4.3 Article

It Has Become a Part of Me: Living With Low Anterior Resection Syndrome After Ostomy Reversal: A Phenomenological Study

Journal

JOURNAL OF WOUND OSTOMY AND CONTINENCE NURSING
Volume 49, Issue 6, Pages 545-550

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/WON.0000000000000910

Keywords

Colorectal cancer; Low anterior resection syndrome; Ostomy; Ostomy reversal; Quality of life; Rectal resection; Stoma

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This study aimed to explore the challenges faced by individuals living with low anterior resection syndrome (LARS) one year or more after ostomy reversal and gain a deeper understanding of their needs. The results revealed that participants faced the central challenges of internalizing their new living conditions, actively planning their new everyday life, and understanding their bodies and controlling symptoms. Unpredictability was identified as the key challenge, and being informed in advance, having the opportunity to talk about problems, and receiving support were identified as means to ease these challenges. Overall, the participants had accepted their new living conditions after stoma reversal.
PURPOSE: The purpose of this study was to explore challenges of individuals living with low anterior resection syndrome (LARS) 1 year or more after ostomy reversal and formulate a greater understanding of their needs. DESIGN: Qualitative study with a phenomenological approach. SUBJECTS AND SETTING: The sample comprised 2 women and 5 men. All participants had undergone low anterior resection in the Comprehensive Cancer Center of a Swiss university hospital. The mean age of participants was 66 years (range, 61-71 years). METHODS: Interviews were conducted 12 to 42 months after ostomy reversal. Data were collected from one-on-one in-depth interviews using a standardized interview guide with open-ended questions. An interpretative phenomenological analysis was used to interpret data. RESULTS: Analysis revealed 3 central categories addressing the burden of living with LARS: Internalizing new living conditions; Actively planning a new everyday life; and Knowing the body and controlling symptoms. Unpredictability emerged as the key challenge. Being informed in advance about the problems expected to arise, having the possibility to talk about problems, as well as receiving peer support and structured aftercare were identified as means to ease patients' challenges when living with LARS. CONCLUSIONS: Twelve to 42 months after stoma reversal, participants had internalized their new living conditions. Their level of acceptance of their situation was substantial. There are indications that a culture of open information before ostomy reversal contributed to being mentally prepared for the situation after surgery. Talking openly about their problems helped participants organize their everyday life.

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