do we have a clear / true picture of what is going on in our patients lives? amanda smith member of...

Do we have a clear / true picture of what is going on in our patients

lives?

Amanda SmithMember of the Ostomy Forum

group

Heard from the patients :

• I don’t feel normal• I am never totally naked• It is like being a child again• I have to rely on a bag• I am always worried• Everybody will know• I hate it!

Revised Follow-up form

Revised Follow-up form

Revised Follow-up form

Revised Follow-up form

Problems experienced after stoma surgery

Stoma observations

Incidence of patients reporting peristomal skin complications.

Case study 1

Intervention

• Advice and support from ET• Reassessment of appliances• Sucralfate powder

Case study 2

1st clinic appointment =3/08/06

Intervention

• Tacrolimus 0.3% in orabase paste underneath steroid impregnated tape.

• Advice and support from local ET• Reassesment of appliances

2nd clinic appointment=17/08/06

3rd clinic appointment =29/09/06

Pain 6 months post surgery

Output

ProblematicOutput

ProblematicStoma

ProblematicSkin

1-2 weeks

Colo 1.27 1.20 3.84

Ileo 1.00 0.89 0.39

3-6 weeks

Colo 3.25 1.27 2.07

Ileo 1.82 0.56 1.25

7-12 weeks

Colo 2.32 0.92 0.82

Ileo 3.18 0.69 0.55

13-26 weeks

Colo 1.57 1.74 1.89

Ileo 3.67 2.71 1.88

The odds of psychological problems when patient has problematic output, a problematic stoma, or problematic skin, as compared to non-problematic.

Conclusion

• Long term access to an ET nurse. • Ongoing input and support is needed.• 40 % fail to maintain their progression to normal

status.• Patients take longer to adjust to the psychological,

sexual and social aspects of life with a stoma.• Advanced counselling and listening skills are needed.• Evidence based practice. • The forms allow movement of patients and records

between different hospitals and countries• Easy to use forms