Social Impact of a Colostomy on Families of Children with Colorectal Disorders: A Mixed methods Study
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Date
2021-11
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Addis Abeba University
Abstract
Background: Colostomy is one of the most commonly performed pediatric surgical procedures in
Tikur Anbessa Hospital. Even though most of the pediatric colostomies are reversible, patients stay a
long time with the stoma because of the long wait list for surgery. Apart from medical complications,
this treatment imposes a tremendous change in lifestyle. It can cause social, financial and
psychological problems. Since parents play an important role in child’s life, it also impacts the whole
family as well.
Objective To assess the social awareness to colostomy and the social, economic and psychosocial
impact on children and their care givers
Methods: The study was a cross-sectional study with prospective data collection conducted from
October – December 2020. Both quantitative and qualitative data was collected in a convergent
parallel design. Convenience sampling technique was utilized to select participants from Tikur
Anbessa hospital.
Results: Thirty caregivers were interviewed for this study. Most of the parents were married (90%),
young (mean age 30.6 years) and living in urban areas (70%). The indications for colostomy were
ARM (53%) and HD (47%). The procedure was mostly performed in infants (mean age 6.5 months)
and as an emergency (87%). Children stayed with a colostomy from 4 months to 6years (mean 22.8
months). Medical complications occurred in half of the children but only 20% required reoperation.
The first reaction towards the colostomy was anxiety. Most parents stated that they did not get
adequate counseling or training from doctors. Learning from other patients was the most helpful
source of information. None of the patients used a colostomy bag and they expressed significant
issues with stoma care. Almost all participants had to stay home to take care of the child and many
lost their jobs. They also faced difficulties in their social life because people are uncomfortable
around a colostomy. Older children were not able to attend school. Around half of the participants
experienced economic challenges because of the colostomy.
Conclusion: We found a high rate of psychological, social and economic problems on families of
children with colostomy. We recommend for the Ethiopian pediatric surgery association to work on
educating the public as well as providing materials, training and support groups for families suffering
with this condition. These children should also be given priority on surgical waiting lists.
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Keywords
Colorectal disorders,children,colostomy