Akademik Veri Yönetim Sistemi
DISEASES OF THE COLON & RECTUM, cilt.66, sa.1, ss.138-147, 2023 (SCI-Expanded)
BACKGROUND: An intestinal stoma has severe psychosocial effects on patients. OBJECTIVE: This study aimed to measure the effects of prehabilitation on stoma self-care, quality of life, anxiety, and depression levels. DESIGN: This study was a a randomized controlled trial. SETTINGS: Patients were allocated into 3 groups according to enterostomal management: group A (stoma marking and postoperative education), group B (marking and pre- and postoperative education), and group C (prehabilitation group) (marking and preoperative education with introduction of the stoma appliance preoperatively and postoperative education). A stoma care follow-up form, the Hospital Anxiety and Depression Scale, and a stoma-specific quality-of-life questionnaire were used for evaluation. PATIENTS: Patients who underwent colorectal surgery and fecal diversion at the Ankara University, Ankara, Turkey, between 2011 and 2016 were included. MAIN OUTCOME MEASURES: The primary outcome was the effect of stoma prehabilitation on self-care ability. RESULTS: Two hundred forty patients were included in the study. The outcome of stoma self-care revealed that 24 patients (31.2%) in group A, 51 patients (78.5%) in group B, and 72 patients (94.7%) in group C could perform stoma care independently (p < 0.001). Among patients with temporary stomas, group C had a better outcome than patients in groups A and B (p < 0.001). There was no similar relationship among patients with permanent stomas. The prehabilitation group had fewer patients with anxiety and depression than the other groups. Among patients with temporary stomas, similar findings were found. No differences were found in either anxiety or depression among patients with permanent stomas. Stoma quality-of-life scores were significantly higher in the prehabilitation group (p < 0.001). Among patients with temporary stomas, similar findings were found. There was no difference among those with permanent stoma. LIMITATIONS: This was a single-center study of heterogeneous groups. CONCLUSIONS: Prehabilitation facilitates stoma self-care, decreases predisposition to anxiety and depression and improves quality of life in patients with stomas. See Video Abstract at http://links.lww.com/DCR/B918.