A multidimensional modeling of predictors influencing the adjustment to a colostomy.

Purpose: Factors contributing to the postoperative adjustment of patients who had undergone permanent colostomy surgery were studied.

Design: Cross-sectional study.

Setting And Subjects: Sixty patients who underwent colostomy surgery at 5 hospitals in Santiago, Chile, between 1987 and 1995 were evaluated. Subjects were between the ages of 27 and 89 and underwent colostomy surgery from 4 months to 19 years before data collection. METHODS AND INSTRUMENTS: A demographic questionnaire and a semistructured interview were used to elicit information concerning psychosocial reactions to a colostomy and perceptions about the changes in lifestyle created by the ostomy. Medical records were reviewed for information about disease-related characteristics and an ostomy self-care scale measured coping skills. Adjustment to the colostomy procedure was measured by means of the Olbrisch ostomy adjustment scale.

Results: Patient adaptation to a colostomy is primarily affected by the following factors: (1) the level of ostomy self-care, (2) psychological support, and (3) social support from family and significant others.

Conclusion: Successful adjustment to a permanent colostomy is most likely to occur if the patient receives adequate instruction in self-care and has the appropriate psychological support to integrate the new physical changes into a healthy body image. This includes continued acceptance from family and the patient's social network.