Difficulties experienced by the ostomate after hospital discharge

Abstract

Purpose: This descriptive study used a mailed survey to identify difficulties related to the stoma that ostomates experience after discharge from the hospital, who they sought help from, and if the advice was perceived as helpful.

Subjects and setting: Ostomates who are 18 years or older and have undergone a urinary or fecal diversion at a North Carolina hospital between January 1, 2003 and June 30, 2005, were asked to respond to a survey about the difficulties related to their ostomy.

Instrument: The survey gathered demographic and anthropometric data, information regarding stomal complications, self-evaluation of emotional state, and contact with clinicians and support groups.

Results: Of the 140 surveys mailed, 43 were returned, demonstrating a return rate of 31%. Thirty-four returned surveys were useable for statistical analysis. The top 5 difficulties experienced by the respondents were peristomal skin irritation (76%), pouch leakage (62%), odor (59%), reduction in previously enjoyed activities (54%), and depression/anxiety (53%). Twenty percent of the ostomates who experienced difficulties after surgery did not seek help. Ostomates primarily sought help from nurses when they experienced problems related to the stoma and its maintenance. For mental health, sleep, and sexual problems, a medical doctor was the practitioner of choice. Ostomates were satisfied with most of the help they received from an ostomy nurse; satisfaction was lower for home health nurses and surgeon or primary care physician practices. Average wear time for a stoma pouch was 4 days.

Conclusion: The majority of the ostomates experienced difficulty with pouch leakage, skin irritation, odor, depression or anxiety, and uneven pouching surfaces. Ostomates desire assistance with these problems and will benefit from long-term follow-up by an ostomy nurse.