Quality of life of patients on chronic parenteral nutrition before and after gastrointestinal tract continuity restoration

• Authors: Michał Ławiński , Edyta Kot-Mielczarska , Aleksandra Gradowska
• Languages of publication: EN

Abstracts

EN

The issue of the quality of life considering patients with a temporary or permanent intestinal stoma, as well as the necessity for chronic parenteral nutrition at home remain a poorly understood problem. Daily care of the intestinal stoma and the need to comply with sterile procedures required for parenteral nutrition require such patients to commit their time, which secondarily is associated with the broad aspects of social and personal life. The aim of the study was to analyse the quality of life considering patients with intestinal stomas subjected to chronic parenteral nutrition, before and after gastrointestinal tract continuity restoration. Material and methods. The survey was conducted between May and July, 2014 on a group of 71 patients (33 female and 38 male) who were under the care of the Department of General Surgery and Clinical Nutrition, Warsaw Medical University, operated during the period between 2007 and July, 2014 with a present stoma (32 patients - 45%), as well as after stoma closure (39 patients - 55%). The analysed questionnaire contained 31 questions, and the SF-36 questionnaire was additionally used, determining the quality of life. Results. Analysis of the study material showed differences in the quality of life, considering three most important determinants. Significantly worse assessment of the quality of life was reported by patients with a stoma and subject to intravenous nutrition (83.2±30.5), as compared to those after stoma closure subject to normal nutrition (52.3±33.8). Based on the SF-36 questionnaire differences between patients with a stoma and those without amounted to t(69)=2.84 (p=0.006) demonstrating that those with a stoma reported a lower quality of life. Analysis between younger and older patients, based on the SF-36 questionnaire (t(62.87)=2.49; p=0.016) showed that younger patients achieved lower results, considering dissatisfaction with life (61.55±27.5), as compared to the elderly (80.8±36.9). Conclusions. The group of patients without a stoma seem to be more independent- the vast majority do not use the help of family members (43.6%), or friends (64.1%). Patients with a stoma more often withdraw from social life. The factor that mostly reduces the quality of life is the presence of a stoma, which impairs daily functioning a lot more than the sterile procedures associated with parenteral nutrition. All patients after stoma closure consider that their overall functioning has significantly improved.

Keywords

EN

quality of life; parenteral nutrition; stoma

• Publisher: De Gruyter Open
• Journal: Polish Journal of Surgery
• Year: 2015
• Volume: 87
• Issue: 4
• Pages: 153-159

Dates

published

1 - 4 - 2015

received

19 - 3 - 2015

online

3 - 7 - 2015

Contributors

author

Michał Ławiński

• Department of General Surgery and Clinical Nutrition, Warsaw Medical University

author

Edyta Kot-Mielczarska

• Department of General Surgery and Clinical Nutrition, Warsaw Medical University

author

Aleksandra Gradowska

• Department of Personality, University of Social Sciences and Humanities

References

• 1. Wiraszka GR: Problemy funkcjonowania chorych z kolostomią wytworzoną po pooperacyjnym leczeniu raka jelita grubego na podstawie badań HRQOL „Problemy Pielęgniarstwa”. Kielce 2007; Zeszyt nr 1, tom 15.
• 2. Palak Z, Lewicka A, Bujnowska A: Jakość życia a niepełnosprawność. UMCS, Lublin 2006.
• 3. Banaszkiewicz Z, Szewczyk MT, Cieżniakowska K, Jawień A: Jakość życia osób ze stomią jelitową. Współczesna Onkologia 2007; vol. 11.
• 4. Snarska J, Lapuc K, Puchalski Z, Hend M: The role of a therapeutic team and The Pol-Ilko Association in readaptation of patients with a stoma to the life in a family and society in the 21st century. Rocznik Akademii Medycznej w Białymstoku 2005; 50 Suppl 1: 123-25. Review.
• 5. Jawień A (red.): Opieka Stomijna. Poradnik dla pacjenta ze stomią. POFAM-POZNAŃ, Poznań 2009.
• 6. Kołodziejczak M, Ciesielski P, Kosim A: Postępowanie terapeutyczne w przypadku powikłań skórnych oraz trudno gojących się ran wokół stomii. Nowa Medycyna. Warszawa 2013; 2/2013.
• 7. Medlin S: Nutritional and fluid requirements: high-output stomas. Br J Nurs 2012 Mar 22-Apr 11; 21(6): S22-25.
• 8. Carlsson E, Bosaeus I, Nordgren S: Quality of life and concerns in patients with short bowel syndrome. Clin Nutr 2003 Oct; 22(5):445-52.
• 9. Michalska P, Majewska K: Problemy dnia codziennego chorych żywionych pozajelitowo w warunkach domowych. „Postępy żywienia klinicznego” nr 2, czerwiec., Wydawnictwo Lekarskie PZWL, Warszawa 2007; tom 2.
• 10. Łukasiak J, Pertkiewicz M: Aktywność dnia codziennego chorych żywionych pozajelitowo w warunkach domowych. „Postępy żywienia klinicznego” nr 3 (5), wrzesień. Wydawnictwo Lekarskie PZWL, Warszawa 2007; tom 2.
• 11. Łukasiak J, Pertkiewicz M: Czynniki warunkujące aktywność chorych przewlekle żywionych pozajelitowo w warunkach domowych. „Postępy żywienia klinicznego” nr 2, czerwiec 2010, tom 5; Wydawnictwo Lekarskie PZWL, Warszawa 2007.
• 12. Pertkiewicz M, Majewska K: Leczenie chorych z zespołem krótkiego jelita. „Postępy żywienia klinicznego” nr 2 (8), czerwiec 2008, tom 3. Wydawnictwo Lekarskie PZWL, Warszawa 2008.
• 13. Tokarczyk J, Majewska K, Kunecki M, Pertkiewicz M: Oczekiwania chorych żywionych pozajelitowo w warunkach domowych - jak chcą być leczeni? „Postępy żywienia klinicznego” nr 5, czerwiec 2010, tom 5; Wydawnictwo Lekarskie PZWL, Warszawa 2010.

Identifiers

DOI

10.1515/pjs-2015-0037