Urinary Stoma Care Guidelines: The Effect on Patients' Self-efficacy and Incidence of Peristomal Complications After Permanent Urostomy

Abstract

Background: Adaptation to the urinary stoma is difficult and need a collaboration of multi-disciplinary team including nurse ,urological physician and surgeon who may be in a powerful position to positively help such  patients to enhance thier self-efficacy, adapt to life with a stoma care and minimizing the associated complications.  Aim: This study aimed to evaluate the effect of urinary stoma care guidelines on patients' self-efficacy and peristomal complications after permanent urostomy. Design: A quasi experimental design. Setting: The study was conducted at urosurgery department and outpatient  urosurgery clinics  at Ain shames universty hospitals,Cairo, Egypt.. Sample: A purposive sample included 50 adult patients after permanent urostomy  and was divided randomly into 25 patients in the study group and 25 patients in the control group. Tools of data collection :I-Patient's structured interview questionnaire, II-Patient's  stoma care practice observational checklist, III- Pittman Ostomy Complications Severity Index (OCSI), IV-Ostomy complications risk factors assessment tool, V- Stoma Care Self-Efficacy Scale. Results: Regarding self-efficacy, 68.0% of the study group and 72.0% of the control group weren't confident pre- guidelines implementation. While, 3 months follow-up, 60.0% of the study group were fairly confident in contrast to 60.0% of the control group weren't confident with statistically significant difference. Concerning peristomal complications, leakage, peristomal dermatitis, stomal pain and stomal bleeding were the most common with statistically significant difference between the two groups 3 months follow up.Conclusions: Urinary stoma care guidelines affected positively on enhancing patients' self-efficacy and minimizing peristomal complications. Recommendations: furthur researches should be done to assess the risk factors for ostomy patient as predictors for peristomal complications occurance after urostomy and    subsequently an early management and preventable measures can be utilized as well as the role of wound ostomy nurse (WON) should be identified and activated in egypt through the Egyption Nursing Syndicate  as they play avital role in caring for ostomy patients.

Keywords: Peristomal complications, permanent urostomy, Self-efficacy, urinary stoma care guidelines