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 inTikur Anbessa Hospital. Even though most of the pediatric colostomies are reversible, patients stay along 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 andpsychological 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 psychosocialimpact on children and their care givers
Methods: The study was a cross-sectional study with prospective data collection conducted fromOctober – December 2020. Both quantitative and qualitative data was collected in a convergentparallel design. Convenience sampling technique was utilized to select participants from TikurAnbessa 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 wereARM (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 22.8months). 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 getadequate counseling or training from doctors. Learning from other patients was the most helpfulsource of information. None of the patients used a colostomy bag and they expressed significantissues with stoma care. Almost all participants had to stay home to take care of the child and manylost their jobs. They also faced difficulties in their social life because people are uncomfortablearound a colostomy. Older children were not able to attend school. Around half of the participantsexperienced economic challenges because of the colostomy.
Conclusion: We found a high rate of psychological, social and economic problems on families ofchildren with colostomy. We recommend for the Ethiopian pediatric surgery association to work oneducating the public as well as providing materials, training and support groups for families suffering awith this condition. These children should also be given priority on surgical waiting lists.
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Keywords
Colorectal disorders,children,colostomy