Purpose : To elucidate the differences in stoma care among occupations and care service facilities/offices.

Methods : The subjects were nurses and care workers working in care service facilities or offices in Toyama Prefecture. A questionnaire survey was conducted focusing on their interest and motivation for stoma care and their understanding and implementation status of stoma care.

Results : Responses from 105 nurses and 209 care workers were analyzed (response rate : 35.8%). Regarding interest and motivation for stoma care and understanding and implementation status of stoma care, some items showed significant differences among care service facilities and offices for both nurses and care workers. The care workers had less understanding of stoma care than the nurses.

Conclusion : Nurses and care workers showed differences in interest and motivation for stoma care and understanding and implementation status of stoma care, depending on their occupations and care service facilities/offices. It seems important to provide nurses and care workers with opportunities to learn information and skills for stoma care depending on their roles. It is also necessary to develop and share consulting services at each facility in cases with stoma troubles.

Purpose : To investigate the relationship between stoma-related early complications and stoma management difficulties after open surgery with gastrointestinal stoma formation.

Methods : The subjects were patients who underwent open surgery with gastrointestinal stoma formation between January, 2010 and September, 2014. During the 2 months after surgery, the relationships among the 3 following factors were retrospectively investigated : stoma-related early complications (≤14 days); stoma site conditions during the rehabilitation period (≤ 2 months); and stoma management difficulties evaluated with the Revised Classification of Stoma Management (RCSM, easy to manage in the order of A, B, and C groups).

Results : Of the 40 patients (median age 79 years ; male 26), 29 (72.5%) developed 56 early complications in total. The proportion of poor stoma site conditions was significantly higher with more severe early complications (no complication : 0% vs mild complication : 33.3% vs severe complication : 73.9%, P=0.0002). The proportions of A, B, C on the RCSM were 91%, 9%, and 0%, respectively, in the No complication group, compared with 45%, 31%, and 24% in the Complication group, indicating that early complications were significantly associated with stoma management difficulties (P=0.028).

Conclusion : Stoma-related early complications were significantly associated with stoma management difficulties in the rehabilitation period.

Purpose : To investigate sleep changes after surgery in patients undergoing ostomies for intrapelvic tumors.

Methods: The subjects were inpatients who underwent surgery for intrapelvic tumors. Sleep changes were investigated using a sleep meter from the day before surgery to the seventh day after surgery. Self-assessment questionnaires for sleep disturbance, HADS, and ICDSC, were used to investigate feelings of insomnia, anxiety, and delirium, respectively.

Results : Thirteen patients were studied. Their median age was 69 years, and all were male. The number of patients with and without a stoma after surgery was 8 and 5, respectively. In patients with a stoma, sleep after surgery was longer than before surgery. On the fourth day after surgery, deep sleep appeared in the first half of sleep, and sleep itself approached a common sleep pattern in which REM sleep appeared between 2 and 5 times. There was no difference between patients with and without a stoma in sleep time and recovery from changes of sleep patterns. However, patients with a stoma tended to wake up during sleep due to stoma care.

Conclusion : To some extent, this study clarified sleep changes after surgery in patients who undergo ostomies for intrapelvic tumors.