Ursäkta, var är toaletten? Patienters upplevelse av att få en tillfällig loop-ileostomi nedlagd efter rektalcancerbehandling
Rectal cancerTemporary loop-ileostomyStoma reversalAnterior resection syndromeCopingPerson-centred careBody image
Introduction: Reversal of a temporary loop-ileostomy is the final step after a long treatment for rectalcancer, an event that the patient has been looking forward to for a long time. Studies have shown that patients often have a significant impact on the bowel function after reversal of the stoma.Aim: To describe how the patient experienced the first time at home after reversal of a temporary loop-ileostomy due to rectalcancer. Method: Qualitative semi-structured interviews, with 15-20 patients who have undergone reversal of a temporary loop-ileostomy due to rectal cancer, will be conducted. The interviewes will be analysed using qualitative content analysis according to Graneheim & Lundman (2004). The patients will be recruited from the colorectal unit at Sahlgrenska University hospital/Östra and from the surgical unit at Kungälvs hospital. Research plan and method was tested in a pilot study in which five patients, four men and one woman in the age between 32-79 years, were interviewed.Findings: The experience following stoma reversal was characterized by being controlled by the altered bowel function, which led to restrictions in social life. Patients were coping by using their ability and knowledge, planning daily life, taking the rough with the smooth, challenging themselves and being positive about the future. To regaine normality the patients found it important to get rid of the stoma and be restored.Discussion: The patients had resources and capacity, but felt that they could not themselves control the situation with the altered bowel function satisfactorily. Through a nurse-led follow-up clinic the nurse can use the patient's capacity to visualize existing resources to help the patient cope with the situation. It would also lead to an increased knowledge about anterior resection syndrome.Key words: rectal cancer, temporary loop-ileostomy, stoma reversal, anterior resection syndrome, coping, person-centred care, body image