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Robert S Krouse - One of the best experts on this subject based on the ideXlab platform.
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applying the chronic care model to support Ostomy self management implications for oncology nursing practice
Clinical Journal of Oncology Nursing, 2016Co-Authors: Elizabeth Ercolano, Marcia Grant, Ruth Mccorkle, Nancy J Tallman, Martha D Cobb, Christopher S Wendel, Robert S KrouseAbstract:Background Living with an Ostomy requires daily site and equipment care, lifestyle changes, emotional management, and social role adjustments. The Chronic Care Ostomy Self-Management Training Program (CCOSMTP) offers an Ostomy self-management curriculum, emphasizing problem solving, self-efficacy, cognitive reframing, and goal setting. Objectives The qualitative method of content analysis was employed to categorize self-reported goals of ostomates identified during a nurse-led feasibility trial testing the CCOSMTP. Methods Thirty-eight ostomates identified goals at three CCOSMTP sessions. The goals were classified according to the City of Hope Health-Related Qualify of Life Model, a validated multidimensional framework, describing physical, psychological, social, and spiritual Ostomy-related effects. Nurse experts coded the goals independently and then collaborated to reach 100% consensus on the goals' classification. Findings A total of 118 goals were identified by 38 participants. Eighty-seven goals were physical, related to the care of the skin, placement of the pouch or bag, and management of leaks; 26 were social goals, which addressed engagement in social or recreational roles and daily activities; and 5 were psychological goals, which were related to confidence and controlling negative thinking. Although the goals of survivors of cancer with an Ostomy are variable, physical goals are most common in self-management training.
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early and late complications among long term colorectal cancer survivors with Ostomy or anastomosis
Diseases of The Colon & Rectum, 2010Co-Authors: Liyan Liu, Marcia Grant, Robert S Krouse, Christopher S Wendel, Lisa J Herrinton, Mark C HornbrookAbstract:Purpose Among long-term (≥5 years) colorectal cancer survivors with permanent Ostomy or anastomosis, we compared the incidence of medical and surgical complications and examined the relationship of complications with health-related quality of life.
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demographic and clinical factors related to Ostomy complications and quality of life in veterans with an Ostomy
Journal of Wound Ostomy and Continence Nursing, 2008Co-Authors: Joyce Pittman, Marcia Grant, Christopher S Wendel, Susan M Rawl, Max C Schmidt, Robert S KrouseAbstract:Purpose The purpose of this study is to describe demographic, clinical, and quality-of-life variables related to Ostomy complications (skin irritation, leakage, and difficulty adjusting to an Ostomy) in a veteran population in the United States. Design The original study employed a descriptive crosssectional study using a mixed method design. This secondary analysis used the quantitative data collected. Sample and setting Two hundred thirty-nine veterans with intestinal ostomies from 3 Veteran's Administration hospitals participated in the study. Methods Instruments used for this investigation included the City of Hope Quality of Life: Ostomy Instrument. Demographic and medical history data were collected from the survey, the Veteran's Administration health information system, and the Tumor Registry database. A self-administered survey questionnaire (mCOH-QOL-Ostomy) was mailed to each participant. Results The severity of skin irritation, problems with leakage, and difficulty adjusting were significantly related to demographic, clinical, and quality-of-life domains. Univariate analyses showed that age, income, employment, preoperative care (stoma site marking and education), having a partner, Ostomy type, reason for Ostomy, time since surgery, total quality-of-life scores and scores on all 4 domains of quality of life were related to the severity of these Ostomy complications. Age was inversely related to severity of all 3 Ostomy complications (skin irritation, leakage, and difficulty adjusting). Having an ileOstomy, rather than a colOstomy, was associated with higher severity of skin irritation. Having had the stoma site marked preoperatively was associated with less difficulty adjusting to an Ostomy, and having had preoperative Ostomy education was associated with less severe problems with skin irritation and leakage. Severity of each Ostomy complication predicted total quality-of-life scores. Difficulty adjusting to the Ostomy was related to all 4 quality-of-life domains (physical, psychological, social, and spiritual). Conclusions This study found important relationships between demographic and clinical factors and Ostomy complications. Skin problems, leakage, and difficulty adjusting predicted total quality of life scores and domains. Establishing relationships among Ostomy complications and demographic, clinical factors, and quality of life can enhance identification of patients at risk for the development of complications and is an important first step in identifying the development of effective interventions to reduce the negative impact of complications for people with ostomies. Further study of predictors and outcomes of Ostomy complications is needed to improve care.
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revision and psychometric testing of the city of hope quality of life Ostomy questionnaire
Quality of Life Research, 2004Co-Authors: Marcia Grant, Betty Ferrell, Grace E Dean, Gwen Uman, David Chu, Robert S KrouseAbstract:Purpose: Ostomies may be performed for bowel or urinary diversion, and occur in both cancer and non-cancer patients. Impact on physical, psychological, social and spiritual well-being is not unexpected, but has been minimally described in the literature. The City of Hope Quality of Life (COH-QOL)-Ostomy Questionnaire is an adult patient self-report instrument designed to assess quality of life. This report focuses on the revision and psychometric testing of this questionnaire. Patients and methods: The revised COH-QOL-Ostomy Questionnaire involved in-depth patient interviews and expert panel review. The format consisted of a 13-item disease and demographic section, a 34-item forced-choice section, and a 41-item linear analogue scaled section. A mailed survey to California members of the United Ostomy Association resulted in a 62% response rate (n = 1513). Factor analysis was conducted to refine the instrument. Construct validity involved testing a number of hypotheses identifying contrasting groups. Results: Factor analysis confirmed the conceptual framework. Reliability of subscales ranged from 0.77 to 0.90. The questionnaire discriminated between subpopulations with specific concerns. Conclusions: Overall, the analyses provide evidence for the validity and reliability of the COH-QOL-Ostomy Questionnaire as a comprehensive, multidimensional self-report questionnaire for measuring quality of life in patients with intestinal ostomies.
Marcia Grant - One of the best experts on this subject based on the ideXlab platform.
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Ostomy telehealth for cancer survivors design of the Ostomy self management training osmt randomized trial
Contemporary Clinical Trials, 2018Co-Authors: Virginia Sun, Marcia Grant, Elizabeth Ercolano, Ruth Mccorkle, Nancy J Tallman, Christopher S Wendel, Frank Passero, Sabreen Raza, Zuleyha Cidav, Michael J HolcombAbstract:Abstract Purpose An Ostomy adversely affects health-related quality of life (HRQOL) in a diverse population of cancer survivors and their caregivers. Hit-or-miss Ostomy care, nurse counseling, and community referral have been the primary modes of self-management education and support in the peri-operative setting. Few evidence-based, systematic Ostomy self-management programs are available to ensure optimal post-operative care. This paper describes the study design of a telehealth-based Ostomy Self-management Training (OSMT) program for cancer survivors and their caregivers. Methods The study is a three-year, randomized trial that tests the effectiveness of the OSMT program on survivor activation, self-efficacy, and HRQOL. The intervention integrates goal setting and problem-solving approaches to enhance survivor activation and self-efficacy to carry out Ostomy care. The curriculum is delivered via four group sessions administered by trained Ostomy certified nurses (WOCNs) and peer ostomates. An additional session is offered to caregivers to address their needs in relation to Ostomy care. Telehealth approaches through videoconferencing are used to enhance program delivery to participants in three different geographic areas across two time zones. Participants join sessions via real-time videoconferencing from their homes. Conclusions The OSMT program has high potential to make a positive impact on the unique physical, psychological, social, and spiritual needs of cancer survivors living with a permanent Ostomy. The study design, process, and telehealth approach contributes to the success of future dissemination efforts of the intervention into diverse clinical and community settings.
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applying the chronic care model to support Ostomy self management implications for oncology nursing practice
Clinical Journal of Oncology Nursing, 2016Co-Authors: Elizabeth Ercolano, Marcia Grant, Ruth Mccorkle, Nancy J Tallman, Martha D Cobb, Christopher S Wendel, Robert S KrouseAbstract:Background Living with an Ostomy requires daily site and equipment care, lifestyle changes, emotional management, and social role adjustments. The Chronic Care Ostomy Self-Management Training Program (CCOSMTP) offers an Ostomy self-management curriculum, emphasizing problem solving, self-efficacy, cognitive reframing, and goal setting. Objectives The qualitative method of content analysis was employed to categorize self-reported goals of ostomates identified during a nurse-led feasibility trial testing the CCOSMTP. Methods Thirty-eight ostomates identified goals at three CCOSMTP sessions. The goals were classified according to the City of Hope Health-Related Qualify of Life Model, a validated multidimensional framework, describing physical, psychological, social, and spiritual Ostomy-related effects. Nurse experts coded the goals independently and then collaborated to reach 100% consensus on the goals' classification. Findings A total of 118 goals were identified by 38 participants. Eighty-seven goals were physical, related to the care of the skin, placement of the pouch or bag, and management of leaks; 26 were social goals, which addressed engagement in social or recreational roles and daily activities; and 5 were psychological goals, which were related to confidence and controlling negative thinking. Although the goals of survivors of cancer with an Ostomy are variable, physical goals are most common in self-management training.
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early and late complications among long term colorectal cancer survivors with Ostomy or anastomosis
Diseases of The Colon & Rectum, 2010Co-Authors: Liyan Liu, Marcia Grant, Robert S Krouse, Christopher S Wendel, Lisa J Herrinton, Mark C HornbrookAbstract:Purpose Among long-term (≥5 years) colorectal cancer survivors with permanent Ostomy or anastomosis, we compared the incidence of medical and surgical complications and examined the relationship of complications with health-related quality of life.
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demographic and clinical factors related to Ostomy complications and quality of life in veterans with an Ostomy
Journal of Wound Ostomy and Continence Nursing, 2008Co-Authors: Joyce Pittman, Marcia Grant, Christopher S Wendel, Susan M Rawl, Max C Schmidt, Robert S KrouseAbstract:Purpose The purpose of this study is to describe demographic, clinical, and quality-of-life variables related to Ostomy complications (skin irritation, leakage, and difficulty adjusting to an Ostomy) in a veteran population in the United States. Design The original study employed a descriptive crosssectional study using a mixed method design. This secondary analysis used the quantitative data collected. Sample and setting Two hundred thirty-nine veterans with intestinal ostomies from 3 Veteran's Administration hospitals participated in the study. Methods Instruments used for this investigation included the City of Hope Quality of Life: Ostomy Instrument. Demographic and medical history data were collected from the survey, the Veteran's Administration health information system, and the Tumor Registry database. A self-administered survey questionnaire (mCOH-QOL-Ostomy) was mailed to each participant. Results The severity of skin irritation, problems with leakage, and difficulty adjusting were significantly related to demographic, clinical, and quality-of-life domains. Univariate analyses showed that age, income, employment, preoperative care (stoma site marking and education), having a partner, Ostomy type, reason for Ostomy, time since surgery, total quality-of-life scores and scores on all 4 domains of quality of life were related to the severity of these Ostomy complications. Age was inversely related to severity of all 3 Ostomy complications (skin irritation, leakage, and difficulty adjusting). Having an ileOstomy, rather than a colOstomy, was associated with higher severity of skin irritation. Having had the stoma site marked preoperatively was associated with less difficulty adjusting to an Ostomy, and having had preoperative Ostomy education was associated with less severe problems with skin irritation and leakage. Severity of each Ostomy complication predicted total quality-of-life scores. Difficulty adjusting to the Ostomy was related to all 4 quality-of-life domains (physical, psychological, social, and spiritual). Conclusions This study found important relationships between demographic and clinical factors and Ostomy complications. Skin problems, leakage, and difficulty adjusting predicted total quality of life scores and domains. Establishing relationships among Ostomy complications and demographic, clinical factors, and quality of life can enhance identification of patients at risk for the development of complications and is an important first step in identifying the development of effective interventions to reduce the negative impact of complications for people with ostomies. Further study of predictors and outcomes of Ostomy complications is needed to improve care.
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revision and psychometric testing of the city of hope quality of life Ostomy questionnaire
Quality of Life Research, 2004Co-Authors: Marcia Grant, Betty Ferrell, Grace E Dean, Gwen Uman, David Chu, Robert S KrouseAbstract:Purpose: Ostomies may be performed for bowel or urinary diversion, and occur in both cancer and non-cancer patients. Impact on physical, psychological, social and spiritual well-being is not unexpected, but has been minimally described in the literature. The City of Hope Quality of Life (COH-QOL)-Ostomy Questionnaire is an adult patient self-report instrument designed to assess quality of life. This report focuses on the revision and psychometric testing of this questionnaire. Patients and methods: The revised COH-QOL-Ostomy Questionnaire involved in-depth patient interviews and expert panel review. The format consisted of a 13-item disease and demographic section, a 34-item forced-choice section, and a 41-item linear analogue scaled section. A mailed survey to California members of the United Ostomy Association resulted in a 62% response rate (n = 1513). Factor analysis was conducted to refine the instrument. Construct validity involved testing a number of hypotheses identifying contrasting groups. Results: Factor analysis confirmed the conceptual framework. Reliability of subscales ranged from 0.77 to 0.90. The questionnaire discriminated between subpopulations with specific concerns. Conclusions: Overall, the analyses provide evidence for the validity and reliability of the COH-QOL-Ostomy Questionnaire as a comprehensive, multidimensional self-report questionnaire for measuring quality of life in patients with intestinal ostomies.
Qing Yang - One of the best experts on this subject based on the ideXlab platform.
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Early enteral fat supplementation improves protein absorption in premature infants with an enterOstomy.
Neonatology, 2014Co-Authors: Qing Yang, Kathleen Ayers, Yuegang Chen, T. Michael O'sheaAbstract:Background: Early enteral fat supplementation and fish oil (FO) stimulates post-resection intestinal adaptation in rats and increases fat absorption in premature infants with bowel resection and an enterOstomy. Objective: To test the hypothesis that early fat supplement and FO increases post-resection protein absorption, intestinal RNA, protein without decreasing intestinal arachidonic acid (AA) in premature infants with an enterOstomy. Methods: 36 premature infants (Results: Compared to controls, the treatment group had higher protein absorption (g/kg/day) and intestinal RNA and protein (μg/mg tissue) proximal to the Ostomy. The two groups had similar FA profiles except that the treatment group had higher n-3 eicosapentaenoic acid (EPA, μg/mg tissue) proximal to the Ostomy. Conclusion: Early supplementation of enteral ML and FO to premature infants with an enterOstomy increased dietary protein absorption, intestinal RNA, protein and n-3 EPA content without altering other FA content.
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early enteral fat supplement and fish oil increases fat absorption in the premature infant with an enterOstomy
The Journal of Pediatrics, 2013Co-Authors: Qing Yang, Kathleen Ayers, Yuegang Chen, Jennifer Helderman, Cherrie D Welch, Michael T OsheaAbstract:Objective To test the hypothesis that in the premature infant with an enterOstomy, early enteral supplementation with Microlipid (fat supplement) and fish oil increases enteral fat absorption and decreases the requirement for Intralipid (intravenous fat emulsion). Study design Premature infants ( Results The interval from initial postoperative feeding to bowel reanastomosis varied from 2 to 10 weeks. The treatment group received more dietary fat and less intravenous fat emulsion and had higher enteral fat absorption, less fecal liquid, and drier feces than the control group. These effects were greater among infants with a high Ostomy compared with those with a low Ostomy. Enteral fat intake was significantly correlated with fat absorption. Conclusion Early enteral fat supplement and fish oil increases fat absorption and decreases the requirement for intravenous fat emulsion. This approach could be used to promote bowel adaptation and reduce the use of intravenous fat emulsion in the premature infant with an enterOstomy.
Kathleen Ayers - One of the best experts on this subject based on the ideXlab platform.
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Early enteral fat supplementation improves protein absorption in premature infants with an enterOstomy.
Neonatology, 2014Co-Authors: Qing Yang, Kathleen Ayers, Yuegang Chen, T. Michael O'sheaAbstract:Background: Early enteral fat supplementation and fish oil (FO) stimulates post-resection intestinal adaptation in rats and increases fat absorption in premature infants with bowel resection and an enterOstomy. Objective: To test the hypothesis that early fat supplement and FO increases post-resection protein absorption, intestinal RNA, protein without decreasing intestinal arachidonic acid (AA) in premature infants with an enterOstomy. Methods: 36 premature infants (Results: Compared to controls, the treatment group had higher protein absorption (g/kg/day) and intestinal RNA and protein (μg/mg tissue) proximal to the Ostomy. The two groups had similar FA profiles except that the treatment group had higher n-3 eicosapentaenoic acid (EPA, μg/mg tissue) proximal to the Ostomy. Conclusion: Early supplementation of enteral ML and FO to premature infants with an enterOstomy increased dietary protein absorption, intestinal RNA, protein and n-3 EPA content without altering other FA content.
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early enteral fat supplement and fish oil increases fat absorption in the premature infant with an enterOstomy
The Journal of Pediatrics, 2013Co-Authors: Qing Yang, Kathleen Ayers, Yuegang Chen, Jennifer Helderman, Cherrie D Welch, Michael T OsheaAbstract:Objective To test the hypothesis that in the premature infant with an enterOstomy, early enteral supplementation with Microlipid (fat supplement) and fish oil increases enteral fat absorption and decreases the requirement for Intralipid (intravenous fat emulsion). Study design Premature infants ( Results The interval from initial postoperative feeding to bowel reanastomosis varied from 2 to 10 weeks. The treatment group received more dietary fat and less intravenous fat emulsion and had higher enteral fat absorption, less fecal liquid, and drier feces than the control group. These effects were greater among infants with a high Ostomy compared with those with a low Ostomy. Enteral fat intake was significantly correlated with fat absorption. Conclusion Early enteral fat supplement and fish oil increases fat absorption and decreases the requirement for intravenous fat emulsion. This approach could be used to promote bowel adaptation and reduce the use of intravenous fat emulsion in the premature infant with an enterOstomy.
Yuegang Chen - One of the best experts on this subject based on the ideXlab platform.
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Early enteral fat supplementation improves protein absorption in premature infants with an enterOstomy.
Neonatology, 2014Co-Authors: Qing Yang, Kathleen Ayers, Yuegang Chen, T. Michael O'sheaAbstract:Background: Early enteral fat supplementation and fish oil (FO) stimulates post-resection intestinal adaptation in rats and increases fat absorption in premature infants with bowel resection and an enterOstomy. Objective: To test the hypothesis that early fat supplement and FO increases post-resection protein absorption, intestinal RNA, protein without decreasing intestinal arachidonic acid (AA) in premature infants with an enterOstomy. Methods: 36 premature infants (Results: Compared to controls, the treatment group had higher protein absorption (g/kg/day) and intestinal RNA and protein (μg/mg tissue) proximal to the Ostomy. The two groups had similar FA profiles except that the treatment group had higher n-3 eicosapentaenoic acid (EPA, μg/mg tissue) proximal to the Ostomy. Conclusion: Early supplementation of enteral ML and FO to premature infants with an enterOstomy increased dietary protein absorption, intestinal RNA, protein and n-3 EPA content without altering other FA content.
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early enteral fat supplement and fish oil increases fat absorption in the premature infant with an enterOstomy
The Journal of Pediatrics, 2013Co-Authors: Qing Yang, Kathleen Ayers, Yuegang Chen, Jennifer Helderman, Cherrie D Welch, Michael T OsheaAbstract:Objective To test the hypothesis that in the premature infant with an enterOstomy, early enteral supplementation with Microlipid (fat supplement) and fish oil increases enteral fat absorption and decreases the requirement for Intralipid (intravenous fat emulsion). Study design Premature infants ( Results The interval from initial postoperative feeding to bowel reanastomosis varied from 2 to 10 weeks. The treatment group received more dietary fat and less intravenous fat emulsion and had higher enteral fat absorption, less fecal liquid, and drier feces than the control group. These effects were greater among infants with a high Ostomy compared with those with a low Ostomy. Enteral fat intake was significantly correlated with fat absorption. Conclusion Early enteral fat supplement and fish oil increases fat absorption and decreases the requirement for intravenous fat emulsion. This approach could be used to promote bowel adaptation and reduce the use of intravenous fat emulsion in the premature infant with an enterOstomy.
