Efficacy of a Social Interaction Intervention in Early Postoperative Period to Improve Coping in Persons With an Ostomy: A Randomized Controlled Trial.

Abstract

The purpose of this study was to analyze the efficacy of a social interaction intervention delivered during the early postoperative time period on the coping process in persons with a new ostomy. Randomized controlled trial. The sample comprised 52 persons who underwent surgical management of colorectal including a fecal ostomy; 27 were randomly allocated to the intervention group and 25 to the control group. One participant allocated to the control group died before data collection; thus, findings are based on data from 51 participants. The study setting is the Regional University Hospital of Malaga, located on the southern coast of Spain. Ostomy visitors (persons living with an ostomy) were taught to listen to the experiences and the concerns of the participant and to serve as an example of an individual who has successfully learned to live with a fecal ostomy. The intervention was a visit with a person with a new ostomy during the early postoperative period. Control group participants were offered standard care that did not include the visit from a person with an ostomy. Outcome measures were taken from the Nursing Outcomes Classification taxonomy. The main outcome measure was coping; secondary outcome measures were health beliefs and acceptance of health status. Bivariate analyses were performed to evaluate differences between groups in terms of the primary and secondary outcomes. A multivariate linear regression analysis was performed to identify predictor variables of the primary outcome, and effect size calculations were used to differentiate statistical significance versus clinical relevance. There were no differences in demographic or pertinent characteristics of participants in the 2 groups. Participants who received the intervention achieved a higher mean coping process scores: 3.90 vs 3.19, P = .002 and Cohen d = 0.97. In addition, intervention group participants achieved a higher mean efficacy for the secondary outcomes: 3.78 versus 2.97 (P = .0004) and Cohen d = 1.11 for health beliefs, and 3.68 versus 2.83 (P = .0001) and Cohen d = 1.24 for acceptance of health status. Linear regression analysis indicated that the social interaction intervention (β= .799; P = .000) and undergoing urgent versus routine ostomy surgery (β=-.610; P = .005) were related to coping. Findings indicate that a visit with a trained person living with an ostomy facilitated coping and improved health beliefs and acceptance of health status.