Untreated Peristomal Skin Complications Among Long-term Colorectal Cancer Survivors with Ostomies

Overview

Journal Clin J Oncol Nurs

Specialties Nursing
Oncology

Date 2011 Nov 29

PMID 22119975

Citations 14

Authors

Carmit K McMullen

Joseph Wasserman

Andrea Altschuler

Marcia L Grant

Mark C Hornbrook

Petra Liljestrand

Catherine Briggs

Robert S Krouse

Affiliations

Soon will be listed here.

Abstract

This ethnography of family caregiving explored why peristomal skin complications are common and undertreated among colorectal cancer survivors with intestinal ostomies. Data were collected through in-depth interviews with 31 cancer survivors and their family caregivers, fieldwork, structured assessments, and medical records review, and analyzed with qualitative theme and matrix analyses. Survivors who received help changing the skin barrier around their stoma had fewer obstacles to detection and treatment of peristomal skin complications. Half of the survivors received unpaid help with ostomy care, and all such help came from spouses. Married couples who collaborated in ostomy care reported that having assistance in placing the ostomy appliance helped with preventing leaks, detecting skin changes, and modifying ostomy care routines. In addition, survivors who struggled to manage ostomy care independently reported more obstacles to alleviating and seeking treatment for skin problems. Oncology nurses can improve treatment of peristomal skin problems by asking patients and caregivers about ostomy care and skin problems, examining the peristomal area, and facilitating routine checkups with a wound, ostomy, and continence nurse.

Citing Articles

Factors associated with leakage in patients with an ostomy: A cross-sectional study.

Indrebo K, Aasprang A, Olsen T, Andersen J Nurs Open. 2023; 10(6):3635-3645.

PMID: 36691880 PMC: 10170928. DOI: 10.1002/nop2.1612.

Experiences and Perceptions in Dyads about Ostomy Care. Meta-synthesis of Qualitative Studies.

Quemba Mesa M, Diaz Fernandez J, Vargas Rodriguez L, Bautista Plazas L, Pulido Barragan S Invest Educ Enferm. 2022; 40(2).

PMID: 36264700 PMC: 9714989. DOI: 10.17533/udea.iee.v40n2e12.

Patient-reported outcomes and experiences from the perspective of colorectal cancer survivors: meta-synthesis of qualitative studies.

Rutherford C, Muller F, Faiz N, King M, White K J Patient Rep Outcomes. 2020; 4(1):27.

PMID: 32335745 PMC: 7183519. DOI: 10.1186/s41687-020-00195-9.

Cancer survivors' challenges with ostomy appliances and self-management: a qualitative analysis.

Sun V, Bojorquez O, Grant M, Wendel C, Weinstein R, Krouse R Support Care Cancer. 2019; 28(4):1551-1554.

PMID: 31720825 DOI: 10.1007/s00520-019-05156-7.

Designing for impact: identifying stakeholder-driven interventions to support recovery after major cancer surgery.

McMullen C, Nielsen M, Firemark A, Price P, Nakatani D, Tuthill J Support Care Cancer. 2018; 26(12):4067-4076.

PMID: 29876832 PMC: 6682403. DOI: 10.1007/s00520-018-4276-0.

References

Lawton M, Moss M, KLEBAN M, Glicksman A, Rovine M . A two-factor model of caregiving appraisal and psychological well-being. J Gerontol. 1991; 46(4):P181-9. DOI: 10.1093/geronj/46.4.p181. View

Mendes de Leon C, Gold D, Glass T, Kaplan L, George L . Disability as a function of social networks and support in elderly African Americans and Whites: the Duke EPESE 1986--1992. J Gerontol B Psychol Sci Soc Sci. 2001; 56(3):S179-90. DOI: 10.1093/geronb/56.3.s179. View

Maddams J, Brewster D, Gavin A, Steward J, Elliott J, Utley M . Cancer prevalence in the United Kingdom: estimates for 2008. Br J Cancer. 2009; 101(3):541-7. PMC: 2720244. DOI: 10.1038/sj.bjc.6605148. View

Ricciardi R, Roberts P, Read T, Baxter N, Marcello P, Schoetz D . Presence of specialty surgeons reduces the likelihood of colostomy after proctectomy for rectal cancer. Dis Colon Rectum. 2011; 54(2):207-13. DOI: 10.1007/DCR.0b013e3181fb8903. View

Richbourg L, Thorpe J, Rapp C . Difficulties experienced by the ostomate after hospital discharge. J Wound Ostomy Continence Nurs. 2007; 34(1):70-9. DOI: 10.1097/00152192-200701000-00011. View

Bober S, Recklitis C, Campbell E, Park E, Kutner J, Najita J . Caring for cancer survivors: a survey of primary care physicians. Cancer. 2009; 115(18 Suppl):4409-18. DOI: 10.1002/cncr.24590. View

Pittman J, Rawl S, Schmidt C, Grant M, Ko C, Wendel C . Demographic and clinical factors related to ostomy complications and quality of life in veterans with an ostomy. J Wound Ostomy Continence Nurs. 2008; 35(5):493-503. DOI: 10.1097/01.WON.0000335961.68113.cb. View

Londono-Schimmer E, Leong A, Phillips R . Life table analysis of stomal complications following colostomy. Dis Colon Rectum. 1994; 37(9):916-20. DOI: 10.1007/BF02052598. View

Leong A, Londono-Schimmer E, Phillips R . Life-table analysis of stomal complications following ileostomy. Br J Surg. 1994; 81(5):727-9. DOI: 10.1002/bjs.1800810536. View

10.

Izal M, Montorio I, Marquez M, Losada A . Caregivers' expectations and care receivers' competence Lawton's ecological model of adaptation and aging revisited. Arch Gerontol Geriatr. 2005; 41(2):129-40. DOI: 10.1016/j.archger.2005.01.001. View

11.

Nybaek H, Knudsen D, Laursen T, Karlsmark T, Jemec G . Quality of life assessment among patients with peristomal skin disease. Eur J Gastroenterol Hepatol. 2009; 22(2):139-43. DOI: 10.1097/MEG.0b013e32832ca054. View

12.

Salvadalena G . Incidence of complications of the stoma and peristomal skin among individuals with colostomy, ileostomy, and urostomy: a systematic review. J Wound Ostomy Continence Nurs. 2008; 35(6):596-607. DOI: 10.1097/01.WON.0000341473.86932.89. View

13.

Lawton M, Brody E . The relationships of environmental factors to changes in well-being. Gerontologist. 1978; 18(2):133-7. DOI: 10.1093/geront/18.2.133. View

14.

Brown M, Stetz K . The labor of caregiving: a theoretical model of caregiving during potentially fatal illness. Qual Health Res. 1999; 9(2):182-97. DOI: 10.1177/104973299129121776. View

15.

Forman D, Stockton D, Moller H, Quinn M, Babb P, De Angelis R . Cancer prevalence in the UK: results from the EUROPREVAL study. Ann Oncol. 2003; 14(4):648-54. DOI: 10.1093/annonc/mdg169. View

16.

Herlufsen P, Olsen A, Carlsen B, Nybaek H, Karlsmark T, Laursen T . Study of peristomal skin disorders in patients with permanent stomas. Br J Nurs. 2006; 15(16):854-62. DOI: 10.12968/bjon.2006.15.16.21848. View

17.

Lyon C, Smith A, Griffiths C, Beck M . The spectrum of skin disorders in abdominal stoma patients. Br J Dermatol. 2000; 143(6):1248-60. DOI: 10.1046/j.1365-2133.2000.03896.x. View

18.

Putnam M . Linking aging theory and disability models: increasing the potential to explore aging with physical impairment. Gerontologist. 2002; 42(6):799-806. DOI: 10.1093/geront/42.6.799. View

19.

Hellman J, Lago C . Dermatologic complications in colostomy and ileostomy patients. Int J Dermatol. 1990; 29(2):129-33. DOI: 10.1111/j.1365-4362.1990.tb04085.x. View

20.

Thomas C, Morris S . Informal carers in cancer contexts. Eur J Cancer Care (Engl). 2002; 11(3):178-82. DOI: 10.1046/j.1365-2354.2002.00336.x. View