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Defining Opportunities to Improve Perioperative Ostomy Care and Education
Hannah Ficarino Sheffer1, Burkely Smith1, Jernell Simmons2
1From the Department of Surgery, University of Alabama at Birmingham, Birmingham, AL.
Objective:
We sought to qualitatively identify opportunities to improve perioperative ostomy care and education.
Background:
Patients with a new ostomy utilize ostomy care-related resources to manage their ostomy. Many patients experience ostomy-related issues after surgery.
Methods:
In this qualitative study, patients who underwent the construction of a new ostomy, their caregivers, and healthcare professionals were purposively recruited for semistructured phone interviews. Interviews included questions about ostomy-related experiences, education, and resources in the perioperative phases of care. Interviews were transcribed and thematically coded using inductive content analysis with NVivo 12 Software. Focus groups of patients, caregivers, and healthcare professionals were conducted to validate themes.
Results:
Overall, 53 interviews including 20 patients, 16 caregivers, and 17 healthcare professionals were conducted. The average age of patients and caregivers was 59 years, 69% were non-Hispanic White, 72% were female, and 39% had limited health literacy. Themes in the preoperative phase included "not knowing what to expect regarding an ostomy," "patient difficulty understanding their health condition," and "overwhelming amount of information regarding an ostomy." Inpatient phase themes included "not knowing the best ostomy supplies to use," "challenges with ostomy appliance application," and "lack of patient acceptance and maladjustment." Postdischarge themes included "difficulty obtaining supplies," "challenges caring for inflamed skin," "variability in the utility of home healthcare," "missing outpatient resources," and "limited information on hydration and diet management." Themes were subsequently validated in focus groups.
Conclusions:
Patients, caregivers, and healthcare professionals reported key perioperative barriers to obtaining, understanding, and utilizing ostomy care-related resources and education. These findings inform the development of interventions to improve ostomy care and education.
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