Quality of Life among Iraqi Ostomy Patients and Its Associations with Demographic and Clinical Characteristics of Patients

Alice Khachian, Belqis H. A. Al‑Zamili, Tahereh A. K. Khoshnazar, Shima Haghani, Masoud Rezaei, Saeb F. Al Saadi

Abstract


Background: The surgical creation of an ostomy can substantially affect patients’ daily functioning and quality of life (QoL). However, no previous study has evaluated QoL among ostomy patients in Iraq, and the influence of demographic and clinical factors remains insufficiently explored. Materials and Methods: This cross‑sectional study included 200 ostomy patients recruited from three oncology centers in Baghdad, Iraq. QoL was assessed using the City of Hope–Quality of Life Ostomy Questionnaire (CoH–QoL–OQ). Associations between demographic and clinical variables and QoL were analyzed using multivariate analysis of covariance (MANCOVA), adjusting for age and sex. Results: Based on the total QoL score, none of the patients had a good QoL; 92.00% had moderate QoL and 8.00% had low QoL. Patients aged ≥48 years had lower overall QoL compared with younger patients (η² =0.05, p = 0.001). Lower QoL was also observed in patients with malignant tumors before surgery (η² =0.10, p < 0.001) and those receiving chemotherapy after surgery (η² = 0.07, p = 0.001). Social QoL differed significantly across marital status, ostomy type, tumor type, and treatment methods (all p < 0.01). Conclusions: Iraqi ostomy patients experience low‑to‑moderate QoL. Age, marital status, ostomy type, tumor malignancy, and postsurgical treatment methods are significant determinants of QoL in this population.

 


Keywords


Cancer, colorectal neoplasms, ostomy, quality of life

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Patel SG, Karlitz JJ, Yen T, Lieu CH, Boland CR. The rising tide of early onset colorectal cancer: A comprehensive review of epidemiology, clinical features, biology, risk factors, prevention, and early detection. Lancet Gastroenterol Hepatol 2022;7:262 74.

Ibrahem S, Ahmed H, Zangana S. Trends in colorectal cancer in Iraq over two decades: Incidence, mortality, topography and morphology. Ann Saudi Med 2022;42:252 61.

Rivet EB. Ostomy management: A model of interdisciplinary care. Surg Clin North Am 2019;99:885 98.

Nasiriziba F, Saati M, Haghani H. Correlation between self efficacy and self esteem in patients with an intestinal stoma. Br J Nurs 2020;29:S22 9.

Vonk Klaassen SM, de Vocht HM, den Ouden ME, Eddes EH, Schuurmans MJ. Ostomy related problems and their impact on quality of life of colorectal cancer ostomates: A systematic review. Qual Life Res 2016;25:125 33.

Post MW. Definitions of quality of life: What has happened and how to move on. Top Spinal Cord Inj Rehabil 2014;20:167 80.

Alenezi A, McGrath I, Kimpton A, Livesay K. Quality of life among ostomy patients: A narrative literature review. J Clin Nurs 2021;30:3111 23.

Davis D, Ramamoorthy L, Pottakkat B. Impact of stoma on lifestyle and health related quality of life in patients living with stoma: A cross sectional study. J Educ Health Promot 2020;9:328.

Zewude WC, Derese T, Suga Y, Teklewold B. Quality of life in patients living with stoma. Ethiop J Health Sci 2021;31:993 1000.

Zhang Y, Xian H, Yang Y, Zhang X, Wang X. Relationship between psychosocial adaptation and health related quality of life of patients with stoma: A descriptive, cross sectional study. J Clin Nurs 2019;28:2880 8.

Kristensen HØ, Thyø A, Christensen P. Systematic review of the impact of demographic and socioeconomic factors on quality of life in ostomized colorectal cancer survivors. Acta Oncol 2019;58:566 72.

Younis NM, Ibrahim RM, Ahmed MM. Health problems related to quality of life among aging in Iraq. J Curr Med Res Opin 2024;7:3015 24

Hamad BW. Lived experiences of Iraqi patients with permanent colostomy: A phenomenological study. J Contemp Med Sci 2025;11:136 43.

Grant M, Ferrell B, Dean G, Uman G, Chu D, Krouse R. Revision and psychometric testing of the city of hope quality of life ostomy questionnaire. Qual Life Res 2004;13:1445 57.

Gandhi PK, Ried LD, Kimberlin CL, Kauf TL, Huang IC. Influence of explanatory and confounding variables on HRQoL after controlling for measurement bias and response shift in measurement. Expert Rev Pharmacoecon Outcomes Res 2013;13:841 51.

Mahjoubi B, Goodarzi KK, Mohammad Sadeghi H. Quality of life in stoma patients: Appropriate and inappropriate stoma sites. World J Surg 2010;34:147 52.

Anaraki F, Vafaie M, Behboo R, Maghsoodi N, Esmaeilpour S, Safaee A. Quality of life outcomes in patients living with stoma. Indian journal of palliative care. 2012;18:176.

Aker FZ, Karazeybek E. Relationship between perceived social support and stoma self efficacy in permanent colostomy patients: A correlational study. J Eval Clin Pract 2025;31:e14117.

Hardt J, Meerpohl JJ, Metzendorf MI, Kienle P, Post S, Herrle F. Lateral pararectal versus transrectal stoma placement for prevention of parastomal herniation. Cochrane Database Syst Rev 2019;4:CD009487.

Osborne W, White M, Aibibula M, Boisen EB, Ainsworth R, Vestergaard M. Prevalence of leakage and its negative impact on quality of life in people living with a stoma in the UK. Br J Nurs 2022;31:S24 38.

Shrestha S, Siwakoti S, Shakya U, Shakya R, Khadka S. Quality of life, anxiety and depression among clients with ostomy attending selected stoma clinics. J Nepal Health Res Counc 2022;20:383 91.

Athanasiadis DI, Martin A, Kapsampelis P, Monfared S, Stefanidis D. Factors associated with weight regain post bariatric surgery: A systematic review. Surg Endosc 2021;35:4069 84.

Mungai MW, Abere MN, Avula EK. Quality of life of ostomates at a teaching and referral hospital in Kenya. Br J Nurs 2021;30:S24 32.

Park S, Jang IS, Kim YS. Risks for depression among ostomates in South Korea. Jpn J Nurs Sci 2018;15:203 9.

Chrobak Bień J, Marciniak A, Kozicka I, Kuiken AL, Włodarczyk M, Sobolewska Włodarczyk A, et al. Quality of life in patients over age 65 after intestinal ostomy creation as treatment of large intestine disease. Int J Environ Res Public Health 2023;20:1749.

Cao Y, Krause JS, Saunders LL, Clark JM. Impact of marital status on 20 year subjective well being trajectories. Top Spinal Cord Inj Rehabil 2015;21:208 17.

Philip K, Jolly A, Diep C, Savage RD, Wijeysundera DN, Witiw C, et al. Association of loneliness and social isolation with postoperative outcomes: A retrospective registry study. Br J Anaesth 2026;136:247 54.

Chow VJ, Tsetsos N, Poutoglidis A, Georgalas C. Quality of life in sinonasal tumors: An up to date review. Curr Opin Otolaryngol Head Neck Surg 2022;30:46 57.

Starkweather AR, Sherwood P, Lyon DE, McCain NL, Bovbjerg DH, Broaddus WC. A biobehavioral perspective on depressive symptoms in patients with cerebral astrocytoma. J Neurosci Nurs 2011;43:17 28.

Schuring N, Markar SR, Hagens ER, Jezerskyte E, Sprangers MA, Lagergren P, et al. Health related quality of life following neoadjuvant chemoradiotherapy versus perioperative chemotherapy and esophagectomy for esophageal cancer: A European multicenter study. Dis Esophagus 2023;36:doac069.


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