Article

Stressors Relating to Patient Psychological Health Following Stoma Surgery: An Integrated Literature Review

Seng Giap Marcus Ang

Hui-Chen Chen

Rosalind Jiat Chiew Siah

Hong-Gu He

Piyanee Klainin-Yobas

stressors, psychological intervention, surgery, literature review, stomatitis
ONF 2013, 40(6), 587-594. DOI: 10.1188/13.ONF.587-594

Purpose/Objectives: To summarize empirical evidence relating to stressors that may affect patients' psychosocial health following colostomy or ileostomy surgery during hospitalization and after discharge.

Data Sources: An extensive search was performed on the CINAHL®, Cochrane Library, PubMed, PsycINFO, Scopus, Science Direct, and Web of Science electronic databases.

Data Synthesis: Eight articles were included with three qualitative and five quantitative research designs. Most studies were conducted in Western nations with one other in Taiwan. Following colostomy or ileostomy surgery, common stressors reported by patients during hospitalization included stoma formation, diagnosis of cancer, and preparation for self-care. After discharge, stressors that patients experienced encompassed adapting to body changes, altered sexuality, and impact on social life and activities.

Conclusions: This review suggests that patients with stomas experience various stressors during hospitalization and after discharge. Additional research is needed for better understanding of patient postoperative experiences to facilitate the provision of appropriate nursing interventions to the stressors.

Implications for Nursing: To help patients deal with stressors following stoma surgery, nurses may provide pre- and postoperative education regarding the treatment and recovery process and encourage patient self-care. Following discharge, nurses may provide long-term ongoing counseling and support, build social networks among patients with stomas, and implement home visit programs.

Knowledge Translation: Stoma surgery negatively affects patients' physical, psychological, social, and sexual health. Postoperative education programs in clinical settings mostly focus on physical health and underemphasize psychological issues. More pre- and postoperative education programs are needed to help patients cope with stoma stressors.

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    References

    American Cancer Society. (2012). Cancer facts and figures 2012. Atlanta, GA: Author.
    Andersson, G., Engström, A., & Söderberg, S. (2010). A chance to live: Women's experiences of living with a colostomy after rectal cancer surgery. International Journal of Nursing Practice, 16, 603-608.
    Black, P.K. (2004). Psychological, sexual, and cultural issues for patients with a stoma. British Journal of Nursing, 13, 692-697.
    Borwell, B. (2009a). Continuity of care for the stoma patient: Psychological considerations. British Journal of Community Nursing, 14, 326, 328, 330-331.
    Borwell, B. (2009b). Rehabilitation and stoma care: Addressing the psychological needs. British Journal of Nursing, 18, S20-S22, S24-S25.
    Broadbent, E., Petrie, K.J., Alley, P.G., & Booth, R.J. (2003). Psychological stress impairs early wound repair following surgery. Psychosomatic Medicine, 65, 865-869. doi:10.1097/01.PSY.0000088589.92699.30
    Brown, H., & Randle, J. (2005). Living with a stoma: A review of the literature. Journal of Clinical Nursing, 14, 74-81.
    Chao, H.L., Tsai, T.Y., Livneh, H.L., Lee, H.C., & Hsieh, P.C. (2010). Patients with colorectal cancer: Relationship between demographic and disease characteristics and acceptance of disability. Journal of Advanced Nursing, 66, 2278-2286.
    Cotrim, H., & Pereira, G. (2008). Impact of colorectal cancer on patient and family: Implications for care. European Journal of Oncology Nursing, 12, 217-226. doi:10.1016/j.ejon.2007.11.005
    Dorman, C. (2009). Ostomy basics. RN, 72(7), 22-27.
    Ferlay, J., Shin, H.R., Bray, F., Forman, D., Mathers, C., & Parkin, D.M. (2010). Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. International Journal of Cancer, 127, 2893-2917.
    Fulham, J. (2008). A guide to caring for patients with a newly formed stoma in the acute hospital setting. Gastrointestinal Nursing, 6(8), 14-23.
    Joanna Briggs Institute. (2011). Joanna Briggs Institute reviewers' manual 2011 edition. Retrieved from http://joannabriggs.org/Documents/sumari/Reviewers%20Manual-2011.pdf
    Kilic, E., Taycan, O., Belli, A.K., & Ozmen, M. (2007). The effect of permanent ostomy on body image, self-esteem, marital adjustment, and sexual functioning. Turkish Journal of Psychiatry, 18, 302-310.
    Lazarus, R.S., & Folkman, S. (1984). Stress, appraisal, and coping. New York, NY: Springer.
    Manderson, L. (2005). Boundary breaches: The body, sex, and sexuality after stoma surgery. Social Science and Medicine, 61, 405-415.
    McKenzie, F., White, C.A., Kendall, S., Finlayson, A., Urquhart, M., & Williams, I. (2006). Psychological impact of colostomy pouch change and disposal. British Journal of Nursing, 15, 308-316.
    Persson, E., & Hellström, A.L. (2002). Experiences of Swedish men and women 6 to 12 weeks after ostomy surgery. Journal of Wound, Ostomy and Continence Nursing, 29, 103-108.
    Readding, L.A. (2005). Hospital to home: Smoothing the journey for the new ostomist. British Journal of Nursing, 14(16), 16-20.
    Sharpe, L., Patel, D., & Clarke, S. (2011). The relationship between body image disturbance and distress in colorectal cancer patients with and without stomas. Journal of Psychosomatic Research, 70, 395-402.
    Simmons, K.L., Smith, J.A., Bobb, K.A., & Liles, L.L. (2007). Adjustment to colostomy. Journal of Advanced Nursing, 60, 627-635.
    Smeltzer, S.C., Bare, B.G., Hinkle, J.L., & Cheever, K.H. (2008). Brunner and Suddarth's textbook of medical-surgical nursing (11th ed.). Philadelphia, PA: Lippincott Williams and Wilkins.
    Solowiej, K., Mason, V., & Upton, D. (2009). Review of the relationship between stress and wound healing. Journal of Wound Care, 18, 357-366.
    Thorpe, G., McArthur, M., & Richardson, B. (2009). Bodily change following fecal stoma formation: Qualitative interpretive synthesis. Journal of Advanced Nursing, 65, 1778-1789.
    Upton, D., & Solowiej, K. (2010). Pain and stress as contributors to delayed wound healing. Wound Practice and Research, 18, 114-122.
    Von Ah, D., Kang, D.H., & Carpenter, J.S. (2007). Stress, optimism, and social support. Research in Nursing and Health, 30, 72-83.
    Williams, J. (2007). Stoma care nursing: What the community nurse needs to know. British Journal of Community Nursing, 12, 342-346.
    Williams, J. (2008). Caring for the older ostomate. Nursing and Residential Care, 10, 64-67.