Longitudinal Evaluation of Bowel Function Recovery and Determinants in Colorectal Cancer Patients Postileostomy: A Comprehensive Study

IF 1.9 4区医学 Q2 NURSING

International Journal of Nursing Practice Pub Date : 2025-06-13 DOI:10.1111/ijn.70024

Yinglian Li, Simeng Song, Yang Li, Yingyi Kuang, Lili Chu, Yi Wen, Xingxing Ai, Xiaoying Tian

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SAS scores peaked on postoperative day 5 and then declined (<i>p</i> < 0.05). Both SSES and Stoma-QOL scores improved significantly over 2 months (<i>p</i> < 0.05). Several factors significantly influenced changes in bowel function, including demographic and clinical characteristics, physical activity, anxiety, self-efficacy and quality of life (<i>p</i> < 0.05). Generalized estimating equations revealed that bowel function improved over time, influenced by age, gender, adjuvant therapy, ostomy output, complications and self-efficacy (<i>p</i> < 0.05).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Recovery of bowel function after ileostomy is a dynamic process influenced by various demographic, clinical and psychosocial factors, emphasizing the need for tailored rehabilitation strategies.</p>\n </section>\n \n <section>\n \n <h3> Summary</h3>\n \n <div>What is already known about this topic?\n\n <ul>\n \n <li>\n <p>Colorectal cancer is a leading cause of morbidity and mortality, with an increasing number of patients requiring ileostomy.</p>\n </li>\n \n <li>\n <p>Ileostomy reduces perioperative risks but often leads to significant bowel dysfunction, negatively impacting quality of life.</p>\n </li>\n \n <li>\n <p>Most studies have focused on short-term bowel function recovery during hospitalization, neglecting long-term recovery in Chinese patients.</p>\n </li>\n </ul>What this paper adds?\n\n <ul>\n \n <li>\n <p>This study provided a longitudinal analysis of bowel function recovery in colorectal cancer patients postileostomy, from admission to 2 months after surgery, using a multifaceted assessment approach.</p>\n </li>\n \n <li>\n <p>Findings showed that bowel function declined immediately postsurgery but gradually improved, with key predictors of recovery such as age, gender, education, physical activity, anxiety, self-efficacy and quality of life.</p>\n </li>\n \n <li>\n <p>Stoma complications, such as anastomotic leaks and infections, along with high output stomas, delayed recovery and highlighted the need for targeted clinical interventions.</p>\n </li>\n </ul>The implications of this paper:\n\n <ul>\n \n <li>\n <p>Personalized rehabilitation strategies are crucial for improving recovery outcomes in colorectal cancer patients postileostomy.</p>\n </li>\n \n <li>\n <p>Early interventions should focus on physical activity, psychological support and enhancing self-efficacy.</p>\n </li>\n \n <li>\n <p>Nurses should regularly assess bowel function and promptly address stoma complications to optimize recovery, emphasizing tailored, evidence-based approaches for high-risk patients.</p>\n </li>\n </ul>\n </div>\n </section>\n </div>","PeriodicalId":14223,"journal":{"name":"International Journal of Nursing Practice","volume":"31 3","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Nursing Practice","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/ijn.70024","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"NURSING","Score":null,"Total":0}

引用次数: 0

Abstract

Aim

The aim of this study was to longitudinally observe bowel function changes in colorectal cancer (CRC) patients postileostomy, analyse factors influencing recovery and provide a multidimensional assessment to enhance understanding of early postoperative bowel function and its determinants, supporting personalized care strategies.

Methods

A prospective longitudinal study was conducted on 116 CRC patients postileostomy at a tertiary hospital in Guangdong Province. After exclusions, data from 102 participants were analysed. Data were collected at four time points: preoperative admission, postoperative day 5, 1 month and 2 months after surgery. Validated tools, including the Memorial Sloan Kettering Cancer Center Bowel Function Instrument (MSKCC BFI), the International Physical Activity Questionnaire Short Form (IPAQ-SF), the Self-Rating Anxiety Scale (SAS), the Stoma Self-Efficacy Scale (SSES) and the Stoma-Quality of Life (Stoma-QOL) questionnaire, were used. Generalized estimating equations analysed associations between bowel function and demographic, clinical and lifestyle factors such as age, gender, comorbidities and physical activity.

Results

BFI scores significantly improved from 69.00 (SD = 7.00) at admission to 47.00 (SD = 5.00) at 2 months postsurgery (p < 0.05). Physical activity levels declined initially (postoperative day 5) but gradually recovered over time (p < 0.05). SAS scores peaked on postoperative day 5 and then declined (p < 0.05). Both SSES and Stoma-QOL scores improved significantly over 2 months (p < 0.05). Several factors significantly influenced changes in bowel function, including demographic and clinical characteristics, physical activity, anxiety, self-efficacy and quality of life (p < 0.05). Generalized estimating equations revealed that bowel function improved over time, influenced by age, gender, adjuvant therapy, ostomy output, complications and self-efficacy (p < 0.05).

Conclusions

Recovery of bowel function after ileostomy is a dynamic process influenced by various demographic, clinical and psychosocial factors, emphasizing the need for tailored rehabilitation strategies.

Summary

What is already known about this topic?

Colorectal cancer is a leading cause of morbidity and mortality, with an increasing number of patients requiring ileostomy.
Ileostomy reduces perioperative risks but often leads to significant bowel dysfunction, negatively impacting quality of life.
Most studies have focused on short-term bowel function recovery during hospitalization, neglecting long-term recovery in Chinese patients.

What this paper adds?

This study provided a longitudinal analysis of bowel function recovery in colorectal cancer patients postileostomy, from admission to 2 months after surgery, using a multifaceted assessment approach.
Findings showed that bowel function declined immediately postsurgery but gradually improved, with key predictors of recovery such as age, gender, education, physical activity, anxiety, self-efficacy and quality of life.
Stoma complications, such as anastomotic leaks and infections, along with high output stomas, delayed recovery and highlighted the need for targeted clinical interventions.

The implications of this paper:

Personalized rehabilitation strategies are crucial for improving recovery outcomes in colorectal cancer patients postileostomy.
Early interventions should focus on physical activity, psychological support and enhancing self-efficacy.
Nurses should regularly assess bowel function and promptly address stoma complications to optimize recovery, emphasizing tailored, evidence-based approaches for high-risk patients.

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结直肠癌造口术后肠功能恢复及决定因素的纵向评价：一项综合研究

本研究的目的是纵向观察结直肠癌（CRC）患者造口术后肠功能的变化，分析影响恢复的因素，并提供多维评估，以提高对术后早期肠功能及其决定因素的认识，支持个性化护理策略。方法对广东省某三级医院116例结直肠癌造口术后患者进行前瞻性纵向研究。排除后，分析了102名参与者的数据。数据收集于术前入院、术后第5天、术后1个月和2个月四个时间点。采用了经验证的工具，包括纪念斯隆凯特琳癌症中心肠功能仪（MSKCC BFI）、国际体育活动问卷简表（IPAQ-SF）、焦虑自评量表（SAS）、造口自我效能量表（ses）和造口生活质量问卷（Stoma- qol）。广义估计方程分析了肠功能与人口统计学、临床和生活方式因素（如年龄、性别、合并症和身体活动）之间的关系。结果BFI评分由入院时的69.00 （SD = 7.00）提高至术后2个月时的47.00 (SD = 5.00)，差异有统计学意义（p < 0.05）。身体活动水平最初（术后第5天）下降，但随着时间的推移逐渐恢复（p < 0.05）。SAS评分在术后第5天达到峰值，随后下降（p < 0.05）。ses和Stoma-QOL评分在2个月内均有显著改善（p < 0.05）。有几个因素显著影响肠功能的变化，包括人口统计学和临床特征、体力活动、焦虑、自我效能和生活质量（p < 0.05）。广义估计方程显示，肠功能随时间而改善，受年龄、性别、辅助治疗、造口量、并发症和自我效能的影响（p < 0.05）。结论回肠造口术后肠功能的恢复是一个受人口统计学、临床和社会心理因素影响的动态过程，需要有针对性的康复策略。关于这个主题我们已经知道了什么？结直肠癌是发病率和死亡率的主要原因，越来越多的患者需要回肠造口术。回肠造口术降低围手术期风险，但常导致明显的肠功能障碍，对生活质量产生负面影响。大多数研究关注的是住院期间短期肠道功能的恢复，而忽视了中国患者的长期恢复。这篇文章补充了什么？本研究采用多方面评估方法，对结直肠癌造口术后患者从入院到术后2个月的肠功能恢复情况进行了纵向分析。研究结果显示，术后肠功能立即下降，但逐渐改善，主要预测因素包括年龄、性别、教育程度、体育活动、焦虑、自我效能和生活质量。吻合口并发症，如吻合口泄漏和感染，以及高输出口，延迟恢复，突出了有针对性的临床干预的必要性。本文的意义：个性化的康复策略对于提高结直肠癌患者造口术后的恢复效果至关重要。早期干预应注重身体活动、心理支持和增强自我效能感。护士应定期评估肠功能，及时处理造口并发症，以优化康复，强调针对高危患者的量身定制的循证方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Nursing Practice NURSING-

CiteScore

4.10

自引率

0.00%

发文量

审稿时长

3 months

期刊介绍： International Journal of Nursing Practice is a fully refereed journal that publishes original scholarly work that advances the international understanding and development of nursing, both as a profession and as an academic discipline. The Journal focuses on research papers and professional discussion papers that have a sound scientific, theoretical or philosophical base. Preference is given to high-quality papers written in a way that renders them accessible to a wide audience without compromising quality. The primary criteria for acceptance are excellence, relevance and clarity. All articles are peer-reviewed by at least two researchers expert in the field of the submitted paper.