Epidemiological Characterization of Patients with Intestinal Stomas

We conducted a cross-sectional study with 47 patients of a Specialized Rehabilitation Center (CER II/APAE) in the municipality of Três Lagoas, state of Mato Grosso do Sul, Midwestern Brazil, from December 2019 to June 2020. Data was analyzed using inferential descriptive statistics (Anderson-Darling, Chi-squared, and Mann-Whitney normality tests).

Results

Regarding the patients, 87.23% were from Três Lagoas, 51.06% were female, 40.43% were aged from 60 to 69 years, 59.57% were married, 53.19% were brown, 59.57% were catholic, 36.17% finished elementary school, 46.81% were retired, and 57.45% earned a monthly income below 1 minimum wage. Moreover, 61.70% had undergone terminal colostomy (61.70%), 61.70% had received guidance about its placing, 57.45% had it placed due to situations of urgency, 74.47% had a stoma installed due to a neoplasia, 38.30% were permanent, with 46.81% located in the inferior left quadrant (ILQ), 59.57% presented pasty effluent, 63.83% had a circular diameter, 53.19% had pouches with 2 pieces and 57.45%, with a flexible base, 87.23% had other adjunct equipment, and 95.74% had been trained in self-care. The most common complication was skin/peristomal irritant contact dermatitis (59,57%), and 65,95% of these cases were solved by teaching self-care. The type of stoma was significantly associated with the consistency of the effluent and the size of the protrusion (p> 0.05).

Conclusion

The results found can support strategies to implement practices to promote health, develop new public policies, to provide training in self-care, and prevent and treat complications.

Keywords
ostomy; intestinal elimination; health profile; self-care

Sample characterization variables	n	%
Hometown
Bataguassu	4	(8.51)
Brasilândia	1	(2.13)
Ribas do Rio Pardo	1	(2.13)
Três Lagoas	41	(87.23)
Sex
Female	24	(51.06)
Male	23	(48.94)
Age group
20-29 years	4	(8.51)
30-39 years	2	(4.26)
40-49 years	7	(14.89)
50-59 years	6	(12.77)
60-69 years	19	(40.43)
70-79 years	6	(12.77)
> 80 years	3	(6.38)
Marital status
Married	28	(59.57)
Divorced	5	(10.64)
Single	11	(23.40)
Widow/widower	3	(6.38)
Skin color
White	19	(40.43)
Brown	25	(53.19)
Black	3	(6.38)
Religion
Catholic	28	(59.57)
Spiritist	1	(2.13)
Evangelical	13	(27.66)
No religion	5	(10.64)
Level of schooling
Illiterate	5	(10.64)
Semi-illiterate	4	(8.51)
Elementary school	17	(36.17)
High school	16	(34.04)
Higher education	5	(10.64)
Occupation
Removed from work by the Brazilian National Institute of Social Security	20	(42.55)
Retired	22	(46.81)
Unemployed	1	(2.13)
Homemaker	1	(2.13)
Employed	3	(6.38)
Family income (in minimum wages)
No income	2	(4.26)
Less than 1	27	(57.45)
2 to 5	17	(36.17)
More than 6	1	(2.13)
Active sex life
No	27	(57.45)
Yes	20	(42.55)
Practice of physical activity
No	37	(78.72)
Walks twice a week	6	(12.77)
Walks three times a week	1	(2.13)
Walks four times a week	3	(6.38)

		Ostomy
Clinical variables		Colostomy (n = 39)		Ileostomy (n = 8)		p-value^a
		N	%	N	%
Type of surgery	Elective	16	41.03	4	50.00	0.641
Type of surgery	Urgency	23	58.97	4	50.00	0.641
Previous guidance about the installation of the stoma	No	14	35.90	4	50.00	0.460
Previous guidance about the installation of the stoma	Yes	25	64.10	4	50.00	0.460
Preoperative stoma demarcation	No	31	79.49	6	75.00	0.759
	Yes	7	17.95	2	25.00
	Did not know	1	2.56	0	0.00
Permanence of the stoma	Permanent	11	28.21	4	50.00	0.200
	Temporary	11	28.21	3	37.50
	No information	17	43.59	1	12.50
Anatomical placement	IRQ/ascending colon	8	20.51	0	0.00	<0.001
	IRQ/ileum	0	0.00	8	100
	ILQ/descending colon	22	56.41	0	0.00
	ILQ/sigmoid colon	3	7.69	0	0.00
	URQ/transverse colon	2	5.13	0	0.00
	ULQ/transverse colon	4	10.26	0	0.00
Color of the ostomy	Dark red	4	10.26	0	0.00	0.370
	Pale red	1	2.56	0	0.00
	Bright red	34	87.18	8	100
Humidity of the stoma	Dry	3	7.69	1	12.50	0.672
Humidity of the stoma	Humid	36	92.31	7	87.50	0.672
Protrusion	No	1	2.56	0	0.00	0.538
Protrusion	Yes	38	97.44	8	100	0.538
Diameter	Circular	23	58.97	7	87.50	0.101
Diameter	Oval	16	41.03	1	12.50	0.101
Size (in mm)	0 to 20	8	20.51	1	12.50	0.475
	20 to 40	26	66.67	7	87.50
	40 to 60	3	7.69	0	0.00
	60 to 80	2	5.13	0	0.00
Skin/peristomal allergy	No	38	97.44	8	100	0.538
Skin/peristomal allergy	Yes	1	2.56	0	0.00	0.538
Type of pouch	Single piece	18	46.15	4	50.00	0.843
Type of pouch	Two pieces	21	53.85	4	50.00	0.843
Base	Flexible	23	58.97	4	50.00	0.641
Base	Rigid	16	41.03	4	50.00	0.641
Effluent consistency	Liquid	3	7.69	5	62.50	<0.001
	Pasty	28	71.79	0	0.00
	Semi-liquid	8	20.51	3	37.50
	Gray	0	0.00	2	25.00
	Brown	34	87.18	6	75.00
	Green	4	10.26	0	0.00
Auxiliary equipment	No	6	15.38	0	0.00	0.120
Auxiliary equipment	Yes	33	84.62	8	100	0.120
Self-care training	No	2	5.13	0	0.00	0.382
Self-care training	Yes	37	94.87	8	100	0.382
Hygiene (stoma)	Caregiver	1	2.56	0	0.00	0.561
	Relative	10	25.64	1	12.50
	Patient	28	71.79	7	87.50
Equipment emptying	Caregiver	1	2.56	0	0.00	0.700
	Relative	8	20.51	1	12.50
	Patient	30	76.92	7	87.50
Equipment replacement	Caregiver	1	2.56	0	0.00	0.606
	Relative	15	38.46	2	25.00
	Patient	23	58.97	6	75.00
Replacement frequency	Daily	4	10.26	1	12.50	0.939
	Every 2 days	5	12.82	1	12.50
	3 to 5 days	29	74.36	6	75.00
	More than 5 days	1	2.56	0	0.00
Reason for the ostomy	Diverticulitis	7	17.95	0	0.00	0.240
	Neoplasia	28	71.79	7	87.50
	Other	4	10.26	1	12.50
Skin/peristomal complications	No	14	35.90	4	50.00	0.654
	Candidiasis	1	2.56	0	0.00
	Dermatitis	24	61.54	4	50.00
Stoma-related complications	No	27	69.23	6	75.00	0.742
Stoma-related complications	Yes	12	30.77	2	25.00	0.742
Resolution of complications	Absence	11	28.21	4	50.00	0.439
	Surgical	1	2.56	0	0.00
	Self-care teaching	27	69.23	4	50.00
Comorbidities	No	22	56.41	5	62.50	0.750
Comorbidities	Yes	17	43.59	3	37.50	0.750
Treatment with chemo/radiotherapy	No	22	56.41	5	62.50	0.750
Treatment with chemo/radiotherapy	Yes	17	43.59	3	37.50	0.750
Self-esteem	Not preserved	10	25.64	2	25.00	0.970
Self-esteem	Preserved	29	74.36	6	75.00	0.970
Body self-image	Partial acceptance	17	43.59	4	50.00	0.856
	Complete acceptance	14	35.90	3	37.50
	Non-acceptance	8	20.51	1	12.50
Support network	Family	24	61.54	6	75.00	0.460
Support network	Family and others	15	38.46	2	25.00	0.460

Continuous variables	Descriptive statistics				p-value^a
	Colostomy		Ileostomy
	Mean ± SD	Md	Mean ± SD	Md
Time of permanence of the stoma (days)	726 ± 952	259	557 ± 776	340	0.977
Protrusion size (cm)	0.91 ± 0.87	0.70	1.26 ± 0.23	1.30	0.003
Mass (Kg)	65.1 ± 17.8	63.0	69.7 ± 14.7	73.0	0.321

Sociedade Brasileira de Coloproctologia Av. Marechal Câmara, 160/916, 20020-080 Rio de Janeiro/RJ Brasil, Tel.: (55 21) 2240-8927, Fax: (55 21) 2220-5803 - Rio de Janeiro - RJ - Brazil
E-mail: sbcp@sbcp.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Address for correspondence Liliane Moretti Carneiro, Nurse, doctoral student, Postgraduate Program in Health and Development in the Midwest Region, Federal University of Mato Grosso do Sul Campo Grande, MS, Brazil (e-mail: liliane-moretti@hotmail.com).