Purpose:This study aimed to evaluate the current status of the standardization of ostomy appliance selection criteria and related issues to be addressed in the future.

Methods:A literature review of studies that used the 2009 “criteria for choosing appropriate ostomy appliances” prepared by the Committee for Assessment of Ostomy Appliance was conducted. Domestic and international studies published between August 2007 and August 2019 that used these criteria were identified and analyzed.

Results:Overall, 47 papers (3 original articles, 4 proceedings, and 40 commentaries) that used the “criteria for choosing appropriate ostomy appliances” were identified. Since the publication of these criteria, many health care professionals have become aware that the standardization of ostomy appliance selection criteria is an issue that must be addressed. However, no studies or reports were found regarding this issue. Furthermore, among the 28 papers published between August 2007 and August 2019 related to the selection of ostomy appliances, the name of the actual appliance was identified in only 13 studies, and the level of evidence in these studies was low.

Conclusion:Additional studies on the standardization of ostomy appliance selection criteria are required;however, the methodology of future studies must be improved.

A “Classification of adhesive ostomy appliances”, a “Stoma physical assessment tool”, and “Criteria for choosing appropriate ostomy appliances” were developed for the appropriate selection of ostomy appliances. The three studies were published in 2009, and the author contributed to the research and the resulting publications. More than 10 years later, a symposium entitled “Selection criteria for ostomy appliances - Challenge for its standardization” was held in 2020 at the 37th Annual Congress of the Japanese Society of Stoma and Continence Rehabilitation. The author had the privilege to present the “Classification of ostomy appliances and its evaluation” at the symposium.

This article reviews the three pivotal studies, the important elements of ostomy appliance classification are identified based on the studies, and some proposals are made for the future development of the classification.

Adhesive ostomy appliances were classified into 14 elements according to their structure and function. Based on the published “Criteria for choosing appropriate ostomy appliances”, the following 8 elements were identified as especially important:(1) system (enterostoma, urostoma);the faceplate's (2) shape, (3) flexibility, (4) skin protecting barrier durability, and (5) stoma hole;(6) accessories;(7) belt-connecting part of the adaptor/interface supporting the functionality of the faceplate;and (8) stoma bag structure.

Purpose: To develop a stoma self-care ability evaluation scale for ostomates.

Method: An anonymous self-administered questionnaire survey was distributed to ostomates who belong to the Japan Ostomy Association. Responses to items on stoma self-care ability were subjected to item analysis, exploratory factor analysis, calculation of Cronbach's α coefficient, and simple correlation analysis with external criteria.

Results: In total, responses from 241 ostomates were analyzed (valid response rate: 24.1%). Of the 47 candidate items on stoma self-care ability, 10 items were deleted based on the results of the item analysis and 10 items were deleted based on the results of the exploratory factor analysis. The final 27 items were categorized into the following 3 factors: “basic stoma management,” “maintenance of social life through stoma management,” and “appropriate evaluation related to stoma management.” Cronbach's α for each factor ranged from 0.819 to 0.890. In the simple correlation analysis with external criteria, a strong correlation was not observed, with most of the correlation coefficients being less than 0.3 and the highest only 0.623.

Conclusion: A new stoma self-care ability evaluation scale was developed for ostomates, although further studies are needed in the future to confirm its reliability and validity.

Purpose:The purpose of this study was to evaluate factors associated with achievement of stoma care (ASC) during the early postoperative period.

Methods:The subjects were patients who underwent intestinal stoma surgery followed by postoperative sessions of stoma care practice between 2018 and 2019. Data collected from medical charts were retrospectively analyzed. The patients were divided into those with and without ASC at discharge. The patients with ASC were also divided into those with early and delayed ASC. The factors associated with ASC were compared between the groups.

Results:Eighty-nine patients (median age:70 years, male:49) were included in the analysis. Non-achievement of stoma care was significantly associated with emergency surgery, postoperative pain, delayed mobilization, lack of stoma site marking, stoma-related complications, peri-stomal skin deformity, and discharge to other institutions. Higher age, non-round stoma, and complex stoma care were also significantly associated with delayed ASC.

Conclusions:When an intestinal stoma is created for elderly patients and/or in an emergency setting, ASC may be difficult or delayed. Preoperative stoma site marking, postoperative pain control, accelerated mobilization, assisting stoma acceptance, easily manageable stoma appliance with appropriate technique, and early support for discharge are important for effective postoperative stoma care.