EP195 - Its not just the patient - impact of new ostomy formation on partners quality of life

Purpose/Background: Approximately 100,000 people in the United States undergo operations that result in a colostomy or ileostomy every year. The implications of having a new ostomy can include physical side effects, impact on activities of daily living, and major psychosocial impact pn a patient. Need for a stoma has been associated with drastic effects on patient's quality of life in multiple studies, however, effects on partner's life have never been fully evaluated. The changes experienced by the ostomy patient are shared by the couple, and both parties must work toward adapting to the condition. Resiliency has been shown to be beneficial in improving perioperative outcomes, however effects on resiliency and resiliency training on new ostomies and their partners have not been evaluated.

The purpose of this study is to evaluate effects of new stoma on partners' quality of life as well as benefits of resiliency training on patient and their significant other

Methods/Interventions: This is a single institution randomized controlled trial. All patients undergoing creation of the new stoma and their partners we offered to participate in the study. Those who agreed, were randomly assigned to either standard care, that included pre operative visit with wound ostomy nurse as well as at least 2 inpatient post operative visits and clinic follow up. Study group were asked to watch video on resiliency training as well as effort to include partners in all the training in addition to standard care. Patients and their partners were asked to fill out pre and post operative surveys that included. Personal Health Questionnaire-9 (PHQ-9), Relationship and Sexual Satisfaction: PROMIS, Connor-Davidson Resilience Scale and Resilience, Information, Support and Empowerment (RISE IBD). Pre and post operative results as well as differences between patients and partners were compared.

Results/Outcomes: Overall, 53 individuals completed surveys including 35 patients and 18 significant others including 23 men and 30 women with average age was 54 years (range 21-77 years). Indications for ostomy were colorectal cancer in 11 (31.4%) cases, IBD in 5 (14.3%), diverticulitis in 5 (14.3%), urogenital pathology including bladder cancer in 6 (17.1%), and functional disorders or other reasons in 8 (22.9%). Most frequently, loop ileostomy was performed in 25 (71.4%), followed by loop colostomy in 4(11.4%) and end ileostomy and colostomy each. In patients, all administered surveys showed post operative decrease when compared to preoperative findings including Personal Health Questionnaire 9 (9.8 to 6.67), Relationship and Sexual Satisfaction (Promise 31.6 to 30.2), RISE IBD (32.8 to 31.1) CD-RISC (68.4 to 65.1). For CD-RISC, highest loss was seen in personal competence, high standards and tenacity, but it was lower in the patients who underwent peri-operative resiliency training.

In significant others all the post operative scores also decreased including CD-RISC (69,4-65.1), RISE-IBD (38.3 to 32.7) also showing better results if resiliency training was undertaken.

Conclusion/Discussion: Creation of stoma imposes substantial effect on quality of life on both patients and their significant others. Peri-operative resiliency training may lead to better outcomes and faster adjustments for patients and their partners