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[Regaining dignity: the experience and process of reconstructing normal defecation functions through an anal
Ching-Hsiang Liu1, Ching-Huey Chen, Lily Yeh
1Department of Nursing, National Cheng Kung University, ROC.
Background:
Resection through an anal sphincter-saving (ASS) operation may affect a low rectal cancer patient'snormal defecation function. The long and complex reconstruction process following such a procedure makes understanding the patient rehabilitation experience necessary in order to develop an effective educational strategy that addresses patient needs.
Purpose:
This study investigated the defecation reconstruction experience of low rectal cancer patients after ASS.
Methods:
Researchers used a case study method and purposive sampling. Participants were followed for a period of 6 to 8 months and interviewed between 5 and 7 times.
Results:
Eleven themes emerged from content analysis. Before temporary colostomy take-down: anal leakage and discomfort, dignity impairment, struggling to locate the contracting muscle, restoring anal strength. After colostomy take-down: loss of defecating control again and damage to peri-anal skin, perceived effects and insistence on persisting with training, faith in effectiveness, trying to comply, trying to restrict medication use, maintaining a hygienic self-image and dignity, promoting quality of life, and a chance to regain a normal life. CONCLUSIONS / IMPLICATIONS: Participants described the rehabilitation exercise as beneficial to controlling the defecation and expressed their intent to continue such. Participant experiences can assist stoma nurses to provide better physical and psychological care to ASS patients.
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