Fatores associados às complicações de pele periestoma em um centro especializado em reabilitação

Abstract

Introduction: Ostomies are designed to ensure survival, but peristomal skin complications are common among people with elimination stomas and are associated with impaired quality of life. Objective: To evaluate the occurrence and factors associated with peristomal skin complications in people with elimination stomas at a Specialized Rehabilitation Center (CER) in northeastern Brazil. Materials and method: This is a survey-based, crosssectional, and analytical study with a quantitative approach, conducted in two phases: document analysis and either telephone or face-to-face interviews. The forms used were: an instrument developed by the researcher based on the literature to assess the clinicalepidemiological profile and the New General Self-Efficacy Scale (NGSE) to assess selfefficacy. The population consisted of 1,276 users. Users who had cognitive, hearing, or motor deficits that prevented them from understanding the interview or performing self-care were excluded, as well as those who reported having undergone intestinal transit reversal surgery. Data collection began after approval by the Research Ethics Committee in accordance with Opinion No. 6,590,416. Exploratory and bivariate analyses were used to identify variables eligible for inclusion in the multivariate model. Poisson regression was employed to estimate adjusted prevalence ratios of the variables independently associated with the outcome of interest. Results: The sample consisted of 302 individuals who agreed to participate in the study. The predominant sociodemographic characteristics were: female biological sex, cis gender identity, age > 50 years, formal education < 12 years of study, nonwhite skin color, having a partner, living in the metropolitan region, family income of at least one minimum wage, no access to supplementary health care, retired, with access to the internet and religious beliefs. They assessed their health status as good to excellent, did not have hypertension or diabetes mellitus, did not have alcohol or smoking habits. They practiced leisure activities, did not participate in therapeutic support groups or associations, did not have an active sex life, did not bathe in the sea or pool and did not practice physical activity. Neoplasms were the main diagnosis indicating the creation of a stoma. Colostomy was the most prevalent type, as were temporary stomas. Among the complications, the most prevalent was peristomal skin dermatitis, followed by allergy to collecting equipment or adjuvants and granulomas. When analyzing self-efficacy, results between 8 and 30 points were found, with an average of 22.19 ± 5.07. Being over 50 years of age (PRa: 0.79; 95% CI: 0.68-0.92; p-value: 0.002), having adapted to the stoma (PRa: 0.79; 95% CI: 0.68-0.92; p-value: 0.003) and practicing physical activity (PRa: 0.79; 95% CI: 0.65-0.96; p-value: 0.020) were associated with a 21% lower prevalence of the outcome of interest in this study. Conclusions: Self-reported peristomal skin complications over the past six months were present in two-thirds of the sample. The prevalence of this outcome was significantly lower among individuals over 50 years of age, those who reported being adapted to the stoma, and those who engaged in physical activity, with no significant association with self-efficacy. Assessing the occurrence and associated factors of peristomal skin complications may provide support for planning nursing actions in the care of people with stomas.