Authors (including presenting author) :
Wong CH (1), Chan SH (1), Chan HK (1), Yam WW (1), Tam ML (1), Wong SL (1), Shit KY (1), Lam CP (1), Chui ST (1)
Affiliation :
(1) Department of Surgery, Prince of Wales Hospital
Introduction :
According to the data from CHP in February 2023, colorectal cancer is the second commonest cancer in Hong Kong. Most cases require surgical resection, while a stoma is sometimes inevitable after colorectal surgery. However, stoma formation often precipitates physical, psychological and social stress, related to living with a stoma. Patients, as stoma-care beginners, lack systematic handling of stoma care products and often put the appliances over the bedside table in a mess. They put the products in a plastic bag and rush to toilet. Patients hold their tops using chin for stoma care. It increases the clumsiness and psychological stress of stoma care. The all-in-one stoma self-care kit incorporates necessary items to facilitate mess-free stoma care during and post hospitalization.
Objectives :
This project aimed to uphold the quality of life for patients with stoma by promoting self-care of stoma. The objectives are (1) To ensure patient competencies on the usage of stoma products and accessories; (2) To reduce psychological stress and anxiety on stoma care; (3) To enhance quality of stoma care during hospitalization, at home and outdoor events; (4) To facilitate resumption of normal life for patients with stoma.
Methodology :
The project was implemented in a Colorectal Surgery unit under Department of Surgery, Prince of Wales Hospital from May 2021 to May 2022. The program arrangement and timeline were introduced to all nursing staff in the unit. “All-in-one ostomy self-care kit” were designed prior to the commencement of the program and would be delivered to the recruited patients. The kit was designed as a working platform with different pockets to accommodate different products. It can be hung up on the washroom door using the S-shaped hook provided. The kit contains stoma measuring guide, flushable wet wipes, mirror and clips for holding clothes. Personalized stoma products can be added in as suggested by stoma specialists. Outcome evaluation was performed using post-intervention patient and staff questionnaire. A self-administered questionnaire using 4-point Likert scale was distributed to assess handiness of the self-care kit, self-management skills, quality of care and overall impression. Another anonymous self-report questionnaire with 4-point Likert scale were administered to nursing staff, focusing on the usage of self-care kit and stoma care delivery.
Result & Outcome :
70 patients undergone colorectal surgery with stoma formation were given the kit and recruited by convenience sampling from October 2021 to May 2022. Over 98% of patients indicated the kit was easy to use, could provide necessary accessories for stoma care, facilitate the process of stoma bag change and self-care of stoma. All patients expressed they would continue to use the kit when they discharge from hospital. All 32 participating nurses believed the kit could help patients facilitate the process of stoma bag change and improve quality of care. Over 98% of nurses revealed the self-care kit was easy to use and could facilitate early self-care of stoma during hospitalization. Overall satisfaction score for both patients and nurses were good or excellent.
