Ostomy Psych0-Social Issues

The reaction to intestinal or urinary diversion surgery varies from one individual to the other. To some, it will be a problem, to other, a challenge; where one person considers its life-saving, another finds it a devastating experience. Each person will adapt or adjust in their own way and in their own time. Some of the following may be the issues faced by different patients, which they can overcome on their own time or with the aid of an ostomy nurse .

Body Image/Self-Esteem Concerns

Permanent and significant changes in the body’s appearance and functional ability may change the way the person internalizes their body image and self-concept.

It is important to understand the impact of the ostomy surgery on the patient’s change in self-image and how they perceive themselves. It may be accepted as the lesser of two evils, or they may refuse to acknowledge its existence, or may hold onto the belief that it is a temporary situation.

Within the rehabilitation process there are times that patients should have the opportunity to express or deny their feelings, about their surgery, the changes in their body or their self-image.

Self-Care Concerns

Patients have to be reassured that they will be taught self-care and that they will be able to master the management process. Basic anatomy and physiology should be explained to new patients, so they can better understand the extent of their surgery. Management options should be offered. Patients should begin to assist the ostomy nurse with caring for the ostomy as soon as possible. Becoming involved in this process will begin to build confidence and help the patient to regain control of his situation.

Relationship Concerns

Patients may fear that their social role may be changed and that others may not accept them as in the past. One of the first concerns seems to be how to tell others about your surgery, who to tell and when.

• Patients should be prepared to explain their surgery with a few brief statements.
• They should understand that they do not have to tell everyone about the surgery. Be selective about who and how much to tell. It may be only to friends who will be supportive throughout the rehabilitation process.

Returning to the work place may present a concern about restroom facilities, interaction with co-workers, and feelings of being “watched.” The Patient need to understand that;
• Maybe a few of their co-workers may need to know in the event of an emergency.
• Employability and insurability are issues for some individuals. If these issues develop, seek help from healthcare professionals and/or talk with others who have found solutions to any of these issues.

Sexual & Intimacy Issues

Sexuality issues are common concerns for the new ostomate. Linked closely to our feelings of sexuality is how we think about ourselves and our body image.

• Any sexuality concerns should be discussed between the patient and his partner.
• Ostomy surgery may present more concerns for single individuals. When to tell depends upon the relationships. Brief casual dates may not need to know. If the relationship grows and leads to intimacy, the partner needs to be told about the ostomy prior to a sexual experience.

Phases of Psychological Adaptation

Just like in any other serious accident or iillness resulting in loss of function of an important part of the body, almost every Ostamy patient and their families goes through four phases of recovery. The patient goes through these phases, varying only in the time required for each phase. People may experience the various phases of adaptation in a different order and at varying rates. Some people may skip certain phases entirely and some may move up and down at different times. Each person will adapt or adjust in their own way and in their own time.

Important - About Bowel Diversion Surgeries (Ostomies)

• Bowel diversion surgery allows stool to safely leave the body when—because of disease or injury—the large intestine is removed or needs time to heal.
• Bowel is a general term for any portion of the small or large intestine.
• The type, degree, and location of bowel damage, and personal preference, are all factors in determining which bowel diversion surgery is most appropriate.
• An ostomy nurse can help patients deal with the practical, social, and psychological issues related to bowel diversion.