进展的不确定性,承受各种负担和担忧;其次,患者自我照顾能力有限且资讯不足,导致对医疗保健专业人员的依赖度提高;第三,患者通过主动自我调整表现出潜在的内在动力;最后,患者表达对情感和社会支持的强烈需求。
居家的临时性肠造口患者面临多方面的挑战,包括负担、自我照顾能力不足、资讯不足和情感需求。确定影响患者居家自我照护的因素并提出缓解障碍的策略,可以为制定和实施针对临时性肠造口患者需求的护理干预措施提供基础框架。