Quality of life in postostomy surgery patients: A cross-sectional survey

Abstract

Background and aim: Ostomy is a radical treatment that is sometimes required due to severe inflammatory bowel disease (IBD), colorectal cancer (CRC), and so on. Around 8000 people in New Zealand live with stoma bags. We studied factors associated with poor quality of life (QoL) in ostomy patients to improve patient care.

Methods: Eligible adult patients identified through the Southern District Health Board database were invited to participate. The survey consisted of the general stoma QoL, IBD, CRC QoL, and dietary and lifestyle questionnaires.

Results: Response rate was 54.5% (n = 241/448). Study participants were a mean (SD) 70.9 (14.2) years old, 60.6% were male, and 89.5% were New Zealand European; 52.5% of the study participants had a colostomy, and 56.4 and 22.4% received their stoma due to CRC and IBD, respectively. Median (first-third interquartile range) duration since ostomy for overall study sample was 6.9 (3.3-15.1) years. Mean (SD) Stoma-QoL score for all the patients was 60.3 (10.8) points (scale 20-80). Stoma-underlying disease (P = 0.28) and type of stoma (P = 0.60) were not associated with Stoma-QoL scores. Older adults had higher Stoma-QoL, IBD questionnaire and QLQ-C30 quality-of-life scores; 73.1% received dietary recommendations for the stoma, And 56.4% changed their diet, 51.4% found it easy to adhere to dietary recommendations, and 9.2% found it quite/very difficult.

Conclusion: This study found high-quality life scores in postostomy patients and no significant association between the underlying disease, time since ostomy, level of comorbidities, and how the appliance worked, which highlight the multifactorial nature of the quality of life concept and difficulties measuring it.

Keywords: colorectal cancer; colostomy; ileostomy; inflammatory bowel disease; stoma.

Figure 1

Stoma‐quality of life (QoL) scores by age group and gender: Stoma‐QoL, inflammatory bowel disease questionnaire (IBDQ) Total, IBDQ Bowel Symptoms, IBDQ Systemic Symptoms, IBDQ Emotional Function, IBDQ Social Function scores. The boxplots show median, 25th, and 75th percentile of scores per age group along with distribution of all the scores for males (blue) and females (red) separately, divided by age categories; higher scores indicate higher quality of life.