EP1034 - Variations in opportunities to improve ostomy care and education by ostomy type

ePoster Presenter(s)

• EK

  Emily Kao, MD

  Fellow
  University of Alabama at Birmingham
  University of Alabama at Birmingham
  Birmingham, AL, United States

  Disclosure information not submitted.

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Author(s)

• 

  Hannah Ficarino Sheffer, MD, MSPH (she/her/hers)

  Resident
  University of Alabama at Birmingham
  University of Alabama at Birmingham
  Birmingham, AL, United States

  Disclosure information not submitted.
• KF

  Karen Fetsch, BS

  Medical Student
  University of Alabama at Birmingham
  Huntsville, Alabama, United States

  Disclosure information not submitted.
• 

  Daniel I. Chu, MD, MSPH (he/him/his)

  Professor and Division Director
  University of Alabama at Birmingham
  University of Alabama at Birmingham
  Birmingham, AL, United States

  All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose

Senior Author(s)

• 

  Robert Hollis, MD, MSPH

  Assistant Professor
  University of Alabama at Birmingham
  University of Alabama at Birmingham
  Birmingham, AL, United States

  All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose

Purpose/Background: Patients with a new ostomy and their caregivers face perioperative barriers to successful ostomy care and education. This study sought to compare barriers reported by patients with a new ostomy and their caregivers stratified by type of ostomy (ileostomy vs colostomy).

Methods/Interventions: We performed a sub-analysis using qualitative data from semi-structured interviews among patients who underwent surgery with construction of a new ostomy and their caregivers to explore perioperative barriers to ostomy care and education. Patients and caregivers were grouped by whether they managed an ileostomy or colostomy confirmed through the electronic medical record. Interviews were transcribed and analyzed using a comparative thematic analysis approach utilizing NVivo 12 software.

Results/Outcomes: Among patients (n=20) and caregivers (n=16) interviewed, 55% of patients underwent ileostomy creation and 81% of caregivers were of patients with an ileostomy. There were no significant differences in age, number of post-operative ostomy nurse visits, or post-operative length of stay (p>0.05). In the preoperative setting, patients and caregivers with an ileostomy frequently reported barriers of "not knowing what to expect" whereas colostomy patients and caregivers more frequently reported challenges related to "difficulty understanding health condition." In the inpatient phase, ileostomy patients and caregivers more frequently reported "challenges with ostomy appliance application." In the post-discharge phase, both ileostomy and colostomy patients and caregivers reported issues with hydration and/or diet management and variability in utility of home healthcare. Ileostomy patients and caregivers more frequently reported challenges "caring for inflamed skin."

Conclusion/Discussion: Patients and caregivers face multiple perioperative learning, technical, and resource-related barriers to successful ostomy management. Experiences vary by ostomy type; recognition of these varying difficulties provides an opportunity for improved care and education tailored to ostomy type.

Table 1
Selected quotes from ileostomy and colostomy patients and their caregivers illustrating perioperative barriers