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Patient education and counselling should information; particularly where visual or
occur both preoperatively and postoperatively. hands-on teaching aids are used.
Patients with a diagnosis of bladder cancer
may already feel overwhelmed by the Educate patients on the importance of
information and choices presented to them. wearing medical alert identification. Wearing
Multiple education and counselling sessions a medical alert bracelet/pendant or carrying
are worthwhile to provide patients and their a card informs health care professionals
significant others with opportunities to fully about their urinary diversion in case of an
understand the information provided and emergency. Patients can apply for these online
the impact it may have on their self-care and or through Canadian pharmacies.
lifestyle. Significant others provide strong
social and emotional support. Providers The interprofessional team needs to
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should guide patients to resources, such as support the patient through counselling
Bladder Cancer Canada or Ostomy Canada and help patients to continue valuing the
Society to help provide peer support and more wide-ranging benefits of active lifestyles.
education. Patients and significant others should be
referred for specialist support as warranted,
James et al. (2014) explored how an Indiana aware that many will be hesitant to ask
pouch or neobladder urinary diversion or discuss questions. 14,15,16 Sociocultural
requires meticulous postoperative care to backgrounds play a critical role in one’s
minimize the risk of complications. They stress comfort in discussing HRQOL issues with their
the need for the patient and significant other significant others and health practitioners. 17
to comprehend the level of commitment The European Association of Urology Nurses
needed prior to surgery. This long-term (EAUN) states that “Modern multi-cultural
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commitment is likely to impact quality of life society requires a health care system that
and satisfaction. reflects and respects an individual’s colour,
culture, religion and customs.” 18
A shorter postoperative length of stay has
increased the emphasis on preoperative Health-related quality of life
education and counselling. The International Creation of a urostomy has a particularly
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Ostomy Association advocates preoperative significant impact on a patient’s quality of
counselling for all persons undergoing stoma life. Rangarjan and Somani, (2019) conclude
surgery to ensure that they are fully aware of quality of life “seems to be the most important
the benefits of the operation and essential element in [urinary diversion] once patients
facts about living with an ostomy. Patient have recovered from their initial surgery.”
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“buddy” systems and access to support groups The impact of a urinary diversion will influence
have also been shown in many countries to some or all of the following aspects:
be effective strategies. Patients who are less • physical limitations to work or physical
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anxious may be better equipped to monitor activity; 20
for complications and seek earlier assistance. 13 • psychosocial disturbances of coping with
self-esteem, self-confidence, body image,
The literature reinforces that preoperative anxiety, depression, emotional well-
personalized education and counselling being; 13,21,22
reduces anxiety for patients and significant • changes in bowel habits as a consequence
others. This leads to improved retention of of the radical cystectomy; either diarrhea
CANADIAN URINARY DIVERSIONs POSITION STATEMENT 10 10
