Ostomies - Background
Recommendations
| Identify and Treat the Cause | ||
|---|---|---|
| 1 | Take a careful history and assess. | Level of Evidence Not Assessed |
| Address Patient-centered Concerns | ||
|---|---|---|
| 2 | Provide information and advice on prevention and treatment options. Ostomate education should include training in ostomy management and care of the skin and support for psychological adjustment. | Level of Evidence Not Assessed |
| Provide Local Care | ||
|---|---|---|
| 3 | Ensure that specialized ostomy nurses provide both pre- and postoperative education to ostomates. | Level of Evidence Not Assessed |
| 4 | Provide regular follow-up and assessment to identify complications promptly and determine appropriate management. | Level of Evidence Not Assessed |
| Provide Organizational Support | ||
|---|---|---|
| 5 | Facilitate healthcare professionals to gain relevant knowledge and skills to offer appropriate advice and information. | Level of Evidence Not Assessed |
Background
An ostomy is a surgically created opening for removal of waste from various parts of the gastrointestinal tract or from the urinary tract. Patients with inflammatory bowel disease, bowel or urinary tract cancer, or abdominal or pelvic surgery may require an ostomy. The main ostomy types are colonostomy, ileostomy and urostomy. An ostomy may be temporary, to allow part of the intestine to heal, or permanent. Data on the number of patients with ostomies (ostomates) are difficult to gather, but estimates indicate than 500,000 to 800,000 Americans are currently living with an ostomy.The ostomy is generally constructed on the abdominal wall at an individually selected site to allow optimum comfort, function and concealment. Postoperatively, recovery may be uneventful and the ostomy may function well for a long period of time. Complications may also occur, either soon after surgery or many years later.
Patient education begins even before the surgical procedure including, ostomy sitting, type of appliance, recommendations, and discussion of the implications of life with an ostomy. Postoperatively, education continues to develop patient confidence in day-to-day management, with outpatient support provided by specialized ostomy nurses. Generally, the more helpful the perioperative education, the better the adjustment.
In addition to learning how to manage their ostomy and care for the peristomal skin, ostomates face many psychological issues. Psychological adaptation may include dealing with issues with self esteem and body image, lack of confidence about self-care, social and sexual relationship concerns, and fears about returning to, or functioning in, the workplace. Support groups may assist ostomates to adjust.
References
| Essential Publications |
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| n/a |