Healthcare professionals' priorities for training to identify and manage distress experienced by young people with a stoma due to inflammatory bowel disease: a consensus study using online nominal group technique.

Saunders, Benjamin; Polidano, Kay; Chew-Graham, Carolyn A; Fisher, Tamsin; Corp, Nadia; McDermott-Hughes, Megan; D Farmer, Adam; Bray, Lucy

Abstract

Objectives: Young people with a stoma due to inflammatory bowel disease (IBD) commonly experience distress; however, this is not always well managed in clinical settings. More effective support may/is likely to reduce the possibility of individuals experiencing sustained distress, which may engender depression or anxiety. This study aimed to gain consensus among a multidisciplinary group of healthcare professionals (HCPs) on priorities for training in the identification and management of distress in this population. One of the authors is a young person with a stoma.

Design: Participants were recruited through Twitter (X) and the researchers’ clinical/research contacts. Two consensus group meetings were conducted using Nominal Group Technique, involving participants generating, discussing and rating on a Likert scale, topics for inclusion in an HCP training package.

Setting: Online video conferencing. Participants were located across England, with one based in the USA.

Participants: Nineteen HCPs participated: three general practitioners, three stoma nurses, two IBD nurses, nine clinical psychologists and two gastroenterologists.

Results: Twenty-five topics were generated by participants; 19 reached consensus of ≥80%, that is, a mean of ≥5.6 on a 7-point Likert scale. These included: recognising and validating different levels of, and variation in, distress; tackling stigma and normalising having a stoma; everyday practicalities of stoma management, including food and sleep; opening and holding conversations about stoma-related distress; considering the impact of different cultural beliefs on adaptation after stoma surgery; training in simple techniques for gauging the patient’s distress during clinical encounters; having conversations about body image; and myth-busting common fears, such as odour.

Conclusions: This study is the first to identify HCP training priorities for managing stoma-related distress in young people. Consensus was reached for 19 topics, reflecting the varied needs of young people with a stoma. Findings will inform development of a training package for HCPs treating young people with IBD and a stoma.

Citation

Saunders, B., Polidano, K., Chew-Graham, C. A., Fisher, T., Corp, N., McDermott-Hughes, M., D Farmer, A., & Bray, L. (2023). Healthcare professionals' priorities for training to identify and manage distress experienced by young people with a stoma due to inflammatory bowel disease: a consensus study using online nominal group technique. BMJ Open, 13(11), Article e072360. https://doi.org/10.1136/bmjopen-2023-072360

• Journal Article Type: Article
• Acceptance Date: Jul 18, 2023
• Online Publication Date: Nov 29, 2023
• Publication Date: 2023-11
• Deposit Date: Dec 11, 2023
• Publicly Available Date: Dec 11, 2023
• Journal: BMJ Open
• Electronic ISSN: 2044-6055
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 13
• Issue: 11
• Article Number: e072360
• DOI: https://doi.org/10.1136/bmjopen-2023-072360
• Keywords: Mental health, Gastroenterology, Inflammatory Bowel Disease, Humans, Inflammatory Bowel Diseases, Communication, Adolescent, Health Personnel, Delivery of Health Care, Surgical Stomas
• Public URL: https://keele-repository.worktribe.com/output/660530
• PMID: 38030248