Commentary: Jordanian ostomates’ health problems and self-care ability to manage their intestinal ostomy: a cross-sectional study

Quality of life (QOL) is an important aspect of cancer patient care. Although this patient group can have a relatively good QOL compared with the general population, changes in social, spiritual, emotional and physical wellbeing will occur as a result of being diagnosed and treated for colorectal cancer. A third of the individuals in this study reported mild anxiety and depression, which was associated with a worse QOL. The context of the study may well be significant with respect to the high scores for social/family wellbeing of QOL and reports that solid social support systems were available to help those in need. By contrast, a large cohort study in the United Kingdom found that nearly a third of participants had insufficient social support and as a result were at a greater risk of a poor QOL (Haviland et al., 2017). Many people do not have anyone to talk to or to ask for help, for example, with household chores, which become challenging to complete after cancer treatment.

To support and improve the QOL of people living with cancer and beyond, NHS England endorsed the Recovery Package (NHS England, 2014), a series of interventions that includes a holistic needs assessment (HNA). An HNA is a simple questionnaire completed by the person affected by cancer to allow them to highlight the most important issues to them at that time, which then informs the development of a care plan. In my role supporting patients recovering from colorectal surgery, I try to conduct the HNA within the first 6 weeks of finishing treatment. Common concerns identified include fatigue, negative body image, peripheral neuropathy, sexual difficulties, emotional distress, pain and urinary and gastrointestinal problems. In addition, for many of these individuals, there can be also be the need to adjust to a stoma (on either a temporary or permanent basis), the presence of which may also negatively influence their QOL (Vonk-Klaassen et al., 2016). This can all take time.

As healthcare providers we have a responsibility to assess for and address any QOL issues that might arise both during and after treatment. Early intervention may result in more appropriate support, improved recovery experiences and even improvement in overall survival.

Biography

Claire Taylor supports patients referred to St Mark’s Hospital with locally advanced and recurrent colorectal cancer and leads the Living with and Beyond Cancer agenda within the trust.