1. Do we have a clear / true picture of what is going on in our patients lives? Amanda Smith Member of the Ostomy Forum group

2. Heard from the patients : I dont feel normal I am never totally naked It is like being a child again I have to rely on a bag I am always worried Everybody will know I hate it!

3. Revised Follow-up form

7. Problems experienced after stoma surgery

8. Stoma observations

9. Incidence of patients reporting peristomal skin complications.

10. Case study 1

14. Intervention Advice and support from ET Reassessment of appliances Sucralfate powder

15. Case study 2

16. 1 st clinic appointment =3/08/06

17. Intervention Tacrolimus 0.3% in orabase paste underneath steroid impregnated tape. Advice and support from local ET Reassesment of appliances

18. 2 nd clinic appointment=17/08/06

19. 3 rd clinic appointment =29/09/06

20. Pain 6 months post surgery

21. Output

22. Problematic Output Problematic Stoma Problematic Skin 1-2 weeksColo1.271.203.84 Ileo1.000.890.39 3-6 weeksColo3.251.272.07 Ileo1.820.561.25 7-12 weeks Colo2.320.920.82 Ileo3.180.690.55 13-26 weeks Colo1.571.741.89 Ileo3.672.711.88 The odds of psychological problems when patient has problematic output, a problematic stoma, or problematic skin, as compared to non-problematic.

23. Conclusion Long term access to an ET nurse. Ongoing input and support is needed. 40 % fail to maintain their progression to normal status. Patients take longer to adjust to the psychological, sexual and social aspects of life with a stoma. Advanced counselling and listening skills are needed. Evidence based practice. The forms allow movement of patients and records between different hospitals and countries Easy to use forms