Berna DİZER, Emine İYİGÜN, Hülya ŞAFAK, Birgül DAĞ, İsmail Hakkı ÖZERHAN, Nail ERSÖZ, Sevgi HATİPOĞLU, Turgut TUFAN

Determining The Effects of Nutrition on The Quality of Life of Patients with Stoma

Amaç: Stoma ile yaşamak hastaya zorluklar getirmektedir. Hastalar stomaya ilişkin korku ve sorularla taburcu edilmektedir. Sorunların çoğunluğunu beslenme oluşturmaktadır. Bu çalışma, stomalı hastalara beslenme eğitimi vermek ve yaşam kalitesi üzerine etkisini belirlemek amacıyla yapılmıştır. Bireyler ve Yöntem: Çalışma Gülhane Askeri Tıp Akademisi Genel Cerrahi Anabilim Dalı Kliniğinde, Mayıs 2008- Haziran 2009 tarihleri arasında gerçekleştirilmiştir. Çalışmaya 31 hasta ile başlanmış, 5 hasta çeşitli nedenlerle araştırma dışı kalmıştır. Araştırmacı beslenme programı geliştirmiştir. Beslenme programı, ana ve ara öğünlerin takibi, beslenme eğitim broşürü ile bilgilendirme ve danışmanlık gibi uygulamaları içermektedir. Hastalara bireysel beslenme programı ve yaşam kalitesi anketi uygulanmıştır. Bulgular: Beslenme programı öncesi hastaların yarısından fazlasında gaz problemi yaşadıkları belirlenmiş olup, sosyal izolasyon yaşadıklarını ifade etmişlerdir. Üç ay sonra hastaların beslenmeyle ilgili problemlerinde azalma olduğu saptanmıştır. İleostomili hastaların yaşam kalitesi anket puanlarının, kolostomili hastalara göre düşük olduğu saptanmıştır. Sonuç: Araştırma sonucunda geliştirilen beslenme programının, stomalı hastaların beslenmeyle ilgili problemlerini azalttığı belirlenmiştir (p

Stomalı Hastaların Beslenmesinin Yaşam Kalitesi Üzerine Etkisinin Belirlenmesi

Aim: Living with a stoma is difficult for the patient. Most of the patients are discharged from the hospital with fear and problems loaded. The majority of their problems are related with nutrition. The aim of the study was to provide nutritional training to patients with a stoma and to determine the effect of stoma on quality of life. Subjects and methods: This study was conducted at a university hospital, Main Scientific Branch of General Surgery (Turkey), between May 2008 and June 2009. Approximately 31 patients participated in the study. However, 5 patients were excluded from the study due to various reasons. The investigator had developed a nutritional program. The nutritional program contains various issues such as, the following-up main and snack meals giving information by the aid of a nutrition training handbook and consultation services. Patients were also asked to fill a questionnaire related with the nutritional program and quality of life. Results: As stated, nearly more than half of the patients experienced a flatulence problem and therefore they were socially isolated. After three months of period, patients stated that they experienced a lesser degree of problems related with nutrition. The quality of life scores of patients with an ileostomy was found lower when compared to patients with a colostomy. Conclusion: We determined that problems related with nutrition in patients with a stoma were reduced at the end of the study by the nutrition program (p<0.05). We also determined an increase in the quality of life according to the postoperative term three months after surgery (p<0.05). Keywords:

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1. Ayaz S. Stomalı bireylerde hemşirenin rolü. Türkiye Klinikleri J Med Sci 2007;27:86-90. 2. Persson E. Experiences of Swedish men and women 6 to 12 weeks after ostomy surgery. JWOCN 2002; 29(2):103-106 3. http://www.saglik.gov.tr/TR/BelgeGoster.aspx?F6E1 0F8892433CFF71B64510F6C8BC9E6DB75D0F6D 6C383 (Accessed 17 March 2009). 4. http://www.colo-proctology.com/general.php?general_ page=9, (Accessed 29 January 2008). 5. Pat B. Christine H. Food management for the stoma patient. 8th ECET Congress 2005;S15 (abstract 123). 6. Fulham J. Improving the nutritional status of colorectal surgical and stoma patients. Br J Nurs 2004;13(12):702- 708. 7. Floruta CV. Dietary choices of people with ostomies. JWOCN 2001;28(1):28-31. 8. Nugent KP, Daniels P, Stewart BS, Patankar R, Johnson CD. Quality of life in stoma patients. Dis Colon Rektum 1999;42(12):1569-1574. 9. Ustündağ H, Demir N, Zengin N, Gül A. Stomalı hastalarda beden imajı ve benlik saygısı. Türkiye Klinikleri J Med Sci 2007;27:522-527. 10. Bozkurt N. Enteral ve parenteral beslenmenin önemi. Enteral Parenteral Beslenme, Türkiye Diyetisyenler Derneği Yayını 1995:1-5. 11. Christ P. Eating plant-based meals. Ostomy Quarterly 1999;36(2):12-14 12. Floruta CV. What should I eat? Ostomy Quarterly 2000;38(1):32-34 13. Ostomy Nutrition Guide: University of Pittsburgh Medical Center, Information for Patients Available at: www.upmc.com Accessed 30 January 2008. 14. Diet and Nutrition Guide. Available at: www. uoaa.org (Accessed 30 January 2008). 15. Marquis P, Marrel A, Jambon B. Quality of life in patients with stomas: the Montreux study. Ostomy Wound Manage 2003;49(2):48-55. 16. Prieto L, Thorsen H, Juul K. Development and validation of a quality of life questionnaire for patients with colostomy or ileostomy, Health and Quality of Life Outcomes 2005;3(62):1-10. 17. Available at: http://www.stoma-qol@ stomaresearhboard.com (Accessed 30 January 2008). 18. Doughty D. Role of enterostomal therapy nurse in ostomy patients rehabilitation. Cancer Suppl 1992;70(5):1390-1392. 19. Colwell JC. Dealing with ostomies: Good care, good device, good quality of life. J Support Oncol 2005;3(1):72-74 20. Olsson U, Bosaeus I, Svedlund J, Bergbom I. Patientssubjective symptoms, quality of life and intake of food during the recovery period 3 and 12 months after uper gastrointestinal surgery. Eur J Cancer Care 2006;16:74-85 21. Sprangers MAG, Taal BG, Aaronson NK. Velde A. Quality of life in colorectal cancer. Dis Colon Rektum 1995;38(4):361-369. 22. Pieper B, Mikols C. Predischarge and postdischarge concern of the person with an ostomy. JWOCN 1996;23:105-109.