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Patients’ bowel symptom experiences and self-care strategies following sphincter-saving surgery for rectal cancer

Authors

  • Margaret Landers MSc, PhD, RM,

    College Lecturer, Corresponding author
    1. Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
    • Correspondence: Margaret Landers, College Lecturer, Catherine McAuley School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, Ireland. Telephone: +353 21 4901457.

      E-mail: m.landers@ucc.ie

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  • Geraldine McCarthy PhD, MSN, RGN,

    Emeritus Professor
    1. Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
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  • Vicki Livingstone BSc, MSc, PhD,

    Biostatistician
    1. Neonatal Brain Research Group, Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
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  • Eileen Savage MEd, PhD, RCN

    Professor
    1. Department of Nursing, School of Nursing and Midwifery, Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
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Abstract

Aims and objectives

To investigate patients’ bowel symptom experiences and self-care strategies following sphincter-saving surgery for rectal cancer and the relationship between bowel symptom experiences and the self-care strategies used.

Background

Earlier diagnosis of rectal cancer allows for less invasive surgical treatments such as sphincter-saving procedures to be performed. Although a permanent stoma is generally not required, patients experience changes in bowel function following this surgery. However, limited research exists on patients’ bowel symptom experiences and the self-care strategies used to manage symptoms following sphincter-saving surgery of rectal cancer.

Design

Quantitative descriptive correlational.

Methods

A convenience sample of 143 patients aged 30 to over 70 years was used. Data were collected (April 2010–December 2010) using the Illness Perception Questionnaires, the Difficulties of Life Scale and a researcher developed Self-care Strategy Measure. The research was underpinned by the Symptom Management Theory.

Findings

Relating to the four most effective self-care strategies used respondents reporting more bowel symptom were more likely to use the self-care strategy proximity/knowing the location of a toilet at all times. Females, respondents with high timeline cyclical scores and respondents with high physiological responses scores were more likely to use protective clothing. Respondents reporting more bowel symptom and with high social responses scores were more likely to use bowel medication. Females were more likely to wear incontinence pads.

Conclusion

This research provides insights into the daily bowel symptom experiences of patients following sphincter-saving surgery for rectal cancer. It demonstrates the range of self-care strategies that individuals use to manage their bowel symptoms and the self-care-strategies that were most effective for them.

Relevance to clinical practice

Patients should be encouraged to report on-going bowel problems following sphincter-saving surgery for rectal cancer. Supportive care for patients should be comprehensive and tailored to meet individual needs.

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