Quality of Life in Ostomy Patients - Research Paper Example

14th June Aazam Dabirian, Farideh Yaghmaei, Maryam Rassouli, and Mansoureh Zagheri Tafreshi ) Quality of life in ostomy patients: a qualitative study article Part 1 Ostomy is an opening made from surgery of an organ in the inside to outside and thus ostomy is attached to the skin while a stoma bag is attached to the opening after surgery. The surgery can be as a result of colostomies, urostomies and ileostomies so the waste products from the body can pass and be drained in the stoma bag for example faeces and urine. This article will be concerned with quality of life after a patient has gone ostomy process in the entire life. In addition the article will use CASP TOOL that will provide doctors and nurses with an example of reading and critiquing research. 1. Was there a clear statement of the aims of the research? Yes. The article’s goal according to Aazam et al 2010 is to indicate how one can cope up with life after undergoing a surgical operation due to various diseases. Through the support of nurses, the patients are educated on how to manage the situation. The treatments of the disease include surgery, chemotherapy and radiotherapy which cause a lot of pain to the patient and worries. 2. Is a qualitative methodology appropriate? Yes a qualitative methodology is appropriate. Aazam et al 2010 indicates various techniques that are qualitative in nature that can be applied by the patients as well as nurses to address the disease. The article focus was to indicate how a patient can continue with life after undergoing surgical operation, according to this article, the problem is quality of life in ostomy patients incase one is diagnosed and treatment starts for instance in case the doctor decides to do a biopsy which may work or not. This is a weakness since if biopsy does not work then pain and bleeding may occur increasingly and the only remaining thing is to start chemotherapy and radiotherapy which again may work or not which is given a number of day so that the doctor can diagnose and see whether things are okay. According to Aazam et al 2010, qualitative methodology is the right methodology for addressing the research goal since at long last is to survive through the entire period with a colostomy, urostomies and ileostomies maintaining good relationship with the stoma nurse. 3. Was the research design appropriate to address the aims of the research? Yes. Aazam et al 2010, article research design was appropriate to address the aims of the research. Aazam and others adopted various ideas from experts in order to address his aims. Additionally, the article included ideas from published nursing articles in order to provide adequate information that is reliable and resourceful for nurses. According to the article, during the entire period of pain and worries, one may have a major or a minor surgery but major surgery is mostly done and this means that an individual will have a bag on his side for the rest of his or life. During this entire period, the patient is given a stoma nurse who usually encourages one and counseling is undertaken in order to make the patient feel as part and parcel of the community. This means that the role of the nurse is to maintain a relationship with the patient. This entire period the nurse introduces one to a person who had a colostomy,urostomy, ileostomy or any other surgery that is related to cancer so that one can be given assurance that he or she is going to wake up in the intensive care. 4. Was the recruitment strategy appropriate to the aims of the research? Yes. The research was an open forum of patients reporting to various health cares the strategy of recruitment was made with various diseases that require surgery and a semi structured interview was conducted. The patient had to participate in counseling section where knowledge was provided. During this entire time which may take more than 5 weeks, the article indicates that the colostomy, urostomy and ileostomy may be experiencing some problems but after the stoma nurse attending regularly and cleaning is done and changing the bag it soon works. While in the hospital, the stoma nurse provides one with information concerning the colostomy, urostomy and ileostomy and the suppliers of equipments needed is delivered to one home so that one can be under medication while in the home. 5. Was the data collected in a way that addressed the research issue? Yes. Through the use of interview method where 14 participants were involved after undergoing ostomy in different period and years, a comprehensive quality of life was presented to the interviewers and later data collected and analyzed. Through interview method that was used, the data collected addresses the issues clearly since those with ostomy are the one who were interviewed. There were no interview guide but the patient gave any information concerning personal life and challenges involving ostomy. The data given was later recorded for the purpose of other patient. Can one cope up with ostomy? For sure one must set the mind that it is part of life and this is just like how a mother goes home with a baby after delivery where care and other medical check ups are provided for the baby by both the mother and the father. Incase one will not be able to manage the ostomy by own a stoma nurse will be provided to make sure that one is attended in the right way. Through the guidance from the stoma nurse one can cope up with ostomy for a long time. 6. Has the relationship between researcher and participants been adequately considered? Yes. According to Aazam et al 2010, good relationship between the patients and nurses must be considered where any information concerning the ostomy must be understood. Any unique thing that may happen to the patient must be reported to the stoma nurse so that incase of any problem then the problem can be curbed in a faster manner. How is the going? Through that question any problem or positive experience was raised and thus guidance to the patient is given and if any medication needed it is prescribed. 7. Have ethical issues been taken into consideration? Yes. Issues related to ostomy and other diseases are a matter that should be kept a secret between the patient and the nurse and this is due to the code of ethics (Shaw et al, 36). During diagnosing, confidentiality is kept and only the person who takes care of the patient will be involved in some cases. The approval to keep our issues confidential is according to the ethics committee. Through the use of statistical qualitative technique, many people undergo surgery because of cancer related diseases and thus awareness should be incorporated for individuals. This is obtained through patients reporting to various health cares. 8. Was the data analysis sufficiently rigorous? Yes. In depth description of the data was taken from different patients and in the case of Aazam et al 2010, the interview was conducted to 14 patients who were under treatment after ostomy was conducted explaining in details how their life is up to date and the result showed that a lot people in United States are diagnosed with different related cases that need surgery. The data is taken from different health cares where patients report for help, through critically examining our own role the data was taken from the hospitals and others were taken in interview method which means that there is no bias during selection and data presentation. 9. Is there a clear statement of findings? Yes. As a living proof with ostomy there is need for one to be associated with Iranian Ostomy Association so that one can volunteer and raise profile of ostomy to those who are with it and they leave in fear and worries. Others find it difficult to cope up with ostomy but through guidance in the research and medication one can live without any problem and daily routines being carried. As a living proof for the entire period there is need for some one to interview people so that an individual who is in a house and cannot walk due to shyness can get courage and hope to continue with life. 10. How valuable is the research? The research by Aazam et al 2010 is of high value. The value of the research lies on the extent to which the issue of ostomy and how an individual can have evidence that after ostomy life will continue as normal and no need to worry. The benefits of the research outweighed its loss in the sense that it provided hope and determination to the patients. If one is experiencing colostomy, urostomy and ileostomy this article argues that he or she should not let it rule their lives and thus it is important to be a volunteer and speak about it convincing others that everything will be good. The strength of one accepting the way he or she is the one to raise awareness that many individuals suffers from surgical related diseases. Other areas where a research is necessary is living with a stoma bag since again it gives a challenge to many though the researchers have not discussed whether the findings can be transferred to other population or can be used. Part b The article quality of life in ostomy patients shows the aim of treatment of different types of surgical related diseases. The article is important to patients and the field of nursing as a whole since this is where critical care is needed by both the patient and the stoma nurse. Since living with the ostomy is not an easy thing and many people do not like to alert others concerning ostomy although it is a deadly disease which the public should be aware of. Individuals should be made aware of ostomy since many die because they do not know or even be are aware of symptoms of different illness like ileostomy, urostomy, colostomy, and gastrostony among others. Ostomy is important to nursing since it is the second killing disease from breast cancer and thus in nursing field it has to be given the maximum attention needed so that massive death that emanate from the same can be controlled. It is still of importance to nursing since it gives the scientist and medical experts time to come up with cure and able to advice individuals chemical food stuffs that cause cancer and other treatable diseases. Reasons for stoma Due to gastrointestinal disorders in the body of a human being like inflammatory bowel disease, neoplasia among others stomas have to be attached to the skin and a stoma bag will have to be attached to the opening that has been made. This article indicates that during this period the patient suffers from discomfort and other disorders since the stoma have to treat with care. Ostomy equipments Once the decision for a stoma to be made is requested by the doctor or the surgeon then the patient is introduced to a stoma nurse who normally provides counseling. In addition, the stoma nurse detects and manages the most common problems for example when the patient is bleeding incase a colostomy when the pouch has been changed. The stoma nurse spends a lot of time with the patient so that reassurance that life can continue as normal is of important since when most patients hear of a stoma, they depict it as a matter of death. Other patient feels that when stoma decision is made bathing, showering and swimming is impossible. The stoma nurse is there to give detailed information concerning the practical aspects for example practically the patient is shown different types of colostomy pouch and available equipments (Aazam et al 2010,). During this period the patient is shown how to change the colostomy pouch since one will take a lot of time with the pouch. The patient practically will have to be taught by the stoma nurse on how to sit since poor sitting will lead to patient not being able to change the pouch and clean it which in return leads to increased risk of skin and other complications. Exercise After the surgery it is recommended that when one has a couple of weeks with the ostomy gentle exercise should be done since they boost one to recover in a faster manner. Incase of pain it should be stopped immediately again for those who work one can return to work but overworking is not encouraged though this can be under the advice of the stoma nurse. Problems associated with stomas Psychological aspects Due to depression and anxiety it is of important for the patient to be provided with a mental specialist who is going to take the patient under counseling due to the stoma. Additionally, the patient should be introduced to a person who had already undergone the procedure so that they can share some information and encourage the patient that life will continue despite the challenges. This is a challenge since the patient will experience low esteem and thus it is the role of the family to support the patient until the end so that the patient will not have low mood towards one. Due to family responsibilities the patient should be considered by the association to cater for the family for a while till the patient is well to avoid stress. Sex Issues arise when one has ostomy in sex life this is because for instance in case of women their rectum is removed in case of colostomy. This will have a negative effect to the partner because the rectum no longer supports the vagina during sex this causes pain to the women. Additionally the vagina becomes dryer and this cause pain and discomfort during sex though through the use of lubricating jelly will make it possible. For men blood supply to the penis is not enough and this leads to difficult in maintaining an erection though through the use of medication the blood that flows to the penis can be increased. Religious considerations During the research participants may be Muslims and Christians and incase the patient is a Muslim then they may find it difficult for their religious rituals since one may find that she or he is not clean incase of colostomy. This is because irrigation has to be considered. Irrigation means that an individual will have to wash the colon with water so that is maintained in good condition. Through the use of colostomy pouch a device can be inserted in the stoma for the purpose of cleaning it and this means after a moment the colon will be clean. Skin problems occurs to the patient especially when the colostomy pouch is leaking and the leak continues for along time, the skin at the site of the stoma sometimes develop an allergic reaction and thus skin inflammation occurring. Due to these allergic reactions they can lead to the patients experiencing other opening around the body though seals are available which will cover and protect the openings. In addition, lotions and cleansing wipes are available to the patient so that they can use incase of allergic reaction due to the contact of the body and the colostomy pouch. Physical problems When ostomy is conducted in the patient body then the patient complains due to irritation around the ostomy site, sleep may not occur due to pain some times, bad breath is still experienced by the patient and gas emission is also experienced but through the stoma nurse one is informed what he or she can use. Working is not recommended and only basic routines can be done and those who are in offices can continue but manual work is not encouraged. Economic challenges Since many of individual when they are diagnosed of ostomy they are informed about it but later when surgical operation is made life becomes miserable since despite hard economic time they will need buying of bags and gloves and other prescribed medications which will increase further financial problems. Others the stoma may smell and they need fresheners in their homes which will further increase the financial challenge. Recommendation I recommend the patient not to practice anal sex and in case of normal sex care should be taken to avoid bleeding and other related issues concerning sex. I do recommend patients to avoid the drugs which are antacids since they comprise of magnesium salts which may cause diarrhea. Aluminum salts may cause constipation which is a problem to the patient in case of colostomy. Antibiotics should be used with care by the patient who have a stoma since it usually cause diarrhea. Diuretics if taken by the patient may cause the patient to be dehydrated and thus it should be taken with a lot of water and every meal should be having a lot of water (Potter et al 24). This happens to patients who are suffering from ileostomy since the patients may become potassium depleted. The need for the patient to take a lot of water when having a stoma is of important since dehydration may cause death of the patients so water should be taken a lot. Due to odors of the stoma, the patient should not use spray deodorants and thus the patient should be encouraged to use household air fresheners. Instead of using spraying deodorants, the patient should use lubricating deodorants to prevent leakage to occur occasionally and thus they should only be prescribed by the stoma nurse. Works Cited Aazam et al 2010, Quality of life in ostomy patients: a qualitative study. Available from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3034300/ Potter et al. Canadian Fundamentals of Nursing, 2006, Elsevier Canada p. 93. Shaw, E., Petchey, P., Chapman, J., Abbott, S. (2009). A double-edged sword? Health research and research governance in UK primary care. Social Science & Medicine, 2009. 68: 912-918 Read More