Individuals With a Permanent Ostomy: Quality of Life and Out-of-Pocket Financial Costs for Ostomy Management

Diane R. Maydick, EdD, RN, ACNS-BC


Nurs Econ. 2014;32(4):204-210. 

In This Article

Abstract and Introduction


Despite advances in medical treatment for inflammatory bowel disease, diverticular disease, and bowel and bladder cancer, thousands of ostomy surgeries are performed each year in the U.S. health care system (Cooke, 2009). Ostomy surgery is accomplished when diseased organs of elimination are removed and an ostomy, or stoma, is created. This results in dramatic changes in patterns of elimination and a need for lifelong use of prosthetic devices or supplies for ostomy management, resulting in out-of-pocket financial costs for self-care. The surgery is accompanied by a full range of physiological and psychological needs and necessitates adjusting to a new way of life. Some profess the psychological impact may be greater than the physical impact (Orsted, 2007).

Pre and postoperative teaching, stoma site marking, and psychological support for individuals who undergo elective ostomy surgery are widely supported by professional medical and nursing associations (American Society of Colon and Rectal Surgeons & Wound Ostomy and Continence Nurse Society Committee Members, 2007; American Urological Association & Wound Ostomy and Continence Nurse Society Committee Members, 2009). It is generally believed that involvement of a wound, ostomy, and continence (WOC) nurse influences quality of life (QOL) for these individuals but there is a paucity of information about the impact of out-ofpocket financial costs on QOL.

A descriptive study was conducted to investigate QOL for individuals with a permanent ostomy and to investigate how out-of-pocket costs affected QOL. The results may be used to inform policymakers and the public about QOL and out-of-pocket costs and may guide nursing interventions to improve health outcomes by promoting wellness and by preventing unnecessary out-of-pocket financial expenses.