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To Explore the Lived Experiences of People who have undergone Irreversible Ileostomy or Colostomy Formation

To Explore the Lived Experiences of People who have undergone Irreversible Ileostomy or Colostomy Formation

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An essay for the 2011 Undergraduate Awards (Lecturer Nomination) Competition by Jacqueline Daniels. It is nominated by Lecturer Dympna Tuohy of University of Limerick in the category of Nursing & Midwifery
An essay for the 2011 Undergraduate Awards (Lecturer Nomination) Competition by Jacqueline Daniels. It is nominated by Lecturer Dympna Tuohy of University of Limerick in the category of Nursing & Midwifery

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Published by: Undergraduate Awards on Sep 01, 2012
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10/27/2013

 
 
Essay Title:
To Explore the Lived Experiences of People who have undergone IrreversibleIleostomy or Colostomy Formation
 (Literature Review as part of A Research Proposal)Submitted as part requirement of a final year project for a Bachelor of ScienceNursing (General) programme, Spring 2011
Word Count 4988 (excluding the footnote and the reference list)
 
Introduction
Due to the increased incidence of colorectal cancer and other bowel diseases in recent timesthe need for stoma formation surgery has become ever more important (Thorpe et al, 2009).Although there has been many advancements in medicine, ostomy formation surgery remainsone of the major treatments for colorectal cancers (Kit Man Wu et al, 2007). To date, inIreland, there has been a lack of both quantitative and qualitative research in relation toostomies. Most of the international research has focused on ostomy formation and its link toaltered body image (McKenzie et al, 2006) whereas little research has focused exactly on theexperiences of those living with an ostomy.
The research question generated by this proposed study is “What are the lived
exp
eriences of people who have undergone irreversible ileostomy or colostomy formation? ”.
A literature review is a comprehensive review of the literature, to identify and critiquewhat is already known about the research topic, to determine what gaps remain to be studiedand to clarify the research question (Doordan, 1998). This literature review intends toexplore recent research in relation to ostomies.
1
An ostomy has been defined as theformation of an ileostomy or a colostomy to rediret contents from the bowel onto the front of the abdomen and the attachment of a bag exteriorly to gather the contents (Thorpe et al,2009). An ileostomy affects the small intestine and a colostomy affects the large intestine(Welser et al, 2009). A stoma may be created to eliminate a disease or to improve the qualityof life for a person (Burch, 2005). An ostomy may be permanent or temporary and this canaffect how well an individual accepts the ostomy. The most common reasons for ostomyformation include colorectal cancer, inflammatory bowel disease (Crohns disease andUlcerative Colitis), diverticular disease and faecal incontinence (Brown and Randle, 2005).The latest published European estimates of colorectal cancers suggest that 432,414 newincidents occur annually, while the mortality rate totalled 212,219 in 2008 (IARCGLOBOCAN, 2008). Having this procedure carried out changes how the bowel works, afunction rarely appreciated when working correctly (Thorpe et al, 2009).
 
Throughout theimmediate period after the procedure, individuals need to begin the acceptance process inorder to regain their independence, manage their condition and interact within society again
1
In researching the literature, electronic databases available in the University of Limerick were used. Thesedatabases included Cinahl, Medline, Science Direct, PsycINFO and Nursing and Allied Health. A further searchwas conducted on the INO databases and these included Internurse.com and Nursing@Ovid. Keywords such as
‘ostomy’, ‘ileostomy’, ‘colostomy’, ‘bowel
 
surgery’ were entered into the search engine first. Terms such as‘acceptance’, ‘psychological’, ‘coping’
,
‘sexuality’, ‘lived experiences’ and ‘altered body image’ were thenadded using the ‘AND’ command to search for data relating to both search term
s. A manual search of booksand journals was also conducted in search of relevant literature.
 
(Simmons et al, 2007). Adjustment could be enhanced dramatically if support and educationwere more readily available (Simmons et al, 2007). Coping, acceptance and adjustment,psychological impact, quality of life and sexuality will be the main areas outlined anddiscussed.
Psychological Impact
The formation of a stoma results in a change in oneself, impacting socially, emotionally,physically, psychologically and sexually. It can
change an individual‟s appearance and
impact on their lifestyle and usual activities of living (Williams, 2005). Large amount of research has been conducted in relation to physical appearance, but one must not forget thatthe psychological aspect of stoma formation is also of vital importance (McKenzie et al,2006). The proposed study aims to explore the lived experiences of people with an ostomyand so it is important to review the literature in relation to the psychological impact of stomas, as this indirectly affects the experiences an individual may encounter.Persson
and Hellstrom‟s
(2002)
 phenomenological study (n=9) described patients‟
experiences regarding body image post stoma formation. The participants had undergoneostomy formation for a minimum of 6 months and 3 were devised to be permanent. 8 of theparticipants were educated preoperatively and one had an ostomy formed as part of emergency treatment and so no preoperative education was given. A limitation of this studyis that data was collected from particpants when some were still adjusting to life with theostomy and had not returned back to activities they once took part in or enjoyed (e.g. sexualactivity and work). Perhaps there is room for a similar study with more follow up post-surgery. Another limitation of this study is that the interviews were conducted by theparticipants own stoma nurse and problems discussed in the interview were already familiarto the interviewer therefore the interview may have been guided to disclose specificinformation (Persson and Hellstrom, 2002). This could have interfered with the datagenerated as the participants may have not been given the opportunity to express their ownpersonal experiences and only data of interest to the researcher may have been discussed.However, a strength of this study is that it highlighted areas of education provided by nursingstaff that need more work as well as the need for support in the early stages post ostomyformation.

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