bowel symptoms, colo-rectal cancer, self-care strategies, sphinctersaving
surgery, Symptom Management Theory
Aims and objectives. To investigate patients’ bowel symptom experiences and
self-care strategies following sphincter-saving surgery for rectal cancer and the
relationship between bowel symptom experiences and the self-care strategies used.
Background. Earlier diagnosis of rectal cancer allows for less invasive surgical
treatments such as sphincter-saving procedures to be performed. Although a permanent
stoma is generally not required, patients experience changes in bowel
function following this surgery. However, limited research exists on patients’
bowel symptom experiences and the self-care strategies used to manage symptoms
following sphincter-saving surgery of rectal cancer.
Design. Quantitative descriptive correlational.
Methods. A convenience sample of 143 patients aged 30 to over 70 years was
used. Data were collected (April 2010–December 2010) using the Illness
Perception Questionnaires, the Difficulties of Life Scale and a researcher developed
Self-care Strategy Measure. The research was underpinned by the Symptom
Management Theory.
Findings. Relating to the four most effective self-care strategies used respondents
reporting more bowel symptom were more likely to use the self-care strategy
proximity/knowing the location of a toilet at all times. Females, respondents with
high timeline cyclical scores and respondents with high physiological responses
scores were more likely to use protective clothing. Respondents reporting more
bowel symptom and with high social responses scores were more likely to use
bowel medication. Females were more likely to wear incontinence pads.
Conclusion. This research provides insights into the daily bowel symptom experiences
of patients following sphincter-saving surgery for rectal cancer. It demonstrates
the range of self-care strategies that individuals use to manage their bowel
symptoms and the self-care-strategies that were most effective for them.
Relevance to clinical practice. Patients should be encouraged to report
on-going bowel problems following sphincter-saving surgery for rectal cancer.
Supportive care for patients should be comprehensive and tailored to meet
individual needs.