Bağırsak Stoması Bulunan Hastaların Tekrar Hastaneye Yatış Nedenlerinin İncelenmesi

Year 2022, Volume: 5 Issue: 3, 306 - 312, 05.12.2022

Esra Makal Orğan , Sacide Yıldızeli Topçu , Mervegül Özkan

https://doi.org/10.38108/ouhcd.1022578

Abstract

Amaç: Bu araştırmanın amacı, bağırsak stoması açılmış olan hastalarda taburculuk sonrası tekrar hastaneye yatış nedenlerinin belirlenmesidir.
Yöntem: Retrospektif ve tanımlayıcı türdeki bu araştırmanın örneklemini Ocak 2013- Aralık 2017 tarihleri arasındaki 5 yıllık süreçte Trakya Üniversitesi Sağlık Araştırma ve Uygulama Merkezi Genel Cerrahi Servisi’nde bağırsak cerrahisi geçirerek, stoma açılan 112 hasta oluşturmaktadır. Verilerin toplanmasında, araştırmacılar tarafından oluşturulan ve hastaların demografik ve sağlıkla ilgili bilgilerini sorgulayan veri toplama formu kullanıldı.
Bulgular: Hastaların %19.6 (n=22)’sında taburculuk sonrası komplikasyon geliştiği ve bu komplikasyonların da %31.8 (n=7)’ini peristomal cilt komplikasyonlarının, %31.8 (n=7)’ini de stomaya ilişkin fonksiyon bozukluklarının oluşturduğu belirlendi. Stoma cerrahisi geçirmiş hastaların %45.5 (n=51)’inin taburculuk sonrası tekrar hastaneye yattığı ve tekrar hastaneye yatan hastaların %33.3 (n=17)’ünde hastaneye yatış nedeninin stomaya ilişkin yaşanan sorunlar olduğu saptandı.
Sonuç: Stoma cerrahisi uygulanan hastalar taburculuktan sonra, basit girişimlerle çözülebilecek ve önlenebilecek stoma ile ilişkili sorunlar nedeniyle tekrar hastaneye yatmaktadır. Stomalı hastalar ile çalışan hemşirelerin stoma bakımı ve stoma sorunlarının önlenmesine yönelik hastaları bilgilendirmeye özen göstermeleri ve hastalara sundukları bakımı ve sonuçlarını kayıt altına aldıkları etkin bir hemşirelik bakımı sağlamaları önerilmektedir.

Keywords

Hemşirelik, Bağırsak Stoması, Stoma Komplikasyonları, Hastaneye Tekrar Yatış

Supporting Institution

Destekleyen kurum bulunmamaktadır.

Thanks

Veri toplama sürecindeki yardım ve destekleri için sağlık uzmanlarına teşekkür ederiz.

Investigation of the Reasons for Rehospitalization of Patients with Intestinal Stoma

Abstract

Objective: The purpose of this study is to determine the reasons for re-hospitalization after discharge in patients with intestinal stoma.
Methods: The sample of this retrospective and descriptive study consists of 112 patients who underwent intestinal surgery at the Trakya University Health Research and Application Center General Surgery Service and opened a stoma in a 5-year period between January 2013 and December 2017. A “Data Collection Form” was used to collect the data, which was created by the researchers and inquired about the demographic and health-related information of the patients.
Results: Complications developed after discharge in 19.6% (n = 22) of the patients and 31.8% (n = 7) of these complications were peristomal skin complications and 31.8% (n = 7) were dysfunction related to stoma. It was determined that 45.5% (n = 51) of the patients who had stoma surgery were re-hospitalized after discharge and 33.3% (n = 17) of the patients who were re-hospitalized were found to have problems related to the stoma.
Conclusion: Patients who undergone stoma surgery were hospitalized again after being discharged due to stoma-related problems that can be solved and prevented with simple interventions. It is recommended that nurses working with stoma patients should take care to inform patients about stoma care and prevention of stoma problems and provide effective nursing care in which they record the care they provide to patients and their results.

Keywords

Nursing, Intestinal Stoma, Stoma Complications, Hospital Readmission

References

• Albaugh JA, Tenfelde S, Hayden DM. (2017). Sexual dysfunction and intimacy for ostomates. Clinics in Colon and Rectal Surgery, 30, 201–206.
• Andrews GR, Sharma A. (2018). Impact of in effect of ınstructional booklet on the knowledge, attitude, problems faced and coping strategies adopted by colostomy patients in selected hospitals of Delhi. Current Medicine Research and Practice, 8(3), 92-95.
• Arolfo S, Borgiotto C, Bosio G, Mistrangelo M, Allaix ME, Morino M. (2018). Preoperative stoma site marking: a simple practice to reduce stoma-related complications. Techniques in Coloproctology, 22(9), 683-687.
• Blevins S. (2019). Colostomy care. Medsurg Nursing, 28(2), 125-126.
• Carlsson E, Fingren J, Hallén A.M, Petersén C, Lindholm E. (2016). The prevalence of ostomy-related complications 1 year after ostomy surgery:a prospective, descriptive, clinical study. Ostomy Wound Management, 62(10), 34-48.
• Marinez AC, Bock D, Carlsson E, Petersén C, Erestam S, Kälebo P, et al. (2021). Stoma‐related complications: a report from the Stoma‐Const randomized controlled trial. Colorectal Disease, 23(5), 1091-1101.
• Duluklu B, Çelik SŞ. (2019). Kolostomisi olan bireylerde yaşam kalitesi: sorunlar ve hemşirelik girişimleri. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi, 6(2), 111-119.
• Engida A, Ayelign T, Mahteme B, Aida T, Abreham, B. (2016). Types and indications of colostomy and determinants of outcomes of patients after surgery. Ethiopian Journal of Health Sciences, 26(2), 117-120.
• Harilingam M, Sebastian J, Twum-Barima C, Boshnaq M, Mangam S, Khushal A, et al.(2017). Patient-related factors influence the risk of developing intestinal stoma complications in early post-operative period. ANZ Journal of Surgery, 87(10), 116-120.
• Harputlu D, Özsoy, SA. (2016). Stoma çevresi cilt komplikasyonlarının tanılanmasında bir araç: peristomal cilt aracı. Florence Nightingale Hemşirelik Dergisi, 24(1), 38-48.
• Hazen SJA, Vogel I, Borstlap WAA, Dekker JWT, Tuynman JB, Tanis PJ, et al. (2022). Long-term stoma-related reinterventions after anterior resection for rectal cancer with or without anastomosis: population data from the Dutch snapshot study. Techniques in Coloproctology, 26, 99-108.
• Jayarajah U, Samarasekara AMP, Samarasekera DN. (2016). A study of long-term complications associated with enteral ostomy and their contributory factors. BMC Research Notes, 9(500), 2-6.
• Karadağ A. (2016). Peristomal cilt komplikasyonları: tanılama, önleme, tedavi. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi, 3(1), 72–83.
• Koç U, Karaman K, Gomceli I, Dalgic T, Ozer I, Ulas M ve ark. (2017). A retrospective analysis of factors affecting early stoma complications. Ostomy Wound Management, 63(1), 28-32.
• Kwiatt M, Kawata M. (2013). Avoidance and management of stomal complications. Clinics in Colon and Rectal Surgery, 26(2), 112-121.
• Malik TAM, Lee MJ, Harikrishnan AB. (2018). The incidence of stoma related morbidity–a systematic review of randomised controlled trials. The Annals of The Royal College of Surgeons of England, 100(7), 501-508.
• Massenga A, Chibwae A, Nuri AA, Bugimbi M, Munisi, YK, Mfinanga R, et al. (2019). Indications for and complications of intestinal stomas in the children and adults at a tertiary care hospital in a resourcelimited setting: a Tanzanian experience. BMC Gastroenterology, 19(157), 2-10.
• Miranda LSG, Carvalho AAS, Paz EPA. (2018). Quality of life of ostomized person: relationship with the care provided in stomatherapy nursing consultation. Escola Anna Nery, 22(4), 1-9.
• Özaydın İ, Taşkın AK, İskender A. (2013). Stoma ile ilgili komplikasyonların retrospektif analizi. Journal of Clinical and Experimental Investigations, 4(1), 63-66.
• Persson E, Berndtsson I, Carlsson E, Halle´n AM, Lindholm E. (2010). Stoma-related complications and stoma size – a 2-year follow up. Colorectal Disease, 12, 971-976.
• Salvadalena GD. (2013). The ıncidence of stoma and peristomal complications during the first 3 months after ostomy creation. Journal of Wound Ostomy & Continence Nursing, 40(4), 400-406.
• Shiraishi T, Nishizawa Y, Nakajima M, Kado R, Ogawa H, Satoh N, et al. (2022). Protocol for the Japanese prospective multicenter observational study to evaluate the timing and frequency of stoma-related complications in patients with malignant rectal tumors. Journal of Japanese Society of Wound, Ostomy and Continence Management, 25(4), 710-716.
• Stokes AL, Tice S, Follett S, Paskey D, Abraham L, Bealer C, et al. (2017). Institution of a preoperative stoma education group class decreases rate of peristomal complications in new stoma patients. Journal of Wound Ostomy & Continence Nursing, 44(4), 363-367.
• Taneja C, Netsch D, Rolstad BS, Inglese G, Lamerato L, Oster G. (2017). Clinical and Economic Burden of Peristomal Skin Complications in Patients with Recent Ostomies. Journal of Wound Ostomy & Continence Nursing, 44(4), 350-357.
• Taylan S, Akıl Y, Cihan R, Arslan, S. (2017). Stoma torbası deneyiminin hemşirelerin farkındalıkları üzerine etkisi. Journal of Human Sciences, 14(3), 2208-2218.
• Terzi B, Kaya N, Aştı T. (2017). Bağırsak yönetim sistemi ve hemşirenin rolü. Cumhuriyet Hemşirelik Dergisi, 6(1), 34-39.
• Vonk-Klaassen SM, Vocht HM, Ouden MEM, Eddes EH, Schuurmans MJ. (2016). Ostomy-related problems and their impact on quality of life of colorectal cancer ostomates: a systematic review. Quality of Life Research, 25, 125–133.