A chronic care ostomy self-management program for cancer survivors

Psychooncology. 2016 May;25(5):574-81. doi: 10.1002/pon.4078. Epub 2016 Jan 25.

Abstract

Background: Individuals with ostomies experience extensive changes in health-related quality of life (HRQOL) and daily routine. Patients and families are typically forced to use trial and error to improve self-management.

Methods: This is a longitudinal one-group design pilot study of a five-session ostomy self-care curriculum based on the Chronic Care Model to improve HRQOL and self-management for cancer survivors with ostomies. Participants were surveyed to evaluate each session. Multiple instruments were administered to examine outcomes at baseline, post-intervention, and at 6-month follow-up (Patient Activation Measure, self-efficacy, Hospital Anxiety and Depression Scale, Ways of Coping, Group Health Association of America Satisfaction with ostomy care survey, and the City of Hope Quality of Life Ostomy). Changes from pre-intervention to post-intervention and pre-intervention to follow-up were evaluated with paired t-tests. Text responses were coded and evaluated for important themes and recommendations.

Results: Thirty-eight subjects participated in the study. Most had a history of rectal cancer (60.5%) or bladder cancer (28.9%). Participants rated the overall program high (4.4-4.8 on 5-point scale). Text feedback indicated that participants enjoyed the group forums, wanted more participants, and more hands-on training. Scores on multiple surveys were shown to be improved and sustained, including patient activation (p = 0.0004), self-efficacy (p = 0.006), total HRQOL (p = 0.01), physical well-being (p = 0.005), and social well-being (p = 0.002). Survivor anxiety was significantly reduced by follow-up (p = 0.047).

Conclusions: This self-management ostomy program can help cancer survivors with ostomies adapt to their stoma. Initiating this program in the community setting would be beneficial to many cancer survivors.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adaptation, Psychological
  • Aged
  • Aged, 80 and over
  • Female
  • Follow-Up Studies
  • Health Care Surveys
  • Health Status
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Ostomy / education
  • Ostomy / psychology*
  • Patient Outcome Assessment
  • Patient Satisfaction
  • Pilot Projects
  • Psychiatric Status Rating Scales
  • Qualitative Research
  • Quality of Life / psychology*
  • Rectal Neoplasms / psychology
  • Rectal Neoplasms / surgery*
  • Self Care*
  • Surveys and Questionnaires
  • Survivors / psychology*
  • Survivors / statistics & numerical data