SEXUALITY AFTER STOMA FORMATION
The Activities on these Portfolio Pages correspond with the learning objectives
of the Guided Learning unit published in Nursing Times 104: 16 (22 April 2008)
and 104; 17 (29 April 2008). The full reference list for this unit follows Activity 4.
Before starting to work through these Activities, save this document onto your
computer, then print the completed work for your professional portfolio.
Alternatively, simply print the pages if you prefer to work on paper, using extra
sheets as necessary.
Recording your continuing professional education
To make your work count as part of your five days’ CPD for each registration
period, make a note in the box below of the date and the total number of hours
you spent on reading the unit and any other relevant material, and working
through the Activities.
Hours:
Date:
ACTIVITY 1
Learning objective: Understand the
importance of discussing sexuality with
patients - and partners - before and after
stoma formation.
Activity: Jeffery*, a 58-year-old married
man, is to undergo formation of a
colostomy for bowel cancer. Before
surgery he is positive and simply wants
the cancer removed. His wife feels the
same. However, post-surgery Jeffery
expresses concerns about his body
image, and further discussion highlights
anxiety about the sexual relationship with
his wife. His wife is not aware of his
worries. Issues of change in sexuality
were barely mentioned pre-operatively,
aside from potential physical alterations
highlighted by the surgeon. A stoma
nurse was not available to see Jeffery, so
you as the ward nurse are responsible for
this aspect of care.
Explain how you would broach these
issues with Jeffery, and his wife if he
wishes. Discuss how you would reduce
such concerns in future patients through
pre-operative discussion.
RESPONSE
Begin your response here.
Nursing Times Portfolio Pages: Sexuality After Stoma Formation
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SEXUALITY AFTER STOMA FORMATION
ACTIVITY 2
body image can affect sexuality in men
and women.
Learning objective: Identify common
psychological concerns about sexuality
following stoma formation.
RESPONSE
Begin your response here.
Activity: Explain how concerns about
Nursing Times Portfolio Pages: Sexuality After Stoma Formation
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SEXUALITY AFTER STOMA FORMATION
ACTIVITY 3
Learning objective: Explain the potential
alterations to sexuality following stoma
formation.
Activity: Explain how sexuality may be
compromised in the following patients
(and their partners) both physically and
psychosocially:
a) A 47-year-old homosexual man, in a
steady relationship, undergoing stoma
formation for bowel cancer;
b) A 26-year-old single woman, having
this surgery for ulcerative colitis;
c) A 78-year-old married man,
undergoing stoma formation for bladder
cancer.
RESPONSE
Begin your response here.
Nursing Times Portfolio Pages: Sexuality After Stoma Formation
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SEXUALITY AFTER STOMA FORMATION
ACTIVITY 4
Learning objective: Identify how
disturbance to sexuality following stoma
formation can be minimised.
Activity: Anne*, a 63-year-old woman
who lives with her partner, Charles*, has
undergone formation of an ileostomy for
bowel cancer. She generally enjoys an
active life, playing tennis and swimming
weekly. Her sex life with Charles is good,
engaging in sexual intercourse on a
regular basis. Anne is concerned that the
surgery and consequent stoma will lead
to decreased physical and sexual activity
and reduced attractiveness. How would
you help Anne come to terms with her
stoma, and what information would you
provide about her concerns?
* Names have been changed
RESPONSE
Begin your response here.
Nursing Times Portfolio Pages: Sexuality After Stoma Formation
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SEXUALITY AFTER STOMA FORMATION
FULL REFERENCE LIST: Part 1
Author, Black, P. (2000) Practical stoma
care. Nursing Standard; 14: 41, 47-55.
Borwell, B. (1997) Psychological
considerations of stoma care nursing.
Nursing Standard; 11: 48, 49-55.
British Medical Association and Royal
Pharmaceutical Society of Great Britain
(2006) BNF 52. London: BMJ Group/RPS
Publishing.
Campbell, J. (2007) Understanding social
support for patients with cancer. Nursing
Times; 103: 23, 28-29.
Colostomy Association (2007) What to
wear. Tidings; 5, 14-15.
Colostomy Association (2003) Rectal
pain (Tail-end pain). Reading: Colostomy
Association.
CREST (2006) Caring for stoma patients:
Best practice guidelines. Buckinghamshire:
Clinimed Ltd.
Galt, E., Hill, H. (2002) What About Sex?
For People with a Stoma and their
Partners. Cambridge: Dansac Ltd.
Hendren, S. et al (2005) Prevalence of
male and female sexual dysfunction is high
following surgery for rectal cancer. Annals
of Surgery; 242: 2, 212-223.
Kelly, M. (2001) Body Image - After Stoma
Surgery. Cambridge: Dansac Ltd.
Kirkwood, L. (2005) An introduction to
stomas. JCN Online; 19: 7. Available at:
www.jcn.co.uk/journal.asp?MonthNum=07
&YearNum=2005&Type=backissue&ArticleI
D=825
Krouse, R. et al (2007) Quality of life
outcomes in 599 cancer and non-cancer
patients with colostomies. Journal of
Surgical Research; 138: 79-87.
Leathard, A. (ed) (2003) Interprofessional
Collaboration: From Policy to Practice in
Health and Social Care. New York:
Brunner-Routledge.
Manderson, L. (2005) Boundary breaches:
the body, sex and sexuality after stoma
surgery. Social Science and Medicine; 61:
2, 405-415.
Marek, J.F., Boehnlein, M.J. (2007)
Preoperative nursing. In: Monahan, F.D. et
al (eds) Phipp’s medical-surgical nursing:
Health and illness perspectives (8th ed).
Missouri: Mosby Elsevier.
McGrath, A., Black, P. (2005) Stoma siting
and the role of the clinical nurse specialist.
In: Porrett, T., McGrath, A. Stoma Care.
Oxford: Blackwell Publishing.
McVey, J. et al (2001) The relevance of
lowered personal control for patients who
have stoma surgery to treat cancer. British
Journal of Clinical Psychology; 40: 337360.
Nicholls, R.J. (1996) Surgical procedures.
In Myers, C. (ed) Stoma Care Nursing: A
Patient-centred Approach. London: Arnold.
Persson, E., Hellstrom, A.L. (2002)
Experiences of Swedish men and women
6-12 weeks after ostomy surgery. Journal
of Wound, Ostomy and Continence
Nursing; 29: 2, 103-108.
Persson, E. et al (2004) Spouses’
perceptions of and reactions to living with a
partner who has undergone surgery for
rectal cancer resulting in a stoma. Cancer
Nursing; 27: 1, 85-90.
Porrett, T. (2005) Questions commonly
asked by the patient with a newly formed
Nursing Times Portfolio Pages: Sexuality After Stoma Formation
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SEXUALITY AFTER STOMA FORMATION
stoma. In: Porrett, T., McGrath, A. Stoma
Care. Oxford: Blackwell Publishing.
Price, B. (1990) Body Image: Nursing
Concepts and Care. Hertfordshire: Prentice
Hall International UK Ltd.
Roper, N. et al (2002) The Elements of
Nursing: A Model for Nursing Based on a
Model of Living (4th ed). Edinburgh:
Churchill Livingstone.
Rutledge, M. et al (2003) Effective stoma
siting. Nursing Standard; 18: 12, 43-44,
Salter, M. (1996) Sexuality and the stoma
patient. In: Myers, C. (ed) Stoma Care
Nursing: A Patient-centred Approach.
London: Arnold.
Simmons, K.L. et al (2007) Adjustment to
colostomy: stoma acceptance, stoma-care
self-efficacy and interpersonal
relationships. Journal of Advanced Nursing;
60: 6, 627-635.
Symms, M.R. et al (2008) Sexual health
and quality of life among male veterans
with intestinal ostomies, Clinical Nurse
Specialist; 22: 1, 30-40.
Tierney, A. (1996) Research in nursing
practice. In: Cormack, D.F.S. (ed) The
Research Process in Nursing (3rd ed).
Oxford: Blackwell Science.
White, C.A. (1997) Living with a Stoma.
London: Sheldon Press.
Wu, H.K.M. et al (2007) Self-efficacy and
quality of life among stoma patients in
Hong Kong. Cancer Nursing; 30: 3, 186193.
Nursing Times Portfolio Pages: Sexuality After Stoma Formation
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SEXUALITY AFTER STOMA FORMATION
FULL REFERENCE LIST: Part 2
Black, P. (2000) Practical stoma care.
Nursing Standard; 14: 41, 47-55.
Borwell, B. (1997) Psychological
considerations of stoma care nursing.
Nursing Standard; 11: 48, 49-55.
British Medical Association and Royal
Pharmaceutical Society of Great Britain
(2006) BNF 52. London: BMJ Group/RPS
Publishing.
Campbell, J. (2007) Understanding social
support for patients with cancer. Nursing
Times; 103: 23, 28-29.
Colostomy Association (2007) What to
wear. Tidings; 5, 14-15.
Colostomy Association (2003) Rectal
pain (Tail-end pain). Reading: Colostomy
Association.
CREST (2006) Caring for stoma patients:
Best practice guidelines. Buckinghamshire:
Clinimed Ltd.
Galt, E., Hill, H. (2002) What About Sex?
For People with a Stoma and their
Partners. Cambridge: Dansac Ltd.
Hendren, S. et al (2005) Prevalence of
male and female sexual dysfunction is high
following surgery for rectal cancer. Annals
of Surgery; 242: 2, 212-223.
Kelly, M. (2001) Body Image - After Stoma
Surgery. Cambridge: Dansac Ltd.
Kirkwood, L. (2005) An introduction to
stomas. JCN Online; 19: 7. Available at:
www.jcn.co.uk/journal.asp?MonthNum=07
&YearNum=2005&Type=backissue&ArticleI
D=825
Krouse, R. et al (2007) Quality of life
outcomes in 599 cancer and non-cancer
patients with colostomies. Journal of
Surgical Research; 138: 79-87.
Leathard, A. (ed) (2003) Interprofessional
Collaboration: From Policy to Practice in
Health and Social Care. New York:
Brunner-Routledge.
Manderson, L. (2005) Boundary breaches:
the body, sex and sexuality after stoma
surgery. Social Science and Medicine; 61:
2, 405-415.
Marek, J.F., Boehnlein, M.J. (2007)
Preoperative nursing. In: Monahan, F.D. et
al (eds) Phipp’s medical-surgical nursing:
Health and illness perspectives (8th ed).
Missouri: Mosby Elsevier.
McGrath, A., Black, P. (2005) Stoma siting
and the role of the clinical nurse specialist.
In: Porrett, T., McGrath, A. Stoma Care.
Oxford: Blackwell Publishing.
McVey, J. et al (2001) The relevance of
lowered personal control for patients who
have stoma surgery to treat cancer. British
Journal of Clinical Psychology; 40: 337360.
Nicholls, R.J. (1996) Surgical procedures.
In Myers, C. (ed) Stoma Care Nursing: A
Patient-centred Approach. London: Arnold.
Persson, E., Hellstrom, A.L. (2002)
Experiences of Swedish men and women
6-12 weeks after ostomy surgery. Journal
of Wound, Ostomy and Continence
Nursing; 29: 2, 103-108.
Persson, E. et al (2004) Spouses’
perceptions of and reactions to living with a
partner who has undergone surgery for
rectal cancer resulting in a stoma. Cancer
Nursing; 27: 1, 85-90.
Porrett, T. (2005) Questions commonly
asked by the patient with a newly formed
Nursing Times Portfolio Pages: Sexuality After Stoma Formation
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SEXUALITY AFTER STOMA FORMATION
stoma. In: Porrett, T., McGrath, A. Stoma
Care. Oxford: Blackwell Publishing.
Price, B. (1990) Body Image: Nursing
Concepts and Care. Hertfordshire: Prentice
Hall International UK Ltd.
Roper, N. et al (2002) The Elements of
Nursing: A Model for Nursing Based on a
Model of Living (4th ed). Edinburgh:
Churchill Livingstone.
Rutledge, M. et al (2003) Effective stoma
siting. Nursing Standard; 18: 12, 43-44,
Salter, M. (1996) Sexuality and the stoma
patient. In: Myers, C. (ed) Stoma Care
Nursing: A Patient-centred Approach.
London: Arnold.
Simmons, K.L. et al (2007) Adjustment to
colostomy: stoma acceptance, stoma-care
self-efficacy and interpersonal
relationships. Journal of Advanced Nursing;
60: 6, 627-635.
Symms, M.R. et al (2008) Sexual health
and quality of life among male veterans
with intestinal ostomies, Clinical Nurse
Specialist; 22: 1, 30-40.
Tierney, A. (1996) Research in nursing
practice. In: Cormack, D.F.S. (ed) The
Research Process in Nursing (3rd ed).
Oxford: Blackwell Science.
White, C.A. (1997) Living with a Stoma.
London: Sheldon Press.
Wu, H.K.M. et al (2007) Self-efficacy and
quality of life among stoma patients in
Hong Kong. Cancer Nursing; 30: 3, 186193.
Nursing Times Portfolio Pages: Sexuality After Stoma Formation
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