PSYCHOLOGICAL ADJUSTMENT AND RELATED FACTORS IN PATIENTS WITH OSTOMY

Abstract

Background: Ostomy has become a common therapy for treating gastrointestinal diseases such as colorectal cancer. Patients with ostomy experience many problems including appearance change, uncontrolled discharge and odour, sexual dysfunction, decreased social functioning, and difficulties taking care of themselves. Because of these problems, many patients with ostomies feel anxious, unconfident and afraid to participate in social activities. However, previous studies investigating psychological adjustment in patients with ostomies are scarce. Objectives: This study aimed to survey the level of psychological adjustment and to determine factors associated with the level of psychological adjustment in patients with ostomies. Materials and Method: A descriptive cross-sectional study was conducted on 77 patients with ostomies at Can Tho University of Medicine and Pharmacy Hospital. The Ostomy Adjustment Inventory-23 (OAI-23) scale was used to interview patients. Results: 61% of patients were male; the mean age of patients was 59.2 ± 14.3 years old, the majority of the Kinh ethnic group (96.1%); 50.6% of participants had a secondary or high school level and 43% of patients had a permanent ostomy. The psychological adjustment score was 40.4 ± 9.8 with 52% of patients assigned to a moderate level of psychological adjustment and 48% assigned to a low level of psychological adjustment. There was a relationship between psychological adjustment and gender (p=0.0001), duration of ostomy (p=0.003) and complication (p<0.001). Patients who received all support related to ostomy care had a higher level of psychological adjustment (p=0.0004). There were no significant differences in psychological adjustment scores among patients with different age groups, residences, ethnicities, marital statuses, education levels, economic statuses, type of surgery, and comorbidities. Conclusions: Patients with ostomy had a moderate level of psychological adjustment. The results indicated a need for supporting programs for patients with ostomies so that they can have better mental health. This can help patients to have optimal treatment and quality of life.