Research Proposal On Quality Of Life In Ostomy Patients (Research Proposal Sample)

Research Proposal: Quality of life in ostomy patients
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Research Proposal: Quality of life in ostomy patients
Introduction
Background Information
Ostomy is a procedure directed towards treatment of conditions caused majorly by colorectal cancer or inflammatory bowel disease for non-cancer patients (Grant et al., 2004, Krouse et al., 2009 and Smith et al., 2007). Colorectal cancer (CRC) has recorded increased incidence and mortality rates over the past years making it a major public health concern (Carlsson et al., 2010 and Marquis et al., 2003). The only standard treatment for colorectal cancer remains to be colostomy. During this procedure, the normal bowel function is interrupted as the waste is passed through the stroma into a collecting equipment (Marquis et al., 2003). Ostomy is meant to treat and reduce the patients’ pain and discomfort.
This results into about a hundred thousand colostomy patients in United Kingdom, seven hundred thousand patients in the United States and one million recorded in China. Over the years, colostomy has experienced an increased treatment advances and high screening rates improving the relative survival rates of CRC patients (Marventano et al., 2013). However, colostomy creates a challenge in terms of normal life functioning as it may lead to intensified distress and patients’ suffering causing attendant stress(Siassi et al., 2008, Neuman et al., 2011 and Taylor & Morgan, 2011). Studies show that 76 percent of colostomy patients reported skin irritation, 62 percent reported pouch leakage, 59 percent recorded offensive odor, 54 percent reported reduction of intimacy and 53 percent recorded depression and or anxiety.
Quality of outcome (QOL) is a standard measure of the patient’s opinions about their wellbeing and functional status (Canova et al., 2013 and Peng et al., 2011). QOL has been a research priority for the past few years even as new methods to improving the whole process are being devised. Although new efforts are made to improve the surgery outcomes and reduce impact on patients’ life (Pereira et al., 2012), there are cases of post stoma stress and physiological problems are still on the rise (Mahjoubi et al., 2010).
Research questions
What are the difference dimensions of the quality of life?
What are the factors associated with stroma-specific QOL among stroma patients?
Research Objectives
To establish the difference dimensions of QOL
To determine the factors associated with stroma-specific QOL among stroma patients.
Justification
This study will provide useful information that will be used by governments and policy makers in implementing further studies and research in colorectal cancer and ostomy. These studies will enhance improvements of the stoma-specific quality of life outcomes.
Literature Review
Research literatures establishes that patients suffering from ostomy experience several challenges in depending on their quality of life(Sprangers et al., 1995, Symms et al., 2008 and Coons et al., 2007). Colostomy is a surgical procedure that is performed on ostomy patients so as to reduce gastrointestinal symptoms and also to prevent the disease progression to other parts of the body (Tafreshi et al., 2010). Mitchell et al. (2007), showed that changes that occur after colostomy such as tangled body function and interference of a number of physical appearance are a major cause of problems in the patients’ privet lives. For instance research establishes that colostomy and after- symptoms affects the patient’s intimate relationship with their partners (R. Krouse et al., 2007 and Coons et al., 2007). Brown and Randle (2005) says that patients from Ostomy surgery tend to worry more about their sexual lives. Other research informs that patients in early stages after surgery and stoma function records the highest sexual problems inflicting a further injury in their quality of life (Smith et al., 2007 and Brown & Randle, 2005). Another research shown that “almost half of patients who were sexually active before ostomy surgery became inactive after the procedure” (Symms et al., 2008). This calls for medical practitioners and counselors to evaluate stroma patients’ sexual health and advice where appropriate (Tafreshi et al., 2010)
Studies have also shown that other than sexual impacts, other physical problems that are related to stroma surgery are, peristomal skin irritation, bad odor and noise from the appliances. This has a definite impact in their life quality (Lynch et al., 2008 and Ohman, 1982). Other studies also records emotional and mental issues from ostomy patients. “Patient had some degree of cognitive and mental problems that they were concerned about” (Richboug et al., 2007)
Economic problems are also associated with most ostomy patients. A research establishes that the cost of ostomy should be an important input in the quality of life consideration. Another research further associates loss of employment with Colostomy. “Most patients reported that they had to change or leave their job after disease onset and their ostomy, and that this had affected their income” (Tafreshi et al., 2010)
Black (2004) suggested that healthcare workers can use their skills to improve the life of ostomy patients. Tafreshi stated that “Health care providers should make every attempt to improve quality of life in their ostomy patients, and nurses in particular should be aware that their knowledge and skills can help to enhance quality of life before and after ostomy surgery.” Nurses should use different approaches to enable the patients understand the importance of coping and acceptance of life with ostomy (Danielsen et al., 2013)
Methodology
Qualitative research depends on purposefully collection of data directed towards investigating a phenomenon of interest (Polit et al., 2005). A sample of interest will be selected from patients with stroma who will present themselves at the local hospital at the location of study.
Inclusion and Exclusion Criteria
The study will include patients diagnosed with colorectal cancer and those who have undergone stroma surgery six months earlier from the time of study. The patients should be free from other diseases. Subjects will have to be 18 years or older with ability to speak and write English. Most importantly patients who will be will be willing to participate in the study. Whilst exclusion criteria will include those patients with physical or psychological disabilities and those just not willing to participate (Minow, 1991).
Ethical consideration
The study will seek approval from the following ethics committees, ethical committee from the hospitals (study sites), ethical committee from the university and an approval from the national ethics committee (Association et al., 2001). Participants will be provided with information about the study as a requirement of requirements for clinical research. A written informed consent will be provided to the participating patients so that they participate in the study voluntarily. The patients will participate in the study while on their normal routine checkups (Gajjar, 2013).
Data collection
Data will be collected from patients (Specific sample size) using interviews by means of semi-structured questionnaires and audiotapes (Canova et al., 2013, Krouse et al., 2007 and Grant et al., 2011). Information will be collected from the patients until saturation (Streubert, 2003). Questionnaires will be designed in a way that they are disease specific and with two sections, the 1st section will consist of demographics, specific questions about the disease and personal characteristics. The 2nd section will be divided into physical, psychological, social and spiritual sub-sections. The sub-section questions will be aimed in determining the patients’ wellbeing using a global quality life scale. The questionnaire will take about 15 mins to finish. Interviewees will be trained on proper data collection to ensure unity and efficiency in data collection (Neuman et al., 2011).
Data analysis
The perception of a problem can be shaped properly using qualitative research (Mayan, 2001 and Polit et al., 2005). The audiotape data will be transcribed using verbatim, and then analysed using the latest version of SPSS software. Each patient’s data will be entered according to the study objectives and descriptive analyses will be used to analyse different subscales from the questionnaires. The mean standard deviation will be used to describe the distribution of quantitative variables and to obtain frequency distribution of the demographics. Chi- square, t-test will be used to determine the significance difference in binary and qualitative variables at p<0.05(Polit et al., 2005).
Bibliography
Association, W. M., & others. (2001). World Medical Association Declaration of Helsinki.
Ethical principles for medical research involving human subjects. Bulletin of the World Health Organization, 79(4), 373.
Brown, H., & Randle, J. (2005). Living with a stoma: a review of the literature. Journal of
Clinical Nursing, 14(1), 74–81. https://doi.org/10.1111/j.1365-2702.2004.00945.x
Canova, C., Giorato, E., Roveron, G., Turrini, P., & Zanotti, R. (2013). Validation of a stoma-
specific quality of life questionnaire in a sample of patients with colostomy or ileostomy. Colorectal Disease, 15(11), e692–e698. https://doi.org/10.1111/codi.12324
Carlsson, E., Berndtsson, I., Hallén, A.-M., Lindholm, E., & Persson, E. (2010). Concerns and
Quality of Life Before Surgery and During the Recovery Period in Patients With Rectal Cancer and an Ostomy: Journal of Wound, Ostomy and Continence Nursing, 37(6), 654–661. https://doi.org/10.1097/WON.0b013e3181f90f0c
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