Keele Research Repository

Stoma surgery is commonly described as a life-changing procedure, due to the radical bodily changes and related psychosocial challenges it brings about; especially so for individuals with Inflammatory Bowel Disease (IBD) who may undergo this surgery at a relatively young age. Although the psychological impact of stoma formation is emphasised in the literature, how stoma-related psychological needs are addressed remains unexplored. This study explores the perspectives of young adults with a stoma and healthcare professionals about access to psychological support within and beyond the healthcare system.
In-depth interviews were conducted with 13 young adults with a stoma (aged 18-29 years) and 15 healthcare professionals (including colorectal surgeons, gastroenterologists, specialist nurses in IBD and stoma care, and general practitioners). Data collection and analysis were informed by constructivist grounded theory and narrative inquiry.
Most young adults reported a positive transformation following stoma surgery, explicated through the concept of ‘biographical renewal’, which is characterised by physical relief from IBD symptoms and a reconfiguration of self and biography. Psychological distress, however, was sometimes found to co-exist alongside these transformations. Several barriers to the identification and management of psychological problems were identified on patient, professional, and systemic levels. Whilst peer support was recognised as a valuable support avenue, preference was expressed for these psychological needs to be met by healthcare services.
Findings indicate the need for clinicians to encourage disclosure of psychological concerns following stoma surgery. The development of more effective care pathways, which include psychological services, as well as more age-appropriate peer support, are recommended to enhance access to psychological support for young adults with a stoma.