03/06/2023
By Maureen Martin

The Zuckerberg College of Health Sciences, Solomont School of Nursing, invites you to attend a doctoral dissertation defense by Sarawut Sritan on " Socio-Spiritual Factors Predicting Quality of Life among Thai Patients Diagnosed with Colorectal Cancer with a Stoma."

Date: Monday, March 20, 2023
Time: 9 a.m. to noon
Location: This will be a virtual defense via Zoom. Those interested in attending should email Sarawut_Sritan@student.uml.edu and committee Chair Ainat_Koren@uml.edu at least 24 hours prior to the defense to request access to the meeting.

Committee Members:

  • Chair Ainat Koren, PhD, DNP, PMHNP, Solomont School of Nursing, University of Massachusetts Lowell
  • Ramraj Gautam, PhD, MA, Associate Teaching Professor, Solomont School of Nursing, University of Massachusetts Lowell
  • Jason Rydberg, PhD, Associate Professor, School of Criminology and Justice Studies, University of Massachusetts Lowell

Abstract:

Background: Colorectal Cancer (CRC) ranks fourth among new cancer cases and ranks the second cause of cancer mortality worldwide. Similarly, in Thailand, CRC ranks the second most common cause of cancer mortality in males and the third in females. New cases are ranked second among all cancers. Surgery is considered the treatment of choice for early-stage CRC, especially ostomy surgery, which is commonly used. A postoperative ostomy can dramatically change and continue impacting the Quality of Life (QOL) among CRC adults with an ostomy. The impact on QOL is multidimensional including physical and mental health, and social and spiritual status. Research from studies describing QOL reported by Thai CRC adults with an ostomy (moderate to high) differed from similar individuals in other countries (low to moderate). These differences might be related to Thailand's distinctive social and spiritual contexts, where most Thai people worship Buddhism and cohabitate as an extended family. Currently, no concept analysis regarding CRC adults with an ostomy has been done, and there are limited quantitative studies that examine the relationship of socio-spiritual factors as predictors of Thai CRC adults with an ostomy's QOL levels, among other demographic, physical, and psychological factors.

Aims: The purpose of this study was to develop an operational definition, define the attributes, identify antecedents and consequences, and provide empirical referents of the QOL concept in the context of CRC adults with an ostomy. Furthermore, this research aimed to examine the impact of socio-spiritual factors on QOL among Thai adult ostomates with CRC guided by the City of Hope QOL Model.

Methods: Walker and Avant's process (2018) guided the concept analysis, while the City of Hope QOL Model was adapted to guide the cross-sectional study. Data were collected between July 2022 and October 2022 at secondary and tertiary hospitals, ostomy clinics in Thailand, and Thai Facebook's Ostomy Support Group. The participants responded to four surveys: Sociodemographic and clinical characteristics, Thai family support, Buddhist belief, and QOL. Multiple linear regression was used to determine the model's variation and the relative contribution of Thai family support and Buddhist belief in the total variance.

Findings: The concept of QOL among CRC adults with an ostomy was defined as multidimensional, including functional statuses, physical symptoms, emotional states, and interpersonal relationships. One hundred sixty participants completed the entire survey (mean age 56.27 years); the majority were male (59%). Thai CRC adults with an ostomy showed high Thai family support (83.85), high Buddhist belief (81.29), and high QOL (84.09) levels. Furthermore, Thai family support and Buddhist belief had a significantly positive association with QOL (r = .713, p < .001; and r = .707, p < .001, respectively). After adjusting for covariates, the multiple linear regression revealed that Thai family support and Buddhist belief could predict QOL among Thai CRC adults with a stoma with statistical significance by 65% (R2 = .646; p < .001).

Conclusion: The study results can guide clinical practice, policy, education, and future research in educating clinical staff, identifying high-risk individuals, developing holistic care in nursing education, and implementing related interventions and evaluations. Thai family support and Buddhist belief were associated with and predicted improved in QOL scores. This finding supported that Thai family support and Buddhist practices among Thai CRC adults with an ostomy potentially can explain the overall high QOL score in Thai patients compared to other individuals from other cultures. These results can be applicable to individuals from similar cultures as well.

Keywords: Buddhist belief, colorectal cancer, nurses, ostomy, quality of life, stoma, Thai family support, Thai population