Abstract
Psychological problems are common among people with inflammatory bowel disease (IBD) following stoma surgery. However, the ways in which stoma-related psychological needs are identified and addressed in health care settings remain unexplored. In this study, we investigated the perspectives of young people with a stoma and health care professionals about access to psychological support. Semi-structured interviews were conducted with young people with an IBD stoma (18–29 years, n = 13) and health care professionals (n = 15), including colorectal surgeons, gastroenterologists, specialist nurses in IBD and stoma care, and general practitioners in England. Data collection and analysis were informed by constructivist grounded theory. Three analytic categories were developed: “initiating support-seeking,” “affirming psychological needs,” and “mobilizing psychological support,” which capture young peoples’ trajectory to access psychological support. Based on the findings, we highlight the need for both patients and health care professionals to assign greater priority to the identification of psychological symptoms post-stoma surgery. More effective care pathways, which include responsive psychological services, would enhance access to psychological support for young people with a stoma.
Highlights
Inflammatory bowel disease (IBD) refers to a group of inflammatory conditions affecting the gastrointestinal tract: the most common of which are ulcerative colitis (UC) and Crohn’s disease (CD)
We present a qualitative exploration of factors influencing access to psychological support following stoma surgery among young people with IBD: from the perspective of both patients and clinicians
Constructivist grounded theory analytic techniques allow the development of high-level conceptual insights on access to psychological support, which are grounded in empirical data that have been co-constructed by study participants and the research team
Summary
Inflammatory bowel disease (IBD) refers to a group of inflammatory conditions affecting the gastrointestinal tract: the most common of which are ulcerative colitis (UC) and Crohn’s disease (CD). Medical therapy for IBD has advanced significantly with the advent of biological therapies, stoma surgery may still be necessary for individuals with severe, long-lasting symptoms, or in those who do not respond to medical management. This surgical procedure involves the removal of the inflamed bowel and creation of an opening in the abdomen, through which either the remaining end of the large bowel or end of the ileum (small bowel) is passed. A review by Spinelli et al (2014)
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