Effect of a Mobile Patient Education Application on Adjustment to Stoma and Development of Peristomal Skin Lesions: A Quasi-Experimental Study

Abstract

BACKGROUND: Patients with a stoma face difficulties in everyday life. A mobile application (app) may assist them in managing their stoma and adjusting to change. PURPOSE: This study developed a mobile app for patients with a stoma and evaluated its effectiveness in improving psychosocial adjustment, self-care, and prevention of peristomal skin lesions. METHODS: The research utilized a quasi-experimental design and was conducted using a posttest control group. The study consisted of 60 patients who had undergone surgery in 3 university hospitals in Istanbul, Turkey, from November 2018 through December 2019. The experimental group (n = 30) used the STOMA-M mobile app, and the control group (n = 30) used an educational booklet that contained images and text that correlated to the content found in the app. Data collection was carried out using an individual characteristics assessment form, Ostomy Adjustment Inventory (OAI-23), Peristomal Skin Lesions Assessment and Classification Instrument, and a stoma care training evaluation form in the first and third months after discharge. Data were analyzed using IBM SPSS Statistics 22.0 software. RESULTS: Sociodemographic characteristics of individuals in the experimental and control groups were similar; 70% (n = 42) required stoma placement because of cancer treatment. More than half of the participants (53.3%; n = 32) had an ileostomy, and 78.3% (n = 47) had a temporary, open stoma. The experimental group’s OAI-23 score, social engagement subscale score, stoma care status, and satisfaction with education e high. The OAI-23 scores in the control group were not significant, and their anger subscale score and the score of item 16, Caring for my stoma is difficult, decreased in the third month compared with baseline. Peristomal skin lesions did not develop in the control group at the third month of follow-up. CONCLUSION: The levels of adjustment to stoma, ability to care for the stoma themselves, and satisfaction with education received were higher in individuals using the mobile app compared with those using the printed booklet. However, the app was not effective in preventing peristomal skin lesions. Additional studies are needed to determine what features of a mobile app may be useful for preventing such lesions.