Decision-making in ostomy surgery: The lifeworld experiences of women with inflammatory bowel disease and the views of healthcare professionals

This study investigates the lifeworld experiences of women who underwent ostomy surgery to manage severe symptoms of inflammatory bowel disease (IBD). IBD includes ulcerative colitis and Crohn's disease and involves chronic inflammation of tissue in the gastrointestinal tract with recurrent symptoms of diarrhea, rectal bleeding, abdominal pain, fatigue, and weight loss. Data collection involved semi-structured interviews with nine women between the ages of 19 and 30 years living with an ostomy they received at a younger age. Seven healthcare professionals who care for IBD patients with an ostomy also participated in interviews. Prior to surgery, the women reported struggling with progressive, severe and unrelenting symptoms of IBD not alleviated by pharmacotherapy that became potentially life threatening. Consequently, the women underwent ostomy surgery to create a stoma opening of the bowel that allowed stool to pass into a bag attached to the opening. Using Habermas's theory of communicative action, this paper examines how IBD altered the women's lifeworld prior to surgery and their ability to socially engage with others in day-to-day life. The paper also discusses the absence of communicative action as an aspect of the women's interactions with medical practitioners, and the strategic subsummation of their lifeworld by the voice of medicine. Additionally, the paper reports on the perspective of healthcare professionals on the care and support they provide patients who receive ostomy surgery. In conclusion, an argument is made for the benefits of a lifeworld approach in IBD care.