Clinical and Sociodemographic Factors Associated With Peristomal Skin Complications in Patients With Ostomies: A Cross‐Sectional Study
Claudia Cuevas‐Sánchez, Carmen Álvarez‐Nieto, César Hueso‐Montoro, Francisco Pedro García‐Fernández, Concepción Capilla‐Díaz, Ana Carmen Montesinos‐Gálvez, Noelia Moya‐Muñoz, María José Sánchez‐Juárez, María López‐Nogues‐Gutiérrez, Isabel Jiménez‐López, María Carmen Rivas‐Molina, Isabel María López‐MedinaABSTRACT
Aim
To analyse the prevalence of peristomal skin complications and identify clinical and sociodemographic factors associated with their occurrence in patients with ostomies.
Design
Descriptive cross‐sectional study conducted in 17 Spanish hospitals. Data were collected by 24 stoma care nurse specialists using a questionnaire based on Functional Health Patterns and the Ostomy Skin Tool. Bivariate and multivariate analyses were performed.
Results
Among 312 adult patients, 52.2% had non‐intact peristomal skin. Skin condition was associated with ostomy type, stool consistency, stoma characteristics, appliance characteristics, protective barriers, symptoms, autonomy in stoma care, and frequency of appliance changes. Ileostomy was associated with greater peristomal skin impairment. In the multivariate binary logistic regression analysis ( n = 262), the overall model was statistically significant ( χ 2 (7) = 43.748, p < 0.001) and explained 20.5% of the variance in intact peristomal skin (Nagelkerke R 2 = 0.205). Stoma characteristics (OR = 1.673, 95% CI [1.154, 2.425], p = 0.007) and ostomy type (OR = 2.199, 95% CI [1.065, 4.537], p = 0.033) were independently associated with intact peristomal skin.
Conclusion
Peristomal skin complications were common and were associated with multiple clinical and self‐management factors. Structured assessment integrating functional status, symptoms, skin condition, and appliance management may help nurses identify patients requiring individualized support and follow‐up.
Implications for the Profession and/or Patient Care
Nursing assessment should integrate peristomal skin monitoring with education, self‐care support, appliance fitting and management, leakage prevention, and individualized skin care. Particular attention is warranted for patients with ileostomies, reduced autonomy, flush or retracted stomas, and frequent appliance changes.
Impact
The study addressed the frequent occurrence of peristomal skin complications. Findings identify patient‐ and care‐related characteristics that can inform nursing assessment and individualized education. The research may support risk‐stratified follow‐up and continuity of ostomy care by specialist nurses.
Reporting Method
The study was reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology guidelines.
Patient or Public Contribution
Patients contributed data to this study but were not involved in its design, analysis, or reporting.