INTRODUCTION:

Colostomy surgery is used to treat intestinal problems caused by a variety of factors. A stoma is an artificial opening created in the intestine to move it onto the surface of the abdomen and redirect the passage of urine or faeces. Colostomy, ileostomy, and urostomy are the three types of stomas that can be removed, and they can be removed temporarily or permanently. Body image can be a serious issue. The first step is accepting who you are. While treating the disease, therapeutic treatments have an impact on the patient's quality of life (QOL).

The physical, mental, emotional, and social lives of stoma patients are greatly impacted by this procedure, which also alters their perceptions of their bodies. In order to treat patients holistically, a solid QOL is necessary. In western nations, support organizations for such patients are easily accessible, but they are not in India.¹

Colostomy patients are more prone to experiencing challenges with their bodily, psychological, social, and spiritual requirements. These problems affect people's overall quality of life, happiness, and level of life satisfaction. A number of subjective factors that represent the physical, emotional, vocational, and social experiences of patients make up the quality of life. The WHO defines quality of life as a person's sense of their place in life in relation to their objectives, aspirations, standards, and concerns as well as the culture and value systems in which they live. In a study conducted in China, it was discovered that participants had issues with their sexuality and body image, difficulties with stoma function, anxiety about privacy when emptying the pouch, constant worry about leakage, constant worry about engaging in social activities, and skin irritation. Yang et al study's also revealed that until the sixth month following surgery, quality of life scores were generally better than preoperative levels, although social function, body image, chemotherapy side effects, and financial challenges remain unusual².

PROBLEM STATEMENT:

A research to evaluate the quality of life among colostomy patients in a chosen hospital in Bangalore.

OBJECTIVES:

1. To evaluate the quality of life for colostomy patients.

2. To ascertain the relationship between baseline factors and the quality of life of colostomy patients.

HYPOTHESIS:

At the 0.05 level of significance, there is a substantial correlation between patients with colostomies' quality of life and certain demographic factors.

METHODOLOGY:

The study employed a quantitative descriptive methodology.

Settings of the study:

Colostomy patients in the cancer ward, urogastro ward, intensive care unit, intensive treatment unit, and stoma clinic at St. John's medical college hospital serve as the study subjects.

Population:

The patients at St. John's hospital who had colostomies make up the population of our studies.

Sample :

Colostomy patients from a chosen Bangalore hospital made up the sample.

Sample size:

After estimating the sample size, the study's sample size included 27 patients.

Sampling technique:

Purposive sampling was the method of sampling used in this investigation.

Criteria for selection of sample:

Patients who have had colostomies for at least six months to a year must meet the inclusion requirements.

Those who were critically ill were excluded.

Instrument:

A common tool called the City of Hope - Quality of Life Questionnaire was used to collect the data.

Description of tool:

For the purpose of gathering data, a patient with a colostomy was given the City of Hope - Quality of Life Questionnaire instrument (Instrument Author: Grant M. Ferrer; B.R. Dean; G. Uman; G. Chu; D. and Krouse.R). The tool had the following headings and had a total of seven sections.

● Section A: Demographic Variables.

● Section B : Work related items.

● Section C : Health Insurance.

● Section D : Sexual Activity.

● Section E : Psychological Support / Concerns.

● Section F : Clothing.

● Section G : Diet.

● Section H : Amount of time since surgery.

● Section I : Food groups.

● Section J : care of Colostomy

● Section K : QOL Questionnaire.

Data collection method:

The study was carried out only after receiving formal approval from the Head of Oncology Surgery at St. John's Medical College Hospital in Bangalore and ethical clearance from the institutional ethical council (IEC).The Oncology Ward, Urogastric Ward, ICU, ITU, and Stoma Clinic in SJMCH served as the study locations. Using the purposive sampling technique, 27 samples were chosen based on the inclusion and exclusion criteria. The samples were given a subject information sheet, the study's objective was described to them, and their informed consent was acquired. The COH-QOL Questionnaire was used to gather information on demographic factors and the quality of life of colostomy patients. Each respondent was given 20 to 30 minutes to complete the data collection. Data was gathered between April 2021 and July 2021, imported into MS Excel, and then analysed.

Data analysis plan:

The following procedures were used to examine the data in accordance with the study's objectives and working hypotheses.

· Created a master sheet out of the data.

· Calculated the frequencies and percentages to display how the respondents were distributed based on the initial variables.

· To describe the data, calculated the Mean and Standard Deviation. To reach the conclusion, applied the Chi-square and Fisher's Exact Test.

RESULTS:

Findings related to baseline variables of patients with colostomy.

In this study, there were 27 patients with colostomies; 37% had permanent colostomies, while 63% had temporary colostomies. Whereas 11 (41%) of the patients with colostomies had cancer, 16 (59%) of the patients with colostomies had another form of sickness that caused their colostomy. At a period of 6 to 9 months following colostomy surgery, 19 patients (70%) and after a period of 10 to 12 months, only 8 patients (30%) returned for follow-up. Male patients with colostomies made up 17 (63%) and female patients made up 10%. 11 (41%) of the subjects with colostomies were under the age of 45, while 16 (59%) of the patients had colostomies. Twenty (74%) of the individuals with colostomies were married, while seven (26%) were not. 33% of the population was employed part-time, compared to 41% who worked full-time. 19% of people were no longer working. 48% of people continued in their previous line of work. Due to a colostomy, 19% of people changed their occupation. 37% of the populace as a whole had colostomy insurance. 52% had no trouble obtaining insurance. 15% of people had no trouble keeping their health insurance. A total of 26% of the respondents had insurance that covered all of their costs for colostomy supplies. Prior to having their colostomy, 52% of the group as a whole engaged in sexual activity. 48% of people who had colostomies stopped having sexual relations. 48% of the participants reported being content with their sexual behaviour. 59% of men had no trouble getting an erection. After getting a colostomy, 59% of the entire sample reported having depression. After getting a colostomy, 85% of patients reported no suicidal ideas or actions. There were no colostomy support groups for 74% of people. 78% did not participate in any other forms of help. 83% of them had no chance to speak with somebody who had a new colostomy or was getting one. 59% of patients encountered issues related to the colostomy site. Due to their colostomy, 74% of people altered their fashion sense. Due to colostomies, 70% of people changed their eating habits. 59% of people altered their diets to avoid passing gas in public. For 85% of people, getting used to their daily colostomy care took months. 19% of people needed a month to get used to their diet. For 81%, regaining their normal appetite took months. After getting a colostomy, 78% of patients avoided drinking anything with carbonation. 56% of the participants kept consuming dairy products. Even after having a colostomy, 81% continued to eat fruits, 59% continued to eat snacks, and 89% continued to eat vegetables. 88.9% of patients received their daily colostomy care in less than 30 minutes. For their colostomy bags, 89% of people used the brand coloplast. 81% of people with colostomies had issues.

Findings related to the quality of life among patients with colostomy.

The average quality of life score for colostomy patients was found to be 114; those who scored >114 had good quality of life, while those who scored 114 had poor quality of life.

Table 1 Description of baseline variables of patients with colostomy. n= 27

Demographic Profile	Frequency	Percentage
Age
<45 YEARS	11	40.7%
>45 YEARS	16	59.3%
Gender
Female	9	33.3%
Male	18	66.7%
Type of colostomy
Temporary	17	63%
Permanent	10	37%
Indications for colostomy
Cancer	12	44.4%
Others	15	55.6%
Duration of Colostomy
6-9 months	19	70.4%
10-12 months	8	29.6%
Marital Status
Married	19	70.4%
Unmarried	8	29.4%

Table 2 - Findings related to the quality of life among patients with colostomy. n = 27

Minimum score	Maximum score	Range	Mean	Mean percentage	Standard deviation
0	430	94-303	182.04	41.9%	51.283

According to Table 2, the mean score was 182.04, the standard deviation was 51.283, and the lowest and highest scores were 94 and 303, respectively.

Fig 1. Distribution of subjects according to the QOL to assess the quality of life among patients with colostomy. n = 27

89% of the individuals reported an excellent quality of life, whereas 11% had a bad quality of life, as seen in figure 1.

Relationship between some baseline characteristics and life quality:

The categories of quality of life do not strongly correlate with demographic variables. As a result, the null hypothesis was accepted.

RECOMMENDATIONS:

A sizable sample can be used for a comparable investigation. The study is reproducible in different contexts. The COH-QOL tool's subdomains can be used to thoroughly evaluate the quality of life.

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Received on 30.05.2023 Modified on 08.10.2023

Int. J. Nur. Edu. and Research. 2024; 12(1):49-52.

DOI: 10.52711/2454-2660.2024.00011