Predicting life with a permanent end colostomy: A prospective study on function, bother and acceptance. (12th August 2021)

• Record Type: Journal Article
• Authors: Sandberg, Sofia; Asplund, Dan; Bock, David; Ehrencrona, Carolina; Ohlsson, Björn; Park, Jennifer; Rosenberg, Jacob; Smedh, Kenneth; Walming, Sofie; Angenete, Eva
• Is Part Of: Colorectal disease. Volume 23:Number 10(2021)
• Page Start: 2681
• Page End: 2689
• Publication Date: 2021-08-12
• Subjects: cancer -- colorectal -- functional -- surgery; Colon (Anatomy) -- Diseases -- Periodicals; Rectum -- Diseases -- Periodicals; 616.34
• DOI: 10.1111/codi.15842
• Languages: English
• ISSNs: 1462-8910

Abstract

Abstract: Aim: The factors that influence a patient's experience of a colostomy are not known. The aim of this study was to characterise stoma function, stoma‐related bother and acceptance among patients operated for rectal cancer and to investigate if there were any preoperative personal factors with predictive impact on long‐term stoma‐related bother. Methods: The QoLiRECT (Quality of Life in RECTal cancer) study is a prospective multicentre study of patients with rectal cancer. This was a subgroup analysis of patients with a permanent colostomy with a 2‐year follow‐up. Penalised regression models with shrinkage estimation were used to predict the 1‐and 2‐year bother using baseline data. The predictive value and the importance of the included variables were evaluated using bootstrap resampling techniques. Results: A total of 379 patients were included. Overall stoma acceptance was high and a majority of patients were not bothered by their stoma; 77% and 83% at 1 and 2 years, respectively. The subgroup of patients with stoma‐related bother had a high prevalence of difficulties, especially fear of leakage, and a low stoma acceptance in daily life. Both clinical and personal factors were associated with stoma‐related bother. The most important factors were quality of life and physical health, but the prediction accuracy was low. Conclusions: Stoma‐related bother was associated with overall stoma dysfunction. As stoma‐related bother is a multifactorial problem, it was not possible to predict which patients will experience stoma‐related bother. It is therefore of importance to prevent stoma‐related symptoms and optimise stoma function to reduce long‐term bother and increase stoma acceptance.