• The Korean Journal of Rehabilitation Nursing
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• v.3 no.1
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• pp.15-26
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• 2000

This study examined the relationship between the level of hardiness and self-care agency of persons with a colostomy. The purpose of the study was to explore the effect of hardiness on self-care agency of persons with a colostomy and to identity factors influencing on. The ultimate goal was to help nurses improve the person's self-care agency and to contribute theoretical base for the planning of supportive nursing interventions to increase the level of self care. The subjects for the study consisted of 43 persons aged above eighteen below seventy had had Miles operation and permanent colostomy. The data were collected from July, 1998 to September 15, 1998. The instruments used for this study were the Health-Related Hardiness (Pollock, 1984) and the Self-carer As Inventory Scale(Genden & Taylor, 1988). The Self-Carer As Inventory translated by So Hyang-sook and was modified by author of this study. The data were analysed by using SAS computerlized program and included number, percentage, t-test, ANOVA and Pearson Correlation Coefficient. The results of the study are summarized as follows. 1. Hardiness was significantly related to Self-care agency(r=-0.531. p=0.0002). That is, the higher the hardiness, the higher the level of Self-care agency. 2. In the relationship between general characteristics and traits of persons with a colostomy and hardiness were significant difference in monthly income (F=2.79, p=0.03), problem in stoma management (F=3.29, p=0.01). 3. In the relationship between general characteristics and traits of persons with a colostomy and Self-care agency were significant difference in monthly income (F=2.93, p=0.03), problem in stoma management(F=2.93, p=0.01). Therefore, in order to increase the level of Self-care agency of ostomate Nurses should be helpful to provide them with hardiness training to strengthen their control, commitment and challenge(subconcepts of hardiness).

• Journal of Korean Academy of Fundamentals of Nursing
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• v.16 no.4
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• pp.506-514
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• 2009

Purpose: This study was conducted to define factors influencing psychosocial adaptation of patients with a permanent colostomy. Independent variables including perceived stress, stoma care self-efficacy, self-care behavior, self-esteem and family support were used to predict psychosocial adaptation. Method: The data was analyzed using the SPSS pc program window version 12.0 for descriptive statistics, Pearson correlation coefficients and stepwise multiple regression. Ninety patients with a permanent colostomy were recruited between September 2007 and May 2008. The reliability of the instruments was tested with Cronbach's alpha which ranged from .78 to .92. Result: The results were as follows: The mean psychosocial adaptation score was 3.05. There were significant correlations between all the predictive variables and psychosocial adaptation (r= .63~ -.43, p<.001). Stepwise multiple regression analysis showed that self-esteem (40%), stoma care self-efficacy (7%), perceived stress (2%), and self-care behavior (2%) accounted for 51% of the variance in psychosocial adaptation. Conclusion: These findings indicate that to improve psychosocial adaptation of patients with permanent colostomy, the major related factors identified in this study should be considered.

• Journal of Korean Academy of Nursing
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• v.1 no.1
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• pp.27-43
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• 1970

This study is designed to find out proper nursing activities for the needs of the colostomy patients, i.e., mental and psychological as well as physical needs for rapid recovery, and to help them build up the follow-up care for proper social adjustment. The study is based on 268 cases out of 381 colostomy patient's records kept in Ewha Womans University Hospital, Yonsei Medical Center, and National Medical Center in between the period from Jan. 1953 to Jan. 1970. The items of study are mainly on etiology, sex, age, duration of hospitalization, mortality rate, seasonal frequency, time from the onset of illness to the admission of the hospital, signs and symptoms. 1. Frequency of onset by etiology: Neoplastic disease 112 cases (42%), Inflammatory disease 33 cases (12%), Congenital malformation 30 cases (11%), Intussusception 25 cases (9.3%), Trauma 24 cases (9%), Volvulus 17 cases (6.3%), and Crohn's disease 6 cases (2.2%). 2. By sex: male 167 cases (62.9%), and female 101 cases (37.1%). So the ratio of portion of male and female 2:1. 3. By age: under 1·year·old 27 cases (10.1%) highest, 41-50 yrs 54 cases (20.2%), 51-60 yrs 42 cases (15.5%), above 71 yrs 5 cases (1.9%). 4. Duration of hospitalization: the shortest is 2-days and the longest is 470 days. 1-20-days 52%, 40-60 days 14%. 5. Mortality rate: Under the 10-days-admission 19.5%, and the beyond 30-days-admission 3.9%. 6. Seasonal frequency: Higher in summer (32% ). 7. Signs and symptoms: abdominal pain (56%), abdominal distention (54%), vomiting (40%), bloody mucoid diarrhea (38%) , pain of anal region (18%), abdominal tenderness, anorexia, indigestion, constipation, disuria, tenesmus, high fever and chilling sensation, bile tingled vomiting. Nursing activities for the patient's physical needs are as follows: Skin care for colostomy region, Prevention of colostomy constriction and depression, Removal of an offensive odor, The use of colostomy bag-selection for, and demonstration of the use of inexpensive colostomy irrigation equipment, Personal hygiene, general skin care, care of hair, finger nails and toe-nails, Oral hygiene, sleep and rest, aquate, Daily activities, etc. Measures for regulation of bowl movement. Keeping the instruction of taking food, Preparing the meal and help for anorexia, Constipation and it's solution, Prevention of diarrhea, helping the removal of mucous, and stretch constricted steam as needed. Nursing activities for pt's socio-psychological needs are as follows; Help the patient to make decision for the operation, Remove pt's anxiety toward operation and anesthesia, To meet the pt's spiritual needs at his death bed, Help to establish family and friends cooperation, Help to reduce anxiety at the time of admission and it's solution, Help to meet religious need, Help to remove pt's anxiety for loosing his job and family maintenance, Follow-up studies for 7 cases have been done to implement the present thesis. The items of the personal interviews with the patients are as follows: Acceptability for artificial anus, The most anxious thing they had in mind at the time of discharge, The most anxious thing they hat·e in mind at present, Their friends and family's attitudes toward the patient after operation, Relations with other colostomy patients, Emotional damage from the operation, Physical problem of enema, irrigation, Control of diet, Skin care, Control of offensive odor, Patient's suggestions to nurses during hospital stay and after discharge. In conclusion, the follow-up care for colostomy patients shares equal weight or perhaps more than the post-operative care. The follow-up care should include the spiritual care for moral support of the patient, to drag him out of isolation and estrangement, and make him fully participate in social activities. It is suggested that the following measures would help to rehabilitate the colostomy patients (1) mutual acquaintance with other colostomy patients if possible form a sort of club for the colostomy patient to exchange their experiences in care (2) through the team work of doctor, nurse and rehabilitation specialists, to have a sort of concerted effort for betterment of the patient.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.14 no.3
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• pp.288-296
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• 2007

Purpose: This study was conducted to investigate the effects of self-efficacy promoting program on self-efficacy, self-care behavior and psychosocial adaptation in patients with a colostomy. Method: A non-equivalent control group pre test post test design was used. The self efficacy promoting programs was composed of a CD image program based on varicaious experience, education and telephone coaching program based on verbal persuasion, and Stoma care practice, and Self care performance based on performance accomplishment. This study was carried out from July 2, 2005 to April 20, 2006 and 21 patients with a colostomy at one of 2 hospitals participated. Descriptive statistics, ${\chi}^2-test$, and Mann-whitney U test were used to analyze the data. Results: There were significantly different for specific self efficacy, self care and psychosocial adaptation between the experimental group and control group. Conclusion: The self efficacy promoting program for patients with stomas was effective in improving degree of specific self efficacy, self care and psychosocial adaptation.

• Korean Journal of Adult Nursing
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• v.19 no.4
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• pp.634-643
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• 2007

Purpose: This study was performed to investigate the type and frequency of end colostomy-related complications and to identify the risk factors for those complications. Methods: Retrospective analysis of medical records was made in 708 patients who underwent end colostomy in Samsung Medical Center between October 1994 and February 2005. The type was divided into stomal and peristomal complications: stomal complications included bleeding, necrosis, mucocutaneous separation, prolapsed stoma, retraced stoma, stenosis, and hyperplasia; peristomal complications did peristomal varix, peristomal hernia, irritant contact dermatitis, allergic contact dermatitis, maceration, folliculitis, hyperplasia, bacterial infection, candidal infection, malignancy in the peristomal area, mechanical damage and pyoderma gangrenosum. Results: For stomal complications, hyperplasia was most common(9.0%). For peristomal complications, irritant contact dermatitis was developed in 17.4%. Sex and BMI were risk factors for irritant contact dermatitis, hyperplasia, peristomal hernia, flat stoma, and retracted stoma. Conclusion: Teaching for preventing irritant contact dermatitis such as proper pouching and peristomal skin protection, and for comprehensive weight control should be emphasized on self care program for ostomates, while ostomy care nurse should take a careful consideration of preoperative ostomy site marking in female obese patients.

• Advances in pediatric surgery
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• v.12 no.1
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• pp.115-125
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• 2006

Postoperative management of anorectal malformation consists of colostomy management and then management after definitive surgery. Colostomy management requires attention to certain details, i. e. complete decompression of the distal limb to avoid secondary megarectosigmoid and prevention and treatment of urinary tract infections in patients with rectourethral fistula. Management after definitive surgery requires the care of catheters placed in the rectourethral fistula or cloacal defect. Prevention and treatment of various complications after definitive operation, i. e. wound infection, anal stenosis or stricture, anal mucosal prolapse, and management of functional disorders, i.e. constipation, fecal incontinence and urinary incontinence are also necessary. In this review, recent trends for the prevention and treatment of the above mentioned problems after operation for anorectal malformation are presented.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.10 no.2
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• pp.141-147
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• 2003

The purpose of this study was to develop and apply a Web-based Nursing Education & Instruction Program to help the clinical nurses improving their knowledge and skills of ostomy care. This program was developed in three different steps: analysis. design. and development. The results of the study were as follows: The analysis step was designed to select the study contents for effective and easy educationthrough the analyses of specialized books. This surveyed and analyzed study contents were categorized into five different sections. Introduction. ostomy classification. ostomy management. elimination management. and life style. After that each section describes necessary information of each category. In the design step. the image files used in this program were created using Adobe Photoshop 6.0. and HTML files were designed and developed using Namo Editor 5.0. In the development step. the developed program was published into Web using FTP (File Transfer Protocol) and then finalized after trial operation for testing of real users. In addition. this Web-based Nursing Education & Instruction Program will be used as excellentand effective tool for continuous and lifelong education in nursingfield. In this study. computer-aided education program was developed for ostomy management and managed at the Web-Server (http://hshong.knu.ac.kr/ostomy) in order to help nurses real-time education in clinical field by this program.

• Journal of Korean Clinical Nursing Research
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• v.26 no.2
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• pp.154-163
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• 2020

Purpose: The aim of this study was to develop an evidence-based guideline for stoma management providing institutional policy, assessment, complications and follow-up care. Methods: The guideline adaptation manual consisting of 23 steps developed by the National Evidence-Based Healthcare Collaborating Agency was used for this study. It presents an overview of the process used to develop the guideline and lists specific recommendations from the guideline. Results: It provides 55 recommendations that include the following 8 topics: 1) Organization and policy recommendations, 2) Preoperative nursing; Ostomy education, stoma site marking, 3) Ostomy formation, 4) Postpoperative nursing; education, assessment, high output stoma management, 5) Selection of ostomy products, 6) Colostomy irrigation, 7) Stomal and peristomal complications, 8) Follow-up care after discharge. Conclusion: The guideline can be used to address stoma management in hospital settings. The intent of the guideline is to provide information that will assist healthcare providers to manage adult patients with ostomies, prevent or decrease complications, and improve patients' outcomes.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.2
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• pp.725-729
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• 2014

Background: Having been known as a virulent disease in 1970s, cancer is now onsidered a chronic disease and 64% of cancer patients live for five years after diagnosis. Home care has gradually gained more importance and it is a great burden on the shoulders of caregivers. Caregivers have to undertake the responsibility of the cancer patient's home management, and organize care and arrange health care services according to the ever-changing condition of patients. Caregivers should be prepared for home care so they can provide accurate and complete care to patients. This descriptive study aims to investigate challenges that caregivers encounter in the home care of patients and the reasons for these challenges. Materials and Methods: The research group consisted of caregivers of outpatients in a daily treatment center in a university hospital. The research sampling consisted of 137 voluntary caregivers of patients who attended the Daily Treatment Center for control, chemotherapy or other supportive cares services between January-June, 2011. Data were collected with face-to-face interviews in the Daily Treatment Center. Ethics Committee approval was taken university hospital; caregivers and their patients were informed about the research and their approval was taken as well. Results: It was found that 54.01% of caregivers help patient's nutrition, 50.36% help medicine use, 26.28% help oral hygiene, 26.28% help to meet urinary needs and 51.82% help to change clothes, 69.34% of caregivers help to change bed sheets, 38.69% help the patient to communicate with their environment and 71.53% help to bring the patient to hospital or outside. Conclusions: This study, it was found that caregivers experience challenges due to following factors: patient nutrition, medicine use, oral and body hygiene, colostomy maintenance and stomach tube feeding, concern of dropping the patient, feeling incompetency in body temperature and fever control, fatigue, and lack of personal time.

• The Korean Nurse
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• v.36 no.1
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• pp.59-76
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• 1997

The purposes of this study were to identify the contents and satisfaction level of the patients received home care service, and to compare the differences of the contents by the characteristics of the patients. Seventy eight patients received home care service from 1st Jan. to 30th Sept., 1996 were data-collected to analyze the contents and outcomes of home care service. Sixty-nine patients currently receiving home care service were participated to evaluate the satisfaction level of home care service. The data were analyzed using mean, standard deviation, $x^2$ test, and ANOVA by SPSS $PC^+$ program. The findings of this study were as follow : 1. The contents & outcomes of home care service 1) The mean age of the subjects was 64.4 years: 58% of them were female. Those who living in Seoul were 83% and the rest of the subjects was living in Kyung-Gi. 2) The subjects who had one diagnosis were 41%. Over 60% of them had the disease of neurologic & sensory system. 3) The mean number of visit was 6. Only one visit was 22%. The mean time of care was 79 minutes. Duration of visit from 31 minutes to 60 minutes were 47 %. The subjects who terminated the visit because of death were 67.3%. 62% of the persons who referred them to the home care service were nurses. 4) The pain after the service was more relieved than before. The amounts of intake, the degree of bed sore, edema & fracture after the service were more improved than before. Health status after the service was improved in general. 5) There were significant differences between initial and last conscious level in tracheostomy care & oxygen inhalation care. There was significant difference between initial and last degree of activity in blood sugar check. 6) There were significant differences on the number of visit in assessment of the status, evaluation & observation, vital sign check, skin care, injection, medication, bed sore care, colostomy care, relaxation therapy for pain relief, patient education, family care, exercise therapy, position change, supply of disinfected equipments and infection control. There were significant differences on visiting time in nasogastric tube care, drainage tube care and oxygen inhalation care. 2. The satisfaction level of home care service 1) 50% were male. Over 60 years of the subjects was 61 %. Those who living in Seoul were 82%. 2) The subjects who had one or two diagnosis were 32% respectively. 55% of the persons who referred them to the home care service were nurses. 3) Total level of satisfaction of home care service was very high. 4) The older the age, the higher the satisfaction level. The larger the number of visit, the higher the satisfaction level. 5) The subjects who were in cloudy state were higher level of satisfaction than in alert or coma state. The subjects whose activity were normal or who needed assistance were higher level of satisfaction than bedridden or immobilized subjects. These findings suggested that the patients had substantial need for posthospital care. They tended to be elderly and to have experienced the wide range of health problems associated with aging, chronicity, including limitations in activities, and other serious health problems. So, the nationwide home care systems beyond the limit of demonstration program by local association and the development of the effective financial system of home based health care are necessary for the clients who are in need of home care.