Describing self-care and its associated variables in ostomy patients

Aims: To describe self-care in ostomy patients, to identify socio-demographic and clinical variables associated with self-care and to identify the association between self-care self-efficacy and self-care over and above the variables associated with self-care. Design: Longitudinal and multicentre study. Data were collected between February 2017-May 2018. Methods: In this study, 523 ostomy patients were enrolled at baseline (T0) and 362 were followed-up after 6 months (T1). The Ostomy Self-Care Index was used to measure self-care maintenance, monitoring, management, and self-efficacy. Correlations between self-care dimensions and patient socio-demographic and clinical characteristics were performed with Pearson's or Spearman's correlations. Three separate two-step hierarchical regression analyses were performed to identify variables associated with self-care maintenance, monitoring, and management. Results: Participants’ mean age was 69 years (SD 12.4); 63.9% were male and most had enterostomies (38.8% colostomies, 29.3% ileostomies) and permanent ostomies (72.5%). Patients had adequate self-care maintenance and monitoring at T0 and T1, while they had lower self-care management and self-efficacy at baseline. Significant variables associated with better self-care maintenance and self-care monitoring were female gender, more information received during hospitalization and better autonomy in stoma management, while a better level of education was an additional variable associated with self-care monitoring. Self-care self-efficacy produced a significant increase in the explained variance of self-care maintenance and self-care monitoring. None of the selected variables were significantly associated with self-care management. Conclusion: Middle-high levels of self-care maintenance, monitoring, management, and self-efficacy were found. The variables associated with ostomy self-care and the role of self-care self-efficacy identified in this study can help in developing tailored nursing interventions. Impact: This study found specific variables associated with ostomy self-care which could contribute to guiding future interventions aimed at improving self-care in ostomy patients.