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- Berndtsson, Ina, 1953-, et al.
(author)
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Long-term adjustment to living with an ileal pouch-anal anastomosis.
- 2011
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In: Diseases of the colon and rectum. - : Lippincott Williams & Wilkins. - 1530-0358 .- 0012-3706. ; 54:2, s. 193-9
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Journal article (peer-reviewed)abstract
- The aim of this study was to describe long-term adjustment to life with an ileal pouch-anal anastomosis after surgery for ulcerative colitis, to investigate the relationship of pouch function to adjustment, and to explore factors affecting quality of life.
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- Carlsson, Eva, 1959, et al.
(author)
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Concerns and quality of life before surgery and during the recovery period in patients with rectal cancer and an ostomy
- 2010
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In: Journal of Wound, Ostomy and Continence Nursing (WOCN). - : Lippincott, Williams & Wilkins. - 1071-5754 .- 1528-3976. ; 37:6, s. 654-661
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Journal article (peer-reviewed)abstract
- PURPOSE: Rectal cancer is the most common reason for a person to undergo ostomy surgery. The aim of this study was to assess concerns and health-related quality of life (HRQOL) before surgery and during the first 6 months following ostomy surgery in the presence of rectal cancer. SUBJECTS AND SETTINGS: The sample comprised 57 patients at a university hospital in Gothenburg, Sweden. Their median age was 66 years (range, 30-87); 35 men and 22 women participated in the study. METHODS: Participants prospectively answered questionnaires preoperatively, and at 1, 3, and 6 months postoperatively.Concerns were assessed using the rating form of the Inflammatory Bowel Disease Patient Concerns, and HRQOL was evaluated using the 36-Item Short Form Health Survey. Results were compared with population norms. RESULTS: Participants expressed concerns associated with developing cancer, being a burden on others, and related to the uncertain nature of disease. Health-related quality of life scores dropped significantly in 6 of 8 domains when preoperative scores were compared to those obtained 1 month postoperatively, but scores improved at 6 months. There were significant differences between preoperative study group scores and population norms on physical and emotional role function, social function, and for mental health domains. Significant differences persisted when population norms were compared to study group scores 6 months following surgery on all these domains except mental health. Participants identified good relations with significant others, social and leisure activities, psychological issues, and health as important for maintaining QOL. Obstacles to maintaining QOL included fatigue, pain, illness-induced limitations in life, and worries over what their new life would entail. CONCLUSION: Surgical management of rectal cancer raises concerns and profoundly impairs QOL during the first several postoperative months. © 2010 Wound, Ostomy and Continence Nurses Society.
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- Joelsson-Alm, Eva, et al.
(author)
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Perioperative bladder distension : a prospective study
- 2009
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In: Scandinavian Journal of Urology and Nephrology. - 0036-5599 .- 1651-2065. - 0036-5599 ; 43:1, s. 58-62
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Journal article (peer-reviewed)abstract
- Objective. Postoperative urinary retention and bladder distension are frequent complications of surgery. The aim of this study was to determine the incidence of perioperative bladder distension in a surgical setting and to identify predisposing factors among patients undergoing common general and orthopaedic procedures. Material and methods. This was a prospective observational study of 147 adult patients admitted to orthopaedic and surgical departments. Bladder volumes were measured with an ultrasound scanner on three occasions: after emptying the bladder before being transported to the operating theatre, and then immediately before and after surgery. Results. Thirty-three patients (22%) developed bladder distension (500 ml), eight preoperatively and 25 postoperatively. A total of 21 patients (14%) had a bladder volume 300 ml immediately before surgery. Orthopaedic patients were more likely to develop preoperative bladder distension than surgical patients and had significantly higher postvoid residual volumes. In the binary logistic regression analysis age, gender and time of anaesthesia could not predict bladder distension. Patients undergoing orthopaedic surgical procedures, however, were prone to bladder distension (odds ratio 6.87, 95% confidence interval 1.76 to 26.79, p=0.006). Conclusions. This study shows that orthopaedic surgical patients are more prone to bladder distension perioperatively. The conventional method of encouraging patients to void at the ward before being transported to the operating theatre does not necessarily mean an empty bladder at the start of the operation.
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- Lindholm, Elisabet, 1946, et al.
(author)
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Ostomy-Related Complications After Emergent Abdominal Surgery : A 2-Year Follow-up Study.
- 2013
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In: Journal of Wound, Ostomy and Continence Nursing (WOCN). - 1071-5754 .- 1528-3976. ; 40:6, s. 603-610
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Journal article (peer-reviewed)abstract
- PURPOSE: The aim of this study was to prospectively evaluate ostomy-related complications and describe ostomy configuration in patients undergoing acute abdominal surgery.SUBJECTS AND SETTING: The study sample comprised 144 patients with a median age of 67 years (IOR: 53.5-78 years) who underwent an intestinal ostomy as part of an acute abdominal surgical procedure. The research setting was the surgical and gynecological clinics at the Sahlgrenska University Hospital in Gothenburg, Sweden.METHODS: Ostomy configuration, diameter, height, and the presence of stomal and peristomal complications were assessed by a WOC nurse 1 to 2 times while in hospital, once at the ostomy outpatient clinic 2 weeks after discharge, and at 3, 6, 12, and 24 months following ostomy creation.RESULTS: The types of ostomies evaluated were end colostomy (58%), end ileostomy (18%), loop ileostomy (17%), and loop colostomy (7%). Most stomal or peristomal complications occurred within 1 year after surgery (31 of 57; 54.4%). Necrosis, separation, and stenosis were most common in patients with an end colostomy. Peristomal skin complications occurred in 45% of subjects during the first 6 months after surgery. The ostomy's diameter decreased significantly during the hospital course and over the first 2 weeks following hospital discharge in patients with end colostomy (P < .0001), end ileostomy (P < .0081), loop ileostomy (P = .008), and loop colostomy (ns). Patients with a low ostomy had peristomal skin problems ranging between 21% and 57% over this time period. The frequency of using a pouching system that incorporated convexity was highest in the case of loop ileostomy, used in 67% at 6 months.CONCLUSION: During the first 2 weeks after discharge, the physical configuration of the ostomy evolves and the pouching system must be frequently adjusted by a WOC nurse. Stomal and peristomal complications are prevalent during the first 2 postoperative years and especially during the first 6 months.
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- Persson, Eva, 1953, et al.
(author)
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Experiences of living with increased risk of developing colorectal and gynaecological cancer in individuals with no identified gene mutation
- 2012
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In: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 26:1, s. 20-27
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Journal article (peer-reviewed)abstract
- Background: In most families with familial cancers, mutations have not been demonstrated; thus, healthy individuals cannot be tested for mutation status. As a consequence, many persons at risk of familial cancer live with an unknown, but presumably high, risk of developing cancer.Aim: The aim of this study was to describe individuals’ perceptions of living with an increased isk of colorectal and gynaecologic cancer where the gene mutation is unknown.Methods: Interviews were conducted with 30 individuals with familial colorectal cancer. These ersons have no known mutation and therefore should be considered presumptive carriers. In onnection with the interviews, all participants were offered to take part in a surveillance programme consisting of a colonoscopy and gynaecological examinations. The interview ranscriptions were analysed by the use of qualitative content analysis.Results: Two themes emerged from the analyses: first, living under a threat with two ubthemes, threat awareness and distancing oneself from the threat. The second theme, living with uncertainty, was divided into four subthemes: influencing one’s family, being on the safe side, facing emotions evoked by examinations and trust and disappointment to the medical services.Conclusion: These persons live with a lifelong uncertainty with a varying intensity depending on what happens throughout the life trajectory. They have no diagnosis or patient group to elate to; therefore, the entire situation is often perceived as abstract. Thus, providing nformation and counselling needs to be more deeply elucidated, and we need to address both ituational and existential ways of uncertainty. This will, however, require professionals of all disciplines to understand the meaning of uncertainty and help ensure that its adverse effects re decreased with adequate nursing interventions.
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