Skip to main content

Advertisement

SpringerLink
Log in

Self-management goals of cancer survivors with an ostomy

  • Original Research
  • Published:
Journal of Cancer Survivorship Aims and scope Submit manuscript

Abstract 

Objectives

Ostomies due to cancer surgery impose complex and enduring care challenges that necessitate cancer survivors” self-management. The objective of this analysis is to evaluate ostomates’ self- management goals using a qualitative approach.

Methods

A multi-site randomized controlled trial testing the Ostomy Self-Management Training program (OSMT) was delivered via telehealth to a group of cancer survivors with an ostomy randomized to either the OSMT program with goal setting or usual care (UC), without goal setting. Goals were classified by type and frequency according to a modified City of Hope Health-Related Quality of Life framework (physical, psychological, social, spiritual, ostomy-specific, and healthcare quality domains), using a directed and systematic content analysis approach.

Results

The 524 self-management goals analyzed by domain frequencies physical (29.4%), ostomy specific (29.0%) and social well-being (25.0%) were predominant. Managing other health issues (7.6%), psychological issues (6.0%), and spiritual well-being issues (3.0%) were next. Common self-management themes were ostomy care independence (87.5%), handling cancer-related issues (62.5%), achieving acceptance (56.2%), resuming physical activity (43.0%), and maintaining fluid/diet balance (43.0%).

Discussion/Conclusion

Goal-setting offers insights into self-management concerns of cancer survivors with ostomies. Results demonstrate the broad aspects of self-management ostomates face.

Practice Implications

Self-management training with patient goal-setting may be used to help ostomates with cancer and their health care providers identify areas for needed education and support.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. McMullen CK, Hornbrook MC, Grant M, Baldwin CM, Ramirez ML, Wendel CS, Mohler MJ, Altschuler A, Krouse RS. The greatest challenges reported by long-term colorectal cancer survivors with stomas. J Support Oncol. 2008;6(4):175–82.

    PubMed  Google Scholar 

  2. Sun V, Grant M, McMullen CK, Altschuler A, Mohler MJ, Hornbrook MC, Herrinton LJ, Wendel CS, Baldwin CM, Krouse RS. Surviving colorectal cancer long-term, persistent ostomy-concerns and adaptions. J Wound Ostomy Continence Nurs. 2013;40:61–72.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Recalla S, English K, Nazarali R, Mayo S, Miller D, Gray M. Ostomy care and management: a systematic review. J Wound Ostomy Continence Nurs. 2013;40:489–500.

    Article  PubMed  Google Scholar 

  4. Grant M, Ferrell B, Dean G, Uman G, Chu D, Krouse RS. Revision and psychometric testing of the City of Hope Quality of Life-Ostomy Questionnaire. Qual Life Res. 2004;13(8):1445–57.

    Article  PubMed  Google Scholar 

  5. Grant M, McCorkle R, Hornbrook MC, Wendel CS, Krouse RS. Development of a chronic care ostomy self- management program. J Cancer Educ. 2013;28(1):70–8.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Wagner EH, Austin BT, Davis C, Hindmarsh M, Schaefer J, Bonomi A. Improving chronic illness care: Translating evidence into action. Health Aff. 2001;20:64–78.

    Article  CAS  Google Scholar 

  7. Krouse RS, Grant M, McCorkle R, Wendel CS, Cobb MD, Tallman NJ, Ercolano E, Sun V, Hibbard JH, Hornbrook MC. A chronic care ostomy self-management program for cancer survivors. Psychooncol. 2016;25(5):574–81.

    Article  Google Scholar 

  8. Hornbrook MC, Cobb MD, Tallman NJ, Colwell J, McCorkle R, Ercolano E, Grant M, Sun V, Wendel CS, Hibbard JH, Krouse RS. Costs of an ostomy self-management training program for cancer survivors. Psychooncology. 2018;27(3):879–85.

    Article  PubMed  Google Scholar 

  9. Sun V, Ercolano E, McCorkle R, Grant M, Wendel CS, Tallman NJ, Passero F, Raza S, Cidav Z, Holcomb M, Weinstein RS, Hornbrook M, Krouse RS. Ostomy telehealthfor cancer survivors: Design of the Ostomy Self-management Training (OSMT) randomized trial. Contemp Clin Trials. 2018;64:167–72.

    Article  PubMed  Google Scholar 

  10. Barlow J, Wright C, Sheasby J, Turner A, Hainsworth J. Self-management approaches for people with chronic conditions: a review. Patient Educ Couns. 2002;48:177–87.

    Article  PubMed  Google Scholar 

  11. Kralick D, Koch T, Price K, Howard N. Chronic illness self-management: taking action to create order. J Clin Nurs. 2004;13:259–67.

    Article  Google Scholar 

  12. DeWalt DA, Davies TC, Wallace AS, Seligman HK, Bryant-Shillday B, Arnold CL, Freburger J, Schillingef D. Goal-setting in diabetes self-management: taking the baby steps to success. Patient Educ Couns. 2009;77:218–23.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Hurn J, Kneebone I, Cropley M. Goal-setting as an outcome measure: a systematic review. Clin Rehab. 2006;20:756–72.

    Article  Google Scholar 

  14. BovendEerdt TJH, Botell RE, Wade DT. Writing SMART rehabilitation goals and achieving goal attainment scaling: a practical guide. Clin Rehab. 2009;23:352–61.

    Article  Google Scholar 

  15. Shilts MK, Horowitz M, Townsend MS. Goal-setting as a strategy for dietary and physical activity behavior change: a review of the literature. Am J Health Promot. 2004;19(2):81–93.

    Article  PubMed  Google Scholar 

  16. Swoboda CM, Miller CK, Wills CE. Impact of a goal-setting and decision support telephone counseling intervention on diet, psychosocial, and decision outcomes among people with type 2 diabetes. Patient Educ Couns. 2017;7(100):1367–73.

    Article  Google Scholar 

  17. Cullen KW, Baranowski J, Smith S. Using goal-setting as a strategy for dietary behavioral change. J Am Diet Assoc. 2001;10(1):562–6.

    Article  Google Scholar 

  18. McCorkle R, Ercolano EA, Lazenby M, Schulman-Green D, Schilling LS, Lorig K, Wagner EH. Self-management: enabling and empowering patients living with cancer as a chronic illness. CA J Clin. 2011;61(1):50–62.

    Article  Google Scholar 

  19. Hammer MJ, Ercolano EA, Wright F, Dickson VV, Chyun D, Melkus GD. Self-management for adult patients with cancer: an integrative review. Cancer Nurs. 2015;38(2):E10-26.

    Article  PubMed  Google Scholar 

  20. Holt A, Hansen KG, Dorte M, Jensen PT. Self-assessment of goals achievements within a gynecological cancer rehabilitation counseling. Can Nurs. 2019;42(1):58–66.

    Article  Google Scholar 

  21. Marin F, Turner A, Bourne C, Batehup L. Development and qualitative education of a self-management workshop for testicular cancer survivor-initiated follow-up. Oncol Nurs Forum. 2013;40(1):E14–23.

    Article  Google Scholar 

  22. Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277–88.

    Article  PubMed  Google Scholar 

  23. Ercolano E, Grant M, McCorkle R, Tallman N, Cobb MD, Wendel C, Krouse RS. Applying the chronic care model to support ostomy self-management: implications for oncology nursing practice. Clin J Oncol Nurs. 2016;20(3):269–74.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Hoskote M, Le G, Cherian R, Zeiger R, Sakar U. Cancer patients perspectives on survivorship goals from Smart Patients online community. Support Care Cancer. 2020;29:2375–84.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Martin F, Wright H, Moody L, Whiteman B, McGillion M, Clyne W, Pearce G, Turner A. Help to overcome problems effectively for cancer survivors: development and validation of a digital self-management program. J Med Internet Res. 2020;22(5):17824.

    Article  Google Scholar 

  26. Risendal BC, Dwyer A, Seidel RW, Lorig K, Coombs L, Ory MG. Meeting the challenges of cancer survivorship in public health: results from the evaluation of the chronic disease self-management program for cancer survivors. Front Public Health. 2015;2:1–8.

    Article  Google Scholar 

  27. Rock CL, Doyle C, Denmark-Wahnefried W, Meyerhardt J, Courneya KS, Schwartz AL, Bandera EV, Hamilton KK, Grant B, McCullough M, Byers T, Gansler T. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012;62:142–274.

    Article  Google Scholar 

  28. Krouse RS, Grant M, Rawl SM, Mohler MJ, Baldwin CM, Coons SJ, McCorkle R, Schmidt CM, Ko CY. Coping and acceptance: the greatest challenge for veterans with intestinal stomas. J Psychosom Res. 2009;66(3):227–33.

    Article  PubMed  Google Scholar 

  29. Ercolano E, Hoffman E, Tan H, Pasacreta N, Lazenby M, McCorkle R. Managing psychosocial distress: lessons learned in optimizing psychosocial distress screening program implementation. Oncology. 2018;32(10):488–93.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Yale University, New Haven, CT, USA

    Elizabeth Ercolano & Ruth McCorkle

  2. Department of Population Sciences, City of Hope, Duarte, CA, USA

    Marcia Grant & Virginia Sun

  3. Unaffiliated, Wound, Ostomy, and Continence Nurse, Tucson, AZ, USA

    Nancy Tallman

  4. Department of Surgery, City of Hope, Duarte, CA, USA

    Virginia Sun & Robert S. Krouse

  5. Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA

    Julia Mo

  6. Patient Stakeholder, New Haven, CT, USA

    Pamela Pitcher

  7. Kaiser Permanente Center for Health Research, Portland, OR, USA

    Mark C. Hornbrook

  8. Arizona Telemedicine Program, University of Arizona, Tucson, AZ, USA

    Peter Yonsetto

  9. University of Pennsylvania, Philadelphia, PA, USA

    Octavio Bojorquez & Sabreen Raza

Authors
  1. Elizabeth Ercolano
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marcia Grant
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Virginia Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nancy Tallman
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Julia Mo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Pamela Pitcher
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Mark C. Hornbrook
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Peter Yonsetto
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Octavio Bojorquez
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Sabreen Raza
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Ruth McCorkle
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Robert S. Krouse
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Elizabeth Ercolano.

Ethics declarations

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ercolano, E., Grant, M., Sun, V. et al. Self-management goals of cancer survivors with an ostomy. J Cancer Surviv 17, 1480–1487 (2023). https://doi.org/10.1007/s11764-022-01164-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11764-022-01164-5

Keywords

Search

Navigation