Article

Multi-centre, retrospective self-report postal survey. OBJECTIVES:
To characterise spinal cord injured (SCI) individuals with a stoma, their stoma
management and outcomes, to identify sources of information and support for
decision making and to explore the impact of a stoma on life satisfaction.
SETTING: Five UK spinal cord injury centres. METHODS: A study-specific
questionnaire accompanied by self-concept, life satisfaction and mood measures,
and three simple rating scales for satisfaction, impact and restriction on life
were sent to all known ostomates at five participating centres. RESULTS:
Respondents were 92 individuals, mean age 56 years, mean duration of injury 26
years, 91% with colostomy. Multiple sources of information were utilised in
deciding on surgery; discussion with other SCI ostomates was important. Duration
of bowel care, faecal incontinence, bowel-related autonomic dysreflexia, dietary
manipulation and laxative use were all significantly reduced following surgery.
Rectal mucous discharge was the most common and bothersome post-stoma problem.
Satisfaction with stoma was high; provision of sufficient information
preoperatively was important, those with ileostomy were more dependent and less
satisfied. Life satisfaction and physical self-concept were both lower in this
sample than in previously reported samples of SCI individuals without reported
bowel difficulties or stoma. CONCLUSION: The findings of this study of
self-selected respondents with a stoma for bowel management after SCI emphasised
the benefits of stoma in selected individuals and the importance of timely
intervention, the complexity of the associated decision-making and of
preoperative counselling. The impact of bowel dysfunction on physical
self-concept warrants investigation.

Langue : ANGLAIS