RESUMEN
PURPOSE: The aim of this study was to determine which internet search engines and keywords patients with ostomies utilize, to identify the common websites using these terms, to determine what aspects of information they wanted, and to perform a quality and readability assessment for these websites. DESIGN: A cross-sectional survey of persons with ostomies to identify search engines and terms, followed by a structured assessment of the quality and readability of the identified web pages. SUBJECT AND SETTINGS: The sample comprised 20 hospitalized patients with ostomies cared for on a colorectal surgical ward of a tertiary care hospital located in Melbourne, Australia. There were 15 (75%) adult males and 5 (25%) adult females; their mean age was 52.2 years. Participants were surveyed between August and December 2020. METHODS: Patients with newly formed ostomies were surveyed about which search engines and keywords they would use to look for information and for which questions regarding ostomies they wanted answers. In addition, 2 researchers then performed independent searches using the search terms identified by patient participants. These searches were conducted in August 2021, with the geographical location set to Australia. The quality of the websites was graded using the DISCERN, Ensuring Quality Information for Patients, and Quality Evaluation Scoring Tool scoring assessments, and their readability was graded using the Flesch Reading Ease Score tool. RESULTS: Participants used Google as their primary search engine. Four keywords/phrases were identified: stoma for bowel surgery, ileostomy, colostomy, and caring for stoma. Multiple web pages were identified, 8 (21%) originated from Australia, 7 (18%) were from the United Kingdom, and 23 (61%) were from the United States. Most web pages lacked recent updates; only 18% had been undated within the last 12 months. The overall quality of the online information on ostomies was moderate with an average level of readability, deemed suitable for patient educational purposes. CONCLUSIONS: Information for persons living with an ostomy can be obtained from multiple web pages, and many sites have reasonable quality and are written at a suitable level. Unfortunately, these websites are rarely up-to-date and may contain advice that may not be applicable to individual patients.
Asunto(s)
Internet , Estomía , Humanos , Estudios Transversales , Femenino , Masculino , Persona de Mediana Edad , Adulto , Estomía/normas , Encuestas y Cuestionarios , Anciano , Australia , Motor de Búsqueda/normas , Motor de Búsqueda/métodos , Motor de Búsqueda/estadística & datos numéricosRESUMEN
BACKGROUND: Malnutrition is independently associated with poor outcomes in colorectal cancer (CRC) surgery including increased complications and length of stay (LOS). The purpose of this study was to identify changes to perioperative nutritional management and surgical outcomes post implementation of an enhanced recovery after surgery (ERAS) protocol. METHODS: Data on LOS and adherence to the ERAS protocol, including preoperative fasting time, nutritional assessment and supplementation was prospectively collected for the pre-ERAS group who underwent surgery for CRC between February and August 2019. The post-ERAS group involved a retrospective analysis of prospectively collected data of patients who underwent surgery between October 2019 and July 2020. RESULTS: One hundred and thirty patients were included, (Pre-ERAS n = 42, Post-ERAS n = 88). A reduction in time to first solid intake by 1 day (P = 0.010), time to first bowel action (P = 0.007) and incidence of nausea (P < 0.001) was seen in the post-ERAS group. Provision of postoperative oral supplements increased from 33.3% to 70.5% (P < 0.001) in the post-ERAS group. Thirteen post-ERAS patients had a ≥ 70% adherence to the ERAS protocol and this subgroup had an associated reduction in LOS, 6.5 (4) days to 5 (3), P = 0.020. CONCLUSION: Implementation of the ERAS protocol improved perioperative patient care and outcomes. Early feeding was associated with reduced gastrointestinal symptoms without an increase in complications. Adherence to ERAS was associated with a reduction in LOS. Further research is required to evaluate the role of preoperative nutritional screening and intervention within an ERAS protocol.