The experience of flatus incontinence from a bowel ostomy: A hermeneutic phenomenology

OBJECTIVE: To interpret and present possible meanings in the stories of people with bowel ostomies about their experience of impact of flatus incontinence on their life and being. DESIGN: Hermeneutic phenomenology guided by a Gadamerian perspective. SETTING AND SUBJECTS: Six people with a bowel ostomy were recruited from a city in Australia. METHODS: In-depth, nonstructured interviews generated rich text. Interviews were videotaped. A variety of interpretive, hermeneutic techniques were applied for text interpretation. RESULTS: Nine existential themes of meaning emerged: I am undignified, I am a secret, I am always with gas, I am not myself alone, I am without choice, I am a seeker of control, I am the smell, I am not normal, and I am living a life-sort of. Through symbiotic interpretation, writing, and re-writing, themes were encompassed in a short story: a creative synthesis of actual events and interpreted understandings for ostomates about possible meanings of experiencing flatus incontinence. CONCLUSION: Flatus incontinence for people with bowel ostomies can be quite discommoding and impact on their interactions, self-image, sexuality, social activity, and psychological wellbeing. Nurses need to-understand this for empathetic interaction, patient assessment, intervention selection, research planning, and pertinent education.