Adjustment, Psychological Well-being, Resilience
Conditions
Keywords
Solution- focused counseling, Adjustment, Resilience, Psychological Well- being
Brief summary
In this study, the effect of online solution- focused group counseling on adjustment, psychological well- being and resilience in individuals will be examined. The research will be carried out as a randomized controlled experimental study with a pre-test, post- test and follow- up design.
Detailed description
Colorectal cancers are among the most frequently diagnosed cancer types both in our country and worldwide and constitute a major public health problem that leads to morbidity and mortality despite advanced diagnostic and treatment methods. Their high prevalence necessitates action to protect both individual and public health. The treatment of colorectal cancers includes radiotherapy (RT), chemotherapy (CT), antibody therapy, and surgical interventions. Surgical procedures for colon cancer vary depending on the location of the tumor. As a result of these surgical interventions, an ostomy may be created for reasons such as saving the patient's life, protecting the anastomosis line, or eliminating the necessity of the anus. The term ostomy is derived from the Greek word stoma, meaning "mouth" or "opening." In medical terminology, a stoma/ostomy refers to a surgically created opening of a hollow organ onto the body surface to allow the elimination of waste products. Colostomy is one of the most common therapeutic interventions applied in pathological conditions of the colon, particularly colorectal cancer, and is defined as the exteriorization of the large intestine onto the skin. Studies indicate that living with a colostomy affects individuals' overall quality of life. Patients with a stoma face not only physical and functional challenges but also psychological, emotional, and social losses. The presence of a colostomy has been associated with various complex problems, including psychological and sexual difficulties, dissatisfaction with altered body image, changes in daily routines, travel difficulties, and fatigue. Changes occurring in the lives of individuals with a colostomy significantly affect their interpersonal and intimate relationships. Adopting a new lifestyle adapted to colostomy management may have an emotional impact on the patient as well as on close individuals such as family members and sexual partners. According to previous studies, married individuals experience major changes in their sexual lives, particularly immediately after surgery or during the early stages of the disease. Moreover, women have been found to have lower quality of life compared to men, a situation associated with body image changes, fear of rejection, and inability to perform household tasks. As having a colostomy may lead to partial or complete job loss, the professional lives of colostomy patients are also seriously affected. Individuals with a colostomy encounter various physiological, psychological, and social challenges. Psychological resilience plays a crucial role in coping with these difficulties. Psychological resilience is defined as a dynamic process of positive adaptation in the face of significant adversity. Research has shown that individuals reporting higher levels of psychological resilience engage more frequently in health-promoting behaviors compared to those with lower resilience. Furthermore, individuals with higher psychological resilience demonstrate better adaptation to chronic illnesses than those with lower resilience. However, research on psychological resilience in individuals with permanent ostomies remains limited. Studies have demonstrated that as psychological resilience increases in individuals with permanent ostomies, their adaptation to the ostomy also improves. Another study reported that decreases in psychological resilience among individuals with permanent ostomies were associated with reductions in health-related quality of life. In a study conducted by Dong X and colleagues (2017), a positive relationship was found between psychological resilience and post-traumatic growth. Solution-focused counseling is a strengths-based approach that emphasizes the resources individuals already possess and how these resources can be applied in the process of change. This approach aims to facilitate change in individuals' lives in the shortest possible time. It is based on the belief that change originates from two main sources: encouraging individuals to define their preferred future (how their lives would look if therapy were successful) and detailing the skills and resources they have already demonstrated (examples of current and past successes). A review of the literature revealed no studies investigating the effects of solution-focused group counseling in individuals with permanent colostomies. Therefore, understanding the effects of online solution-focused group counseling on adaptation, psychological well-being, and psychological resilience in individuals with permanent colostomies due to colorectal cancer is of great importance for the entire healthcare team, particularly for mental health and psychiatric nurses, who constitute a vital component of this team.
Interventions
BEHAVIORALSolution- focused group counseling
After the follow-up tests will be completed, it is planned to apply 6 sessions group counseling to the intervention group in the same way to the control group, upon their request.
Sponsors
Gazi University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Subject, Outcomes Assessor)
Masking description
Due to the nature of study, it is not possible to blind the researcher implementing the intervention and the participiants. To prevent bias in the study, the pretest will be applied before randomization. It is planned to blind the statistical and report writing process in the study. The assignment of students to the intervention and control groups will be made by a statistician independent of the study. The researcher and participiants will not know which group they are in until the application begins. After applying the follow- up tests, the researcher will code data as A and B groups and transfer it to SPSS. With this method, it is planned that the statistician will do the analysis and reporting without knowing which group is the intervention and which group is the control group. It is planned to explain the codes of the groups after the analysis and reporting data. In this way, detection bias, statistical bias and reporting bias will be prevented.
Intervention model description
In the study, 48 individuals were taken as sampling, 24 of which were experimental and 24 were control.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Being 18 years of age or older, * Having a permanent colostomy due to colorectal cancer, * At least 2 months having passed since the permanent colostomy was placed, * Being able to use computers and online applications, * Having no problems with verbal and written communication, * Not having any physical or mental condition that would prevent cooperation.
Exclusion criteria
* Having previously had an ostomy • Having received psychotherapy in the last year or currently receiving it.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Adaptation of the ostomy adjustment | Pre-intervention, immediately after the intervention, 3rd month follow-up | Adaptation of the ostomy adjustment scale, developed by Simmons et al. (2009), was adapted into Turkish by Karadağ et al. (2011). The scale consists of 23 items and includes four subscales: Acceptance, Anxiety/Concern, Social Adjustment, and Anger. It is structured as a 5-point Likert-type scale and is scored on a range from 0 to 4 (strongly agree, agree, undecided, disagree, strongly disagree). The total scale score ranges between 0 and 92. Higher scores obtained from each item indicate a higher level of adjustment. BTwelve items in the scale (items 2, 5, 7, 8, 10, 11, 12, 13, 16, 17, 18, and 21) contain negatively worded statements and are therefore reverse-coded. For positively coded items, responses are scored from 0 to 4, whereas for reverse-coded items, scoring is applied from 4 to 0. In the Turkish version of the scale, the overall Cronbach's alpha coefficient was calculated as .93. |
| Psychological Well-Being | Pre-intervention, immediately after the intervention, 3rd month follow-up | The Psychological Well-Being Scale, developed by Diener et al. (2009; 2010), was adapted into Turkish by Telef (2011; 2013). The scale is unidimensional and consists of eight items. Items of the Psychological Well-Being Scale are rated on a 7-point Likert scale ranging from 1 (strongly disagree) to 7 (strongly agree). All items are positively worded. Total scores range from 8 (if strongly disagree is selected for all items) to 56 (if strongly agree is selected for all items), with higher scores indicating that the individual possesses greater psychological resources and strengths. In the Turkish version of the scale, the overall Cronbach's alpha coefficient was calculated as .80. |
| Resilience | Pre-intervention, immediately after the intervention, 3rd month follow-up | The Resilience Scale for Adults, developed by Friborg et al. (2003), was adapted into Turkish by Basım and Çetin (2011). The scale consists of 33 items and includes six subscales: Perception of Self, Perception of Future, Structured Style, Social Competence, Family Cohesion, and Social Resources. It is a 5-point Likert-type scale presented in five response options. The scale does not have a specific cut-off score. Items numbered 1, 3, 4, 8, 11, 12, 13, 14, 15, 16, 23, 24, 25, 27, 31, and 33 are reverse-coded. For positively coded items, responses are scored from 1 to 5, whereas for reverse-coded items, scoring is applied from 5 to 1. In the Turkish version of the scale, the overall Cronbach's alpha coefficient was calculated as .86, while the Cronbach's alpha values for the subscales ranged between .66 and .81. |
Countries
Turkey (Türkiye)
Outcome results
None listed