Patient education has a positive effect in patients with a stoma: a systematic review

Aim A systematic review was performed to assess whether education of patients having stoma formation improves quality of life and whether it is cost effective. Method A literature search was performed to identify studies on the structured education of ostomates and outcome using the following databases: MEDLINE, Cinahl, Embase, Cochrane and PsycInfo. Inclusion criteria were: clinical studies reporting effects of educational interventions in relation to patients with a stoma. Commentaries or studies not testing an intervention were excluded. Results Seven articles met the inclusion criteria of having rigorously evaluated an educational programme related to living with a stoma. The programmes were organized in different ways and had explored various interventions. The results showed an increase in health-related quality of life, as measured using a stoma quality of life instrument (P=0.00001) and with the Short Form 36 (SF-36) (P=0.000-0.006), an increase in proficiency in management of the stoma (P=0.0005), two studies pointed to a reduction in postoperative hospital stay (8days vs 10days, P=0.029; and 8days vs 14days, P=0.17), a significant reduction in cost in the intervention group ($US 8570.54) compared with the control group ($US 7396.90) as well as higher effectiveness scores in the intervention group (166.89) compared with the control group (110.98), a significant rise in stoma-related knowledge (P=0.0000) and an increase in psychosocial adjustment (P=0.000). Conclusion Structured patient education aimed at patients' psychosocial needs seems to have a positive effect on quality of life as well as on cost. The interventions may be performed before, during or after hospital stay. However, the available data come from few studies with differences in interventions and in study design, and further studies are therefore needed before a final conclusion can be drawn.