Umeå University's logo

umu.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Battle of the Bulge: a qualitative analysis of living with a parastomal hernia
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences. (clister)ORCID iD: 0000-0002-4155-1170
Luleå University of Technology, Department of Administration and Industrial Engineering, Luleå, Sweden; Halmstad University, The School of Business, Innovation and Sustainability, Halmstad, Sweden.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.ORCID iD: 0000-0002-3806-2114
Show others and affiliations
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Background: Parastomal hernia (PSH) is a common complication of a colostomy. Approximately one third of patients have a PSH 3 to 5 years after surgery. There is much qualitative research into living with a stoma, less so when it comes to living with a PSH.

Method: A qualitative study using semi-structured interviews. The participants were participants in a large randomised trial studying the effects of a prophylactic mesh when creating a colostomy. All participants were survivors of rectal cancer. Inductive content analysis was used for data processing. 17 heterogeneous informants (age, gender, geographical location) were interviewed based on a saturated selection.

Results: A major theme was identified in the interviews; “patients coping with parastomal hernia.” In line with this we identified four core coping strategies; meaningfulness; knowledge-based coping; social-based coping; and problem-based coping. For each category further subcategories were identified. We found that a deep sense of gratitude, for survival rectal cancer impacted the informant’s perception on their general wellbeing. Furthermore, we found the paramount importance of stoma nurses, or similar health care workers, enabling the patient to overcome different problems with a PSH.

Discussion: There is a need to better understand the patient’s perception of living with PSH and how to cope with this. The purpose is to ease the transition into living with a stoma, and perhaps a PSH. The coping strategies identified in this report may be incorporated into teaching and information material and also be used by nurses and doctors meeting patients.

Keywords [sv]
parastomalt bråck, kvalitativ
National Category
Surgery
Research subject
Surgery
Identifiers
URN: urn:nbn:se:umu:diva-216045OAI: oai:DiVA.org:umu-216045DiVA, id: diva2:1808474
Available from: 2023-10-31 Created: 2023-10-31 Last updated: 2023-10-31
In thesis
1. Aspects of parastomal hernia
Open this publication in new window or tab >>Aspects of parastomal hernia
2023 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Parastomal hernia (PSH) is a common complication to all ostomies, and all too well known to colorectal surgeons. Up to half of all stomates get a PSH. PSH may present itself as a protrusion or a bulge of the stoma that contains bowel or other content of the abdominal cavity. The symptom load varies from none to debilitating. An unknown fraction of patients with PSH receives correctional surgery. The overall aim of this thesis was to investigate prevalence and treatment of PSH in Sweden, explore whether prophylactic mesh when constructing a colostomy is a viable option for prevention, investigate the health economic impact of PSH and probe into the patient’s own experiences of living with a PSH. The thesis is based on both qualitative and quantitative research. Paper I and III are a randomised controlled multicentre trial, paper II is retrospective audit of the treatment of PSH in Sweden, paper IV is a health economic analysis of colostomy costs and paper V is an interview of survivors of colorectal cancer, with a colostomy and PSH.

The conclusions are as follows: The frequency of PSH surgery was much lower than expected, no specific risk factor could be identified, and perhaps centralisation of surgery should be considered. Most common cause for surgery was cosmetic. Prophylactic mesh in a sublay position don’t prevent PSH but doesn’t seem to add significant complications. PSH cost no more than a colostomy with no PSH, regarding appliances and stoma nurse visits. The common theme of long-time rectal cancer survivors with PSH is coping and a deep sense of gratitude being a survivor.

Place, publisher, year, edition, pages
Umeå: Umeå Universitet, 2023. p. 72
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 2262
Keywords
parastomal hernia, colostomy, surgical technique, patient experience
National Category
Surgery
Research subject
Surgery
Identifiers
urn:nbn:se:umu:diva-216046 (URN)978-91-8070-170-9 (ISBN)978-91-8070-171-6 (ISBN)
Public defence
2023-12-01, Aulan, Sunderby sjukhus, Sjukhusvägen 12, Sunderby, 10:00 (English)
Opponent
Supervisors
Available from: 2023-11-10 Created: 2023-10-31 Last updated: 2023-11-01Bibliographically approved

Open Access in DiVA

No full text in DiVA

Authority records

Odensten, ChristofferNäsvall, PiaGunnarsson, Ulf

Search in DiVA

By author/editor
Odensten, ChristofferNäsvall, PiaGunnarsson, Ulf
By organisation
Department of Surgical and Perioperative Sciences
Surgery

Search outside of DiVA

GoogleGoogle Scholar

urn-nbn

Altmetric score

urn-nbn
Total: 196 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf