Prevalence of NANDA-I Diagnoses in Individuals with Intestinal Ostomies: A Systematic Review and Meta-Analysis
Luis Fernando Reis Macedo1, Igor Emanuel Soares-Pinto2, Juliana de Lima Lopes1
1Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, Brazil.
Abstract:
BackgroundIntestinal ostomies affect physical, emotional, and social dimensions of life, requiring systematic assessment and individualized nursing care. Although the NANDA-I Classification of Nursing Diagnoses (NDs) supports diagnostic reasoning and care planning, systematic evidence on the most frequent NDs in this population remains limited.ObjectiveTo analyze the available evidence on the prevalence of the NANDA-I NDs in individuals with intestinal ostomies.MethodA systematic review with meta-analysis was conducted following the Cochrane guidelines in Web of Science, Scopus, Embase, CINAHL, MEDLINE/PubMed, and the Virtual Health Library, with no language or time restrictions. Quantitative studies reporting the prevalence of NANDA-I NDs were included. The methodological quality was assessed, and prevalence proportions were pooled using the DerSimonian-Laird random-effects model.ResultsSix studies published between 2000 and 2023 were included, five of which met quality criteria for the meta-analysis, totaling 508 participants. The most prevalent NDs were Ineffective sleep pattern (53%; 95% CI 28-77%); Risk for impaired skin integrity (34%; 95% CI 0-90%); Disrupted body image (33%; 95% CI 8-64%); Impaired resilience (31%; 95% CI 23-40%); Situational low self-esteem (27%; 95% CI: 21-34%); Impaired sexual function (23%; 95% CI 16-32%); Impaired physical mobility (23%; 95% CI 11-36%); Acute pain (22%; 95% CI 13-33%); Inadequate nutritional intake (21%; 95% CI: 10-33%).ConclusionThe most prevalent NDs identified reflect common altered human responses in individuals with intestinal ostomies. Identifying these NDs can support diagnostic assessment and care planning targeted at optimizing sleep, protecting skin integrity, promoting satisfactory body image perception, and enhancing emotional adaptation and resilience.
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An ostomy is a surgical procedure that creates an artificial opening from the intestines to the outside of the body, allowing for the rerouting of effluent. This opening is known as a stoma. A stoma usually protrudes above the skin surface, appearing pink or red, moist, and round, and it lacks nerve sensations.
There are different types of ostomies, including colostomies, ileostomies, and urostomies:

