Quality of life of adult individuals with intestinal stomas in
Uganda: a cross sectional study
Yasin Ssewanyana
1
, Badru Ssekitooleko
2
, Bashir Suuna
1
, Emmanuel Bua
1
, Joseph Wadeya
1
,
Timothy K Makumbi
1,2
, William Ocen
2
, Kizito Omona
3
1. Department of Surgery, College of Health Sciences, Makerere University, Kampala, Uganda.
E-mail: yasinsewa@gmail.com Tel; +256774988991
2. Department of Surgery, Mulago National Referral and Teaching Hospital, Kampala, Uganda
3. Faculty of Health Sciences, Uganda Martyrs University. E-mail: komona@umu.ac.ug,
Tel: +256706464873
Abstract
Introduction: Intestinal stomas remain important life-saving surgical options in a wide range of gastrointestinal pathologies
globally. Living with a stoma has potential to impair the patient’s quality of life, often with associated negative psychological
effects.
Objective: To evaluate the quality of life among intestinal stoma patients under Mulago National Referral Hospital (MNRH),
with emphasis on psychological effects and effects on family-social interactions.
Methodology: A cross-sectional study carried out at surgical outpatient clinics of MNRH between January and June 2018.
Data was collected using Stoma-QOL questionnaire, PHQ-9 and GAD-7 from 51 participants who had lived with intestinal
stomas for at least a month.
Results: Of the 51 participants, male: female ratio was 4:1 and aged 18-84 years (mean age 44.04+18.47 years). 76.5% had
colostomy; 23.5% had ileostomy. Majority (88.2%) had temporary stomas. The overall mean Stoma-QOL score was 55.12+
17.04. Only about a quarter (24%) of participants had Stoma-QOL scores >70 (best). Most patients exhibited negative psy-
chological effects (anxiety-100%, concerns about changed body image - 96.1% and depression - 88.4%).
Conclusion: Most participants had low levels of stoma-related quality of life, suffered negative psychological effects and
exhibited limited social interactions. This calls for efforts to support Stoma patients adapt beter life.
Keywords: Stoma; Quality of Life (Stoma-QOL); Psychological effects; Patient Health Questionnaire (PHQ-9); General-
ized Anxiety Questionnaire (GAD-7).
DOI: https://dx.doi.org/10.4314/ahs.v21i1.53
Cite as: Ssewanyana Y, Ssekitooleko B, Suuna B, Bua E, Wadeya J, Makumbi TK, et al. Quality of life of adult individuals
with intestinal stomas in Uganda: a cross sectional study. Afri Health Sci. 2021;21(1):427-36. https://dx.doi.org/10.4314/ahs.
v21i1.53
Corresponding author:
Kizito Omona,
Faculty of Health Sciences, Uganda Martyrs
University.
Tel: +256706464873
E-mail: komona@umu.ac.ug
Introduction
Background to the study
An intestinal stoma is a surgically created opening of
the intestine onto the front wall of the abdomen, that
allows removal of feces from the body, to drain into a
pouch or other collection device
1
. The stoma can be
temporary or permanent depending on its indication
and may be put as part of an emergency procedure or
planned electively. Over the past three centuries, intes-
tinal stomas have signifcantly improved surgical out-
comes for a wide range of pathologies, reducing both
morbidity and mortality
2,3
.
The lack of sphincter function results in fecal and fatus
incontinence. There is an abrupt transition from hav-
ing no stoma to having one, sometimes with no prior
knowledge of such likelihood.
Quality of life(QOL) is the individual’s perception of
their health status in relation to social, physical, psycho-
logical, economic and spiritual aspects
4
. The concept of
QOL broadly encompasses how an individual measures
“goodness” of multiple aspects of their life
5
. Research
directed to studying QOL has become increasingly im-
portant since the 1960’s
6
and QOL is now a major fac-
tor to consider when instituting any form of therapy
7
.
Several studies documented low levels of quality of life
specifcally because of having the stoma
8-15
.
© 2021 Ssewanyana Y et al. Licensee African Health Sciences. This is an Open Access article distributed under the terms of the Creative commons Attribution
License (https://creativecommons.org/licenses/BY/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original
work is properly cited.
African
Health Sciences
African Health Sciences, Vol 21 Issue 1, March, 2021 427