Readiness for stoma reversal in patients with a diverting stoma: a concept analysis

Background Readiness for stoma reversal is an important concept for patients with a diverting stoma during the transition from “living with a stoma” to “resumption of transanal defecation and adaptation to postoperative bowel function.” However, its conceptual meaning remains unclear, limiting the development of related research and clinical practice. Therefore, it is necessary to clearly define the concept of readiness for stoma reversal in patients with a diverting stoma. Objective To clarify the concept of readiness for stoma reversal in patients with a diverting stoma using Rodgers’ evolutionary concept analysis. Methods Relevant studies on readiness for stoma reversal in patients with a diverting stoma were systematically searched in PubMed, Web of Science, ScienceDirect, CINAHL, the Cochrane Library, Embase, CNKI, Wanfang Data, and VIP Database. Rodgers’ evolutionary concept analysis was used to synthesize and analyze the included studies. The conceptual attributes, antecedents, consequences, and related concepts of readiness for stoma reversal in patients with a diverting stoma were extracted and summarized. Results The core attributes of readiness for stoma reversal in patients with a diverting stoma include pre-reversal assessment, physical and functional readiness, information and knowledge readiness, and psychological readiness. The main antecedents included rectal cancer control and anastomotic healing, systematic health education and health literacy, socioeconomic conditions and support systems, and multidisciplinary assessment and collaboration. For patients, adequate readiness may facilitate bowel function recovery, enhance engagement in rehabilitation and self-management, reduce anxiety and fear, lower the risk of postoperative complications, and improve quality of life. For healthcare systems, it may help shorten hospital stays, reduce readmissions and other unplanned healthcare use, and lower related medical costs. Conclusion Readiness for stoma reversal is a multidimensional and dynamic state that develops before reversal in patients with a diverting stoma. It reflects the patient’s ability to cope with stoma reversal, bowel function recovery after reversal, and related lifestyle changes. Clarifying the attributes, antecedents, and consequences of this concept may support the development of assessment tools for readiness for stoma reversal. It may also provide a basis for designing individualized and continuous nursing interventions.