Quality of Life of Clients with Post Colostomy

Abstract

Summary A Colostomy is an artificial opening that is created as a means for evacuation of bowel contents in the event that the large intestine, otherwise known as the colon, is incapable of performing this function. A colostomy can be created for a number of reasons and they may or may not be temporary.In cases of colon-rectal cancer however, these colostomies are almost always permanent as sometimes the entire colon is removed (Gopez, 2012). Quality of life is of central concern in evaluative research and improved quality of life is probably the most desired outcome of all healthcare policies. Quality of life has been defined as a “descriptive term that refers to people’s emotional, social and physical well-being and their ability to function in the ordinary tasks of living (Quality of Life. Research unit, 2010). Aim of the study: This study aimed to assess the quality of life for clients with postcolostomy through: assessing quality of life for clients with colostomy regarding (physical, psychological and social, identifying factors affecting quality of life for clients with colostomy & assessing quality of life for clients with colostomy & assessing the clients practice regarding the care of colostomy. Subjects and methods Research design: This study is a descriptive design aimed to assess quality of life of clients with post colostomy. Study setting Setting: The study was carried in the outpatient clinics in the Ain Shams Specialized hospital and radiation unit on oncology nuclear medicine cancer at Ain Shams University Hospital. Sampling Sample types: purposive sample of 244 clients attended in previously mentioned setting through 6 months&having the following inclusion criteria: • Adult clients from both sexes • Both temporary&permanent colostomy Tool of data collection: One tool was used for data collection. Itwas an interviewing questionnaire, it was developed by the investigator based on review of literature and content validated by the supervisor and expert opinion.it constructed to assess knowledge, practices toward colostomy, it composed of 65 questions, it included four parts (Appendix I). Part one:Itwas concerned withclients socio-demographic data including, age, sex, level of education, residence, working&duration of colostomy Part Two: It was constructed to assessment the knowledge's, of clients about colostomy and its care (definition, types, colostomy care, how to treat irritated skin, follow up visits, call doctor) Part three: It was constructed to assessment clients practices toward care of colostomy as reported by clients. Part four:It was constructed to assessment thequality of life and activities of daily living for clientswith colostomy. The findings of the present study could be summarized as follows: • The study shows that, the mean age of the study sample was 43.9 ± 11.02 years, near half of clients had university education, less than one quarter of clients had permanent colostomy. • The majority of clients had malignant cancer. • More than half of clients had satisfactory knowledge about colostomy. • More than three quarters of clients had changed their diet pattern. • Most of clients had changes in their sleep pattern & changes in their sexual pattern. • Most of the clients were suffering from psychological problems with colostomy including depression, anxiety, low self-esteem & poor body image. • Most of theclients had changed their work schedule. • The highest affected QOL domain was psychological followed by physical thenspiritual and social. • Two thirds of clients had adequate level of personal care about colostomy. • The present study revealed a highly statistically significant difference between clients total knowledge scores& their adequate practices related to colostomy. • Also, a statistically significant difference was found between clients' total knowledge scores& their of QOL. • Nostatistically significantdifference was found between clients' total knowledge scores& their gender & marital status. • A highly statistically significant difference was revealed between clients' total QOL and their practical level. • More than quarterof clients had poor QOL, more than quarter of clients had good QOL. The following recommendations were inferred from the study: • Developingan orientation and teaching programs about knowledge, practice, and QOL should be prepared for clients with colostomy. • A psychological health program & psychiatric team should be planned to help such group of clients & their family to adopt the changes that occurred after surgery. • Encourage social agencies to support colostomy clients in their disease process.