The Influence of the Mental State on the Emergency Colostomized Patients Postoperative Evolution

Abstract

A colostomy creates a temporary or permanent opening for the colon through the abdominal wall, in order to eliminate fecal matter, which is collected in a closed or open bag, attached to the skin with the help of an adhesive. It is obvious that the patient with colostomy faces psycho-emotional problems, due to the alteration of the body image and the need to change the lifestyle. Under emergency conditions, when the informed consent of the critically ill patient, as well as the psychological preparation for the colostomized future, are difficult, incomplete or impossible to achieve, psychological assistance in the postoperative evolution of patients becomes a problem, on which the whole medical staff (doctors, nurses, psychologists, stomatotherapists) involved in their care must insist. In the immediate postoperative period, combating pain, ensuring biological comfort (hydric, caloric and nutritional), local care and prevention of so-called minor complications, are very important. The patient must also know the alternatives in choosing the type of colostomy bag and the prospects of social reintegration, over time. The measures of emotional support of these patients must be applied intensively, but with tact and professionalism, in parallel with the education and preparation for the new anatomical-physiological changes. In such situations, in addition to the surgical act and the postoperative physical care, the postoperative evolution and the therapeutic success depend, to a large extent, on the modelling of the patient’s mental state. The present paper focuses on the above-mentioned aspect, drawing on the data from the literature and the experience of the authors.