Publication: Kalıcı abdominal stomalı hastalarda beden imajı değişiminin yaşam kalitesine etkisi
Abstract
Bu çalışma, kalıcı abdominal stomalı hastalarda beden imajı değişiminin yaşam kalitesi üzerine etkisini belirlemek amacıyla planlanmıştır. Araştırma İstanbul il sınırı içinde bulunan S.B. Okmeydanı Eğitim ve Araştırma Hastanesinde 1 Ekim 2005 ile 30 Ağustos 2006 tarihleri arasında gerçekleştirilmiştir. Araştırma kapsamına 58 hasta alınmıştır. Verilerin toplanmasında araştırmacı tarafından hazırlanan, Hasta Görüşme Formu ve Kısa Form 36 (The MOS 36 Item Short Form Healt Survey–SF 36) kullanılmıştır. Verilerin değerlendirilmesinde yüzdelik, ortalama, standart sapma, Kruskal Wallis test, Mann Whitney, U test ve Ki Kare testi kullanılmıştır. Sonuçlar %95’lik güven aralığında, anlamlılık p>0,05 düzeyinde değerlendirilmiştir. Grubun SF 36 sağlık statüsü ortalama puanları; fiziksel fonksiyonellik 65,60±22,98, fiziksel rol sınırlamaları 35,77±39,76, ağrı 66,03±21,27, sosyal fonksiyonellik 60,56±30,33, mental rol sınırlamaları 50,57±45,55, ruh sağlığı 57,44±17,53, enerji/ zindelik 37,84±21,15 ve genel sağlık algısı boyutunda ise 39,39±20,60 olarak bulunmuştur. Tüm SF 36 sağlık statüsü boyutlarında cinsiyet, medeni durum, eğitim, ameliyat öncesi hastaya bilgi verilmesi istatistiksel olarak anlamlı farklılık yaratmamıştır (p>0,05). Çalışan ve stoma bakımını kendisi yapan bireylerin yaşam kalitesi puanları olumlu olarak etkilenmiştir. Ameliyattan sonra geçen süre 6 ay ile 1 yıl arasında olan bireylerin yaşam kalitesi puanları olumsuz olarak etkilenmiştir. Stomanın koku yapacağından endişe duyan bireylerin fiziksel ve sosyal fonksiyon puanları ileri düzeyde düşük bulunmuştur (p:0,006) ; (p<0,01). Ameliyattan sonra beden imajı nedeniyle üzüntü duyan, stomanın kendisini çirkinleştirdiğini düşünen bireylerin yaşam kalitesi puanları düşük tespit edilmiştir. (p<0.01) (p:0,004; p<0,01). Stoma bireylerin partnerleri ile ilişkilerini, cinsel ve sosyal yaşamlarını olumsuz olarak etkilemiştir. Bu çalışma kalıcı kolostomili hastaların fiziksel, sosyal ve psikolojik sorunlar yaşadıklarını göstermiştir.Yaşanan sorunlar ve beden imajı değişikliği SF 36 yaşam kalitesi ölçeğinde düşük puanlar alınmasına neden olmuştur
This study is designed to identify the effects of changes in body image on quality of life, in patients with permanent stomas. The study was carried out at Ministry of Health, Okmeydani Education and Research Hospital, from 1 October 2005 to 30 August 2006. The study covered 58 patients. For data collection, Patient Interview Form which was prepared specifically for this study and Short Form SF36 were used (The MOS 36 Item Short Form Healt Survey – SF 36). Percent, median, standard deviation, Kruskal Wallis test, Mann Whitney U test and Chi-square tests were used for data evaluation. Results were considered significant at p<0.05, with a confidence level of 95%. The SF36 health status points for the group were; for the physical functioning scale 65.60±22.98, for the physical role limitation scale 35.77±, for the pain scale 66.03±21.27, for the social functioning scale 60,56±30,33, for the metal role limitations scale 50,57±45,55, for the metal health scale 57,44±17,53, for the energy/ fitness scale 37,84±21,15, and for the general health perception scale 39,39±20,60. In all SF36 health status scales, sex, marital status, education and informing the patient before the surgery had no significant effect. (p>0,05) Those individuals who were employed and who could handle their own stomas scored higher quality of life points. Individuals who received help from the hospital, and those who had their operation during the past 6 months-1 year period, scored lower quality of life points. Patients who had concerns that the stoma will cause excessive smell, scored significantly lower physical and and social function points (p:0,006; p<0,01). Those patients who had anxiety after the surgery regarding their body image, and those who believed that the stoma made them uglier, scored lower quality of life points (p,0,01) (p:0,004;p<0,01). Stoma had a negative influence on individual’s relation with his/ her partner, their sexual and social life. This study has shown that the patients with permenant stomas, experience physical, social and psycological problems and difficulties. These problems and the anxiety and sorrow over the changed body image has resulted in lower points on the SF36 quality of life scale.
This study is designed to identify the effects of changes in body image on quality of life, in patients with permanent stomas. The study was carried out at Ministry of Health, Okmeydani Education and Research Hospital, from 1 October 2005 to 30 August 2006. The study covered 58 patients. For data collection, Patient Interview Form which was prepared specifically for this study and Short Form SF36 were used (The MOS 36 Item Short Form Healt Survey – SF 36). Percent, median, standard deviation, Kruskal Wallis test, Mann Whitney U test and Chi-square tests were used for data evaluation. Results were considered significant at p<0.05, with a confidence level of 95%. The SF36 health status points for the group were; for the physical functioning scale 65.60±22.98, for the physical role limitation scale 35.77±, for the pain scale 66.03±21.27, for the social functioning scale 60,56±30,33, for the metal role limitations scale 50,57±45,55, for the metal health scale 57,44±17,53, for the energy/ fitness scale 37,84±21,15, and for the general health perception scale 39,39±20,60. In all SF36 health status scales, sex, marital status, education and informing the patient before the surgery had no significant effect. (p>0,05) Those individuals who were employed and who could handle their own stomas scored higher quality of life points. Individuals who received help from the hospital, and those who had their operation during the past 6 months-1 year period, scored lower quality of life points. Patients who had concerns that the stoma will cause excessive smell, scored significantly lower physical and and social function points (p:0,006; p<0,01). Those patients who had anxiety after the surgery regarding their body image, and those who believed that the stoma made them uglier, scored lower quality of life points (p,0,01) (p:0,004;p<0,01). Stoma had a negative influence on individual’s relation with his/ her partner, their sexual and social life. This study has shown that the patients with permenant stomas, experience physical, social and psycological problems and difficulties. These problems and the anxiety and sorrow over the changed body image has resulted in lower points on the SF36 quality of life scale.