Clinical and epidemiological aspects of children and adults with intestinal stoma of the Bahia-Brazil reference center

1.Escola Bahiana de Medicina e Saúde Pública – Curso de Especialização Enfermagem em Estomaterapia – Salvador (BA), Brazil. 2.Universidade Federal de Minas Gerias – Escola de Enfermagem – Departamento de Enfermagem Básica – Belo Horizonte (MG), Brazil. 3.Universidade Federal de Minas Gerais – Escola de Enfermagem – Programa de Pós-graduação em Enfermagem – Belo Horizonte (MG), Brazil. *Correspondence author: anaclaudia_gonzaga@hotmail.com Received: Jan. 10, 2019 | Accepted: Feb. 24, 2020 ABSTRACT Objective: To characterize children and adults with intestinal stoma in relation to sociodemographic and clinical aspects of the State Reference Center of Bahia. Method: This is a cross-sectional descriptive research, with a quantitative approach and a convenience sample of 43 patients that met the inclusion criteria. The data were collected through an interview and evaluation of the stoma and skin, around and analyzed by descriptive statistics, with frequency and percentage distribution. Results: There was a predominance of males, aged between 40 and 59 years old, unmarried, with incomplete elementary education, family income of a minimum wage, having colorectal cancer and firearm trauma as responsible for the stoma. It emphasized the occurrence of temporary descending colostomy, use of a drainable device, a single piece, with a cut-off, with a cut greater than the diameter of the stoma, presence of dermatitis. Stomatal hygiene and device switching were performed independently. Conclusion: The results of the study indicated a need to reassess the strategies used in specialized care, with emphasis on educational actions aimed at self-care and greater participation of the user in the program, aiming at their rehabilitation and improvement in quality of life.


INTRODUCTION
The number of patients undergoing stoma-generating surgery in Brazil is growing, especially due to the high incidence of colon and rectum cancer 1  The stoma can be temporary or definitive. This temporality is related to the fact that it was necessary to make it. Temporary stoma may be necessary to protect the anastomosis until it heals, to put at rest a certain intestinal segment that presents an inflammatory process or fistula, for example in Crohn Thus, it is mandatory that health professionals, especially nurses, know the demographic and clinical aspects of patients with stoma treated in health services for adoption or review of institutional protocols. This stage aims to improve user care in primary, secondary and tertiary care, thus expanding the professional commitment of the nurse, from prevention to the patient's rehabilitation process. Promoting the mediation of education in the search for autonomy for self-care, for the defense of their rights of citizenship, dignity and quality of life 5 .

DESCRIPTORES:
Niño; Adulto; Estomía; Perfil de salud; Estomaterapia. stoma in specialized services in Bahia. It is believed that the result will subsidize health professionals and managers to obtain information to structure and plan quality care, aiming at early rehabilitation and quality of life for such patients attended and followed up at the Reference Center of the city under study.
This study aimed to identify the profile of children and adults with stoma treated at a State Reference Center in the State of Bahia.

METHODS
It is an observational, exploratory, descriptive, cross-

RESULTS
The sample consisted of 43 patients with intestinal stoma, coming from different parts of Bahia and proximity. The protrusion varied from 0.0 to 12 cm, being absent in 5 (11.6%) stomata and predominance of 3.0 cm    (Table 3).

DISCUSSION
The results of this study showed a predominance of adults, with colorectal cancer and firearm trauma as the main causes of stoma. These findings may be related to an increase in the incidence of this type of cancer, which has been described in the literature related to the pattern of inappropriate eating, excessive consumption of alcoholic beverages, smoking and sedentarism. Another factor is the increase in the number of traumas due to automobile accidents, urban violence with firearm and white weapons perforation, situations that constitute motivating causes for a stoma 6,7. In the study, when analyzing the children's group, the age group from 0 to 5 years prevailed. This finding is in line with other studies of epidemiological profile   Ø of the device the size of the stoma Ø of the device 2mm bigger than the stoma Ø of the device 3mm bigger than the stoma Ø of the device 4mm bigger than the stoma Ø of the device 5mm bigger than the stoma Ø of the device 6mm bigger than the stoma Ø of the device 7mm bigger than the stoma Ø of the device 10mm bigger than the stoma Ø dof the device 15mm bigger than the stoma Ø dof the device 20mm bigger than the stoma Ø of the device 28mm bigger than the stoma Ø of the device 39mm bigger than the stoma The low level of schooling may have influenced family income, the majority of which was up to a minimum wage. These sample characteristics are in line with other studies 7,9,12,14,16,17 .
It is noticeable that the population studied has low purchasing power, which makes it difficult to acquire, with own resources, scholarships and adjuvants suitable for self-care, considering their high cost. The facts presented encourage the nurse professional to ensure that these patients receive through the Pole Care, by SUS, such equipment in adequate quantities, respecting individual needs.
Regarding marital status, it was observed that most adults were single, separated or widowed, since it differs from the results found in the various articles analyzed that cover this subject 7,12,14,15,17 . The negative impact that the experience of living with a stoma has on patterns of sexuality, personal and family relationships, generating conflicting feelings that end up wearing down affective relationships, leading to social isolation or rejection of the partner 7 .
Regarding the origin of people with stoma, it was found in this study that the majority lived in the capital, although the service is a reference in the State of Bahia.