Equilibrio emocional, capacidad de autocuidado e integridad cutánea en la persona ostomizada

  1. Mª Elena García Manzanares
  2. Ignacio Zaragoza García
  3. Candelas López López
  4. Carolina Hidalgo Dóniga
  5. Juana Mª Aguilar Ortega
  6. Santiago Pérez García
Journal:
Metas de enfermería

ISSN: 1138-7262

Year of publication: 2019

Volume: 22

Issue: 3

Pages: 50-57

Type: Article

DOI: 10.35667/METASENF.2019.22.1003081389 DIALNET GOOGLE SCHOLAR

More publications in: Metas de enfermería

Abstract

Objective: to explore the relationship between emotional balance, self-care and skin integrity in ostomized persons through the NOC Outcomes Criteria. Method: a prospective observational study, including ostomized patients under follow-up in the Ostomy Unit at seven days after discharge, and at two, six and 12 months. Sociodemographical, clinical and outcome variables were studied, based on eight indicators associated with the NOC (1101) Tissue Integrity: Skin & Mucous Membranes, (1615) Ostomy Self-Care and (1204) Emotional Balance. A descriptive analysis was conducted, using frequencies, means and standard deviations (SD). Correlations between NOC-derived indicators were studied. Results: the study included 55 patients; 65.45% (n= 36) were male, with 67.45 (13.4) years as mean age (SD), and 58.2% were >65-year-old. Intestinal continuity was restored in 50.90% (n= 28) of the participants; 10.90% (n= 6) achieved skin integrity (visit 1), reaching 100% (n= 20) (visit 4). An adequate self-care was achieved by 18.18% (n= 10) (visit 1), reaching 100% (n= 20) (visit 4). No patient achieved emotional balance at Visit 1; 34% (n= 17) had achieved it at Visit 2, 59.5% (n= 21) at Visit 3, and 70% (n= 14) at Visit 4. Correlations between variables were presented in a direct and positive manner, with Moderate-Good association levels; all of them were statistically significant. Conclusions: the proportion of patients with problems in peristomal skin improved throughout follow-up. Self-care was gradually increased, as well as emotional balance. There was a direct and positive relationship between skin integrity and self-care, quality of sleep, appetite, maintaining personal hygiene and care, and reporting a serene mood.

Bibliographic References

  • Iglesias de la Iglesia A. Técnica de manejo y cuidado de los estomas digestivos y urinarios: colostomía, ileostomía y urostomia. Barcelona: Elsevier; 2011.
  • Organización Colegial de Enfermería. El Consejo General de Enfermería reclama la implantación de la enfermera estomaterapeuta en todo el SNS [internet]. 2014 [citado 12 mar 2019]. Disponible en: https://www.consejogeneralenfermeria.org/sala-de-prensa/noticias/item/8087-el-consejo-general-de-enfermeria-reclama-la-implantacion-de-la-enfermera-estomaterapeuta-en-todo-el-sns
  • García Martínez C, García Cueto B. Cuidados de Enfermería al paciente ostomizado. RqR Enfermería Comunitaria (Rev SEAPA). 2017; 5(4):35-48.
  • Vieira Cascais FM, Gue Martín J, dos Santos Almeida PJ. El impacto de la ostomía en el proceso de la vida humana. Texto contexto enferm. 2007; 16(1):163-7.
  • Silva A, Shimizu HE. El significado del cambio en el modo de vivir de la persona con ostomía intestinal definitiva. Rev Latino-Am Enfermagem. 2006; 14(4):483-90.
  • Thorpe G, McArthur M, Richardson B. Bodily change following faecal stoma formation: qualitative synthesis. J Adv Nurs. 2009; 65(9):1778-89.
  • Lyon CC, Smith AJ, Griffiths CE, Beck MH. The spectrum of skin disorders in abdominal stoma patients. B J Dermatol. 2000; 143:1248-60.
  • De Miguel Velasco, Jiménez Escovar F, Parajó Calvo A. Estado actual de la prevención y tratamiento de las complicaciones de los estomas. Revisión de Conjunto. Cir Esp. 2014; 92(3):149-56.
  • Salvadalena G. Incidence of complications of the stoma and peristomal skin among individuals with colostomy, ileostomy, and urostomy: a systematic review. J Wound Ostomy Continence Nurs. 2008; 35(6):596-607.
  • Colwell J, Ratliff C. Goldberg M, Baharestani M, Bliss DZ, Gray M, et al. MASD part 3: peristomal moisture-associated dermatitis and periwound moisture-associated dermatitis. J Wound Ostomy Continence Nurs. 2011; 38: 541-53.
  • Ratliff CR. Factors Related to Ostomy Leakage in the Community Setting. J Wound, Ostomy Cont Nurs. 2014; 41(3):249-53.
  • Bandura A. Self efficacy: Toward a Unifying Theory of Behavioral Change. Psychol Rev.1977; 84:191-215.
  • Wu HK, Chau JP, Twinn S. Self-efficacy and Quality of Life Among Stoma Patients in Hong Kong. Cancer Nurs. 2007; 30(3):186-93.
  • Martins LM, Sonobe HM, Vieira FS, De Oliveira MS, Lenza NF, Da Silva Teles AA. Rehabilitation of individuals with intestinal ostomy. Br J Nurs. 2015; 24(22):4.
  • Moorhead S, Johnson M, Maas ML, Swanson E (eds.). Clasificación de Resultados Enfermería (NOC). 5ª ed. Madrid: Elsevier; 2014.
  • Davidson F. Quality of life, wellbeing and care needs of Irish ostomates. Br J Nurs. 2016; 25(17):4-12.
  • Wade BE. Colostomy patients: psychological adjustment at 10 weeks and 1 year after surgery in districts which employed stoma-care nurses and districts which did not. J Adv Nurs.1990; 15(11):1297-304.
  • Martínez Ortega RM, Tuya Pendás LC, Martínez Ortega M, Pérez Abreu A, Cánovas AM. El coeficiente de correlación de los rangos de Spearman caracterización. Rev Haban Cienc Méd. 2009; 8(2).
  • De Frutos Muñoz R, Solís Muñoz M, Hernando López A, Béjar Martínez P, Navarro Antón C, Mayo Serrano MN. Calidad de vida de los pacientes con colostomía e ileostomía a corto y medio plazo. Metas Enferm 2011; 14(2): 24-31.
  • Jansen F. A mixed-method study on the generic and ostomy-specific quality of life of cancer and non-cancer ostomy patients. Support Care Cancer (2015) 23:1689–97.
  • Conceição de Gouveia Santos VL. Health-Related Quality of Life in Persons With Ostomies Managed in an Outpatient Care Setting. J Wound Ostomy Continence Nurs. 2016;43(2):158-64.
  • Poletto D, Silva DMGV. Vivir con estoma intestinal: la construcción de la autonomía para el cuidado. Rev. Latino-Am. Enfermagem. 2013; 21(2).
  • Burch J. Caring for peristomal skin: what every nurse should know. B J Nurs. 2010; 19(3):166-72.
  • Wu HK, Chau JP, Twinn S. Self-efficacy and Quality of Life Among Stoma Patients in Hong Kong. Cancer Nurs. 2007; 30(3):186-93.
  • Juul K. Quality of Life with an Intestinal Stoma. Seminars in Colon and Rectal Surgery. 2008; 19(3):167-73.
  • Sun V, Grant M, Mcmullen CK, Altschuler A, Mohler MJ, Hornbrook MC, et al. Surviving Colorectal Cancer: Long-Term, Persistent Ostomy- Specific Concerns and Adaptations. J Wound Ostomy Continence Nurs. Jan. 2013; 40(1):61-72.
  • Vorbeck E, Willette-Murphy K, Meiers S, Rudel R, Alakhras M. A descriptive study to assess the impact of surgical stomas on individuals’ sleep perceptions & response to sleep hygiene. Ostomy Wound Manage. 2010 Jan 1; 56(1):36-44.
  • Chartier-Kastler E, Davidson K. Evaluation of quality of life and quality of sleep in clinical practice. Eur Urol. 2007; 6:576-84.
  • Claessens I, Probert R, Tielemans C. The ostomy life study: the everyday challenges faced by people living with a stoma in a snapshot. Gastrointest Nurs. 2015; 13(5):18-25.
  • Bechara RN, Bechara MS, Bechara CS, Queiroz HC, Oliveira RB, Mota RS, et al. Abordagem Multidisciplinar do Ostomizado. Rev Bras Coloproct. 2005; 25(2):146-9.
  • Oliveira DLLC. A enfermagem e suas apostas no autocuidado: investimentos emancipatórios ou práticas de sujeição? Rev Bras Enferm. 2011; 64(1):185-8.
  • Martín Muñoz B, Panduro Jiménez RM, Crespillo Díaz Y, Rojas Suárez L, González Navarro S. El proceso de afrontamiento en personas recientemente ostomizadas. Index Enferm. 2010; 19(2-3):115-9.
  • Entwistle VA, Stacy M. Carter, Alan Cribb, Kirsten McCaffery. Supporting Patient Autonomy: The Importance of Clinician-patient Relationships. J Gen Intern Med. 2010; 25(7):741-5.
Data source: Dialnet