BACKGROUNDThe aim of this research was to explore quality of life (QOL) and acceptance of disability and social support of colostomy patients as well as the relationship between these factors.

METHODSA descriptive, correlational study was conducted using four scales: the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and European Organization for Research and Treatment of Cancer Colorectal Cancer-Specific Quality of Life Questionnaire (EORTC QLQ-CR38) scales, the Acceptance of Disability Scale (ADS), and the Social Relational Quality Scale (SRQS). A convenience sample of 111 colostomy patients from four hospitals in Guangzhou who underwent colostomy operation at least one month prior to the study and who visited the stoma clinic or association from August 2011 to February 2012 was evaluated for inclusion in the study. All statistical analyses were performed using SPSS 17.0 software (SPSS Inc., Chicago, IL, USA).

RESULTSThe patients' general health status was better than the reference level recommended by European Organization for Research and Treatment of Cancer, and the overall ADS score was average. The SRQS score was similar to that found in a Hong Kong study. The general health status and dimensions of QOL were significantly correlated with ADS and all of its dimensions (P < 0.05). The general health status and dimensions of QOL were also significantly correlated with SRQS and all of its dimensions (P < 0.05).

CONCLUSIONSQOL, acceptance of disability, and social relational quality of colostomy patients were closely related. Our results emphasize that patients should work to form rational values and close bonds with families and friends to achieve a better QOL.

Aged ; Colostomy ; adverse effects ; psychology ; Female ; Humans ; Male ; Middle Aged ; Quality of Life ; Social Support ; Surveys and Questionnaires

Fecal incontinence is defined as either the involuntary passage of gas or stool or the inability to control the passage of fecal contents through the anus. Patients are reluctant to report fecal incontinence, resulting in underestimated prevalence. Studies have reported that its prevalence ranges from 2% to 20%. Diverse causes are involved in the generation of fecal incontinence. Fecal incontinence leads to a loss of self-esteem, social isolation, and a diminished quality of life. Antidiarrheals are useful for diarrhea with incontinence. Biofeedback therapy and exercise therapies may be helpful, particularly in patients with weak sphincters and/or impaired rectal sensation. Sacral nerve stimulation can be an option if other treatments have not been successful. Although some studies have shown the efficacy of injectable bulking agents, data on their long-term outcome and experience are lacking. Sphincteroplasty can be considered in selected patients who have failed nonsurgical measures or biofeedback therapy. A colostomy is a less preferable option. The various treatment options can be chosen with an individualized approach, depending on the causes of fecal incontinence, the action mechanism of treatment, comorbidities, general condition, and procedure-related risks.
Anal Canal ; Antidiarrheals ; Biofeedback, Psychology ; Colostomy ; Comorbidity ; Diarrhea ; Exercise Therapy ; Fecal Incontinence ; Humans ; Prevalence ; Quality of Life ; Sensation ; Social Isolation

PURPOSE: This study was designed to construct and test the structural equation model on sexual satisfaction in patients with a colostomy. METHODS: The model construction was based upon Roy's adaptation model. Stoma-related discomfort (SRD), age, frequency of sexual intercourse, treatment modality, and gender affect sexual satisfaction and are mediated by physical, psychosocial, and interdependence modes. Each mode was conceptualized as sexual function, body image/depression, and marital intimacy. The patients were 112 colostomates with colorectal cancer who were asked to complete a mail-back survey on their demographic data, SRD, body image, depression, marital intimacy, sexual function, and sexual satisfaction. Data were analyzed using SPSS WIN 15.0 and AMOS WIN 7.0. RESULTS: Significant variables for sexual satisfaction in the final model were body image affected by SRD, depression affected by body image and SRD, marital intimacy affected by depression, and sexual function affected by marital intimacy. CONCLUSION: The results of this study suggest that specific guidelines for SRD are necessary to improve sexual satisfaction among colostomates. Nurses should be vigilant in monitoring depression and body image disturbance, and providing appropriate interventions to increase marital intimacy. Treatment modality, gender, and age should be considered in developing education programs pertaining to sexuality.
Adult ; Aged ; Body Image ; Colostomy/*psychology ; Demography ; Depression ; Female ; Humans ; Male ; Middle Aged ; Questionnaires ; Sex Factors ; *Sexual Behavior ; Sexual Partners ; Sexuality/*psychology

BACKGROUND/AIMS: Studies evaluating the human pylorus as a sphincter are scanty and contradictory. Recently, we have shown technical feasibility of transposing the human pylorus for end-stage fecal incontinence. This unique cohort of patients provided us an opportunity to study the sphincter properties of the pylorus in its ectopic position. METHODS: Antro-pylorus transposition on end sigmoid colostomies (n = 3) and in the perineum (n = 15) was performed for various indications. Antro-pylorus was assessed functionally (digital examination, high resolution spatiotemporal manometry, barium retention studies and colonoscopy) and by imaging (doppler ultrasound, MRI and CT angiography) in its ectopic position. RESULTS: The median resting pressure of pylorus on colostomy was 30 mmHg (range 28-38). In benign group, median resting pressure in perineum was 12.5 mmHg (range 6-44) that increased to 21.5 mmHg (range 12-29) (P = 0.481) and 31 mmHg (range 16-77) (P = 0.034) on first and second follow-up, respectively. In malignant group, median post-operative pressures were 20 mmHg (range 14-36) and 21 mmHg (range 18-44) on first and second follow-up, respectively. A definite tone and gripping sensation were felt in all the patients on digital examination. On distal loopogram, performed through the diverting colostomies, barium was retained proximal to the neo-pyloric valve. Both perineal ultrasound and MRI showed viable transposed graft. CT angiography and color doppler studies confirmed vascular flow in the transposed position. CONCLUSIONS: The human pyloric valve can function as a tonic sphincter when removed from the gastroduodenal continuity.
Angiography ; Barium ; Cohort Studies ; Colon, Sigmoid ; Colostomy ; Fecal Incontinence ; Follow-Up Studies ; Gastroepiploic Artery ; Hand Strength ; Humans ; Manometry ; Perineum ; Pylorus ; Retention (Psychology) ; Sensation ; Transplants