Critique assignment

Correlation between self-efficacy and self-esteem

in patients with an intestinal stoma
Article 2
Course: NUR (40207)
Submitted to : Dr Adnan Yaqoob
Submitted by : Fouzia Gill

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 Correlation between self-efficacy and self-esteem
in patients with an intestinal stoma
Background
Problem:

. Patients with an intestinal stoma experience psychological difficulties, including

disturbances in self-efficacy and self-esteem. There is an evidence that they are
interdependent.
Problem was valid because it has been proven by many studies that there a relationship
between self –efficacy and self-esteem in patients with an intestinal stoma and it is
important to address this problem so quality of care can be improved.

Introduction:

Nasiriziba et al (2018) was conducted a study on patient with an intestinal stoma

experience psychological difficulties including disturbances in self-efficacy and self-esteem in two
hospitals affiliated to Iran University of Medical Sciences and the Iranian Ostomy Association.
The aim of this study was to determine the correlation between self-efficacy and self-esteem in
patient with an intestinal stoma. The study design was a descriptive correlation (quantitative) and
tool for the collection of data was used demographic questions with the stoma self-efficacy scale
and Rosen berg self-esteem cycle. collected data was analyzed by using descriptive and analytical
statistics. Their study was seventy-nine men and 76 women with the age group of (50-70) had
highest proportion of participants with diagnosis, 52.26% had cancer and 45.81% had
inflammatory bowel disease or related conditions. They find a positive, significant correlation
between total self-efficacy and its dimension with self-esteem (P<0.001; r=0.54) by Pearson's
correlation coefficient.

Literature review:

They reviewed and added the different latest literature those support their claim. They
quoted them with the reference in their study like Changes in the ability to excrete cause
psychological and emotional problems in patients, and mostly affect self-esteem and sexual
activity (Salome and de Almeida, 2014). Mental health difficulties affect various aspects of
patients’ lives and include poor body image, lower self-esteem and a greater risk of suicide
(Knowles et al, 2013). Illness and negative changes in body image are important issues that can
lower self-esteem (Gozuyesil et al, 2017). Poor self-esteem is associated with behavioral and
communication problems, psychological disorders such as anxiety and depression, and physical
illness (Johansson et al, 2018). Self-esteem concerns the positive and negative feelings people have
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about themselves. In other words, it shows how valuable people consider themselves to be
(Coopersmith, 1990). Without doubt, it affects mental health, and good self-esteem is linked to
positive psychological health (Su et al, 2016).

Protection of Human Rights

They received approval from the ethics committee (ethics code IR.IUMS.REC.
1396.9511686003) of the Iran University of Medical Sciences and was granted jointly by the
Iranian Ostomy Association and the hospitals for their study. The study goals and design were
clearly explained to patients by the researcher and his assistant. Because patients can be
reluctant to cooperate, it proved difficult to collect data. There are limitations to this method;
some patients did not want to fill out questionnaires by themselves because of a psychological
or physical condition. In such cases, the questions were read out by the researcher or research
assistant, and patients’ responses were entered into the questionnaire verbatim.

The study been designed to minimize risk and maximize benefits to participants they
took proper permission and explained the patients before time but the limitation they applied
was coercion in which they knew that some patients will not be able to fill their questioner
because of their psychological or physical condition but they force them to participate by reading
a loud questioner and filled by researcher himself, this kind of data can create error in results.
They should have eliminated them from the study. It shows that patient can be reluctant to
cooperate.

Quantitative Analysis:

The study questions were fit with the analysis methods used and the research design was fit
with the analysis methods as well. The type of statistics which used was appropriate in relation to
the level of measurement of the data. Graphics an d results were displayed simple and clear. Link
between analysis and the findings are clear.

Table 1. Demographic variables (n=155) Variable Response Total Percentage Post-surgery job
change Yes No 37 117 24 76 Duration of ostomy 1 month–1 year 1–5 years >5 years 108 21 26
69.7 13.5 16.8 Level of education Academic (college and university) Non-academic (school) 25
130 16.1 83.9 Table 2. Self-efficacy Variable Range Mean SD Minimum Maximum Ostomy care
14–70 53.61 9.92 28 70 Social self-efficacy 14–70 40.86 12.19 16 80 Total self-efficacy 28–140
94.47 19.06 48 139 Table 3. Self-esteem Variable Mean SD Minimum Maximum Self-esteem
19.10 4.26 7 30 Table 4. Correlation between self-esteem and self-efficacy Stoma self-efficacy
Social self-efficacy Total self-efficacy Correlation r=0.39 P

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Discussion

They found a positive, significant correlation between total self-efficacy and its dimensions
with self-esteem in patients with an intestinal stoma. Evaluating the mean scores of self-efficacy
and its dimensions showed that patients had weaker self-efficacy in the area of ostomy-related
social activities. This is similar to the results of Wu et al (2007) and Rafi et al (2013). In a study
by Devan et al (2019), the average self-efficacy score was similar to that in the present study. Su
et al (2016) found that 85.6% of patients had low or moderate self-efficacy in the dimension of
stoma care, which required a focus on mental and social health as well as social support for
patients.

Conclusion
Results of data analysis clearly explained in reference to research questions,
hypotheses and theoretical framework that Self-efficacy and self-esteem are important
factors in patients with an intestinal stoma. Self-efficacy was positively correlated with
self-esteem in these patients; social self-efficacy had the greatest influence on self-
esteem. Therefore, the potential benefits of this study were educational and supportive
interventions can be designed to improve patients’ self-esteem and social interaction.
Most of the patients in this study had had their stoma for less than 1 year. Therefore, it is
recommended that healthcare teams should plan to provide educational interventions as
early as possible and it is supported by data.

Strengths of the study

 They chose the patient who had stoma for less than 1 year so that early intervention can be
provided.
 Data was collected by student nurses who had experience of working with these kind of
patients.
 Ethical consideration kept in mind and apply it properly before conducting a study. They
took proper permission from the ethics committee (ethics code IR.IUMS.REC.
1396.9511686003) of the Iran University of Medical Sciences and was granted jointly by
the Iranian Ostomy Association and the hospitals and from patients as well.
 Sample selection was appropriate for the targeted population. They had limitation in which
they provide help for those who cannot fill their forms
 Study design was appropriate as well.
 Data analysis was done using the SPSSv16 statistical package, t-test independent and
variance ANOVA were used because it multiple variables, Pearson’s correlation

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 coefficient was applied to check the correlation which was appropriate for quantitative
study.
 They reviewed and added the latest literature to support their claim.
 Problem was valid because it has been proven by many studies that there a relationship
between self –efficacy and self-esteem in patients with an intestinal stoma and it is
important to address this problem so quality of care can be improved.

Weakness or Gaps:
 Data should not be collected by student nurses because they were less experienced working
with this kind of patients. Moreover, mentally disturbed patients because of their treatment
can not cooperate easily and error in data can come.
 Only authors names were mentioned in the beginning of the article and date, year, setting,
were not included.to know all these things you need to read all the article.
 The questionnaires were distributed, completed and collected on the same day.
 some patients did not fill out questionnaires by themselves.
 Hypothesis was not stated properly because they did not mention alternative hypothesis as
it is a quantitative study.
 The study been designed to minimize risk and maximize benefits to participants they took
proper permission and explained the patients before time but the limitation they applied
was coercion in which they knew that some patients will not be able to fill their questioner
because of their psychological or physical condition but they force them participate by
reading a loud questioner and filled by researcher hence, this kid of data can arise error in
the results. They should have eliminated them from the study