Friday, July 26, 2019
A specific health care topic of interest to you --Nursing Essay
A specific health care topic of interest to you --Nursing - Essay Example According to Bracken, ââ¬Å"every patient who faces this type of surgery struggles with fears and anxieties that are universal...â⬠(n.d. cited in International Ostomy Association, 2006). Pre-operative and post-operative health teachings are routine interventions that help the patient prepare for, and manage surgical outcomes; however, studies supporting the common areas of stomal patient concern are scarce. This meta-analysis was done to identify the subject matter that needed further emphasis during patient teaching; as well as to identify the different factors that contributed to the low self-esteem experienced by these patients. Although pre-operative and post-operative education in managing the stoma are being employed by health care institutions, the subject matter and the patient concerns addressed during patient teaching should be assessed in order to provide individualized health teaching that can address patient uncertainty in managing the stoma; allay anxiety in rela tion to social issues; and prepare the patient for the changes associated with the surgery. Background and Introduction A stoma is an artificial opening made on the side of the abdomen that is used as a permanent, or temporary outlet for feces or urine (Clinimed, n.d.). There are three different types: colostomy--for solid fecal outlet; ileostomy--for soft fecal outlet; and urostomy--as outlet for urine (Clinimed, n.d.). Indications for stoma surgery include: congenital conditions such as malformations in the anus and urethra, and diseases like inflammatory bowel disease, colorectal cancer, diverticulear disease, and ulcers. Ostomy surgery is performed by taking a portion of the large, or small intestine through the abdominal wall to provide an outlet for feces and urine (Encyclopedia of Surgery, n.d.). A collection bag is worn over the stoma and requires routine irrigation to prevent infection and other complications. This procedure is performed to aid healing by diverting fecal ma tter from an injured or diseased part of the large intestine, for temporary stomas, and to construct an alternative excretory pathway for fecal matter and urine, for permanent stomas. The estimated of the number of patients with a stoma vary across the globe. In the US, approximately 800,000 patients with a stoma were reported in 2000; with growth rate of 3% each year (Turnbull, 2008). Ontario, Quebec and British Columbia were reported to have the highest number of ostomy surgeries annually in 2009; with colostomy accounting for 55%; ileostomy 31%; and urostomy 14% (Registered Nurseââ¬â¢s Association of Ontario, 2009). According to Renzulli and Candinas (2007), stoma formation and delayed closure is associated with high morbidity; and complications including: stomal necrosis, stomal retraction, stomal stenosis, mucocutaneous separation and stomal prolapse. In a study conducted by Makela and Niskasaari (2006), which explored stoma care related problems experienced by stoma surgery patients in Northern Finland, it was found out that 35 patients of the 163 respondents developed stoma complications, particularly parastomal herninas (18 cases). Apart from the problem of having to live with the life-long risks associated with a stoma, self-esteem issues may also surface. According to Honkala and Bertero (2009), the most common concerns of patients before and after an ostomy surgery were
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