Congress Abstracts 2004

77

A UNIQUE APPROACH TO OSTOMY TEACHING. Dona Isaac, BSN, Susannah Rose, MSW, CSW, Christina Corban, RN, ANP, and Debra Rodrigue, RN, MA, Memorial Sloan-Kettering Cancer Center, New York, NY.

An innovative collaborative approach for ostomy teaching and counseling has been implemented at this NCI-designated cancer center. This approach uses a group format and capitalizes on the unique expertise of the oncology nurse (RN) and clinical social worker (MSW).

Patients who undergo surgery for colorectal and other cancers resulting in ostomies need extensive teaching and support to adequately adjust to their new lifestyle. Studies on the adjustment of patients with ostomies illuminate the relationship between ostomy self care and psychosocial coping, and these investigations indicate that patients with ostomies are at increased risk of depression and social isolation (Oades-Souther & Olbrisch, 1984). Prior to group formation, inpatient teaching and support for new ostomates involved multiple interventions on separate occasions by RNs and MSWs to address their psychosocial and self-care concerns.

This program was developed by an inpatient, RN, and MSW to (1) reinforce bedside ostomy self-care teaching, (2) discuss dietary changes and offer suggestions for appropriate food choices, (3) provide emotional support and psychoeducation with the intention of reducing psychosocial distress, depression, and isolation after discharge, and (4) normalize patients’ experiences by facilitating discussion among patients and family members. The session begins with the RN reviewing and demonstrating ostomy self-care techniques and incorporating hands-on experience while encouraging questions. The MSW then leads open discussion regarding coping and lifestyle changes and provides community support resources. These 45-minute voluntary classes are held twice weekly and are open to all ostomy patients within the center.

This unique teaching strategy has had a positive affect on this patient population as evidenced by feedback from patients, family members, and staff.

This program empowers the patients as they strive to adjust with their new ostomies while encouraging family support. This group may serve as a model for ostomy patients as well as other patients undergoing body-altering procedures. An unforeseen benefit has been the decreased amount of individual time needed by professional staff to prepare the ostomate for discharge. Time studies may also prove the efficacy of ostomy group classes versus individual teaching sessions. A formal evaluation using standarized tools that measure quality of life and psychosocial outcomes would be beneficial in validating positive program results and directing future improvements.