The Effects of Clinical Nursing Practice Guideline Implementation in Patients with Colorectal Cancer Receiving Stoma Creation on Quality of Life and Clinical Outcomes

Main Article Content

Sujinda Ladasoontorn
Suchira Chaiviboontham
Weerapat Suwanthanma

Abstract

This quasi-experimental research aimed to develop and examine the effects of implementing clinical nursing practice guidelines (CNPG) in patients with colorectal cancer receiving stoma creation on the quality of life and clinical outcomes. Orem’s self-care theory was used as the conceptual framework. The sample consisted of 54 patients with colorectal cancer receiving stoma creation at a university hospital. The patients were divided into two groups: the control group receiving usual care and the experimental group receiving the CNPG implementation, with 27 participants in each group. The CNPG included nursing care at the preoperative, postoperative, and postdischarge phases. Data were analyzed using descriptive statistics, the Chi-square test,the Mann-Whitney U test, and one-way repeated measures analysis of variance. Results showed that the stoma QOL in the CNPG group one month after discharge was significantly higher than before and one week after discharge. For clinical outcomes, the length of stay, postoperative length of stay, postoperative complications, ostomy complications, and 30 days re-admission between the groups were not significantly different. The study revealed that CNPG implementation helps patients have a good quality of life. The incidence of postoperative and ostomy complications in the CNPG group tended to decline. However, further study should be done before fully implementing the CNPG in patients with colorectal cancer receiving stoma creation.
Keywords: Clinical nursing practice guideline, Clinical outcomes, Colorectal cancer,Quality of life, Stoma creation

Article Details

How to Cite
1.
Ladasoontorn S, Chaiviboontham S, Suwanthanma W. The Effects of Clinical Nursing Practice Guideline Implementation in Patients with Colorectal Cancer Receiving Stoma Creation on Quality of Life and Clinical Outcomes. Nurs Res Inno J [Internet]. 2023 Aug. 11 [cited 2024 Apr. 28];29(2). Available from: https://he02.tci-thaijo.org/index.php/RNJ/article/view/257733
Section
Research Articles

References

American Cancer Society. Colorectal cancer risk factors[Internet]. Atlanta, Ga: ACS; 2018 [cited 2020 Jan 27]. Available from: https://www.cancer.org/cancer/colon-rectal-cancer/causes-risks-prevention/risk-factors.html

World Health Organization & International Agency Research on Cancer. Global cancer observational [Internet]. Geneva; WHO, 2020, [cited 2020 Jan 27].Available from: https://gco.iarc.fr/today/onlineanalysis-multi-bars?v=2018&mode=cancer

National Cancer Institute. Hospital-level cancer registry 2020. Bangkok: Agency for Medical Records and Cancer Database Digital Medicine Working Group National Cancer Institute; 2021. (in Thai)

National Cancer Institute. Screening guidelines. Diagnose and treat colon and rectal cancer. National Cancer Institute,Department of Medicine, Ministry of Public Health.Bangkok: Kosit Printing; 2015. (in Thai)

Benson AB, Venook AP, Al-Hawary MM, Arain MA,Chen YJ, Ciombor KK, et al. NCCN guidelines insights:rectal cancer, Version 6.2020. J Natl Compr Canc Netw.2020;18(7):806-15. https://jnccn.org/view/journals/jnccn/18/7/article-p806.xml

Tevis SE, Kennedy GD. Postoperative complications:looking forward to a safer future. Clin Colon Rectal Surg.2016;29:246–52.

Younis J, Salerno G, Fanto D, Hadjipavlou M, Chellar D,Trickett JP. Focused preoperative patient stoma education,prior to ileostomy formation after anterior resection,contributes to a reduction in delayed discharge within the enhanced recovery programme. Int J Colorectal Dis.2012;27(1):43-7.

Näsvall P, Dahlstrand U, Löwenmark T, Rutegård J,Gunnarsson U, Strigård K. Quality of life in patients with a permanent stoma after rectal cancer surgery. Qual Life Res. 2017;26(1):55-64.

Szpilewska K, Juzwiszyn J, Bolanowska Z, Bolanowska Z, Milan M, Chabowski M, et al. Acceptance of disease and the quality of life in patients with enteric stoma. Pol Przegl Chir. 2018;90(1):13-7.

Vonk-Klaassen SM, de Vocht HM, den Ouden ME,EddesEH, Schuurmans MJ. Ostomy-related problems and their impact on quality of life of colorectal cancer ostomates: a systematic review. Qual Life Res. 2016;25:125–33.

Liao C, Qin Y. Factors associated with stoma quality of life among stoma patients. Int J Nurs Sci. 2014;1(2):196-201.

Teerathongdee G, Ronnaritthiwichai C, Thongcharoen W,Phongthawornkamol K. Factors predicting quality of life in elderly patients undergoing ostomy surgery. World Jour Cancer. 2014;34(2):68–78. (in Thai)

Taneja C, Netsch D, Rolstad BS, Inglese G, Lamerato L,Oster G. Clinical and Economic Burden of Peristomal Skin Complications in Patients With Recent Ostomies. J Wound Ostomy Continence Nurs. 2017;44(4):350-7.

WOCN Society Clinical Guideline: Management of the Adult Patient With a Fecal or Urinary Ostomy-An Executive Summary. J Wound Ostomy Continence Nurs.2018;45(1):50-8.

Portinari M, Ascanelli S, Targa S, Dos Santos Valgode EM, Bonvento B, Vagnoni E, et al. Impact of a colorectal enhanced recovery program implementation on clinical outcomes and institutional costs: A prospective cohort study with retrospective control. Int J Surg. 2018;53:206-13.

Kim B, Park S, Park K, Ryoo S. Effects of a surgical ward care protocol following open colon surgery as part of an enhanced recovery after surgery programme. J Clin Nurs.2017;26(21-22):3336-44.

Lohsiriwat V. Enhanced recovery after surgery vs conventional care in emergency colorectal surgery. World J Gastroenterol. 2014;20(38):13950-5.

Ripollés-Melchor J, Ramírez-Rodríguez JM, Casans-Francés R, Aldecoa C, Abad-Motos A, Logroño-Egea M, et al. Association between use of enhanced recovery after surgery protocol and postoperative complications in colorectal surgery: the postoperative outcomes within enhanced recovery after surgery protocol (POWER) study.JAMA Surg. 2019;154(8):725-36.

Forsmo HM, Pfeffer F, Rasdal A, Sintonen H, Körner H,Erichsen C. Pre- and postoperative stoma education and guidance within an enhanced recovery after surgery (ERAS) programme reduces length of hospital stay in colorectal surgery. Int J Surg. 2016;36(Pt A):121-6.

Gustafsson UO, Scott MJ, Hubner M, Nygren J,Demartines N, Francis N, et al. Guidelines for perioperative care in elective colorectal surgery: enhanced recovery after surgery (ERAS(®)) society recommendations: 2018.World J Surg. 2019;43(3):659-95.

Ostomy and wound clinic, Ramathibodi Hospital. Statistic of stoma complication; 2020. (in Thai)

Orem D. Nursing: Concept of practice. 3rd ed. New York:McGraw-Hill; 1985.

Hanucharurnkul S. Self-care: nursing science and arts.Bangkok: VJ Printing; 2001. (in Thai)

Xia L. The effects of continuous care model of informationbased hospital-family integration on colostomy patients:a randomized controlled trial. J Cancer Educ. 2020;35(2):301-11.

Aree-ue S, Youngcharoen P. The 6 Item Cognitive Function Test-Thai Version: psychometric property testing. Ramathibodi Nursing Journal. 2020;26(2):188-202. (in Thai)

Soukup SM. The center for advanced nursing practice evidence-based practice model: promoting the scholarship of practice. Nurs Clin North Am. 2000;35(2):301-9.

Prieto L, Thorsen H, Juul K. Development and validation of a quality of life questionnaire for patients with colostomy or ileostomy. Health Qual Life Outcomes. 2005;3:62.

Silva KA, Duarte AX, Cruz AR, de Araújo LB, Pena GDG.Time after ostomy surgery and type of treatment are associated with quality of life changes in colorectal cancer patients with colostomy. PLoS One. 2020;15(12):e 0239201.

Heng G, Lohsiriwat V, Tan K-Y. Suitability of enhanced recovery after surgery (ERAS) protocols for elderly colorectal cancer patients. Siriraj Medical Journal.2019;72(1):18-23.

Topcu SY, Oztekin SD. Effect of gum chewing on reducing postoperative ileus and recovery after colorectal surgery:a randomised controlled trial. Complement Ther Clin Pract.2016;23:21-5.

Nakamura T, Sato T, Hayakawa K, Takayama Y, Naito M, Yamanashi T, et al. Risk factors for perineal wound infection after abdominoperineal resection of advanced lower rectal cancer. Ann Med Surg (Lond). 2017;15:14-8.

Xiong S, Zhu W, Li X, Zhang P, Wang H, Li X. Intestinal interposition for complex ureteral reconstruction: a comprehensive review. Int J Urol. 2020;27(5):377-86.

Rahul A, Robin F, Adarsh H. Spontaneous rupture of hepatic metastasis from pancreatic adenocarcinoma. Case Rep Oncol Med. 2016. doi:https://doi.org/10.1155/2016/6968534.

Marciano S, Díaz JM, Dirchwolf M, Gadano A.Spontaneous bacterial peritonitis in patients with cirrhosis:incidence, outcomes, and treatment strategies. Hepat Med.2019;11:13-22.