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Going With the Flow: Quality‐of‐Life Outcomes of Cancer Survivors With Urinary Diversion

Gemmill, Robin; Sun, Virginia; Ferrell, Betty; Krouse, Robert S.; Grant, Marcia

Journal of Wound, Ostomy & Continence Nursing: January/February 2010 - Volume 37 - Issue 1 - p 65–72
doi: 10.1097/WON.0b013e3181c68e8f
Ostomy Care

PURPOSE: The purpose of this descriptive study was to describe health-related quality of life (HRQOL) concerns among cancer patients with continent urinary diversion (UD) and incontinent UD.

SUBJECTS and SETTINGS: Study participants were accrued from members of the California United Ostomy Association and 2 cancer centers in Southern California.

INSTRUMENT: The City of Hope HRQOL-Ostomy Questionnaire (COHHRQOL-O) is a modified HRQOL measurement tool based on the original work done over a number of years by Grant and colleagues.

METHODS: The COHHRQOL-O was mailed to 2,890 individuals. Of the 1,600 returns, there were 307 responses from patients with UD, indicating that they had a UD and a diagnosis that clearly indicated cancer.

RESULTS: The majority of respondents were diagnosed with bladder cancer, and the average time since surgery was 9.5 years. While most patients reported being sexually active prior to UD, less than 27% resumed sexual activity after surgery. More than 75% of patients also reported difficulty in adjusting to their UD, with the majority reporting difficulty with urine leakage. Those who were incontinent reported a range of bothersome issues, such as skin problems around the UD, difficulties in managing UD care, fear of recurrence, financial worries, family distress, and uncertainty about the future.

CONCLUSIONS: The results of this study add to our understanding of how patients adjust to a UD and what problems and issues can occur, even years after the initial surgery. Mastering UD care is best done under the guidance of a WOC nurse, and access to WOC nurse is essential when problems occur.

Robin Gemmill, MSN, RN, CNS, CWOCN, Senior Research Specialist, Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, California.

Virginia Sun, MSN, RN, ANP, Senior Research Specialist, Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, California.

Betty Ferrell, PhD, RN, FAAN, Research Scientist, Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, California.

Robert S. Krouse, MD, FACS, Associate Professor, Surgery, Southern Arizona Veterans Affairs Health Care System and University of Arizona College of Medicine, Tucson, Arizona.

Marcia Grant, DNSc, RN, FAAN, Director and Professor, Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, California.

Corresponding author: Robin Gemmill, MSN, RN, CNS, CWOCN, Senior Research Specialist, Division of Nursing Research and Education, Department of Population Sciences, City of Hope, 1500 E Duarte Rd, Duarte, CA 91010 (rgemmill@coh.org).

Copyright © 2010 by the Wound, Ostomy and Continence Nurses Society