The Effect of Mobile Health Education on Adaptation to Stoma, Self-efficacy, and Peristomal Lesions
Condition: Nurse's Role; Patient Compliance; Peristomal Skin Complication; Self Efficacy
Study type: Interventional

Summary: 
      To explore the effect of the Stoma Mobile application-based training method on the
      psychosocial adjustment, self-efficacy, and development of peristomal skin complications in
      individuals with a stoma.

      Quasi-experimental study with a post-test control group. Patients who met the inclusion
      criteria were randomly selected. While the experimental group (n=30) received training with
      the Stoma Mobile application, the control group (n=30) received training with the booklet.
      Stoma compliance, self-efficacy level, and the presence of complications were compared in
      both groups in the first and third months after discharge.

      H11: Individuals who receive stoma care training via STOMA-M will have a higher adaptation to
      stomas than individuals who receive stoma care training via a booklet.

      H12: The SE levels of individuals who receive stoma care training via STOMA-M will be higher
      than those who receive stoma care training via a booklet.

      H13: Peristomal skin complications of individuals who receive stoma care training via STOMA-M
      will be lower than those who receive stoma care training via a booklet.

      The population of the study included patients who had a stoma for the first time, were in a
      university hospital in Istanbul between December 2020 and December 2021, and who were 18
      years of age and older, literate, without any physical and psychological disabilities, able
      to use smartphones, and willing to participate in the study. Patients who were in the same
      room or underwent a urostomy were not included in the study.

      The experimental group using the Stoma Health Mobile application had higher psychosocial
      adjustment and self-efficacy scores than the control group, and the peristomal skin lesion
      complication rate was lower than that of the control group. Social self-efficacy positively
      affects stoma compliance, and the Stoma Mobile application positively affects the level of
      social self-efficacy and adaptation of ostomates to the stoma
    

Detailed description: 
      Ostomates need to learn to cope with new self-care routines and emotional problems related to
      changes in body image and self-perception. This learning process is defined as psychosocial
      adjustment. Adaptation of the patient to the stoma after surgery is part of the process in
      which the patient re-coordinates the body, self, and external world. In addition to the
      follow-up process after surgical treatments, psychosocial adjustment is one of the most
      important factors that define SE and quality of life.

      Bandura (1994) defines SE as the belief that people can effectively initiate the necessary
      activities and reach results in events related to their lives. In other words, SE is a
      dynamic cognitive process that expresses the confidence of individuals with a stoma in their
      own ability to be successful in stoma care. SE plays an important role in adapting to the
      stoma. Not only do individuals who can self-care better adapt to a stoma.

      Structured education has an important place in the ability of ostomates to cope with these
      problems. This training is indispensable, as it helps ostomates cope with physical,
      psychological, and social difficulties. Face-to-face training given during hospitalization is
      a traditional and effective method designed to impart new information and self-care behavior.
      However, it has its limitations. This type of training is time-consuming, and retaining the
      given information is often difficult for patients, as they experience postoperative anxiety
      and pain. In addition, the number of ostomy and wound care nurses in Turkey is not
      sufficient. When ostomates experience a problem with their stoma, they may not be able to
      contact the ostomy nurse. Considering that stomas are usually applied to cancer patients,
      their general condition deteriorates due to chemotherapy and radiotherapy. For this reason,
      it is important that ostomates receive information on living with a stoma in their mobile
      environment, thus having such information accessible at any time through their smartphones.

      The literature contains limited studies comparing the effects of face-to-face/booklet and
      mobile training on the adaptation, self-efficacy, and peristomal skin complications of
      ostomates. Accordingly, this study evaluated the effect of the mobile application and booklet
      training in the education of ostomates on the adaptation and skin complications of ostomates.
      Thus, the study examined the effect of using innovative, technology-based education
      approaches in the education of ostomates, offering a significant contribution to the
      literature and individual-centered care.
    

Intervention name(s): Assigned Interventions STOMA-M
Intervention type(s): Other
Intervention description(s): The training, which includes information on stoma care, maintenance of daily life activities, and complication management, was given to the patients in the experimental group via the STOMA-M.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Quasi-experimental study with a post-test control group.
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: ostomy adjustment; mobile application; self-efficacy; peristomal skin lesions; nursing