Altschuler A, Ramirez M, Grant M The influence of husbands’ or male partners’ support on women’s psychosocial adjustment to having an ostomy resulting from colorectal cancer. J Wound Ostomy Continence Nurs. 2009; 36:(3)299-305

Anaraki F, Vafaie M, Behboo R The city of hope-quality of life-ostomy questionnaire: Persian translation and validation. Ann Med Health Sci Res. 2014; 4:(4)634-637

Black PK. Psychological, sexual and cultural issues for patients with a stoma. Br J Nurs. 2004; 13:(12)692-7

Çakmak A, Aylaz G, Kuzu MA. Permanent stoma not only affects patients’ quality of life but also that of their spouses. World J Surg. 2010; 34:(12)2872-2876

Dabirian A, Yaghmaei F, Rassouli M, Tafreshi MZ. Quality of life in ostomy patients: a qualitative study. Patient Prefer Adherence. 2010; 5:1-5

Davidson F. Quality of life, wellbeing and care needs of Irish ostomates. Br J Nurs. 2016; 25:(17)S4-S12

Gao W, Yuan C, Wang J A Chinese version of the City of Hope Quality of Life-Ostomy Questionnaire: validity and reliability assessment. Cancer Nurs. 2013; 36:(1)41-51

Gautam S, Poudel A. Effect of gender on psychosocial adjustment of colorectal cancer survivors with ostomy. J Gastrointest Oncol. 2016; 7:(6)938-945

Grant M, Ferrell B, Dean G, Uman G, Chu D, Krouse R. Revision and Psychometric Testing of the City of Hope Quality of Life–Ostomy Questionnaire. Qual Life Res. 2004; 13:(8)1445-1457

Hu A, Pan Y, Zhang M Factors influencing adjustment to a colostomy in Chinese patients: a cross-sectional study. J Wound Ostomy Continence Nurs. 2014; 41:(5)455-459

Ketterer SN, Leach MJ, Fraser C. Factors associated with quality of life among people living with a stoma in nonmetropolitan areas. Nurs Res. 2021; 70:(4)281-288

Kiliç E, Taycan O, Belli AK, Ozmen M. Kalici ostomi ameliyatinin beden algisi, benlik saygisi, eş uyumu ve cinsel işlevler uzerine etkisi (The effect of permanent ostomy on body image, self-esteem, marital adjustment, and sexual functioning) (original in Turkish). Turk Psikiyatri Derg. 2007; 18:(4)302-10

Knowles SR, Wilson J, Wilkinson A Psychological well-being and quality of life in Crohn's disease patients with an ostomy: a preliminary investigation. J Wound Ostomy Continence Nurs. 2013; 40:(6)623-639

Konjevoda V, Zelić M, Munjas Samarin R, Petek D. City of Hope Quality of Life-Ostomy Questionnaire validity and reliability assessment on a Croatian sample. Int J Environ Res Public Health. 2020; 17:(3)

Krouse RS, Grant M, McCorkle R A chronic care ostomy self-management program for cancer survivors. Psychooncology. 2016; 25:(5)574-581

Kwiatt M, Kawata M. Avoidance and management of stomal complications. Clin Colon Rectal Surg. 2013; 26:(2)112-121

Jansen F, van Uden-Kraan CF, Braakman JA, van Keizerswaard PM, Witte BI, Verdonck-de Leeuw IM. A mixed-method study on the generic and ostomy-specific quality of life of cancer and non-cancer ostomy patients. Support Care Cancer. 2015; 23:(6)1689-97

The City of Hope Quality of Life Stoma Questionnaire: Malayalam Translation and Validation. 2019. (accessed 24 November 2021)

Neuman HB, Fuzesi Patil S Impact of a temporary stoma on the quality of life of rectal cancer patients undergoing treatment. Ann Surg Oncol. 2011; 18:(5)1397-1403

Pringle W, Swan E. Continuing care after discharge from hospital for stoma patients. Br J Nurs. 2001; 10:(19)1275-1288

Sarabi N, Navipour H, Mohammadi E. Relative tranquility in ostomy patients’ social life: a qualitative content analysis. World J Surg. 2017; 41:(8)2136-2142

Psychosocial experiences of the patients with colostomy/ileostomy: a qualitative study. 2014. (accessed 29 November 2021)

Sinha A, Goyal H, Singh S, Rana SP. Quality of life of ostomates with the selected factors in a selected hospital of Delhi with a view to develop guidelines for the health professionals. Indian J Palliat Care. 2009; 15:(2)111-4

Sukhpal S, Das K, Gupta R. Physical, nutritional and sexual problems experienced by the patients with colostomy/ileostomy: a qualitative study. Nursing and Midwifery Research Journal. 2012;

Susanty S, Rangki L. Changes and adaptation in patients post colostomy. IOSR Journal of Nursing & Public Health Science. 2016; 5:(6)123-129

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

Quality of life of ostomates at a teaching and referral hospital in Kenya

09 December 2021
Volume 30 · Issue 22



Ostomy surgery is performed to maintain gastrointestinal function. However, there is a lack of knowledge and experience about ostomies among patients and clinicians in public hospitals in Kenya. The issue is compounded by the social isolation and stigma ostomates face in the wards and in the community after discharge. Although it is not easy to identify the exact number of ostomates in Kenya and other African countries, there is need to shift the focus from curing symptoms in ostomates to maximising patients’ quality of life (QoL) and integrating services for ostomates in mainstream public hospitals.


To understand the effects of ostomies on patients’ QoL, with a focus on nutrition, psychosocial aspects and challenges around sexuality after ostomy creation.


A descriptive study was undertaken using an interviewer-administered QoL questionnaire with 81 patients.


Most patients were male (54%); the largest age group was 35–44 years (24.7%). Colorectal carcinoma, intestinal obstruction and traumatic injuries were the main indications for ostomy. Ostomates resumed sexual activity, but did not find it fulfilling (P=0.002). Most reported feeling depressed, with suicidal attempts that negatively correlated with QoL. Ostomates adjusted their diets regardless of whether their level of QoL was poor, fair, good or excellent after ostomy creation (P=0.564).


Ostomates experience low QoL. Patients’ lives can be improved by focusing on providing individualised ostomy care services after discharge. Enhancing stoma therapy training for nurses and running ostomy clinics alongside mainstream services, as well as support for ostomates towards enrolment into the country’s National Hospital Insurance Fund, will also improve patients’ QoL.

The purpose of an ostomy is to correct developmental anomalies, for decompression and lavage of the intestinal tract, stool diversion with obstruction and exteriorisation of the elimination passage, and also on a temporary basis to treat and reduce patients’ pain and discomfort related to disease. However, the creation of an ostomy alters a patient’s elimination patterns and can affect an individual both physically and psychologically.

Patients undergo ostomy surgery (colostomies, ileostomies and urostomies) for both permanent and temporary maintenance of gastrointestinal/urinary function. However, in Kenya, there is a general lack of knowledge about or experience of ostomy surgery and the implications of living with an ostomy among both patients and clinicians, an issue that is often observed during a patient’s hospitalisation. This lack of knowledge is compounded by the social stigma associated with ostomy care in most Kenyan communities.

There is limited documentation on quality of life (QoL) of ostomates in Kenya and equally little information on how ostomies affect patients’ QoL, as well as the interventions undertaken in public hospitals to improve ostomates’ QoL.

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