Social adaptation following intestinal stoma formation in people living at home: a longitudinal phenomenological study

Disabil Rehabil. 2017 Nov;39(22):2286-2293. doi: 10.1080/09638288.2016.1226396. Epub 2016 Oct 10.

Abstract

Purpose: Intestinal stoma formation profoundly changes the relationship between a person and their social world. The aim of this study was to understand the experience of living with a new stoma; this paper explores the theme "disrupted social world," highlighting how stoma-forming surgery impacts on individuals' abilities to participate and interact socially over time.

Method: A longitudinal phenomenological approach. Twelve participants with a new stoma were recruited using purposeful sampling. Data were collected at three, nine and 15 months following surgery through in-depth, unstructured interviews and analysed using a bespoke iterative framework.

Results: Three categories were identified: participation in the social environment; interpersonal relationships: changes and challenges; and setting and achieving goals.

Conclusions: Stoma-forming surgery changes the ways people relate to their social environment and connect with others, creating self-consciousness and impeding social confidence and autonomy. Understanding the social implications of stoma-forming surgery can help clinicians to provide responsive and appropriate support to facilitate social rehabilitation. Implications for Rehabilitation Assisting people with a stoma to develop competent stoma self-care skills will promote social adaptation and self-acceptance. Clinicians should promote access to others with a stoma, an important source of support for many people adjusting to a new stoma. Graded exposure to social participation can engender feelings of control and confidence for people with a stoma. Clinicians can help individuals with a stoma to set realistic goals for their recovery, while encouraging a range of positive coping strategies.

Keywords: Colorectal surgery; UK; adjustment; ostomy; social adaptation.

MeSH terms

  • Adaptation, Psychological*
  • Adult
  • Colostomy
  • Female
  • Humans
  • Ileostomy
  • Interpersonal Relations
  • Interviews as Topic
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Self Care
  • Social Adjustment*
  • Social Participation*
  • Surgical Stomas*