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Article: Quality of Life and Financial Impacts of Permanent Colostomy for Rectal Cancer

Colbran, R. / Gillespie, C. / Christensen, P. / Kristensen, HØ. / Warwick, A.

2024 Volume 44, Issue 01, Page(s) e47–e52

Abstract: Introduction: Returning to work is an important cancer recovery milestone. Permanent colostomy can be required for rectal cancer treatment and can significantly impact well-being. We aimed to evaluate the impact of permanent colostomy on health-related ... ...

Abstract	Introduction: Returning to work is an important cancer recovery milestone. Permanent colostomy can be required for rectal cancer treatment and can significantly impact well-being. We aimed to evaluate the impact of permanent colostomy on health-related quality of life and return to work in patients with rectal cancer. Methods: This was a retrospective cohort study on 23 employed patients receiving curative surgery for rectal cancer requiring permanent colostomy. Demographic and health-related quality-of-life questionnaires (the Colostomy Impact Score (CIS), the EORTC Quality of Life Questionnaire (QLQ)-C30, and the EORTC QLQ-CR29) were posted to eligible patients. Results: On average, patients (10 female, 13 male, mean age 61.8 years) were 5.0 ± 3.5 years post-surgery. At the time of questioning, 73.9% had returned to work (21.7% changed their type of work), while 17.4% never returned to work. Of those that returned to work, 11.8% returned within 1 month of surgery, while 23.5% had not returned after 12 months. Comparison of CIS between patients that returned to the same work (14.6 ± 0.93), changed their work (13.0 ± 0.74), and did not return to work (14.3 ± 2.3) revealed no significant differences ( p = 0.36). CIS did not correlate with days worked on return, or time to return to work (p > 0.05). Conclusion: Returning to work following rectal cancer treatment with permanent colostomy is challenging, with 17.4% never returning to work. Of those who returned to work, 23.5% required more than 12 months. This was not associated with CIS in our study.
Keywords	rectal cancer ; colostomy ; quality of life ; employment
Language	English
Publishing date	2024-03-01
Publisher	Thieme Revinter Publicações Ltda.
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	2664477-0
ISSN	2317-6423 ; 2237-9363 ; 2317-6423
ISSN (online)	2317-6423
ISSN	2237-9363 ; 2317-6423
DOI	10.1055/s-0044-1782155
Database	Thieme publisher's database

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Article ; Online: Patient reported outcome measures assessing quality of life in patients with an intestinal stoma: A systematic review.

Skibsted, Christian Valdemar / Jensen, Bente Thoft / Juul, Therese / Kristensen, Helle Ø

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

2022 Volume 24, Issue 10, Page(s) 1128–1139

Abstract: Aim: Living with a stoma can greatly influence quality of life. The purpose of this systematic review was to identify all patient reported outcome measures (PROMs) assessing health related quality of life (HRQoL) or similar constructs related to an ... ...

Abstract	Aim: Living with a stoma can greatly influence quality of life. The purpose of this systematic review was to identify all patient reported outcome measures (PROMs) assessing health related quality of life (HRQoL) or similar constructs related to an intestinal stoma and to evaluate their level of validation. Methods: The study was reported in line with PRISMA guidelines. The protocol was registered in PROSPERO prior to the study. Eligible studies were any study investigating psychometric properties of a stoma-specific PROM. The databases MedLine, Embase, CINAHL and Cochrane Libraries were searched for eligible studies. Studies were screened on title and abstract, then full-text for eligibility. Data extraction on the study populations, PROM characteristics, psychometric properties as well as quality assessment using the COSMIN Risk of Bias checklist was performed. Results: In total, 40 studies were included concerning the development and/or validation of 21 PROMs. For most PROMs, few psychometric properties were assessed. In general, quality of content validity was poor, quality of construct validity and reliability was good. Assessment of responsiveness was lacking. Conclusion: This systematic review offers an overview of existing PROMs measuring stoma-related HRQoL and their psychometric properties. A large number of PROMs exist and their measures overlap considerably. The PROMs generally have a low level of validation, emphasizing the need for future studies to further validate existing PROMs, rather than developing new ones.
MeSH term(s)	Humans ; Quality of Life ; Patient Reported Outcome Measures ; Reproducibility of Results ; Psychometrics
Language	English
Publishing date	2022-06-16
Publishing country	England
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	1440017-0
ISSN	1463-1318 ; 1462-8910
ISSN (online)	1463-1318
ISSN	1462-8910
DOI	10.1111/codi.16202
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Article ; Online: Validation of the Chinese version of the colostomy impact score in rectal cancer patients with permanent colostomy.

Wang, Jing / Zhong, ChangKun / Kristensen, Helle Ø / Christensen, Peter / Liu, Jin / Pang, Dong

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

2022 Volume 24, Issue 6, Page(s) 773–781

Abstract: Objective: To test the reliability and validity of the Chinese version of the colostomy impact score (CIS) among patients with a permanent colostomy in China.: Methods: A total of 218 patients completed the survey either in the clinic or remotely and ...

Abstract	Objective: To test the reliability and validity of the Chinese version of the colostomy impact score (CIS) among patients with a permanent colostomy in China. Methods: A total of 218 patients completed the survey either in the clinic or remotely and mailed their responses. Reliability was estimated based on test-retest reliability. Validity was evaluated based on content validity, construct validity, and discriminative validity. The sensitivity and specificity of the score were analysed. The area under the curve was analysed by drawing the receiver-operating characteristic (ROC) curve; the optimal cutoff point was calculated to assess the impact of a stoma on domestic patients. Results: The test-retest reliability of the CIS was 0.967. The content validity was 0.98, and the construct and discriminative validities were good; sensitivity, specificity, and area under the ROC curve were 100, 48.53, and 0.806%, respectively. The optimal cutoff point for the Chinese version of the Colostomy Impact Score was 11.5. Conclusions: The Chinese version of the CIS indicated good reliability and validity, making it suitable for the evaluation of the impact of a permanent colostomy.
MeSH term(s)	China ; Colostomy ; Humans ; Psychometrics ; Rectal Neoplasms/surgery ; Reproducibility of Results ; Surveys and Questionnaires
Language	English
Publishing date	2022-03-02
Publishing country	England
Document type	Journal Article
ZDB-ID	1440017-0
ISSN	1463-1318 ; 1462-8910
ISSN (online)	1463-1318
ISSN	1462-8910
DOI	10.1111/codi.16068
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Article ; Online: Systematic review of the impact of demographic and socioeconomic factors on quality of life in ostomized colorectal cancer survivors.

Kristensen, Helle Ø / Thyø, Anne / Christensen, Peter

Acta oncologica (Stockholm, Sweden)

2019 Volume 58, Issue 5, Page(s) 566–572

Abstract: Background: ...

Abstract	Background:
MeSH term(s)	Aged ; Cancer Survivors ; Colorectal Neoplasms/surgery ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Ostomy ; Quality of Life ; Socioeconomic Factors
Language	English
Publishing date	2019-01-30
Publishing country	England
Document type	Journal Article ; Systematic Review ; Video-Audio Media
ZDB-ID	896449-x
ISSN	1651-226X ; 0349-652X ; 0284-186X ; 1100-1704
ISSN (online)	1651-226X
ISSN	0349-652X ; 0284-186X ; 1100-1704
DOI	10.1080/0284186X.2018.1557785
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Article ; Online: Validation of the colostomy impact score in patients ostomized for a benign condition.

Kristensen, H Ø / Krogsgaard, M / Christensen, P / Thomsen, T

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

2020 Volume 22, Issue 12, Page(s) 2270–2277

Abstract: Aim: The colostomy impact (CI) score is a patient-reported outcome measure assessing reduction in health-related quality of life (HRQL) due to a stoma. The score was originally developed and validated in a cohort of rectal cancer survivors with a ... ...

Abstract	Aim: The colostomy impact (CI) score is a patient-reported outcome measure assessing reduction in health-related quality of life (HRQL) due to a stoma. The score was originally developed and validated in a cohort of rectal cancer survivors with a permanent colostomy. For the CI score to be applied to patients with a colostomy after surgery for a benign condition it must be validated in this patient group. The aim of this study was to assess construct validity and known groups validity of the CI score in patients with a colostomy after surgery for a benign condition. Method: In a cross-sectional survey among ostomates in the Capital Region of Denmark, patients completed the CI score and the SF-36 v2 questionnaires. Construct validity was assessed by Pearson's correlation coefficients and known groups validity was assessed by t-test when dividing patients into groups of minor or major CI. Results: The CI score showed a moderate negative correlation with the Physical Component Summary (PCS) of -0.41 and a weak negative correlation with the Mental Component Summary (MCS) of -0.39. The strength of the correlation depended on the underlying condition leading to stoma formation. Differences were significant between the minor and major CI groups in mean PSC and MCS with t-values of 5.32 and 3.86, respectively. Conclusion: The CI score is a valid instrument for assessing stoma-related impact on HRQL regardless of the underlying condition leading to stoma formation, and the CI score discriminates meaningfully between groups with known differences in stoma-related reduced HRQL.
MeSH term(s)	Colostomy ; Cross-Sectional Studies ; Humans ; Quality of Life ; Surgical Stomas ; Surveys and Questionnaires
Language	English
Publishing date	2020-08-19
Publishing country	England
Document type	Journal Article
ZDB-ID	1440017-0
ISSN	1463-1318 ; 1462-8910
ISSN (online)	1463-1318
ISSN	1462-8910
DOI	10.1111/codi.15290
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Article: Transanal Irrigation for Neurogenic Bowel Disease, Low Anterior Resection Syndrome, Faecal Incontinence and Chronic Constipation: A Systematic Review.

Mekhael, Mira / Kristensen, Helle Ø / Larsen, Helene Mathilde / Juul, Therese / Emmanuel, Anton / Krogh, Klaus / Christensen, Peter

Journal of clinical medicine

2021 Volume 10, Issue 4

Abstract: Transanal irrigation (TAI) has received increasing attention as a treatment option in patients with bowel dysfunction. This systematic review was conducted according to the PRISMA guidelines and evaluates the effect of TAI in neurogenic bowel dysfunction ...

Abstract	Transanal irrigation (TAI) has received increasing attention as a treatment option in patients with bowel dysfunction. This systematic review was conducted according to the PRISMA guidelines and evaluates the effect of TAI in neurogenic bowel dysfunction (NBD), low anterior resection syndrome (LARS), faecal incontinence (FI) and chronic constipation (CC). The primary outcome was the effect of TAI on bowel function. Secondary outcomes included details on TAI, quality of life (QoL), the discontinuation rate, adverse events, predictive factors for a successful outcome, and health economics. A systematic search for articles reporting original data on the effect of TAI on bowel function was performed, and 27 eligible studies including 1435 individuals were included. Three randomised controlled trials, one non-randomised trial, and 23 observational studies were included; 70% of the studies were assessed to be of excellent or good methodological quality. Results showed an improvement in bowel function among patients with NBD, LARS, FI, and CC with some studies showing improvement in QoL. However, discontinuation rates were high. Side effects were common, but equally prevalent among comparative treatments. No consistent predictive factors for a successful outcome were identified. Results from this review show that TAI improves bowel function and potentially QoL; however, evidence remains limited.
Language	English
Publishing date	2021-02-13
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm10040753
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Article ; Online: [Toothpick perforation in the ventricle].

Hansen, Marlene Aagaard / Kristensen, Helle Ø / Andersen, Lars Maagaard

Ugeskrift for laeger

2016 Volume 178, Issue 42

Abstract: A 60-year-old male was admitted with acute abdominal pain and fever. Computed tomography (CT) of the abdomen revealed free air. Diagnostic laparoscopy showed a toothpick perforating the ventricle, and the toothpick was removed successfully. This ... ...

Abstract	A 60-year-old male was admitted with acute abdominal pain and fever. Computed tomography (CT) of the abdomen revealed free air. Diagnostic laparoscopy showed a toothpick perforating the ventricle, and the toothpick was removed successfully. This condition is severe with a reported mortality of 9.6%. A practical guideline based on 136 cases was presented in 2014. Endoscopy was found to be superior to CT in identifying toothpicks as well as offering therapeutic intervention, rendering endoscopy the first choice in diagnostic and treatment. Subsequently CT or ultrasound is recommended in the unresolved patient.
MeSH term(s)	Foreign Bodies/diagnosis ; Foreign Bodies/surgery ; Humans ; Intestinal Perforation/etiology ; Intestinal Perforation/surgery ; Laparoscopy ; Male ; Middle Aged ; Stomach/injuries ; Stomach/surgery
Language	Danish
Publishing date	2016-10-12
Publishing country	Denmark
Document type	Case Reports
ZDB-ID	124102-3
ISSN	1603-6824 ; 0041-5782
ISSN (online)	1603-6824
ISSN	0041-5782
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Article ; Online: Life with a stoma across five European countries-a cross-sectional study on long-term rectal cancer survivors.

Krogsgaard, Marianne / Kristensen, Helle Ø / Furnée, Edgar J B / Verkuijl, Sanne J / Rama, Nuno José / Domingos, Hugo / Maciel, João / Solis-Peña, Alejandro / Espín-Basany, Eloy / Hidalgo-Pujol, Marta / Biondo, Sebastiano / Sjövall, Annika / Emmertsen, Katrine J / Thyø, Anne / Christensen, Peter

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer

2022 Volume 30, Issue 11, Page(s) 8969–8979

Abstract: Purpose: Stoma-related problems are known to be important to patients and potentially affect everyday life. The prevalence of stoma-related problems in rectal cancer survivors remains undetermined. This study aimed to examine aspects of life with a long- ...

Abstract	Purpose: Stoma-related problems are known to be important to patients and potentially affect everyday life. The prevalence of stoma-related problems in rectal cancer survivors remains undetermined. This study aimed to examine aspects of life with a long-term stoma, stoma management, and stoma-related problems and explore the impact of stoma-related problems on daily life. Methods: In total, 2262 patients from 5 European countries completed a multidimensional survey. Stoma-related problems were assessed using the Colostomy Impact score. Multivariable regression analysis, after adjusting for potential confounding factors, provided odds ratio (OR) and 95% confidence intervals (CI) for stoma-related problems' association with restrictions in daily life. Results: The 2262 rectal cancer survivors completed the questionnaire at a median of 5.4 years (interquartile range 3.8-7.6) after stoma formation. In the total sample, leakage (58%) and troublesome odour (55%) were most prevalent followed by skin problems (27%) and pain (21%). Stoma-related problems were more prevalent in patients with parastomal bulging. A total of 431 (19%) reported feeling restricted in daily activities in life with a stoma. Leakage, odour, skin problems, stool consistency, and frequent appliance changes were significantly associated with restrictions in daily life. The highest risk of experiencing restrictions was seen for patients having odour (OR 2.74 [95% CI: 1.99-3.78]) more than once a week and skin problems (OR 1.77 [95% CI: 1.38-2.27]). Conclusion: In this large cohort with rectal cancer, stoma-related problems were highly prevalent and impacted daily life. Supportive care strategies should entail outreach to patients with a long-term stoma.
MeSH term(s)	Humans ; Cross-Sectional Studies ; Cancer Survivors ; Surgical Stomas/adverse effects ; Colostomy ; Rectum ; Rectal Neoplasms/surgery ; Quality of Life
Language	English
Publishing date	2022-08-05
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1134446-5
ISSN	1433-7339 ; 0941-4355
ISSN (online)	1433-7339
ISSN	0941-4355
DOI	10.1007/s00520-022-07293-y
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Article ; Online: Long-term outcome of peroral endoscopic myotomy for esophageal achalasia in patients with previous Heller myotomy.

Kristensen, Helle Ø / Kirkegård, Jakob / Kjær, Daniel Willy / Mortensen, Frank Viborg / Kunda, Rastislav / Bjerregaard, Niels Christian

Surgical endoscopy

2017 Volume 31, Issue 6, Page(s) 2596–2601

Abstract: Background: Peroral endoscopic myotomy (POEM) is an emerging procedure in the treatment of esophageal achalasia, a primary motility disorder. However, the long-term outcome of POEM in patients, who have previously undergone a Heller myotomy, is unknown.! ...

Abstract	Background: Peroral endoscopic myotomy (POEM) is an emerging procedure in the treatment of esophageal achalasia, a primary motility disorder. However, the long-term outcome of POEM in patients, who have previously undergone a Heller myotomy, is unknown. Methods: Using a local database, we identified patients with esophageal achalasia, who underwent POEM. We compared patients with a previous Heller myotomy to those, who had received none or only non-surgical therapy prior to the POEM procedure. We conducted follow-up examinations at 3, 12, and 24 months following the procedure. Results: We included 66 consecutive patients undergoing POEM for achalasia, of which 14 (21.2 %) had undergone a prior Heller myotomy. In both groups, the preoperative Eckardt score was 7. Postoperatively, the non-Heller group experienced a more pronounced symptom relief at both 3-, 12-, and 24-month follow-up compared with the Heller group, and there was a tendency for the effect of POEM to reduce over time. We suggest that there is a correlation between preoperative measurements of gastroesophageal sphincter pressures and the chance of a successful POEM. Conclusions: POEM has a place in the treatment of esophageal achalasia in patients with a prior Heller myotomy and persistent symptoms as it is a safe procedure with acceptable long-term results.
Language	English
Publishing date	2017-06
Publishing country	Germany
Document type	Journal Article
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-016-5267-1
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Article: Cargo Transport by Sea and Road

Kristensen, Hans O.

Technical and Economic Environmental Factors

2002 Volume 39, Page(s) S. 239–249

Abstract: Die Umweltbeeinflussung durch Motorenabgase hat auch in der Handelsschifffahrt dazu gefuehrt, diese Emissionen zu berechnen. Hier wird eine Berechnungsmethode vorgestellt, mit der ein vereinfachter Algorithmus zur Berechnung der Abgasemissionen fuer ... ...

Abstract	Die Umweltbeeinflussung durch Motorenabgase hat auch in der Handelsschifffahrt dazu gefuehrt, diese Emissionen zu berechnen. Hier wird eine Berechnungsmethode vorgestellt, mit der ein vereinfachter Algorithmus zur Berechnung der Abgasemissionen fuer herkoemmliche Handelsschiffe abgeleitet wird. Die hierzu benoetigten Parameter sind u.a. Schiffstyp, Schiffsgroesse, Geschwindigkeit, Zuladung und Auslastung. Zahlreiche Berechnungsbeispiele werden fuer unterschiedliche Schiffstypen beschrieben und durchgefuehrt. Im zweiten Teil dieser Ausfuehrungen werden weitergehende spezifische Berechnungen ueber den Ausstoss von Schadstoffen (CO2, NOX, SO2 usw.) fuer Schiffe und Lastkraftwagen durchgefuehrt und miteinander verglichen. Weitere Berechnungen enthalten Angaben zu extern verursachten Transportkosten und Kosten, die der Allgemeinheit durch den Warentransport entstehen. Ein Vergleich dieser Kosten ergibt dann, dass der Schiffstransport bei weitem billiger ist als der Strassentransport. Das ist ein Faktum, das eigentlich lange bekannt ist, das hier aber rechnerisch und zahlenmaessig bewiesen wird.
Keywords	Abgasemission ; Schiff ; Transportkosten ; Strasse ; Kohlendioxid ; Stickstoffoxid ; Strassenverkehr ; Transportwesen ; Oekologischer Faktor ; Gueterverkehr ; Schifffahrt ; Schadstoffemission ; Lastkraftwagen ; Kostenanalyse ; Berechnungsverfahren ; Vergleichsuntersuchung ; Verkehrsemission ; Schwefeldioxid ; Oekonomisch-oekologische Effizienz
Language	German
Document type	Article
Database	OPAC and Environmental database (ULIDAT) of The Federal Environment Agency (UBA)

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