Quality of life of people with intestinal stomas

Silva, Cynthia Roberta Dias Torres; Andrade, Elaine Maria Leite Rangel; Luz, Maria Helena Barros Araújo; Andrade, Jesusmar Ximenes; Silva, Grazielle Roberta Freitas da

doi:10.1590/1982-0194201700023

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Original Article • Acta Paul Enferm. 30 (2) • Mar-Apr 2017 • https://doi.org/10.1590/1982-0194201700023 linkcopy

Quality of life of people with intestinal stomas

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objectives To evaluate the quality of life of people with intestinal stomas and verify its association with sociodemographic and clinical characteristics.

Methods A cross-sectional descriptive study was carried out with 96 people registered in an ostomy program, with the use of the City of Hope-Quality of Life-Ostomy Questionnaire.

Results The mean score of total QoL in this study was 6.2± 2.8. The highest mean score was found in the spiritual well-being dimension 7.5 (±1.9) and the lowest in the social well-being dimension 5.6 (±2.1). Sociodemographic characteristics (per capita income, education level, religion) and clinical characteristics (length of use and adaptation to the stoma, length of time needed for ostomized people to feel comfortable, difficulty with self-care, and limitation to perform activities of daily living) were associated with total quality of life and its dimensions (p <0.05).

Conclusion Intestinal stomas interfere with quality of life, especially in physical and social dimensions.

Ostomy; Quality of life; Colorectal neoplasms; Self care

Variables	n(%)	Standard Deviation
Gender
Male	51(53.1)
Female	45(46.9)
Age (years)		59.7(18.6)
Marital status
Married/stable union	46(47.9)
Single	23(24.0)
Widowed	17(17.7)
Divorced	10(10.4)
Religion
Catholic	79(83.2)
Evangelic	12(12.6)
None	4(4.2)
Education level
Elementary school	37(38.5)
High school	26(27.1)
Illiterate	21(21.9)
Higher education	12(12.5)
Monthly household income (R$)		1,789.9(2,036.2)
Per capita income (R$)		582.2(679.2)

Variables	Physical well-being	Psychological well-being	Social well-being	Spiritual well-being	Total quality of life
Gender
Male (SD)	5.73(1.91)	6.33(2.09)	5.77(2.05)	7.16(2.07)	6.16(1.78)
Female (SD)	5.96(2.03)	6.09(2.00)	5.41(2.12)	7.93(1.61)	6.17(1.59)
Test (p-value)	0.560¹(0.577)	-0.586¹(0.559)	-0.836¹(0.405)	918.5²(0.092)	0.028¹(0.978)
Age (years)
Test (p-value)	0.082⁵(0.425)	0.121⁵(0.241)	0.124⁵(0.230)	0.042⁵(0.685)	0.141⁵(0.169)
Marital status
Married (SD)	5.79(2.08)	6.37(2.10)	5.50(2.26)	7.70(1.82)	6.19(1.81)
Single (SD)	5.87(20.3)	6.14(1.94)	5.35(1.91)	7.45(1.93)	6.06(1.53)
Widowed (SD)	5.98(1.73)	5.80(2.18)	6.26(1.68)	7.26(1.94)	6.21(1.63)
Divorced (SD)	5.76(1.83)	6.42(1.96)	5.47(2.44)	7.30(2.24)	6.13(1.72)
Test (p-value)	0.048³(0.986)	0.353³(0.787)	0.720³(0.542)	0.804⁴(0.849)	0.037³(0.990)
Lives with other people at home
Yes (SD)	5.79(2.01)	6.22(2.09)	5.66(2.12)	7.55(1.90)	6.17(1.74)
No (SD)	6.44(1.16)	6.23(1.62)	4.99(1.67)	7.16(1.90)	6.09(0.81)
Test (p-value)	-0.909¹(0.366)	0.016¹(0.987)	0.866¹(0.389)	285.000²(0.374)	0.229¹(0.822)
Religion
Catholic (SD)	5.86(1.97)	6.21(1.99)	5.66(2.11)	7.62(1.89)	6.20(1.67)
Evangelic (SD)	5.93(1.71)	6.06(2.09)	5.15(1.78)	7.82(1.12)	6.06(1.52)
None (SD)	5.09(2.95)	6.35(3.42)	5.42(2.81)	4.43(1.60)	5.45(2.65)
Test (p-value)	0.302³(0.740)	0.038³(0.963)	0.313³(0.732)	7.281⁴(0.026)*	0.382³(0.683)
Education level
Illiterate (SD)	5.36(1.85)	5.39(1.83)	4.92(1.49)	6.50(1.75)	5.43(1.34)
Elementary school (SD)	5.48(1.91)	6.03(2.09)	5.51(2.11)	7.45(1.96)	5.97(1.71)
High school (SD)	6.68(2.14)	7.01(2.02)	6.04(2.22)	8.24(1.40)	6.86(1.69)
Higher education (SD)	5.93(1.42)	6.52(1.86)	6.11(2.45)	7.99(2.22)	6.50(1.63)
Test (p-value)	2.590³(0.058)	2.795³(0.045)*	1.415³(0.243)	12.735⁴(0.005)*	3.334³(0.023)*
Monthly household income (R$)
Test (p-value)	0.083⁵(0.422)	0.142⁵(0.168)	0.122⁵(0.236)	0.156⁵(0.130)	0.154⁵(0.133)
Per capita income (R$)
Test (p-value)	0.242⁵(0.018)*	0.318⁵(0.002)*	0.267⁵(0.008)*	0.234⁵(0.022)*	0.332⁵(0.001)*

Variables	Physical well-being	Psychological well-being	Social well-being	Spiritual well-being	Total quality of life
Type of stoma
Colostomy (SD)	5.90(1.91)	6.26(1.98)	5.66(2.12)	7.41(1.87)	6.19(1.66)
Ileostomy (SD)	5.57(2.36)	6.30(2.35)	5.51(1.75)	8.45(1.14)	6.24(1.77)
Colostomy/ Ileostomy (SD)	4.82(0.90)	4.00(2.28)	3.83(2.83)	6.14(5.45)	4.51(2.60)
Test (p-value)	1.115⁴(0.573)	2.065⁴(0.356)	1.498⁴(0.473)	2.690⁴(0.261)	1.221⁴(0.443)
Length of stoma
Temporary (SD)	5.43(1.82)	5.74(1.93)	5.25(2.02)	7.34(1.89)	5.78(1.57)
Permanent (SD)	6.38(1.97)	6.81(1.91)	6.03(2.07)	7.88(1.77)	6.66(1.60)
Test (p-value)	-2.410¹(0.018)*	-2.657¹(0.009)*	-1.839¹(0.069)	854.500²(0.119)	-2.641¹(0.010)*
Complication with the stoma
No (SD)	6.00(2.16)	6.24(1.69)	5.20(2.04)	6.83(1.66)	5.98(1.56)
Yes SD)	5.82(1.95)	6.22(2.09)	5.65(2.09)	7.60(1.91)	6.18(1.70)
Test (p-value)	0.272¹(0.786)	0.031¹(0.976)	-0.641¹(0.523)	305.500²(0.135)	-0.352¹(0.726)
Complication with peristomal skin
No (SD)	0.22(1.86)	0.24(2.00)	0.25(2.11)	0.21(1.78)	0.20(1.65)
Yes (SD)	0.42(2.19)	0.41(2.13)	0.37(1.96)	0.41(2.13)	0.33(1.72)
Test (p-value)	-0.741¹(0.461)	-1.286¹(0.202)	-1.486¹(0.141)	771.500²(0.192)	-1.467¹(0.146)
Adaptation to the stoma
Excellent (SD)	7.00(2.04)	7.73(1.83)	6.31(2.44)	8.57(2.12)	7.31(1.77)
Good (SD)	6.50(1.83)	7.20(1.80)	6.43(2.03)	7.90(1.84)	6.92(1.52)
Regular (SD)	5.43(2.05)	5.48(1.97)	5.07(1.57)	7.63(1.33)	5.70(1.37)
Poor (SD)	5.13(1.61)	5.13(1.46)	4.94(1.76)	6.71(1.94)	5.33(1.29)
Very poor (SD)	5.31(2.05)	5.60(2.15)	4.91(2.29)	7.26(2.12)	5.61(1.68)
Test (p-value)	2.798³(0.031)*	6.086³(0.000)*	3.142³(0.018)*	8.384⁴(0.078)	5.069⁴(0.001)*
Length of time ostomized (months)
Test (p-value)	0.191⁵(0.063)	0.247⁵(0.015)*	0.198⁵(0.054)	0.136⁵(0.186)	0.228⁵(0.025)*
Length of time needed to feel comfortable with the stoma (days)
Test (p-value)	-0.301⁵(0.005)*	-0.261⁵(0.016)*	-0.265⁵(0.015)*	-0.171⁵(0.120)	-0.310⁵(0.004)*
Difficulty with self-care
No (SD)	6.31(1.84)	6.71(1.73)	6.04(2.01)	7.68(1.71)	6.58(1.45)
Yes (SD)	4.85(1.85)	5.19(2.28)	4.68(1.95)	7.18(2.23)	5.28(1.82)
Test (p-value)	-3.632¹(0.000)*	-3.624¹(0.000)*	-3.136¹(0.002)*	886.000²(0.341)	-3.767¹(0.000)*
Limitation to perform activities of daily living
No (SD)	6.54(1.92)	6.82(1.95)	6.34(2.04)	7.63(1.84)	6.75(1.56)
Yes (SD)	5.13(1.75)	5.62(1.98)	4.86(1.87)	7.42(1.96)	5.57(1.61)
Test (p-value)	-3.767¹(0.000)*	-2.990¹(0.004)*	-3.685(0.000)*	1078.000²(0.587)	-3.610¹(0.000)*

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[TFN1001] (SD): mean (standard deviation); ¹Student’s t-test; ²Mann-Whitney; ³ANOVA; ⁴Kruskall-Wallis; ⁵Spearmann’s correlation coefficient; *Value of p<0.05