127 6 Better Stoma Care using the Stoma App – does it help? INTRODUCTION In the Netherlands, it is estimated that over 7,000 new stomas are created every year.1 Ileostomies or colostomies may be necessary for patients with colorectal malignancy, inflammatory bowel disease, or to resolve or mitigate intestinal leakage for other reasons. Getting a stoma may negatively impact patients’ self-image and daily functioning, leading to a reduced quality of life. 2-4 In the initial postoperative period, patients must learn to cope and adapt to the new situation which can be challenging. This may result in several psychosocial problems such as insecurity, depression, stress, anxiety, decreased social participation and sexual problems.5 Patients are also at risk of stoma-related morbidity which has an incidence of 20-80%, the most common complications are peri-stomal skin problems and leakages.6,7 Complications themselves can exert a significant negative impact on the mental and social well-being of patients.8 Self-efficacy has been found to be very important for patients having a stoma. When self-efficacy is high, psychosocial problems and stoma-related morbidities are effectively reduced. 9-10 Therefore, it is crucial to provide adequate patient education and guidance, especially in the immediate preoperative and postoperative period. Several educational interventions have demonstrated positive results in terms of enhancing psychosocial skills, self-efficacy, and quality of life.11,12 However, providing adequate stoma care or obtaining information in the out-of-hospital setting can be challenging. In general, Dutch patients reported only moderate satisfaction with the stoma care they received, highlighting several shortcomings in information provision and postoperative care. Also, they express a need to be in contact with peer patients.13,14 A mobile application (app) may act as a medical device and have great potential to improve and support healthcare.15 Introducing a personalised app as an addition to regular stoma care can provide stoma patients with important benefits. These benefits include easily accessible information that relates to specific circumstances, and the opportunity to engage in peer-to-peer contact with other patients in a safe, anonymous environment, if one should desire so.13,14 Providing reliable and understandable information on stoma management is very important for patients. This should include what is considered to be ‘normal’ and what is not, along with the possibility for patients to interact and learn from other patients in the same situation (peers). Having access to such information at any time may contribute to acceptance, self-confidence, and self-efficacy, enabling patients to regain control of their new situation. In turn, this may reduce the demand for caregivers and potentially avoid returning to the clinic. The app ‘Stoma App’ offers a wide range of relevant stoma-related information. It provides personalised and timed guidance and facilitates peer-to-peer patient contact. It includes –among others- step-by-step videos on how to take care of a stoma, information on stoma
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