Keywords

Continuity of patient care, Ostomy, Patient care bundles, Quality of life, Randomized controlled trial, Rectal neoplasms, Self-efficacy

 

Authors

  1. Su, Xi MD, RN
  2. Zhong, Mei-hua MSPH, RN, ET
  3. Ye, Xin-mei MS, RN, ET
  4. Zhen, Li BN, RN, ET
  5. Yin, Xue-xia BN, RN
  6. Qin, Fang MS
  7. Zhu, Mu-lan BN, RN, ET
  8. Kuang, Yin-yi BN, RN
  9. Wang, Hui-zhen MS, RN

Abstract

Background: The patients with temporary stomas after anterior resection for rectal cancer may experience significant impact on their health outcomes, and hence continuing care is necessary and important for these patients. However, the effects of some single continuing care interventions remain unclear. Continuing care bundle may be an effective approach to address this uncertainty.

 

Objective: The aim of this study was to investigate the effects of an evidence-based continuing care bundle on selected health outcomes in patients with temporary stomas after anterior resection for rectal cancer.

 

Methods: This was a multicenter randomized controlled trial. A total of 124 patients with temporary stomas after anterior resection for rectal cancer were recruited from 4 general tertiary hospitals in Guangzhou, China, and were randomly assigned to a control group or an intervention group. Both groups received usual care, whereas the intervention group additionally received evidence-based continuing care bundle. Self-efficacy, quality of life, and stoma-related complications were collected at baseline and 4 and 12 weeks after surgery. Satisfaction and outcomes of stoma reversal were collected at the end of the observation.

 

Results: The intervention group had significantly improved the self-efficacy (F = 11.88, P = .001), quality of life (F = 17.99, P < .001) over time, satisfaction (t = 4.08, P < .001), and outcomes of stoma reversal ([chi]2 = 5.93, P = .015) and reduced the incidence of complications (P < .05).

 

Conclusions: Evidence-based continuing care bundle can be an effective method to improve the health outcomes among these patients

 

Implication for Practice: By using the evidence-based continuing care bundle, nurses can help these patients improve their health outcomes in stoma-specific nursing.