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Bowel Problems, Self-care Practices, and Information Needs of Colorectal Cancer Survivors at 6 to 24 Months After Sphincter-Saving Surgery

Nikoletti, Sue PhD, BSc (Hons), RN; Young, Jeanne PhD(c), BSc (Hons), RN; Levitt, Michael MBBS (UWA), FRACS; King, Mary DipContinence, DipNatTherapy, BAppScN, RN, STN; Chidlow, Christine PostGradDipPhy (Women's Health), BAppSc (Phy); Hollingsworth, Shelley BSc (Hlth Inf Man), BA (Psychology)

doi: 10.1097/01.NCC.0000305759.04357.1b

The aim of this study was to describe bowel problems, self-care practices, and information needs of patients who have recovered from the acute effects of sphincter-saving surgery for colorectal cancer. A retrospective, descriptive survey was conducted using a structured telephone interview and mailed questionnaires. The sample consisted of 101 patients who had undergone sphincter-saving surgery for colorectal cancer in the last 6 to 24 months. Most participants (71.3%) reported a change in bowel habits after surgery. The 6 most frequently reported gastrointestinal problems were incomplete evacuation (75.2%), excessive flatus (75.2%), urgency (73.3%), straining (61.4%), perianal soreness or itching (49.5%), and bloating (43.6%). Incontinence of feces (varying from smears to complete bowel action) was reported by 37.6% of participants. The most frequently reported information needs were related to diet (50.5%) and managing conditions such as diarrhea (31.7%), bloating/wind/gas (28.7%), pain (21.8%), and incomplete emptying of the bowel (18.8%). Patients who had recovered from the acute effects of sphincter-saving surgery for colorectal cancer reported a wide range of bowel problems and ongoing concerns about managing symptoms. Findings from this study provide valuable information to guide the development of educational resources to prevent or better manage bowel problems after surgery.

Authors' Affiliations: Sir Charles Gairdner Hospital, Nedlands, Western Australia (Dr Nikoletti, Ms Young, Ms King, and Ms Chidlow); Edith Cowan University, Joondalup, Western Australia (Dr Nikoletti, Ms Young, and Ms Hollingsworth); St John of God Health Care, Subiaco, Western Australia (Mr Levitt).

Mr Levitt is formerly a medical codirector of the Gastro-Renal Clinical Service Unit at Sir Charles Gairdner Hospital.

This project was funded by a National Continence Management Strategy grant from the Australian Government Department of Health and Ageing.

Corresponding Author: Jeanne Young, PhD(c), BSc (Hons), RN, Centre for Nursing Research, Sir Charles Gairdner Hospital, Hospital Ave, Nedlands Western Australia 6009, Australia (

Accepted for publication January 24, 2008.

© 2008 Lippincott Williams & Wilkins, Inc.