Abstract | Kolostoma nastaje operativnim zahvatom, izvođenjem zdravog dijela debelog crijeva na
površinu trbušne stijenke, a čini novi izlaz za stolicu. Najčešća indikacija za izvođenje
operativnog zahvata kolostome je karcinom debelog crijeva. U oboljele osobe se događa
gubitak dosadašnje funkcije pražnjenja stolice i uspostavlja se novi put pražnjenja. Promjene
koje dolaze s formiranjem kolostome nisu male i svakako utječu na fizičko i psihičko stanje
osobe i njezine obitelji. Stanje oboljelog ovisi o prihvaćanju bolesti, mogućnosti liječenja i
oporavaku. Mijenja se način pražnjenja stolice, mogućnosti prehrane i aktivnosti, a dolaze
nove obaveze održavanja, njege kolostome i ograničenja. U bolesnika se pojavljuju strahovi
od bolesti, boli, promjene životnog stila, stigme u društvu. Pojavljuju se osjećaji nemoći,
gubitka kontrole, tuge i anksioznosti. Medicinske sestre sudjeluju u svim fazama postavljanja
kolostome, od prve postavljene indikacije za operacijom kolostome pa do postoperacijskog
oporavka. Dakle, prije operacije, za vrijeme operacije i nakon operacije medicinske sestre su
uz bolesnika i ravnopravno sudjeluju u svim fazama zbrinjavanja. Intervencije medicinske
sestre specifične su u svakoj fazi perioperacijske skrbi za bolesnika sa kolostomom, a provode
ih u dogovoru s liječnicima. Sastoje se od edukacije, savjetovanja, psihičke podrške, fizičke
pomoći i ohrabrivanja. Perioperacijska sestrinska skrb mora biti sveobuhvatna, kvalitetna,
brza, dostupna svim bolesnicima s kolostomom i njihovim obiteljima, upravo zbog svih
promjena i poteškoća koje ih očekuju prije, za vrijeme i nakon formiranja kolostome, a
medicinska sestra ih uvelike može riješiti ili ublažiti intervencijama iz područje zdravstvene
njege. |
Abstract (english) | A stoma is formed by a surgical procedure, by taking out a healthy part of the large intestine
to the surface of the abdominal wall, forming a new exit for the stool. The most common
indication for performing a colostomy surgical procedure is colorectal cancer. In a diseased
person, the loss of the previous function of bowel movement occurs and a new path of
emptying is established. The changes that come with the formation of the stoma are not small
and certainly affect the physical and psychological condition of a person and their family. The
condition of the diseased depends on the acceptance of the disease, and the possibility of
treatment and recovery. The manner of performing bowel movements, and the possibilities of
diet and activity are changed, and new obligations of maintenance, stoma care and restrictions
occur. Fear of illness, pain, lifestyle changes, and stigma in society appear in patients.
Feelings of powerlessness, loss of control, sadness and anxiety appear as well. Nurses
participate in all stages of stoma placement, from the first set indication for colostomy surgery
to postoperative recovery. Thus, before surgery, during surgery and after surgery, the nurses
are with patients and participate equally in all phases of patient care. Nurse interventions are
specific at each stage of perioperative care for patients with a stoma and are carried out in
consultation with physicians. They consist of education, counseling, psychological support,
physical assistance and encouragement. Perioperative nursing care must be comprehensive,
high-quality, fast and accessible to all patients with the stoma and their families, precisely
because of all the changes and difficulties that await them before, during and after the
formation of the stoma, and the nurse can largely solve or mitigate them with interventions
from the field of nursing care. |