Authors
Donglin Wang, Na Zhou, Yingjie Zhang, Jianjuan Dai
Published in
Asia-Pacific journal of oncology nursing. Volume 13. Pages 100955. Epub Apr 16, 2026.
Abstract
This study aimed to systematically evaluate the impact of DHIs on self-management, quality of life (QoL), and clinical outcomes in patients with an ostomy.
We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs). Fourteen RCTs (n = 1753) were included. Primary outcomes were self-management competence and QoL; secondary outcomes included stoma complications, psychological well-being, patient satisfaction, and health care utilization. Data were pooled using random-effects models and certainty of evidence was assessed via Grading of Recommendations Assessment, Development and Evaluation (GRADE).
DHIs significantly improved self-management competence (SMD = 0.96, 95% CI: 0.65-1.23) and QoL (SMD = 0.67, 95% CI: 0.30-1.03). They also reduced the risk of stoma-related complications by 46% (RR = 0.54, 95% CI: 0.35-0.84). Benefits for psychological well-being and patient satisfaction were significant but associated with high heterogeneity and low certainty. Subgroup analyses revealed that effects were substantially larger in upper-middle-income countries and among patients with permanent stomas. Exploratory analyses found no significant difference in unplanned readmissions or patient retention between DHI and control groups.
DHIs are effective for improving self-care, QoL, and reducing complications in patients with an ostomy. The greatest impact was observed in resource-limited settings and for permanent diversions. These tools should be integrated into standard postoperative care pathways. Future research requires standardized outcome measurement and long-term evaluations to confirm sustainability.
PMID:
42318596
Bibliographic data and abstract were imported from PubMed on 19 Jun 2026.
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