J Korean Acad Nurs.  2009 Aug;39(4):539-548. 10.4040/jkan.2009.39.4.539.

Model Construction of Sexual Satisfaction in Patients with a Colostomy

• Park S
• Kim KS

• KMID: 820231
• DOI: http://doi.org/10.4040/jkan.2009.39.4.539

Abstract

PURPOSE: This study was designed to construct and test the structural equation model on sexual satisfaction in patients with a colostomy.
METHODS
The model construction was based upon Roy's adaptation model. Stoma-related discomfort (SRD), age, frequency of sexual intercourse, treatment modality, and gender affect sexual satisfaction and are mediated by physical, psychosocial, and interdependence modes. Each mode was conceptualized as sexual function, body image/depression, and marital intimacy. The patients were 112 colostomates with colorectal cancer who were asked to complete a mail-back survey on their demographic data, SRD, body image, depression, marital intimacy, sexual function, and sexual satisfaction. Data were analyzed using SPSS WIN 15.0 and AMOS WIN 7.0.
RESULTS
Significant variables for sexual satisfaction in the final model were body image affected by SRD, depression affected by body image and SRD, marital intimacy affected by depression, and sexual function affected by marital intimacy.
CONCLUSION
The results of this study suggest that specific guidelines for SRD are necessary to improve sexual satisfaction among colostomates. Nurses should be vigilant in monitoring depression and body image disturbance, and providing appropriate interventions to increase marital intimacy. Treatment modality, gender, and age should be considered in developing education programs pertaining to sexuality.

Keyword

Colostomy; Sexual behavior; Structural model

MeSH Terms

Adult
Aged
Body Image
Colostomy/*psychology
Demography
Depression
Female
Humans
Male
Middle Aged
Questionnaires
Sex Factors
*Sexual Behavior
Sexual Partners
Sexuality/*psychology

Figure

• 

  Figure 1 Conceptual framework based on Roy's adaptation model.

• 

  Figure 2 The hypothetical model. x1=physical stoma-related discomfort (SRD); x2=psychological SRD; x3=management-related SRD; x4=age; x5=frequency of sexual intercourse; x6=treatment modality; x7=gender; y1=body image; y2=depression; y3=intimacy; y4=sexual function; y5=sexual satisfaction.

• 

  Figure 3 Path diagram for the modified model. *p<.05; **<.01. x1=physical stoma-related discomfort (SRD); x2=psychological SRD; x3=management-related SRD; x4=age; x5=frequency of sexual intercourse; x6=treatment modality; x7=gender; y1=body image; y2=depression; y3=intimacy; y4=sexual function; y5=sexual satisfaction.

Reference

1. Arndt V, Merx H, Stegmaier C, Ziegler H, Brenner H. Quality of life in patients with colorectal cancer 1 year after diagnosis compared with the general population: A population-based study. Journal of Clinical Oncology. 2004. 22:4829–4836.

2. Chang SB. An analytic study of influencing factors for sexual satisfaction in women who have had a hysterectomy. Journal of Korean Academy of Nursing. 1989. 19:160–172.

3. Cho SB. Structural equation model. 1996. Seoul: Youngji Munwhasa.

4. Choi KS, Kim MS. A study on the difficulties and coping process of ostomates. The Journal of Korean Academy of Adult Nursing. 1997. 9:297–301.

5. Chon KK, Rhee MK. Preliminary development of Korean version of CES-D. The Korean Journal of Clinical Psychology. 1992. 11:65–76.

6. Gloeckner MR. Perceptions of sexual attractiveness following ostomy surgery. Research in Nursing & Health. 1984. 7(2):87–92.

7. Health Insurance Review & Assessment Service. 2007 Health insurance review statistics. 2008. Seoul: Author.

8. Hurlbert DF. A comparative study using orgasm consistency training in the treatment of women reporting hypoactive sexual desire. . Journal of Sex & Marital Therapy. 1993. 19:41–55.

9. Jung MS. A study on adjustment of daily life & body image of individuals having a colostomy. 1984. Seoul: Seoul National University;Unpublished master's thesis.

10. Kim GS. Analysis of structural equation model. 2006. Seoul: Hannarae Publishing.

11. Kim HK. Health-related quality of life and its related factors in patients with rectal cancer. 2003. Seoul: Yonsei University;Unpublished master's thesis.

12. Kim J. Relationship among the body image, self-esteem and depression in patients with colostomy. 2002. Seoul: Ewha Womans University;Unpublished master's thesis.

13. Kim SN. A structural model for quality of life in women having hysterectomies. Journal of Korean Academy of Nursing. 1999. 29:161–173.

14. Klopp AL. Body image and self-concept among individuals with stomas. Journal of Enterostomal Therapy. 1990. 17:98–105.

15. Lee HJ. The relevance between sexual function in married women and their psychological features. 2004. Seoul: Sungshin Women's University;Unpublished master's thesis.

16. Lee KO, Kim YH. Sexuality and marital satisfaction of married women. Journal of the Korean Home Economics Association. 2003. 41(7):39–58.

17. Lee SY. A study on sexual life of cancer patients. 2006. Seoul: Ewha Womans University;Unpublished master's thesis.

18. Park HM, Ha NS. Influencing predictors of quality of life in colorectal cancer patient with colostomy. Journal of Korean Clinical Nursing Research. 2006. 12:123–131.

19. Pollock SE. Adaptation to chronic illness: A program of research for testing nursing theory. Nursing Research Quarterly. 1993. 6(2):86–92.

20. Richbourg L, Thorpe JM, Rapp CG. Difficulties experienced by the ostomate after hospital discharge. Journal of Wound Ostomy Continence Nursing. 2007. 34:70–79.

21. Roy SC, Robert SL. Theory construction in nursing: An adaptation model. 1981. Upper Saddle River, NJ: Prentice-Hall.

22. Shipes E. Psychosocial issues: The person with an ostomy. Nursing Clinics of North America. 1987. 22:291–302.

23. Smets EM, Garssen B, Schuster-Uitterhoeve AL, de Haes JC. Fatigue in cancer patients. British Journal of Cancer. 1993. 68:220–224.

24. Waring EM, Reddon JR. The measurement of intimacy in marriage: The Waring Intimacy Questionnaire. Journal of Clinical Psychology. 1983. 39:53–57.

25. Whipple B. Woman's sexual pleasure and satisfaction: A new view of female sexual function. Female Patient. 2002. 27:44–47.

26. White CA, Unwin JC. Postoperative adjustment to surgery resulting in the formation of a stoma: The importance of stoma-related cognitions. British Journal of Health Psychology. 1998. 3:85–93.

27. Young M, Denny G, Young T, Luquis R. Sexual satisfaction among married women age 50 and older. Psychological Reports. 2000. 86:1107–1122.

28. Zhou M. A survey of sexual states of married, healthy, reproductive age woman. The Journal of Personal & Human Sexuality. 1993. 6(2):15–28.