21 Sep It doesn’t have to be taboo: The person and the ostomy. Nurse explains
“The term ostomy is used to designate the opening built for externalization to the skin of a hollow viscera, through a surgical intervention, with the aim of creating a path”, explains Isabel Morais, president of the Portuguese Association of Nurses in Stomatherapy Care (APECE), in an opinion article she shared with Lifestyle ao Minuto.
The construction of an ostomy can happen for several reasons and the types of stoma are named according to the external segment. Thus, if it is the larynx that is removed, it is said that the person has a laryngectomy (respiratory ostomy), if the small intestine is externalized, it is said that the person has an ileostomy (digestive ostomy), if it is the large intestine, it is said that the person has a colostomy (digestive ostomy), and if the ureters are externalized, the person is said to have a urostomy (urinary ostomy). Therefore, we can add that the person with an ostomy is someone who, after surgery, has a stoma.
In Portugal, it is estimated that there are about 15 thousand people with ostomy, of which 80% to 90% due to oncological pathology and of these, the most frequent, are digestive disorders.
The first impact after the clinical diagnosis or in the postoperative period with the confrontation of the presence of the ostomy, can generate a negative emotional pattern not only for the presence of the disease, but for the adaptation imposed by the presence of the stoma. This need to acquire new skills can generate feelings of loss of self-control and, consequently, implications for self-esteem with repercussions on quality of life.
Psychosocial problems are also common and result from inevitable changes such as changes in body image, feelings of mutilation, inferiority and rejection of oneself, insecurity, fear of not being able to manage the new condition. In the case of people with digestive ostomy, the fear of involuntary noises (gases), from the unstuck device, can lead to isolation, social marginalization, reduced leisure activities and participation in family and social activities.
If, on the one hand, some people see the ostomy as a potential cure, attributing it as an essential value for treatment, on the other hand the ostomy may represent the existence of the disease, making it more difficult to accept the ostomy than the disease itself.
We also know that a good adaptation to the devices is directly related to the quality of life of the person with a stoma, providing safety and comfort, essential to resume the activities of daily living, facilitating the integration not only family but also social.
The last few years have been characterized by having been a highly relevant period because awareness was raised and it was possible to work together with qualified health professionals in this area. At the moment, at the national level, there is a regulation based on legislation to establish national guidelines for people with ostomy that guarantee the rights of access to material and health care.
In terms of health care needs, the Nurse with a Differentiated and Advanced practice in Stomatherapy was also identified, recognized by the Order of Nurses who approved, the draft Stomatherapy Competence Regulation and defined the profile of the Stomatherapy Nurse.
The publication of these documents allowed the consolidation and opening of new Stomatherapy consultations in most Hospital Units and in various services in the community, in the Mainland and Islands. Stomatherapy Nursing care, in Portugal, is characterized by high scientific and differentiation standards, therefore, Stomatherapy Care Nurses accompany technological advances and surgical techniques, devices and accessories for ostomy care and peri-stoma skin, providing the person with an ostomy and family with appropriate responses to their condition.
For the person with ostomy, I leave some words, which I hope reassuringly: use only the materials indicated for your situation and your needs, indicated by the Stomatherapy Care Nurses. Watch for signs of complications and consult the Stomatherapy Nurse whenever you have any questions.
Don’t let the presence of a stoma limit your life, we are here to help you regain your well-being and move on. Count on us.