Self-image changes with time in the cancer patient with a colostomy after operation.

Abstract

Persons undergoing colostomy surgery face body mutilation and some loss of body function, which in turn causes their concept of self to change. Although nurses use physical and behavioral indicators as bases for assessment, planning, and evaluation of nursing intervention, only minimal empiric data is available on the physical and behavioral indicators of self-concept changes (e.g., lack of participation in self-care, depression, anxiety, fear of social rejection) among these patients. This study is a beginning in the description of the self-concept changes with time of the patient with a colostomy. The purpose of this study was twofold: (1) to begin the description of the postoperative behavioral indicators of cancer patients with colostomies according to Erikson's stages of trust and autonomy at 4 and 12 weeks after operation; and (2) to measure several indexes of psychosocial discomfort anticipated by patients before colostomy operations and them measurements with measurements of psychosocial discomfort at 4 and 12 weeks after operation. The study design incorporated three serial assessments. Each consenting subject was interviewed once before the operation and twice after (at 4 and 12 weeks). The study sample consisted of 12 subjects who had colostomy operations for cancer. Ages ranged from 41 to 74 years, with a mean age of 59.4 years. Results show an increase in trust, from a mean of 203.6 at 4 weeks to a mean of 221.7 at 12 weeks. Autonomy scores decreased, from 146.2 at 4 weeks to 143.9 at 12 weeks. Psychosocial discomfort decreased from 25.7 before to 22.1 4 weeks after and 8.0 12 weeks for operation.(ABSTRACT TRUNCATED AT 250 WORDS)