Identifying needs of patients being discharged home from hospital with a newly formed Ileostomy

This exploratory study was conducted to find out more about the experiences of six people when they were discharged from hospital with a newly formed ileostomy. There has been a lack of qualitative research about the problems people experience when they go home with an ileostomy. Commonly, research in this area has been characterised by patients being asked to rate items identified by ‘experts’ related to their post-stoma experiences. We may thus be collecting data about things that don’t really concern patients. This project seeks to go some way towards resolving that. In determining more about the experience of going home with a new ileostomy and what complications arise after discharge from hospital the project will help to provide guidance regarding follow-up care after discharge from hospital with a newly formed ileostomy. Semi-structured interviews and examination of the stoma and peristomal skin were conducted at week 1 and week 4 after discharge from hospital in the Stomal Therapy Clinic. Thematic analyses of the transcribed consultations were conducted using NVivo software package to organise the data. The most important finding of this study is that it shows that using a qualitative methodology revealed important issues for patients, not previously shown by more structured methodology using instruments with predetermined problem lists for patients to rate or rank. Physical stoma complications were found to exist in line with the literature including peristomal skin excoriation due to shrinkage of the stoma and stoma retraction. At follow-up after one week at home some participants had adopted obsessive checking and emptying behaviours. Changed eating habits were also found to exist. Neither of these issues has been identified amongst post-stoma patients before. Another, perhaps more unexpected finding throughout the study, was a reluctance to call for help when experiencing stoma complications.