Association of sociodemographic and clinical factors with the self-image and self-esteem of individuals with intestinal stoma

Salomé, Geraldo Magela; Almeida, Sergio Aguinaldo de

doi:10.1016/j.jcol.2014.05.005

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Journal of Coloproctology (Rio de Janeiro)

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Original Article • J. Coloproctol. (Rio J.) 34 (3) • Jul-Sep 2014 • https://doi.org/10.1016/j.jcol.2014.05.005 copy

Association of sociodemographic and clinical factors with the self-image and self-esteem of individuals with intestinal stoma

Assoiação dos fatores sociodemográficos e clínicos à autoimagem e autoestima dos indivíduos com estoma intestinal

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective:

To evaluate the clinical and sociodemographic factors and correlate them to the self-image and self-esteem.

Methods:

A study conducted at Ostomy Pole of PousoAlegre. The data were collected between December 2012 and May 2013. This was a non-probabilistic, by convenience, sample. For data collection, the Rosenberg Self-Esteem Scale/UNIFESP-EPM and Body Investment Scale were used. For statistical analysis, chi-squared test, Kruskal-Wallis test and Spearman correlation were used. Levels of significance of 5% (p ≤ 0.05) were considered.

Results:

Participants had a mean score of 10.81 in the Rosenberg Self-Esteem Scale/UNIFESP. Regarding Body Investment Scale results, the mean total score was 38.79; the mean in the domain of body image was 7.74, and for personal touch, 21.31. When comparing data related to the stoma and sociodemographic profiles with the Rosenberg Self-Esteem Scale/UNIFESP and Body Investment Scale, we realize that all patients demonstrated a decrease in self-esteem and self-image. Individuals were over 60 years old, male, retired, married and were not participants in support group/association. With regard to the characteristics of the stoma, those permanent colostomized had as causes of stoma implementation inflammatory disease and neoplasia; stomata measured between 20 and 40 mm; these people used two-piece devices. People who have not been notified that would be subjected to the stoma and in whom no demarcation was done showed worsening in self-esteem and self-image in relation to other features related to injury and sociodemographic data.

Conclusion:

Patients who participated in this study had low self-image and self-esteem in all characteristics of the stoma and in sociodemographic data, meaning that these individuals had negative feelings about their own bodies.

Ostomy; Quality of life; Body image; Self-image; Self-esteem

Variable		P	N	% Overall	% Valid	% Cumulative
Gender
	Male	0.003	52	74.3	74.3	100.0
	Female		18	25.7	25.7	25.7
	Total		70	100.0	100.0
Age groups
	44–59 years		17	24.3	24.3	24.3
	60–67 years		18	25.7	25.7	50.0
	68–74 years	0.057	16	22.9	22.9	72.9
	75 to 85 years		19	27.1	27.1	100.0
	Total			70	100.0	100.0
Marital status
	Married		34	48.6	48.6	48.6
	Separated		14	20.0	20.0	68.6
	Widow(er)	0.035	22	31.4	31.4	100.0
	Total		70	100.0	100.0
Occupation
	Retired		50	71.4	73.5	73.5
	Unemployed		4	5.7	5.9	79.4
	At work		14	20.0	20.6	100.0
	Total	0.003		68	97.1	100.0
	No answer			2	2.9
	Total		70	100.0
Participation in support group/association
	Yes		38	54.3	54.3	54.3
	No	0.075	32	45.7	45.7	100.0
	Total			70	100.0	100.0
	Total		70	100.0	100.0

Variable		P	N	% Overall	% Valid	% Cumulative
Cause of ostomy
	Diverticulitis		3	4.3	4.3	4.3
	Inflammatory bowel disease		5	7.1	7.1	11.4
	Neoplasia	0.003	52	74.3	74.3	85.7
	Crohn's disease		10	14.3	14.3	100.0
	Total		70	100.0	100.0
Type of stoma
	Colostomy		54	77.1	77.1	77.1
	Ileostomy	0.007	16	22.9	22.9	100.0
	Total			70	100.0	100.0
Diameter of the stoma
	0 to 20 mm		10	14.3	14.3	14.3
	20 to 40 mm		34	48.6	48.6	62.9
	40 to 60 mm	0.056	23	32.9	32.9	95.7
	60 to 80 mm		3	4.3	4.3	100.0
	Total			70	100.0	100.0
Complication type
	Dermatitis	34	48.6	48.6	48.6	34
	Fistula	1	1.4	1.4	50.0	1
	Peristomal hernia	5	7.1	7.1	57.1	5
	Pseudo-verrucous	0.0023	1	1.4	1.4	58.6
	Allergic reaction to device		1	1.4	1.4	60.0
	Pseudo-verrucous injuries/dermatitis		1	1.4	1.4	61.4
	Retraction		14	20.0	20.0	81.4
	Prolapse		13	18.6	18.6	100.0
	Total		70	100.0	100.0
Demarcation was carried out
	Yes		17	24.3	24.3	24.3
	No	0.002	53	75.7	75.7	100.0
	Total			70	100.0	100.0
Device type
	Single System		22	31.4	31.4	31.4
	Two Parts	0.043	48	68.6	68.6	100.0
	Total		70	100.0	100.0
Makes irrigation
	Yes		26	37.1	37.1	37.1
	No	0.047	44	62.9	62.9	100.0
	Total			70	100.0	100.0
It was reported that you have a stoma
	Yes		48	68.6	68.6	68.6
	No	0.049	22	31.4	31.4	100.0
	Total			70	100.0	100.0
Stoma characteristic
	Temporary		18	25.7	25.7	25.7
	Definitive	0.003	52	74.3	74.3	100.0
	Total			70	100.0	100.0

Rosenberg Self-Esteem Scale/UNIFESP Dominium		Body Investment Scale Dominium				p-Value
Rosenberg Self-Esteem Scale/UNIFESP Dominium		Total score	Body image	Personal care	Personal touch	p-Value
Mean	10.81	38.79	7.74	21.31	10.19
Median	11.00	39.00	8.00	21.00	10.00	0.002
Mode	11	36	9	19	10
Standard Deviation	5.395	6.057	3.077	6.342	3.965

		Rosenberg Self-Esteem Scale/UNIFESP			Body Investment Scale			p-Value
		Mean	Median	Standard deviation	Mean	Median	Standard deviation	p-Value
Cause of stoma
	Diverticulitis	15.00	15.0	10.000	40.40	40.0	2.881	0.016
	Inflammatory disease	10.00	11.0	3.808	32.67	29.0	6.351
	Neoplasia	10.40	11.0	4.770	37.77	38.0	5.501
	Other	12.10	10.0	7.520	45.10	45.0	5.744
	Total	10.81	11.0	5.395	38.79	39.0	6.057
Stoma type
	Colostomy	10.70	11.0	5.279	38.33	38.0	6.100	0.306
	Ileostomy	11.19	11.0	5.935	40.31	40.0	5.839
	Total	10.81	11.0	5.395	38.79	39.0	6.057
Diameter of stoma
	0–20 mm	13.70	13.5	6.783	37.40	37.0	7.891	0.187
	20–40 mm	9.76	11.0	4.881	37.67	39.0	6.110
	40–60 mm	11.09	11.0	5.169	38.70	38.0	6.574
	60–80 mm	11.00	14.0	7.000	39.35	39.0	5.256
	Total	10.81	11.0	5.395	38.79	39.0	6.057
Demarcation of the stoma was carried out
	Yes	11.59	14.0	4.757	38.88	38.0	7.339	0.110
	No	10.57	11.0	5.604	38.75	39.0	5.667
	Total	10.81	11.0	5.395	38.79	39.0	6.057
Device type
	Systematic	11.02	11.0	5.537	39.09	38.5	5.639	0.546
	Two-piece	10.36	11.0	5.169	38.65	39.0	6.292
	Total	10.81	11.0	5.395	38.79	39.0	6.057
It was reported that you have a stoma
	Yes	10.92	11.0	5.386	39.82	39.0	5.877	0.634
	No	10.59	11.0	5.535	38.31	38.0	6.141
	Total	10.81	11.0	5.395	38.79	39.0	6.057
Stoma character
	Temporary	12.00	11.5	6.589	39.15	39.0	6.182	0.332
	Definitive	10.40	11.0	4.5924	37.72	37.5	5.717
	Total	10.81	11.0	5.39	38.79	39.0	6.057

		Rosenberg Self-Esteem Scale/UNIFESP			Body Investment Scale			p-Value
		Mean	Median	Standard deviation	Mean	Median	Standard deviation	p-Value
Age group
	<59 years	12.67	12.0	8.102	40.31	40.0	2.549	0.034
	60–67 years	10.00	11.0	4.664	38.22	37.0	7.818
	68–74 years	10.19	11.0	3.176	37.00	38.0	6.245
	≥75 years	10.32	11.0	4.151	39.63	38.0	6.057
	Total	10.00	11.0	5.395	38.79	39.0	6.057
Gender
	Female	11.26	11.0	5.915	39.71	39.0	5.834	0.260
	Male	10.39	11.0	4.901	37.92	38.0	6.217
	Total	10.81	11.0	5.395	38.79	39.0	6.057
Marital status
	Married	10.41	11.0	5.082	35.21	37.0	4.264	0.017
	Separate	11.71	12.0	3.811	40.47	41.5	5.945
	Widow(er)	10.86	11.0	6.728	38.45	39.0	6.368
	Total	10.81	11.0	5.395	38.79	39.0	6.057
Schooling
	Illiterate	11.33	11.0	5.877	40.06	43.0		0.034
	Can read and write	12.72	13.0	4.039	39.53	38.0
	Incomplete primary education	9.26	11.0	5.039	38.18	36.0
	Incomplete secondary education	9.09	6.0	6.580	37.71	38.0
	Total	10.77	11.0	5.421	38.90	39.0
Occupation
	Retired	11.06	11.0	5.936	38.58	39.0	6.541	0.522
	Employed	8.75	9.0	2.630	37.00	37.0	1.155
	Unemployed	10.50	11.5	3.590	39.57	39.0	5.331
	Total	10.81	11.0	5.376	38.69	38.5	6.099
Participation in support group/association
	Yes	11.66	12.0	5.637	38.31	38.5	6.542	0.162
	No	10.11	11.0	5.151	39.18	39.0	5.675
	Total	10.77	11.0	5.395	38.79	39.0	6.057

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[1] *Corresponding author. E-mail: geraldoreiki@hotmail.com (G.M. Salomé).