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Patients’ Experiences of Performing Self-care of Stomas in the Initial Postoperative Period

Lim, Siew Hoon PhD(c), BSc (Nurs)(Honours), RN; Chan, Sally Wai Chi PhD, RN; He, Hong-Gu PhD, MD, RN

doi: 10.1097/NCC.0000000000000158

Background: With the loss of an important bodily function and the distortion in body image, a stoma patient experiences physical, psychological, and social changes. With limited current studies exploring experiences of patients in the management of their stoma, there is a need to explore their experiences, their needs, and factors that influence their self-management.

Objective: The aim of this study was to investigate patients’ experiences of performing self-care of stomas in the initial postoperative period.

Methods: This study adopted a descriptive qualitative approach from the interpretive paradigm. Semistructured interviews were conducted with 12 patients 1 month postoperatively in a colorectal ward in a hospital in Singapore. Thematic analysis was applied to the interview data.

Results: Five themes were identified: process of acceptance and self-management of stoma, physical limitations, psychological reactions, social support, and need for timely and sufficient stoma preparation and education.

Conclusions: This study highlights the importance of health professionals’ role in helping patients adjust preoperatively and postoperatively and accept the presence of a stoma. Health professionals need to be aware of the physical, psychological, and social impact of stoma on patients in the initial 30-day postoperative period.

Implications for Practice: Research findings informed the type and level of assistance and support to be offered to patients by nurses and the importance of encouraging patients to be involved in stoma care at an early stage, which will ultimately contribute to effective and independent self-management. Patients can be prepared preoperatively to reduce the psychological and social impact of stoma after creation of their stoma.

Author Affiliations: Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore (Ms Lim and Drs Chan and He); and Division of Nursing, Singapore General Hospital (Ms Lim).

The authors have no funding or conflicts of interest to disclose.

Correspondence: Hong-Gu He, PhD, MD, RN, Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore 117597 (

Accepted for publication March 8, 2014.

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