A Mixed-Methods Evaluation of Health-Related Quality of Life for Male Veterans with and without Intestinal Stomas
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Intestinal stomas have a major impact on Cases’ lives. It is essential to better understand the areas in which interventions may help to minimize the negative consequences.
This was a case-control survey study using validated instruments (City of Hope Quality of Life-Ostomy and Short Form 36 for Veterans). Cases were accrued from Veterans Affairs Medical Centers in Tucson, Indianapolis, and Los Angeles. Eligibility included a major intra-abdominal surgical procedure that led to an ostomy (cases), or a similar procedure that did not mandate a stoma (controls). Analysis included quantitative and qualitative responses.
The response rate was 48 percent (511/1063). Cases and controls had relatively similar demographic characteristics. Because of low numbers of female respondents (13 cases and 11 controls), only results for males are reported. Based on both the City of Hope Quality of Life-Ostomy and Short Form 36 for Veterans, cases reported significantly poorer scores on scales/domains reflecting psychologic and social functioning and well being. Additionally, cases reported poorer scores on Short Form 36 for Veterans scales reflecting physical functioning and significantly lower scores on multiple items in the social domain of the City of Hope Quality of Life-Ostomy compared with controls. Two-thirds of cases replied to an open-ended question on their “greatest challenge” related to their ostomy, which led to further clarification of major issues.
Multiple health-related quality of life problems were reported by male veterans with intestinal stomas. The greatest differences between cases and controls were observed in the social and psychologic domains/scales. Findings from this study provide a greater understanding of the challenges faced by ostomates and will inform the development and evaluation of urgently needed intervention strategies.
Key wordsOstomy Focus groups Quality of life Stomas
- 1.United Ostomy Associations of America, Phoenix Ostomy Chapter. Available at: http://www.phoenixostomychapter.org/info.html. Accessed May 8, 2006
- 4.Walker CS. Quality of life: assessment and application. London: MTP Press, 1987.Google Scholar
- 5.Osoba D. Lessons learned from measuring health-related quality of life in oncology. J Clin Oncol 1994;12:609–16Google Scholar
- 7.Spilker B. Introduction. In: Spilker B. Quality of life and pharmacoeconomics in clinical trials. 2nd ed. Philadelphia: Lippincott-Raven, 1996:1–10.Google Scholar
- 8.Grant M. Quality of life issues in colorectal cancer. Develop Support Care 1999;3:4–9Google Scholar
- 9.Grant M, Ferrell B, Rivera L, Dean G, Chu D, Krouse RS. Quality of life for cancer Cases with ostomies. Qual Life Res 1998;7:599–600Google Scholar
- 12.Klopp AL. Body image and self-concept among individuals with stomas. J Enterostom Ther 1990;17:98–105Google Scholar
- 14.Grunberg KJ. Sexual rehabilitation of the cancer patient undergoing ostomy surgery. J Enterostom Ther 1986;13:148–52Google Scholar
- 18.Borweil B. The psychosexual needs of stoma Cases. Prof Nurse 1997;12:250–5Google Scholar
- 21.Hurny C, Holland JC. Psychosocial sequelae of ostomies in cancer Cases. Cancer 1985;36:170–83Google Scholar
- 26.City of Hope/Beckman Research Institute Pain Resource Center Research Instruments. Available at: http://www.cityofhope.org/prc/pdf/Quality%20of%20Life%20Ostomy.pdf. Accessed July 20, 2006
- 29.Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructions. Med Care 1992;31:247–63Google Scholar
- 32.Sloan J, Symonds T, Vargas-Chanes D, Fridley B. Practical guidelines for assessing the clinical significance of health-related quality of life changes within clinical trials. Drug Information J 2003;37:23–31Google Scholar
- 33.Krippendorff K. Content analysis. Beverly Hills: Sage, 1980.Google Scholar
- 34.Miles MB, Huberman AM. Qualitative data analysis. Thousand Oaks: Sage, 1994.Google Scholar
- 35.Morse JM, Field PA. Qualitative research methods for health professionals. Thousand Oaks: Sage, 1995.Google Scholar
- 40.Krouse RS, Grube B, Grant M, et al. Ostomy-related sexual dysfunction: an important quality of life issue [abstract]. Proc-Am Soc Clin Oncol 1999;18:599aGoogle Scholar
- 41.Karadağ A, Mentes BB, Ayaz S. Colostomy irrigation: results of 25 cases with particular reference to quality of life. J Clin Nurs 2005;14:479–85Google Scholar