The pre- and postoperative nursing care for patients with a stoma

This article revisits the various issues that surround the nurse caring for a patient with a stoma (colostomy, ileostomy or urostomy). Understanding the basic anatomy, reasons for stoma formation and the surgical operations, including variations such as continent stomas, can assist the nurse in caring for this patient group. The article discusses briefly the various stoma appliances that can be used by the nurse or ostomate (person with a stoma). Practical tips on pre- and postoperative nursing care of the patient with a newly formed stoma are provided for the nurse. In some cases, unfortunately, complications may occur following stoma-forming surgery; these are discussed and nursing advice provided. One of the most important ways in which the nurse can support the patient is to teach the patient his/her stoma care, ensuring independence before discharge and showing empathy and compassion.     

永久性乙状结肠造口患者生活质量及其影响因素的分析

目的 探讨永久性乙状结肠造口患者的生活质量及其影响因素.方法 对73例直肠癌行永久性乙状结肠造口3个月以上的患者进行生活质量、手术后适应能力、社会支持和自尊的问卷调查.结果 造口患者的生活质量与患者对造口适应能力、社会支持和自尊各变量均呈正相关（r=0.37～0.44,P＜0.01）.感知到的能力,婚姻,社会支持,造口旁疝,造口用品费用,便秘,家庭关系这7个变量进入了造口患者生活质量总分的回归方程等是影响患者生活质量的主要因素.结论 造口治疗师或护士应帮助患者及其家人接受并适应有造口的生活,提高造口自理能力,减少与造口有关的并发症和问题,加快患者的生理和心理康复,从而帮助患者提高生活质量.     

Life with a urostomy: A phenomenological study

AimTo explore the experiences of self-care of patients with urostomy and to identify the influencing factors of self-care.BackgroundThe creation of a urostomy results in the loss of an important bodily function and an alteration of the body image and causes physical, psychological, and social changes in the lifestyle through the adjustment and management of the new condition. In literature, there are few studies that analyze the lifestyle of people with urostomy.MethodsIn this qualitative design, an interpretative phenomenological analysis was used. Eleven people living with urostomies took part in semi-structured interviews consisting of open-ended questions about their self-care experience. Data were collected between March and September 2016.ResultsSix themes and twelve subthemes emerged from the data analysis. The themes were: Surgery impact, body image, daily and social-life activities, stoma and sexuality, managing stoma education, family and friends' support.ConclusionsThis study highlights the impact a stoma has on people's lives. This impact should be absorbed with personalized education before the surgery with the eventual need of a continuous and planned educational course respecting the patients' needs. This study shows that a continuous and planned educational plan is crucial for patients living with urostomies. Therefore, nurses should provide patients an adequate support and a personalized education program to cope with ostomy.     

Peristomal skin care and the use of accessories to promote skin health

Stomas are frequently encountered by nurses. Common complications include problems with the peristomal skin-the skin around the stoma. It has been reported that up to 80% of people with a stoma, who are termed ostomates, are affected. The three main types of stomas are colostomy, ileostomy and urostomy; all these come with a risk of sore peristomal skin. These stomas pass faeces or urine, which are collected in a stoma appliance that adheres to the peristomal skin. It is essential to ensure that this skin is free from breaks or soreness as this might lead to appliance leakage. This article is aimed at ward nurses and will focus on some of the stoma accessories that are used to treat, protect or 'level' peristomal skin. Accessories, such as barrier creams or films, can be used to protect skin. Filler paste, seals and convex appliances, for example, can be used to resolve creases in the skin or to treat a retracted stoma. The situations in which stoma accessories might be useful in resolving peristomal skin problems or retaining its integrity are numerous.     

Living with a stoma: a review of the literature

Aims and objectives. This systematic review looks at the psychological and social impact of stoma surgery on peoples’ lives. Background. The formation of a stoma can have a negative effect on a person's quality of life and affect lifestyle in a number of ways. Methods. The review examines nursing literature from 1990 to date and focuses on how stoma patients’ lives are affected by the presence of a stoma. It informs nursing practice so nurses are better able to help individuals improve, maintain or recover their health following ostomy surgery. Results. The findings of the review indicate that stoma surgery can impact on individuals’ lives in many different ways. Relevance to clinical practice. Knowledge of the problems stoma patients can experience can help nurses plan care in an individualized way. Recommendations for nursing practice and future research are made.     

Care of patients with complications following formation of a stoma

Adjusting to living with a stoma is a difficult process that can be made even harder if complications arise. Community nurses should be aware of the most common problems that can occur and of the solutions or treatments required. Working with specialist stoma-care nurses, community nurses can offer psychological support and practical solutions.     

A review of the outcome of stoma surgery on spinal cord injured patients

A study was conducted to determine the short-term and long-term outcome of stoma formation on spinal cord injured (SCI) patients. Twenty-seven medical records of SCI patients with colostomy, ileostomy or urostomy were reviewed. Eighteen SCI patients were then interviewed or completed a comprehensive questionnaire to determine the physical and psychological effects of the surgery and to assess changes in lifestyle due to the formation of the stoma. It was found that bowel and bladder management was greatly improved in most cases, resulting in improved quality of life for these patients. Other positive psychological effects were noted and the question of a colostomy being offered earlier in the rehabilitation of the SCI patient was raised.     

Exploring the conditions leading to stoma-forming surgery

The most common disease leading to the formation of a stoma is cancer. However, there are many other diseases that affect the gastrointestinal or urinary system that may also require either a temporary or permanent stoma to be formed (a colostomy, ileostomy or urostomy). Stoma-forming surgery may be undertaken for a number of reasons, such as to eradicate a disease or improve the patient's quality of life. Cancer, inflammatory bowel disease and diverticular disease are the most common conditions that lead to stoma formation. However, faecal incontinence, familial adenomatous polyposis, Hirschsprung's disease, spina bifida and Ehlers-Danlos syndrome may also require a stoma to be formed. The nurse's role in caring for these patients at a potentially traumatic period of their life is discussed.     

尿路造口患者自护能力现状及其影响因素分析

目的调查尿路造口患者出院后自护能力的现状并分析其影响因素,旨在为该类患者自护能力的干预性研究提供依据。方法于2019年6—9月选取门诊就诊的尿路造口患者为调查对象,采用一般资料调查表、造口自我护理量表-早期版（SSCS-ESV）、中文版造口接受度问卷、自尊量表、社会影响量表（SIS）进行调查。结果共收回有效问卷191份,有效回收率为90.95%（191/210）。自护情况:59例（30.89%）完全自己护理造口（完全自护组）,29例（15.18%）需要他人协助护理造口（协助自护组）,103例（53.93%）不是自己护理造口（非自护组）。完全自护、协助自护组造口自护得分分别为（34.71±2.12）分、（26.62±3.82）分,处于中等水平。有序Logistic回归分析显示,造口存在时间、术后开始自护时间、造口接受度、病耻感是影响患者自护情况的主要因素;多元逐步回归分析显示,造口存在时间、造口接受度、自尊水平、病耻感是影响患者出院后自护水平的主要因素。结论尿路造口患者的造口自护能力处于中等水平,以自护情况、自护水平及其影响因素作为干预的切入点,可提高患者造口的自护能力和生活质量。     

Common stoma problems: a brief guide for community nurses

It is estimated that there are 100,000 people in the United Kingdom who have a stoma, some 47% of whom will suffer at least one complication (Lyon and Smith, 2001). District nurses work with specialist stoma care nurses to manage the majority of these complications, so it is vital that they maintain their knowledge. This article reviews some of the stoma complications that many arise, and uses two case studies to illustrate how these may be dealt with in the community.     

Quality of life of a hospitalized vagrant with type 2 diabetic mellitus: applying Parse practice methodology

Diabetic patients who don't control their disease well often develop complications. Their quality of life can then be substantially affected. Lacking social support a vagrant who develops such complications will find it particularly hard to maintain a good quality of life. The application of Parse practice methodology with supplementary social-support theory can help a vagrant diabetic patient to meet his needs and improves his quality of life. The purpose of paper is to provide nurses with a point of reference in relation to the care of such patients.     

Management of stoma complications

More than 100,000 people in the UK have a stoma and most experience problems at some point. This article gives an overview of some of the more common complications and possible solutions. Treatment often involves using stoma accessories, which are products used in conjunction with stoma appliances. Nurses or patients can also contact the stoma specialist nurse in their local hospital for further help and advice.     

Nursing grand rounds: multiple sclerosis.

Multiple sclerosis (MS) is a highly variable, unpredictable disease and one of the most life-altering diagnoses a person can receive. Because it usually strikes in the prime of life, frequently progresses to disability, and has no cure, MS can make a strong emotional impact--not only on those who suffer from it, but also the healthcare team. Because MS is such a complex, multifaceted disorder, nurses who care for people with MS are faced with numerous clinical challenges. Many of the challenges are unique to MS, demanding, and time-consuming. Well-informed nurses are positioned to evaluate and explain the disease process, assist in the alleviation of symptoms, educate partners and families, and help improve quality of life. A case example can help nurses understand the real-life concerns of a person with MS.     

How to manage hypoglycaemia

Hypoglycaemia is a common side-effect of insulin therapy and of some oral hypoglycaemic tablets that stimulate insulin production. It affects quality of life, can prevent people with diabetes from achieving the blood glucose control required to reduce their risk of diabetes complications, and can also be fatal. This article defines hypoglycaemia, what causes it, how can it be identified and treated, and how nurses can support people at risk of this disabling and frightening condition.     

综合护理干预对膀胱肿瘤手术泌尿造口患者生活质量的影响

目的探讨给予膀胱肿瘤手术泌尿造口患者综合护理干预对生活质量的影响。方法选取实施膀胱肿瘤手术行泌尿造口的患者70例,随机分为观察组和对照组,各35例。对照组给予常规护理干预,观察组给予综合护理干预,对比2组心理状态、生活质量。结果护理后2组的SAS、SDS评分均低于护理前,且观察组低于对照组(P0.05);护理后2组的社会功能、认知功能、情绪功能、角色功能、身体功能及总体健康状况的评分均高于护理前,观察组高于对照组(P0.05)。结论综合护理干预在膀胱肿瘤手术泌尿造口患者中的应用效果较为显著,可缓解患者的心理压力,促进康复,提高生活质量和护理满意度。     

基于IMB模型的护理干预对浸润性膀胱癌膀胱全切尿流改道腹壁造口患者并发症及生活质量的影响

目的探讨基于信息-动机-行为技巧(IMB)模型的护理干预对浸润性膀胱癌膀胱全切尿流改道腹壁造口患者并发症及生活质量的影响。方法选择2017年6月至2019年6月在本院行膀胱全切尿流改道腹壁造口手术的100例浸润性膀胱癌患者作为研究对象,采用随机抽签法将其分为对照组和研究组,各50例。对照组给予常规护理干预,研究组在对照组基础上给予基于IMB模型的护理干预。比较两组的造口自我护理能力、并发症发生情况和生活质量评分。结果干预后,两组造口认知、造口装置拆装、造口周围皮肤护理、尿袋排空、底盘修剪评分均高于干预前,且研究组高于对照组(P<0.05)。研究组并发症总发生率低于对照组(P<0.05)。干预后,两组功能领域、特异性条目评分均高于干预前,症状领域评分低于干预前,且研究组优于对照组(P<0.05)。结论基于IMB模型的护理干预可提高浸润性膀胱癌膀胱全切尿流改道腹壁造口患者造口自我护理能力,减少术后并发症,提高生活质量。     

Older people, continence care and catheters: dilemmas and resolutions

Urinary incontinence (UI) is a common problem and has a profound impact on quality of life among older people. There are various nursing interventions and treatments which can improve UI for the majority of people. Catheterization should be considered for specific clinical indications only when other options have been ruled out. Many complications are associated with catheterization, including catheter-associated urinary tract infections (CAUTIs), which are the most common cause of hospital-acquired infections. It is important for nurses and other healthcare professionals to appreciate how catheters produce infection so that appropriate catheter care is used. The best way to avoid CAUTI is to avoid catheterization, whenever possible, and to remove indwelling catheters when they are no longer required. There is a need to raise public awareness about UI and the interventions and treatments available so that more older people seek help. The challenge for nurses is to avoid using catheters and develop alternative approaches to the care of older people with incontinence.     

护理干预对膀胱肿瘤手术行泌尿造口患者生活质量的影响

目的探讨护理干预对膀胱肿瘤手术行泌尿造口患者生活质量的影响。方法采用癌症患者生活质量核心量表（EORTC QLQ-C30）对29例膀胱肿瘤手术行泌尿造口患者生活质量进行调查,针对原因进行护理干预。结果进行护理干预后,患者的生活质量评分显著提高。结论护理干预可以明显提高膀胱肿瘤手术后泌尿造口患者生活质量。     

Stoma care in the school setting.

An ostomy is an artificial opening in the body for the purpose of eliminating excretions from a working organ or for providing nourishment. Artificial openings may be from the stomach, intestine, urinary bladder, kidney, or trachea. The stoma is the terminal end of the ostomy, or the opening that is visible on the surface of the skin. This article will discuss stoma creation and the care of a stoma, as well as the complications and effects of living with one. Although the focus of this article is urinary stomas, the care is similar for all types. It is imperative that all care providers understand stoma care and potential problems that may arise. There are ongoing issues of quality of life for children with stomas, including body image and peer reaction. School nurses are in a unique position to educate children and families on the proper care of a stoma, to recognize potential complication, and to educate staff and student peers.     

Professional holistic care of the person with a stoma: online learning

Stoma care nurse specialists are valued for their diverse expertise, but it is essential that all practitioners who regularly care for people with stomas have the opportunity to develop professionally and influence this important area of practice. The vision of a clinical and educational team from Suffolk and south Norfolk led to the development of innovative web-based learning material. The aim is to inspire nurses to engage actively with people who have a stoma. 'Professional care of the person with a stoma' is about caring for the whole person, physically and emotionally, from the period before surgery, to their continuing care in the community. An overview of four aspects of stoma care is presented here as a way of sharing with a wider audience the expert practice harnessed during the development of this web-based module.