Uncertainty and Adaptation Among Adults Living With Incontinent Ostomies

The purpose of this study was to examine the relationship between uncertainty and adaptation among individuals requiring surgery resulting in an incontinent ostomy.

Descriptive correlational study.

The study sample comprised adult persons with incontinent ostomies created during calendar years 2009 and 2010. The research setting was an academic medical in the Northeastern United States. Respondents were 18 to 83 years old, with a mean age of 53.88 ± 19.58 years (mean ± SD); 54.9% were women.

A WOC nurse reviewed electronic medical records of patients who had undergone incontinent ostomy surgery to determine whether they met inclusion criteria. A letter outlining the study was mailed to potential subjects requesting their participation; 2 validated instruments were included: the Ostomy Adjustment Scale and the Mishel Uncertainty in Illness Scale-Adult Form. The form also queried demographic information. After 2 weeks, a postcard was sent to remind study participants to complete and return the documents.

The leading medical diagnosis resulting in ostomy surgery was cancer (45.1%), followed by Crohn's disease or ulcerative colitis (35.3%). The sample was evenly distributed between those having their ostomies less than 1 year and those having them more than 1 year. Most incontinent stomas were ileostomies (60.8%), 33.3% were colostomies, and 5.9% were urostomies. Nearly three-quarters (74.5%) indicated that they were independent regarding ostomy self-care.

The results suggest a strong association between certainty and adaptation among adult patients with an incontinent ostomy. The WOC nurse, as patient advocate, can offer persons with a new ostomy an overall perspective on the ostomy experience.