Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2022 Mar;78(3):722-738.
doi: 10.1111/jan.15085. Epub 2021 Oct 27.

A systematic review and meta-analysis of the effectiveness of self-management interventions in people with a stoma

William Goodman  1 , Matthew Allsop  1 , Amy Downing  1 , Julie Munro  2 , Claire Taylor  3 , Gill Hubbard  2 , Rebecca J Beeken  1   4
Affiliations
Free article
Meta-Analysis

A systematic review and meta-analysis of the effectiveness of self-management interventions in people with a stoma

William Goodman et al. J Adv Nurs. 2022 Mar.
Free article

Abstract

Aims: Explore the evidence from randomized controlled trials for the effect of self-management interventions on quality of life, self-management skills and self-efficacy, and to explore which intervention characteristics are associated with effectiveness.

Design: Systematic review.

Data sources: A search of the literature was conducted in these databases: MEDLINE (OVID), EMBASE (OVID) and PsychINFO (OVID) from January 2000 to February 2020.

Review methods: Studies were included if participants had a bowel stoma, were over the age of 18 and the design was a randomized controlled trial of a self-management programme. The outcome measures for this review were quality of life, self-management skills and self-efficacy. The Behaviour Change Technique Taxonomy was used to code interventions for underlying components and alongside other intervention characteristics, associations with improvements in outcomes were explored.

Results: The search identified 3141 articles, 16 of which were eligible. A meta-analysis of self-efficacy scores from five studies (N = 536) found an improvement in those that received the self-management intervention at follow-up with a 12-point mean difference compared with the usual care group. Effects on quality of life and self-management skills were mixed, and meta-analyses of these data were not possible. Across 13 studies an average of 10 behaviour change techniques were used with, credible source (e.g. nurse, doctor, therapist) (n = 13), instruction on how to perform the behaviour (n = 13), demonstration of the behaviour (n = 12) used most often. The behaviour change technique of self-monitoring was associated with an improvement in quality of life. The involvement of a nurse was associated with higher self-efficacy and self-management skills.

Conclusion: This review suggests that self-management interventions can increase peoples' self-efficacy for managing their stoma.

Impact: A standardized approach to the reporting of interventions and the measures used is needed in future studies to better understand the effect on quality of life and self-management skills.

Keywords: meta-analysis; nurses; quality of life; self-efficacy; self-management; stoma; systematic review.

PubMed Disclaimer

References

REFERENCES

    1. Ayling, K., Brierley, S., Johnson, B., Heller, S., & Eiser, C. (2015). Efficacy of theory-based interventions for young people with type 1 diabetes: A systematic review and meta-analysis. British Journal of Health Psychology, 20, 428-446. https://doi.org/10.1111/bjhp.12131
    1. Barlow, J., Wright, C., Sheasby, J., Turner, A., & Hainsworth, J. (2002). Self-management approaches for people with chronic conditions: A review. Patient Education and Counseling, 48, 177-187. https://doi.org/10.1016/S0738-3991(02)00032-0
    1. Borwell, B. (2013). Continuity of care for the stoma patient: Psychological considerations. British Journal of Community Nursing, 14(8), 326-331. https://doi.org/10.12968/bjcn.2009.14.8.43511
    1. Burch, J. (2004). The management and care of people with stoma complications. British Journal of Nursing, 13(6), 307-308. https://doi.org/10.12968/bjon.2004.13.6.12526
    1. Carlsson, E., Berndtsson, I., Hallen, A. M., Lindholm, E., & Persson, E. (2010). Concerns and quality of life before surgery and during the recovery period in patients with rectal cancer and an ostomy. Journal of Wound, Ostomy and Continence Nursing, 37(6), 654-661. https://doi.org/10.1097/WON.0b013e3181f90f0c

LinkOut - more resources