Self-Care Strategies in Managing Physical Discomfort: Experience of Patient with an Intestinal Stoma
DOI:
https://doi.org/10.31674/mjn.2026.v17i03.010Abstract
Background: The physiological changes resulting from stoma formation necessitate that patients actively engage in self-care practices to manage their physical condition and maintain their well-being. In nursing, supporting and enhancing patients’ self-care abilities forms a key aspect of postoperative education and continuity of care. However, research on stoma self-care practice in Malaysia remains limited. This study aims to explore the self-care strategies employed by patients with an intestinal stoma in managing physical discomfort. Methods: This exploratory qualitative study employed a case study approach, using semi-structured interviews conducted among 17 patients with an intestinal stoma in a public hospital in Malaysia over an eight-month period. The data were analyzed using a framework analysis approach. Results: Three key themes emerged from the analysis: managing pain, stoma care, and adjustment of daily routines. Participants identified these self-care practices as their experience managing their physical discomfort due to having an intestinal stoma. Conclusion: The findings underscore the complexity and multifaceted nature of self-care among stoma patients. These insights are essential for nurses in Malaysia, particularly in developing supportive frameworks and interventions to enhance patients' self-care abilities, which ultimately improve their quality of life (QOL) and healthcare outcomes.
Keywords:
Ostomy, Physical Discomfort, Patient Experience, Self-CareDownloads
References
Alwi, F., Chiu, Y. C., & Ginting, S. (2025). Self‐Care experiences of patients who have recently undergone colostomy: A qualitative study. Nursing Open, 12(5), e70193. https://doi.org/10.1002/nop2.70193
Aryani, R., Lalisang, T. J., Dahlia, D., Martha, E., Rustina, Y., & Pujasari, H. (2025). Unpacking self-management in colorectal cancer with stoma patients: a comprehensive concept analysis. Palliative Medicine in Practice, 19(2), 125-132. https://doi.org/10.5603/pmp.101549
Barlow, J., Wright, C., Sheasby, J., Turner, A., & Hainsworth, J. (2002). Self-management approaches for people with chronic conditions: a review. Patient Education and Counseling, 48(2), 177-187. https://doi.org/10.1016/S0738-3991(02)00032-0
Brown, D., & McCormack, B. (2006). Determining factors that have an impact upon effective evidence‐based pain management with older people, following colorectal surgery: An ethnographic study. Journal of Clinical Nursing, 15(10), 1287-1298. https://doi.org/10.1111/j.1365-2702.2006.01553.x
Collado-Boira, E. J., Machancoses, F. H., Folch-Ayora, A., Salas-Medina, P., Bernat-Adell, M. D., Bernalte-Martí, V., & Temprado-Albalat, M. D. (2021). Self-care and health-related quality of life in patients with drainage enterostomy: A multicenter, cross-sectional study. International Journal of Environmental Research and Public Health, 18(5), 2443. https://doi.org/10.3390/ijerph18052443
Creswell, J. W., & Creswell, J. D. (2017). Research design: Qualitative, quantitative, and mixed methods approaches. Sage publications.
Engida, A., Ayelign, T., Mahteme, B., Aida, T., & Abreham, B. (2016). Types and indications of colostomy and determinants of outcomes of patients after surgery. Ethiopian Journal of Health Sciences, 26(2), 117-122. https://doi.org/10.4314/ejhs.v26i2.5
Ertürk, E. B., Ari, H., Üstündağ, Ç., Yilmaz, E., & Topdemir, Ü. (2025). Factors influencing daily living and ostomy self‐care management in ostomates: A Mixed Methods Study. Journal of Clinical Nursing, 34(7), 2677-2689. https://doi.org/10.1111/jocn.17676
Giordano, V., Nicolotti, M., Corvese, F., Vellone, E., Alvaro, R., & Villa, G. (2020). Describing self‐care and its associated variables in ostomy patients. Journal of Advanced Nursing, 76(11), 2982-2992. https://doi.org/10.1111/jan.14499
Griffiths, H., Kent, B., & Martin, D. (2023). Exploring incidence and risk factors for persistent postoperative opioid use in adult surgical patients: A systematic review protocol. JBI Evidence Synthesis, 21(4), 805-811. https://doi.org/10.11124/JBIES-22-00106
Gupta, A., Nizamuddin, J., Elmofty, D., Nizamuddin, S. L., Tung, A., Minhaj, M., ... & Shahul, S. (2018). Opioid abuse or dependence increases 30-day readmission rates after major operating room procedures: A national readmissions database study. Anesthesiology, 128(5), 880-890. https://doi.org/10.1097/aln.0000000000002136
Helnarska, K. J. (2024). The impact of religion and culture on compliance with COVID-19 restrictions on the example of Malaysia. Pedagogika Katolicka, 34(1). https://doi.org/10.62266/PK.1898-3685.2024.34.05
Hussain, S., & Dioso, R. I. P. (2025). Quality of life in patients with permanent colostomy: A cross-sectional study at the Tertiary Care Hospital in Swat. Medtigo Journal of Medicine, 3(2). https://doi.org/10.63096/medtigo30623218
Jeppesen, P. B., Vestergaard, M., Boisen, E. B., & Ajslev, T. A. (2022). Impact of stoma leakage in everyday life: data from the Ostomy Life Study 2019. British Journal of Nursing, 31(6), S48-S58. https://doi.org/10.12968/bjon.2022.31.6.S48
Jin, Y., Tian, X., Li, Y., Jiménez-Herrera, M., & Wang, H. (2022). Effects of continuous care on health outcomes in patients with stoma: A systematic review and meta-analysis. Asia-Pacific Journal of Oncology Nursing, 9(1), 21-31. https://doi.org/10.1016/j.apjon.2021.12.006
Kalayci, F., & Duruk, N. (2022). Assessment of the difficulties experienced by individuals with intestinal stomas: A qualitative study. Advances in Skin & Wound Care, 35(5), 1-7. https://doi.org/10.1097/01.asw.0000805752.01398.2d
Lincoln, Y. S., & Guba, E. G. (1982, March). Establishing dependability and confirmability in naturalistic inquiry through an audit. Paper presented at the Annual Meeting of the American Educational Research Association, New York. ERIC (ED216019). https://eric.ed.gov/?id=ED216019
Liu, F., Diao, W., Huang, H., Guo, W., & Luo, X. (2025). Factors influencing quality of life in patients with a colostomy due to rectal cancer: A retrospective cohort study with multivariate and subgroup analyses. Oncology Letters, 29(6), 295. https://doi.org/10.3892/ol.2025.15041
Liu, H., Zhu, X., Yu, J., He, P., Shen, B., Tang, X., ... & Li, X. (2021). The quality of life of patients with colorectal cancer and a stoma in China: A quantitative cross-sectional study. Advances in Skin & Wound Care, 34(6), 302-307. https://doi.org/10.1097/01.ASW.0000744348.32773.b9
Lo, P. S., Lin, Y. P., Hsu, H. H., Chang, S. C., Yang, S. P., Huang, W. C., & Wang, T. J. (2021). Health self-management experiences of colorectal cancer patients in postoperative recovery: A qualitative study. European Journal of Oncology Nursing, 51, 101906. https://doi.org/10.1016/j.ejon.2021.101906
Marcomini, I., Iovino, P., Rasero, L., Manara, D. F., Vellone, E., & Villa, G. (2024). Self-Care and quality of life of ostomy patients: A structural equation modeling analysis. Nursing Reports, 14(4), 3417. https://doi.org/10.3390/nursrep14040247
Michońska, I., Polak-Szczybyło, E., Sokal, A., Jarmakiewicz-Czaja, S., Stępień, A. E., & Dereń, K. (2023). Nutritional issues faced by patients with intestinal stoma: a narrative review. Journal of Clinical Medicine, 12(2), 510. https://doi.org/10.3390/jcm12020510
Naz, S., Riaz, M. N., & Akbar, M. (2022). Effect of pain-coping strategies on post-operative pain perception and recovery in surgical patients. Pakistan Social Sciences Review, 6(2), 763-780. https://ojs.pssr.org.pk/journal/article/view/172
Riegel, B., Jaarsma, T., & Strömberg, A. (2012). A middle-range theory of self-care of chronic illness. Advances in Nursing Science, 35(3), 194-204. https://doi.org/10.1097/ANS.0b013e318261b1ba
Ritchie, J., Lewis, J., Elam, G., Ritchie, J., & Lewis, J. (2003). Chapter 4 in qualitative research practice: A guide for social science students and researchers. Designing and Selecting Samples, 6. https://psy.au.dk/fileadmin/PSY/Centre/Kvalitativ_metodeudvikling/NB36/ritchie.pdf
Rud, C. L., Baunwall, S. M., Bager, P., Dahlerup, J. F., Wilkens, T. L., Tøttrup, A., ... & Hvas, C. L. (2022). Patient-reported outcomes and health-related quality of life in people living with ileostomies: a population-based, cross-sectional study. Diseases of the Colon & Rectum, 65(8), 1042-1051. https://doi.org/10.1097/DCR.0000000000002100
Selau, C. M., Limberger, L. B., Silva, M. E. N., Pereira, A. D. A., Oliveira, F. S. D., & Margutti, K. M. D. M. (2019). Percepção dos pacientes com estomia intestinal em relação às mudanças nutricionais e estilo de vida [Patients with intestinal stomas perceive changes in nutrition and lifestyle]. Texto & Contexto-Enfermagem, 28, e20180156. https://doi.org/10.1590/1980-265X-TCE-2018-0156
Shukri, N. A. M., Basir, S. M. A., Rahman, M. S. A., & Bakar, W. A. A. (2018). Perception on postpartum dietary practices among Malay women in Hospital Tengku Ampuan Afzan (HTAA), Kuantan, Pahang. International Journal of Allied Health Sciences, 2(1), 244-264. https://doi.org/10.31436/ijahs.v2i1.122
Ssewanyana, Y., Ssekitooleko, B., Suuna, B., Bua, E., Wadeya, J., Makumbi, T. K., ... & Omona, K. (2021). Quality of life of adult individuals with intestinal stomas in Uganda: A cross sectional study. African Health Sciences, 21(1), 427-36. https://doi.org/10.4314/ahs.v21i1.53
Stavropoulou, A., Vlamakis, D., Kaba, E., Kalemikerakis, I., Polikandrioti, M., Fasoi, G., ... & Kelesi, M. (2021). “Living with a stoma”: exploring the lived experience of patients with permanent colostomy. International Journal of Environmental Research and Public Health, 18(16), 8512. https://doi.org/10.3390/ijerph18168512
Sumari, M., Baharudin, D. F., Khalid, N. M., Ibrahim, N. H., & Ahmed Tharbe, I. H. (2020). Family functioning in a collectivist culture of Malaysia: A qualitative study. The Family Journal, 28(4), 396-402. https://doi.org/10.1177/1066480719844334
Temiz, Z., Cavdar, I., Ozbas, A., Altunsoy, M., Akyuz, N., & Kutlu, F. Y. (2022). Sleep quality and factors affecting sleep in individuals with an intestinal ostomy: A descriptive cross-sectional study. Wound Management & Prevention, 68(5), 28-36. https://doi.org/10.25270/wmp.2022.5.2836
Tsujinaka, S., Suzuki, H., Miura, T., Sato, Y., & Shibata, C. (2022). Obstructive and secretory complications of diverting ileostomy. World Journal of Gastroenterology, 28(47), 6732. https://doi.org/10.3748/wjg.v28.i47.6732
Villa, G., Mannarini, M., Della Giovanna, G., Marzo, E., Manara, D. F., & Vellone, E. (2019). A literature review about self‐care on ostomy patients and their caregivers. International Journal of Urological Nursing, 13(2), 75-80. https://doi.org/10.1111/ijun.12182
Vogel, I., Shinkwin, M., Van der Storm, S. L., Torkington, J., A. Cornish, J., Tanis, P. J., ... & Bemelman, W. A. (2022). Overall readmissions and readmissions related to dehydration after creation of an ileostomy: A systematic review and meta-analysis. Techniques in Coloproctology, 26(5), 333-349. https://doi.org/10.1007/s10151-022-02580-6
Wang, Y., Li, S., Gong, J., Cao, L., Xu, D., Yu, Q., ... & Chen, Y. (2022). Perceived stigma and self-efficacy of patients with inflammatory bowel disease-related stoma in China: A cross-sectional study. Frontiers in Medicine, 9, 813367. https://doi.org/10.3389/fmed.2022.813367
Wasserman, M. A., & McGee, M. F. (2017). Preoperative considerations for the ostomate. Clinics in Colon and Rectal Surgery, 30(03), 157-161. https://doi.org/10.1055/s-0037-1598155
Yin, R. K. (2018). Case study research and applications (Vol. 6). Thousand Oaks, CA: Sage. https://ebooks.umu.ac.ug/librarian/booksfile/Case%20Study%20Research%20and%20Applications.pdf
Zheng, M. C., Wong, F. K. Y., Ying, J., & Zhang, J. E. (2021). Immediate postoperative experiences before discharge among patients with rectal cancer and a permanent colostomy: A qualitative study. European Journal of Oncology Nursing, 51, 101911. https://doi.org/10.1016/j.ejon.2021.101911
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 The Malaysian Journal of Nursing (MJN)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
