The effect of video-assisted stoma care training given to stoma patients on postoperative anxiety, stoma compliance, and complications: A Randomied controlled study

Introduction:: Colorectal cancer, which is the primary cause of stoma opening in the intestine, has become a problem that increases morbidity and mortality in the world. Stoma surgery is a surgical application that leads to a change in the normal evacuation pattern in patients. Stoma surgery, in addition to being an effective treatment method in maintaining or regaining health, prolonging life span, maximizing organ functions, relieving pain and improving appearance, can cause the individual to experience various physiological, social, psychological and emotional problems. Therefore, patient education and counseling in the surgical process is an indispensable part of patient care and an important nursing initiative. Objective: The aim of this study is to evaluate the effect of video-assisted stoma care training given to patients with stoma on postoperative anxiety, stoma compliance and complications Material and Methods: This study was conducted in a double-blind randomized controlled experimental type within the scope of doctoral thesis, between January 2021 and September 2022, in the General Surgery Clinics of Aydın Atatürk State Hospital, Aydın State Hospital and Aydın Adnan Menderes University Practice and Research Hospital, in 21 intervention groups (in the post-operative period) who met the sampling criteria. The study was carried out with 42 patients (who received video-assisted stoma care training) and 21 control group. Randomized block randomization method was used to determine the status of the patients in the intervention or control group. Research data were collected with "Patient Diagnosis Form", "State Continuity Anxiety Scale", "Stoma Adjustment Scale" and "Pittman Ostomy Complication Severity Index". In the postoperative period, video-assisted stoma care training was given to the patients in the intervention group, while the patients in the control group were trained with plain lecture and demonstration methods. During the research process, patients were visited in 3 different time periods in order to determine the anxiety level of the patients, to evaluate their compliance with the stoma and to evaluate complications. Results: In our study, the State-Trait Anxiety scale scores of the patients in all variable groups did not show a statistically significant difference, and moderate anxiety was observed in the intervention and control group patients; The intervention group's overall total score on the Ostomy Adjustment Scale and the sub-dimension mean scores were lower than those of the control group; It was determined that the Pittman Ostomy Complication Severity Index (OCSI) total score average of the intervention group was lower than that of the control group patients. Conclusion and Suggestions: It was found that the video-assisted stoma care training given to the patients who underwent stoma surgery during the surgical process did not affect the anxiety level of the patients in the postoperative period, and moderate anxiety was observed in both patient groups; It was determined that the overall ostomy compliance scale mean score and sub-dimension mean score of the intervention group patients were lower than the control group patients, and the ostomy compliance of the intervention group patients decreased over time, and the pittman ostomy complication severity index score average of the intervention group patients was lower than the control group patients. In conclusion; Video-assisted stoma care training given to patients with stoma was found to be effective in reducing complications. In line with these results, in order to reduce the anxiety level of the patients, the use of mixed education methods including other education methods other than video education by diverting the attention of the patients or the application of alternative treatment methods such as music concerts and aromatherapy; In order to increase the compliance of the patients with the stoma, the video-assisted stoma care education and perioperative counseling to the patients should be continued and repeated dynamically throughout the surgical process starting from the first admission of the patient to the clinic, and also considering that the stoma was newly opened to the patients in the 1st, 3rd and 6th months. It is recommended to use a common language in patient care by using a measurement tool with validity and reliability, such as the Pittman Ostomy Severity Index, while evaluating the complications related to stoma.