DISCUSSION
The presuppositions of the analysis and interpretation
of the collected data were related to the intellectual
condition, isolation issues, the lack of family and social
support, and the motivation to learn, all of which
interfere in the adoption of care measures. The
therapeutic demand of self-care proposes a description
of the patient and her environment (aspects of the
patients life, health or wellness), recognizing the effective
instruments and specific techniques, chosen by the patient,
which can be used to change development factors(12). In
this sense, the patients interaction with supporting social
networks and the care provider could represent an
obstacle to the self-care actions.
The ostomy-related aspects can be physical or social.
Physical problems are related to the change in the form
of feces elimination, which implies the mandatory use
of a device adhered to the abdomen. In the social aspect,
there can be discomfort and insecurity when dealing with
the equipment, which leads to the isolation of family
and social contact(3).
The fact that the patient abandoned her studies after
the beginning of the symptoms, besides reducing
relationships with the groups, denotes the beginning of
isolation, which can bring about psychosocial
consequences. The absence of labor activity may lead
ostomy patients to idleness and social isolation. These
conditions impair their quality of life(17).
According to literature, ostomy individuals face real
and symbolic losses, which bring about negative
feelings in their relationships. Particularly, the mutilation
and social disrepute in make it difficult for patients to
face this situation, which can affect lifestyle and quality
of life(18).
Taking care of these patients can represent a challenge
for health professionals, for it demands preparing
patients to live with the ostomy. The academic courses
do not focus on the physical care of the stoma, and,
thus, professionals are not prepared to deal with the
changes they pose in ones life style(17).
We choose to focus interventions on the diagnosis
deficient knowledge. This decision was made with the
patient, in the second visit. This topic was chosen because
understanding the whole health-illness process would
allow to overcome some of the fears or uncertainties
that compromise a healthier interaction with her relatives,
friends and, above all, with herself.
Researchers have proposed that self-care demands
be solved by developing the patients abilities5. However,
in order for the patient to acquire potential to decide
about his or her health status, it is necessary for nurses
to contribute with this learning.
Previous studies state that support-education systems
are based on the patients needs. They refer to the
guidance provided about certain themes and occur
through the promotion of therapeutic self-care by the
nurse, making it possible for the individual to execute