Rectal cancer patients from rural areas in northern Sweden report more pain and problems with stoma care than those from urban areas
INTRODUCTION: Having a stoma after bowel surgery is associated with inferior quality of life (QoL). The county of Västerbotten in Sweden is a large and sparsely populated area. Competence regarding stoma-related problems is restricted to hospital-based stoma nurses and surgeons. Patients living in r...
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Umeå universitet, Kirurgi
2021
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ftumeauniv:oai:DiVA.org:umu-168715 2023-10-09T21:54:38+02:00 Rectal cancer patients from rural areas in northern Sweden report more pain and problems with stoma care than those from urban areas Näverlo, Simon Gunnarsson, Ulf Strigård, Karin 2021 application/pdf http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-168715 https://doi.org/10.22605/RRH5471 eng eng Umeå universitet, Kirurgi Rural and Remote Health Rural and remote health, 1445-6354, 2021, 21:2, orcid:0000-0001-5076-7400 http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-168715 doi:10.22605/RRH5471 PMID 33980026 Scopus 2-s2.0-85105839726 info:eu-repo/semantics/openAccess defunctioning stoma permanent stoma quality-of-life rectal cancer Sweden Surgery Kirurgi Article in journal info:eu-repo/semantics/article text 2021 ftumeauniv https://doi.org/10.22605/RRH5471 2023-09-22T13:53:52Z INTRODUCTION: Having a stoma after bowel surgery is associated with inferior quality of life (QoL). The county of Västerbotten in Sweden is a large and sparsely populated area. Competence regarding stoma-related problems is restricted to hospital-based stoma nurses and surgeons. Patients living in rural areas instead largely rely on their general practitioner. The purpose of the study was to investigate the impact of distance to nearest hospital on the QoL of rectal cancer patients who receive a stoma at index surgery. METHODS: A cross-sectional study performed in Västerbotten county, Sweden. Validated questionnaires assessing QoL (EORTC QLQ C-30 and CR-29) were sent to all rectal cancer patients diagnosed in 2007-2014 who received a stoma at index surgery. Socioeconomic variables were retrieved from Statistics Sweden. Distance from home to the nearest hospital was determined using Google Maps™. The effect of distance was assessed using two separate models, the first based on distance to the nearest hospital and the second based on access to a stoma care nurse. Within the first model all patients living in rural areas constituted the study group while all patients living in non-rural areas constituted the control group. Within the second model all patients with no access to stoma care nurse constituted the study group while those with such access constituted the control group. RESULTS: The response rate was 69%. In the first model the rectal cancer patients living further away from the nearest hospital reported significantly more pain and sore skin (p=0.032 and p=0.003, respectively). When considering patients who still had a stoma, those living further away also reported more stoma care problems (p=0.004) and a poorer global QoL (p=0.038). In the second model, access or not to a stoma care nurse had no impact on stoma care problems or QoL. CONCLUSION: Rectal cancer patients receiving a stoma at index surgery and who came from rural areas reported more pain than those living closer to the nearest hospital. The ... Article in Journal/Newspaper Northern Sweden Umeå University: Publications (DiVA) Rural and Remote Health |
institution |
Open Polar |
collection |
Umeå University: Publications (DiVA) |
op_collection_id |
ftumeauniv |
language |
English |
topic |
defunctioning stoma permanent stoma quality-of-life rectal cancer Sweden Surgery Kirurgi |
spellingShingle |
defunctioning stoma permanent stoma quality-of-life rectal cancer Sweden Surgery Kirurgi Näverlo, Simon Gunnarsson, Ulf Strigård, Karin Rectal cancer patients from rural areas in northern Sweden report more pain and problems with stoma care than those from urban areas |
topic_facet |
defunctioning stoma permanent stoma quality-of-life rectal cancer Sweden Surgery Kirurgi |
description |
INTRODUCTION: Having a stoma after bowel surgery is associated with inferior quality of life (QoL). The county of Västerbotten in Sweden is a large and sparsely populated area. Competence regarding stoma-related problems is restricted to hospital-based stoma nurses and surgeons. Patients living in rural areas instead largely rely on their general practitioner. The purpose of the study was to investigate the impact of distance to nearest hospital on the QoL of rectal cancer patients who receive a stoma at index surgery. METHODS: A cross-sectional study performed in Västerbotten county, Sweden. Validated questionnaires assessing QoL (EORTC QLQ C-30 and CR-29) were sent to all rectal cancer patients diagnosed in 2007-2014 who received a stoma at index surgery. Socioeconomic variables were retrieved from Statistics Sweden. Distance from home to the nearest hospital was determined using Google Maps™. The effect of distance was assessed using two separate models, the first based on distance to the nearest hospital and the second based on access to a stoma care nurse. Within the first model all patients living in rural areas constituted the study group while all patients living in non-rural areas constituted the control group. Within the second model all patients with no access to stoma care nurse constituted the study group while those with such access constituted the control group. RESULTS: The response rate was 69%. In the first model the rectal cancer patients living further away from the nearest hospital reported significantly more pain and sore skin (p=0.032 and p=0.003, respectively). When considering patients who still had a stoma, those living further away also reported more stoma care problems (p=0.004) and a poorer global QoL (p=0.038). In the second model, access or not to a stoma care nurse had no impact on stoma care problems or QoL. CONCLUSION: Rectal cancer patients receiving a stoma at index surgery and who came from rural areas reported more pain than those living closer to the nearest hospital. The ... |
format |
Article in Journal/Newspaper |
author |
Näverlo, Simon Gunnarsson, Ulf Strigård, Karin |
author_facet |
Näverlo, Simon Gunnarsson, Ulf Strigård, Karin |
author_sort |
Näverlo, Simon |
title |
Rectal cancer patients from rural areas in northern Sweden report more pain and problems with stoma care than those from urban areas |
title_short |
Rectal cancer patients from rural areas in northern Sweden report more pain and problems with stoma care than those from urban areas |
title_full |
Rectal cancer patients from rural areas in northern Sweden report more pain and problems with stoma care than those from urban areas |
title_fullStr |
Rectal cancer patients from rural areas in northern Sweden report more pain and problems with stoma care than those from urban areas |
title_full_unstemmed |
Rectal cancer patients from rural areas in northern Sweden report more pain and problems with stoma care than those from urban areas |
title_sort |
rectal cancer patients from rural areas in northern sweden report more pain and problems with stoma care than those from urban areas |
publisher |
Umeå universitet, Kirurgi |
publishDate |
2021 |
url |
http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-168715 https://doi.org/10.22605/RRH5471 |
genre |
Northern Sweden |
genre_facet |
Northern Sweden |
op_relation |
Rural and remote health, 1445-6354, 2021, 21:2, orcid:0000-0001-5076-7400 http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-168715 doi:10.22605/RRH5471 PMID 33980026 Scopus 2-s2.0-85105839726 |
op_rights |
info:eu-repo/semantics/openAccess |
op_doi |
https://doi.org/10.22605/RRH5471 |
container_title |
Rural and Remote Health |
_version_ |
1779318302959468544 |