Understanding patients' perspectives when unprepared for the emergence of a parastomal bulge—a qualitative study

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Aim
The aim was to investigate patients' experiences of being prepared for the development of a parastomal bulge in relation to a stoma.

Methods
The paper draws on a qualitative interview study conducted with 20 Danish patients participating in five focus groups. Analysis was performed using a phenomenological-hermeneutic approach.

Results
We identified three themes. The first theme is ‘The unforeseen bulge gives rise to increasing concern and a search for an explanation’. Patients searched for explanations in their own life and suspected that their behaviour or previous illness induced the bulge. The second theme is ‘Missing or confusing information leads to counterproductive behaviour’. Patients lacked information on the prevention and treatment of parastomal bulging which led to disappointment with healthcare professionals. The third theme is ‘Weighing the pros and cons of life with the bulge against the gamble of surgical repair’. Some patients came to terms with their situation, but for others a deadlocked situation arose when surgical repair was not an option.

Conclusion
Healthcare communication directly impacts on patients' experiences and outcomes. When unprepared for the emergence of a parastomal bulge, patients' emotional and psychological well-being are affected and likewise patients' possibility of using their own health beliefs as a preventive strategy. To preserve patient autonomy, satisfaction and well-being, surgeons and stoma nurses should provide patients with tailored information bearing in mind the current lack of clear evidence on the prevention and treatment of parastomal bulging.
OriginalsprogEngelsk
TidsskriftColorectal Disease
Vol/bind25
Udgave nummer11
Sider (fra-til)2198-2205
Antal sider8
ISSN1462-8910
DOI
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
We thank patients for participating in our study. We acknowledge stoma nurses in the Capital Region of Denmark for the recruitment of participants and Anne Kjærgaard Danielsen for her commitment and contributions to the project overall. We thank the Capital Region of Denmark, the Foundation for Health Research; the Research Council at Herlev Gentofte Hospital; and the Novo Nordic Foundation NNF160C0023578 for supporting this study financially.

Funding Information:
This research was funded by the Capital Region of Denmark, Foundation for Health Research; the Research Counsel at Herlev and Gentofte Hospital; and the Novo Nordic Foundation NNF160C0023578. The funding had no impact on the study protocol, design or other aspects of the study.

Publisher Copyright:
© 2023 The Authors. Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.

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