Qualidade de vida e complicações dos portadores de ostomia de eliminação

Introduction: An ostomy generates in the patient a high stress situation, which may result from the diagnosis as well as surgical intervention and may cause changes in their quality of life. The quality life of a person with an ostomy depends of the personal capacity of learning in relation to teh personal self-control behavior, autonomy and social learning (1). The surgical intervention that results in a construction of an ostomy, leads the ostomate to use adaptive behaviors and problem-solving strategies. The answer to the problems caused by the construction of a stoma, is influenced by the personal characteristics, as well as external changes, the quality of family, economic and care support received during the stages of surgical treatment that originated the ostomy (2). Objectives of this study were to characterize the person with an elimination ostomy disposal; identify the most common complications in the postoperative period; know the perception of the ostomy patient on adapting to their new condition of life; identify the impact caused by intestinal elimination ostomy in the person's lifestyles; and assess their quality of life. Methods: An exploratory, quantitative and cross-sectional study, with a convenience sample of all patients with intestinal elimination ostomy, temporary or permanent, of both sexes who agreed to participate in the study, with maximum time of surgery 3 months in eight national institutions. Data collection was conducted through an interview by the nurse responsible for stomatherapy consultation and appropriate completion of a questionnaire. The collection of data took place in the period from 1 June 2014 to 31 March 2014. The study was approved by the respective ethics committees of each institution. Results: 224 completed questionnaires, 68% male and 32% female were obtained with a mean age of 65.33 years (SD = 14.01) and over 70% have basic education. It was also identified that 60.3% of patients with an ostomy report to have caregiver; 20% of them live alone; and 22% said economic dependence on third parties. As for his health situation 25% of patients considered their health as bad, and when compared to five years ago 80% think it is worse (p <0.001). Regarding the economic situation according to Graffar classification, 39% were in classes III and IV classified as low or poor economic level. The family functionality was evaluated by Apgar test, which showed that the (17%) belongs to a family with moderate to high dysfunction. Regarding the stoma type: 75% colostomys and 25% ileostomys; 61% of the ostomys are temporary; 62.9% are prominent as anatomical feature, and the most prevalent cause of making the stoma (69.5%) were câncer. The most common complications in the stoma identified in the previous month study: decrease (3.2%), edema (3.2%), suture dehiscence (2.7%) and prolapse (2.7%). The most common complications peristoma skin, rash (30%) was the most prevalent complication. About Ostomy impact on lifestyles: 42% of patients with ostomy have a negative perception of their quality of life, 7.5% of users still rejects their stoma and 36.6% resigns with their situation, despite 63.8% reported having been depressed after the making of the ostomy. The major changes in daily life activities: 74% stopped working, 17.4% have difficulty dressing and / or adapt their clothing; 62.9% changed / adapted their diet to their new condition; 51% report reduced sexual activity and 42% of men reported problems with erection. Conclusions: autonomy, independence and quality of life are increasingly important issues in providing care, but related to the bearer of ostomy people are still scarce. These results help to understand stoma complications and facilitate adaptation to this transition. early identification of complications in the stoma and peri-lesional skin as well as its prevention, reduces costs and reduced quality of life. Taking into account the needs identified in this study is likely to implement educational programs for ostomy carrier and carer.