Immediate postoperative experiences before discharge among patients with rectal cancer and a permanent colostomy: A qualitative study.

Purpose: Patients with rectal cancer with a permanent colostomy often have issues in physical, psychological and
social domains. Since discharge is an important transition period, the patient experience at that time is worthy of
attention. The aim of this study was to explore the immediate postoperative experiences before discharge among
patients with rectal cancer and a permanent colostomy in China.
Methods: A qualitative design was used. Semi-structured interviews were conducted with 18 patients newly living
with colostomy in China, who were asked open-ended questions about their postoperative experience. The
thematic analysis approach was used to analyze the data.
Results: Four themes and twelve sub-themes were identified from the interviews: (1) psychological reactions
(stoma self-acceptance, negative emotion and social isolation), (2) daily life concern (daily life misunderstandings,
sexual life compromise and work restriction), (3) stoma care consideration (strong stoma selfcare
willingness, decreased stoma self-care confidence and access to high-quality stoma care), and (4) support
from others (enterostomal nurses, family members and stoma friends).
Conclusion: Colostomy patients experience various obstacles in physiological, psychological, and societal aspect.
Nurses should provide effective discharge guidance to correct misunderstandings about the stoma, refer patients
to psychological care, and promote transitional care.