Umeå universitets logga

umu.sePublikationer
Ändra sökning
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Battle of the Bulge: a qualitative analysis of living with a parastomal hernia
Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap. (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 universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap.
Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap.ORCID-id: 0000-0002-3806-2114
Visa övriga samt affilieringar
(Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
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.

Nyckelord [sv]
parastomalt bråck, kvalitativ
Nationell ämneskategori
Kirurgi
Forskningsämne
kirurgi
Identifikatorer
URN: urn:nbn:se:umu:diva-216045OAI: oai:DiVA.org:umu-216045DiVA, id: diva2:1808474
Tillgänglig från: 2023-10-31 Skapad: 2023-10-31 Senast uppdaterad: 2023-10-31
Ingår i avhandling
1. Aspects of parastomal hernia
Öppna denna publikation i ny flik eller fönster >>Aspects of parastomal hernia
2023 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
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.

Ort, förlag, år, upplaga, sidor
Umeå: Umeå Universitet, 2023. s. 72
Serie
Umeå University medical dissertations, ISSN 0346-6612 ; 2262
Nyckelord
parastomal hernia, colostomy, surgical technique, patient experience
Nationell ämneskategori
Kirurgi
Forskningsämne
kirurgi
Identifikatorer
urn:nbn:se:umu:diva-216046 (URN)978-91-8070-170-9 (ISBN)978-91-8070-171-6 (ISBN)
Disputation
2023-12-01, Aulan, Sunderby sjukhus, Sjukhusvägen 12, Sunderby, 10:00 (Engelska)
Opponent
Handledare
Tillgänglig från: 2023-11-10 Skapad: 2023-10-31 Senast uppdaterad: 2023-11-01Bibliografiskt granskad

Open Access i DiVA

Fulltext saknas i DiVA

Person

Odensten, ChristofferNäsvall, PiaGunnarsson, Ulf

Sök vidare i DiVA

Av författaren/redaktören
Odensten, ChristofferNäsvall, PiaGunnarsson, Ulf
Av organisationen
Institutionen för kirurgisk och perioperativ vetenskap
Kirurgi

Sök vidare utanför DiVA

GoogleGoogle Scholar

urn-nbn

Altmetricpoäng

urn-nbn
Totalt: 83 träffar
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf