Soelling Stefanie J, Rubio-Chavez Atziri, Ingram Zoe, Baird Laura, Brindle Mary E, Cooper Zara, Vranceanu Ana-Maria, Ritchie Christine S, Cauley Christy E
Ariadne Labs, Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.
Ariadne Labs, Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.
J Gastrointest Surg. 2025 Mar;29(3):101963. doi: 10.1016/j.gassur.2025.101963. Epub 2025 Jan 15.
Education and support for ostomy are instrumental in surgical recovery and adaptation. This study aimed to evaluate (i) the challenges faced by fecal ostomy patients with colorectal cancer and (ii) the resources necessary for recovery.
This study recruited patients 21 to 90 days after scheduled fecal ostomy surgery for locally advanced or metastatic colorectal cancer from a single tertiary academic center. This study conducted 1:1 semistructured interviews until thematic saturation using hybrid deductive-inductive coding.
This study interviewed 20 patients (80% male; mean age of 59.7 years). Several major themes emerged, including challenges in (i) practical ostomy management, (ii) emotional distress, (iii) adaptation to daily life, and (iv) provider relationships. The participants faced ostomy care challenges owing to peristomal skin issues, leaks, and difficulty ordering supplies. Many participants noted significant distress or anxiety related to embarrassment caused by leaks, odors, or noise. This distress led participants to fear going out in public, embarrassment from the ostomy, and anxiety about their daily activities (eg, returning to work and relationships). When adapting to life with an ostomy, several participants noted that anxiety affected their ability to care for the ostomy and resume their daily activities, leading to social isolation. Patients reported challenges with provider relationships and a lack of anticipatory guidance from the surgical team preoperatively, including insufficient education on practical management, ordering of ostomy supplies, ensuring adequate hydration, and maintaining proper nutrition.
Patients with colorectal cancer who require fecal ostomy face several challenges related to ostomy. Interventions that address practical management, navigating distress, adaptation, and provider education are needed to provide tailored education and support.
造口术的教育与支持对手术恢复及适应过程至关重要。本研究旨在评估：（i）结直肠癌粪便造口患者所面临的挑战；（ii）恢复所需的资源。
本研究从一家单一的三级学术中心招募了计划进行粪便造口手术21至90天的局部晚期或转移性结直肠癌患者。本研究采用混合演绎-归纳编码法进行1:1半结构化访谈，直至达到主题饱和。
本研究访谈了20名患者（80%为男性；平均年龄59.7岁）。出现了几个主要主题，包括：（i）造口实际管理方面的挑战；（ii）情绪困扰；（iii）日常生活适应；（iv）与医护人员的关系。由于造口周围皮肤问题、渗漏以及订购用品困难，参与者面临造口护理挑战。许多参与者指出，因渗漏、气味或噪音导致的尴尬引发了显著的困扰或焦虑。这种困扰使参与者害怕外出、因造口感到尴尬，并对日常活动（如重返工作岗位和人际关系）感到焦虑。在适应造口生活时，一些参与者指出焦虑影响了他们护理造口和恢复日常活动的能力，导致社会隔离。患者报告了与医护人员关系方面的挑战，以及术前手术团队缺乏前瞻性指导，包括在实际管理、造口用品订购、确保充足水分摄入和维持适当营养方面的教育不足。
需要进行粪便造口的结直肠癌患者面临与造口相关的若干挑战。需要采取针对实际管理、应对困扰、适应以及医护人员教育的干预措施，以提供量身定制的教育与支持。
