References

Bladder and Bowel Community. What is a stoma?. 2019. https://tinyurl.com/y5wpv69l (accessed 28 February 2019)

Brazier J, Roberts J, Deverill M. The estimation of a preference-based measure of health from the SF-36. J Health Econ. 2002; 21:(2)271-292

Claessens I, Probert R, Tielemans C The ostomy life study: the everyday challenges faced by people living with a stoma in a snapshot. Gastrointest Nurs. 2015; 13:(5)18-25 https://doi.org/10.12968/gasn.2015.13.5.18

Cronbach LJ. Coefficient alpha and the internal structure of tests. Psychometrika. 1951; 16:(3)297-334 https://doi.org/10.1007/BF02310555

Gray M, Colwell JC, Doughty D Peristomal moisture-associated skin damage in adults with fecal ostomies: a comprehensive review and consensus. J Wound Ostomy Continence Nurs. 2013; 40:(4)389-399 https://doi.org/10.1097/won.0b013e3182944340

Herlufsen P, Olsen AG, Carlsen B Study of peristomal skin disorders in patients with permanent stomas. Br J Nurs. 2006; 15:(16)854-862 https://doi.org/10.12968/bjon.2006.15.16.21848

Kriza C, Emmert M, Wahlster P, Niederländer C, Kolominsky-Rabas P. Cost of illness in colorectal cancer: an international review. Pharmacoeconomics. 2013; 31:(7)577-588 https://doi.org/10.1007/s40273-013-0055-4

Lindholm E, Persson E, Carlsson E, Hallén A-M, Fingren J, Berndtsson I. Ostomy-related complications after emergent abdominal surgery: a 2-year follow-up study. J Wound Ostomy Continence Nurs. 2013; 40:(6)603-610 https://doi.org/10.1097/won.0b013e3182a9a7d9

User's manual for the sf-36v2 health survey. In: Maruish M (ed). Lincoln (RI): QualityMetric Inc; 2011

Maydick D. A descriptive study assessing quality of life for adults with a permanent ostomy and the influence of preoperative stoma site marking. Ostomy Wound Manage. 2016; 62:(5)14-24

Nichols T. Health utility, social interactivity, and peristomal skin status: a cross-sectional study. J Wound Ostomy Continence Nurs. 2018; 45:(5)438-443 https://doi.org/10.1097/won.0000000000000457

Nichols TR. Quality of life in us residents with ostomies assessed via the sf36v2: Role-physical, bodily pain, and general health domain. J Wound Ostomy Continence Nurs. 2016; 43:(3)280-287 https://doi.org/10.1097/won.0000000000000219

Nichols TR, Inglese GW. The burden of peristomal skin complications on an ostomy population as assessed by health utility and the physical component summary of the sf-36v2®. Value Health. 2018; 21:(1)89-94 https://doi.org/10.1016/j.jval.2017.07.004

Nybaek H, Knudsen DB, Laursen TN, Karlsmark T, Jemec GBE. Quality of life assessment among patients with peristomal skin disease. Eur J Gastroenterol Hepatol. 2010; 22:(2)139-143 https://doi.org/10.1097/meg.0b013e32832ca054

Optum. SF-36v2 health survey. 2018. https://tinyurl.com/y5b8lhv4 (accessed 28 February 2019)

Pittman J, Rawl SM, Schmidt CM Demographic and clinical factors related to ostomy complications and quality of life in veterans with an ostomy. J Wound Ostomy Continence Nurs. 2008; 35:(5)493-503 https://doi.org/10.1097/01.won.0000335961.68113.cb

Richbourg L, Thorpe JM, Rapp CG. Difficulties experienced by the ostomate after hospital discharge. J Wound Ostomy Continence Nurs. 2007; 34:(1)70-79

Salvadalena G. Incidence of complications of the stoma and peristomal skin among individuals with colostomy, ileostomy, and urostomy: a systematic review. J Wound Ostomy Continence Nurs. 2008; 35:(6)596-607 https://doi.org/10.1097/01.won.0000341473.86932.89

Salvadalena GD. The incidence of stoma and peristomal complications during the first 3 months after ostomy creation. J Wound Ostomy Continence Nurs. 2013; 40:(4)400-406 https://doi.org/10.1097/won.0b013e318295a12b

van der Valk ME, Mangen M-JJ, Severs M Evolution of costs of inflammatory bowel disease over two years of follow-up. PLoS ONE. 2016; 11:(4) https://doi.org/10.1371/journal.pone.0142481

Walters SJ, Brazier JE. Comparison of the minimally important difference for two health state utility measures: EQ-5D and SF-6D. Qual Life Res. 2005; 14:(6)1523-1532

A multinational evaluation assessing the relationship between peristomal skin health and health utility

14 March 2019
13 min read
Volume 28 · Issue 5

Abstract

Background:

irritation to peristomal skin remains one of the most prevalent ostomy-related complications influencing an individual's health status and quality of life.

Aims:

to assess the impact of damaged peristomal skin on the health utility and quality-adjusted life days (QALD) in an international adult ostomy population.

Methods:

a cross-sectional survey incorporating the SF-6D preference-based health utility index was developed to assess a random selection of post-surgical patients.

Findings:

health utility decreased with increasing skin irritation among the three geographic groups. The total mean health utility of normal peristomal skin for the three groups dropped incrementally for mild, moderate, and severe irritation. There were no differences in health utility or QALDs between the three country groups.

Conclusion:

improvement of peristomal skin health is associated with improvements to QALDs. Clinicians, caregivers and patients have the responsibility to address a critical unmet need in skin health through interventions and products designed to support healthy peristomal skin.

Advances in medical innovations have resulted in the ability of patients with gastrointestinal disease to manage their care through the broader availability of biological therapies. In fact, reports have demonstrated that care for patients with inflammatory bowel diseases and colorectal cancer have shifted to the use of targeted biological therapies (Kriza et al, 2013; van der Valk et al, 2016). Despite these advances, surgery with the intent to create an abdominal stoma to support the management of benign and malignant gastrointestinal problems is still prevalent globally.

A stoma is an opening on the abdomen that can be connected to either the digestive or urinary system to allow waste (urine or faeces) to be diverted out of the body (Bladder and bowel Community, 2019). Effluent from the stoma is collected by an ostomy pouch that is attached to the skin surrounding the stoma (peristomal skin) by an adhesive barrier. Leakage of effluent to the peristomal skin is a major complication, creating not only a psychological burden concerning 9 out of 10 patients (Claessens et al, 2015), but also a clinical burden that leads to irritation and skin injury (Herlufsen et al, 2006).

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