Psychological assistance to ostomate patients. Proposal of intervention protocol (Perrotta-Guerrieri Psychological Care for Ostomy Patients, PCOP) and clinical questionnaire (Perrotta-Guerrieri Psychological Care for Ostomy Patients Questionnaire – first version, PCOP-Q1)
Article Sidebar
Main Article Content
Abstract
Ostomy patients are subject to significant negative psychological impact, affecting their quality of life in all respects (physical, psychological, social, economic, and spiritual), especially if they are not properly constructed or if there are complications during the recovery phase. In the light of published research and studies, the main problems are as follows: a) alteration of body image; loss of sphincter control; b) odor, leakage, and complications related to the stoma; c) impairment of sexuality; d) alteration of nutrition and sleep; e) anxiety, depression, and loneliness; embarrassment and shame; f) loss of control of the situation; drop in self-esteem; g) rejection; h) stigmatization; i) disinvestment in social activities; l) abandonment of work and sports activities; isolation; m) difficulties in couple relationships and social contacts. The psychological problems caused by ostomy can be avoided, or at least contained, by comprehensive care of the patient, both before and after the operation. In addition to purely technical care, teaching, accompaniment and constant support are the main components of care that can make a difference to how the patient will accept his or her ostomy. Setting the care only on the management of the physical dimension will hardly allow the person to integrate the ostomy into his life. The present work proposes a specific protocol of psychological intervention (Perrotta-Guerrieri Psychological Care for Ostomy Patients, PCOP), for all the clinical phases (pre-operative, operative, post-operative, follow-up) and a specific questionnaire (Perrotta-Guerrieri Psychological Care for Ostomy Patients Questionnaire - first version, PCOP-Q1) to be submitted to the patient which investigates the 9 subjective functions (physical, psychological, sexual, emotional, sentimental, work, family and social), in 45 items with a response on L1-5 scale, for the study of quality of life in the ostomised patient.
Downloads
Article Details
Copyright (c) 2022 Perrotta G, et al.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Porrett T (2006) La persona stomizzata: assistenza, cura e riabilitazione. Milano: McGraw-Hill. Link: https://bit.ly/36zR68E
Franceschini F (1993) Il paziente stomizzato: problemi di assistenza e riabilitazione. Torino: UTET. Link: https://bit.ly/3tO3bjs
Bernasconi C (2016) Convivere con una stomia. Tesi di Laurea in Scienze Infermieristiche. SUPSI, Svizzera.
Putzu F (2015) L’approccio infermieristico educativo al paziente stomizzato. Tesi di Laurea in Scienze Infermieristiche. Università degli Studi di Genova. Link: https://bit.ly/3IOWAtx
Ferrara F, Parini D, Bondurri A, Veltri M, Barbierato M, et al. (2019) Multidisciplinary Italian Study group for STOmas (MISSTO). Italian guidelines for the surgical management of enteral stomas in adults. Tech Coloproctol 23: 1037-1056. Link: https://bit.ly/36QX5G2
AA.VV (2018) Malattie gastrointestinali ed epatiche. Fisiopatologia, diagnosi e trattamento (Sleisenger e Fordtran), I-II 10, trad. ita, Edra Ed.
Pine J, Stevenson L (2014) Ileostomy and colostomy. Intestinal Surgery 32: 212- 217.
Coiro S (2012) Open resection without derivative stoma for rectal cancer: our experience. Prevent Res 2: 170-174.
Bosio C (2010) Qualità di vita e assistenza personalizzata al paziente stomizzato. Stoma-Qol applicazione di uno strumento internazionale valido. Tesi di Laurea in Scienze Infermieristiche. Università degli Studi di Torino.
Berti-Hearn L, Elliott B (2019) Ileostomy care: A guide for Home Care Clinicians. Home Healthc Now 37: 136-144. Link: https://bit.ly/3DmQmzD
Vasilopoulos G, Makrigianni P, Polikandrioti M, Tsiampouris I, Karayiannis D, et al. (2020) Pre- and post-operative nutrition assessment in patients with Colon Cancer undergoing Ileostomy. Int J Environ Res Public Health 17: 6124. Link: https://bit.ly/3NFCDJg
GlobalSurg Collbrative (2019) Global variation in anastomosis and end colostomy formation following left-sided colorectal resection. BJS Open 3: 403-414. Link: https://bit.ly/3wIUGbp
Zelga P, Kluska P, Zelga M, Piasecka-Zelga J, Dziki A (2021) Patient-Related Factors Associated With Stoma and Peristomal Complications Following Fecal Ostomy Surgery: A Scoping Review. Review J Wound Ostomy Continence Nurs 48: 415-430. Link: https://bit.ly/3iK58Hn
Marinez AC, Bock D¸ Carlsson E, Petersén C, Erestam S, et al (2021) Stoma-related complications: a report from the Stoma-Const randomized controlled trial. Colorectal Dis 23: 1091-1101. Link: https://bit.ly/3JRzjbp
American Psychiatric Association (2014) DSM-5. Manuale diagnostico e statistico dei disturbi mentali. Milano: Cortina Raffaello. Link: https://bit.ly/3JNEXv7
Acevedo-Ibarra JN, Juárez-García DM, Espinoza-Velazco A, Buenaventura-Cisneros S (2019) Cognitive Behavioral Stress Management intervention in Mexica colorectal cancer patients: Pilot study. Psychooncology 28: 1445-1452. Link: https://bit.ly/3iHBR03
Ang MS, Chen HC, Siah RJ, He HG, Klainin-Yobas P (2013) Stressors relating to patient psychological health following stoma surgery: an integrated literature review. Oncology Nursing Forum 40: 587-594. Link: https://bit.ly/3uEfcHov
Bekkers MJ, van Knippenberg FC, van den Borne HW, van Berge-Henegouwen GP (1996) Prospective Evaluation of Psychosocial Adaptation to Stoma Surgery: The Role of Self-efficacy. Psychosom Med 58: 183-191. Link: https://bit.ly/3IT4amB
Shaffy-Kaur S (2014) Psychosocial experiences of the patients with colostomy/ileostomy: a qualitative study. Indian Journal of Social Psychiatry 30: 28-34.
Zheng MC, Zhang JE, Qin HY, Fang YJ, Wu XJ, et al. (2013) Telephone follow-up for patients returning home with colostomies: views and experiences of patients and enterostomal nurses. Eur J Oncol Nurs 17: 184-189. Link: https://bit.ly/3uDvaBK
Krouse R, Grant M, Rawl SM, Mohler MJ, Baldwin CM (2009) Coping and acceptance: The greatest challenge for veterans with intestinal stomas. J Psychosom Res 66: 227-233. Link: https://bit.ly/3wLMyH5
Sie HL, Chan SWC, Chow A, Zhu L, Lai JH, et al. (2019) Pilot trial of a STOMA psychosocial intervention programme for colonrectal cancer patients with stomas. J Adv Nurs 75: 1338-1346. Link: https://bit.ly/3qG1By8
Smith D, Loewenstein G, Rozin P, Sherriff RL. Ubel PA (2007) Sensitivity to disgust, stigma, and adjustment to life with a colostomy. J Res Pers 41: 787-803. Link: https://bit.ly/3wHEvuZ
Simmons KL, Smith JA, Bobb KA, Liles LL (2007) Adjustment to colostomy: stoma acceptance, stoma care self-efficacy and interpersonal relationships. J Adv Nurs 60: 627-635. Link: https://bit.ly/36Uyksu
Borwell B (2009) Rehabilitation and stoma care: addressing the psychological needs. Br J Nurs 18: 20-25. Link: https://bit.ly/3uFKGx3
Tseng H, Wang HH, Hsu YY, Weng WC (2004) Factors Related to Stress in Outpatients with Permanent Colostomies. Kaohsiung J Med Sci 20: 70-76. Link: https://bit.ly/3iMgWsw
Zhang T, Shi CG, Hu A, Xu H, Zheng MC, et al. (2014) Correlation between acceptance of disability and social relational quality in patients with colostomy. International Journal of Nursing Sciences 1: 102-106. Link: https://bit.ly/3iK5tK9
Fioravanti M (1991) Adattamento psicologico e riabilitazione in pazienti enterostomizzati. Psicologia in ospedale, esperienze a confronto. Nuova Editrice Spada.
Canestrari R, Ricci Bitti PE (1975) Sulle reazioni psicologiche alla colectomia totale. Medicina Psicosomatica 20.
Celani G (2001) Influenza del sostegno psicosociale per l’adattamento alla malattia in pazienti con neoplasia maligna: una rassegna meta-analitica, Psicologia della salute, n. 1/2001, Franco Angeli, Milano.
Bartoli B (2000) La narrazione della malattia nella ri-Costruzione della salute: l’esperienza della lettera a se stessi, Psicologia della Salute, 3, Franco Angeli, Milano.
Pozzolo A (2015) Efficacia degli interventi di educazione terapeutica rivolti ai pazienti stomizzati: revisione di letteratura. Tesi di Laurea in Scienze Infermieristiche. Università degli Studi di Padova. Link https://bit.ly/3NGx6lN
Mulhall JP, Incrocci L, Goldstein I, Rosen R (2011) Cancer and Sexual Health. New York: Humana Press. Link: https://bit.ly/3wLW0tX
Kiliç E, Taycan O, Belli AK, Ozmen M (2007) The Effect of Permanent Ostomy on Body Image, Self-Esteem, Marital Adjustment, and Sexual Functioning. Turkish Journal of Psychiatry 18: 1-8. Link: https://bit.ly/3NtD2hG
Jenks JM, Morin KH, Tomaselli N (1997) The Influence of Ostomy Surgery on Body Image in Patients With Cancer. Appl Nurs Res 10: 174-180. Link: https://bit.ly/3iP4tnS
Sharpe L, Patel D¸ Clarke S (2011) The relationship between body image disturbance and distress in colorectal cancer patients with and without stomas. J Psychosom Res 70: 395-402. Link: https://bit.ly/3tN900F
Steinhagen E, Colwell J, Cannon LM (2017) Intestinal Stomas-Postoperative Stoma Care and Peristomal Skin Complications. Clin Colon Rectal Surg 30: 184-192. Link: https://bit.ly/3LpaBQg
Rivet EB (2019) Ostomy Management: A Model of Interdisciplinary Care. Surg Clin North Am 99: 885-898. Link: https://bit.ly/3uBLNO7
Maydick-Youngberg D (2017) A Descriptive Study to Explore the Effect of Peristomal Skin Complications on Quality of Life of Adults With a Permanent Ostomy. Ostomy Wound Manage 63: 10-23. Link: https://bit.ly/3iK4x8M
Martins L, Ayello EA, Claessens I, Steen Hansen A, Hentze Poulsen L, et al. (2010) The ostomy skin tool: tracking peristomal skin changes. Br J Nurs 19: 960. Link: https://bit.ly/3Dmlrn2
Jemec GB, Martins L, Claessens I, Ayello EA, Hansen AS, et al. (2011) Assessing peristomal skin changes in ostomy patients: validation of the Ostomy Skin Tool. Br J Dermatol 164: 330-335. Link: https://bit.ly/3IIvm7z
Maculotti D, Melis V, Roveron G, Spena PR, Villa G, et al. (2020) Patient flow for the management of ostomy patients. Minerva Chir 75: 365-372. Link: https://bit.ly/37YRxd0
Fellow J, Richbourg L (2018) Advanced Practice Ostomy Care. J Wound Ostomy Continence Nurs 45: 276-278. Link: https://bit.ly/3tOxcjl
Perrotta G (2019) Anxiety disorders: definitions, contexts, neural correlates and strategic therapy. J Neur Neurosci 6: 046. Link: https://bit.ly/2WSmiaT
Perrotta G (2019) Neural correlates in eating disorders: Definition, contexts and clinical strategies. J Pub Health Catalog 2: 137-148. Link: https://bit.ly/3mWmf8s
Perrotta G (2019) Post-traumatic stress disorder: Definition, contexts, neural correlations and cognitive-behavioral therapy. J Pub Health Catalog 2: 40-47. Link: https://bit.ly/3rvaCc6
Perrotta G (2019) Sleep-wake disorders: Definition, contexts and neural correlations. J Neurol Psychol 7: 09. Link: https://bit.ly/3hoBiGO
Perrotta G (2019) Depressive disorders: Definitions, contexts, differential diagnosis, neural correlates and clinical strategies. Arch Depress Anxiety 5: 009-033. Link: https://bit.ly/2KADvDm
Perrotta G (2019) Panic disorder: definitions, contexts, neural correlates and clinical strategies. Current Trends in Clinical & Medical Sciences 1. Link: https://bit.ly/38IG6D5
Perrotta G (2019) Obsessive-Compulsive Disorder: definition, contexts, neural correlates and clinical strategies. Cientific Journal of Neurology 1: 08-16. Link: https://bit.ly/3pxNbNu
Perrotta G (2019) Behavioral addiction disorder: definition, classifications, clinical contexts, neural correlates and clinical strategies. J Addi Adol Beh 2. Link: https://bit.ly/3rAT9ip
Perrotta G (2019) Delusions, paranoia and hallucinations: definitions, differences, clinical contexts and therapeutic approaches. Cientific Journal of Neurology (CJNE) 1: 22-28. Link: https://bit.ly/3ht2nKz
Perrotta G (2019) Bipolar disorder: definition, differential diagnosis, clinical contexts and therapeutic approaches. J Neuroscience and Neurological Surgery 5. Link: https://bit.ly/34SoC67
Perrotta G (2019) The reality plan and the subjective construction of one's perception: the strategic theoretical model among sensations, perceptions, defence mechanisms, needs, personal constructs, beliefs system, social influences and systematic errors. J Clinical Research and Reports 1. Link: https://bit.ly/3b34baH
Perrotta G (2020) Suicidal risk: definition, contexts, differential diagnosis, neural correlates and clinical strategies. J Neuroscience Neurological Surgery 6: 114. Link: https://bit.ly/3aMqcu5
Perrotta G (2020) Borderline Personality Disorder: definition, differential diagnosis, clinical contexts and therapeutic approaches. Ann Psychiatry Treatm 4: 043-056. Link: https://bit.ly/3hx2B1N
Perrotta G (2020) Narcissism and psychopathological profiles: definitions, clinical contexts, neurobiological aspects and clinical treatments. J Clin Cases Rep 4: 12-25. Link: https://bit.ly/2X8wzzF
Perrotta G (2020) Psychotic spectrum disorders: definitions, classifications, neural correlates and clinical profiles. Ann Psychiatry Treatm 4: 070-084. Link: https://bit.ly/2QI9kNc
Perrotta G (2021) Maladaptive stress: Theoretical, neurobiological and clinical profiles. Arch Depress Anxiety 7: 001-007. Link: https://bit.ly/3sDs39Y
Perrotta G (2021) The state of consciousness: from perceptual alterations to dissociative forms. Defining, neurobiological and clinical profiles. J Neuro Neurol Sci Disord 7: 006-018. Link: https://bit.ly/3n24oPI
Perrotta G (2020) The strategic clinical model in psychotherapy: theoretical and practical profiles. J Addi Adol Behav 3: 5. Link: https://bit.ly/3aPMx9X
Perrotta G (2020) Accepting "change" in psychotherapy: from consciousness to awareness. Journal of Addiction Research and Adolescent Behaviour 3. Link: https://bit.ly/36Vw80Q
Perrotta G (2021) Strategic psychotherapy and the "decagonal model" in clinical practice. Ann Psychiatry Treatm 5: 028-035. Link: Link: https://bit.ly/3iCCwzs
Perrotta G (2021) "Perrotta Psychotherapeutic Protocol for Disorder of the Neurotic Area (PPP-DNA)": proposal of protocol, profiles and clinical applications. Open J Trauma 5: 010-018. Link: https://bit.ly/3ILW5QL
Angott AM, Comerford DA, Ubel PA (2013) Imagining life with an ostomy: Does a video intervention improve quality-of-life predictions for a medical condition that may elicit disgust? Patient Education and Counseling 91: 113-119. Link: https://bit.ly/3NwVPZF
Aronovitch SA, Sharp R, Harduar-Morano L (2010) Quality of Life for Patients Living With Ostomies. Influence of Contact With an Ostomy Nurse. J Wound Ostomy Continence Nurs 37: 649-653. Link: https://bit.ly/36D3UeD
Brown H, Randle J (2005) Living with a stoma: a review of the literature. J Clin Nurs 14: 74-81. Link: https://bit.ly/3JPoLd3
Concepciòn CD, Bonill-de Las Nieves C¸ Hernández-Zambrano SM, Montoya-Juárez R, Morales-Asencio JM, et al. (2019) Living With an Intestinal Stoma: A Qualitative Systematic Review. Qual Health Res 29: 1255-1265. Link: https://bit.ly/3JQYpaq
Cotrim H, Pereira G (2008) Impact of colorectal cancer on patient and family: Implications for care. Eur J Oncol Nurs 12: 217-226. Link: https://bit.ly/3JP1NTr
Dabirian A, Yaghmaei F, Rassouli M, Tafreshi MZ (2010) Quality of life in ostomy patients: a qualitative study. Patient Preference and Adherence 5: 1-5. Link: https://bit.ly/3II2b4E
Fortes RC, Cavalcante Monteiro TMR, Kimura CA (2012) Quality of life from oncological patients with definitive and temporary colostomy. Journal of Coloproctology (Rio de Janeiro) 32: 253-259. Link: https://bit.ly/3LmEZL8
Kimura CA, Kamada I, Guilhem D, Monteiro PS (2013) Quality of life analysis in ostomized colorectal cancer patients. Journal of Coloproctology 33: 216-221. Link: https://bit.ly/3LrabIT
Krouse R, Grant M, Ferrell B, Dean G, Nelson R, et al. (2007) Quality of Life Outcomes in 599 Cancer and Non-Cancer Patients with Colostomies. J Surg Res 138: 79-87. Link: https://bit.ly/3iGobT3
Luo B, Qin HY, Zheng MC (2014) Correlation between social relational quality and hope among patients with permanent colostomies. International Journal of Nursing Sciences 1: 405-409. Link: https://bit.ly/3tN9bcl
Salles V, Becker C, Faria G (2014) The influence of time on the quality of life of patients with intestinal stoma. Journal of Coloproctology 34: 73-75. Link: https://bit.ly/3NsCOY5
Sprangers MA, Taal BG, Aaronson NK, te Velde A (1995) Quality of Life in Colorectal Cancer: Stoma vs. Nonstoma Patients. Diseases of the Colon & Rectum 38: 361-369. Link: https://bit.ly/3IQ7orb
Lai E, Peterson AC, Liu G, et al. (2018) Psychometric validation of the Stoma-Qol questionnaire in Canadian cross-sectonal sample of colostomy and ileostomy patients. Scand J Gastroenterol 53: 721-726. Link: https://bit.ly/3uwFewe
Perrotta G (2021) The intestinal microbiota: towards a multifactorial integrative model. Eubiosis and dysbiosis in morbid physical and psychological conditions. Arch Clin Gastroenterol 7: 024-035. Link: https://bit.ly/36VwRPC
Perrotta G (2021) Intestinal dysbiosis: definition, clinical implications, and proposed treatment protocol (Perrotta Protocol for Clinical Management of Intestinal Dysbiosis, PID) for the management and resolution of persistent or chronic dysbiosis. Arch Clin Gastroenterol 7: 056-063. Link: https://bit.ly/3BVKrQH
Gallagher K, Flint A, Mouzaki M, Carpenter A, Haliburton B, et al. (2018) Blenderized Enteral Nutrition Diet Study: Feasibility, Clinical, and Microbiome Outcomes of Providing Blenderized Feeds Through a Gastric Tube in a Medically Complex Pediatric Population. JPEN J Parenter Enteral Nutr 42: 1046-1060. Link: https://bit.ly/3uBsrZr
Qian T, Zhu H, Zhu L, Chen C, Shen C, et al. (2020) Small intestinal microbiota composition and the prognosis of infants with ileostomy resulting from distinct primary diseases. BMC Gastroenterol 20: 224. Link: https://bit.ly/3DiRswz
van Trijp MPH, Rosch C, An R, Keshtkar S, Logtenberg MJ, et al. (2020) Fermentation Kinetics of Selected Dietary Fibers by Human Small Intestinal Microbiota Depend on the Type of Fiber and Subject. Mol Nutr Food Res 64: e2000455. Link: https://bit.ly/3uAyVb4
Zoetendal EG, Raes J, van den Bogert B, Arumugam M, Booijink CCGMC et al. (2012) The human small intestinal microbiota is driven by rapid uptake and conversion of simple carbohydrates. ISME J 6: 1415-1426. Link: https://go.nature.com/3IRF1J4
Cotter PD (2011) Small intestine and microbiota. Curr Opin Gastroenterol 27: 99-105. Link: https://bit.ly/3ISCzSG
Gulati M, Singh SK, Corrie L, Pal Kaur I, Chandwani L (2020) Delivery routes for faecal microbiota transplants: Available, anticipated and aspired. Pharmacol Res 159: 104954. Link: https://bit.ly/3JILAPv
Bauer CM, Zhang X, Long MD, Sandler RS (2020) Characteristics of Fecal Microbiota Transplantation Use in Inflammatory Bowel isease Cohort. Crohns Colitis 2: otaa024. Link: https://bit.ly/36uys2h