Evaluation of the quality of life of adult patients with digestive stomas in Congo-Brazzaville: a multicenter study

D. Massamba Miabaou; Ikama Maléla; P. Elion Ossibi; M. E. J. Note Madzélé; A. Massamba

doi:10.18203/2349-2902.isj20260125

Authors

D. Massamba Miabaou Department of Digestive Surgery, University Hospital Center of Brazzaville, Congo
Ikama Maléla Department of Digestive Surgery, University Hospital Center of Brazzaville, Congo
P. Elion Ossibi Department of Digestive Surgery, University Hospital Center of Brazzaville, Congo; Department of Surgery, Faculty of Health Sciences, Marin Ngouabi University, Brazzaville, Congo
M. E. J. Note Madzélé Department of Digestive Surgery, University Hospital Center of Brazzaville, Congo; Department of Surgery, Faculty of Health Sciences, Marin Ngouabi University, Brazzaville, Congo
A. Massamba Faculty of Sciences, Marien NGOUABI University, Brazzaville, Congo

DOI:

https://doi.org/10.18203/2349-2902.isj20260125

Keywords:

Digestive stoma, Colostomy, Congo-Brazzaville, Ileostomy, Adult, Quality of life

Abstract

Background: Digestive stomas remain a surgical option indicated for various gastrointestinal pathologies. However, living with a stoma can significantly impair a patient's quality of life. The objective of this study is to evaluate the perceptions of adult Congolese patients with digestive stomas regarding their quality of life.

Methods: This multicenter, descriptive, and prospective study was conducted from 01 August 2019 to 01 November 2020. It included patients aged 18 years and older living with digestive stomas. They were consecutively recruited from seven hospitals in Congo-Brazzaville. Quality of life (QoL) was assessed using the Stoma-QoL questionnaire.

Results: In total, 56 patients (39 men and 17 women, male/female ratio of 2.29), aged. A mean age of 42±17 years (range: 18–75 years) participated in the study. All ostomy patients reported a change in body image. They felt self-conscious about their appearance and significantly affected their physical attractiveness. Nearly all patients (96%) experienced negative psychological repercussions (depression, anxiety). Most of them (87%) had stopped their professional or daily activities due to the ostomy. The quality of sexuality was impaired for both patients and their partners. Those close to the patients experienced anxiety and spent more time at home.

Conclusion: The daily lives of ostomy patients are significantly disrupted in every way. It is therefore essential to provide more support to ostomy patients to help them better adapt to daily life. To this end, a multidisciplinary approach involving surgeons, ostomy therapists, and psychologists is crucial to improving their quality of life.

Metrics

Metrics Loading ...

References

Soravia C, Beyeler S, Lataillade L. Intestinal stoma: preoperative and postoperative management. Rev Med Suisse. 2005;1(10):708-9.

Leplege A. La mesure de la qualité de vie. PUF Coll. Que sais-je? 1999. Available at: http:// dx.doi.org/10.19044/esj.2017.v13n9p1942017. Accessed on 10 October 2025.

World Health Organisation. HEALTH PROMOTION: A discussion document on the concept and promotion. 1984. Available at: https://iris.who.int/server/api/core/bitstreams/03b586a1-90a0-4b6a-8772-e8dab9ec09ea/content. Accessed on 10 October 2025.

Serage C, Fachet G, Meurette G. Soins de stomie. Colon et Rectum. 2014;5(4):246-4. DOI: https://doi.org/10.1007/s11725-011-0335-4

FMCHGE Nantes. Tumeur stromales digestives. 2002. Available at: https://www.fmcgastro.org /postu-main/archives/postu-2002-nantes/tumeurs-stromales-digestives. Accessed on 10 October 2025.

Ferrera F, Parini D, Bondurri A, Veltri M, Barbierato M, Pata F, et al. Italian guidelines for the surgical management of enteral stomas in adults. Tech Coloproctol. 2019;23(11):1037-56. DOI: https://doi.org/10.1007/s10151-019-02099-3

Prieto L, Thorsen H, Juul K. developement and validation of a quality of life questionnaire for patients with colostomy or ileostomy. Health and Quality of Life Outcomes. 2005;3(1):62. DOI: https://doi.org/10.1186/1477-7525-3-62

Berger A, Frileux R, Morel R, Roche A, Théodore Ch. Iléostomie et colostomie. Editions techniques-Encyclopédie Med-Chir-gastro-Entérologie, Paris. 1994.

Karadag A, Mentes BB, Ayaz S. Colostomy irrigation: results of 25 cases with particular refrence to quality of life. J Clin Nurs. 2005;14(4):479-85. DOI: https://doi.org/10.1111/j.1365-2702.2004.01083.x

Bwelle Metto G, Bang GA, Chopreng Ngoumfe JC, Ekani Boukar YM, Kom de Sendjong RL, Ngo Nonga B, et al. Outcomes and quality of life of patients with a digestive stoma in Sub-saharan Africa: Case of the Yaounde Central Hospital, Cameroon. Surg Sci. 2021;12:381-9. DOI: https://doi.org/10.4236/ss.2021.1211040

Massenga A, Chibwae A, Nuri AA, Bugimbi M, Munisi YK, Mfinanga R. et al. Indications for and complications of intestinal stomas in the children and adults at a tertiary care hospital in a resource-limited setting: a Tanzanian experience. BMC Gastroenterol. 2019;19(1):157. DOI: https://doi.org/10.1186/s12876-019-1070-5

Sanogo ZZ, Yena S, Simaga AK, Doumbia D, Ouattara Z, Diallo AK, et al. Stomies Digestives: Expériences du service de chirurgie A du CHU du point G. Mali Méd. 2004;19:24-7.

Bail JP. Les stomies digestives: Présentations-indications-complications. CHU de Brest. 2015. Available at: https://www.oncobretagne.fr/WP-content/Uploads/2015/01/bail2.pdf. Accessed on 10 October 2025.

Pittman J, Rawl SM, Schmidt CM, Grant M, Ko CY, Wendel C, et al. Demographic and clinical factors related to ostomy complications and quality of life in veterans with an ostomy. J Wound Ostomy Continence Nurs. 2008;35(5):493-503. DOI: https://doi.org/10.1097/01.WON.0000335961.68113.cb

Berger A, Frileux R, Morel R, Roche A, Théodore Ch. Iléostomie et colostomie. Editions techniques-Encyclopédie Med-Chir-gastro-Entérologie, Paris. 1994.

Soravia C, Beyeler S, Latallade L. Les stomies digestives: indications, complications, prise en charge pré et post opératoire. Revue Médicale Suice. 2005;1:708-9. DOI: https://doi.org/10.53738/REVMED.2005.1.10.0708

Edwards D, Leppington A, Sexton R. Stoma-related complications are more frequent after transverse colostomy than loop ileostomy: a prospective randomised clinical trial. Br J Surg. 2000;88(3):360-3. DOI: https://doi.org/10.1046/j.1365-2168.2001.01727.x

Faury S, Quintard B, et Rullier E. Image du corps, dépression et anxiété des patients atteints d'un cancer du rectum avec stomie temporaire: Une étude longitudinale exploratoire. Ann Medico-psychologiques. 2017;175:849-55. DOI: https://doi.org/10.1016/j.amp.2016.02.019

Anakari F, Vafaie M, Behboo R, Maghsoodi N, Esmaeil-pour S, Safae A. Quality of life outcomes in patients living with stoma. Indian J Palliative Care. 2012;18(3):176. DOI: https://doi.org/10.4103/0973-1075.105687

Knowles SR, Cook SI, Tribbick D. Relationship between health status, illness perceptions, coping strategies and psychological morbidity: a preliminary study with IBD stoma patients. J Crohns Colitis. 2013;7(10):e471-8. DOI: https://doi.org/10.1016/j.crohns.2013.02.022

Smith DM, Loewenstein G, Rozin P, Sherriff R L, Ubel PA. Sensitivity to disgut, stigma, and adjustment to life with a colostomy. J Res Pers. 2007;41(4):787-803. DOI: https://doi.org/10.1016/j.jrp.2006.09.006

Yuan J, Zhang J, Zheng M, Bu X. Stigma and its influencing factors among Chinese patients with stoma. Psychooncology. 2018;27(6):1565-71. DOI: https://doi.org/10.1002/pon.4695

Susanty S, Rangki L. Changes and Adaptation Patient Post Colostomy. IOSR J Nurs Health Sci. 2016;5(6):123-9.

Ntozi J, Zirimenya S. Changes in household composition and family structure during the AIDS epidemic in Uganda. The continuing African HIV/AIDS epidemic. 1999;193-209.

Feddern M, Emmertsen KJ, Lauberg S. Life with stoma after curative resection for rectal cancer: a population-based cross-sectional study. Colorectal Dis. 2015;17(11):1011. DOI: https://doi.org/10.1111/codi.13041

Salomé G, De Almeida SA, Silveira MM. Quality of life and self-esteem of patients with intestinal stoma. J Coloproctol. 2014;34(4):231-9. DOI: https://doi.org/10.1016/j.jcol.2014.05.009

Hubbard G, Taylor C, Beeken, B, Campbell A, Gracey J, Grimmett C, et al. Research priorities about stoma-related quality of life from the perspective of people with a stoma: A pilot survey. Health Expectations. 2017;20(6):1421-7. DOI: https://doi.org/10.1111/hex.12585

Zhu X, Chen Y, Tang X, Chen Y, Liu Y, Guo W, et al. Sexual Expériences of Chinese Patients Living With an Ostomy. J Wound Ostomy Continence Nurs. 2017;44(5):469-74. DOI: https://doi.org/10.1097/WON.0000000000000357

Fang Q, Ye X, Wei H, Wen Y, Shi L, Zhen L, et al. Sexual Experience and Stigma Among Chinese Patients With an Enterostomy: A Cross-sectional, Descriptive Study. Wound Manag Prev. 2009;65(12):22-30. DOI: https://doi.org/10.25270/wmp.2019.12.2230

Ferreira E, Barbosa MH, Sonobe HM, Barichello E. Self-esteem and health-related quality of life in ostomized patients. Rev Bras Enferm. 2017;70(2):271-8. DOI: https://doi.org/10.1590/0034-7167-2016-0161

Xu S, Zhang Z, Wang A, Zhu J, Tang H, Zhu X. Effect of Self-efficacy Intervention on Quality of Life of Patients With Intestinal Stoma. Gastroenterol Nurs. 2018;41(4):341-6. DOI: https://doi.org/10.1097/SGA.0000000000000290

Cakmak A, Aylaz G, Kuzu MA. Permanent stoma not only affects patients’ quality of life but also that of their spouses. World J Surg. 2010;34(12):2872-6. DOI: https://doi.org/10.1007/s00268-010-0758-z

Persson E, Gustavsson B, Hellstrom AL, Fridstedt G, Lappas G, Hultén L. Information to the relatives of people with ostomies: is it satisfactory and adequate? J Wound Ostomy Continence Nurs. 2005;32(4):238-45. DOI: https://doi.org/10.1097/00152192-200507000-00008