Body image and self-esteem in patients with stoma: Review

Intestinal stoma is an artificial opening which small intestine or colon directly opens to the abdominal wall. Intestinal stoma (colostomy or ileostomy) is created for the patients to live longer, to help them to return into a healthier and productive life and to increase the quality of life. But people with stoma experience many physiological, psychological and social problems. Creating a stoma may cause many changes in emotion and life style. Among these changes, psychological changes like alteration in body image, anxiety (fear from unknown), decrease in self-esteem, dislike of self take place. In order to resume a normal life mood changes of the patients must be identified and the patient have to learn to cope with those changes. During this coping period, it is important for the patient with stoma to tell his negative feelings. For these reasons, training and counseling services given to these patients must be in a holistic approach including physical, social and psychological concerns. Nurses have care giving, training, counseling, supportive, coaching and facilitating roles in patient care. In addition to this, nurses' listening to the problems carefully, noticing the person's anxiety, active questioning and using anticipatory, perception and reflection techniques help to identify person's problems. Nurses can also help in gaining skills to the patient by preparing the patient for the future, by using teaching-learning method and preparing an individualized training program. Person with stoma must be informed and supported about mood changes, alterations in body image and decrease in self-esteem. For the continuation of this support ostomy care nurses have important role and responsibility.