Purpose: The purpose of the present study was to obtain suggestions for nursing support by describing the ways in which female ostomates cope with difficulties in their sexual lives.Cases and Method: Five married female ostomates for whom 5 years had passed since undergoing stoma construction were used as subjects, and data were collected through semistmctured interviews qualitative induction analysis.
Results: Patients coped with difficulties in their sexual lives by “acknowledging the difficulty in their sexual life,“seeking the cause of the difficulty in their sexual life,““remaking up their sexual life,“and“establishing new relations.““Confirming the husbands perceptions“is also necessary for“remaking up their sexual life,“and“establishing new relations“.
Conclusion: The results suggested that nursing support related to difficulties in a patients sexual life should include sexual counseling and couple counseling together with the husband before hospital discharge. It is necessary to give ostomates nursing support for regard to difficulties in the patient' s sexual life in order to help them to better adapt.

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[in Japanese]

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The reasons to construct stoma vary. It seems that procedure and technique of the construction is not so difference. However, those are thought to be some difference between institutions and or individuals. Therefore, to discuss methods of colostomy, we performed questionary survey of 43 institutions in Kyusyu.
［results］ As for permanent colostomy, oval skin incision in a diameter of 2 or 3cm was performed (74%) and the front sheath of rectus abdominis muscle was done by crucial incision (77%). The bowel was lead with extraperitoneal route (79%) to the outside. The ligation of intestine to the rectus sheath was performed in about half. The handling of a needle was begun at dermis in skin and it to mucosa was done last. Finally, the height of colostoma was adjusted at 1-2cm (90%) .
［conclusions］ We understood that there were some differences in methods of procedure between each institutions. However, we need to inspect scientifically which procedure becomes better stoma without complications and is easier to management.

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The aim of this review of literature is to clarify necessary evidence for creating stoma appliance selection standards. 4,040 literatures were hit as a result of searches conducted on the Ovid versions of MEDLINE, CINAHL, ＆ JMED plus and others from 1980 to July 2007 by using key words “ostomy”,“ostomate”,“stomas”, and “stoma equipment” or “ostomy appliance” or “ostomy equipment supplies”. 48 literatures that fit the purpose of this study were manually selected from these searched documents. 11 research reports, 11 case reports, 1 review of literature, 1 explanation and 24 meeting minutes were adopted as appropriate references for the selection criterion of the ostomy appliance. Also the content of literatures were 7 comparison researches, 10 ostomy appliance use investigations, 27 case reports of equipment selection, 1 suggestion of equipment selection and 3 miscellaneous. There were many literatures based on expert opinions but the evidence was level low. The literature suggested that Ostomy appliances with convexity are useful to prevent the leakage of effluent from the stoma.

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It is important to fully understand the features and functionality of stoma appliances in order to select an appliance that meets a patient's individual needs. Our research team classified stoma appliances to develop criteria for selection of the optimal appliance for a patient. The classifications were based on the results of an investigation of factors required for selecting proper stoma appliances, together with expert opinions. Appliances were classified into five categories on the basis of structure： 1) system, 2) face plate, 3) adaptor/interface to support the functionality of face plate, 4) flange, and 5) stoma bag. They were also classified into subcategories on the basis of structure and functionality. We will need to verify the effectiveness and advantages of our criteria for choosing stoma appliances and continue research to ensure that our classifications are practically useful in clinical situations.

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There is no assessment tool to evaluate the local condition at the stomal site，which is essential to select the most appropriate ostomy appliance. The aim of this study was to make stoma physical assessment tool (SPAT). First, we figured out to pick up several assessment factors and ostomate's physical position to assess, then preliminary study was done for 10 ostomates. Next, we made a draft of SPAT which include assessment factors and decision criteria. Using this draft, we evaluated 81 ostomates to verify the validity of SPAT. Final version of SPAT contained 3 ostomate's physical position to assess and 9 assessment factors. Although we need additional verification, this SPAT may be useful to select best ostomy appliance for each ostomate.

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Purpose: Stoma that is constructed as a palliative treatment without cancer resection due to far advanced malignancy is called“palliative stoma”. The purpose of this study is to clarify stoma care for palliative stoma and social support for patients with palliative stoma Materials and Methods: Conditions and stoma care of 67 patients with palliative stoma are investigated.
Results: The mean age was 67.5 years old. The mean survival period after stoma was 180 days. 43% of such was transverse colon loop colostomy. The stoma sizes at the time of discharge and the time of medical treatment at home were 35 and 45 mm, respectively. Continuous and proper stoma care was provide and social support as well. As a result, many patients maintained oral intake and stayed at home until just before their death. Conclusion: As the patients with palliative stoma can live receiving stoma care support and social support, it is important to offer appropriate stoma care support and social support.

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To establish scientific criteria useful for medical staff when choosing appropriate stoma appliances for ostomates during their rehabilitation process, we selected 121 subjects who: 1) received care by nurses of the stoma appliance assessment committee, 2) used an ostomy pouching system with skin barrier and an adhesive ostomy bag, 3) experienced no or only a slight fecal or urinary leakage, achieving expected endurance hours, and 4) had no complications that hindered treatment including the stoma prolapse and the stoma hernia. The crosstabulation analysis was used to determine significant differences among 154 combinations of 14 aspects of stoma appliance and 11 aspects of stoma. Concerning the appropriate selection of stoma appliances, a clear significant difference was found in 34 cells, a certain significant difference in 12 cells, and no significant difference in 108 cells in the tabulation. Regarding the endurance hours, a significant difference was detected in the aspects of the system, the type of face plate, the flexibility of face plate, and the durability of skin barrier. Based the analysis results and expert opinions, we defined 9 criteria “to be used,” 17 criteria “to be recommended,” and 10 criteria “to be considered.”

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