Self- Care Knowledge and Practice for Patients with Permanent Stoma and their Effect on Their Quality of Life and Self Care Efficacy

Abstract

Background: Quality of life (QOL) and self-care efficacy especially for patients with permanent stoma are importance. Addressing knowledge and self-care practice and their relationship with QOL is needed especially for patients in different age groups. This would serve as a base for developing a culturally competent educational intervention for these specific population.  The aim of present study was to assess the level of knowledge and self-care practice for patients with permanent stoma and its effect on their QOL and self-care efficacy. Methods: A descriptive correlational cross-sectional design was utilized to collect data from Clinical Oncology and Nuclear Medicine Department and its relevant outpatient's clinic of Tanta Main University Hospital and Outpatient's Clinic of General Surgical Department of Emergency Hospital at Tanta University. A convenience sampling of 140 adults and adolescents’ patients with permanent stoma were interviewed. The study questionnaire included a self-reported checklist that include sociodemographic data, knowledge of stoma and stoma self-care practice that was developed by the researchers.  A modified version of the Stoma Quality of Life Scale (SQOL) and Stoma self - Efficacy Scale were also utilized.Results: Majority of the adolescents were males, singles and in age group 16 to 21.  The main cause of stoma among adolescents was cancer, 90% had the operation within 6 months and 57% reported having difficulty with self-care.  Regarding adults, 67% were in age group 31 to 60, 50% were married males, 47% were university graduates with a majority were working.   Causes of stoma were mainly abdominal trauma, 46% were smokers, 57% had the operation within 6 months and 43% reported having difficulty with self-care. Two thirds of adolescents and 41% of adults reported fair level of knowledge of stoma definition, causes, types, complication and risks. More than half of the adolescents reported fair knowledge and more than one third reported good knowledge regarding stoma pouch, appliance for stoma, criteria of changing pouch of stoma.  Fifty-eight percent of the adults reported good knowledge and 27% reported fair knowledge regarding same item.  64% of the adolescents and 50% of adults reported fair knowledge of diet, fluids and activity.  Knowledge of self-care practice was presented as fair among 50% of the adolescents and 43% of adults. Meanwhile, good level of knowledge was reported among 52.9% of adults and 28.6% of adolescents for the same item. Total QOL and all subscales except for sexual aspect were reported as fair with statistically significant association between both groups. Self-care efficacy was negative among majority adolescents and positive among most of the adults. Conclusion and recommendations: The current study provided an evidence of unsatisfactory level of knowledge and self-care practice among adolescents and adults patients with permanent stoma.  Quality of life and self-efficacy were also alarming. There is a need for culturally competent intervention with larger sample and qualitative methods of research to deeply explain this area.

Keywords: Stoma, self- Care, quality of life, self-care efficacy, adult, adolescent.

DOI: 10.7176/JHMN/60-13

Publication date:March 31^st 2019