Estudo da efetividade da demarcação de estoma intestinal por estomaterapeuta em pacientes com doença oncológica

Abstract

Introduction: The intestinal stoma of elimination is the exteriorization of the intestinal loops in the abdominal wall, which may be temporary or definitive. Objective: To evaluate the effectiveness of the site demarcation performed by the stoma nurse to prepare an intestinal stoma for patients with cancer, with and without their guidance for self-care with ostomy. Method: Observational, longitudinal study of a prospective cohort of follow-up of similar individuals (groups of cancer patients undergoing intestinal ostomy with and without demarcation and with and without orientation for post-surgical self-care). The research was carried out at the Fundação Centro de Controle em Oncologia, of the State Department of Health of Amazonas. The sample consisted of 22 (twenty-two) participants that resulted in surgical therapeutic submission of an eliminating intestinal stoma. A convenience sample was carried out, not probabilistic and not random. To determine the sampling, the average number of colostomies and ileostomies was raised, which indicated the preparation of intestinal stomas, performed in the quadrennium (2014-2017). The cohort consisted of two follow-up groups: group of cancer patients undergoing intestinal ostomy with demarcation and guidance by the stoma nurse for self-care with ostomy and group of cancer patients undergoing intestinal ostomy without demarcation and without guidance by the stoma nurse for self-care with ostomy. Data collection was performed through the intervention of three procedures: demarcation of the stoma site by a stoma therapist nurse, patient guidance for self-care with intestinal ostomy and data collection on a surgical map. The data were tested and analyzed using non-parametric tests, after verifying that some variables did not follow a normal distribution, using the KolmogorovSmirnov test. A significance level of 5% (p <0.05) was adopted. Results: Of the 22 ostomized patients, 16 (72.7%) were female and 6 (22.3%) were male. Regarding color, most were brown 13 (59.1%), followed by white 4 (18.2%), black 2 (9.1%) and yellow 1 (4.5%), 2 (9, 1%) did not inform the color. In the inspection of the abdominal area, regarding the presence of alterations that may hinder the construction of the stoma and adherence of the collection bag, when comparing the participant's gender and the abdomen area, the female sex was more vulnerable. Regarding the making of the stoma type, 12 were temporary and 10 were definitive. Comparing the demarcated, non-demarcated groups and those oriented and not oriented towards self-care, those not demarcated as those not oriented showed more complications in stomata and peristomal skin. It was also observed in the results that 81.8% of the stomata were generated by surgeons at sites in the abdominal region previously examined and demarcated by the nurse. Conclusion: evaluation and delimitation of the abdominal area by the stoma nurse before the surgery proved effective for the prevention and reduction of complications in the stoma and peristomal skin, as well as the orientation for self-care provided to the client.