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Evaluation of the Expert Patient Program in a Chinese Population With Permanent Colostomy

Cheng, Fang MS, RN; Xu, Qin MS RN; Dai, Xiao-dong BS, RN; Yang, Lin-li BS, RN

doi: 10.1097/NCC.0b013e318217cbe9
Articles: Online Only

Background: A colostomy can negatively impact patients’ quality of life. Recent research findings suggest that self-efficacy and psychosocial adjustment are positively associated with quality of life, but there are few research reports about the self-efficacy and psychosocial adjustment of patients with a permanent colostomy.

Objectives: The objective of the study was to evaluate the effect of a 3-week Expert Patient Program (EPP) on colostomy knowledge, stoma care self-efficacy, self-management, and psychosocial adjustment in Chinese patients who had a permanent colostomy.

Methods: Eleven patients with permanent colostomy volunteered to be trained to be expert patients. Eighty-one patients with permanent colostomy were recruited and participated in the 3-week EPP courses. Questionnaires with items about knowledge on colostomy, stoma care self efficacy, self-management, and psychosocial adjustment were administered before and at 4 weeks following the EPP courses. Each EPP participant also completed a verbal interview at the end of the program.

Results: The EPP participants demonstrated statistically significant improvement (P < .01) in knowledge, self-efficacy, self-management, and psychosocial adjustment to colostomy (mean [SD]: 51.89 [11.45] vs 89.22 [19.90], 71.56 [5.93] vs 85.61 [14.32], 125.44 [19.27] vs 140.78 [15.34], 47.59 [9.64] vs 53.37 [10.68], respectively). Most participants gave positive ratings to the EPP.

Conclusions: This study showed that the EPP was applied effectively in patients with permanent colostomy.

Implications for Practice: This study highlights the importance of psychosocial support for patients with permanent colostomy. It offers a model of self-help practice in colostomy patients, supported by community that can benefit more patients with permanent colostomy.

Author Affiliations: Nursing School of Nanjing Medical University, Jiangsu Cancer Hospital, Nanjing (Ms Cheng); and Nursing School of Nanjing Medical University (Mrs Xu) and Department of General Surgery (Mss Dai and Yang), the First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

The study is funded by the Nursing School of Nanjing Medical University.

The authors have no conflicts of interest to disclose.

Correspondence: Qin Xu, MS, RN, Nursing School of Nanjing Medical University; the First Affiliated Hospital of Nanjing Medical University, Hanzhong Rd 140, Nanjing 210029, China (

Accepted for publication February 26, 2011.

© 2012 Lippincott Williams & Wilkins, Inc.