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