Quality of life of adult intestinal stoma patients in Uganda, A cross-sectional study at Mulago National Referral Hospital

Abstract

Introduction; Intestinal stomas remain important life-saving surgical options in a wide range of gastrointestinal pathologies globally. Knowledge of the effects of any medical or surgical intervention on the patients‘ quality of life is important in clinical practice. Several scholars in differing settings have documented that the quality of life of intestinal stoma patients is usually below desirable levels associated with negative psychological effects and poor social functioning. This was only speculative in the Ugandan setting before this study. Objective: This study sought to evaluate the stoma-specific quality of life among intestinal stoma patients attending Mulago National Referral Hospital, with particular emphasis on the psychological effects and the effects intestinal stomas impart on family-social interactions. Methodology: This was a descriptive cross-sectional study carried out at the surgical outpatient clinic of Mulago National Referral Hospital (MNRH). Following ethical approval from the School of Medicine Research and Ethics Committee (SOMREC) of Makerere University College of Health Sciences, data was collected using the Stoma-QOL questionnaire from participants 18years and above living with intestinal stomas for at least a month that were recruited purposively during the study period. Data was analyzed at both bivariate and multivariate levels using Stata, version 14.0. Results; A total of 51 participants were recruited into the study with a male: female ratio of 4:1 and age range of 18-84 years (mean age 44.04+18.47 years). Of these, 76.5% had colostomy and 23.5% had ileostomy. Majority (88.2%) had temporary stomas. The overall mean Stoma-QOL score was 55.12+ 17.04. Almost half of the participants (45%) had below average Stoma-QOL of 50. Only about a quarter (24%) had ―best‖ scores. Patients exhibited serious negative psychological feelings (in forms of anxiety, concerns about changed body image and depression) as well as significant limitation of social interactions as a consequence of having stomas. There was no statistically significant association between the psychological concerns and social interaction with patient characteristics. Conclusion: Majority of intestinal stoma patients attending MNRH have unfavorable stomaspecific quality of life; suffer serious negative psychological effects and much limitation of social interactions. It is thus more than necessary that multidisciplinary efforts be employed to improve the psychosocial wellbeing of these patients and help them attain desirable levels of quality of life.