Relationship between resilience and health-related quality of life among patients with a permanent colostomy
The assessment of health-related quality of life (HRQoL) and resilience are important aspects of colorectal cancer care, as well as an indicator of patients' health status. This study was conducted to investigate the relationship between resilience and HRQoL among patients with a permanent colostomy.
A cross-sectional descriptive correlational design employing the City of Hope Quality of Life Ostomy Questionnaire and the Resilience Scale was adopted. A purposive sample population was recruited.
The study enrolled 158 colostomy patients. Half the participants (50.6%) were female and the mean age was 58.20 years [standard deviation (SD)=8.70]. Colostomy patients had a mean HRQoL score of 129.61 (SD)=98 (interquartile range: 109–148), with a spiritual domain that was lower than any other HRQoL domain. The Resilience Scale mean score was 106 (interquartile range: 82–126).
This study observed a general low score on the HRQoL Questionnaire and this was reflected in the Resilience Scale score of this group of patients with a colostomy.
Colorectal cancer (CRC) remains one of the most common malignant tumours worldwide. In recent years, the incidence of CRC in Egypt has increased, with CRC now constituting 3.47% of male cancers and 3% of female cancers. It is expected that incidence and mortality rates will continue to rise in the near future due to the lack of screening, a higher proportion of advanced-stage cancer at the time of diagnosis, and the lack of specialised care outside of major cities (Ibrahim et al, 2014; Metwally et al, 2018).
A colostomy is the opening of the colon onto the abdominal wall. The stoma lacks any form of sphincter which controls flatus and faecal output in the anus. Therefore, the patient is rendered incontinent as they pass bowel contents into a bag without being able to control the timing. This can lead to odour and leakage, and physical discomfort may be of concern (Moya-Muñoz et al, 2019). As a result, colostomy patients often have a poor body image and low self-esteem, while also battling with cancer, and may suffer from fear of potential rejection by partners, family and friends. Colostomy and CRC surgery complications have been found to have a substantial and detrimental effect on health-related quality of life (HRQoL), which is a valuable indicator of outcomes for cancer patients (Turkmen and Ozbas, 2019; Miller and Peck, 2020).
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