Living With a Permanent Colostomy: An Interpretative Phenomenological Analysis of Patients' Experiences in Kazakhstan

Living with a permanent colostomy involves changes that extend beyond physical stoma management to identity, everyday routines, social participation, relationships and emotional well-being. Although existing research has documented quality-of-life and psychosocial outcomes, less is known about how people make sense of these changes and gradually reconstruct everyday life. The study aims to explore the lived experiences of patients living with a permanent colostomy in Kazakhstan.

This study explored the lived experiences of patients living with a permanent colostomy.

This qualitative study used Interpretative Phenomenological Analysis and was grounded in phenomenology, hermeneutics and idiography.

The study was conducted in a tertiary hospital in Astana, Kazakhstan. We purposively recruited sixteen adults with a permanent colostomy of at least 6 months' duration. Face-to-face semi-structured interviews were conducted between March and April 2026, audio-recorded and transcribed verbatim. Data were analysed using Interpretative Phenomenological Analysis, with each participant analysed as an individual case before cross-case comparison. Reflexive journaling, peer debriefing, member checking and an audit trail supported methodological transparency. Reporting followed the Standards for Reporting Qualitative Research guidelines.

The initial analytic process generated 107 preliminary analytic notes across the transcripts. Through iterative within-case and cross-case analysis, convergent and divergent patterns were identified and organized into 12 emergent themes, which were subsequently clustered into four higher-order themes: (1) Initial Crisis, (2) Identity Crisis, (3) Social and Functional Reorganization and (4) Adaptation and Transformation.

Adaptation to a permanent colostomy involved more than learning technical self-care. The participants' retrospective accounts suggested an evolving and non-linear process of adaptation involving interconnected changes in identity, daily routines, relationships and coping. The findings support nursing care that combines technical stoma education with repeated assessment of psychosocial needs, body image, intimacy, disclosure and self-management across the care continuum.

No patient or public contribution. Patients with permanent colostomies participated as research participants and shared their lived experiences through individual interviews; however, patients or members of the public were not involved in the design, conduct, analysis, interpretation or preparation of the manuscript.

(1) This study offers an in-depth, context-specific account of how patients in Kazakhstan make sense of living with a permanent colostomy. The findings conceptualize adaptation as an evolving process of reconstructing identity and everyday life, rather than merely acquiring technical stoma-management skills. By bringing patient perspectives from Kazakhstan into the international literature, the study provides a contextual basis for considering how nursing support can address the emotional, identity-related, social and functional dimensions of colostomy adaptation. (2) The main findings show that patients experience an initial period of shock, fear and emotional distress, followed by a gradual process of adaptation influenced by healthcare guidance, family support and personal coping strategies. Over time, participants reported changes in self-identity, body image concerns, social anxiety related to stigma and challenges in intimacy. Despite these difficulties, many individuals demonstrated resilience, acceptance and personal growth through meaning-making and increased health awareness. (3) The findings provide context-specific insights that may inform nursing assessment and support for patients living with permanent colostomies. They highlight the importance of addressing emotional adjustment, body image, social participation, intimacy and self-management alongside technical stoma care. These findings may also provide a basis for comparison with experiences reported in other healthcare and cultural contexts.

This study highlights the critical role of nurses in supporting patients before and after colostomy formation. Findings underscore the need for structured preoperative education, individualized stoma care training and ongoing psychosocial support addressing body image concerns, intimacy issues and stigma-related distress. Nursing care should extend beyond technical management to include emotional support, counselling and family involvement. Early identification of psychological distress and timely referral to support services may improve adjustment and quality of life.