Self-Concept Among Adults with Permanent Stomas Secondary to Colorectal Cancer: A Literature Synthesis

Colorectal cancer is one of the most common forms of cancer diagnosed in adults. Adults with colorectal cancer (AWCC) often receive surgical interventions, including the creation of a permanent stoma. According to recent data, more than 700,000 Americans live with a permanent stoma. As colorectal cancer survival rates continue to improve, psychosocial issues related to living with cancer and cancer-related treatment have become important issues for nurses to address. Little is known, however, about the psychosocial issues AWCC with permanent stomas experience, nor is it known what types of interventions nurses implement to help facilitate more positive outcomes among AWCC who have permanent stomas. Therefore, the purpose of this Honors College project was to perform a literature synthesis related to AWCC living with a permanent stoma. To address this purpose, a search of the literature was conducted using the Cumulative Index of Nursing and Allied Health Literature (CINAHL) database to locate original research published in the nursing/health-related literature; the search revealed 13 studies. The literature synthesis indicated that following surgical creation of a permanent stoma, AWCC often experience self-concept and body image disturbances, sexual dysfunction, anxiety, depression, feelings of stigma, and social impairment. Nurses caring for AWCC awaiting or following creation of a permanent stoma need to be vigilant in assessing for the presence of psychosocial issues in order to recognize and manage the complex problems that the presence of a stoma can create.