The Effects of Empowerment Program on Knowledge toward Colostomy Care and Self-care Ability in Patients undergoing Colostomy Surgery and Families
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Abstract
This is a quasi-experimental study with two group posttest design. The study purpose was to determine the effects of the empowerment program in patients who underwent colostomy surgery and family caregivers on knowledge and self-care ability regarding colostomy care, using Gibson's empowerment model. The research sample were 46 patients who underwent colostomy surgery and admitted at the male surgery wards in Udonthani hospital and 46 family caregivers, a total of 92 patients. The patients and family caregivers were equally allocated, 23 participants in each group, to the experimental group and the control group by purposive sampling. The experimental group received the empowerment program while the control group received usual care. Data were collected from August 2020 to January 2021. The research instruments were: 1) the empowerment program and a manual of self-care guidelines on colostomy care; and 2) the questionnaires for knowledge assessment and self-care ability in patients and family caregivers. The reliability of the questionnaires for knowledge assessment in patients and family caregivers regarding colostomy care was examined using Kuder-Richardson Formula 20, with the values of 0.83 and 0.85, respectively. The Cronbach’s alpha coefficient was used to determine the reliability of the questionnaires for self-care ability in patients and family caregivers, with the values of 0.94 and 0.96, respectively. The differences between the two groups were analyzed using independent T tests. A p-value of < .05 was considered statistically significant.
The findings revealed that the patients and family caregivers who received the empowerment program had significantly higher mean scores for knowledge on colostomy care and self-care ability (p < .001) compared to those who received the usual care. This study indicates that the empowerment program can improve knowledge and self-care ability among patients who underwent colostomy surgery as well as their family caregivers. The surgical service departments could apply this empowerment program for improving the quality of care among patients undergoing colostomy surgery.
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References
Hendren S, Hammond K, Glasgow SC, Perry WB, Buie WD, Steele SR, et al. Clinical practice guidelines for ostomy surgery. Dis Colon Rectum 2015;58(4):375-87.
Melotti LF, Bueno YM, Silveira GV, Silva MEN, Fedosse E. Characterization of patients with ostomy treated at a public municipal and regional reference center. Journal of Coloproctol 2013;33(2):70-4.
Chaithat B. Caring for colorectal cancer patients undergoing ostomies: roles of enterostomal therapy nurses. Thai Red Cross Nursing Journal 2016;9(1):19-33. (in Thai).
McMullen CK, Wasserman J, Altschuler A, Grant ML, Hornbrook MC, Liljestrand P, et al. Untreated peristomal skin complications among long-term colorectal cancer survivors with ostomies. Clin J Oncol Nurs 2011;15(6):644-50.
Pittman J. Characteristics of the patient with an ostomy. Journal of Wound Ostomy & Continence Nursing 2011;38(3):271-9.
Dabirian A, Yaghmaei F, Rassouli M, Tafreshi MZ. Quality of life in ostomy patients: a qualitative study. Patient Preference and Adherence 2011;5:1-5.
Vonk-Klaassen SM, de Vocht HM, den Ouden ME, Eddes EH, Schuurmans MJ. Ostomy-related problems and their impact on quality of life of colorectal cancer ostomates: a systematic review. Qual Life Res 2016;25(1):125-33.
Kittinouvarat S. A study of difficulties experienced by Thai ostomates after hospital discharge. World Council of Enterostomal Therapists Journal 2014;34(4):7-12.
Roshini AP, Sunny A, Anthony P, Rozario AP. Quality of life assessment in stoma patients in a tertiary care hospital in South India: a cross-sectional study. International Surgery Journal 2017;4(6):2037-41.
Chaleoykitti S, Pooncha S, Sawangchit S, Bandansin J. The way of life among patients with colostomy. Journal of The Royal Thai Army Nurses 2013;14(3):31-8. (in Thai).
Herlufsen P, Olsen AG, Carlsen B, Nybaek H, Jemec GB, Karlsmark T, Laursen TN. Study of peristomal skin disorders in patients with permanent stomas. British Journal of Nursing 2006;15(16):854-62.
Burch J. Management of peristomal skin complications. British Journal of Healthcare Management 2014;20(6):264-9.
Cheng F, Meng AF, Yang LF, Zhang YN. The correlation between ostomy knowledge and self-care ability with psychosocial adjustment in Chinese patients with a permanent colostomy: a descriptive study. Ostomy Wound Manage 2013;59(7):35-8.
Di Gesaro A. Self-care and patient empowerment in stoma management. Gastrointestinal Nursing 2012;10(2):19-23.
Cleek EN, Wofsy M, Boyd-Franklin N, Mundy B, Howell Lcsw TJ. The family empowerment program: an interdisciplinary approach to working with multi‐stressed urban families. Fam Process 2012;51(2):207-17.
Gibson CH. A concept analysis of empowerment. J Adv Nurs 1991;16(3):354-61.
Gibson CH. The process of empowerment in mothers of chronically ill children. J Adv Nurs 1995;21(6):1201-10.
Diniz IV, Barra IP, Silva MA da, Soares SH de O, Mendonça AEO de, Soares MJGO. Epidemiological profile of people with intestinal ostomy at a referral center. [Internet]. [cited 2021 April 9]. Available from: https://www.revistaestima.com.br/estima/article/view/929.
Meira IFDA, Silva FRD, Sousa ARD, Carvalho ESS, Rosa DOS, Pereira A. Repercussions of intestinal ostomy on male sexuality: an integrative review. Revista Brasileira de Enfermagem 2020;73(6):1-8.
Duchesne JC, Wang YZ, Weintraub SL, Boyle M. Stoma complications: a multivariate analysis/discussion. The American Surgeon 2002;68(11):961.
Sanitlou N, Sartpetch W, Naphaaruk Y. Sample size calculation using G*Power program. Journal of Suvarnabhumi Institute of Technology (Humanities and Social Sciences) 2019;5(1):496-507. (in Thai).
Thirathongdee K, Ronritthivichai C, Thongcharoen W, Pongthawornkamol K. Factors predicting the quality of life of elderly patients who underwent open abdominal surgery. Thai Canc J 2014;34:68-78. (in Thai).
Bloom BS. Learning for mastery: instruction and curriculum. Regional Education Laboratory for the Carolinas and Virginia, Topical Papers and Reprints, Number 1. [Internet]. [cited 2021 April 9]. Available from: https://files.eric.ed.gov/fulltext/ED053419.pdf.
Evers GCM. Appraisal of self-care agency ASA-scale: reliability and validity testing of the Dutch version of the ASA-scale measuring Orem's concept' self-care agency. Assen/Maastricht: Van Gorcum and Comp BV; 1989.
Blevins S. Colostomy care. Medsurg Nursing 2019;28(2):125-6.
Finset A. Family involvement, patient engagement and benefits of patient education interventions. Patient Educ Couns 2018;101(6):969.
Chutikamo N, Navicharern R, Lohsiriwat V. Predicting factors of quality of life in colorectal cancer adult patients with colostomy. Royal Thai Navy Medical Journal 2017;44(3):103-16. (in Thai).
Dickson VV, Riegel B. Are we teaching what patients need to know? Building skills in heart failure self-care. Heart & Lung 2009;38(3):253-61.
Acelya T. Investigating the effect of the health status of patients with stoma on illness perception: descriptive-cross sectional study. International Journal of Caring Science 2019;12(2):1-8.
Yilmazer T, Tuzer H, Akyuz S. Effect of information-motivation-behavioral skills model-based intervention on quality of life of ostomy patients. Turkiye Klinikleri J Nurs Sci 2020;12(2):182-9.