This research work had 3 objectives:
1) To observe the repercussions of the confection of an ostomy and to observe the presence of psychological distress in the pre-operative phase
2) Identify the determinants contributing to psychosocial adjustment
3) Demonstrate the effectiveness of a therapeutic education program
Summary
Study 1: Few studies have evaluated the impact of the stoma and the onset of psychological distress in patients with colorectal cancer (CRC), from the pre-surgical phase to the post-surgical phase in a cross-cultural context. The objective of this 1st longitudinal study is to determine the periods of psychological distress of the Martinican and Toulouse patient, carrier of a temporary or definitive stoma, from the pre-surgical phase to the post-surgical phase. We will observe the consequences of this distress on the quality of life (QoL) of the patient. Anxiety and depression are predictors of quality of life (QOL). Trajectories of psychological distress vary according to the country of origin of the patient.
Study 2: Although numerous studies have emphasized the importance of good technical management of the appliance and of preoperative education, the determinants of psychosocial adaptation to the stoma and their impact on quality of life must be demonstrated. Using a mixed methodology, qualitative, through the analysis of the discourse and quantitative through the use of the PAIS-SR questionnaire, a census of the adaptive strategies has been highlighted as well as their impact on the quality of life.
Study 3: Educational activities and therapeutic education programs (PETP) have demonstrated their effectiveness on the QOL of ostomy patients. Better self-management of the appliance is associated with a reduction in complications and a decrease in hospitalizations. There are few cross-cultural studies analyzing the differences in care contexts regarding patient education and its impact on quality of life. This third study aims to demonstrate the efficiency of patient education and of a (universal) French Therapeutic Education program. Our results show that therapeutic education improves the patient’s physical quality of life.