Stoma Care Research Articles

An 89-year-old gentleman presented to the dermatology clinic with a progressively worsening ulcerated lesion around his peristomal site. He had a long-standing ileal conduit in place for 11 years, and initially, a mild erythematous rash developed around the stoma site. Over the course of a few months, the area became increasingly painful, irritated, and tender. Despite conservative management, including proper stoma care and the use of topical barrier creams and topical steroids, the lesion failed to improve.

Intestinal stoma formation in neonates with severe gastrointestinal diseases or congenital malformations remains a critical and challenging issue in neonatology. Postoperatively, preventing associated complications-such as high enteric stoma losses, electrolyte imbalances, malabsorption syndrome, cholestasis, and small intestinal bacterial overgrowth — is equally urgent. Effective neonatal resuscitation with intensive stabilization, comprehensive monitoring, homeostasis correction, and infection control is essential. Early initiation of enteral nutrition (starting with trophic feeds and gradually advancing based on the preserved bowel’s capacity) alongside parenteral support is crucial post-surgery. Breast milk provision and maternal involvement in stoma care are vital components. The ultimate goal of management is to prepare the infant for definitive reconstructive surgery.

To explore how, why and under what circumstances transitional care can be normalised as a routine care practice for adult patients with enterostomy after discharge from hospitals. Realist review. This review was conducted in three iterative phases: (1) constructing an initial programme theory to identify the scope of the study; (2) retrieving and evaluating the evidence, extracting data and integrating the evidence; and (3) analysing and integrating the evidence to refine the programme theory. Five bibliographic databases and the grey literature were searched from 1947 to 2024 to identify the studies of two core concepts: enterostomy and transitional care. A total of 36 papers were included, identifying nine context-mechanism-outcome configurations that explain how, why and under what circumstances transitional care can be normalised as routine care for adult patients with enterostomy after discharge: (1) Responsibilities of individual roles; (2) Interdisciplinary team collaboration; (3) Support from upper management; (4) Communication and interaction; (5) Multiple linkage; (6) Professional training; (7) External support and policy formulation; (8) Personalised measures; and (9) Evaluation and feedback. The normalised implementation of transitional care is essential to help enterostomal patients better adapt to stoma life and improve their quality of life. An effective transitional care model not only relies on the support of professional caregivers, but requires the close cooperation of patients, family members, communities and healthcare organisations. Reporting was adhered to the RAMESES publication standards: realist syntheses. Patients and members of the public were involved in study design. Their contributions were participating in advisory groups, ensuring the research was addressed. This study provides theoretical guidance for clinical stoma transitional care, translating the research findings into routine healthcare practices, constantly optimising and improving the stoma care system, and offering patients higher-quality and more efficient services. This research, through the realist review approach in combination with the Normalisation Process Theory (NPT) and the Consolidated Framework for Implementation Research (CFIR), systematically elucidates for the first time how, why and under what circumstances transitional care can be regularised as a routine post-discharge care measure for adult enterostomy patients. The research findings will: Improve the quality of life of patients: Through personalised care plans and multidisciplinary team cooperation, help patients better adapt to life with an ostomy, reduce complications and improve self-management ability. Optimise clinical practice: Provide theoretical guidance for medical staff, promote the regular implementation of transitional care and improve the quality and efficiency of care. Promote education and training: Emphasise the importance of professional training and communication skills, and provide new ideas for nursing education. Support policy formulation: Call on the government and medical institutions to improve relevant policies, provide more resources and support and promote the rational allocation of medical resources.

BackgroundStoma formation for inflammatory bowel disease, cancer or trauma can adversely affect sexual function and overall sexual wellbeing. There is a recognised unmet need to address patients' concerns within clinical practice. This study aimed to identify patient‐reported sexual wellbeing concerns, explore experiences of discussing these issues within clinical settings and determine patients' priorities regarding their sexual wellbeing needs.MethodsAn international, web‐based cross‐sectional survey was disseminated via social media across English‐speaking countries, in collaboration with local ostomy and inflammatory bowel disease charities.ResultsA total of 370 participants completed the anonymous survey between March 2023 and March 2024. Over 61% reported ongoing concerns related to sexual wellbeing, while 68% had not received any information regarding the potential impact of a stoma on their sexual life. Despite this, 89% expressed a desire for such information. When information was provided, surgeons were the most frequently reported source.Primary concerns identified were body image (32%), appliance‐related issues (29.7%), difficulties in intimate relationships (28.1%) and reduced self‐confidence (9.9%). Over half of respondents preferred that all health professionals address sexual wellbeing as a routine part of care. Participants also recommended a variety of information resources. Age and time since stoma formation were significantly associated with the extent of concerns (p < 0.05).ConclusionsSexual wellbeing concerns following stoma formation are common and frequently unmet. The lack of information provision contributes to patient distress. The routine integration of sexual wellbeing discussions, supported by accessible and diverse resources, is essential to delivering holistic, patient‐centred stoma care.

The "National Cancer Patient Home-Care Pilot Program" was launched in South Korea to provide continuous management for cancer patients with a stoma. However, participation by medical institutions was low, and services were inconsistently provided. We investigated nurses' satisfaction with and demand for the pilot program for home care of cancer patients with a stoma. Data were collected through a survey administered to 196 nurses from November 13, 2022, to January 19, 2023. The questionnaire gathered information on the respondents' characteristics, the status of stoma patient management, their satisfaction with the program, and their needs. Of the 196 nurses surveyed, 42 (21.4%) participated in the home-care pilot program. Among them, 35 nurses (85.4%) were satisfied with the program, and 30 nurses (71.4%) reported that home care implementation needed to be expanded and standards of care improved. To enhance the home-care pilot program for cancer patients with a stoma, better medical services must be provided by improving the medical fee standard. This will enable more patients and medical institutions to participate in the program.

Many people living with a stoma face challenges beyond their physical needs. Although stoma care products and services have advanced, significant gaps persist in national policies and equitable access. Current policies appear to prioritise cost savings over the wellbeing of people living with a stoma, not appreciating the expertise of specialist stoma care nurses (SSCNs) and the experience of people living with a stoma. The absence of an established, evidence-based treatment pathway in stoma care and the lack of standardised practices leave many people susceptible to inconsistent care and unmet needs. The authors call for a shift in focus to empower SSCNs to advocate nationally for people living with a stoma and to challenge inconsistent, inequitable practices. The authors highlight an urgent need to establish and implement a nationwide, long-term, evidence-based treatment pathway that provides a standardised approach with ongoing monitoring to deliver optimum, personalised care for people living with a stoma.

Sex and intimacy are generally considered to be vital to an individual's psychological wellbeing. As such, anything that affects a person's ability to engage in sex and intimacy has the potential to significantly impact their mental health. It is well known that stoma-forming surgery can leave ostomates with body-image issues and a profound feeling of lack of control over their body. Subsequently, this can lead to ostomates avoiding sex and intimacy. Despite the well-documented link between sex and psychological wellbeing, many stoma care nurses may, understandably, be uncomfortable discussing sex with their patients. However, there are several tools that can help the nurse facilitate these conversations, allowing them to better support their patients. In addition, stoma care nurses can support ostomates by raising awareness of sexual dysfunction, encouraging open communication, and discussing the use of support garments.

A brief overview of recently published articles on gastroenterology, hepatology and stoma care

Aim: To critically examine the evolving clinical role of ostomy seals in supporting peristomal skin health and to define key performance attributes aligned with evidence-based stoma care. Background: Ostomy seals are often perceived as additional accessories. However, advances in material science and clinical understanding have re-defined their role as essential components in maintaining peristomal integrity and improving patient outcomes. Discussion: This article explores the functional and clinical expectations of modern ostomy seals, including moisture management, adhesion, mouldability and compatibility. It critiques the influence of added ingredients and calls for a return to core performance metrics. Skin protection, wear-time, ease of application and consistency are highlighted as critical domains for clinical decision-making. The importance of nurse confidence in product selection and outcomes is also discussed. Conclusion: Modern ostomy seals should be regarded as active clinical tools, not passive barriers. When selected intentionally, based on clinical reasoning, seals can enhance skin protection, reduce complications and reinforce nurse-led, patient-centred care.

The focus on late complications after colorectal surgery has increased in the last decade, including the difficulty of surgical and non-surgical management of parastomal bulging. Parastomal bulging is the most significant complication of a stoma, affecting half of ostomy patients in the long term and negatively impacting on quality of life. Stoma care nurses mainly manage a parastomal bulge, although most stoma care nurses find treatment complex and symptoms related to the bulge difficult to handle. Evidence-based guidelines and a structured approach to the many symptoms patients present are limited. Thus, this paper aimed to describe the development of a complex nursing intervention program for the management of parastomal bulges. The study was based on the Medical Research Council (MRC) framework for Complex Interventions. To strengthen the clinical applicability and relevance of the program, Bleijenberg's approach was integrated into the MRC framework. The program development followed three phases outlined by the MRC framework: 1) identifying the evidence base, 2) developing theory and 3) modelling process and outcomes. The intervention was designed for stoma care nurses working in hospital ostomy clinics. The intervention was developed through an iterative process over 12 months and comprised a Scoping review, workshops and a Consensus Conference. Feedback from clinical experts was integrated throughout the development process. The program, named Parastomal Bulging Intervention (PBI) - a nurse-led intervention for identifying, assessing and managing symptoms in patients with parastomal bulge, consisted of three components: A) Systematic approach to the nursing consultation, B) Symptom-specific nursing treatment algorithms and C) Supplemental information and guidance. The MRC framework was successfully applied to develop a program for complex nursing interventions for patients with a parastomal bulge. By incorporating elements from Bleijenberg during the development phase, we ensured that the needs of recipients and providers were addressed, thereby enhancing the program's suitability for clinical practice. The feasibility and acceptability of the PBI will be tested in future studies. Not applicable.

Multifocal intestinal obstruction (IO) due to peritoneal metastases (PM) presents significant surgical challenges, with traditional approaches often falling short. The Clover stoma, a four-lumen technique, combines a loop ileostomy and transverse loop colostomy into a single stoma, decompressing both small and large bowel while minimizing complications. In six patients with multifocal IO, it effectively relieved symptoms, prolonged obstruction-free intervals, and prevented re-obstructions. This technique simplifies stoma care, improves postoperative recovery, and can be adapted as disease progresses. The Clover stoma offers a promising strategy for managing complex IO in PM patients, enhancing surgical outcomes and quality of life in this challenging population.

A 69-year-old man with a history of subtotal colectomy and ileostomy developed asymptomatic pericolostomy nodular lesions, which improved significantly after specialized stoma care.

The effect of sexual counseling based on the Ex-PLISSIT model on sexual quality of life and sexual satisfaction in women with stoma: a randomized controlled trial.

General practice nurses may encounter patients who are living with a stoma when undertaking primary care nursing activities, such as vaccinations or general health consultations. Living with a stoma requires a degree of lifestyle modifications, such as those relating to dietary intake, as well as stoma appliance care. It is important that practice nurses understand the common issues that people living with a stoma may report when accessing primary care, such as peristomal skin damage. Practice nurses are not expected to manage all stoma-related issues, but it is important to recognise when patients need a referral to a stoma care specialist, and be able to signpost them to other useful resources, such charity services.

ABSTRACTForeign body aspiration in tracheostomized patients is preventable. This novel case highlights the aspiration of a spectacle handle during stoma care—an unreported hazard from repurposing nonmedical tools. Proactive education on sterile techniques and avoiding household items is critical. Flexible bronchoscopy proved effective despite altered anatomy postlaryngectomy.

To investigate the impact of nurses' occupational fatigue and exhaustion levels on their self-efficacy in managing pressure injuries. A descriptive cross-sectional study. The data were collected from 682 nurses employed at three institutions from May 15 to July 31, 2023. Occupational fatigue and exhaustion were assessed using the OFER scale, while self-efficacy in pressure injury (PI) management was evaluated using the PUM-SES. Correlation and multiple linear regression methods were used for data analysis. The STROBE checklist was used in the study. The study included 682 nurses, 85.3% female. The average age was 29.99 years, with a mean work experience of 7.52 years. Most participants (70.7%) worked in public training and research hospitals, with 327 nurses working mixed day-night shifts and 358 nurses managing 1-5 patients per shift. Fatigue levels, measured using the OFER, showed a mean score of 67.54 (22.89) for chronic fatigue. Self-efficacy in pressure ulcer management, assessed using the PUMSES, had a mean score of 48.39 (24.87). Higher PUMSES scores were found among nurses with certification in stoma and wound care (p < 0.001) and those who had attended relevant training (p < 0.001). Significant correlations were identified between OFER recovery scores, professional characteristics and PUMSES scores. This study revealed that nurses experience moderate-to-high levels of occupational fatigue and low levels of self-efficacy in PI management. Although no significant relationship was found between fatigue and self-efficacy, occupational factors such as poor sleep quality, long working hours and irregular shift patterns were associated with increased fatigue. In contrast, higher educational attainment, greater knowledge about PI and participation in professional training significantly enhanced nurses' self-efficacy in PI management. This study offers some early data on the possible role of occupational fatigue and PI preventive practices.

To evaluate the state anxiety levels and concerns expressed by patients with a stoma at hospital discharge and identify predictors. The investigators recruited 136 patients with a stoma who were discharged from the hospital between March and December 2021. Participants completed the demographic questionnaire, the State-Trait Anxiety Inventory state anxiety subscale (STAI-S), and questions about stoma-related concerns. Data were analyzed with descriptive statistics, independent-sample t test, and analysis of variance. Multiple regression analysis was conducted to identify the significant predictors of STAI-S score. The mean STAI-S score of all patients was 44.75 ± 9.53 at discharge, and approximately 84.5% consistently experienced stoma-related concerns. Stoma status, cause of stoma, marital status, stoma self-care ability, and patients' thoughts on stoma care self-efficacy were all significant predictors of anxiety levels. Patients' primary concerns at discharge related to the sufficiency of stoma care training, stool leakage, stoma bag puncture while sleeping, touching the stoma region, and the appearance of the stoma. Patients with a stoma experience moderate anxiety and significant concerns at discharge; if left unaddressed, patients may be prematurely discharged with high anxiety. Healthcare providers should pay attention to at-risk patients: those with permanent stomas, who have undergone colorectal cancer surgery, who are single, who believe their stoma care self-efficacy is insufficient, and who primarily rely on others for stoma care. Clinicians should assess anxiety levels and concerns of stoma patients before discharge and refer patients for psychological counseling as needed.

A brief overview of recently published articles on gastroenterology, hepatology and stoma care

Effective postoperative care is pivotal, and parents play a vital role in managing complications and outcomes. Despite their importance, parents often struggle with the complexities of stoma care. Managing pediatric stomas necessitates a collaborative effort between healthcare professionals and community support, forming a multidisciplinary team that empowers parents with the knowledge and confidence required for effective stoma management. This study assesses the impact of collaborative efforts between doctors and community support systems on children's quality of stoma care. A cross-sectional study involving 224 participants evaluated the influence of stoma support communities in Jakarta. The study used a validated 11-question questionnaire to measure community impact and stoma care knowledge. Spearman Correlation analysis indicated significant relationships between doctor-patient communication and factors such as the stoma's condition (r:0.285, p<0.001), knowledge (r:0.417, p<0.001), support in stoma care (r:0.458, p<0.001), self-confidence (r:0.440, p<0.001), support systems (r:0.407, p<0.001), and ease of access to care (r:0.357, p<0.001). Multivariate analysis highlighted that the quality of doctor-patient communication significantly affects stoma condition, support systems, self-confidence, and access to care (p<0.025). ROC prediction analysis showed that effective doctor-patient communication through Komunitas Stoma Pada Anak Jakarta (KOSPAJA) significantly enhances support and self-confidence in stoma care (A>0.70). The collaboration between doctors and community support significantly enhances parents' knowledge, confidence, and support in managing their child's stoma, leading to improved care quality and reduced complication rates.

A study to assess the effect of using one-piece versus two-piece ostomy appliances on self-maintenance of stoma care among cancer patients with ostomy in selected hospital of Kolkata, West Bengal