Strategies for learning to live again: A thematic inquiry into the process of ostomy adjustment

While the formation of a fecal ostomy (colostomy or ileostomy) can be a lifesaving event, it can also be life changing as people adjust and adapt to new ways of being. Little is known about differences in adaptation, leading to adjustment between those with temporary and permanent ostomies. The current study employs reflexive thematic analysis as the primary analytical approach within a qualitative descriptive methodology to explore the circumstances influencing adjustment. It explores the perceptions and experiences of participants with either a temporary or permanent ostomy and the perspectives of interdisciplinary healthcare professionals who care for them using the Roy Adaptation Model to inform the interpretive process. Nineteen participants were recruited through purposeful sampling from a single tertiary referral healthcare facility in Australia: five participants with a temporary ostomy, six with a permanent ostomy, and eight interdisciplinary healthcare professionals. Participants completed a single, semi-structured interview. Reflexive thematic analysis was employed to interpret the data and generated five interconnected themes and 16 sub-themes. The major themes included: reconstructing a health identity, developing new ways of living with an ostomy, help seeking behaviors, the hidden layers of ostomy adaptation, and perception of care. To facilitate successful integration of the ostomy into daily life, equitable access to education, psychosocial support, and encouragement should be provided to both TO and PO patients. Given the increasing global incidence of conditions requiring ostomy formation, including colorectal cancer and inflammatory bowel disease, investigation into the processes of adaptation and adjustment to temporary or permanent ostomies represents an important research priority.