Scientific research presented at the 17th Biennial Congress of Enterostomal Therapis, Lubliana, Slovenia - 15-19/06/08.
Beatriz Yamada; Eliane Souto, Rosangela Lombardi
Stoma can result in suffering, reduction in quality of life (QoL) and odor exhaling from pouches. Controlling the odor might have a positive influence on the QoL and some products have been used clinically to this purpose. However, its effectiveness has not been clearly demonstrated. Thus, the present study aims to assess the effectiveness of a LONS in decreasing stoma pouch odor, improving QoL and satisfaction of PWS.
A prospective open-label clinical trial was performed in two outpatient settings in Brazil. A series of 32 unselected PWS, who underwent surgery at least 30 days before interview, were interviewed. The outcomes were evaluated at the baseline and 30 days following use of the LONS. Ileostomy and urostomy patients received 2 bottles (236 mL) and colostomy patients one. Exclusion criteria were colostomy irrigation and use of stoma plug. Four structured questionnaires (three developed by the authors) were used: a sociodemographic and clinical history, a self assessment of QoL (SAQoL) and satisfaction with odor; a qualitative assessment of clinically significant change and the Ferrans and Powers Quality of life Index (QLI) - Generic Version III. The QLI includes four subscales: health and functioning(HF), social and economic(SE), psychological-spiritual(PS) and family (Fa). In this study, Cronbach’s alpha for the QLI total score(QT) and subscales was > 0.70, except for the SE (0.65). Paired t-test, effect-size, Kolmogorov-Smirnov test were used.
Thirty-two subjects (53.1% female), with a mean age of 57.09±13.63 years, and with a mean time of stoma of 30.7±68 months provided full information. 50% had left colostomy. After use of the LONS, subjects were significantly (p=0,000) and clinically (ES=2.41) more satisfied with odor and had a significant improvement on their SAQoL and QT, SF, PE and SE domains (p=0.000), independently of their gender [men and women, p<0.001], partnership status [with and without partner, p<0.001], and type of stoma [right (p=0.01) and left colostomy (p=0.000), and ileostomy (p=0.000)]. Shorter duration of stoma was associated with greater satisfaction with the effectiveness of the odor neutralizer (r= -0.42; p= 0.034). Most of the subjects were more satisfied with odor (96.9%) and QoL (93.8%), and reported higher improvement in QT (71.9%), HF (40.6%), SE (37.5%), PS (81.3%) and Fa (81.3%) domains.
The LONS was effective in reducing stoma pouch odor, improving QoL and satisfaction of PWS.
Further large randomized, blinded controlled trials are required to provide more evidence of the effectiveness of LONS.