SURVIVAL AND PSYCHOSOCIAL ADJUSTMENT TO STOMA SURGERY AND NONSTOMA BOWEL RESECTION - A 4-YEAR FOLLOW-UP

A prospective 4-year follow-up study was conducted to compare the psyc hosocial adjustment process and survival rate of 59 stoma patients wit h 64 bowel-resected nonstoma patients. Adjustment was assessed at 4 mo nths, 1 year, and 4 years after surgery by the Psychosocial Adjustment to Illness Scale, a self-report questionnaire (PAIS-SR). Analyses of covariance demonstrated that both subgroups experienced the same level of psychosocial problems 4 years after surgery. Interestingly, patien ts with poor early adjustment scores (4 months after surgery) were at significantly higher risk of dropping out because of death and termina l status during the follow-up period (1 and 4 years postoperatively). The presence of a stoma did not influence the risk rate for dropping o ut. These results demonstrate the need for prolonged psychosocial guid ance of outpatients who have been surgically treated for colorectal ca ncer or inflammatory bowel disease. (C) 1997 Elsevier Science Inc.