Social adaptation following intestinal stoma formation in people living at home: a longitudinal phenomenological study

Abstract

Purpose: Intestinal stoma formation profoundly changes the relationship between a person and their social world. The aim of this study was to understand the experience of living with a new stoma; this paper explores the theme “disrupted social world,” highlighting how stoma-forming surgery impacts on individuals’ abilities to participate and interact socially over time.

Method: A longitudinal phenomenological approach. Twelve participants with a new stoma were recruited using purposeful sampling. Data were collected at three, nine and 15 months following surgery through in-depth, unstructured interviews and analysed using a bespoke iterative framework.

Results: Three categories were identified: participation in the social environment; interpersonal relationships: changes and challenges; and setting and achieving goals.

Conclusions: Stoma-forming surgery changes the ways people relate to their social environment and connect with others, creating self-consciousness and impeding social confidence and autonomy. Understanding the social implications of stoma-forming surgery can help clinicians to provide responsive and appropriate support to facilitate social rehabilitation.

Implications for Rehabilitation

• Assisting people with a stoma to develop competent stoma self-care skills will promote social adaptation and self-acceptance.

• Clinicians should promote access to others with a stoma, an important source of support for many people adjusting to a new stoma.

• Graded exposure to social participation can engender feelings of control and confidence for people with a stoma.

• Clinicians can help individuals with a stoma to set realistic goals for their recovery, while encouraging a range of positive coping strategies.

Keywords:

• Colorectal surgery
• ostomy
• UK
• adjustment
• social adaptation

Acknowledgements

Many thanks to all those who took part in this study and to Dr Barbara Richardson.

Disclosure statement

There are no declarations of interest.