09 Oct “HFF Close to You” | The stoma and the role of nursing in empowering patients

in www.correiodesintra.pt – 19 September, 2023

In this edition of “HFF Close to You” we’re going to give visibility to yet another topic that is often still taboo – the stoma, which is a reality for all patients who have undergone an ostomy, i.e. people who have had to have a hole surgically opened to divert (either temporarily or permanently) the normal transit of food, ventilation or elimination.

Stomas and ostomies are rarely talked about, because of shame or embarrassment. But the fact that they aren’t talked about much doesn’t mean that they aren’t more common than you might think.

There are several diseases or health conditions that can lead to a stoma, including: cancers or tumours of the stomach (gastrostomy), colon and rectum (ileostomy and colostomy), or bladder (urostomy). Acute inflammatory bowel diseases can also cause this, as can kidney disease (nephrostomy) or severe abdominal infection (peritonitis). On the other hand, stomas may be necessary due to serious trauma caused by accidents. In other cases, they are caused by congenital malformations.

There has been so much demand for follow-up care for stoma patients that the Professor Fernando Fonseca Hospital (HFF) has been offering a dedicated Stomatherapy Nursing Consultation for 12 years now. This is a specialised nursing consultation that takes place every day at the Outpatient Clinic, providing personalised support to these patients, namely by teaching them how to deal with the stoma, its hygiene and placement, and how to minimise its impact on their daily lives and quality of life.

The quality of life and self-esteem of the ostomised person, resulting from the physical and emotional impact that the ostomy has on their life and family and social relationships, can be devastating without proper monitoring and demystification. These implications extend to the family, particularly formal and informal carers. Everyone, without exception, needs to be trained and empowered to live autonomously and without the limitations that may initially be associated with an ostomy.

Taking the last two years as a reference, the HFF’s stomatherapy clinic has an average of around 1,000 consultations per year (2021 with 1,033 consultations and 2022 with 1,079 consultations).

These numbers are particularly significant, given all the constraints that Covid-19 has caused in extra-pandemic care activity over the last three years, particularly in the articulation and interaction with hospital services and the community, as well as with primary health care.

The need for this consultation to grow has meant that it now operates every working day of the week, from Monday to Friday. There is also a direct mobile phone number where patients can contact the stomatherapy nursing team.

In addition to the response provided to outpatients in the Outpatient Clinic, the HFF Stomatherapy Nursing Clinic liaises with all the hospital’s services through internal referrals, monitoring the patient from the preoperative phase through to discharge and integration into life in the community, always available to overcome the challenges of ostomies and stomas in patients’ lives.