Quality of Life of Patients with Abdominal Stoma and the Predictor Factors: A Cross-sectional Study in a Teaching Tertiary Hospital
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Abstract
Background: An abdominal stoma is instrumental in preserving life; however, its impact on a patient’s quality of life (QoL) is multifaceted and influenced by a complex interplay of various factors, including sociodemographic and clinical factors. This study aimed to assess patients’ QoL and examine its relationship with these factors.
Methods: A cross-sectional telephone survey was conducted among patients with abdominal stoma at a teaching tertiary hospital from December 2020 to February 2021. Participants were identified from the medical records of postoperative patients with a stoma and underwent eligibility assessment via medical record reviews. Data on sociodemographic characteristics and clinical conditions were obtained from medical records. A telephone survey employing the City of Hope-Quality of Life-Ostomy Questionnaire (CoH-QoL-OQ) facilitated QoL data collection. Predictor factors of QoL were examined using multiple linear regression.
Results: The mean QoL score was 6.86 (standard deviation [SD] = 0.84), indicating a moderate to high QoL. Physical well-being was the most affected (6.29; SD = 0.76), and spiritual well-being was the least affected (8.07; SD = 1.17). Employment status (b = –0.94 [95% CI: –1.67, –0.22]; P = 0.014) and colorectal cancer (CRC) (b = 0.92 [95% CI: 0.13, 1.71]; P = 0.025] were significant predictors of QoL (R² = 0.389).
Conclusion: The study found that patients with stomas generally experience a moderate QoL, with poorer QoL associated with unemployment and non-CRC diagnoses. These findings provide valuable insight into the need to strengthen patient-centred care to ensure appropriate and equitable supportive interventions for all patients.
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References
Davis D, Ramamoorthy L, Pottakkat B. Impact of stoma on lifestyle and health-related quality of life in patients living with stoma: a cross-sectional study. J Educ Health Promot. 2020;9(1):328–334. https://doi.org/10.4103/jehp.jehp_256_20
World Health Organization (WHO). Colorectal cancer [Internet]. Geneva: WHO; 2023 [Retrieved 2024 Feb 28]. Available at: https://www.who.int/news-room/fact-sheets/detail/colorectal-cancer
Ferlay J, Ervik M, Lam F, Laversanne M, Colombet M, Mery L, et al. Global Cancer Observatory: Cancer today [Internet]. France: International Agency for Research on Cance; 2024 [Retrieved 2024 Feb 28]. Available at: https://gco.iarc.who.int/today
Ayalon R, Bachner YG. Medical, social, and personal factors as correlates of quality of life among older cancer patients with permanent stoma. Eur J Oncol Nurs. 2019;38;50–56. https://doi.org/10.1016/j.ejon.2018.11.010
Magaji BA, Moy FM, Law CW, Sii HL, Roslani AC. Pattern of health-related quality of life and its association among patients with colorectal cancer. Asian Pac J Cancer Care. 2019;4(2):45–52. https://doi.org/10.31557/apjcc.2019.4.2.45-52
Valeikaite-Tauginiene G, Kraujelyte A, Poskus E, Jotautas V, Saladzinskas Z, Tamelis A, et al. Predictors of quality of life six years after curative colorectal cancer surgery: results of the prospective multicenter study. Medicina. 2022;58(4):482. https://doi.org/10.3390/medicina58040482
Vonk-Klaassen SM, de Vocht HM, den Ouden MEM, Eddes EH, Schuurmans MJ. Ostomy-related problems and their impact on quality of life of colorectal cancer ostomates: a systematic review. Qual Life Res. 2016;25:125–133. https://doi.org/10.1007/s11136-015-1050-3
Tong G, Zhang G, Liu J, Zheng Z, Chen Y, Li M, et al. When do defecation function and quality of life recover for patients with non-ostomy and ostomy surgery of rectal cancer? BMC Surg. 2020;20:57. https://doi.org/10.1186/s12893-020-00719-6
Abdul Wahab P, Mohamed N, Ismail N, Hassan II, Haryanto H. A descriptive analysis of patients with stoma attending a tertiary hospital on the east coast of Peninsular Malaysia. Int J Care Sch. 2024;7(3):4–10. https://doi.org/10.31436/ijcs.v7i3.365
Hubbard G, Taylor C, Beeken B, Campbell A, Gracey J, Grimmett C, et al. Research priorities about stoma-related quality of life from the perspective of people with a stoma: a pilot survey. Health Expect. 2017;20(6):1421–1427. https://doi.org/10.1111/hex.12585
Lupo R, Rubbi I, Barletta A, Mele C, Lezzi A, Triglia C, et al. Quality of life and psychophysical consequences in individuals with intestinal stoma: an observational study. Int J Environ Res Public Health. 2025;22(9):1327–1344. https://doi.org/10.3390/ijerph22091327
Zhang Y, Xian H, Yang Y, Zhang X, Wang X. Relationship between psychosocial adaptation and health-related quality of life of patients with stoma: a descriptive, cross-sectional study. J Clin Nurs. 2019;28(15–16):2880–2888. https://doi.org/10.1111/jocn.14876
Phan TD, Nguyen TPL, Pham PK, Nguyen DC. Quality of life of patients with permanent colostomy after the miles operation for low rectal cancer at Vietnam National Cancer Hospital, Hanoi. Thai J Surg. 2021;4(2):49–53.
Alenezi A, McGrath I, Kimpton A, Livesay K. Quality of life among ostomy patients: a narrative literature review. J Clin Nurs. 2021;30(21–22):3111–3123. https://doi.org/10.1111/jocn.15840
Lowe BG, Alsaleh E, Blake H. Assessing physical activity levels in people living with a stoma. Nurs Stand. 2019;35(1):70–77. https://doi.org/10.7748/ns.2019.e11278
Ketterer SN, Leach MJ, Fraser C. Factors associated with quality of life among people living with a stoma in nonmetropolitan areas. Nurs Res. 2021;70(4):281–288. https://doi.org/10.1097/NNR.0000000000000511
Grant M, Ferrell B, Dean G, Uman G, Chu D, Krouse R. Revision and psychometric testing of the City of Hope Quality of Life-Ostomy Questionnaire. Qual Life Res. 2004;13:1445–1457. https://doi.org/10.1023/B:QURE.0000040784.65830.9f
Konjevoda V, Zelić M, Samarin RM, Petek D. City of Hope Quality of Life-Ostomy Questionnaire validity and reliability assessment on a Croatian sample. Int J Environ Res Public Health. 2020;17(3):768. https://doi.org/10.3390/ijerph17030768
Anaraki F, Vafaie M, Behboo R, Esmaeilpour S, Maghsoodi N, Safaee A, et al. The City of Hope-Quality of Life-Ostomy Questionnaire: Persian translation and validation. Ann Med Health Sci Res. 2014;4(4):634–637. https://doi.org/10.4103/2141-9248.139355
Vural F, Sutsunbuloglu E. Quality of life of patients with a stoma: a descriptive study. Turk J Colorectal Dis. 2021;31(3):246–251. https://doi.org/10.4274/tjcd.galenos.2020.2020-7-11
Mishra P, Pandey C, Singh U, Gupta A, Sahu C, Keshri A. Descriptive statistics and normality tests for statistical data. Ann Card Anaesth. 2019;22(1):67–72. https://doi.org/10.4103/aca.ACA_157_18
Alenezi A, Livesay K, McGrath I, Kimpton A. Ostomy-related problems and their impact on quality of life of Saudi ostomate patients: a mixed-methods study. J Clin Nurs. 2023;32(13–14):3707–3719. https://doi.org/10.1111/jocn.16466
Goodman W, Downing A, Allsop M, Munro J, Taylor C, Hubbard G, et al. Quality of life profiles and their association with clinical and demographic characteristics and physical activity in people with a stoma: a latent profile analysis. Qual Life Res. 2022;31:2435–2444. https://doi.org/10.1007/s11136-022-03102-5
Leite Junior VDO, Vieira GG, Lima KS, Costa SM, Carvalho ARBD, Soeiro VMDS, et al. Quality of life and its determinants in older adults with intestinal stomas: a cross-sectional study. Int J Environ Res Public Health. 2025;22(3):375–389. https://doi.org/10.3390/ijerph22030375
Aluzaite K, Nuttall JW, O’Connor M, Harvie R, Schultz M. Quality of life in postostomy surgery patients: a cross-sectional survey. JGH Open. 2020;4(5):987–994. https://doi.org/10.1002/jgh3.12383
Shrestha S, Siwakoti S, Shakya U, Shakya R, Khadka S. Quality of life, anxiety and depression among clients with ostomy attending selected stoma clinics. J Nepal Health Res Counc. 2022;20(2):383–391.
Lau J, Ng A, Koh W-L, Peh CH, Luo N, Tan K-K. Associations between ostomy creation and health‐related quality of life in colorectal cancer patients: a longitudinal observational study. Cancer Med. 2025;14(23):e71388. https://doi.org/10.1002/cam4.71388
Mo J, Wendel CS, Sloan JA, Sun V, Hornbrook MC, Grant M, et al. Stoma location and ostomy-related quality of life among cancer survivors with ostomies: a pooled analysis. Am J Surg. 2022;223(5):963–968. https://doi.org/10.1016/j.amjsurg.2021.09.023
Golpazir-Sorkheh A, Ghaderi T, Mahmoudi S, Moradi K, Jalali A. Family-centered interventions and quality of life of clients with ostomy. Nurs Res Pract. 2022;2022(1):9426560. https://doi.org/10.1155/2022/9426560
de Brito Sena MA, Damiano RF, Lucchetti G, Peres MFP. Defining spirituality in healthcare: a systematic review and conceptual framework. Front Psychol. 2021;12:756080. https://doi.org/10.3389/fpsyg.2021.756080
Flórez JES, Zapata JL, Duarte MCP, Acevedo VV, Calle JAZ, Montoya AR, et al. Factors associated with quality of life among colorectal cancer patients: cross-sectional study. Cancer Control. 2024;31:1–10. https://doi.org/10.1177/10732748241302915
Wang M, Dai L, Fang X, Zheng Y, Shen Y, Yu Y. The differences in postoperative nursing between temporary ileostomy and temporary colostomy: a retrospective cohort study. Nurs Open. 2025;12(3):e70189. https://doi.org/10.1002/nop2.70189
Nagano M, Ogata Y, Ikeda M, Tsukada K, Tokunaga K, Iida S. Peristomal moisture-associated skin damage and independence in pouching system changes in persons with new fecal ostomies. J Wound Ostomy Cont Nurs. 2019;46(2):137–142. https://doi.org/10.1097/WON.0000000000000491
Liu S, Sun B, Tian W, Zhang L, Kong F, Wang M, et al. Experience of providing care to a family member with Crohn’s disease and a temporary stoma: a qualitative study. Heliyon. 2023;9(10):e21013. https://doi.org/10.1016/j.heliyon.2023.e21013
Lojo JJ, de La Villa R, Vega-Torres MM, Torres EA. Ostomy-related quality of life in Puerto Ricans living with inflammatory bowel disease: a prospective cohort study. J Wound Ostomy Continence Nurs. 2023;50(3):222–226. https://doi.org/10.1097/WON.0000000000000964