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The Influence of Husbands' or Male Partners' Support on Women's Psychosocial Adjustment to Having an Ostomy Resulting From Colorectal Cancer

Altschuler, Andrea; Ramirez, Michelle; Grant, Marcia; Wendel, Christopher; Hornbrook, Mark C.; Herrinton, Lisa; Krouse, Robert S.

Journal of Wound, Ostomy and Continence Nursing: May-June 2009 - Volume 36 - Issue 3 - p 299–305
doi: 10.1097/WON.0b013e3181a1a1dc

OBJECTIVE Some patients with colorectal cancer (CRC) require a permanent ostomy, which changes bodily function and can create psychosocial distress. However, little is known about the influence of men's support on women's psychosocial adjustment to having an ostomy as a result of CRC.

METHODS Participants initially completed the City of Hope-CRC Quality of Life questionnaire. We then conducted in-depth interviews with 30 female participants. Interview questions focused on body image, gender, and sexuality. Interviews were recorded and transcribed. We used qualitative methods to analyze the interview data and compared global health-related quality of life (HRQOL) quartile scores to the overall ways that women discussed husbands' or partners' support regarding psychosocial adjustments to having ostomies.

RESULTS Of 30 participants, 22 were married or partnered at the time of surgery and 8 were single. The nonpartnered respondents are not included in this analysis. Of the 22 married/partnered women, 17 described positive support from husbands being central to their psychosocial adjustment, 3 described a lack or withdrawal of support negatively affecting adjustment, and 2 described support as neither positive nor negative. In 17 cases, women's high or low quantitative HRQOL scores matched the positive or negative qualitative findings. There were 3 cases in which there were positive qualitative data and low HRQOL scores, but in each of these cases, women reported serious current comorbidities.

CONCLUSIONS These findings suggest that the provision or withdrawal of husbands' or partners' support can have a considerable impact on the psychosocial adjustment of female CRC patients with ostomies. These findings appear to be both short term and long term. Survivorship assessments should include appraisals of women's relationships to their spouses/partners.

Andrea Altschuler, PhD, Kaiser Permanente Northern California, Oakland.

Michelle Ramirez, University of the Sciences in Philadelphia, Philadelphia, Pennsylvania.

Marcia Grant, DNSc, City of Hope National Medical Center, Duarte, California.

Christopher Wendel, MS, Southern Arizona VA Health Care System, Tucson.

Mark C. Hornbrook, PhD, Kaiser Permanente Northwest Region, Portland, Oregon.

Lisa Herrinton, PhD, Kaiser Permanente, Northern California, Oakland.

Robert S. Krouse, MD, University of Arizona, Tucson, Southern Arizona VA Health Care System, Tucson.

Corresponding author: Andrea Altschuler, Kaiser Permanente Division of Research, 2000 Broadway, Oakland, CA 94612 (

Copyright © 2009 by the Wound, Ostomy and Continence Nurses Society