INTRODUCTION
Ostomy is an artificial communication between organs
or viscera and the external environment for draining,
evacuation or nutrition. The creation of an intestinal
ostomy is considered a simple procedure in surgery.
Digestive stomas are performed in intestinal loops, giving
priority to the adequate mobility and length to the
exteriorization of the abdominal wall(1-2).
Depending on the origin of the disease, intestinal
stomas can be temporary or definite. Temporary stomas
have the objective to protect an anastomosis and can be
reversed after a while. Definite stomas, generally
recommended in cases involving cancer, are done when
it is impossible to re-establish intestinal motility. Ostomy
patients require continuous support, for their problems
are long-lasting and cyclical(3).
The epidemiological data regarding ostomy are scarce,
due to the difficulties in systemizing data and health
information. Besides, they are consequences of diseases
or trauma and are not causes or diagnostics. However,
when projecting estimates of the International Ostomy
Association on the year 2000 Brazilian census, it is estimated
there is 170 thousand ostomy patients in the county(4).
In a broader health-disease concept, in which relations
are not only cognitive or social, but also affective, the
literature specialized in stomal therapy has shown that
body image disturbance is a determinant of the quality
of life in ostomy patients during their rehabilitation
process(5).
The holistic health view focuses on the ostomy patients
health care needs, regarding not only his or her new health
condition, but also the subjective aspects related to the
social representation of the new stoma in his or her body.
As literature shows, the body image disturbances are
determinants of the ostomy patients quality of life in the
several phases of rehabilitation(6).
According to the International Declaration of Ostomy
Patient Rights, the patient has the right to receive
specialized nursing care in the pre and post surgical period,
both at the hospital and in their own communities(7).
Several factors influence the patients self-care, as well
as the compliance and motivation toward treatment and
proposed interventions. Knowing them is essential in order
to understand the challenges of the care process in stomal
therapy(6).
An effective way to promote nursing care is through
applying the Self-Care Theory, respecting its essential
aspects. By doing so, health care becomes directed to the
patients needs, and approaches the holistic aspects of
care. In a simplified manner, self-care can be considered
as the individuals capacity to perform all activities
necessary to live and survive. Among these are the
physical, psychological and spiritual needs(8).