Skip to main content
SpringerLink
Log in

A Stoma Quality of Life Scale

  • Published:
Diseases of the Colon & Rectum

Abstract

Purpose

Few studies have evaluated the impact of a stoma on patient quality of life because of a lack of specific validated measures. This study documents the development and initial application of a Stoma Quality of Life Scale.

Methods

Content experts generated initial questions. Patient focus groups were conducted to ensure that the questions addressed all stoma-related issues considered important by patients. Responses from pilot groups allowed refinement to produce the final measure, the Stoma Quality of Life Scale, a 21-item questionnaire. Three scales are featured: Work/Social Function (6 items), Sexuality/Body Image (5 items), and Stoma Function (6 items). In addition, one item (scored separately) measures financial impact, one measures skin irritation, and two measure overall satisfaction. This questionnaire was administered to 100 consecutive ostomy patients, and readministered three weeks later. Reliability was assessed by using coefficient alpha for internal consistency and intraclass correlation coefficient for test-retest reproducibility. To test validity in extreme groups, scores were compared for patients with improved quality of life vs. those whose stoma worsened their quality of life. To evaluate convergent validity, we analyzed correlation of instrument scales with the SF12.

Results

The Stoma Quality of Life scales demonstrated adequate test-retest reproducibility (intraclass correlation coefficient >0.8) and acceptable internal consistency (coefficient alpha approximately 0.8). The scales were capable of discriminating between patients with better and worse quality of life after stoma formation (P < 0.02 for all scales). The Stoma Quality of Life scales significantly correlated (range, 0.12–0.75) with the Physical and Mental Health Composite Scale Scores of the SF-12.

Conclusions

The Stoma Quality of Life Scale demonstrates reasonable psychometric properties for measuring quality of life in patients with stomas. Further studies are needed to refine the instrument.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1

Similar content being viewed by others

References

  1. LO Nilsson NG Kock F Kylberg HE Myrvold I Palselius (1981) ArticleTitleSexual adjustment in ileostomy patients before and after conversion to continent ileostomy Dis Colon Rectum 24 287–290 Occurrence Handle1:STN:280:Bi6B3M7lsFE%3D Occurrence Handle7238239

    CAS  PubMed  Google Scholar 

  2. MJ Follick TW Smith DC Turk (1984) ArticleTitlePsychosocial adjustment following ostomy Health Psychol 3 505–517 Occurrence Handle1:STN:280:BiqB2MjjvVw%3D Occurrence Handle6536500 Occurrence Handle10.1037/0278-6133.3.6.505

    Article  CAS  PubMed  Google Scholar 

  3. W Foulis JF Mayberry (1990) ArticleTitleElderly ileostomists and their social problems J Clin Gastroenterol 12 276–278 Occurrence Handle1:STN:280:By%2BA3c%2FhtlE%3D Occurrence Handle2362096

    CAS  PubMed  Google Scholar 

  4. EW Gerharz K Weingartner T Dopatka UN Kohl HD Basler HN Riedmiller (1997) ArticleTitleQuality of life after cystectomy and urinary diversion: results of a retrospective interdisciplinary study J Urol 158 778–785 Occurrence Handle1:STN:280:ByiH3c3ntVY%3D Occurrence Handle9258080 Occurrence Handle10.1097/00005392-199709000-00023

    Article  CAS  PubMed  Google Scholar 

  5. BA Walsh BK Grunert GL Telford MF Otterson (1995) ArticleTitleMultidisciplinary management of altered body image in the patient with an ostomy J Wound Ostomy Continence Nurs 22 227–236 Occurrence Handle1:STN:280:BymD3M7htVQ%3D Occurrence Handle7550779

    CAS  PubMed  Google Scholar 

  6. KP Nugent P Daniels B Stewart R Patankar CD Johnson (1999) ArticleTitleQuality of life in stoma patients Dis Colon Rectum 42 1569–1574 Occurrence Handle10.1007/BF02236209 Occurrence Handle1:STN:280:DC%2BD3c%2FnvVKgtA%3D%3D Occurrence Handle10613475

    Article  CAS  PubMed  Google Scholar 

  7. MJ Bekkers FC Knippenberg Particlevan HW Borne Particlevan den H Poen J Bergsma GP Berge-Henegouwen Particlevan (1995) ArticleTitlePsychosocial adaptation to stoma surgery: a review J Behav Med 18 1–31 Occurrence Handle10.1007/BF01857702 Occurrence Handle1:STN:280:ByqA3MfpslQ%3D Occurrence Handle7595949

    Article  CAS  PubMed  Google Scholar 

  8. J Camilleri-Brennan RJ Steele (2002) ArticleTitleProspective analysis of quality of life after reversal of a defunctioning loop ileostomy Colorectal Dis 4 167–171 Occurrence Handle12780610 Occurrence Handle10.1046/j.1463-1318.2002.00352.x

    Article  PubMed  Google Scholar 

  9. DP O'Leary CJ Fide C Foy ME Lucarotti (2001) ArticleTitleQuality of life after low anterior resection with total mesorectal excision and temporary loop ileostomy for rectal carcinoma Br J Surg 88 1216–1220 Occurrence Handle10.1046/j.0007-1323.2001.01862.x Occurrence Handle11531870

    Article  PubMed  Google Scholar 

  10. MA Kuzu O Topcu K Ucar et al. (2002) ArticleTitleEffect of sphincter-sacrificing surgery for rectal carcinoma on quality of life in Muslim patients Dis Colon Rectum 45 1359–1366 Occurrence Handle12394435 Occurrence Handle10.1007/s10350-004-6425-4

    Article  PubMed  Google Scholar 

  11. MA Sprangers BG Taal NK Aaronson A Velde Particlete (1995) ArticleTitleQuality of life in colorectal cancer. Stoma vs. nonstoma patients Dis Colon Rectum 38 361–369 Occurrence Handle10.1007/BF02054222 Occurrence Handle1:STN:280:ByqB3snos1U%3D Occurrence Handle7720441

    Article  CAS  PubMed  Google Scholar 

  12. MJ Bekkers FC Knippenberg Particlevan AM Dulmen Particlevan HW Borne Particlevan den GP Berge Henegouwen Particlevan (1997) ArticleTitleSurvival and psychosocial adjustment to stoma surgery and nonstoma bowel resection: a 4-year follow-up J Psychosom Res 42 235–244 Occurrence Handle10.1016/S0022-3999(96)00288-7 Occurrence Handle1:STN:280:ByiB2snkt1M%3D Occurrence Handle9130180

    Article  CAS  PubMed  Google Scholar 

  13. J Camilleri-Brennan RJ Steele (2001) ArticleTitleObjective assessment of quality of life following panproctocolectomy and ileostomy for ulcerative colitis Ann R Coll Surg Engl 83 321–324 Occurrence Handle1:STN:280:DC%2BD38%2FotVamsw%3D%3D Occurrence Handle11806556

    CAS  PubMed  Google Scholar 

  14. K Nordin L Pahlman K Larsson M Sundberg-Hjelm L Loof (2002) ArticleTitleHealth-related quality of life and psychological distress in a population-based sample of Swedish patients with inflammatory bowel disease Scand J Gastroenterol 37 450–457 Occurrence Handle10.1080/003655202317316097 Occurrence Handle1:STN:280:DC%2BD383ltFCqtg%3D%3D Occurrence Handle11989837

    Article  CAS  PubMed  Google Scholar 

  15. J Camilleri-Brennan A Munro RJ Steele (2003) ArticleTitleDoes an ileoanal pouch offer a better quality of life than a permanent ileostomy for patients with ulcerative colitis? J Gastrointest Surg 7 814–819 Occurrence Handle10.1016/S1091-255X(03)00103-3 Occurrence Handle13129563

    Article  PubMed  Google Scholar 

  16. B Pieper C Mikols TR Dawson Grant (1996) ArticleTitleComparing adjustment to an ostomy for three groups J Wound Ostomy Continence Nurs 23 197–204 Occurrence Handle1:STN:280:ByiD2MnjtlY%3D Occurrence Handle8900672

    CAS  PubMed  Google Scholar 

  17. JM Jenks KH Morin N Tomaselli (1997) ArticleTitleThe influence of ostomy surgery on body image in patients with cancer Appl Nurs Res 10 174–180 Occurrence Handle1:STN:280:DyaK1c%2FotFejtQ%3D%3D Occurrence Handle9419913 Occurrence Handle10.1016/S0897-1897(97)80548-4

    Article  CAS  PubMed  Google Scholar 

  18. AW Gooszen RH Geelkerken J Hermans MB Lagaay HG Gooszen (2000) ArticleTitleQuality of life with a temporary stoma: ileostomy vs. colostomy Dis Colon Rectum 43 650–5 Occurrence Handle10.1007/BF02235581 Occurrence Handle1:STN:280:DC%2BD3c3osVKmuw%3D%3D Occurrence Handle10826426

    Article  CAS  PubMed  Google Scholar 

  19. JC Nunnally IH Bernstein (1994) Psychometric theory EditionNumber3rd ed. McGraw Hill New York

    Google Scholar 

  20. J Ware M Kosinski SD Keller (1996) ArticleTitleA 12-item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity Med Care 34 220–33 Occurrence Handle10.1097/00005650-199603000-00003 Occurrence Handle8628042

    Article  PubMed  Google Scholar 

  21. B Burnand WN Kernan AR Feinstein (1990) ArticleTitleIndexes and boundaries for “quantitative significance” in statistical decisions J Clin Epidemiol 43 1273–1284 Occurrence Handle10.1016/0895-4356(90)90093-5 Occurrence Handle1:STN:280:By6D2szhsFc%3D Occurrence Handle2254764

    Article  CAS  PubMed  Google Scholar 

  22. J Cohen (1988) Statistical power analysis for the behavioral sciences Lawrence Erlbaum Associates Hillsdale, New Jersey

    Google Scholar 

  23. S Kluka LJ Kristjanson (1996) ArticleTitleDevelopment and testing of the ostomy concerns scale: measuring ostomy-related concerns of cancer patients and their partners J Wound Ostomy Continence Nurs 23 166–170 Occurrence Handle1:STN:280:BymH3czjtFM%3D Occurrence Handle8845906

    CAS  PubMed  Google Scholar 

  24. ME Olbrisch SW Ziegler (1982) ArticleTitlePsychological adjustment and patient information in inflammatory bowel disease: development of two assessment instruments J Chronic Dis 35 649–658 Occurrence Handle1:STN:280:Bi2B3sbmslQ%3D Occurrence Handle7096528 Occurrence Handle10.1016/0021-9681(82)90017-0

    Article  CAS  PubMed  Google Scholar 

  25. P Marquis A Marrel B Jambon (2003) ArticleTitleQuality of life in patients with stomas: the Montreux Study Ostomy Wound Manage 49 48–55 Occurrence Handle12598701

    PubMed  Google Scholar 

  26. GV Padilla C Presant MM Grant G Metter J Lipsett F Heide (1983) ArticleTitleQuality of life index for patients with cancer Res Nurs Health 6 117–126 Occurrence Handle1:STN:280:BiuD2czmvVU%3D Occurrence Handle6556698

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA

    Nancy N. Baxter M.D., Ph.D., FRCSC

  2. Department of Biostatisics, Mayo Clinic Cancer Center Statistics, Rochester, Minnesota, USA

    Paul J. Novotny M.S. & Jeff Sloan Ph.D.

  3. Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota, USA

    Therese Jacobson R.N., B.S.N., C.W.O.C.N., W.O.C. Nurse & Laurie J. Maidl R.N., B.S.N., C.W.O.C.N., W.O.C. Nurse

  4. Division of Colon and Rectal Surgery, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, Arizona, 85259, USA

    Tonia M. Young-Fadok M.D., M.S.

Authors
  1. Nancy N. Baxter M.D., Ph.D., FRCSC
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Paul J. Novotny M.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Therese Jacobson R.N., B.S.N., C.W.O.C.N., W.O.C. Nurse
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Laurie J. Maidl R.N., B.S.N., C.W.O.C.N., W.O.C. Nurse
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jeff Sloan Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Tonia M. Young-Fadok M.D., M.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tonia M. Young-Fadok M.D., M.S..

Additional information

Poster presentation at Digestive Disease Week, Orlando, Florida, May 17 to 22, 2003.

Appendices

The Stoma Quality of Life Scale (SQOLS) Questionnaire

We would like to use your opinions and experiences to help us improve the care of individuals with ostomies. Please read each statement and decide the way it applies to you. Some questions may seem to be more important to you than others; however, try to answer all questions to the best of your ability. Your responses are confidential.

Part 1

  1. 1.

    Rate your overall satisfaction with your life in general right now on a scale of 0 to 100, with 0 being totally unsatisfied and 100 being totally satisfied.

  2. 2.

    Rate your overall satisfaction with your life in general during the last month on a scale of 0 to 100, with 0 being totally unsatisfied and 100 being totally satisfied.

Part 2

Never (1) Seldom (2) Occasionally (3) Frequently (4) Always (5)

For each of the following questions, please choose a number from the choices above that corresponds to your answer.

  1. 3.

    I am able to participate in hobbies that I enjoy. _____

  2. 4.

    I am able to go out with friends. _____

  3. 5.

    My stoma interferes with my ability to work or attend school. _____

  4. 6.

    I worry about traveling because of my stoma. _____

  5. 7.

    I enjoy sexual activity. _____

  6. 8.

    I feel attractive. _____

  7. 9.

    My sexual partner is bothered by my stoma. _____

  8. 10.

    It bothers me if others are aware I have a stoma. _____

  9. 11.

    I worry about lack of privacy when I need to empty my pouch. _____

  10. 12.

    I feel comfortable in my clothing. _____

  11. 13.

    I am satisfied with the foods I eat. _____

  12. 14.

    I have financial concerns regarding my ostomy supplies. _____

  13. 15.

    I have problems with odor. _____

  14. 16.

    I am able to share my feelings and concerns about my ostomy with a family member or friend. _____

  15. 17.

    I am embarrassed by gas (noises or rapid filling of bag). _____

  16. 18.

    I worry my ostomy appliance will leak. _____

  17. 19.

    I am bothered by skin irritation around the stoma. _____

  18. 20.

    Social situations make me feel anxious. _____

  19. 21.

    I perform the same household and family duties. _____

Appendix 2 Suggested Scoring of the SQOLS

Part 1

Overall satisfaction with life is scored from 0 to 100. Question 1 reflects current satisfaction and may be more useful when changes over short periods of time are important. Question 2 reflects satisfaction during the previous month.

Part 2

  • Work/Social Function Scale = 25 × (12 + Que3 + Que4 − Que5 − Que6 − Que20 + Que21)/6

  • Sexuality/Body Image = 25 × (1 + Que7 + Que8 − Que9 + Que12 + Que16)/5

  • Stoma Function = 25 × (24 − Que10 − Que11 + Que13 − Que15 − Que17 − Que18)/6

  • Financial Concerns = 25 × (5 − Que14)

  • Skin Irritation = 25 × (5 − Que19)

If any two questions are missing for a subscale, the entire subscale should be set to missing. If one is missing, the scale score can be prorated.

About this article

Cite this article

Baxter, N.N., Novotny, P.J., Jacobson, T. et al. A Stoma Quality of Life Scale. Dis Colon Rectum 49, 205–212 (2006). https://doi.org/10.1007/s10350-005-0275-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10350-005-0275-6

Key words

Search

Navigation