RESUMO
BACKGROUND: Peristomal skin complications are frequent in ostomy patients, mostly occurring as a result of effluent leaking from the system. Accurate selection of ostomy products prevents complication onset, but still largely relies on the subjective evaluation of professionals. PURPOSE: To evaluate the functionality of a tool conceived to help practitioners objectively identify the most appropriate ostomy system based on patient characteristics. METHODS: Professionals completed a dedicated questionnaire focused on new ostomy surgeries and changes in the abdominal profile and ostomy characteristics after 30 days from prescription. RESULTS: The questionnaires supported a high functionality of the tool; the pouching system chosen immediately after intervention was largely confirmed (911/959 = 95% of cases; P < .001) also in the short-term. System revision was needed only in few cases (48/959 = 5%) and mostly after ileostomy (27/959 = 2.82% of total cases), even though confirmation did not significantly vary depending on intervention (P = .1). CONCLUSIONS: The tool can help practitioners in selecting the most adequate ostomy product(s), thus preventing postsurgical complications due to effluent leakage from the stoma and improving patients' quality of life.
Assuntos
Estomia , Humanos , Inquéritos e Questionários , Estomia/enfermagem , Estomia/estatística & dados numéricos , Estomia/métodos , Estomia/efeitos adversos , Masculino , Feminino , Enfermeiros Especialistas/estatística & dados numéricos , Pessoa de Meia-Idade , Adulto , IdosoRESUMO
BACKGROUND: Peristomal skin complications (PSCs) are the most common complication among patients with ostomies after ostomy creation. PURPOSE: This systematic review and meta-analysis aimed to evaluate the factors influencing the occurrence of peristomal skin complications. METHODS: A systematic review was conducted across multiple databases by using a combination of subject terms and free words for online search. The databases were searched from their inception to October 31, 2023. All studies that met inclusion criteria were examined to identify risk factors for PSCs. Two researchers independently conducted literature screening and information extraction, evaluated the literature quality using the Newcastle-Ottawa Scale, and performed descriptive analysis of the results. RESULTS: Ten studies were included in this review. A total of 3753 patients with ostomies participated in the studies, and 981 patients suffered from PSCs, with PSC incidence ranging from 15.5% to 47.7%. Type of ostomy, diabetes, self-care knowledge, and chemotherapy were significant factors associated with PSCs. CONCLUSION: This review highlighted 4 factors that influence the occurrence of peristomal skin complications. The quality of included literature is generally low, with significant heterogeneity in study design and choice of outcome indicators. Therefore, further research involving high-quality studies with larger sample sizes is needed for deeper investigation.
Assuntos
Estomia , Humanos , Fatores de Risco , Estomia/efeitos adversos , Estomia/estatística & dados numéricos , Complicações Pós-Operatórias/etiologia , Dermatopatias/etiologiaRESUMO
BACKGROUND: Negative pressure wound therapy (NPWT) promotes wound sterilization, improves tissue granulation, and ensures appropriate wound healing. Its potential in contaminated abdominal procedures is still under study, but the results are promising. PURPOSE: This research provides insight into the use of NPWT for the effective preparation of laparotomy wounds in close proximity to ostomies. It also demonstrates the application of NPWT systems for successful skin graft take under these conditions. METHODS: The authors describe 3 cases in the burn unit of an academic hospital in the northeastern United States treated successfully with a combination of NPWT and skin grafting to manage open abdominal laparotomy wounds in close proximity to ostomies. RESULTS: NPWT improved skin graft survival by promoting the creation of a clean base, which is important for ensuring appropriate skin graft take, and strengthening the bond between the graft and the recipient wound bed. CONCLUSION: Despite these successful results, evidence in this area is still mixed and would benefit from further studies in the field.
Assuntos
Laparotomia , Tratamento de Ferimentos com Pressão Negativa , Transplante de Pele , Cicatrização , Humanos , Tratamento de Ferimentos com Pressão Negativa/métodos , Tratamento de Ferimentos com Pressão Negativa/normas , Transplante de Pele/métodos , Laparotomia/métodos , Laparotomia/estatística & dados numéricos , Masculino , Cicatrização/fisiologia , Pessoa de Meia-Idade , Feminino , Adulto , Estomia/métodos , Estomia/estatística & dados numéricosRESUMO
PURPOSE: The purpose of this research was to develop the Satisfaction Concerning Stoma Care Questionnaire (SSCQ) and evaluate its structural and convergent validity and internal reliability. DESIGN: Instrument development and evaluation of validity and reliability. SUBJECTS AND SETTING: A preliminary 22-item SSCQ was administered in a larger web-based survey to members of 2 ostomy-related patient associations with members throughout the Netherlands. The data of patients who underwent surgery within 2 years were selected for analysis. METHODS: The development of the SSCQ was informed by a preexisting survey that focused on the experiences of stoma patients with general health care. Structural validity and homogeneity of the SSCQ were assessed using explanatory factor analysis and Cronbach's α coefficients. Convergent validity was also evaluated. RESULTS: The final SSCQ comprised 20 items covering 3 domains: "preoperative care and information," "postoperative care and guidance," and "contact with and ostomy nurse." The SSCQ demonstrated structural and convergent validity and internal reliability. The Cronbach's α value of the SSCQ was 0.95, whereas the independent domains retrieved a high α coefficient ranging from 0.90 to 0.93. The SSCQ and independent domains were able to distinguish between high and low patients' ratings for satisfaction concerning the received stoma care. CONCLUSIONS: The SSCQ demonstrated structural and convergent reliability, along with internal consistency. It may be used to measure the satisfaction of patients with ostomies concerning stoma care. Future prospective studies using the SSCQ are needed to generate additional insights into providing optimal care for ostomy patients.
Assuntos
Satisfação do Paciente , Psicometria , Estomas Cirúrgicos , Humanos , Inquéritos e Questionários , Feminino , Masculino , Pessoa de Meia-Idade , Países Baixos , Reprodutibilidade dos Testes , Idoso , Psicometria/instrumentação , Psicometria/métodos , Estomas Cirúrgicos/efeitos adversos , Adulto , Estomia/psicologia , Estomia/enfermagemRESUMO
Postoperative stoma education is an essential aspect of care for all types of stoma formation because having a stoma impacts on every aspect of a person's life. This critical review of the literature explores stoma patients' needs and wants; postoperative education care guidelines; the role of ward link nurses; and care pathways. The findings from this review demonstrate that there is no national standard postoperative stoma care pathway, yet such pathways are a cost-effective means to improve patient outcomes and care. The review also identified that structured care pathways are not a new concept, but there is a lack of formal research to determine best practice in postoperative stoma education. In the UK, there is wide variation in practice and outcomes, which means that effectiveness cannot be accurately measured. The author has developed and implemented a multidisciplinary postoperative education pathway in line with a national need to further refine postoperative stoma care services to meet stoma patients' needs.
Assuntos
Estomia , Educação de Pacientes como Assunto , Humanos , Estomia/enfermagem , Reino Unido , Procedimentos Cirúrgicos Eletivos , Cuidados Pós-Operatórios , Estomas CirúrgicosRESUMO
BACKGROUND/AIM: To investigate the factors related to non-reversal of ostomy after cytoreductive surgery in ovarian cancer. In many women with ovarian cancer, transitory ostomies are performed to limit the consequences of anastomotic leak. Although intended to be temporary, a proportion of these ostomies might never be reversed. PATIENTS AND METHODS: This was a retrospective study of patients with 2014 International Federation of Obstetrics and Gynecology stage IIB-IVB ovarian cancer requiring a transitory ostomy during primary or secondary cytoreductive surgery at the Bergonie Institute, France, and the University Hospital of Las Palmas, Spain, between January 2012 and December 2022. Rate of ostomy reversal, its timing (weeks) and postoperative complications were assessed. Multivariate logistic regression analysis was performed to identify limiting factors for ostomy reversal. RESULTS: During the study period, we reviewed data on 181 consecutive patients with ovarian cancer with transitory ostomy creation; 89 (49.2%) patients were not candidates for an ostomy reversal surgery because of disease progression (n=65), death (n=16), and patient's refusal of surgery (n=8). A total of 92 patients were candidates for reversal surgery and were therefore included in the final analysis. In total, 57 (62%) patients had their ostomy reversed. The mean time from ostomy creation to ostomy closure was 47.7 (standard deviation=33.1) weeks. Hartmann's procedure (leaving a rectal stump of 5-6 cm) was identified as an independent predictive factor for non-reversal of ostomy (odds ratio=6.42, 95% confidence interval=1.61-25.53; p=0.008). Complications after ostomy reversal occurred in 32 patients (34.8%). CONCLUSION: Hartmann's procedure is a limiting factor for ostomy reversal in patients with ovarian cancer. We recommend avoiding Hartmann's procedure during cytoreductive surgery, even after colorectal anastomotic leak.
Assuntos
Procedimentos Cirúrgicos de Citorredução , Neoplasias Ovarianas , Humanos , Feminino , Neoplasias Ovarianas/cirurgia , Neoplasias Ovarianas/patologia , Procedimentos Cirúrgicos de Citorredução/efeitos adversos , Procedimentos Cirúrgicos de Citorredução/métodos , Estudos Retrospectivos , Pessoa de Meia-Idade , Idoso , Adulto , Complicações Pós-Operatórias/etiologia , Estomia/efeitos adversos , Estomia/métodos , Idoso de 80 Anos ou mais , Fístula Anastomótica/etiologiaRESUMO
INTRODUCTION: Parastomal hernia (PH) is a prevalent complication following ostomy formation, presenting significant challenges in surgical management. This study aims to validate the European Hernia Society classification for PH through the application of the Hybrid Parastomal Endoscopic Repair (HyPER) method. The study focuses on establishing the practical utility of the European Hernia Society classification in a clinical setting, particularly in guiding surgical approaches and improving patient outcomes. MATERIALS AND METHODS: This retrospective observational study aimed to assess the utility of the European Hernia Society classification in planning surgical strategies for parastomal hernias. The validation of the classification of PH was based on the experience involving 160 patients in single center. Patients were classified according to the European Hernia Society criteria, and data were collected on patient demographics, clinical presentations, and surgical outcomes. Main goal was to assess the consistency and applicability of the European Hernia Society classification in predicting surgical challenges and outcomes. RESULTS: The study found a predominance of complex Type III and IV hernias. The European Hernia Society classification was effective in categorizing PH, aiding in surgical planning and highlighting the increased complication rates associated with more complex hernia types. This study represents the largest single-center cohort treated for PH by a single team, providing a controlled evaluation of the HyPER technique's effectiveness. CONCLUSIONS: The validation of the European Hernia Society classification in this study is a significant advancement in the standardization of PH management. The findings demonstrate the classification's utility in enhancing surgical planning and patient-centered care. The study also opens avenues for further research into standardized approaches and techniques in PH treatment.
Assuntos
Herniorrafia , Humanos , Estudos Retrospectivos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Herniorrafia/efeitos adversos , Herniorrafia/métodos , Estomas Cirúrgicos/efeitos adversos , Adulto , Hérnia Incisional/cirurgia , Hérnia Incisional/etiologia , Idoso de 80 Anos ou mais , Hérnia Ventral/cirurgia , Hérnia Ventral/classificação , Hérnia Ventral/etiologia , Estomia/efeitos adversos , Endoscopia/métodosRESUMO
This study aimed to develop and validate a community-based ostomy care training program for nursing staff, with the goal of enhancing their ostomy nursing competencies and improving patient satisfaction. Between March 2021 and October 2021, 20 registered nurses and 50 patients with enterostomy surgery who took part in the promotion of a new nursing technique in five community health service centers in the Wuxing District, Huzhou City, were enrolled in this study (forming the intervention group). In addition, 15 registered nurses and 40 patients with enterostomy surgery from four community health service centers with similar economic and health conditions in the same area were randomly selected as the control group. All community health service centers were independent institutions. The indexes before and after the promotion of the technique were compared, and the effectiveness of the training was evaluated by observing the improvement in nursing skills and changes in patient quality of life after the training. The "quality-of-life scale" was used to analyze the quality of life of patients who had undergone colostomy surgery. The new approach to ostomy care delivered in a community setting was found to improve staff knowledge and skill in ostomy care (p < 0.001), improve the quality-of-life scores of patients and reduce patient travel time and medical expenses. The promotion of ostomy nursing techniques in community health service centers has several benefits. It improves the ostomy nursing skill levels of community medical staff. This reduces the occurrence of ostomy complications. Additionally, it establishes an effective connection between tertiary hospitals and community health service centers. This connection is conducive to better nursing care for patients who have undergone ostomy surgery. The hospital - community - family nursing model can improve self-management abilities and reduce the incidence of complications of enterostomies.
Assuntos
Enfermagem em Saúde Comunitária , Estomia , Qualidade de Vida , Humanos , Feminino , Masculino , Estomia/enfermagem , Pessoa de Meia-Idade , Adulto , Enfermagem em Saúde Comunitária/métodos , China , Satisfação do Paciente , IdosoRESUMO
BACKGROUND: Peristomal skin complications are prevalent among patients with ostomies and significantly impact their quality of life. Ostomy care is crucial for patients with ostomies because it ensures proper adhesion and protects and reduces the peristomal skin complications. OBJECTIVES: To assess the effectiveness of nail polish as a novel skin barrier and compare its performance with the commonly available ostomy barriers in the market. DESIGN: Phase I randomized controlled trial. SETTINGS: A single trauma and surgery center. PATIENTS: Forty patients who were hospitalized for ostomy implantation were enrolled. Twenty cases were included in each group. MAIN OUTCOME MEASURES: The use of nail polish as a baseplate was tested against the common ostomy pastes. Over 6 months, the study enrolled 40 patients who required loop ileostomy and were followed up for 8 weeks. Postoperative evaluation was performed using the City of Hope-Quality of Life ostomy and 36-Item Short Form questionnaires, as well as physical examinations conducted 1 day after surgery and at 4 and 8 weeks after surgical treatment. RESULTS: Forty patients were included in the study. At all 3 time points, significant differences were observed in 36-Item Short Form scores, time, and costs spent on ostomy care. The intervention group experienced fewer peristomal skin complications (skin itching, redness, inflammation, and burning) and skin allergies at the first and second time points (p < 0.05). Furthermore, none of the patients in the intervention or control group experienced rare complications such as folliculitis, candidiasis, contact dermatitis, or pyoderma gangrenosum. LIMITATIONS: Single institution. CONCLUSIONS: The utilization of nail polish as a baseplate reduces skin allergies, peristomal skin complications, and the time and financial resources spent on ostomy care. Furthermore, using nail polish has demonstrated promising results in patients' quality of life. Consequently, using nail polish emerged as the preferred choice among study participants. See the Video Abstract . EVALUANDO LA APLICACIN DE ESMALTE DE UAS COMO PLACA BASE DE OSTOMA UN ANLISIS COMPARATIVO CON PASTAS DE OSTOMA CONVENCIONALES EN EL MERCADO EN UN ENSAYO CLNICO: ANTECEDENTES:Las complicaciones de la piel periestomal son frecuentes entre los pacientes con ostomías y afectan significativamente su calidad de vida. Los cuidados de la ostomía son cruciales para los pacientes ostomizados, ya que garantizan una adhesión adecuada y protegen y reducen las complicaciones de la piel periestomal.OBJETIVOS:Evaluar la eficacia del esmalte de uñas como nueva barrera cutánea y comparar su rendimiento con las barreras de ostomía comúnmente disponibles en el mercado.DISEÑO:Ensayo clínico aleatorizado de fase I.ENTORNO:Un único centro de traumatología y cirugía.PACIENTES:Se incluyeron cuarenta pacientes hospitalizados para la implantación de una ostomía. Se incluyeron veinte casos en cada grupo.MEDIDAS DE RESULTADO PRINCIPALES:Se probó el uso de esmalte de uñas como placa base frente a las pastas de ostomía comunes. Durante un periodo de 6 meses, el estudio incluyó a 40 pacientes que necesitaban una ileostomía en asa y fueron sometidos a un seguimiento de 8 semanas. La evaluación postoperatoria se llevó a cabo mediante los cuestionarios City of Hope-quality of life ostomy y SF-36, así como mediante exámenes físicos realizados 1 día después de la cirugía y a las 4 y 8 semanas del tratamiento quirúrgico.RESULTADOS:Se incluyeron en el estudio cuarenta pacientes. En los 3 puntos temporales, se observaron diferencias significativas en las puntuaciones SF-36, el tiempo y los costos dedicados al cuidado de la ostomía. El grupo de intervención experimentó menos complicaciones cutáneas periestomales (picor, enrojecimiento, inflamación y quemazón de la piel), así como alergias cutáneas en el primer y segundo momento (p < 0,05). Además, ninguno de los pacientes del grupo de intervención ni del de control experimentó complicaciones poco frecuentes como foliculitis, candidiasis, dermatitis de contacto o pioderma gangrenoso.LIMITACIONES:Una sola institución.CONCLUSIÓN:La utilización de esmalte de uñas como placa base reduce las alergias cutáneas, las complicaciones cutáneas periestomales y el tiempo y los recursos económicos dedicados al cuidado de la ostomía. Además, el uso de esmalte de uñas ha demostrado resultados prometedores en la calidad de vida de los pacientes. En consecuencia, la utilización de esmalte de uñas resultó ser la opción preferida entre los participantes en el estudio. (Traducción-Dr. Aurian Garcia Gonzalez).
Assuntos
Ileostomia , Qualidade de Vida , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Ileostomia/métodos , Ileostomia/efeitos adversos , Idoso , Adulto , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/prevenção & controle , Estomia/efeitos adversos , Estomia/métodosRESUMO
BACKGROUND: Living with an ostomy is a chronic condition, and self-care in such cases improves patient outcomes. PURPOSE: To adapt and test the psychometric properties of the Turkish version of the Ostomy Self-Care Index (T-OSCI) and the Turkish version of the Caregiver Contribution to Self-Care in Ostomy Patient Index (T-CC-OSCI). METHODS: A psychometric study was conducted on a convenience sample of 202 adult patients with an ostomy and their 165 caregivers. Translation and back translation, face and content validity, construct validation, and reliability assessment of the T-OSCI and the T-CC-OSCI were performed. Exploratory factor analysis was used to evaluate the construct validity. Reliability was established using Cronbach α coefficients, ceiling and floor effects, and the Hotelling T2 test, Wilcoxon signed rank test, and intraclass correlation coefficient. RESULTS: Content validity values were in the range of 0.85 to 1 for both the T-OSCI and the T-CC-OSCI. Exploratory factor analysis demonstrated generally acceptable factor loadings. The overall index revealed a high level of internal consistency (T-OSCI = 0.968, T-CC-OSCI = 0.862). No statistically significant difference was found between test-retest measurements. There was no indication of either ceiling or floor effects, or response bias. CONCLUSION: The T-OSCI and the T-CC-OSCI are valid and reliable indexes to measure the self-care of patients with an ostomy and their caregivers. These indexes may allow health care professionals to evaluate self-care in research and clinical settings, identify educational needs, and collaborate in developing and supporting appropriate self-care initiatives for patients with an ostomy and their caregivers.
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Cuidadores , Estomia , Psicometria , Autocuidado , Humanos , Psicometria/instrumentação , Psicometria/métodos , Autocuidado/métodos , Autocuidado/estatística & dados numéricos , Masculino , Feminino , Cuidadores/psicologia , Cuidadores/estatística & dados numéricos , Reprodutibilidade dos Testes , Estomia/psicologia , Estomia/enfermagem , Estomia/estatística & dados numéricos , Pessoa de Meia-Idade , Turquia , Inquéritos e Questionários , Adulto , IdosoRESUMO
ABSTRACT: Skin complications in individuals with an ostomy are widely reported and can cause physical and emotional challenges in everyday life. Chronic parastomal skin complications can be difficult to heal and cause significant pain.Two patients presented to the stomal therapy clinic for treatment and were diagnosed with chronic parastomal skin ulceration. Following standard treatment of wound management, topical corticosteroid ointment, and appliance review, the ulcers either were not improving or had reoccurred. Treatment with a combination cream consisting of 0.2% hyaluronic acid and 1% silver sulfadiazine was initiated, and both patients demonstrated complete healing.Treatment of parastomal skin ulceration with dual-action cream 0.2% hyaluronic acid and 1% silver sulfadiazine was successful for these two patients, with a reduction in pain and purulent fluid noted throughout treatment, in addition to a reduced cost of treatment when compared with standard protocols.
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Anti-Infecciosos Locais , Ácido Hialurônico , Sulfadiazina de Prata , Cicatrização , Humanos , Ácido Hialurônico/efeitos adversos , Ácido Hialurônico/uso terapêutico , Ácido Hialurônico/administração & dosagem , Sulfadiazina de Prata/uso terapêutico , Sulfadiazina de Prata/administração & dosagem , Feminino , Anti-Infecciosos Locais/uso terapêutico , Anti-Infecciosos Locais/efeitos adversos , Doença Crônica , Cicatrização/efeitos dos fármacos , Masculino , Úlcera Cutânea/tratamento farmacológico , Úlcera Cutânea/etiologia , Úlcera Cutânea/terapia , Idoso , Resultado do Tratamento , Pessoa de Meia-Idade , Estomia/efeitos adversos , Estomia/métodosAssuntos
Incontinência Urinária , Humanos , Fatores de Risco , Incontinência Urinária/complicações , Incontinência Urinária/enfermagem , Incontinência Fecal/complicações , Incontinência Fecal/enfermagem , Dermatite/etiologia , Dermatite/prevenção & controle , Estado Terminal/enfermagem , Criança , Estomia/efeitos adversos , Estomia/enfermagem , Estomia/métodosRESUMO
PURPOSE: The purpose of this study was to describe the knowledge and practices of ostomy care nurses related to the United Kingdom's Association of Stoma Care Nurses (ASCN) 2016 guidelines for prevention and management of parastomal hernia (PSH) in adults. DESIGN: Cross-sectional descriptive study. SUBJECTS AND SETTING: The target population was approximately 300 stoma care nurses; 120 useable responses to the survey were received, reflecting a response rate of approximately 40%. METHODS: A 31-item questionnaire was developed for the purposes of this study, consisting of multiple choice and short answer questions grouped into 2 sections; demographics, and knowledge and practices. The questionnaire was distributed to members of the ASCN who work with adults via an online survey platform with the aim of reaching as many respondents as possible. The Chi-square test was used to determine relationships between the nominal demographic data and the nominal knowledge and practices data. RESULTS: Almost two-thirds of respondents (65%, n = 78) rated their knowledge relating to prevention and management of PSH as good or excellent. Nevertheless, 79.8% (n = 95) indicated they needed additional education to improve their knowledge and practice related to prevention of PSH. Those who rated their knowledge as excellent or good were significantly more likely to be aware of the guidelines compared to those who ranked their knowledge as average or poor. CONCLUSIONS: Study findings suggest variability in knowledge among UK stoma care nurses, along with a desire for additional education in this area of care.
Assuntos
Estomia , Humanos , Reino Unido , Estudos Transversais , Inquéritos e Questionários , Adulto , Feminino , Masculino , Estomia/enfermagem , Estomia/efeitos adversos , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/estatística & dados numéricos , Enfermeiras e Enfermeiros/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Competência Clínica/normas , Competência Clínica/estatística & dados numéricos , Estomas Cirúrgicos/efeitos adversosRESUMO
PURPOSE: The purpose of this study was to determine predictors of health-related quality of life (HRQOL) in persons aged 18 to 40 years living with inflammatory bowel disease (IBD) and a fecal ostomy. DESIGN: Descriptive cross-sectional study. SUBJECTS AND SETTING: The sample comprised 98 participants recruited from online discussion boards/support groups for individuals living with IBD and an intestinal ostomy. More than three-quarters (76.5%) were female; 45.9% (n = 44) had lived with an ostomy for 2 years or less. Data were collected through an online survey made available from October 2018 to December 2018. METHODS: HRQOL was measured using the Healthy Days Core Module (Centers for Disease Control and Prevention HRQOL-4). Item 1 from the CDC HRQOL-4 represented the variable self-rated health (SRH). The subscales of bodily pain, general mental health, and vitality from the Short-Form 36 Health Survey and the subscales of ostomy function and body image/sexuality plus skin irritation item from the Young-Fadok Stoma Quality of Life (QOL) Scale were used to measure predictors of pain, psychological distress, fatigue, peristomal skin irritation, leakage of ostomy appliance, and body image/sexual disturbance. Correlational and hierarchical multiple linear regression analyses were conducted to complete hypotheses testing. RESULTS: Significant correlations were found between pain, fatigue, peristomal skin problems, psychological distress, SRH, and HRQOL. Pain, fatigue, psychological distress, and self-related health explained 53.2% of the variance in HRQOL based on hierarchical multiple linear regression and controlling for demographic variables such as marital and employment status. CONCLUSIONS: Findings suggest global disease symptoms of IBD in the form of pain, fatigue, and psychological distress and individual perception of health (SRH) are more important than transient ostomy symptoms of peristomal skin complications and leakage of ostomy appliance in predicting HRQOL. Individuals in this population regularly use online resources indicating a need to understand and gain insight into the information posted online in the management of the fecal ostomy and IBD.